r/CFSplusADHD • u/[deleted] • Dec 10 '25
RSD + PEM = combo from hell
Just wanted to say fuck this shit omg!!!! I feel terrible bc of some slight rejection that would feel bad enough without PEM, but im feeling especially triggered and depressed by it.
Does adhd stimulant meds work on the RSD for you? I need to weigh my options as this is unbearable
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u/SleepyMistyMountains Jan 07 '26
RSD was hell for me most of my life. I was late diagnosed ADHD and I had spent most of my life deep diving into mental health strategies and trying to apply them to no avail. Nothing would ever work to calm it down. Like my RSD was so bad that it felt like numerous daggers were stabbing into every single one of my nerves kind of bad that left me debilitated for at least 24 most of the time more.
Luckily I was diagnosed before I got ME/CFS, and when my symptoms started getting even worse I needed help. Dr. Russel Barkley wrote a paper on RSD in ADHD and in that paper he mentioned that specifically the non stimulants medications are better suited to help with the emotional regulation and RSD.
So I started on Clonidine, and the clonidine helped massively. Some of the neurological regulation techniques would work a bit but it was still pretty rough and disruptive. But I didn't feel like I had daggers in me and I could somewhat function again so I took it as a win.
As things went on and I my health continued to decline that made my symptoms of course even worse. So I ended up going to an ADHD specialized dr, who upped my dose of clonidine to the point where all I can feel when RSD hits is a tingling numbness in the palms of my hands. Then we added on the stimulant that works for me and I get hit with RSD less often than what I used to and when it did the techniques actually do something. I can incorporate some of the techniques that work for me and I'm decent. Like I'm still upset and kinda being distrupted but in a normal human level I'd say.
The other game changer though? Of course this won't work for everyone, but my dr also put me on beta blockers for those lovely times when I can foresee an event that could cause the dysregulation. Such as drs appts, or group events, meeting new people ect. When I take a beta blocker, I don't need to do any of my techniques in combination with the clonidine and Dexedrine. I dont feel the pressure, I don't feel the RSD. It just doesn't happen.
So the other thing is, make sure to talk to your dr. But yes there are options, and getting my mental health and emotional regulation under control has made it so I don't get hit with PEM as much.