I finally have my Chistmas holidays now – and a much needed break from university – so will be updating my blog more often in the next few weeks. I apologise again for the jumbled, tedious mess of a post which follows – I never really manage to get things down in the written form in the way that I want to.
The woman who carried out my second autism assessment finally got back to us in February. Despite being an expert herself and having asked for the opinion of a colleague, she couldn’t say for sure whether I do or do not have autism. She explained that while I do display some of the behaviours associated with Asperger’s, I lack the ‘triad of impairments’ needed to make a diagnosis. She said that I appeared to be presenting on the high-functioning autistic spectrum and left it at that, really. She seemed shocked when she found out about me being suicidal and reflected that this definitely could have affected the results of the assessment. One thing made me wonder though. I mentioned in the post on my childhood that I was delivered by ventouse after a failed trial of forceps. She mentioned that birth complications/ fetal distress (as in my case – my fetal heart rate during birth was apparently rather high) are common in autistic people. She also said that improper use of forceps could have resulted in extremely mild, microscopic damage to the ‘social’ part of my brain. I wasn’t sure whether to believe this or not. Could this explain why I had been this way as long as I could remember – my brain structure was very slightly different? Was my high fetal heart rate an indication that I may have indeed been anxious from the very beginning? Ultimately I don’t know…I don’t even know whether I am autistic or not. I change my mind about it often. Sometimes I will look back on things and think that perhaps I do show signs of Asperger’s, but the vast majority of the time, I believe that my difficulties with social interaction are purely to do with social anxiety disorder. Not knowing is a source of great annoyance to me. I would have much preferred if the expert could have just told me one way or another. However, I have become much more confident that it is just SA as time goes on, but there is still that odd bit of doubt in my mind – Asperger’s or no Asperger’s?
I attended a club/group for people with HFA/Asperger’s over the summer. I know that everyone with the condition is different but I felt completely different from everyone there. I went along to the ‘late diagnosis group’, but only around a quarter of the typical traits/ problems faced by those on the autistic spectrum applied to me, and each of these could be better explained by social phobia. This further strengthened my opinion that I do not have autism. I’ve ultimately decided that the results of both autism assessments were inaccurate (the second being due to my extremely depressed state at the time, as well as my usual anxiety). The only reason not knowing bothered me so much at first was that I’d been led to believe by professionals that if I was just anxious, if I just kept facing the things I was afraid of, my anxiety would gradually decrease, whereas if I had Asperger’s/ HFA, I could face the things I was afraid of over and over again and never show any improvement (as seemed to be the case for me). I now believe that this is – to be blunt – a load of utter bollocks. I believe that for social anxiety disorder, exposure alone is not enough. Overcoming it is (for many people) a lot complex than that. It certainly plays a large role, but without examining your underlying thought processes, negative self perception, inaccurate beliefs about yourself, other people and the world, it’s not enough for most people. Anyway, that’s another post… Likewise, I don’t see why someone who has both SA and Asperger’s can’t improve. They will probably always find social situations confusing/ a lot more difficult than most people, due to their conditon, but that does not mean that they can’t reduce their anxiety. Maybe this was just another case of me having to deal with the opinions of unprofessional/ ignorant professionals… Ultimately, perhaps knowing whether or not I have Asperger’s/HFA doesn’t matter. I am who I am. And I will make the best efforts to reduce and overcome my anxiety regardless.
In March, both my psychiatrist and the community psychiatric nurse who I’d been seeing once a week since January recommended that I apply for Disability Living Allowance and take a year out of uni in order to recover. Taking a year out of uni – or at least deciding to go part time for the remainder of my degree – seemed like a good idea, considering that my mental health had reached an all time low and only seemed to be getting worse as the years went on, hence massively affecting my ability to carry out the uni workload. If I’d struggled to keep on top of things even in first year, how could I possibly manage later on? I had – for the most part – hated my first year at uni, and taking a year out would give me the opportunity to think things through and consider my next move. However, ill as I was at the time, I was very much against claiming Disability Living Allowance because I’d feel like a benefit scrounger. I was finding things extremely difficult but I could still do some things. I eventually decided against both claiming DLA and taking a year out, because I knew that my depression would almost definitely continue regardless of circumstances, because I would still be extremely lonely and isolated, and my S.A.D would continue.
*Trigger warning for the next paragraph: self harm*
In April, I finally agreed to let the psych nurse tell my mum about my self harm. I took the dog for a walk while they talked about it because again, I didn’t want to be there when my mum found out, due to fear of how she’d react. As with finding out I was suicidal, she took the news well. She said that it didn’t come as much of a surprise to her considering how I felt, and that she had wondered about it before. She made me show her my scars and seemed slightly shocked/ saddened when I did. I hated having to show her what I’d done to myself. She didn’t really understand it at first but said that she was deeply saddened that I felt so bad that I cut myself in an attempt to dull the pain. She told me that she loved me and would try to support me to stop self harming as much as possible. She even said that if I felt like self harming – even if it was in the middle of the night – I was to go to her and talk about how I felt instead. I was reluctant to do this due to potentially having to wake her up when she had work the next morning – which seemed a rather selfish thing to do – and also because I find it extremely difficult to express myself when I feel that low. I remember one night in early May, I had the overwhelming desire to basically slice up my arm. I couldn’t find the words to tell my mum how I was feeling, so ended up locking myself in the bathroom in a state of inconsolable misery and self hatred. My mum somehow figured out what I was going to do and demanded that I unlock the door. When I finally did, she sat with me for over an hour on the cold bathroom floor (I had a pack of 5 razor blades concealed in my clothing and, in my messed up state, refused to move). She just stayed and talked to me and tried to comfort me, and stopped me from hurting myself. I know that I’m lucky to have a parent who has been so supportive – I know many people lack that. I am immensely grateful that my mum has done so much for me and to help me. Since she found out that I self harm, I have only relapsed twice, and I haven’t cut at all in nearly 7 months.
After leaving CAMHS, I was transferred to the adult community mental health service in May. My new psychiatrist seems completely incompetent. I could rant on as to why this is for ages, but I will save that for another post. It’s plain to me that he doesn’t care at all about the welfare of his patients though. He seems to just recite jargon which sounds like it’s come straight out of a bio-psychiatric textbook, rather actually give any real answers. But I digress…
I somehow ended up getting merits in all 6 of my modules in my first year at uni, which is apparently quite rare. Unfortunately I can never really take pride in my accomplishments though – I always feel that I should be doing so much better. I eventually decided to go back as a full time student for my second year, despite worries about my mental health being much the same as it was the year before – thankfully it hasn’t been as bad so far. I applied for ‘Disabled Students’ Allowance’ after being recommended to do so on the grounds of my mental health. It’s hard to say whether it has been of much help or not yet. I came off sertraline in May since it had not helped me. The side effects of withdrawal were ridiculous. The worst of these was when I’d walk down the street and have a ‘brain shock’ with every step I took. It felt like my brain was bouncing off the pavement. I’m puzzled as to how I can have such a myriad of side effects without any positive effects taking place. So far, SSRIs have done nothing for me. I don’t know if I will try medication again, but it won’t be any time soon.
My mum told my dad and my siblings about my self harm in June. I didn’t want them to find out but it would pretty much impossible to hide my scars whilst on holiday, and as we couldn’t really come up with any convincing ‘white lies’ as to how they got there, my mum and I decided that honesty was the best policy. I was really worried that they would lose a lot of respect for me but they took it quite well. My middle sister has a close friend who has also self-harmed, so was quite understanding. The younger two didn’t really seem to understand but were at least accepting of it, which I’m glad of. It relieved me quite a lot that I no longer had to hide my scars all the time and worry about my sisters (who I share a room with) seeing them if I was getting dressed or couldn’t wear long sleeves to bed or whatever. No one really comments on my scars unless it’s my mum making sure that I’m still SH-free. I was extremely self-concious at first when we went on holiday, as the scars on my arm were visible most of the time. I was convinced that whenever we went out, everyone must be judging me as weak or pathetic or thinking “look at what that freak does to herself”. However, I eventually managed to almost not care about what others thought after realising that I’d never see any of them again. It was nice to feel that way for a change.
My mood was a lot better but still low during the remainder of the holidays. The feeling of extreme loneliness – having no friends/ a relationship and seeing no way that you ever will – was the worst thing. I started to do Cognitive Behavioural Therapy from a self help book in an attempt to improve how I felt. Sometimes it helped; sometimes it made things worse. I don’t even remember what I did over the summer holidays, apart from attend the HFA/Asperger’s group…my memory is a blur. I did manage to get referred to a psychologist for CBT, who is working with me now. I’ve only had a few appointments with him so far, but he seems a lot more sympathetic and understanding than my psychiatrist. I unfortunately remain quite pessimistic that this will help me to overcome my SA, but I’m willing to put in the work and effort to at least reduce it/ to address my often flawed thinking patterns.