I’ve been in a strange position where people have repeatedly described me as calm, handling things well, good with stress. Not ways I am typically described.
I’m in the midst of some objectively bad circumstances. What makes this situation unusual is that other people are going through it with me. I’m so used to the majority of my suffering coming from mental illness. That’s an isolating struggles. It is bizarre to have a struggle that with social support embedded in it.
People around me in this mess are experiencing their first run ins with clinically significant anxiety and depression. I’m in strange situation where years of dealing with internal stressors that felt worst; somehow have me coping more effectively in the face of an actual objective undeniably shitty situation. I guess of coping with buckets of anxiety and depression that were disproportionate to the situation got me some benefit for handling my present difficulties. I’m still secretly cutting of course, but that is my baseline level of functioning.
Don’t get me wrong. I am miserable. But within normal range and at most adjustment disorder miserable. Not trying to find the fastest way to kill myself miserable.
I’m so aware of my past propensity to quickly escalate to suicide attempts that even being many steps removed I panicked asked my psychiatrist for seroquel prn just in case I need to knock myself out to keep myself safe. I’ve lost some major protective factors in my life. I’m in this strange place of having built so much insight into what makes me suicidal, that losing protective factors makes me anxious even if I am not having suicidal ideation.
But I’m not suicidal. I’m grieving in a way. Not from death, but due to an unexpected and uncontrollable major life change.
When I first started graduate school I viewed the negative comments and despair represented in phd comics as something of hyperbole. I’m deep enough in that that comic is my truth now. I started of thinking grad school was just a matter of systematically plugging way at things and that I would make it through. Now I’m treading water and have a vague idea of where land is. I am working towards finding land but I don’t know if it is the right way or if I will make it. I think I will, but these doubts about finishing are new. I didn’t view failing to get the phd as a possible risk before.
Somehow I have landed in a space where my misery is within the realm of normative graduate school emotions. I find myself wondering if I still meet criteria for GAD at times. Then I’ll be ambushed by something stressful and decide yep, still there. But at least in how I am outwardly presenting to others somehow it appears I have my shit together. I guess years of mental health difficulties have actually boosted my coping skills. At least making me look normal compared to a bunch of neurotic graduate students undergoing a major stressor.
Tales of a Crazy Psychology Major 
I just read your post here: https://psychologytales.com/2010/01/07/adddrugs/
I apologize for the assumptions I made in the above post,
Though, hilariouslly, you are apparently my doppleganger. Except I was homeschooled, and my parents refused to put me on stimulants because they believe drugs are the devil.
Perhaps the similarities I see in our personalities, as much as that is worth coming from a creepy faceless internet user, is due to having the same disorder expressed in the same or very similar way. Or perhaps, ADHD doesn’t exist in the way it is commonly thought to, and we both have a similar personality that doesn’t “function” well according to current society’s standards. I don’t know.
I am a very thorough, careful person. In fact, I read your post on finding a therapist, and it read almost point for point how I searched for my psychiatrist. Yours was more thorough of course, I didn’t think to look into LinkedIn profiles. But an incredibly similar approach born of stress, anxiety, and learned cautiousness.
Also, you are a bit more experienced than me, as far as the research goes. Maybe I will have some tips to share when I am on therapist 20-ish.
Have you considered Vyvannse? It has a long half life, and apparently less of a comedown. Right now I also struggle with comedowns as I have no insurance and can only afford generic adderall, but I am taking intuiv, as stated above, at least the generic formulation guanfacine ER. This greatly ameliorates stress. It removes the “edgy”, “tweaky” nature of the amphetamine, and also helps me feel more “zen”.
The medication is largely prescribed to lower blood pressure. In the medical literature I have seen there is no signs of long term health effects. It might even be overall a positive to life expectancy and health due to the reduction of blood pressure.
I understand your preference for control over your dosage schedule though. I generally am somewhat obsessive with the time, and know exactly when to take the next dose. Being able to decide when to be medicated is a powerful thing. However, maybe a desire to control when you are on the methylphenidate is due your horrific comedowns? Alcohol also works great for this, but is obviously a terrible long term solution.