Anyone got any insight into the aftermath of a melt down

[mattrix]

(A bit of intro)
There are lots of situations that I find challenging.
Generally I will try to plan for a difficult situation,
OR If I am really stressed I will script it, this is overkill and I tend to stick to the script no matter what
OR If it is optional I can just avoid it, my preferred option.

I am 70yo male in Australia (now this sounds like a dating app)

I recently had a meltdown.
My melt downs invariably happen during interactions with people.
I throw the occaisional tantrum at objects, but it is difficult to remain angry at an inanimate object.

I am not very eloquent during a melt down, I don't want to talk, I want them to feel what I am feeling, or to leave me alone.

I have a few triggers, that I know of.
* I have a few linguistic triggers, eg being told I "can't" do something (it is impossible) that I have already done (so I am lying) etc. I usually get argumentative (and probably sound like a crazy person) or walk away. I feel terribly hurt but I head off a full blown meltdown.
* medical procedures, what medical people think is the appropriate way to treat people boggles my mind.

This one was a medical procedure,
in my mind someone snuck up while I wasn't looking and stabbed me with a sharp instrument. It would have been better if I had seen it.
This was followed up by their usual insensitive and threatening behaviour. They expect that my life is in their hands, that I trust them, and I have no interest in it anymore.
I don't trust them, I feel that they are attacking my "self", my autonomy; and I freek out.

Now I'm trying to deal with the aftermath, and not coping well. It is a long time since I had a meltdown like this and I don't understand what is going on, or what to expect.

The day after, I was exhausted and very emotional to the point of tears. Snippets of what had happened kept popping into my head uncalled for.

Later I'm still very emotional, but the emotions are no longer connected to the events. I feel like my 'self' has been shattered into disjoint pieces.

Any insights appreciated.

 

[Neonatal RRT]

I recently had a meltdown.
My melt downs invariably happen during interactions with people.
I throw the occaisional tantrum at objects, but it is difficult to remain angry at an inanimate object.

I am not very eloquent during a melt down, I don't want to talk, I want them to feel what I am feeling, or to leave me alone.

I am more likely to gradually shut down as opposed to having a full-blown meltdown... but I have had a few. For me, it's almost an out-of-body experience, extremely violent, I will literally hurt my vocal cords for days afterwards. On the other hand, I am typically pretty quick to squelch it down once it happens... but by then the damage was done... the other person terrified... and now I have to put my tail between my legs and apologize. I hate that loss of control. So embarrassing.

I have a few triggers, that I know of.
* I have a few linguistic triggers, eg being told I "can't" do something (it is impossible) that I have already done (so I am lying) etc. I usually get argumentative (and probably sound like a crazy person) or walk away. I feel terribly hurt but I head off a full blown meltdown.

Triggers... (1) being told how I feel, (2) being called a liar, and (3) disrespected. I usually don't have the time to become argumentative... it just wells up too quickly and I loose all sense of composure. Like someone just clicked on a switch. Zero tolerance.

* medical procedures, what medical people think is the appropriate way to treat people boggles my mind.

This one was a medical procedure,
in my mind someone snuck up while I wasn't looking and stabbed me with a sharp instrument. It would have been better if I had seen it.
This was followed up by their usual insensitive and threatening behaviour. They expect that my life is in their hands, that I trust them, and I have no interest in it anymore.
I don't trust them, I feel that they are attacking my "self", my autonomy; and I freek out.

I've been in health care for nearly 40 years... and I can tell you for certain, at my hospital, people can get fired for that sort of behavior. When people are put into a strange, scary environment... and they are sick or in pain... they are often the worst versions of themselves. We know that, so we are so careful with what and how we do and say anything. We will never impose anything on anyone... not even a child. If you are a grown adult of sound mind, you are a customer and client. You are paying your hard-earned money, taking up your precious time, interrupting your life, and asking for help. You hired us. If you want to refuse something... fine. As one might say, "You've made your bed, now you're going to lie in it."

Now I'm trying to deal with the aftermath, and not coping well. It is a long time since I had a meltdown like this and I don't understand what is going on, or what to expect.

The day after, I was exhausted and very emotional to the point of tears. Snippets of what had happened kept popping into my head uncalled for.

Later I'm still very emotional, but the emotions are no longer connected to the events. I feel like my 'self' has been shattered into disjoint pieces.

Any insights appreciated.

All I know is that after a major shutdown or meltdown, I might need a few days to recover. My brain is absolute trash. Good food. Good sleep. No social interactions. Leave me alone. Give me time regain my composure.

 

[Judge]

When I experience a rare shutdown, it's as if at the most intense point of it all, everything just fades into a white fog. Visually and mentally, where I cannot recall anything beyond that point until after it all subsides.

Somewhat reminiscent of those who claim to have experienced "lost time".

For an equally disturbing experience as the shutdown itself.

 

[Matthias]

Meltdowns are intense emotional reactions. The cause of emotions is well known. Event -> perception (based on beliefs and experiences) -> emotion. The strength of the perception influences the strength of the emotion. This is why therapy involves helping people change their beliefs (often based on cognitive distortions) and their perception of earlier experiences.

Putting it all together, if someone telling you that you can't do something you've already done (which you perceive as lying) triggers a meltdown, it's because you either have very strong beliefs (honesty is very important, liars are evil) or because your brain perceives it very negatively (which is often due to the brain associating something with very negative experiences).

 

[Outdated]

I've been known to chuck a tantrum from time to time but I console myself with the fact that they well and truly earned it. I have a quick temper and a quick mouth to match.

I got giggles out of the security guards in the Prince Alfred in Melbourne one night. I had no faith that the doctor knew what she was talking about so I apologised for wasting her time (sarcasm) and walked out. She followed me out yelling and screaming at me which is what brought the security guards running, and she was waving a packet of pain killers around.

With the security guards there as an audience I let fly in my big booming voice - "I don't want your drugs lady. What I wanted was a competent bloody doctor!". The guards burst out laughing and I continued limping out the door.

Now I'm trying to deal with the aftermath, and not coping well. It is a long time since I had a meltdown like this and I don't understand what is going on, or what to expect.

I cheer myself up and restore my faith in humanity by doing nice things for people. Just little acts of kindness like letting someone in in the traffic or holding a door open for someone. Their reactions brighten my day.

 

[thejuice]

It takes time for the body to reach equilibrium again. You were in a period of high anxiety and nervous system excitement, so will probably have an equal and opposite period of depression, exhaustion and unpleasant hopeless thoughts. I often get ripples of anxiety in the aftermath for the next few days as well. I'd have lots of rest!

 

[Tuffsy]

Reading all the replies makes me feel like I’m not alone. I usually feel embarrassed and ashamed after a meltdown. These days I tend to tell groups that I join that I might have a meltdown. It probably makes no difference to their responses to my meltdown but it makes me feel better!

 

[Richelle-H]

Not sure anything that follows is anything that rises to the level of an insight for anyone other than myself.

The first meltdown I remember was at 5 years old and was triggered by high anxiety. I was in kindergarten and the class was being ushered out for something very benign in retrospect, but I latched onto a stanchion outside the classroom and wrapped myself tightly around it, screaming my lungs out, necessitating the school phoning my mother to come, talk me down, and take me home.

Since then I have had many other emotional meltdowns and over time I learned to recognize the signs of one developing. This gave me an entry point to begin training myself to guide any potentially emotional runaway freight train away from a crash and burn scenario. I taught myself, using deep breathing techniques and shifted focus, methods for keeping my emotional state from collapsing into a black hole of misery and mental flagellation. After all, it is my head and my feelings and I can control them to some extent through not dwelling on whatever triggered the repeating negativity. Negative feelings directed inward have always been my particular vector for meltdowns.

Today, I am capable of keeping things in reasonable check or at the very least I can let go of all the negativity much quicker than in my youth. I tend to think of them now more as temporary upsets than actual meltdowns, because I can usually get myself back to a calm and centered state within a few hours, and in that time frame I can still function in a competent if somewhat hesitant manner.

As I am the only one that I can truly point a finger at, it falls to me to deal with my own emotions and to prevent inflicting my negativity on others. Not an easy prospect for anyone to navigate but....

The potential for change is within everyone, but quite difficult to get to a permanent new paradigm.

So, not much help but I do hope you are able to find ways to relax and tame the demons that trigger you.

 

[mattrix]

Hi everyone,
Thanks so much for your experiences, they have really helped, though they have brought me to tears.

I don't get usually get violent, at least not since I was much,much younger. But then I don't usually have meltdowns. Once triggered they build up like a kettle boiling, I know time is short and I need to take the kettle off the fire. Each new assault threatens my existence and I get more argumentative. Lacking the words, at the time, I use my arms to express myself, which is not taken as frustration but rather aggression.

(sorry, just a bit of a rant here)

The bloody arrogant ambo decided to treat me like a 3 year old, openly lying to me and others about me. Not letting me know what he was doing but rather deliberately hiding it. I got some satisfaction when he tried to start a drip but wasn't able to.
He complained about me not worshiping him when i last saw him, I wish I had been together enough to say "What did you expect from a 3 year old?"

Why do I let stupid people upset me so much??

Getting to the hospital actually calmed me down a bit, familiar surroundings, all hospital corridors are the same. Until I was moved to a bed, and the the pokes started again.
I'm not telling you what THIS is but I want to do it, I'm going to do it ... because I'm more important than you and what you want doesn't matter ... I ( the nurse) am taking control.
I need to know what is going on so that I can rationalise it instead of reacting emotionally.

I reached breaking point and had another argument about disconnecting me so I could go somewhere and calm down.
Oh no, WE can't (wont) do that, ... , you do it or I WILL.

I had no faith that the doctor knew what she was talking about so I apologised for wasting her time (sarcasm) and walked out. She followed me out yelling and screaming at me which is what brought the security guards running, and she was waving a packet of pain killers around.

Similar here, Here I am sitting half naked in a corner of the parking area trying to calm down, and the bloody head nurse follows me and reads me the riot act, throwing more barbs and threats. Once she had got her satisfaction, she arranged a posse of guards to make sure I didn't abscond.

 

[mattrix]

Today my mind is still trying to put all this together, to make sense of it, to understand it.
It is totally occupying my time. My executive function has gone down the toilet.

Its trying to put together 'pithy' responses that I could have said, if I was less emotional. And to put together scenarios that would show them how stupid they are, but of course they would have got offended and refused to play the game.

Rewriting the history ???

 

[the_tortoise]

Medical people can be very insensitive and authoritarian...traumatizing...this is why I will soon be done with healthcare forever. Would much rather die. Sensitive and respectful medical people clearly exist, like @Neonatal RRT , but they represent a very small minority of those I have seen...

I'm regularly infantilized in medical settings and it makes it worse when I have meltdowns in front of the people who infantilize me...

I have had a few meltdowns in doctor's offices this year in response to outright bullying. Meltdowns are horrible anywhere, exhausting and humiliating and frightening...and I think the bad responses people have even though I am not aggressive, merely loud (in my case it boggles my mind how I was perceived as threatening when hiding behind exam room furniture in obvious terror, cowering and sobbing, shouting only non-threatening self-defensive things like "stop hurting me" and "let me speak" and "why are you doing this?" and unable to even stand up without my crutches on the other side of the room....but i was), make it more traumatic and add to the feelings of shame and fear over having lost control of myself....give me that much more to process and recover from.

Takes time and self-compassion. And if you feel traumatized that is another layer that easily prolongs recovery time from a bad meltdown situation.

Hope you feel better soon. And I'm sorry you were treated badly -- medical people should be people you can trust - but they should know they have to earn that trust by treating you with respect and sensitivity.

 

[Neonatal RRT]

Medical people can be very insensitive and authoritarian...traumatizing...this is why I will soon be done with healthcare forever. Would much rather die. Sensitive and respectful medical people clearly exist, like @Neonatal RRT , but they represent a very small minority of those I have seen...

... and I am immersed in this environment, and I would suggest that there is a very small minority that treat people this way. There are those who do, but are quickly called out for it when it is witnessed. As mentioned earlier... this is absolutely unacceptable behavior.

I'm regularly infantilized in medical settings and it makes it worse when I have meltdowns in front of the people who infantilize me...

This is the unfortunate reality of the cognitive biases that occur when there is an association between social and communication skills... and intelligence. We've had these discussions before, but I do think this is rather pervasive. Personally, I have to admit that I, too, had this ignorance for decades. It's never something that is ever discussed during our training... and hindsight being 20/20... I think it is a crime. In my role as an educator, I now incorporate this aspect into my training. Never assume anyone's intellect... never infantilize... and most especially with the non/minimally-verbal... as they just might have 50% more IQ than you do. You just piss them off and you (the healthcare worker) are the made the fool.

 

[the_tortoise]

. and I am immersed in this environment, and I would suggest that there is a very small minority that treat people this way. There are those who do, but are quickly called out for it when it is witnessed. As mentioned earlier... this is absolutely unacceptable behavior.

I might just have really bad luck - in fact I hope I just have really bad luck, but I do have a thought:

If you work in a children's hospital and have spent most or all of your career in pediatrics that alone would explain for me why you instantly recognize unacceptable behavior for what it is and why in your experience mistreatment is vanishingly rare and called out...As the amount of poor treatment I recieved at children's hospitals growing up was really none at all....The only traumatic experience I ever had in a children's hospital was forgiveable, and I believe 100% innocent and the sad result of pervasive ignorance.

Now, my experience is at the more extreme end for poor treatment in healthcare and may be unusual, but it's not at all uncommon for people to be shocked at the difference betwen pediatric and all-ages/adults-only care in a Canadian context when they (or sometimes their children) transition into adult care...it's often the case there is much, much less sensitivity for all kinds of things in adult care, and ironically a lot less respect for autonomy and waaaay less attention paid (usually zero attention paid) to any individual differences a patient might have that have significant impact on appropriate approaches to care provision and communication. The difference between equity and equality seems often to not be understood and if you cannot act at least normal (if not ideal patient) then you are a Problem and a frustration and not much else. Accomodations for say, needing written communication, for example, just don't happen and I have repeatedly had a short page of written symptom notes carefully typed out handed back to me with disdain and words like "I'm not reading this, talk to me" spoken as if I'm doing something wrong....inevitably I cant talk to them fast enough or clearly enough and bad things happen just from misunderstanding....which I am always blamed for.

Also the only doctor who ever stood up for me against mistreatment he witnessed by other medical people, I am pretty sure he was just punished for doing so. (and after that he completely changed everything about how he treats me and has never explained why.)

I have been subject to sneak attack exams and procedures my entire life, I don't think it will ever stop. I've been repeatedly given no chance to offer or decline consent (despite having full capacity I can demonstrate if anyone bothers to check and gives me enough time) instead just suddenly held down and had stuff done to me without any warning beforehand or any explanation ever. I'm usually treated like I'm stupid and understand nothing, and the rare time I ever manage to prove that's not true I'm suddenly seen as crazy or some kind of malingering faker with no communication challenges or cognitive differences and expected to be socially normal, to speak normally, and to understand things I don't, and get treated even worse than average (average being how I am treated by people
who think I am stupid and understand nothing)...I started just quietly walking out on appts with people who come to believe the latter (crazy or malingering - about literally anything it seems like) in my early twenties when they would start harshly and unprofessionally berating me for things I had never done or couldnt help being unable to do or couldnt even understand and knew would never be explained to me. (This is only possible in situations where the doctor does not physically block the only exit...in the family practice clinic i had a couple of meltdowns in and that I am soon dismissed from forever not for meltdowns or anything remotely similar but for filing a complaint about mistreatment [ this is not in the official letter, which blames me in a very strange way for not trusting the doctor -- but is what I was verbally told in the most hate-filled tone of voice i had ever heard this doctor use in an unrecorded conversation...anyways in this doctor's clinic:] in every single exam room the doctor sits square in front of the door, and then examining you is still positioned so that they block your path to the door because of how tiny and elongated all the exam rooms are and how everything is arranged with the exam tables and guest/chaperone/patient chair wedged into one corner on a diagonal from the only door, which the doctor's little desk area and spinny chair is placed directly in front of...my doctor is a foot talller than I am and can move the exam tables with one hand sitting down and scares me when he is angry...in the other clinic, a specialist refusing to answer or in any way discuss a valid question I had asked him that essentially would maintain or destroy the doctor-patient relationship depending on his answer and which he had more than once promised to finally address at the appt during which this happened, everything was somewhat similarly arranged with the patient boxed in but specialist doctor's chair normally was off to the side leaving a clear path to the door...however when he, treating me as usual like anything I said or asked was stupid and irrelevent, decided to break his promise and say we werent discussing the question he promised to answer that day and basically just demanded I submit to his examination immediately, he actually stood up and placed himself squarely in the middle of the only pathway to the door while pointing at the exam table...to walk out on these guys I would have had to push past them, which I was unwilling to do in both cases and would have easily been prevented from doing by the doctor who is way bigger than I am)

I know that sane, kind, ethical and competent healthcare workers exist and consider myself fortunate to have met and been treated by some of them....I would be dead if not for them (at this point it is a mixed blessing as I wish I was dead) but I don't seem to meet a whole lot of them.

Perhaps the issue is one of bias or I am the problem and just bring out the worst in people, and they are sane and kind to most people just not people like me....or perhaps the situation in the USA is not the same as in other countries?

Could just be random chance, too. My bet is on mostly random chance with a whole lot of bias and ignorance mixed in, and probably healthcare worker burnout.

My sample size is tiny...a drop in the bucket of all medical practitioners out there -- but bigger than average....I am told I am so "medically complex" that it is hard for primary care doctors to get specialists to accept referrals to see me and I suspect at this point it would be hard to even get a primary care doctor to see me. I have seen more doctors than years I have been alive (am 40 next year and couldnt even hope to count them all - is way more than 40) in 3 different provinces and many different cities; by the time I was 16 had probably been to the hospital for various things more than most people will in a lifetime. Just to say; its not that I have seen a maybe 5-10 bad actor healthcare workers and assume every doctor or nurse out there is awful...I have seen lots of them, and i know on balance there are lots of good people in healthcare -- that most people in healthcare are good actors or at least want to be. I even think that probably most of the people who have been truly awful to me have good intentions, but they don't know what they don't know, they don't receive enough training in how to be sensitive to people and don't know enough about human diversity, they are educated in a culture that encourages them to discard feelings and to be dominating and competetive, they are overworked and in managed public health systems (which is most of Canada's healthcare system) often underpaid and micromanaged in ways that are detrimental both to their patients and to them...

I assume most of them have understandable reasons for being awful to me, and that they dont even realize they are being awful...

But it is not exaggeration that for me, personally, being treated badly is the rule, not the exception.

I am glad you are an educator in medicine -- seriously very glad.