Occupation: Girl

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

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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.

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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."

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