Published on 12, July, 2020
I'm 31, male and was diagnosed with autism last year. Though I find Asperger's fits me better, but anyway... I've thought for a while that seeing a psychiatrist would help me with my depression, feelings of self worth and suicide. I even saw a haematologist last week about a blood clotting disorder I have who strongly advised I see a psychiatrist. However, I have a classmate on my college course who has autism and who's off ill due to her depression and anxiety etc. When I suggested to them about seeing a councillor or therapist, she said that they wouldn't work because she has autism. Is this the case for autistic people? Does counselling/therapy not work for people on the spectrum...? It would make sense considering our brains are hardwired differently, therefore making it unlikely that changing our mindset would be effective, or is this just someone who's been misguided...? I imagine seeing a psychiatrist would help in the sense of having someone to talk to and unload my problems onto, but that's probably as far as it'll go.
Thanks
Very interested to see your post, I am a 57 year old male who was diagnosed with Autism last year. I have suffered from depression, low self-esteem & even suicidal thoughts for most of my life, but originally I used to put it down to the aftershock of being very badly bullied at school for many years.
Five years ago, my depression became much worse, so my Doctor prescribed anti-depressants & referred me for therapy. Rather than the knee-jerk offering of CBT, I had quite a few pre-assessment meetings to determine what therapy would suit me best, with CBT being eliminated quite quickly. In the end, I was offered a year of 'Transference Focussed Psychotherapy' which is usual offered to people with Borderline Personality Disorder. I don't have BPD, but since I do have many issues with sense of identiity & self esteem, that seemed like the best fit.
After a further year of waiting (18 months from the initial referral), the therapy started, but although my therapist was very good, it was obvious to me from the start that it wasn't going anywhere. I just used to turn up, talk about very distressing & emotional things, then go home again. I couldn't understand how doing that was supposed to help with my mental heath problems, because my memories of traumatic events were more like perfect holographic recordings that didn't change just because I talked about them. If anything it made me feel worse because it just seemed to increase the level of intrusive thoughts about my past. My therapist used to say that "I couldn't allow anything to help me unless I understood how it was supposed to work on a scientific level", to which my response was always "What's wrong with that?".
After my 12 months were up, my therapist recommended to my Doctor that I had an Autism assessment, which I had also discussed with her during sessions. She felt that my thought patterns were unusually rigid & resistant to change, which meant that I could not benefit from psychotherapy. After many more months of waiting for my ASD assessment with LancUK, I finally received my diagnosis early last year.
It isnt just therapy that doesnt work for me though, as I seem to be effectively immune to all the usual SSRI, SNRI anti-depressants as well. I have tried quite a few different ones over the last five years with no real success other than possibly an initial placebo effect because I was desperate for something to help. Until four months ago, I had been on a fairly high dose of Venlafaxine for over a year, but after telling my Doctor that I thought that didnt work either, I decided to test the theory by phasing it out over three weeks & could easily have done it faster. The recommended discontinuation is far longer than that, with some people taking years to cut it out. After that my Doctor agreed it was pointless to prescribe more variations of the same thing & referred me to see a psychiatrist in order to review different avenues of medication.
After seeing a specialist mental health nurse, I am now waiting for another assessment with LancUK, this time for ADHD. I hadn't considered ADHD until seeing the mental health nurse & didn't know much about it other than the usual cliches. There is a high overlap with ASD, & the symptoms can often be hidden for people on the spectrum. I wasn't aware that ADHD can cause the same chronic feelings of low self esteem & depression that I have always suffered from. I also wasn't aware that the flip side of ADHD was hyperfocus, where people can become so engrossed in things that interest them that they lose all track of time. Hyperfocus is usually my only refuge from depression, if I can find something that really interests me, then it's almost as if I blank out & temporarily at least can forget about my problems.
The reason the ADHD diagnosis is important though & not just another label to add to the list, is that unlike ASD it is treatable with medication. Allegedly, the ADHD drugs are highly effective at reducing those horrible racing negative thoughts, allowing you to relax & enjoy things without constant self criticism. There are several very good websites that describe adult ADHD, with https://www.additudemag.com being a particularly good one.
Hopefully I am not just building an additional ADHD diagnosis into some magic fix for all my problems, but the mental health nurse that I saw was convinced that it was the root of my depression & also why I am completely unresponsive to conventional treatments. I just need to wait a very long time for an appointment with LancUK again, where hopefully they will agree.
Sorry if this is a bit long, I've never been very good at giving short answers to questions .
This is very interesting and helpful. I really appreciate the fact that you went into so much detail in your reply. I like a long read on an important subject such as this.
It makes perfect sense to me to want to understand how a treatment works. I am not diagnosed ASD yet (but I will find out if I am later on today). My mind is quite open about what makes life so challenging for me.
I have had counselling several times over the years. Interestingly I sometimes get tangled up in words so therapists resorted to things like guided visualisations or getting me to build things with Lego (maybe that was a clue that I might be autistic!).
The bit about ADHD and hyper focus is new to me. I am off to check out additudemag.
Thanks again for all this helpful reflection and information.
Sunflower said:The bit about ADHD and hyper focus
Hyper Focus is my best friend, and sometimes my worst enemy. It can be a release, but if I go in too far, it becomes a bit unhealthy.