Anxiety spirals
I have done a lot of hard work in therapy throughout my adult life. I've had two therapists especially who I credit with helping me to make my biggest breakthroughs so that I could function as a healthy (albeit imperfect) adult. Because of all of this hard work I am generally able to maintain my moods and emotional well-being with extremely low doses of a particular medication and a heaping mountain of self awareness and self-care practices (thanks social worker friends!) Diet and exercise also play a roll.
Throwing chronic pain into my mix, though...I didn't see that freight train coming, y'all.