Wild Idea?

A year ago today I posted the following status on my facebook wall:

What a day. Along with flu jab and asthma review, a very successful meeting with the doc who listened to a whole load of my waffling and has put in a referral to the sort of docs who will try to fathom what’s going on between my ears!*

Feels like a huge relief and real progress.

*good luck with that then folks!

Since, at the time, I wasn’t telling very many people about the “autism hypothesis”, I didn’t elaborate further on my visit to the doctor. It was easy just to talk vaguely about what might or might not have been going on between my ears and also to refer, as I did in another post, to “head stuff” because it had been well known for years that I had considerable mental health problems and I was already totally open about them, so, for most people that probably covered it.

What I didn’t mention at the time was that we’d purposely made a double appointment with my GP, and that I took my husband and about a dozen pages of notes with me. We’d made the notes while out on a walk a few days earlier (“Starting to examine my childhood”, from Still Here), taking 25 kilometres and six hours and several cups of coffee to persuade my brain to start thinking back to my childhood, and to pause every so often while my husband wrote my rambling thoughts down in a notebook he was carrying. I think very much better while on the move – in the car, walking, running – so it seemed like a good way to approach things. It had been a strange process, forcing myself to think back and to remember things I hadn’t thought about for decades – as far as I was concerned, the “real childhood memories” file had been closed long ago and I just remembered the sanitized version as part of my life narrative. I certainly hadn’t tried to remember the difficult bits, the painful bits, the bits that were needed for an autism diagnosis.

We’d already been at the surgery for some time before the appointment with my GP because it was also time for asthma reviews and flu jabs, so we’d seen the asthma nurse and discussed inhalers and so on first. By the time we were in the waiting area for the doctor I was ready to go home. I regretted that the only way of getting to the surgery was by car and so I couldn’t even have a drink to try to calm myself down. We sat and stimmed in the waiting room (although we still didn’t refer to it as stimming at that point as we’d only seen the word a few times and weren’t quite sure what it actually meant), and I was determined not to bottle it and give up.

I didn’t even know, back then, what “self-diagnosis” was. It didn’t occur to me that, having found something that might be “wrong” with me, my first course of action wouldn’t be to go and see a doctor, not because I had any notion of being “fixed” but because I believed that, as with bipolar disorder, with which I had considerable experience, autism was something the medical profession might help me manage (that turned out to be somewhat optimistic on my part)! I also, even at that early stage, needed official permission to “be autistic” and the thought of telling anybody that I was without an official piece of paper seemed far too wild to even consider. My thoughts on official diagnosis were developed further as time went on, and I examined some of them in Why Bother?

Once we’d been called in for the appointment, the conversation ran something like this:

Me: Hi Doc, this is going to sound well random and well weird and you’ll probably think I’ve gone even more bonkers than I usually am, but I had a bit of a strange summer and my head went a bit wrong and a bunch of folk said they thought I might be autistic or something so I read a couple of books and we made some notes about all sorts of stuff and, er, here we are, and, yes, I know it’s a bit barmy and a seriously wild idea and stuff and… but anyway… erm… well…

(all the time, jiggling my leg, flapping my fingers, and staring fixedly at a bit of badly done paintwork in the corner of the room)

I then looked hopefully at my husband because I’d run out of what to say next.

The doctor saved both of us having to say anything.

Doc: Oh of COURSE! It’s so absolutely obvious now you mention it. So sorry for not knowing earlier, but with only short appointments and so much to get through and so little time to spend with you…

(then, the doc paused, as if a thought had just come out of the blue)

Doc: Didn’t you have an incident at the swimming pool a few years ago? And they called us here and said you were violent and aggressive and you came in and said you weren’t violent at all but you were scared and distressed and they’d got it all wrong…

(there followed discussions of meltdowns, of how these episodes had been happening all my life, and of various other things, and by this time I was rocking hard in the chair and the pennies were dropping fast in the doc’s head, just as they had in mine a couple of weeks earlier)

The referral for formal assessment was being started before we were even out of the door. My GP had needed no convincing whatsoever. I didn’t know then that that had been the easy bit, and that finding somebody who could actually diagnose me as autistic would take a whole load more work, and that “letting the medics take it from here and look after me” wasn’t an option, and that I’d have to do my own research, fill in forms seemingly infinitely (that’s what it felt like at the time), and that I was only at the beginning of a very long journey, but that journey was underway.

I left the surgery and went round to my best mate’s house for tea. I told him that yes, the doc thought I was autistic too. He already knew what was going on and was totally cool with the whole idea and thought it made absolute sense. I then went off to a rehearsal that evening, and then away for the weekend to play music, still very fragile and broken after the summer, still reeling from the discovery, but starting, already, to accept myself as an autistic person, even at that stage. I still hadn’t actually said that I WAS autistic at that point – every time I mentioned it to anybody it was “it’s been suggested that I might be autistic” taking the label (or diagnosis, or whatever you want to call it) for myself without anyone giving me permission to seemed to be terribly presumptious at that stage, so I stuck to “might” and “a possibility” and so on.

The fact that my GP believed it made a huge amount of difference though, and something that had been “just an idea being pondered by me and a few mates” became something a little bit official. We’d told someone “proper”, who hadn’t dismissed the idea, and had, in fact, confirmed it.

I regained a little bit of confidence. Maybe I wasn’t totally crazy after all. Maybe this wasn’t some sort of “weird thing that happened over the summer but now we’re back to normal life everything just goes back to how it was and the “holiday romance” is over!”

It still felt really odd. Two months earlier I’d had absolutely no inkling that I might be autistic at all. I wasn’t one of those people who’d “suspected for a while” because I didn’t have enough knowledge of anything to suspect. I’d only started taking the idea seriously and investigating it properly myself about three weeks earlier. The whole of life felt so very peculiar and weird and like it had all gone a bit crazy somehow. My mental state was still fragile, and was, in fact, although I didn’t know it at the time, getting worse. Things felt wrong…

…but things also, suddenly, after over 4 decades of a different sort of wrong, felt right.

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The Preamble

I have become increasingly conscious over the last few weeks that there is a significant part of my “autistic journey” still absent from this blog. I’m also conscious that I have so far erred on the side of pointing out some of the inadequacies of services available, and that the only account of an autism assessment I have thus far published is a pretty scary and negative one.

It is true that I have encountered some difficult times during the diagnostic process and that there is much that could be improved. I still look back to the end of November 2016 with some horror and still hope to be able to feed back what happened at some point (one reason I try to type things up is so that they don’t vanish from my mind). And I also look back further to other “care” I have received, including the unhelpful GP who, two decades ago, told me to stop crying and sent me away with a packet of citalopram, and the counsellor I saw, a decade ago, who told me that it was my fault I didn’t fit in with the people at the office and I needed to try harder and learn to wear make-up and be able to discuss it and so on. These times were not good.

However, I can also look back into the history of my mental healthcare and pick out some people who were really good and really helpful. The locum GP who first referred me to a psychiatrist, realising how terribly ill I was, my current GP who has been totally supportive throughout, and a team of people who really did help with issues relating to my mental health and bipolar disorder in particular – an excellent CPN (community psychiatric nurse) and several charity workers who were brilliant. And I can look back into more recent history and see that the triage service (the stage between my GP appointment and my autism assessment) were also as helpful as they could be, and that I eventually ended up having a thorough, helpful, and successful autism assessment, carried out by people who really did know their stuff and really did help me to work out what was going on.

The only comparison I’ve thus far made between the two assessments I went through has been that in A Tale of Two Assessments, but now is the time to expand upon that post a little, and to try to write up, as best I can, five months on, what happened at that second assessment (or, indeed, third, if you count the assessment that was cancelled only hours before it was due to happen). Unlike the first assessment, which I didn’t write up for nearly a month because it was so triggering and upsetting, I’ve left the second assessment until now partly because external factors intervened (my father’s cancer diagnosis, various events to which I was committed, the need to sort out admin that had piled up prior to diagnosis, working on the report with my assessor) and partly because I have simply been exhausted and trying to process the whole thing. I knew, from reading what others had said on the topic, that getting a diagnosis would come with a whole load of conflicting emotions, and my assessors had also told me that alongside the relief would come a whole lot of other stuff, so I was prepared to go through another set of ups and downs like those described in Various Feelings.

What I had been less aware of is just how exhausted I would be, not only from relief because the fight to be recognized and validated was over and my life finally made sense and so on, but also from the energy used to gather the information over the preceding months. Looking back now, I can see that my life, from the end of August 2016 onwards, was almost totally taken up with researching autism. I read over 20 books, hundreds of blog posts, and spent hours and hours making lists, going through traits, going through my life, discussing with a few trusted friends, filling in quizzes and forms and questionnaires. The enormity of the discovery sent my mind into overdrive, and throughout September, October, and much of November I hardly slept or ate, was permanently on a sort of hypervigilant alert, and had a really intense time of discovery, of learning about my early childhood, of piecing things together, and of finally learning how to listen to my body and allowing myself to stim intensively, often for hours each day. Four decades of masking suddenly ended, the energy to pretend gone, completely burned out, and autistic me emerged somewhat powerfully.

Then came the first assessment and the crisis that followed it. My burnout finally reached the stage where I spent a lot of the time in shutdown, increasingly nonverbal, and retreating from the world, just trying to survive. However, the job of getting a diagnosis was still not done, so I kept pushing and pushing, started this blog, gathered more evidence, went through more stress, and my husband worked like crazy to get me the second referral to the team who eventually diagnosed me. Having been through the six months prior to February, it’s not really surprising that once the objective was achieved, I was utterly exhausted. And I still have to cope with being autistic, in my mid-40s and in perimenopause, working out where to go from here, and trying to maintain sufficient levels of self-care not to fall apart completely. I’ve also, tentatively, started to sort out the pieces of my life that were abandoned several months ago and have started to get back out into the world a bit more and begun the process of working out where I go from here, as I’m finally beginning to regain a bit of functionality again.

But now I am as ready as I’ll ever be to fill in the gap in the story of my diagnosis, the tale of the time between Weekend Journal and An Announcement, and of the five hours of my life that gave me the validation and permission to be myself and confirmed that what I’d learned over the preceding six months was true, confirmed by somebody who clearly knew what they were talking about and was willing to give me as much time as I needed to explain, to talk, to work things out, and who made the experience as smooth as it possibly could have been. I can’t yet predict how many blog posts telling this story will take, nor how long it will take me to write them all, nor what other posts I might feel moved to write in between times, before I complete the whole “diagnosis” story, but once I’ve documented the whole process I’ll try to find some way of linking everything up so anyone who’s interested can follow everything sequentially. I’m in the process of trying to organize the whole blog a bit better anyway.

It’s strange now to think, just over five months later, about those five hours on that day. It was a day that had been long awaited in several senses – the time after the first assessment had felt like an eternity, the months following the discovery had been intense and focused almost entirely on getting a diagnosis, and the four decades of a life that didn’t quite work had finally got to the stage where all those little things that weren’t quite “right” would be explained and validated by one sentence on one rather surreal day.

It was certainly one of the most significant days of my entire life!

The Incident

I can still remember the moment, even though it was some years ago now. It was the moment the woman kicked me, and then shouted at me, and I went into a total panic, terrified, unable to articulate anything, unable to cope, and my senses went haywire and I needed to scream and run away and not be where I was any more and everything felt terribly terribly wrong.

Running away at that moment, however, was really really difficult. The best I could do was to get to the side of the pool, get out as fast as I could. Shaking and trembling I managed to retrieve my stuff from the locker, put minimal clothes on over my wet costume, then slammed the locker door, screamed in anguish, and ran towards the exit of the leisure centre, and to my car, and to safety.

Except that I never reached my car. The manager of the leisure centre stopped me and wouldn’t let me leave. She made me sit down and I started to feel really sick. She started talking about police. I started to think “Oh fuck, this is seriously bad news”. I managed, just, to say the words “Mental health” to her, hoping desperately that once she realised I was in the middle of what I believed at the time was a really bad panic attack she’d let me go. She didn’t, although she did decide not to call the police on me, but instead called the local doctor’s surgery, taking my name from my leisure centre admission card.

Eventually I was deemed calm enough to be allowed to leave, and I returned home, where I then received a call from the surgery, which didn’t help matters at all because it reignited the panic. I slammed the phone down on the doctor, desperate to be left alone.

I never went back to that particular leisure centre, even though I had a membership that had some time still to run. I swam a few times again at a different pool, until it became too much and I just gave up swimming, even though it was something I loved doing, and, at the time, was the only regular exercise I took. Somehow it was just too difficult and the memories of that “panic attack” were just too painful.

I saw my own GP shortly after the incident and tried to explain to her what had happened and to get the incident erased from my medical records. It had been reported and noted that I was “violent and aggressive”, which I disagreed with. I didn’t feel violent or aggressive – I felt scared and distressed and not in control of my actions or my head, like there was some sort of explosive reaction inside me that I was powerless to stop. There was no violence. If anything I was trying to STOP anything that might have been perceived as violence, trying really hard to stop whatever it was that was making the world feel so awful at that moment.

My GP was sympathetic but said she couldn’t erase the record completely, however, she would add to my notes to put my side of the story on there and to point out that I had a history of these rather extreme “panic attacks” and that none of it was my fault. It was a damage limitation exercise at that point, but it was the best I could do.

Just over three years ago we moved to a different area, and to a place within easy walking distance of a swimming pool. I was aware that it was there. I took up running shortly after we moved and ran past it fairly regularly. Before the “incident” (as it is now known) I’d have been straight down there and joined, but I hesitated, because swimming had ceased to be my thing, even though it had very much been my thing for many years. Running was now my thing – it was safer, easier to be alone, with no time constraints, and so on. However, I did eventually take out a membership, which I only used once – after I’d run my first marathon someone said to me that swimming was a really good way of recovering, so I went down to the pool and did 42 lengths (one length for each full kilometre of the marathon distance) a couple of days after the race.

Then last September I went to see my GP again, following the suggestions from several friends that I might be autistic. My husband and I took quite a lot of notes we’d made about my childhood and my subsequent life and a list of things we’d taken as examples of autistic traits that were listed in various books we’d used for research. I think I started by saying something like “This is going to sound really random, but some folks have suggested I might be autistic…” before letting my husband take over the narrative because it all felt so weird.

My GP almost literally kicked herself and said something along the lines of “Of course, why didn’t we see this earlier?” or similar. And then, in a further “lightbulb moment” she mentioned, unprompted by us, the “swimming pool incident” and at that moment it became obvious that what had happened that day, several years earlier, was not a panic attack but an autistic meltdown (one of rather a lot of such things that have happened over the years). Bizarrely, the incident I’d tried so hard to have erased from my medical records actually confirmed the autism hypothesis, and my GP was writing the referral for a formal autism assessment pretty much before we’d even left the room.

After that one post-marathon swim, well over 2 years ago, I never went back even to the new pool. I discovered quite quickly that I could recover from marathons perfectly well without swimming, and something I’d enjoyed as a child, absolutely loved as a student, and done reasonably regularly throughout adulthood simply disappeared from my life. I had running now in any case, so it really didn’t matter whether I swam or not.

I’ve pondered for the last year or so whether I’d ever swim again. I vaguely have in mind that I’d like to do a triathlon some day, so thought that swimming might feature in my future somehow, although it was always “in the future” and since I don’t currently have a working bicycle or anywhere to keep one, triathlon is still firmly “in the future” and will probably require another house move in any case.

But last week a friend of mine went swimming. And I was suddenly rather envious. And I googled the opening hours of the pool to see when they might be. And I found my swimming bag, as it had been left, over 2 years ago, with costume, goggles, towel, and so on, all ready to go. Maybe? Just maybe? Then this morning on my facebook memories from a few years back there was a status saying that I’d been swimming for the first time in a year (evidently one of the times I was trying to get back into it, but that didn’t stick).

And the temptation was finally too much. Armed with the knowledge that it would be a total sensory overload experience and that how far I’d get with it depended not upon my physical swimming ability, but upon my system’s ability to cope with noise and light (even though my goggles are slightly tinted, they’re not as dark as I’d like) and being in close proximity to other people. KNOWING this was the case I was better prepared than I have been in the past, and the magic of the internet was also able to provide a little graph showing when the “least busy times” were, so I picked the time when it was likely to be emptiest (over lunchtime as it turned out), and it was indeed quite empty in the main pool.

And I bought a single swim, not a membership, so there’s no pressure to go again. If it turns out to be something I can manage to do regularly I’ll consider a membership at that point – rather than going in fast and crashing out, I’m trying to take it gently, one swim at a time, and not pushing how long I stay in the pool until I work out what my sensory system can cope with because I really really want to avoid a repeat of the meltdown scenario, which should be easier now that I know what it was all about and what caused the “incident” all those years ago.

Being back in the water was lovely. My arms aren’t as strong as they were, and my cardio isn’t what it was a couple of years ago (I already know that from recent running exploits), but I happily swam 40 lengths – I thought I’d go for a kilometre to be gentle, rather than the mile that used to be my regular swimming distance for many years. I was conscious that the real challenge wasn’t the swimming at all, but just being in the pool with people and noise, and I was trying to monitor how that felt. So far, so good, although I was pretty wrecked when I got home and needed total dark and silence for a while to calm down.

Who knows what happens next. One swim at a time for the moment. But I’m hopeful I’ll get back something that I used to love, now I know what caused it to go wrong several years ago.

Talking and Listening

As a runner who has mental health issues it was, of course, a foregone conclusion that I would watch a television programme entitled “Mind over Marathon” – an account of how a group of people who have a variety of mental health conditions train to run the London Marathon in order to help improve their mental health. The programme is presented by a good and sensitive presenter with a team of “experts” to help, and also features a couple of young princes who are advocates for mental health awareness.

As a blogger who is currently trying to use the written word to explore my feelings about various things it was, of course, a foregone conclusion that my brain would be fizzing with thoughts that needed translating and my fingers would be itching to get to the keyboard in order to do that work. How successful I will be in trying to impart some of those thoughts, who knows, but I’ll give it a try.

But first, two really really big disclaimers, or “health warnings” or whatever you want to call them, about what I want to write later on.

ONE

I am in absolutely no doubt at all that it is massively massively good thing to talk about mental health. I think it’s great that young royals are getting involved in the whole business and raising awareness and making mental health part of the discourse of current life. Anything that can be done to “normalise” words such as “mental” (one of the participants on the television programme mentioned how uncomfortable he was using the word because of the derogatory connotations it sometimes has) and, indeed, “autistic” (which I’ve heard people say mustn’t be used because it’s an “insult” – er, no, if people are using it as an insult then they are misusing the word) is a good thing as far as I’m concerned. To take words such as “mental” and “autistic” and treat them in some ridiculous Voldemortesque way simply continues to ignore issues that need addressing in many people’s lives.

I have seen many posts online indicating that “It’s all very well for wealthy figureheads to talk about mental health, but what about the ordinary folk?” I have heard those messages and, to an extent, agree, and in no way do I believe that “Prince Harry says talk about mental health” means that the job is done and that “awareness has been raised” and we can all now comfortably go back to ignoring the real, everyday, practical problems that people are facing. BUT, out of my bubble of friends and online pages and groups, most of whom are pretty savvy about mental health issues (“mental” is a commonly used word in my life and I’ve been open about mental health issues for decades), there are still those out in the wider world who are not taking these things on board (some of the comments on mainstream media facebook pages alone are enough to indicate this is the case), and if a high-profile person talking openly helps, then yes yes yes, all to the good. Yes, a young privileged man who has suffered exogenous mental health issues as a result of going through the process of grieving the death of his mother in the public eye is not one with which most of us can relate, but it is valid personal experience and he has used the advantage of his position in the public eye to open the discourse.

TWO

I am also in absolutely no doubt that exercise has a huge and important role to play where mental (and indeed physical) health is concerned. I absolutely don’t need to be convinced about the wonder of running – I’m an ultrarunner and in the ultrarunning community it’s well-known that people have overcome depression, addiction, and all manner of other difficulties through the power of running. I don’t need to be convinced to enter a marathon – I do that just because I like doing it. I enter the ballot to run London every year but am yet to be successful. Running is awesome and cool and fabulous. I’m currently frustrated because my own difficulties currently mean I’m struggling to run and I’m really really keen to get back to it and gently pushing myself in that direction whenever I have the energy. I do not need anyone to tell me about the excellence of running – the sheer wonder that comes from being out on the trails alone in the middle of the night, with the moths fluttering in my head torch, is more than ample to persuade me.

I am, however, aware that running per se (and particularly yomping around the countryside alone at night) might not suit everybody and that other forms of exercise are available. Some people prefer to have a team around them, some have physical impairments that mean swimming is gentler on joints, and there are many barriers to some people exercising at all – it’s by no means easy, and it’s no panacea, rather, part of a toolkit that can really help improve mental health in some circumstances. I am also aware of the dangers of exercise addiction and its link to eating disorders and that not every journey to run a marathon ends in a triumphant finish line smile – for some, the stress of training or the frustration of injury can make mental health worse, not better. But, with these provisos, and other similar ones, I absolutely see how wonderful exercise can be, and it can play a really important part in achieving and maintaining good mental health.

***

Having said all of the above, what do I now want to add? What actually prompted me to write this post? And how can I address the issues to which I have alluded above?

The moment that triggered it for me was the point in the programme where they were interviewing a young woman who was clearly struggling with coming to terms with a massively traumatic experience in her life several years ago. Her child died suddenly, and her husband, overcome by grief, killed himself shortly afterwards. And this young woman sat on the telly and recounted what support had been available to her at the time – or, more accurately, recounted that there had been NO support available to her at the time. Nothing.

I don’t know what has occurred with her in the intervening years, and neither do I have the energy to do a research project on it, but it strikes me as shocking that her issues are only really being dealt with FIVE YEARS LATER! Five years is a very long time to be in mental anguish before you are eventually picked up by a TV programme. And, even now, it seems that in order to get the level of support that the TV people are providing, in terms of “experts” and so on, the woman has to run a bloody marathon – literally! (Please see disclaimer TWO above – and, of course, the marathon is the point of the programme).

And, watching the programme I was struck, not by the rigors of marathon training (that’s all familiar stuff to me – I went, as an obese fortysomething, from couch to marathon in seven months a couple of years back, and the training, exercises, foam rollering, so on are all part of the deal), but by the level of support that these people were given. Admittedly, the support came with a rather large side order of “we’re going to film this so you’ll be exposing your emotional vulnerability on national telly”, which I didn’t have to contend with, but neither did I have a cuddly TV presenter or an “expert” come and look after me when I was shaking because of the stress of leaving the flat before going out on training sessions – I had to do that bit on my own. The TV marathon training programme is therefore not looking at the effect of exercise alone on mental health, because it is providing these people with someone to talk to, someone who will listen to their issues (both the people on the show who can give feedback, and those of us sitting on our sofas at home), and that listening is really important.

I have been talking about mental health online for around a decade now. I’m pretty cool with it. I very quickly became totally public about being autistic. I talk about both mental health and autism. A LOT (probably too much, truth be told). When I have been in mental health crisis I have posted on my facebook wall and the overwhelming advice has been “seek help”, “go to see your doctor”, “get referred to a specialist”, and so on. So I have tried, on many occasions, to do just that. But it is a fight, and if you are already struggling, already finding life difficult, and already reluctant to ask for help because you feel, somehow, that it is your fault you are feeling this way (there’s an awful lot of guilt comes with many mental health conditions), then fighting through the system to get the help you need can be a seriously tough process. And if you have nobody who can advocate for you then it’s even worse. Persuading someone to listen to you can be very very difficult.

The problems I had trying to get an autism diagnosis in a psychological services department and my analysis of the situation are documented earlier on this blog (the only “treatment” available to me at that time was to “go to A&E” if I actually tried to kill myself). I was struck at the time by how little cohesion there was between the different services available and how there seems to be nobody available who can deal with all of my issues, as well as the fact that those with really low self esteem are seen in a building so dilapidated that the plants are growing through the wall! Even the superb autism service elsewhere that eventually diagnosed me as autistic, cannot, for example, suggest any medications that might help with the anxiety I get, and neither can they help me establish whether I also have comorbid ADHD (all the online tests and so on and research I’ve done suggest that I do), because that’s somebody else’s department (if I can ever find “somebody else” and can face the exhausting process of telling my life story, yet again, to another stranger).

So “seeking help” is not as easy as it might seem. In fact, for most of us, it’s really jolly difficult. I have heard tales of people who are totally broken being offered “telephone CBT” (when you’re vulnerable, you get rung up by a total stranger, who gives you your allotted time on the phone then hangs up, leaving you in a worse state), people who are unable to communicate with services they need because communication is only by post (not so good if you are frightened of opening the mail because of what it might say), and, people asking for help with fear of the telephone and who struggle to speak on the phone being given a leaflet and, yes, you’ve guessed it – told to call a telephone number!!!

Equally, “taking up exercise” is not as easy as it seems, especially when you’re mentally unwell. If you feel insecure and frightened walking down the street (many of us do) then you’re unlikely to find going out to walk or run very easy. Furthermore, if you want to swim, or join a gym, or get any sort of personal trainer, then it is expensive, even at reduced rate, and many mentally ill people are out of work and struggling financially – if you have to choose between paying your rent or joining a gym then you’d be pretty daft not to pay the rent. When I started running I was lucky – I had enough confidence to get out of the door and a husband who supported me all the way. I had enough money to get a pair of trainers and a sports bra to get started with (this wouldn’t always have been the case in my life), and I live in a place where many people run, and it isn’t a big deal. I also have serious hardcore willpower and a level of “persistence” that gobsmacks most people (possibly one of my autistic traits), but many do not. Though I know many people who are trying, some even apparently inspired by my own accounts of running and so on.

I fear I’ve raised more questions than answers here, and maybe that’s actually what’s needed. My experience in both the mental illness and autistic communities has been that so much of the support comes from within, from people also struggling. I am trying to work out what might have enabled me to continue in employment in order to help those might follow me and be able to maintain jobs where I couldn’t. I have developed strategies to support myself based on the writings of others whose blogs I read. There are groups and people everywhere trying to piece things together and help each other.

Equally, and, sometimes surprisingly, the running groups and fitness groups have also provided a source of support for me and, I observe, for others. Those who do not have the support of a TV programme have to look after each other, encourage each other, either to get out there for a run or whatever, to cope with the frustrations of injury, or to discuss the fates of toenails and so on. The online responses to people who are struggling with whatever aspect of their lives or training can sometimes be amazing.

However, online support can only go so far. And there is a danger that those of us in the mental health “world” exist in something of a bubble and that people outside of that world don’t realise just how tough it is to get help or to get out there and run a marathon when your mind is telling you to sit in your chair and wait to die or even to hasten the process by your own actions. What is really needed is concrete, joined-up support, and both mental health services and physical activities that are easy to access. That is a much much bigger ask, and I’m only one very ordinary person sitting alone typing into a computer, a person who is still struggling day to day, and trying to translate the thoughts whizzing round my head into comprehensible words, so I don’t really know what more I can do, other than keep talking and keep raising the issues.

And so I come to at least one conclusion, which is that programmes like “Mind over Marathon” and statements by young princes, are important. And they’re important because they raise issues that those of us who are just individuals with no resources and no power are unable to raise, because we cannot reach the people that TV programmes or princes can. They can persuade people who will never encounter somebody like me (for whom mental health is a normal part of daily discourse) to talk about their mental health issues, and they can encourage far more people to take up running or physical exercise than I ever will.

However, the worry with such high-profile campaigns is that people will feel that they have “done” mental illness. They’ve all watched the programme, they all know what it’s about, and, like with autism “awareness” there will be a general feeling of “yes yes, mental health, blah blah blah”, but mentally struggling people will still be showing up at their GP surgeries after weeks of angst about whether to attend the appointment because it’s all so scary, and will be given a telephone number, or a web address, or, at best, put on a waiting list that might be months, or even years, long. There are lots of small, quiet, voices out there, trying to talk about their mental health issues and begging for help.

There are also people like me, who are slightly noisier and more forthright and link to blog posts and so on and share mental illness stuff whenever we can, even though, sometimes, writing a post such as this one uses up all available energy for the day. Interestingly (and I’m not alone in this observation), when I share mental health stuff or posts from this blog (I know that this is, technically, an autism blog and that autism is not a mental illness etc etc) on my facebook wall, these days I get a small handful of “likes”, maybe 3 or 4 on average, if that. If I share a status about doing the laundry then I often get 30 or 40 responses! This suggests to me that people are ten times more interested in laundry than they are in autism or mental health issues!!! (Of course, it’s not quite as simple as that because facebook algorithms magnify posts that have already been liked and try to force people who share blog links to pay money for extra publicity and so on, but whatever the cause, the result is still the same).

On one level, it’s great to talk and to raise the profile of mental health issues, and it’s totally fabulous to run marathons if you can do it. If more people are encouraged to talk and run then that’s brilliant!

But on another level, there are many of us who are already talking about mental health issues (and in my case, now, also autistic issues), have been talking for years, and will continue to talk while we still have breath.

But is anybody listening?

Circles

Amazingly, this is my 100th post on this blog. When I first posted to it, last December, I didn’t know whether it would ever get beyond The Discovery, and it was really just a convenient way to let people know that I had discovered I was autistic. In the last four months the blog has seemed to acquire a life of its own, and, from time to time, a few people seem to read it. I can hardly believe that it’s only around eight months since the idea of my being autistic was even suggested – in that time I’ve learnt so much about myself and my life and just how much being autistic has influenced me during the last 45 years.

One of the criteria for receiving a formal diagnosis of “autism spectrum disorder” under the current system is that autistic traits and behaviours need to have been present throughout life (because autism is a lifelong condition). Consequently, the diagnostic process involves a lot of looking back through life and, particularly, back to early childhood. I’m fortunate enough to have a mother with a good memory who is still alive and was able to supply me with lots of information about my early life (I’ll write more on that another time), and it has been interesting to discover what she remembers about my childhood and how it relates to my own memories and experiences.

I’d like to indulge, if I may, in a little imaginary time travel, back through my life, to what, for me, has become an important point as far as my life as an autistic person is concerned. I start from now, 2017, when I am 45 years old, newly diagnosed, and slowly recovering from an episode of burnout. As I go back through my life I think about the 39-year-old receiving a diagnosis of bipolar disorder, the 36-year-old who still couldn’t cook a meal, the 33-year-old who got randomly ill on holidays, the 29-year-old who spent nights bashing their head against the wall and drank bottles of whisky and ate packets of pills and hoped never to wake up again, the 26-year-old who sat at their desk trying to write their doctoral thesis while feeling like they were in a bubble and the world was unreachable, the 23-year-old who graduated top of their class but who ate the same thing for dinner every night and drank alcohol before breakfast every morning, the 19-year-old who couldn’t learn from lectures and dropped out of their first degree, the 16-year-old who was still being bullied at school and whose best friend was a cat, the 13-year-old who was routinely pinned down on the floor of the toilets by the other kids, the 9-year-old whose headmaster thought they were being abused at home, and, eventually, my time travel stops in a primary school in Bradford in 1975, where a little girl sits on the steps of a temporary classroom, crying.

The little girl is crying because it is playtime and she hates playtimes. She hates small children. They are noisy and they run around all over the place in a disorganized manner, and some of them step on the cracks in the pavements which means that very bad things will happen, and they are mean to her and some of them eat sweets in the morning which is against the rules, and so she cries, and she waits, desperately, for playtime to finish, so that she can retreat to the safety of the classroom where there is a teacher who might protect her, and where the children sit down and where it is quieter.

I know these things about the little girl, and have always known them, because I remember them. I remember many things about being 4 years old, but, as I started to question my mother, I discovered that there were things about my 4-year-old self that I didn’t know. One of these was that my teacher summoned my parents to school because she was concerned about me. I didn’t interact with the other children, and, most particularly, I wasn’t learning to write. I just sat and made my pencil go round and round in circles, filling page after page with scribbled circular patterns. The teacher said she’d never encountered a child like me and didn’t know what to do.

Finding out about this “circle drawing” was the first of many rather surreal discoveries about myself that I’d never have made if I hadn’t started asking questions because I was gathering information for an autism assessment. It shocked me somewhat, and I felt a huge sadness for that frightened stressed little kid, trying to withdraw from the world into something comforting, trying to survive in what felt like a very hostile environment. I cried many tears for her, because I couldn’t go back in time and help her, and I knew what she would have to go through before she finally understood why life was so tough. Just after diagnosis I wrote the letter below (complete with muddled tenses) to her, and during the information-gathering stage I went to a shop and bought pens and paper and drew circles and coloured them in. Because that was all I could do.

You will now realise why the “profile picture” on this blog and on the facebook page is what it is, and why I chose that particular picture for the post in which I revealed publicly that I am autistic. Today’s picture is from a similar, but different, drawing of circles.

The most important question I had for my autism assessor during my follow-up appointment was something like this: “If I had been 40 years younger, would I have still been receiving an autism diagnosis at this point in time, i.e. in 2017?” Her answer was that I would have. And she went on to say that, with the knowledge of the present day, the point at which I would have been identified as autistic would have been the point at which I went to school and sat on my own drawing circles and my teacher was concerned about my behaviour to the extent that she summoned my parents in to discuss it. That coupled with things we know about my behaviour at nursery the previous year, and various other things during my early development, would have triggered a diagnosis.

For some reason, knowing that, if I were 4 years old today I would be being diagnosed autistic, as a 4-year-old, is important to me. I have tried to think about why that is, and I came to the conclusion that the diagnosis my 45-year-old self received in February, although it covers my entire life, is a diagnosis for the future, for planning, for strategies, for rebuilding my life. The “diagnosis” my 4-year-old self received, retrospectively, in the follow-up appointment yesterday is, for me, the diagnosis that starts the process of making peace with my past – it feels like some kind of justice for that distressed little girl, crying on the steps of the classroom.

Of course, the other reason that age 4 is so significant for me as far as being autistic is concerned is that, as I started school and had to work out how to survive, it was the time I started to mask. It was the time that I started to learn what to do by watching other people, teaching myself to interact with other human beings. The social codes that came so naturally and intuitively to most others, who sought out human contact, were things that I had to learn through a cognitive process. I’m only just beginning to understand this, and how it has impacted my life. Being undiagnosed protected me from being “written off” or “cured” or whatever, but it meant that I worked fearsomely hard to try to make the world work for me and expectations were made of my abilities that I simply couldn’t fulfil. I believe the damage to my mental health started around that time – as an undiagnosed 4-year-old trying to fit in, learning to sit still, learning to socialize, and to do as I was told to avoid punishment, I was storing up the trauma that would eventually result in decades of mental illness and suicidal ideation (which switched to active attempts to end my life in my late 20s).

I’m certain I’ve mentioned it before, but one of the things that is so interesting about an autism diagnosis later in life is that it not only suggests strategies for coping with life better in the future, it also makes sense of the past. I cannot change the past, obviously, but getting the “diagnosis” for my 4-year-old self is another step in accepting it and understanding it.

Dear Four-Year-Old,

I was talking about you recently, to some nice people.

I was remembering what it was like for you at playtime at school. I was telling the people about the three big girls who used to be mean to you, and how noisy it always was at playtimes, and how much you wanted to get back to the safety of the classroom where there was a teacher who might protect you from the other children, who were frightening and who you didn’t want to be with.

I was also talking to your mother recently. She was telling me how she and your father were summoned to school to talk to your teacher, because there was a problem. In fact, there were a few problems.

I know you could already read very well before you went to school, and the teacher wasn’t very pleased about that, because she was supposed to teach you to read but you already could. She wasn’t very happy with your parents, who had supplied the books.

I found out from your mother that your teacher was concerned because you weren’t learning to write, like the other children were. Instead of writing you just sat and made circles in your writing book, using up all the paper, and any other paper available. Your teacher said that she had never met a child like you, and she didn’t really know what to do. Your parents didn’t know what to do either, so it was decided that you would not be allowed any more books so you didn’t damage them or use up the paper by drawing circles on it.

I know where you lived. I remember the street. I also remember that some kids from the street let your Space Hopper down and you were really unhappy about that because you loved bouncing up and down the street on it. And even though there was a man who worked at the garage and took it to blow it up again it wasn’t quite as bouncy as it had been before, which was sad.

I could send this to your address, which I still remember well, even though you only lived there briefly. But it would never reach you, because the mail can only go forwards in time, normally a few days or weeks. It cannot go backwards 41 years, which it would need to to reach you.

Neither can I come back in time myself, because there is no time machine. But if I could, I’d talk to your parents and teacher. And I’d try to explain that you are a bit different from most other children, and I’d give them a list of things they might look out for, and I’d work out what they could do to try to help make your life a bit easier, because I know that your life turned out to be very very hard in so many ways.

I’m not sure how convincing I’d be. A crazy person from the future, nearly as old as your granny is in your time. And, of course, there would be so many problems anyway because most of the information I have now is from books that will not be written until decades after the time you live in. I have a magic machine that allows me to read lots and lots of information about kids like you, but it won’t work in your time, because it relies on things that haven’t been invented yet.

If I could come and see you I’d try to protect you. I feel sad that you had to go through what you did, and I feel sad that your life was so hard and nobody knew how hard it was. I’d like to tell you that it got better soon, but I can’t, because you have many years of really hard stuff still to go through and many many tough times ahead. Life will be harder than you can even imagine right now. I’m sorry I can’t do anything about that, but you will find a way through, and eventually you will find out why it is like that.

But I would pick you up and hold you tight and tell you that you will, sometimes by strength, sometimes by accident, find a way to keep going through it all for at least another 41 years. There will be things that will help – your parents will not really understand you and they will not know for a long time that you really need extra help and support, but some of the things they do will help anyway. They will continue to supply books, which will help. They will get you a friend who is more comforting than any school friend could ever be, who will have soft fur and will purr for you. And they will let you do some of the things that make life feel better to you.

You know that recorder? The one you chew (yes, I know about that – I’ve still got it somewhere, and your teeth marks are still on the mouthpiece), keep playing it, and the other musical instruments you will learn in the future, because they will be really important to you. Keep reading and keep learning all the other stuff too – being interested in things and learning things is going to be one of the ways you survive in the world.

I will never be able to tell you this, but in 41 years time I will find out about the circle drawing, and I will draw some circles for you, because that is the best I can do for you. Because I am grown up now I can buy lots of really nice paper, and loads of books, and felt pens, and I can draw neat circles now and make patterns and colour them in – you’d have loved that!

When I finally tell the nice people all this, and I tell them about you and about all the other things your mother has recently told me, they will finally understand. And they will tell me some information that will explain why your life didn’t work out the way it was supposed to.

I can’t come back in time to care for you, or to explain. I wish I could.

But I will eventually find out why it all happened as it did and I will discover what makes life so hard for us. There is a word that describes people like us, even though nobody will apply that word to you in 1975. We are autistic.

The nice people listened, and heard all about you, and about the person you became, and they told me that my discovery was correct. You had a different sort of head. I have a different sort of head. We were never designed to fit into the world in the ordinary sort of way.

Stay strong little person. You will survive, and in 41 years you will understand. And you will finally be listened to and believed. And it will make life feel better and you can start to work out how to make an easier future.

See you in 41 years’ time!

A Forty-Five-Year-Old from the future

P.S. In 10 years’ time some girls at school will tell you that you’re too ugly to get a boyfriend. They are lying. You find someone who understands you perfectly and you will have a wedding with really nice cake!

Validation

I had the first of two follow up sessions with my autism assessor. It had been a tough week, one that had tested my resolve to stay alive somewhat significantly. So much doubt, so many thoughts planted in my mind about whether I really knew what I was on about. Was I as wrong about things, as I had been told? Confidence so very low.

I parked. My husband met me, with coffee, which we drank while sitting on a low wall in the sunshine. We walked the 15 minutes or so to the arranged venue (different from where I went for the assessment, closer to home).

And there she was, the assessor. Same dress as before. Familiar. Room set up so I could escape if needed. Lights off, just the sunlight from the window. She made me a cup of tea and fetched my husband a glass of water. I took off my boots and folded my legs under me on the chair, gently rocking back and forth, chewing my fingers a bit.

We discussed the report. We went through the list of questions I’d sent her, one of which was particularly important to me. We discussed what had happened in the weeks since my diagnosis. We discussed the reactions of various people I’d told about my diagnosis – both the positive and the more challenging.

This is not the post for coherent detail – it is written on the evening of the follow up. I am feeling, for the first time this week, that it is worth staying on the planet, and that there might actually be a point to all this. I am relaxed, positive, and maybe even happy. I am not writing an academic essay right now, with proper structure or detail, just a brief account. Nearly one of those “maybe poems”, but not quite.

And, with a professional in front of me, I asked the other questions. Not the ones on the paper, the answers to which were so important to me in any case and really clarified things in my mind. But the other ones, the ones that have been swirling round my mind all week.

Because I had been told that I was wrong. I was told that my analysis of the situation was incorrect, and the implication was that I should listen to someone else, who believed they knew better than me, who believed that I didn’t know what I was talking about.

So I asked the professional. The person who has massive experience, and knows what the answers are to the questions. And she said I was right. My analysis of the situation and my needs was correct. I was not going crazy, and if anyone told me that I was wrong about these things then I should ignore them, because I did know, and I was right.

The sense of validation was huge. Maybe even more so than the day of my diagnosis.

We emerged from the appointment after an hour or so, having arranged to be in e-mail contact. Back into the sunshine and what had just become a considerably more lovely day. My husband bought me some cheese. We chatted for a while, about the positive experience and maybe some hopes for the future.

And he stayed in town to work, the work he has to do to sustain us. I drove home.

And didn’t consciously have to stay alive.

Because I am right, and I am validated.

In many many ways.

Reactions to Diagnoses

79-2017-01-05-13-36-21“Diagnosis” is a word that has featured rather heavily in my life recently, and even more so during the last couple of weeks. It’s a word that is loaded with all sorts of associations, both good and bad. A diagnosis can provide relief or despair, enlightenment or desperation. It can be something wanted and welcomed, or something that is most definitely not welcome and not wanted. But I would suggest that a diagnosis of almost any description provides information, and therefore the ability to make choices based on that information.

One of the first (and simplest) diagnoses I received was that of asthma. It was clear, once the doctor had assessed my lung function and made the diagnosis, what I needed to do. I was prescribed inhalers (and later pills), given advice about using them, and sent off to enjoy my new breathing capabilities (and new found ability to exercise). Once flu jabs were introduced I also started having one each year to reduce the likelihood of getting the sort of infection that might aggravate my already sensitive lungs. Although having asthma isn’t the greatest thing in the world, the fact that I received a diagnosis and can therefore get appropriate treatment is, in general, a really positive thing. Discovering that the reason I still had a persistent cough after many many months (I was drinking 2 bottles of cough syrup every day and not improving) was the result of my being asthmatic rather than having some more sinister problem was actually a great relief.

And so, a week and a half ago, I received my autism diagnosis. It’s not been quite as simple as getting a diagnosis of asthma, and the way I “use” (for want of a better word) the diagnosis will be very very different. It’s going to take quite a long time to work out how I live my life from now on and I’m going to have to continue to learn about autism, how it affects me and my life, and how I can best utilise my skills and compensate for my impairments to maximise my quality of life and productivity in the future. I’m already starting to adapt strategies that I’ve used for many years while coping with anxiety, depression, and bipolar disorder. I’m refining my notion of spoons (do read about Spoon Theory if you’re not sure what I’m talking about) and have already started to think in terms of “sensory spoons” and “social spoons” (thinking this way makes it easier for me to work out how much energy I have available for different sorts of activities). I’m considering how I can adapt the mood diary, which I’ve kept since my diagnosis of bipolar disorder, to include things relevant to autism – maybe how my various sensory systems are behaving, how good my executive functioning is, how exhausted I’ve been, what the state of my speech has been, how much my stimming has differed from whatever my “normal” turns out to be, and that sort of thing. I’m already certain that receiving this diagnosis is a positive thing and, although things are very difficult at the moment, I’m confident that they will eventually be easier as I adapt to my changed circumstances.

However, I was not the only member of my family who received a diagnosis last week. And I now have permission to say what it was that threw me into such a state of shock when I was told about it just six days after my autism diagnosis. I’ve been very much keeping quiet about it until I had explicit permission to mention it because we very much subscribe to Silk Ring Theory in our household, so as far as my autism diagnosis is concerned, I’m at the centre of the ring and I get to decide how to handle it and what I disclose. But somebody else’s diagnosis is entirely a different matter. However, this other diagnosis has affected me very significantly, and I hope that those who read this blog who are closer to it than I am will understand my need to mention it here.

A few weeks ago my father went for a routine health check with his doctor. Nothing very exciting – as far as anybody knew at that point he was a reasonably fit and healthy man in his 60s. Some blood was taken for a blood test, and when the results came back they were rather alarming. He saw a consultant just a few days after I received my autism diagnosis and received his own diagnosis – of advanced prostate cancer, which his consultant believes in his case will “see him off”. He then spent the next few days breaking the news as gently as he could to those of us who are close family members – my stepmother who was at the appointment with him, my mother, my brother, and me, followed by a few others. The prognosis is not fully known at this stage. There will be scans and histology and maybe biopsies (I’m not really very knowledgeable about all this stuff – though much more so than I was a few days ago). Current estimates vary between 12 months and (a “very slim chance”) 5 years (although there is always the tale of the outlier who survives much longer against the odds – it would seem that absolutely exact predictions are not possible). There will, obviously be treatment options discussed and weighed up, but the news that my father, who we’d sort of assumed would follow my grandfather into his late 90s, might well not reach 70, is a huge thing to absorb. My whole family is in shock, and my stepmother is in for a particularly hard time, for reasons it is not my place to write about here.

So, my life has been turned upside down yet again. My priorities are changing rapidly. I had hoped that after my diagnosis had sunk in, one of the effects it would have would be to go through some of the difficulties I had as a child, and also, particularly, some of the problems I’ve had with my father through my adulthood – many now obviously caused by undiagnosed autism and communication difficulties. For every event I’ve had with a boyfriend (such as that described in Mysterious Argument) there have been a dozen similar incidents with my father. I recall one from my late teens where we’d had “a fight” about something and I couldn’t explain any of it and I kept opening my mouth to speak to try to say something and couldn’t (I realise now that it was a nonverbal episode following a meltdown). There have been times throughout adulthood where communication has failed and not knowing I was autistic has meant that we have been unable to understand why things kept going so badly wrong. I was hoping to have years to go through all of this stuff and to be able to get back to the times when I was a younger child and my Dad was basically my hero, the one who was like me, and got me, and we could settle into a more comfortable relationship than has been the case through some of the more difficult years of my life.

But that now has to happen soon. I am already making plans to go to visit (he lives some distance away) and my brother is trying to work out how to organise things so that I can manage them. Considering I’m only managing to leave the flat around once or twice a week at the moment, it’s going to use a very great deal of energy. My father is, predictably, handling the whole thing by learning, and researching, and finding out all that he can. He’s taking a very practical and philosophical approach to it all. Exactly as I would have expected. One of the other reasons I’ve been silent on this blog for much of the week is that all my communication energy has been taken up communicating with my family. I spoke to my mother on the phone (she’s the only person I usually speak to at all on the phone, so that was reasonably smooth), and also to my brother (my words started to fragment somewhat, so we’ve now returned to e-mail), and my father and I have exchanged e-mails with things we hope to do together over the next few months. I hope I can find enough of the right words to say the things I want to say and to make some good memories for after he’s gone, because through all the difficulties and so on, he’s still my Dad and…

My reactions this week have been, maybe, predictable for someone six days out from an autism diagnosis. I described in Sensory Reaction how my system initially responded to the overload in my head. My husband worked only part of Monday in order to keep an eye on me, and to try to make sure I ate. Monday I basically felt completely numb. Tuesday I spent almost entirely dissociated, with no hope of any sort of functioning at all. By Wednesday my words were fragmenting and disappearing. Only yesterday afternoon did I regain any semblance of functionality, and it’s still very very brittle.

In a perfect world I would still be processing my autism diagnosis at this point, but the world is very much not a perfect one. I am, however, trying to use my father’s diagnosis as information to guide my actions (just as I take inhalers for asthma and just as I am learning to adapt my life to living a way that works for me as an autistic). I am rethinking the things I need to do in my life over the next few months and will be trying to find some sort of a balance that gives me time with my Dad, time to keep myself as well as possible, and maybe works out a way to leave some other parts of my life available to me in some form in the future. There are things I can simply drop for now and pick up later (they’re the nice easy ones), but there are some things that might not make it through because I simply can’t manage them and the option to continue in the future isn’t there. That’s just the way it has to be. Life happens and priorities change.

Diagnoses really do change lives – in all sorts of different ways.