off the spectrum

I wrote previously that my new therapist asked me to do some research about autism, and see if I thought I might have it. I looked at multiple reputable sources, and after reading many lists of symptoms and presentations, I don’t seem to fit the overall autism profile. I suppose some of the criteria could apply to me, but it seems like two general patterns of autistic behavior are a lack of understanding of social norms, and difficulty with communication. I don’t feel like those two conditions apply to me at all, currently or in the past.

I know autism is a broad spectrum of different abilities and limitations, and it expresses itself in different ways with different people, but it just doesn’t feel right to me the way other diagnoses feel right. My actions and behaviors seem to be better explained by a combination of bipolar, ADHD, and personality changes resulting from years of emotional abuse in childhood. Even if my therapist and I decided I was a little bit autistic, what good would it do for me to have another label? There’s no treatment, and having that diagnosis doesn’t help me solve anything.

When I was diagnosed with bipolar, it explained everything that had happened up to that point in my life, and I finally got the treatment I needed. After being diagnosed with anxiety disorder, I am working on ways to finally deal with childhood traumas in order to help cope with my anxiety. I have also been diagnosed with avoidant personality disorder; I haven’t researched it extensively, but it seems to describe my thoughts and behaviors related to social interactions. My psychiatrist and I discussed OCD, and it seems to fit pretty well, but we didn’t really dive deep into that rabbit-hole. And although I haven’t been officially diagnosed with ADHD, I am very sure I meet almost all of the criteria for the inattentive type.

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disorders on order

I feel like I’m being pulled in many different directions right now, like that Stretch Armstrong doll when I was a kid. I don’t have much time for myself, and I have to be “on” a lot. I’m often asked to solve the emergency of the day. I have to play different roles for different people, and it is really tiring right now. I need a break, but I don’t have time for a break. I have one vacation day remaining at work, and I need it for something fun in September.

I have so many unfinished tasks and projects, and it’s a trigger for anxiety. I can feel it closing in around the edges of my vision. I wish I had the motivation to finish a few things, or just to make progress, but I give up because I can’t break things down into manageable pieces. It’s all or nothing, and I know it is distorted thinking, but as a result I’m mentally paralyzed.

I have been officially diagnosed with social anxiety and general anxiety, and I’m certain I have ADD and some elements of OCD. I don’t know how likely it is that someone has all of these things going on, but here I am. My new therapist asked me to consider if I might be on the mild side of the autism spectrum. I’m skeptical, but I’m doing some research to see what I think. I don’t think I need another label at this time, so I will ask her to table that discussion and help me work on social anxiety (which currently seems to be my biggest problem).

therapy 5.0

You might recall that I didn’t seem to connect very well with my previous therapist, who was intent on making me do mindfulness techniques despite my lack of enthusiasm. He then suddenly left the practice, and I declined his invitation to follow him to his new office. I thought I could work on my anxiety on my own. Yeah, right.

This week, I started seeing my fifth therapist, who works at my psychiatrist’s office. The first appointment is always difficult, especially for someone like me who feels awkward talking about myself, to a stranger, trying to summarize my dumpster-fire life in an hour. I started out very nervous, like it was a test I had not prepared for; she actually offered me some fidget toys if they would help. I passed on the toys, but I calmed down a little while we talked.

She seems like a good listener; even though she was typing notes as fast as I was talking, she asked the right questions when necessary. She appears to be quite young, but I don’t have any problem with that. Her personality would be good with children, but she didn’t treat me like a child. Overall I got a good feeling from the visit.

After the short life history (which I struggled to keep short), she asked what the most important things were to discuss. I told her that I have already written a “field guide” to my many mental health problems, but maybe we could start with my social anxiety and general anxiety. She was interested in reading my lists, so I will print that out for next time.

I’m guessing that starting with a new therapist is as difficult for everyone else as it is for me. I am forced to immediately allow her within my “trusted circle” rather than getting to know her slowly, which is quite unnerving. This is a place where only a few people are allowed, and yet here is a stranger I am telling things usually only reserved for my blog friends. At the same time, I have to remember she is a professional, paid to listen and help me solve problems, and we’re not going out for coffee afterward.

ending therapy

I received a letter from my therapist explaining that he is no longer practicing at my psychiatrist’s office, and my scheduled appointments are canceled. If I want to continue seeing him, I would need to visit him at his new location.

After some thought, I’ve decided I’m not going to continue therapy with him, or anyone else. I was thinking about ending our sessions anyway, as I wasn’t getting a lot of benefit out of them. His emphasis on mindfulness didn’t seem to work for me, and sometimes he appeared to not really have any alternatives. There were a couple uncomfortable moments where he would struggle to find something to talk about. He might be effective for someone else, but apparently not for me.

I’m not really emotionally affected by this. I know some people have a true connection to their therapist and see them as a lifeline to their continued mental health, but I never had that feeling. In the past I have had the idea that I “failed” therapy three different times. I don’t feel this was a failure for either me or the therapist, I think we just weren’t compatible or complimentary.

When I started seeing him, I wanted some techniques to work on the constantly increasing anxiety that I struggled with a year ago. I now think it was a physical effect of a long manic episode, because my anxiety slowly decreased when we got the medication right. I still have plenty of anxiety, but it has returned to a manageable level at this time. I don’t think I need individual assistance in dealing with my problems. I need strategies to work on my social anxiety, but I think I can do it on my own at this time.

up, down, sideways

I have been in the midst of a hypomanic spell, but I think it has ended. It was actually more of a mixed mood, because while I was exhibiting my typical signs of hypomania, I was depressed as well. During these times I have especially jumbled and chaotic thinking (more than normal), decreased ability to concentrate, feelings of work-related stress, increased nervousness and anxiety, restlessness, irritability, higher blood pressure, decreased sleep when I need more sleep, and increased appetite. I also increase the rate at which I pick at my fingers, leaving them raw and bloody sometimes (which warrants a separate post someday). At the same time I have very depressive thoughts which take the form of catastrophizing, lack of self-esteem, pessimism, and obsessive thinking. 

Ironically, I produce some of my best poetry during these times when my creative energy is high but my thoughts are especially dark. I wrote something the other day which is honestly too dark to share right now, but it sits on my computer as a reminder of my thought process at the time.

I had an appointment with my psychiatrist during the middle of this phase, and it was very stressful for me. First he took my blood pressure, and it was 162 over 105, which is not good; I take medicine to control my BP, and usually it is much lower. I told him I wasn’t surprised; I tried to explain what was going on, and tried to discuss ADD symptoms (another future post), but I wasn’t expressing myself very clearly. In addition he had three med students in the room (all females), and it was a little distracting with them listening. Then there was a banging on the roof, which kept taking my attention away from the moment. He worked with me though, made an adjustment to my medication, and I felt better as I left. 

However … I wondered if the P-doc and the students talked about my case, and it bothers me not knowing, but obviously I’m making too big a deal out of it if it is still on my mind. I overanalyze and obsess over every social situation, because I feel like I fuck up most of my interactions with people. I feel like I said the wrong thing, or I was misunderstood, or that they are judging me afterward (the worst). I always wish I could think about it, then go back to the situation and fix whatever I did poorly the first time (as if that would work).