Published on 12, July, 2020
Hi. Young autistic guy here.
I just recently signed up here and I'm not used to writing in forums at all, but with this subject I find myself really eager and passionate to write about it.
Maybe I haven't dug deep enough on the internet, but I see less resources for people who have both mental illness and autism. I have both. There's a stigma surrounding it, where it seems 'impossible' to have both be co-morbid, to basically have both at the same time. The fact is, both are possible. If anyone's needed to read that, who feels invalid, or a complete fraud/fake, you're not. Many factors can create mental illness. Trauma, loss, bullying, etc. Even non-autistics can have one or more mental illnesses or physical ailments.
Why is it important to have more resources? Because from my own personal experience of being made to feel as if I'm lying about having both, you can feel so, so misunderstood. The mental health side gets put on the back burner and gradually things deteriorate for those affected, because there's not enough discussion and resources about mental illness and autism being both common together.
You say that the mental health side gets put on the back burner. HOWEVER, I would contend that by focussing on managing the autism, you treat the source of the MH problems, so not focussing on MH is not necessarily bad..
Mytwenty said:You say that the mental health side gets put on the back burner. HOWEVER, I would contend that by focussing on managing the autism, you treat the source of the MH problems, so not focussing on MH is not necessarily bad..
Providing the symptoms are on account of the condition of autism spectrum disorder itself, better managing the condition will ameliorate those symptoms. When though we refer to co-morbid symptoms, we are referring to illnesses and or diseases that occur alongside the condition of autism spectrum disorder, and require separate or additional therapeutic treatment, whether it be medical, clinical or verbal.
Consider the following statement from Medical Comorbidities in Autism Spectrum Disorder: A Primer for Health Care Professionals and Policy Makers pdf ~ which on page 4 of 19 states:
Widespread reports of severe medical conditions being attributed, without investigation and sometimes without physical examination, to autism behaviours have compelled the creation of this document in order to present relevant information to healthcare providers,policy makers and the wider audience. A summary of current research, including the positions of leading governmental and professional bodies, is hoped and expected to help bridge the knowledge and training gap, and as a consequence, decrease the premature attribution of physical symptoms to 'autism behaviours'.
Current research, shared below, offers support to health care and care providers in understanding the possible mechanisms, symptomatology, and consequences of common comorbidities in ASD, thus allowing improved patient care and reduced long-term costs.This document also provides a list of symptoms and behaviours that are indicative of health problems but often dismissed as ‘autism’, and offers common sources of such behaviour. Case studies highlight and contextualize some challenges faced in diagnosing this unique patient group and the possible outcomes of successful identification of underlying medical problems.
https://nationalautismassociation.org/pdf/MedicalComorbiditiesinASD2013.pdf
I was speaking with specific reference to MH comorbidities, not physical ones with 'physical symptoms' whose erroneous conflation with autism is dispelled in the report you cite. I don't advocate the dismissal of the existence of co-morbid MH issues, or the identification of every issue as 'autism'. It's a well-known fact that having autism engenders MH issues in the first place, so I just believe that foremost managing and accepting the autism spectrum condition is the way to alleviate those MH symptoms.
I agree - both should ideally be diagnosed ASAP.
I also agree that support should be tailored for autistic MH sufferers
My view is that both should be picked up on as soon as possible, and a failure to do so will result in substandard treatment of both . There would have been potentially a lot more I could have done if the Asperger's had been dxed in 1992 when I was 35, and help and support provided tailored to the combination of Asperger's and severe mental illness.
Mytwenty said:So, the main point of contention here is whether accepting and managing autism is a more important factor with dealing with co-morbid conditions, or an equally important consideration. Can we agree to disagree?
Well through treatment programs autism has become known as a condition, and public awareness campaigns are rather dependent upon Doctor's reports in the first instance as have in many cases involved physical and or mental co-morbidities.
Rather than though agreeing to disagree with you as you request, I instead respect differences of opinion involving additional and alternative perspectives.
Mytwenty said:I’m really interested as to how mental illness is left ignored and untreated, like you say. Do you mean that when you go to your GP, and they see that you have autism, they ignore your MH symptoms and attribute them to the autism? Is that what happens?
In terms of mental illness being left ignored and untreated ~ there are the examples already referenced in terms of autism masking or camouflaging other conditions, or those other conditions that have biological or sociological causalities that mask the condition of autism itself.
There is of course the problem of being prescribed antidepressants ~ but then receiving no treatment for the depression itself. Then there is the post code lottery problem of no available services for some and lack of funding where there are services ~ so long waiting lists, limited treatment options and no long term support.
There is also the fact that people due to social stigma or shame of being considered mad would rather ignore or deny their poor mental health symptoms to the point of breakdown, isolating themselves and even committing suicide, or enforced interventions have to be carried out by the social and emergency services ~ with individuals being forcibly hospitalized on account of their mental health having deteriorated to a dangerous extent for themselves, and or other people.
Mytwenty said:A disclaimer: I realise my experience may be different to usual, as my mental illness, type one bipolar disorder, has been recognised and treated before autism. I believe experiences stemming from my autism - namely, being bullied - caused the bipolar disorder in the first place. So, if my autism had been recognised and managed first, my bipolar may never have started. So my perspective with its slant towards the autism may be skewed.
My mental illness, Schizoaffective Personality Disorder (SPD), was diagnosed (originally as being "schizoid and or psychopathic") when I was 12 and updated to SPD and confirmed by different therapists during my twenties, thirties and forties, before getting my Autism Spectrum Disorder diagnosis when I was 45.
The original diagnosis of being schizoid and or psychopathic at school was due to an emotional breakdown because of bullying, which involved mental and emotional breakdowns at two and four year intervals ~ due to the instabilities 'learnt' at school for 5 years, and the socially shared and enforced abuse by others which was and continues to be normalized in society as Stockholm Syndrome.
My special interest is metaphysics, psychology and sociology, so my perspective with its slant towards recognizing autism 'and' facilitating treatment options ~ is as such inclusively biased.
Personally though ~ I do not think your perspective slant towards autism is skewed, as such, just exclusively biased ~ keeping in mind if it is not already that our specialized interests are biases, and recognizing and declaring yours is a credit to you.
So perhaps drop the skewed notion possibly?
Yes, your perspective is different to mine and many others. And you're also right; I have and still do get my mental health taken less seriously, what with having personality disorders. This could attribute to where you live, the type of doctors you have, etc. In my case, I don't live in an area very well funded, thus making it harder for me to find the correct person for my mental health. But believe it or not, even in areas with more access to care, not everyone has the financial backup at their fingertips to seek out professional help for their mental health conditions, leading to not only those worsening, but also their autism. They feed off of each other, but are in no way shape or form the same.
I've found healthy coping skills for my autism, resources, others who have the diagnosis, etc, but if you utter the simple words 'mental illness' to a select few uneducated professionals, they will indeed use ridiculous reasons for these issues as excuses. They won't refer you for treatment for the severe, debilitating illnesses. They like to pin the blame on one thing, which has nothing to do with it.
Sorry for the essay; To conclude; Imagine if you go to see a GP, mental health professional, and they pin the blame on your autism and refuse to treat you for mental health illnesses that have no relation to autism. That's why I wrote this forum post, because I'm not happy with how often myself and others have professionals latch onto that as an excuse to not treat us.
So, the main point of contention here is whether accepting and managing autism is a more important factor with dealing with co-morbid conditions, or an equally important consideration. Can we agree to disagree?
I’m really interested as to how mental illness is left ignored and untreated, like you say. Do you mean that when you go to your GP, and they see that you have autism, they ignore your MH symptoms and attribute them to the autism? Is that what happens?
A disclaimer: I realise my experience may be different to usual, as my mental illness, type one bipolar disorder, has been recognised and treated before autism. I believe experiences stemming from my autism - namely, being bullied - caused the bipolar disorder in the first place. So, if my autism had been recognised and managed first, my bipolar may never have started. So my perspective with its slant towards the autism may be skewed.
Deepthought said:So I state that accepting and managing autism as a condition is a very important consideration ~ most certainly, just as certainly as having access to treatments for co-morbid conditions is as well an equally important consideration also.
As is supported by the following statement that I underlined from the following article:
Conditions that accompany autism, explained
More than half of people on the spectrum have four or more other conditions1. The types of co-occurring conditions and how they manifest varies from one autistic person to the next.
These conditions can exacerbate features of autism or affect the timing of an autism diagnosis, so understanding how they interact with autism is important.
Here is what researchers know about the conditions that often accompany autism.
Which traits or conditions commonly accompany autism?
The conditions that overlap with autism generally fall into one of four groups: classic medical problems, such as epilepsy, gastrointestinal issues or sleep disorders; developmental diagnoses, such as intellectual disability or language delay; mental-health conditions, such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder or depression; and genetic conditions, including fragile X syndrome and tuberous sclerosis complex.
How common are these conditions among people with autism?
It depends on the condition, and estimates vary widely. For instance, between 11 and 84 percent of autistic children also have anxiety2. Similarly, serious sleep problems may affect anywhere between 44 and 86 percent of children on the spectrum3. Differences in diagnostic criteria and other study variables may explain these wide margins. And the age, sex, race and intelligence quotient of the person being evaluated can all influence whether and when they are diagnosed. For instance, autistic black children are more likely than autistic white children to be diagnosed with intellectual disability4. And if a child doesn’t speak, mood disorders may be difficult to detect. Certain conditions, such as anxiety, may also look different in people with autism than they do in other people, adding another layer of complexity.
What’s more, the tools used to identify the conditions may not work as well in people with autism. Researchers are developing autism-specific scales, such as a depression-screening questionnaire, to help solve these diagnostic puzzles.
What can scientists gain from studying these conditions?
Nearly all conditions that accompany autism can have serious effects on well-being. And some have more severe consequences than autism does.
A better understanding of these conditions could improve quality of life for autistic people. For instance, identifying the genes involved could lead to early detection — and treatment — of the conditions.
“We really need to understand the roots of problems in mood and depression, as well as problems of impulsivity,” says Paul Lipkin, director of the Interactive Autism Network at the Kennedy Krieger Institute in Baltimore. “As we identify better understandings of the neurologic roots of these, we can hopefully develop more and better targeted medical treatments for them.”
Treating a related condition may also ease autism traits. For instance, treating seizures early may decrease cognitive and behavioral problems in children with tuberous sclerosis complex5.
Resolving sleep or gastrointestinal problems may also offer behavioral benefits. Sleep quantity and quality can affect mood and the severity of repetitive behaviors, for example.
How might co-occurring conditions complicate autism diagnosis?
Some autism traits, such as poor social skills and sensory sensitivities, overlap with those of other conditions. For instance, people with autism and those with schizophrenia both have trouble picking up on social cues. When a person presents with one of these common traits, her doctor may simply assign to her the most plausible diagnosis. “It can be very hard to figure out what the root of a behavior is,” says Carla Mazefsky, associate professor of psychiatry at the University of Pittsburgh.
ADHD traits may also mask or be mistaken for those of autism — and delay when a child receives an autism diagnosis.
Autism diagnosis may be particularly tricky in people with intellectual disability or severe language delays.
What can studies of co-occurring conditions reveal about the biology of autism?
Some of these conditions may share biological mechanisms with autism. For instance, a study published this year revealed that gene-expression patterns in the brains of people with autism are similar to those in people with schizophrenia or bipolar disorder6. People with these conditions may also share genetic variants and traits, such as language difficulties or aggression.
In other cases, the relationship to autism may be multifaceted. For instance, about one in three people with autism has epilepsy — and people with epilepsy are at an eightfold risk of autism compared with the general population. The connection may be partly genetic, but it is also possible that early seizures pave the way for certain autism features.
https://www.spectrumnews.org/news/conditions-accompany-autism-explained/
Mytwenty said:I was speaking with specific reference to MH comorbidities, not physical ones with 'physical symptoms' whose erroneous conflation with autism is dispelled in the report you cite.
When I stated that:
Deepthought said:Providing the symptoms are on account of the condition of autism spectrum disorder itself, better managing the condition will ameliorate those symptoms. When though we refer to co-morbid symptoms, we are referring to illnesses and or diseases that occur alongside the condition of autism spectrum disorder, and require separate or additional therapeutic treatment, whether it be medical, clinical or verbal.
I was not only then referring to medical treatments (for physical illnesses and or diseases) but also clinical ones (involving mental illnesses such as Bipolar Disorder that require medicinal treatment such as Lithium to balance the manic and depressive states of mind that are involved with this condition) or verbal treatments (such as Cognitive Behavioral Therapy (CBT) or Transactional Analysis (TA)) as being 'Talking Therapies'.
I do apologize as I thought the medicinal analogy would carry over to the clinical and verbal treatments quite readily, I was though too tired to explain things so used the paper instead.
Mytwenty said:It's a well-known fact that having autism engenders MH issues in the first place, so I just believe that foremost managing and accepting the autism spectrum condition is the way to alleviate those MH symptoms.
Autism does not engender mental health issues in all cases as some autistic people find their way into society and employment and live productive and contededly fulfilling lives ~ whether they be scientists, doctors, artists, teachers or whatever.
Better managing the condition of autism is not though 'the' way ~ but is 'an' important way to prevent (in developmental terms) or when viable helps to alleviate (in co-morbid terms) mental health conditions,
When management is not viable though; another important way involves the necessity of therapeutic treatments for co-morbid conditions ~ which if left untreated would make the management of the autistic condition impractical.
Just maintaining for instance a healthy routine for autistic people will not be enough whilst they have obsessive, suicidal, paranoid and catastrophic ideation involving inferior, mediocre and superior fantasies, delusions and Post Traumatic Shock Syndrome (PTSD as being memorial or behavioral flashbacks) where they (regarding internalization) and or others (regarding externalization) get to experience their abusive history daily, weekly or monthly.
So I state that accepting and managing autism as a condition is a very important consideration ~ most certainly, just as certainly as having access to treatments for co-morbid conditions is as well an equally important consideration also.