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On escaping ADHD paralysis, autistic inertia, and other frozen states
There are many ADHD-specific terms for human behaviors floating around the internet now, and while I understand the urge to taxonomize, my brain can’t help but make connections.
When people talk about ADHD paralysis, it sounds a whole lot like something else I know well — the freeze state.
Even ADDitude uses polyvagal theory to explain ADHD paralysis. If you’re not familiar, polyvagal theory is a framework developed by Dr. Stephen Porges that focuses on the body’s automatic fight-flight-or-freeze responses to stress.
There’s hyperarousal (fight or flight), hypoarousal (freeze), and in between them, The Good Place, referred to as the window of tolerance.
Descriptions of ADHD paralysis are based around overwhelm — you have a lot to do, you’re anxious, you’re feeling pressured, and as a result, you can’t do anything at all.
Freezing up is a pretty understandable response to being overwhelmed, and when you’re sensitive to stimulation or prone to ruminating, it probably takes less to get you stuck.
These contextual causes are usually presented as an innate brain malfunction, though. One Medium article describes it like this:
ADHD targets, among other things, the brain’s executive functions: the ability to start, organize and sustain effort on a task. The results are analysis paralysis and procrastination. When we use the term 'ADHD Paralysis,' what we’re referring to is that feeling of the fly buzzing around your head — you know you are meant to do a task, but you find it impossible to make any forward progress with it.
The language here — targets — supposes that ADHD is an entity that attacks “the brain’s executive functions”, and it also suggests that “executive functions” are parts of the brain.
But they’re not. They’re “a set of capitalist values masquerading as skills” as my friend Marta says — values that include linear timekeeping, goal-directed behavior, and sustained attention.
Sustained attention is not the only type of attention, though, it’s just the type that’s most valued in a society reliant on workers completing monotonous tasks. The idea that you are dysfunctional if you aren’t particularly good at this one type of attention that allows you to quickly generate wealth for your boss is far more of a value judgement than an objective measure.
I have my own struggles with “ADHD paralysis” everyday, though I don’t call it that. I prefer bottom-up descriptions that describe experiences but don’t necessarily reinforce pathology, so usually I just say I’m overwhelmed or shutting down. But reading other people’s descriptions of it always gets me nodding along in understanding — these experiences are frustrating and painful, because you want to do more, but you just can’t.
How much of that want is truly mine, though, and how much of it is the wants of others? The want of pleasing people, the want of meeting social expectations, the want of doing the things we are told we should do.
Overwhelm does get in the way of things I genuinely enjoy and want to do for myself, but I see this as a side effect of struggling under the weight of everything else. All the things I have to do to survive bleed over into the things I love doing, until I don’t have energy left for them.
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I see a lot of similarities between ADHD paralysis and what Autistic people call “autistic inertia”. Granted, there are some differences — autistic inertia seems to have a lot to do with monotropism and a focus on detail, but the general experience of knowing “you are meant to do a task” but finding it “impossible to make any forward progress” is the same.
I send this 2021 study that interviewed autistic people about their experiences with inertia to all kinds of neurodivergent people who also see themselves in it:
Participants described their experience as “physical” and that although they knew what to do, they “just can’t.”
Perfectionism and a desire to make the ideal choice exacerbated these issues.
This difficulty did not only affect things that were aversive or difficult; it also included “things I want to do and enjoy doing”
A lot of the techniques that participants identified for coping with inertia are also pretty common advice for dealing with ADHD paralysis, things like co-working, music, and the sense of urgency created by having a deadline.
But by far:
The most often reported helpful factor was the assistance of another person.
One participant described it like this:
The only thing that helps me, only thing that works, and it works consistently, is just to have a stuck buddy that I text. … And all I have to do is text, ‘I’m stuck.’ […] And we just text it out and kind of make a plan.
Stress was also a huge factor in the difficulty of dealing with autistic inertia, but there was something else, too:
..negative emotions and inaction were connected in a self-perpetuating cycle, where failing to do things created bad feelings which, in turn, made it more difficult to act.
Shame is a significant barrier to initiation that compounds with every perceived failure over time. You can see it in this cartoon by the popular ADHD influencer Dani Donovan, where the inner monologue is full of words like should, bad, lazy, and embarrassed:
Another link the researchers in this study made was the similarities between autistic inertia and what’s called catatonia, although they remarked that it was more subtle.
Catatonia is basically what it sounds like. Sufferers can’t move or speak, withdraw from their environments, don’t eat, and sometimes get frozen in “unusual poses” — quite literally, a freeze state. It’s mostly reported in people labelled schizophrenic, but also can be seen in people labelled with Major Depressive Disorder, Bipolar, and PTSD.
Benzodiazepines like Xanax and Lorazepam have been shown to be quite effective for quickly relieving catatonia, and I can attest that this class of sedatives is quite a helpful as-needed tool for both my frozen states and the more panicked flight experiences.
The autistic inertia study notes that most participants who experienced these catatonic states did not report feeling anxious, but instead felt emotionally detached:
During such episodes, our participants also often experienced altered awareness of self, the environment and the passage of time…
Dissociation is associated with stress and trauma, an area of increasing interest in autism research…and more than one third of our sample reported a current or past diagnosis of Post-Traumatic Stress Disorder.
Catatonic states have been theorized as a kind of tonic immobility, what we call “playing dead” when we talk about other animals. Evolutionary psychology certainly has its issues, but I don’t think it’s a stretch to say autistic inertia and ADHD paralysis are both different terms for the overwhelm and dissociation that can be caused by stressors, and the intensely physical sensation of being stuck.
Defining “stressor” is difficult, because people have different levels of tolerance for stress. Some people get overwhelmed more quickly, some people struggle to initiate tasks that others consider easy, and some people need more help from other people.
These are not bad things, just different things, and I think we have far more to gain by recognizing the commonalities in our struggles rather than creating syndrome-specific labels that reify the biomedical model of mental illness and further divide us.
What I find most heartening in this struggle against overwhelm is the way that it points toward our relational needs. Co-working is extremely helpful for ADHDers because the presence of others can be comforting and motivating in itself, something the autistic inertia study found, too.
The researchers noted:
Participants also found it easier to do anything where another person was depending or counting on them, even from a distance, and most difficult to do something only for themselves.
We are interdependent beings. The best way to get unstuck is to reach out a hand and ask someone else to pull you up. True support won’t be found by altering the chemicals in our brains, but by nurturing our social relationships — strengthening the links that hook together to create strong chains of community.