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As I just said on Twitter, I keep forgetting that chronic health issues are chronic and that I can't just wait them out. "Oh, I feel like shit today, I'll post/work/exercise once the aches and/or pains and/or anxieties have let up." And then they just... don't, and another four weeks have slipped by. In fact, I'm typing this straight into the "new post" field on my phone because if I try to ~draft~ something, I won't finish it. I wanted to post something, several somethings, more substantial about the last few months, but: ow.

At this point, the best and easiest thing I can think of to do for myself is drink a shit ton of water, healthwise, and try to catch up on some reading, considering that I am specifically in physical pain right now. I feel like there is probably always something you can do for yourself, even if that something is "breathe deep and drink a water."

I have a yearly PCOS checkup scheduled for September, which I think is also when I have my next quarterly med check (for bipolar II, if you do not have my health conditions memorized, she said dryly). You know, I'll go ahead and say--it's a long long story that I don't really know how to start or finish, and so maybe I'm finding reasons to put off more in-depth posts on (subconscious) purpose, but: it seems, based on some preliminary discussion, that I may be on the autism spectrum. I have a referral to a clinical specialist, but I don't think I can afford another doctor's visit right now, or maybe even for 2-3 months.

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Question! (If you are knowledgeable and feel like answering, that is.)

I have some issues with executive dysfunction and occasional sensory overload, and have long suspected I might have ADHD (though I have not been diagnosed). It sounds like some of your symptoms might be similar to mine? I guess what I'm wondering is how you decided that autism was the more fitting diagnosis, or if that's too personal, how one might generally distinguish between the two.

Oh, no problem! I talk about mental health issues a lot around here, you can only hope to contain me.

Diagnoses are honestly a guessing game with this kind of thing--I was diagnosed with chronic depression and ADHD in college, which later got refined to bipolar II (i.e, manic depression). I might still also have ADHD qualities, but I don't know to what extent I might actually still have it, or if those aspects belong to the bipolar business. But my doctor and I realized after several years of medicating for depression that I had a pretty visible mood cycle and distinct hypomanic episodes--I'd been having them since I was a kid, but because they were largely positive and creative, it never occurred to me to describe them as symptoms. Which is something I keep telling people over the years--they can't diagnose you with something you don't tell them about. It really has to be kind of cooperative, and it's kind of guesswork. I honestly didn't think to ask about bipolar until a longtime reader said, "You know, I've noticed some manic patterns in your posting over the years." So for the last few years, my doctor and I have worked on a mix of meds to keep the cycle more even--I know I'm going on and on about this, sorry, but this is kind of my standard Mental Health Spiel at this point--medication really does not work for everyone, nor is it necessary for everyone, even everyone who happens to be bipolar. I'm a big advocate of finding a doctor you trust and being upfront about whether something is or is not working for you, and making sure that doctor respects your concerns. Certain medications do work for me, and I was having real trouble coping with depressive downswings and manic upswings, which became less pleasant as I got older.

What happened, though, was that even considering that the depression and the mania and the cycling itself was being treated, I still had several problems or issues I just didn't know how to get through. I felt blocked or stuck or incapable and didn't know why. Disordered eating, panic attacks, I know how to drive but I panic, I can't finish or sometimes even start projects--I just kept thinking, maybe I'm not "good enough" at being bipolar, somehow? Maybe if I just try harder... even though I didn't know what "try harder" in this context would even mean. So when a teacher friend said, "This chart about how autism manifests in girls, I think you need to look at it," it suddenly explained a LOT of the things that were left over after bipolar disorder was accounted for.

But the thing is, iirc, a number of these things light up the same areas of the brain on scans. Several of these conditions have symptoms or traits that overlap or coexist or present similarly while not quite being the same. I have a friend who is autistic but not bipolar, as she discovered when meds went horribly for her. I have another friend who only recently realized she IS probably bipolar as well as autistic, like me. My sister has had tactile sensory issues since she was a kid, but an informal internet test ruled autism out for her about as definitively as an informal internet test can; I think she's still diagnosed as bipolar and most likely ADHD, if I'm remembering correctly. So any of these things could coexist--or not.

I think what you really pretty much have to do is start looking at the symptoms and traits of various conditions and start looking for what you DON'T have. It's really easy to end up with that internet hypochondria thing, so I started looking for reasons I WASN'T autistic, and... that counter-hypothesis didn't hold up. Not everything I read applied to me, but a preponderance of major things, in terms of how autism presents in women, did. I think talking to a professional at some point would probably help; I know my psych ran through a whole checklist of things when I first saw her. And even that initial diagnosis evolved. Really, you probably want to look for a therapist or doctor who says they specialize in one or more of the conditions you think might apply, too--they might have a more finely-grained idea of what to look for, what to rule out.

It sounds like, regardless of where it leads in terms of clinical whatever, your diagnosis has led to useful new self-knowledge, so congrats!

I am hopeful that someday, we as a society will be more open about and comfortable with neurodiversity, so that rather than feeling like these differences are necessarily a ~problem~, it'll be like, "okay, your brain came from the factory with the following driver and bios versions installed, so you're going to be pretty standard in these areas, these things will probably be comparatively easy for you, and these other things will probably be comparatively hard. Here's some stuff that people with brains like yours generally find useful." And that would be a normal conversation that everybody would have with their doctor early on in life, and you'd revisit it a couple times a decade.

Yeah, this is what I wanted to get more into with a full post, but the more I thought it over--I really think my strengths come from autistic brain wiring. That's literally the way I started thinking of it, "wiring." It's absolutely not something I would want to "cure," and I'm honestly pretty glad I have it, all things considered. And of course there are some difficulties--which I have a better idea how to deal with now that I know what hardware's involved. (Actually, it's kind of funny to think of sensory overload as overheating, or short term memory problems as buffering or something.) It also reminds me a lot of looking for a new laptop, when I said that processing speed and multitasking were most important to me, but I didn't necessary need top-of-the-line graphics. So, unlike my laptop, I didn't get to choose my brain, but I did end up with extremely good processing speed, overheats easily but it'll be fine if you put it on sleep mode periodically, tons of data storage, great research software, sometimes social media services crash and don't come back up for a while, actually pretty bad at running multiple programs at once but you could download some organizational software maybe to help with that, and so on.

I'm really glad it's been a good experience for you — I always find things about myself easier to cope with/explain when I have a word for them. I'm (to the best of my knowledge) neurotypical, but because my brother has Asperger's (or the Artist Formerly Known As Asperger's, idk) I've been interested in that area for a while and the writing from that community helped me SO MUCH in understanding my own problems that resulted from my longterm anxiety disorder chronic depression, like sensory overload (sometimes everything is suddenly really loud and I feel sick and it triggers a panic attack) and executive dysfunction. I also had a similar experience to findingawayh0me with asexuality, in that it's something you already experience but when you find the words to describe it (and the community that comes with) it's such a relief. Plus, I didn't have to keep telling people that I wanted to be an atheist nun, I could just be like, "I'm asexual! Don't know what that means? Google it!" and skip away :P

PS: I finally found someone selling a copy of your M15M book and I am very excited for its arrival.

Aw, yay for the book!

Yeah, honestly, what helped me realize I was bisexual was seeing people on Tumblr (I know, I know) talk about how female desire is normalized as "well of course you're attracted to women, EVERYONE is, women are just beautiful," sort of in service to herding women back towards men and heteronormativity. There's this vested interest in making sure questioning and/or bisexual women don't FEEL "queer enough" to count, and I definitely didn't, and therefore I didn't even consider it until like 2-3 years ago. (I think this is not unrelated to my fear in the main post about "WHAT IF I'M NOT AUTISTIC ENOUGH AND THEY WANT TO KICK ME OUT?!") So basically, yeah, it was seeing other people talk about sexuality as a more fluid and low-key thing that didn't have to meet a Queerness Threshold that helped me figure that out. And this realization that I was "enough" was just such a huge relief.

And yeah, sensory overload was a HUGE factor in realizing I was really very probably autistic. I would literally tell someone, "I'm having another I Hate Voices day" or "why is everything so loud. why." I was wearing earbuds around the house and playing music because the sound of the TV and people in the room talking was just driving me batty, to the point where I just wanted to SCREAM. Or someone would be venting at me about their day, and about thirty minutes in I would suddenly feel like I was just shutting down. Or like, I would be out doing stuff for the afternoon, and suddenly I would just be DONE. Autism really, really explained that, and it's made it easier to say, "sometimes I just can't handle a lot of sound, so if we're going to be talking anyway, can you turn the TV off."

You are the bestest. That's all.

It can be a relief when things about oneself start making sense. Doesn't always make life *easier*, but can be helpful.

I wish you all the possible luck with all the current and future self-discovery.

As a late-not-yet-diagnosed-but-likely-on-the-spectrum woman (nearly 50) it's been somewhat of a relief - that there is a REASON that I think/work this way. I will be exploring this further in some upcoming therapy, but for the past 2 years I've been essentially acting as if I had a diagnosis and wow things make a hell of a lot more sense now

Don't they? I was really, really surprised to find out how many women aren't diagnosed until their 40s. I almost feel like 37 was catching it early, at that rate. I'm to a point where if the specialist says it's not autism, I'm going to have to be like, "Okay, then what IS it, because it is clearly SOMETHING."

Every now and then I wonder if I have Asperger's or even ADHD, but I think I really just am an introvert who's shy, with situational anxiety and social awkwardness, as well as an HSP. None of it's crippling, although the travel anxiety can be terrible. It's a set of related issues but there isn't really *that* much overlap with Asperger's, and I don't really match up with ADHD either because when I get disorganized that's more due to depression. My social awkwardness isn't the Asperger's variety, but is more rooted in consciousness of having been a weird quiet child and resenting being judged and being overly sensitive to it. (Essentially, what it boils down to is, I just want to be left alone, although sometimes to my detriment.) ...And I'm talking about myself because... I think it's good to hash these things out with others. Yeah, sort of went on a tangent there. Edit: Oh, and I also constantly pick my cuticles, which is somewhere between stimming and self-harm without being either.

Edited at 2016-08-04 02:50 am (UTC)

I need to remember that bit about chronic conditions as well. Because "I'll work on my dissertation when I feel better, or when I'm in a better headspace" basically just means that it's been three years since I defended my prospectus and I'm still not done writing the stupid thing. (And it's been like 8 months since I've actually done any work on it).

I feel you so bad on the "what diagnosis do I have now" thing. Because I've been diagnosed with GAD and Depression, but my kid got diagnosed with OCD, and I'm like, oh, are those things NOT normal? Because I do all of them. And now I'm kind of wondering if I should get evaluated for Bipolar II because I've been having really really regular and frequent depression cycles. Punctuated by a week of GETTING SHIT DONE and then like, 5 weeks of barely being able to get out of bed. And I can't figure out if it's hypomania, or just, like, oh, normalcy again. Anyway... diagnoses are weird and difficult and I hope you're able to get to a doctor soon and that maybe you'll be able to sort things out. I know for me, even without officially being diagnosed as OCD, identifying myself that way has been helpful for my own mental state. Just being like, oh, that's A THING, not just another weird way in which I am failing at life.

I typed in a comment and then deleted it. And then again. There're too many things in the comments that resonate, and l'm scared.

Let me just say - I'm sorry that you're in pain, wish I could help.

And you know, whether this ends up being what you're thinking, it's okay to be scared. (That's something I write in my CBT notebook a lot, "I feel scared. It's okay to be scared.") And it's how I felt the first few weeks when I was mulling over the autism thing. I wasn't even entirely sure why I felt scared, particularly after I came to the conclusion, intellectually, that this was probably a positive development. I finally just went, you keep feeling however you feel, even if you don't know why, and keep reading up on the whole thing and thinking about it, and you'll catch up to yourself eventually. It took me a couple months, but eventually I did, and here we are.

Speaking from the position of having just finished an MA in clinical psych:

In the most technical terms, the DSM is meant to allow any practitioner with a modicum of training to diagnose a given case in the same way. In practice, there's so much room for variability of experience, context, and human error that this obviously isn't the cut and dry case.

The usefulness of the DSM also depends on the iteration being used. The DSM-V made the Asperger's diagnosis extinct, which created a good deal of anxiety for a lot of people who had been diagnosed with it--the same thing happened years ago to Multiple Personality Disorder (now DID), and Borderline Personality Disorder is threatened with extinction on the regular. This isn't because these diagnoses are suddenly considered "fake" or something, but rather because the old definition is considered in some way insufficient to capture a given phenomena. The symptomology of Asperger's is now meant to be contained in the DSM-V's autism spectrum. BPD may one day be made extinct, but only if an alternative--based on new research and theory--is devised.

So when the DSM-V did other things like complicate the diagnosis of PTSD, it was with good intention, but it didn't necessarily yield the best results. There are now something like 17,000 possible symptom combinations to warrant a PTSD diagnosis, and people still slip through the cracks because of the complicated symptom categorization requirements.

The DSM also suffers from phenomena like co-morbidity. It's actually pretty darn rare to find people who are Only Clinically Depressed or Only Clinically Anxious, as the two conditions overlap and feed into each other. Research is also pulling from increasingly diverse populations, which is complicating assumptions about how symptomology presents.

Basically, we're confident that "depression" and "anxiety" and "autism" are real, but we have a long way to go before we understand how to correctly identify, let alone treat them (and then, what does treatment mean? imo 'pain relief' but that's another comment).

What's more, as some earlier commenters noted, mental health diagnosis really is in a big way about playing the insurance game (relatedly: the only good thing about any gender-related diagnosis still being in the DSM is that it's leverage to guarantee insurance covers biomedical treatment for gender affirmation purposes). Practitioners need to give their clients a specific word so that the capitalistic structure underlying everything will actually do something to help them.

But diagnosis can also have immense therapeutic value for some people. Finally, a word for what's happening to me! For the most part I think it's usually just best to approach these diagnoses, these labels, as being fairly open-ended. They're sign posts, not boxes. "This way to stuff that might help you."

It's a comfort that you talk about mental health so openly. It's a subject that's so vast and deep and troublesome. Looking through your post, things started resonating, they made sense. I hope you receive a swift diagnosis and help for it.
I'll be looking into doing the same thing, because finding and reading through that chart put my life into sharp and painful focus.

Please excuse how disjointed this comment is. There's a lot of work, exhaustion, and now emotional hyper-awareness I'm dealing with right now. But thank you so much for sharing your experiences with us. Best wishes.

Glad I could help! There's a comment a bit higher up I made about being a scared at first, and how that's okay. I'll write about this more, but I'm also kind of still going through a period of self-consciousness where I'm wondering how I appeared to people all these years, given that I am clearly not as "normal" as I thought I was. (I'll have to go into this as well, but I said this to my mom, and she blurted out, "But you ARE normal! This is how you've always been, this IS normal for you!" Which I thought was sweet.) It's been kind of emotional, maybe still is a little sometimes, but it's something I think can be gotten through okay--best wishes for you too.

Stumbling onto personal research about the way one's brain functions is sort of how I found out about being on the Spectrum, too. I read a bunch of people's, largely other women's, experiences with autism and the crossover among women and girls with depression, etc etc, very similar to what you described in brief for yourself.

So I did MORE digging, some online looooong self tests/questionnaires and came to the conclusion that yeah, yep that is me so much.

And then I mentioned it to my mom and she was all "Oh, yeah, I pushed for you to not be officially diagnosed with it when your were tested in 2nd grade and diagnosed with depression, it had way too much stigma and I didn't want it to hold you up in school because you were academically doing fine." Cue surprised me face.

So yeah. I feel ya.

Hi!! I just randomly happened to check here again. I swore off tumblr as the vicious timesuck that it is and I don't have twitter, so I'm glad to have caught you here even as just a once-off. I've been reading for forever and think you're pretty great. =)

I hope that things get better and you get things figured out mental-health wise. I'm feeling you on the "oh wait this ISN'T EVER GOING TO GO AWAY FML" and just having to Do Shit anyway.

I can't say much that hasn't already been said on this thread, but thank you, again, for being so open about things. You make it easier for me to talk about my own issues and you've given me a lot to think about here. I've often wondered if I was on the spectrum too -- those traits have lessened in me as I've gotten older, but learning how to function in society was a tough, conscious process.

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