Generalised Anxiety Disorder (GAD)

Before even getting to speak with a prescribing psychiatrist, one of the screening questions (on clinic websites) checks specifically for any history of psychosis or schizophrenia. All appropriate medical and regulatory considerations are also identified and taken into account by the prescribing psychiatrists.

SSRI's didn't work for me either.

I would be careful of proscribing cannabis to literally everyone though.  Those who have experienced psychosis in the past should probably avoid it.

I enjoyed this post.  You explained the autistic condition well.

Hergé said:

I've been on just about every antidepressant know. I don't find CBT remotely effective. I asked about pregabalin which is the go to med if the usual fails to hit the mark. I was told that I wasn't a suitable candidate for it, I have the wrong type of depression, what ever that means.

I had a medication review earlier this week and I was told that they've tried everything pharmacology has to offer me within the mental health service. Nothing seems to be effective

I went on a similar journey with trying to find an antidepressant that worked, but failed to find one that fitted my needs and/or didn't cause intolerable issues with side effects.

Maybe don't worry too much about not having been offered pregabalin. It was suggested for me by a psychiatrist (after I'd tried several other options), but I suffered bad side effects - including with my vision - and I had to stop after a few days.

I'm currently finding good benefit from medical cannabis (in my case, containing both THC and CBD), which I buy on prescription via a private clinic and pharmacy. Alongside other things (eg helping with my mood, anxiety level, and busy mind), I find that it also helps with sleep, which you mentioned is an issue for you. Perhaps it's something worth looking into, if you haven't yet done so?

Hi,

I'm 54 and I have seen my online medical records that I was also diagnosed with "Anxiety" with no other notes.  I've been on SSRIs for over 20 years and been prescribed bouts of CBT with little to no effect countless times. I mask quite heavily, so counselling and CBT never really do anything.  The medication does work on my anxiety in that I feel the difference whenever I try to reduce them, and not in a good way.  You've summed up everything perfectly here in a way that I've never heard it explained before. Although I oversleep as a response and am always tired.

out_of_step said:

Now understanding my individual experience - rumination is largely monotropic thoughts. An inability to sleep is an over stimulated brain. You cannot think your way out of a more sensitive fight or flight response. The physical symptoms experienced when diagnosed GAD were autistic stress and burnout. Perceived social anxiety is EF overload, masking & coping strategies and difference in communication with neurotypical people. A high intolerance of uncertainty because our brains are wired that way.

Because I have not been tested, I constantly make excuses as to why I can't possible be autistic and try and work through total overload with disastrous results. I came back to the site to compare notes again. Every time I do this things make sense until I talk myself out of it again.  I don't know anyone here, but you seem to understand things no one else does.  So thanks for your comment.

I have been diagnosed with GAD and 'social phobia', I think it is a by-product of my autism. I suspect that I have lived my life scanning other people - allistic people - constantly, to find cues about how I am supposed to behave, because my natural behaviour in childhood was often found strange or was criticised. I am on high alert in social situations and, because how I behave is a performance, I have 'performance anxiety'. In effect, in social situations with people who I am not intimate with, I am often suffering from the equivalent of 'stage fright'. No wonder I have high levels of anxiety.

I'm always anxious, and I'm sick of it. I'm always on high alert & worrying about mistakes from the past and fears for the future. It's a constant whirlpool of thoughts, and I can't stop it.

I constantly feel stressed, I'm on the diagnosis waiting list, three years and counting. I've been on just about every antidepressant know. I don't find CBT remotely effective. I asked about pregabalin which is the go to med if the usual fails to hit the mark. I was told that I wasn't a suitable candidate for it, I have the wrong type of depression, what ever that means.

I had a medication review earlier this week and I was told that they've tried everything pharmacology has to offer me within the mental health service. Nothing seems to be effective and since I haven't had a confirmed diagnosis, I'm in limbo as I can't be referred to a specialist that deals with autism.

I've tried hypnotherapy which didn't really help but it gave me extra relaxation techniques. Today I'm trying acupuncture.

I've no idea how to unmask or who the person under the mask is.

So here I am a chronically stressed insomniac with currently unconfirmed ASD .

Isn't life grand.

Talking only from my own experience as a high masking individual, everyone is different. GAD diagnosed before autism. Prescribed SSRIs and various bouts of CBT both of which were largely ineffective.

I learned in CBT that "worry = anxiety" so for this purpose, it is thought based. While i learned some general effective coping strategies, this idea didn't seem to fit.

Now understanding my individual experience - rumination is largely monotropic thoughts. An inability to sleep is an over stimulated brain. You cannot think your way out of a more sensitive fight or flight response. The physical symptoms experienced when diagnosed GAD were autistic stress and burnout. Perceived social anxiety is EF overload, masking & coping strategies and difference in communication with neurotypical people. A high intolerance of uncertainty because our brains are wired that way.

I find mindfulness a far better coping strategy than CBT. Also understanding the root causes of autistic anxiety are often vastly different to neurotypical. This can make things calmer. The D stands for "disorder". Or it could be seen as a natural response?

Our sensitivities make us more resilient. The journey we find ourselves on - we may end up understanding ourselves far more than others do. Despite all the difficulties faced, this is a positive thing.

Doing some deep breathing helps also.

I've had my own struggles with anxiety, and I get where you're coming from. I’ve also got OCD, and for me, anxiety isn't just about specific situations; it’s more like a constant background noise. It’s definitely linked to my OCD and maybe some of the challenges I face with autism. I’ve found talking to a therapist really helps. If you’re thinking you might have a similar issue, it might be worth checking in with a professional. Understanding what’s going on can really help manage things better.

I think that anxiety is only part of everyday life if you are autistic?

NT people do get anxious obviously, but I think it's usually linked to a specific thing like an exam, interview, worry about redundancy or relationship problems. But with Autistic people I think it's always just below the surface and is triggered more often by things that shouldn't be triggers, like being on public transport, being in a supermarket queue, being in the same room as someone who is upset or angry, things not happening at the expected time, etc.

I was suspected of having it a few years before by autism diagnosis. I can't remember what all the questions were, but I had most of them. Particularly the tense shoulders.

I now see it as due to my autism.

I've so many examples, but one thing is since COVID, my wife also works from home when I always did. Hearing her on the phone stresses me. I don't mean annoying. But I take on and get stressed by all her work problems when there is literally nothing I can do about them. 

I was speaking to a nice lady from Autism Herts the other day and she knew what I was talking about - she said it's like your anxiety starts at 3/4s full before your day even starts when I described always feeling anxious even before I think of things to be anxious about.

I am very anxious most of the time.  The more I engage with others, the more anxious I get.  It's very tough being Autistic.