What could be wrong with me?

The article does suggest medicating though. It still suggests mood stabilisers, and much more potent ones than for traditional bi-polar at that. 

I'm not assuming that the subject matter of the article is bad because I've heard bad things about it at all. That's an assumption in itself. I'm basing my opinion on the fact that they are advocating a drug that commonly (>10% prevalence) causes horrible and potentially lethal side effects, as well as major personality changes and the fact that the article does not have much in the way of evidence over opinion. Keeping an open mind doesn't mean I should have no opinion on a matter; that would totally negate my right to free speech.

My reading of the article is different. They are suggesting that bipolar is over diagnosed and that you could deal with the subjects as just autistic without medicating for bipolar.

Differentially diagnosing these conditions just seems difficult and error prone. At the end of the day you might get diagnosed with bipolar and then find that the meds work or they don't. That might be the best test for an individual. Keep an open mind and don't assume that everything that you read on that site is bad because they have done some bad things.

Hmm... the Autism Speaks article seemed a little subjective for my liking. The author seems to make quite a few assumptions based on nothing but personal opinion:

In a recent study of children with autism (ages 7 to 17), we found that nearly a third had frequent episodes of “elevated mood.” Just over 60 percent could be described as “very irritable.” Just over half talked excessively. Other common symptoms included excessive activity such as pacing (43 percent), accident proneness (44 percent), distractibility (43 percent) and a tendency to “get in trouble” (47 percent). Sleep disturbances were also common.

The point is that all these behaviors could be considered symptoms of bipolar disorder!

Yet clearly these children did not all have bipolar disorder. In many cases, their “mania” symptoms were, in fact, symptoms of autism. ADHD symptoms also overlap with these behaviors.

There is nothing to suggest the children do not have a co-morbity of ASD and bipolar disorder, yet the author assumes they do not simply because of the percentages seem too high to them. There are no facts or figures to support their view.

The author also seems very keen to push for people with autism and bipolar to be put on valproic acid, citing it a safer treatment for managing symptoms of those conditions than lithium. However, when comparing the side effects of the two drugs, the adverse effects for valproic acid are far more numerous and common that those of lithium, including potential liver failure and severe birth defects if taken during pregnancy:

www.drugs.com/.../lithium-side-effects.html
www.drugs.com/.../valproic-acid-side-effects.html

Autism Speaks is renowned for pushing for dangerous, cruel and controversial treatments for autism. They appear to be continuing a trend with valproic acid. It is almost as if Autism Speaks is advocating cruelty to people with autism.

And, for balance, here is a link of criticism of that org.

thecaffeinatedautistic.wordpress.com/.../

if we are going to be sceptical then I would be sceptical about both parties in this disagreement. There's probably more than a grain of truth, and a grain of error, on each side.

Scepticism is a good thing! I can't vouch for them, the article doesn't look too contentious but you have to keep an open mind to all possibilities. The article is now at a new URL

www.autismspeaks.org/.../there-connection-between-autism-and-bipolar-disorder

I'm a bit sceptical of anything Autism Speaks has to say. Word has it that the organisation has been very outspoken on the notion that autism is a thing to be cured and eradicated rather than understood as a different way of perceiving the world. The article has been taken down now in any case.

I've realised that BPD stands for Borderline Personality Disorder rather than Bipolar Disorder. Sorry for any confusion! I'll go through my posts and correct them for posterity!

You can build up gradually. Just aim to do something active every day, say run round the block. It can be hard to get motivated, but if you make yourself do 15 mins of walking or running, you may find you want to continue. If not, you can tell yourself you have done something to improve your health, mental and physical, and just be proud of that.

Hi Marjorie. That's good advice too, thank you. I do always feel really good after exercise - always feel really upbeat and positive. I'm just not sure what yet! If I was fit enough to do parkhour, I would be on that like a fly on rubbish

Hi Laddo, I think you have been given a lot of good advice above, but would like to suggest 1 thing. Do some energetic physical activity, walking, running, anything strenuous. It is known that physical activity helps with depression. It will help you sleep and get you out of the house, doing something. You can do it alone and maybe eventually do sport with others. The build up of tension to fight or flight needs to be burnt off. You also get the happy hormones when you do exercise.

Ive been there, you will get through it. Good luck

No need to apologise, socks. I tend to waffle quite a lot in my posts so I thought I might have been unclear about my family situation.

Both socks and longman have made some good points here and I will take both of your advice. I will try and get myself off to a doctor but I fear I will be making a lot of posts on here as this forum and another ASD forum I am a member of are the only places where I feel I can get some support from people who understand. I can't talk to family about it - their solution is basically 'take it on the chin/grow up/man up/stop being so weak'. What do they expect me to do, open up my skull and re-wire my brain? Anyone got a screwdriver... But yes, I will try and get some help from a psychiatrist and I hope my future postings about it won't get on too many people's nerves

Firstly I am sorry for mixing you up about the kids with another thread. :-( My mistake.

I have to disagree with Longman about the autism specialists, such people do exist.

It really is not possible or fair on anyone to try and confirm BPD here. In my opinion laddo should present to the doctor with his symptoms and fears but leave a diagnosis to the professionals. You can print out this thread and give it to the doctor, this may help to be taken seriously.

Ah ....must be just where I live then....for most of us there is little chance of meeting "a specialist in autistic psychiatry/psychology who can disentangle your complex web of symptoms - someone with a deep understanding of autism".

Are there such people around??!!

Are there that many GPs who will simply refer you for a diagnosis let alone and expensive consultant?

I perceive paranoia to be quite common in autism. Indeed it was often confused with paranoid schizophrenia. One of the reasons for that was obsession about other people's reactions and feelings towards you. Which follows if you are not getting the best out of social interchange.

I don't think Laddo is having a mental breakdown. He might be wise to get some GP advice on BPD, and I understand why he is scared to do so. Because health professionals find it hard enough to comprehend autism, the danger is he has a GP who instead puts him on inappropriate medication as a "knee-jerk" response.  It isn't easy to get sensible help fom health professionals where autism is concerned.

Having difficulty understanding what people are saying, and being misunderstood by them, especially if they start prying and thinking themselves able to set you straight, is likely to give rise to feelings of paranoia.

But sport amongst NTs includes taking pleasure in other people's negativity and self doubt. It ranks alongside taking the wings off flies.  Some NTs love to observe other people's discomforture.

This is something I really do know about because I'm prone to it, and I have to be alert to spot it. My humour is often self depracatory - I joke to my own disadvantage. Some people spot this and play on it. The draw me into cleverly contrived discussions that end up making me feel more negative. As I say, certain types of NTs get a "kick" out of doing this, although it stems from the fact that a lot of NT humour is about playfully "knocking the other person down" verbally, to see how they react. People on the spectrum do poorly at that.

So one thing Laddo needs to watch out for is whether his feelings are down to others playfully or vindictively manipulating his own low feelings for their entertainment.

I agree Laddo may have to pursue the BPD line just to be sure. But he needs to scrutinise whether his friends are real friends. They may be winding up his social difficulties for a laugh.

Hi recombinantsocks

Yes, I am near breaking point. Stress really is accumulating for me. I don't have a young family fortunately - I know I would have pushed them away by now. I can't have kids any time soon as it would not be fair on them and as much as I want a relationship I know that I would just push my partner away like I always do. But other stressors are pushing me to the limit. I can't get a job despite trying so hard and getting sacked from my last job has tainted my job history beyond repair, my mother has basically disowned me due to an argument that started because she got angry when I said I want to take up some autism activism (she hates all activists equally just because her ex-husband - my father - was one and she assumes they must be all exactly like him) and there is not enough room for me to live at my dad's house and I'm likely to be going to court for non-payment of council tax. My brother should be liable for half the council tax too but he refused to contact the council tax office so all it is in my name and as a result, I'm going down for it. That was always the way in my family - I went without so other family members could benefit. On top of all this, a lot of repressed memories from childhood are starting to come up.

I'm desparate. I know I need to see a pscyhiatrist but I am so afraid that my GP will just ignore me as they always have done. Just because I find it difficult to make eye contact with them they think I'm lying about my symptoms. I could really do with help from an autism support group but none of them are free in my area. I'm so scared

Dear Laddo,

It sounds to me as though you are near breaking point. Your argumentative phases and persecution comlplexes tell me that you are in a very bad place mentally. I am not a doctor but have been through similar periods of self doubt, depression, paranoia so I think I have got some insight and a good deal of sympathy for you.

I think that you need to see a specialist in autistic psychiatry/psychology who can disentangle your complex web of symptoms. Someone with a deep understanding of autism will be able to work out what is due to the autism and what is another independent condition.

One thing that occurs to me is that all of the stress in your life is accumulating and the pressure is increasing. You now have a young family who add to your previous stresors. They will be demanding and will not give you any peace. Before this, you have struggled through the 'normal' ASD life of misunderstanding and conflict. The effects are cumulative and relentless unless you have got a good mental understanding of how to manage your mind.

If you want to keep your family and your current life then you need to see someone fairly urgently.

Please get to the doctor and ask to see a specialist.

By the way are you already on any medication? Sometimes these create nasty side effects.

Thanks for your replies and advice. However, I'm not so sure that what I'm experiencing is that much down to Aspergers. Most of the time, I'm not particularly socially isolated. I usually see a few friends a few times a week. I will develop social phobia during the epsiodes, which makes me less inclined to see those friends and stops me from leaving the house much. A lot of the arguments I'm involved in spring from me being irrational rather than rational, too. I develop a very strong persecution complex at these times and think everyone is out to get me. It's led to the loss of some very good friendships. The whole thing smells of BPD but I'm too afraid to go to the doctors in case I don't get taken seriously

Hi Laddo,

My understanding of your/our ASD situation is as follows.

We have two problems that contribute to this mix of mental issues.

a) Social interaction difficulties.

b) Dichotomous thinking

The social interaction issues cause us to have a stream of diasagreements, misunderstandings and disputes. This leads to a life of stress and anxiety as we continually live in a state of apprehension about what will go wrong next and a state of misunderstanding about why things keep going wrong.

The dichotomous thinking bit makes us too black/white good/bad, brilliant/catastrophic etc etc in our analysis of our own thoughts and in our analysis of events that impinge on us.Another way to look at this is that we come to unreasonable views about things. Dichotomous thinking makes us more logical or Spock-like than NT people. Unreasonable thinking is a recognised source of depression.

Both of these factors create depression, anxiety, mood swings. If we continually catastrophise about things (i.e. we see more black than white) then we simply get depressed. If we see black one moment and then white the next then this will get confused with bipolar. (It is common to misdiagnose bipolar in ASD sufferers) If we continually come into conflict with other people then this will push us further into the black and we then obsess about how awful our lives are.

I've wondered about the PTSD thing too. My analysis is that a life of continual stress will put us into a PTSD state. The stress arises from the 2 factors above and I can easily recognise the continual unmitigated stress in my own life (pre dx) and others on this forum.

There are two things to remedy this situation.

1) Be on the lookout for when you are being unreasonably dichotomous. Question your decisions that things are black and try and work out whether your thoughts are reasonable. Replace the black and white with the occasional compromise. This is a CBT approach but, given the difficulty of getting CBT, it is reasonable to do a bit of diy/reading/self analysis or work with friends such as the rest of the community on this forum.

2) Learn how to be better at dealing with other people. This doesn't come naturally to us so we have to make special efforts, read books etc where a NT person would just pick it up as they go along.

Does this make sense to you? I've been trying to figure it out for my own benefit but I'm sure that other people will have different thoughts too.

Certain times of year are bad if you are socially isolated, such as through being on the autistic spectrum. Christmas is one, because it is get together time, loaded with commercial festive cheer, and tends to make you feel left outside.

Spring is another bad time. It is partly the warm up after winter, with leaves on the trees and flowers and colour, but that is also a social stimulus, particularly thoughts of forming relationships. Hormonal/sexual stimuli rocket in spring, possibly because cold wet weather makes people less so inclined. So the rebirth at Spring sets NTs off.

So I'm not at all surprised you have a low from April to July. I suspect bipolar would have more frequent peaks and troughs.

I'm very lucky - I only get lows for a few weeks, which is a timescale I can "see to the other side of", and find activities to try to alleviate the impact, like treating myself more often. But I can imagine it is much harder if you have depressions lasting months.

The GP situation as regards autism and people suffering from depression is dire. I cannot conceive that GPs think their behaviour is professional. Some of them to my mind or borderline criminal. Certainly professionally negligent and irresponsible.

I think meltdown propensity can be alleviated by removing resolvable stress sources. I do regular clear outs. Some things that get me down are resolvable if I get down to doing something about it, or seek advice. That way I can reduce the "pile up" effect when things are getting bad.

This post traumatic stress thing may be very valid. What happened to me as a child, teenager and in early adulthood continued as very burdensome and constantly resurfacing "baggage" into my fifties, and only really cleared up after diagnosis. But unfortunately health professionals show little understanding of this, and I cannot see NAS "getting its finger out" on so many aspects of adult autism.

Also it might be worth noting that I have many symptoms of PTSD (and so does my brother) but no clear memories of any specific trauma. I think one of the doctors who assessed me for Asperger's touched me inappropriately when I was 7 or 8 but I don't think it would have affected me like this for so long. My mother is always quick to deny anything happened to me or my brother but she always seems kind of 'strange' when she does this - I'm wondering if she has anything do with it. She did use to hit me a lot whenever I acted out-of-the-ordinary, called me a burden several times when I was young - could any of this cause PTSD-like symptoms?