Hello, sorry for a long post, want some feedback, what do you guys think, I thin its PPD but Ive also been told my joint laxity (EDS type III, Im more flexible than 99% of males around my age according to Beighton scores) may be a structural cause but Im skeptical because I wasnt always in chronic pain. I've been having chronic, light sensitive migraines (5 to 6 days a week) since 2016 and chronic joint pain (DeQuairvains syndrome, pain under my wrist, pain in between my fingers, pain at the medial epicondyle along the ulnar nerve, exacerbated by typing, clicking the mouse, or writing) since fall of 2018. I have also had chronic pain in my right ankle (“extensor tendinitis”) and my right knee (“IT band syndrome”) since summer 2019, although the ankle pain has mostly resolved. I’ve been perfectionistic and an overachiever my whole life (gifted ed, aced the ACT in middle school, went to college 3 years early and studied engineering, worked at a top aerospace company, about to begin a PhD in computer science). My extended family is full of overachieving individuals: an ex-CEO of a foreign investment bank, a doctor, and the founder of a foreign skincare chain. There is a lot of pressure to do well, and comparison in the family (my sister goes to a PhD program in a well known Ivy League school). My immediate family however is full of dysfunction. My father got cancer twice, and is currently terminal but is still quite stable for several years. My mother suffers from a chronic untreated depression my whole childhood. There was a lot of verbal abuse between my parents, constant daily fighting, and I remember frequently hiding upstairs or under my bed. My mother took me out of the household at 15 because I was scared of my Dad and keeping scissors under my pillow at night as I was occasionally woken up by him yelling. I was blamed for their divorce by my mother, at the same time that I went to college. I couldn’t stand living with my depressed mother who expected me to console her so at age 15 I lived on my own during the weekdays in an apartment my the college campus. I had trouble fitting in socially at college because I was, well, 15 so I often felt alone and ostracized. Timeline of Possible PPD Symptoms: 2009: Mother filed protection order and divorce when I was in 5th grade, we lived in a family friends house for a few months and then an apartment. They eventually reconciled. 2012: Father got cancer, was treated. Became irritable and aggressive, frequent road rage, would get out of the car to bang on someones window occasionally. I believe around this time I got TMJ pain syndrome. I also got a concussion from a mild head hit, and post concussive headaches for several months. 2013: Father was cured and then got another form of cancer, became more aggressive, especially verbally. 2014: I entered college early. Mother removed me from the house. We lived at a family friend’s, and then I lived alone during the week at a college apartment. 2015: I broke up with a long term relationship, was a major support, so had a hard time getting over. I lived at the college dorms for a few months, a fraternity for a few months, but had a hard time fitting in so started commuting from home. Reconciled with my father, his aggression calmed down after the divorce. 2016: I joined a business fraternity, but had a lot of social anxiety and hard time fitting in. Around this time got my first major depressive episode. Began living with some friends in the fall, but they were not very inclusive and I felt left out, depression worsened, began to try meds. Also experienced a second concussion, and post concussive migraine syndrome that has lasted till this day. 2017: Got in my second major relationship, very supportive and helpful about my mood struggles, but I became dependent and followed her to work to study and used her as a crux for my depression. Became withdrawn from some friendships due to depression. Changed majors and had less friends as a result. Had frequent communication issues though. 2018: Got into my college major of engineering, and didn’t know many people, still depressed. Struggled to find an internship, when I did began having pain in my right index finger using the mouse. Had bad job prospects so struggled to join an engineering team, which required even more work after classes and less free time. Saw several doctors and PT, arm pain “spread” over a month when I went home to see extended family I hadn’t seen over most of college. Then had pain in my finger, thumb, elbow, and other hand. 2019: Pain stayed, and I became depressed and anxious about it. Had to quit the engineering team joined and get help from my girlfriend to write out assignments I dictated. I did start to make friendships at school, and engage in more hobbies like swimming and skiing though. Around summer right before I graduated, I started getting bad foot pain in my ankle, thought it might have been from swimming but it progressed and soon I could barely walk around campus and had trouble driving. I took a month off before I started my first job in aerospace to “heal” my RSI. Got a dog and thought he was making my RSI worse by pulling. Work began and the hand pain got worse, couldn’t take as many breaks or get help dictating assignments. 2020: Doctor told me to try taking a couple month leave of absence to heal my RSI. It was unpaid so it was very financially stressful, but one of my parents helped. Didn’t get any better with rest. Well I did, and then as soon as I used my hands to type, write, navigate the computer, or even scroll my phone it got wore again. Became very depressed. Got the vertigo episode. Some family members were very unsupportive. Got diagnosed with hypermobility of my thumb, fingers, and spine. Got surgery to correct my thumb, and ankle collapsing (flat foot). Hand surgery helped a bit and I got back to work, but then the DQ in my thumb got worse again. Foot surgery took a long time to rehab. Also got botox shots for ulnar nerve entrapment (thoracic outlet) and a lot of ergonomic improvements (posture braces, standing desk, mechanical split keyboard, vertical mouse) Got back to wrok with 75% hours, and struggled through some pain and managed to make it work (WFH covid also helped). Found out about TMS/PPD on an RSI forum in mid last month, personality seems to describe me well. Some things were striking about how my pain spread and bounced around, but it always was a small localized area wherever it was. Forced myself to type more and surprisingly worked up my way to 3 or 4 hours per day, some days it hurts worse but sometimes I notice after a while the pain goes away. Also forced myself to bike through knee pain and noticed that sometimes, after a while (20 min) it would go away. Some inconsistencies in my pain. Headaches got worse (I also was so confident in PPD that I stopped one of my migraine meds and tried my best not to take NSAIDs). I spend about 40 minutes each day on chronic pain and TMS techniques, like journaling and rereading the books and CBT, some meditating. Stopped PT, postponed my next surgery, and noticed my pain didn’t get worse. Have been able to exercise more, even walk my dogs sometimes. It feels like Im getting better but I worry my progress will plateau, or that I wont be able to handle 50 hour weeks or a rigorous top engineering PhD versus my current 30 hour schedule, also got laid off from covid so grad school is my only option now (the pay at the end is very, very good though). Trying to focus less on the pain, and not use the word pain to describe it, got a appt with Dr Schecter later this month, going to try rTMS for my depression. Been focusing on my hobbies more and not being all work focused, took up chess, car racing games, board games, and meditation. I really want improvements to stay and continue and not get any new pain areas though, and I really want to not let paint come back and get in the way of my PhD.