Occupation: Girl

Please close the door and switch on the fun without fail.

Previous Entry Share
msauvage purple
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.

So it's not an ironclad clinical diagnosis. But it would explain A LOT about my painfully lonely and anxious childhood, why I have panic attacks while trying to drive, problems I have both starting and/or finishing things, and those times when I'm just like "that's it, I'm done, I have lost my will to function, I will be sitting in this corner of the convention hall if you need me." And I know some of these things may be true of many people. But in the preliminary research I started doing, a revelatory preponderance of them turned out to be true of me.

And that's the kind of thing I wanted to post about in depth. Things like how autism can present very differently in girls, how many women aren't diagnosed until adulthood, how (contrary to a lot of stereotypes) empathy overload and high verbal skills can be involved, mirror neurons, how bipolar disorder often overlaps with or is mistaken for autism, intense world theory, executive dysfunction, sensory overload, how Hans Asperger only studied boys, how I'm not sure if Asperger's syndrome is still clinically a thing or if it even reflects what's going on with me but who am I to say that, how I'm not entirely sure if "high-functioning end of the spectrum" is a thing or if that terminology upsets people, how I might be blundering into an existing community, and not knowing the right words and being afraid I don't belong because I don't KNOW for sure, but how it's already helped me a lot to reconsider how I think and feel and function. It has, perhaps contrary to expectation, been a largely positive experience.

Anyway. I think I am stealing my own thunder here because trying to write about Autism, Maybe has been turning into Let Me Slideshow You My Brain. Like, we could be here a while. So. Voilà.

(In keeping with current policy, comments are screened by default. If you would like to comment on this subject in particular but keep it screened, please say so in your comment. I will not be able to answer screened comments, however.)

Won't medicinal marijuana help you with the pain?

That tends to be illegal here in Alabama.

Not sure how to start a comment, because the default empathetic "I'm sorry" is, I think, not applicable here. I am sorry for the unending suck of chronic pain, but I'm not "sorry" about you exploring a diagnosis for a condition you may have, both because you say that it has been a largely positive experience and because you're you and having you in my life has been positive for me.

I am also sorry because as soon as I read "Let Me Slideshow You My Brain", I immediately got an image of Sylar from Heroes doing the "I'd like to see your brain (and put my fingers all over it, like, ew, did you even wash your hands)" thing.

Awww. Yeah, sometimes I just want to be like, "Well! That is certainly a thing going on with you! You just keep on thinging that thing! Unless you don't want to! Thing."


(do we do emojis now? I'm old)

(Deleted comment)
I have missed you. Sorry you are going thru all this. High-functioning is a thing and I don't think the term is offensive. It makes much more sense than "mild." I didn't know Asperger only studied boys. Girls and women are certainly overlooked on the spectrum. A couple years ago they (DSM) looped Aspergers and PDD-NOS (Pervasive Development Disorder- No Other Symptoms) into ASD and I think it was unfortunate. Nuances of Aspergers and PDD-NOS still hold true. Best wishes in your journey.

Thank you! Yeah, as with a lot of communities, there seems to be some internal disagreement and/or evolution of terminology. I'm kind of trying to tiptoe until I get a better feel for it. I thought I'd read about the DSM-V (?) changing precisely how all that was classified, but wasn't entirely sure.

A (male) colleague of mine is high-functioning. Brilliant, highly verbal, empathetic -- yep, yep, yep. All of the above. So yeah, that could be it. Hoping and praying for less pain for you, and a doctor's visit in the near future.

Aw, thanks. If I can just make myself go out and get a new desk chair, that might hold me until the doctor's appointment.

It has, perhaps contrary to expectation, been a largely positive experience.

As someone who may or may not have Asberger's Syndrome (I was never formally diagnosed, but I have displayed behaviors that sure look a lot like it), I can definitely see that. It puts a name and a label on an unknowable thing that has been part of you all your life. Whether that exact label is correct or not, at least it's something, which is vastly preferable to wondering what the heck is wrong with me. In my experience.

Besides, Asperger's/High Functioning Autism/What Have You can be useful when you are dealing with reams of dry information and facts. And it's not like the whole "having trouble socializing with people" thing means you're never going to be able to get better at it. I've gotten better at it since my ex dragged me (kicking and screaming) out into the wider world, and getting a job that requires me to talk to people a lot (journalism) helped too. So is having people who care, which, in your case, is in no short supply.

The weird thing is that I actually got relatively good at socializing in the right settings--at conventions, I've freely talked to strangers, hugged people I've never met before, done panels, all kinds of things. I tend to clam up if I feel like I'm at a huge disadvantage, like at a party with college friends who all have interesting adult careers and I... don't, and I'm vaguely terrified that's going to come up.

I do wonder what I would have turned out like if I'd had an Asperger's/autism label before now, though. Like, it feels like there's a lot more support for autism now... relatively speaking, I know... but I don't know how I would have been treated as a child in the '80s. I was a squirrelly neurotic mess, but I fully believed that was my own fault? So one hand, having the label might impose lower expectations on you, but not having it leaves you blaming yourself? (I had the same experience when I was diagnosed with chronic depression--relief that things weren't "my fault.") I don't know what the road not taken is like. All I know is, at this point in time, it's allowed me to say, okay, you do have sensory overload and that's not your fault and it's perfectly okay that you need to sit down with a bottle of water for a minute, and then you can go on being the best of you. I hope that's the kind of experience kids going forward can have, rather than the "well you're autistic so of course you'll never be able to do all these things" that I probably would have gotten thirty years ago.

One late-diagnosis autistic person to a (probable) nother, the autistic community (at least online) has been one of the most welcoming places I've ever been. Because of just the things you mention in your post, most autistic people I know are way accepting of things like "I'm not sure" or self-diagnosis or whatever. For most of us, we spent enough time getting things "wrong" for no apparent reason that we don't want to shut out people who could benefit from inclusion.

Anyway my general impression is that whatever terminology you want to use for yourself, go right ahead, it's just that applying it to other people gets iffy. Like no, Asperger's is no longer a separate thing, but a lot of people (including myself) still use it as a way of describing a place on the spectrum. Lots of people don't like the functioning labels because people make it into a dichotomy when it is more of a spectrum, or even a random collection of things that may be useful/functional in some circumstances and less so in others. But I think that's sort of the case in most communities, in my experience: it's your choice of how to describe you, and probably as long as you're acknowledging your choice won't work for everyone you're cool.

And for what it's worth, as a person who has followed your online presence for a long time, I think you being autistic makes a lot of sense. Probably not just because I'm constantly like "one of us" about people. (But woo, other bipolar autistics!)

One of the things that really sold me on the idea of probably being autistic was the idea of fear being a primary emotion. Because I am afraid of like everything all the time, and have explicitly said to people more than once, "What I feel the most is fear." Not literal phobias but this constant ambient anxiety that I'm about to fuck something up. What I *saw* of the autistic community *looked* incredibly welcoming; it's almost a testament to the idea that I probably am autistic that my immediate feeling nonetheless was "I'M GONNA FUCK THIS UP AND THEY'RE GONNA HATE ME." Just constant baseless terror that I'm going to do something "wrong," exactly like you're saying.

I did see that "Aspergirls" was a whole thing (I need to read the book), so I was kind of leery of saying "I don't know that I identify with the concept of Asperger's because it was a study of boys and it's precisely the different presentation that kept me from realizing it." Like, I don't want to take anything away from women who DO identify with that and find community in it, you know? Maybe I WOULD if I knew more about it? So yeah, my instinct is to proceed carefully when a culture already exists, rather than just Kool-Aid Man in.

And for what it's worth, as a person who has followed your online presence for a long time, I think you being autistic makes a lot of sense.

Okay, I am FASCINATED by this, partly because you're not the first person to say that, and partly because it was one of y'all, one of my readers here, who correctly diagnosed me as bipolar rather than unipolar depressive, and otherwise I'm not sure I OR my psych would have figured it out. This time around, I was genuinely surprised when a teacher friend of mine said, "This chart is about autism in girls, I think you need to look at it." (She's on the spectrum too.) Granted, I think partly I didn't see this coming because I didn't have an accurate idea of what it looked like, and if you're also autistic, you'd recognize it in someone else. But what tipped you off, exactly?

I really don't know what to write to support you, I'm not good in supporting people. Just wanted to say that I'm so sorry you're in pain. And that I hope with all my heart , you'll feel better.

Aw, that's good, though. Thank you. :)

Good luck with your diagnosis. Can I just say thank you for being so open with talking about mental health? I remember finding your blog years ago and just being blown away that someone was being so candid, and it really helped fight the stigma for me. This year I finally started seeing a therapist, which led to me starting medication recently. I finally feel a lot better, and you helped pave the way by making mental health stuff not seem so scary. Thank you!

Aw, glad I could help! I kinda needed 2-3 months to process this whole business for myself, but I figured I would get to the "talking about it" point eventually, and it does seem to help.

I suspect I'm in the same category re: autism with many of the same difficulties although I still need a diagnosis, but with the possibility in mind it's helped so much to be able to expect when and how I'll run out of spoons and to be able to say "nope, I'm overloaded, I can't go/have to go home now" versus "WHY AREN'T I HAVING FUN AFTER AN EARLY MORNING AND SIX ACTIVITIES???????"

FWIW I've been hearing from more and more women/trans people/people with atypical autism presentations and it's a very familiar story, so you are/may be in good company. Kintsugi is a nice little community if you're ever looking for people to chat with.

Spoon theory has really, really helped me explain the overload thing to people, particularly my mom. Like I can even get a spoon or two back if I have a bottle of water or five minutes of quiet, but if we plan to do something, I am really rationing out the spoons there and I need to have an idea of what all we're planning to do. You can't just spring an extra five errands on me or I am going to be Done way sooner than I planned. It's not that I'm entirely unspontaneous, I'm happy to change plans or add things sometimes, but it really depends on how many spoons I have at that time.

It's funny, I have been noticing so many more people over the years being diagnosed, both as kids and late in life as adults, that I'm starting to think of the spectrum as something literally everyone is on, and "neurotypical" is just the far end of it. I'm not big on imposing modern diagnoses on historical figures, but there genuinely are a number of people who pretty plainly seem to have been autistic before "autism" was recognized.

I don't have the knowledge necessary to really comment on a lot of this stuff, so I'll just say that I'm thinking good thoughts for you and I hope that your pain eases up soon and you can figure out your diagnosis.

Also, it's really nice to see you back on LJ. (Heck, it's really nice to see anybody back on LJ.)

Heh, sometimes I feel like it's me and the tumbleweeds and George R. R. Martin, but short of the actual service going under, I mean--all my shit is here, it's got a perfectly robust commenting/moderating infrastructure, why would I want to bother getting a real blog now? I just tend to disappear for a few months now and then, is all. I am trying to look into backups/alternates, though, if only because nothing is forever on the internet.

(Deleted comment)
Thank you for reminding me of that, because I keep meaning to pick that book up. (And thanks!)

Thank you for your willingness to speak openly about these things. I know it helps a lot of people - myself included - to hear about this journey of yours. Good luck with your diagnosis.

Not to get all TMI but I went through something similar (sort of?) with asexuality, where the most valuable thing I learned was, "Look, if labeling yourself as this helps, then great. If not, that's great too. But here are the signs, here's how to cope, so on and so forth." Not quite the same, obviously, but it sure helps in figuring out what's going on by knowing you're not alone.

What I'm saying is, brains are weird.

Right? And don't worry about TMI--I don't even think I ever got around to "P.S. I'm bisexual." But I probably should have? It just never came up, I guess? But hooooo boy did I get to throw out a ton of preconceived notions/expectations when I figured that out. And what you're saying is something I came across--sometimes it really helps to have a label, and sometimes for other things it doesn't help as much. And I guess basically you have to go whichever way seems to help you more at the time.

My daughter is on the spectrum - it's hard, especially for high functioning/Aspies. People don't get that you have a "thing", because you look "normal" -whatever that means.(daughter is 19, but has a maturity level of 8-going-on-40. She NEEDS to carry a plush toy around with her to cope with society.....try explaining that to outsiders!)

I am not a doctor, but you might see if your doc will prescribe one of the many ADHD meds (if you think it might help). Concerts was a godsend to us when she was in public school! (I pulled her out and homeschooled high school, because that was best for her. Mean girls.......she deserved better.)

Good luck - it's tough to come to grips with this. Feel free to PM me if you want - I might be able to point you to help (Aspies can qualify for disability, but it's not an easy process, for example.)

I know that at one point I was diagnosed with chronic depression and ADHD; I can't remember if the ADHD is still accurate or if it was wholly superseded by the diagnosis of bipolar II, which has some overlapping elements. Anyway, I'm on a pretty carefully balanced cocktail of meds at this point going on several years now; I have some issues concentrating, but that's generally during stress or hypomanic periods. I did read that sometimes bipolar disorder is mistaken for autism, but it can also just overlap with it; I tend to think I'm genuinely also bipolar because I have a discernable mood cycle and meds have actually made a huge positive difference.

I may take you up on that, though--I'm assuming I would need a more formal clinical diagnosis for disability, but once I see the specialist, you may be hearing from me.

I would love to read about your experiences insofar as you're comfortable writing about them.

This feels like something I will probably run my mouth about a good bit, heh. At this point, it's just a lot of THOUGHTS to corral, so I'm trying to organize my "research" in a Storify. Although the process of putting it all together is itself kind of revealing--like, no wonder I depend so much on Storify and outlines and "numbered thoughts are organized thoughts."

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."


Log in

No account? Create an account