Hello, and welcome back to The Autistic Writer. I hope you’re all doing okay. By the time you read this, I will have passed a couple of anniversaries. Firstly, I will have turned 57 years old. Secondly, I will have completed 12 of the most difficult months of my life – and that’s saying something, considering most of my life has been characterised by strife and unhappiness. Birthdays are weird, for me. I find the song, Happy Birthday ironic; very few of my birthdays have been even remotely happy. But I’m a sucker for anniversaries, or anything that puts down what I feel is a significant marker of the passage of time. I get emotional. And so it is that I look back over the last 12 months, since my life turned upside down at the end of April last year. Despite all my effrots, I have made no personal progress in my life over the past year. Okay, that’s not entirely true – I did publish my novel, Aberrations. But my domestic circumstances remain the same; I am in a rented flat that I don’t want to be in, and I still haven’t been able to find a place to buy; I’ve either been outbid, or messed about by estate agents and vendors every time I thought I’d found a new home. My physical and mental health issues continue to be problematic, so no change there, either.
I’ve often talked about mental health issues in this blog. As my regular readers will no doubt be aware, I reject any notion that autism is a mental illness, and like many other autistic people, I fight a daily battle against such damaging preconceptions. This is not in any way to demonise mental illness; it is simply that neurodivergence such as autism needs to be understood correctly by the general public if autistic people are ever to live without struggling against prejudice. If we can achieve a proper public understanding of autism, then that is likely to reduce the incidence and severity of mental illness in autistic people, as it will be one less source of trauma we have to deal with. As it is, mental illnesses such as depression and anxiety are shockingly prevalent among autistic people, largely due to the mental and emotional trauma we face daily.
I want to share some thoughts about my own mental health situation in this week’s blog. It makes me feel weird opening up in a blog about my mental health, even though I’ve done it quite a few times, now. It makes me feel vulnerable and exposed, particularly to the people out there who see mental illness as a weakness, and a source of ridicule. A major worry is that my openness about mental health problems triggers unconscious bias in people who would never admit, or even recognise in themselves, that such bias exists. I know from conversations with other autistic people that disclosing one’s autism or mental health status can have a very detrimental effect on future interactions with people. Whether it be in school, higher education, the workplace, friendships, or romantic relationships, disclosing changes the way people see you, react to you, and… rate you. It can be very difficult for autistic people because we often have different neurocognitive approaches to relationships and interactions than neurotypical people. It can often take us quite a while to distinguish between people who are genuinely supportive and non-discriminatory towards us, and those who are outwardly supportive but who will in fact harbour discriminatory biases, either consciously or unconsciously. To put it shortly; we autistic people can never really be sure about the neurotypical people around us. So, with these concerns I have, why do I continue to openly write about mental health and autism? Well, the more people open up about mental illness, the more likely people are to talk about it, and the more normal it becomes; the taboo is diluted. This in turn encourages even more people to open up and talk about mental illness. Talking about things like depression can actually reduce the likelihood of suicide, and encourage people with depression or other mental illnesses to seek help. When people like me (there are many of us) speak openly about mental health issues, we are taking small steps toward helping alleviate a global problem with how mental illness is perceived.
Before I go further, let’s break off for some very quick and simple statistics about mental health:
- In England, 1 in 4 people will suffer a mental health problem in any given year. Have a think about all the people you know… there is a good chance that some of them are struggling with mental health issues right now. Do you know which ones? Do they trust you enough to tell you?
- Let’s take it a step further; in any given week, roughly 1 in 6 people will be struggling with depression or anxiety. Every week. Again, look at all the people you know… who is struggling? Do you know? Can you guess?
- Suicide remains one of the leading causes of death in young men in the United Kingdom.
- Roughly 1 in 5 people in England will have suicidal thoughts at some point in their lives.
- 1 in 15 people make an actual suicide attempt.
- About 1 in 14 people self-harm.
- Depression is the most common form of mental illness globally, closely followed by anxiety.
None of the above figures are likely to come as a shock to anyone who is dealing with their own issues of depression and anxiety. What is shocking is the slow rate of change in social attitudes to mental illness, and the continued prejudice and unconscious bias towards people who disclose mental health problems.
What is it like for me? I have struggled with depression quite literally my whole life. Sometimes things get a bit better, sometimes a bit worse. I made one actual attempt on my life, many years ago. I am in a fortunate position at present in that, even though I am socially isolated, I do have people who care about me, and understand my mental health situation without prejudice. I have also struggled with anxiety my whole life. The two problems go hand in hand, and can create a vicious cycle during flare-up periods. There is no doubt in my mind that since childhood, the leading driver of my depression and anxiety issues has been living in a neurotypical world and being autistic – and for a long time not even knowing I was autistic. This world is hard for all autistic people, don’t get me wrong; but when, like me, you’ve lived a long time before you find out you’re autistic (I was diagnosed at age 54), it does add a different slant to things. As a young man, I fought back against how I was feeling by masking with incredible determination and aggression, and mentally compartmentalizing my fears about being different. For a long time, I did this quite successfully, by some measures. But of course, it is not sustainable to try to live as someone you are not, and to pretend problems don’t exist. For me, it led to autistic burnout so catastrophic that I have literally never been the same since. And this burnout has changed the nature of my depression and anxiety issues. My resistance to stress and other triggers of depression and anxiety is now irreversibly impaired. My “normal” state of being is now what would be a pretty serious case of depression for many people. I continue to carry on, but I get physically and emotionally exhausted so much more quickly, now. And with my mental health level being at such a permanently low ebb, when I get a flare-up of depression and anxiety, the results can be pretty grim in terms of my ability to function. That’s what happened to me a few weeks ago, when I plummeted into a pit of despair, and had to seek help. Unfortunately, help, for me, can be difficult to come by…
I have a pretty good GP, who listens to me, and understands. But he is not a mental health specialist. He did offer me some guidance which has been helpful, and I’ll come to it shortly, but before I do, let me talk about what was not helpful, didn’t work, and has left me frustrated…
My GP recognised pretty quickly that I needed some kind of specialist support, and asked me to self-refer to IAPT (the Improving Access to Psychological Therapies service. I completed an online referral form, and was pleasantly surprised to be given a date for a telephone consultation with a mental health professional very quickly. I say pleasantly surprised, but I should qualify that; phone calls, video meetings, and live online “chat” are things I struggle with quite badly, and these difficulties were actually part of what led to my eventual autism diagnosis. Anyway, the phone consultation happened, and it was quite a way in when I referred to something about my autism, and the consultant revealed he hadn’t realised I was autistic. This was despite me making it clear on the referral form that I was autistic. This did not fill me with confidence. A suggestion for anti-depressant meds was made, but my GP had already agreed with me that anti-depressants are not a great option for me, due to the side effects I have experienced in the past. CBT (Cognitive Behavioural Therapy) was also suggested, but I’ve already tried it twice in the past with no benefit; it’s just not right for me. The consultant then suggested an online course, using Microsoft Teams, which – if you read the first part of this paragraph – you will understand was a non-starter. Finally, the consultant admitted he had little or no knowledge of autism, and – while still on the call with me – googled to see what support might be available in my city. He recommended a website for me to try. With that, he told me he would discharge me from IAPT, and wished me luck. When I looked at the website he gave me, it was actually for the place that had originally given me my autism diagnosis, and where it had been suggested I could try IAPT for further mental health support… What a mess. As many late-diagnosed autistic people like myself have found out, there is little or no appropriate mental health support for us. The key here is the word appropriate. Some autistic people, of course, respond well to anti-depressants, or CBT. We are all different. But for many of us, our neurodivergence is such that these approaches to our depression and anxiety are not relevant. So we struggle on.
What, then, is the solution for me? I have to find a way of making my life easier, thereby reducing the number of stressors and triggers in my life. The last couple of years have been tough, the last 12 months particularly so. Problems with my spine and shoulder, and some other physical health issues haven’t helped. My domestic situation – the breakup of my marriage and living in this flat – are also difficult. There’s a lot of stuff I need to work on. But is there anything simple and practical I can do right now that might help me just… feel better?
One helpful thing my GP did was to point me to a couple of podcasts about mental health and diet. One of these in particular fired me up. I have always known that it’s important to think about how you refuel yourself – that’s one of the reasons why I always feel guilty if I drink alcohol, and I’d already decided to stop the occasional evening glass of wine some weeks ago. But what about food? After listening to the podcast, I felt like I’d been given a wake-up call, and I had a critical look at my diet. It was not good. The research discussed in the podcast showed a quite stunning correlation between diet and mental health, and how mental health can benefit from improvements in diet. I had gradually, due to a slow slide into depression, let my dietary choices get increasingly worse. For most of the days of the week, the quality of my food was appalling; ready meals, high-fat food, high-sugar food, lots of processed stuff, and large amounts of high-calorie snack foods; chocolate, crisps, ice cream. And while I would make an effort for healthy main meals at the weekend, putting fresh meat and veg in the slow cooker, my weekend breakfasts had become massive, unhealthy fry-ups.
When I looked honestly and critically at what I was eating, I was aghast. I took action. I will remain alcohol-free for the foreseeable future. To be honest, I think that will be permanent, now. I have real concerns about the health implications of alcohol consumption. I have also, in a move that will shock anyone who knows me, stopped eating crisps altogether. My healthy eating choices are made at the supermarket; if I don’t buy crap, I can’t eat it. My evening snack, for example, has changed from bingeing on crisps and ice cream, to having a bowl of fresh grapes and berries with natural yoghurt. I’ve bought myself a wok, and had a go at healthy stir-frying, which, considering my mental block with cooking, has gone surprisingly well. My fridge and cupboards are now full of fresh, healthy food. I’ve been eating like this for a couple of weeks now, and I have actually started to feel physically better for it. Will a change of diet solve everything? Of course not, but it might help. I’m looking to make incremental improvements to my life which will hopefully lead to a longer-term easing of my mental health issues. There is a definite link between diet and mental health, and I’m banking on that as part of my toolkit for improvement.
I don’t really know what the future holds for my mental health. I’m trying to take control of things, and behave in the right way to look after myself. But the latest flare-up of depression has taught me that when I think I’m in control, I’m probably at my most vulnerable to something going wrong. Depression is a sneaky bastard that cosies up to you all subtle like, and then suddenly punches you in the gut. The struggle is ongoing.
If you’re interested in the podcast I listened to, here is a link to the YouTube version: https://youtu.be/HBKqU3YSiTE
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That’s all for this week. Until next time, take care.
Darren
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Why Do I Write This Blog?
When I first found out I was autistic, I was a middle-aged adult and I knew nothing about autism. I quickly learned that there was a serious shortage of information and resources for adults in my situation. With this blog, I aim to inform about autism and autism-related issues as I learn, hopefully helping people who are on a similar journey of discovery. Like anyone who writes a blog, I want to reach as many readers as possible; if you like what I’m doing, please share it with your friends and followers. I will never hide this blog behind a paywall, but running the website does incur costs. If you would like to support, feel free to make a small contribution at BuyMeACoffee.Com.
You might also be interested in David Scothern’s blog, Mortgage Advisor on FIRE, which covers a range of topics including mental health issues and financial independence.
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