Day 8 post failed suicide attempt – Autistic Burnout

Sunday

5:00am

Nurse takes blood pressure. Inspects the wound on my wrist, stitches can be removed in the next day or two. Healing very well.

Breakfast

Shower

Wait for Psychiatrist…

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He arrives at 9:00 and we start talking in a very relaxed manner. He looks calmer than in the previous sessions. He is as tall as I am and today he is wearing casual wear. It adds to the relaxed environment. He even smiles a bit. I feel like he is actually onto something and I start to feel a bit of hope spring up inside me.

He starts asking me about the feelings I experienced just before I tried to commit suicide (and I didn’t want to kill myself).

I explained it like this:

I was always aware of extreme pressure in my life. Mentally, emotionally and physically. Life was always tough. I remember the day my body drove me out to the mountains and tried to kill me, that I felt exhausted. I felt empty. I needed rest. I needed sleep. I felt that I have reached the end of what was possible to give in this life. My life-force has been drained. My ‘chi’ was disappearing. I felt that this wonderful scary adventure called life has come to an end. I was done…

He looked at me with a little bit of a smile and said I experienced autistic burnout. I literally lived my life to the fullest and I drained every last drop out of every facet of my life, and the suicide attempt was me trying to end me because I had nothing left to give. I spent it all.

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He complimented me on my self awareness and my ability to communicate extremely well in describing exactly what transpired. He started explaining to me that people with autism build a public persona to mask their condition, in order to be able to function in society. This masking or camouflaging is extremely taxing on your resources: spiritually, mentally and physically. He explained that my unique, complex condition fascinated him. Apparently people with my condition and the co-morbid ADHD and OCPD (OCD) and depression, usually attempt suicide at 15. I managed to fight off this dragon of death until I was in my early forties! I started building an entire personality with this masking technique and drifted away from my own core. I also started developing a third entity when I drank alcohol, a kind of a man-child if you will. The rebel, the risk taker, the instigator, the reckless, the dangerous one. He suspects that my true self, and the other two were at loggerheads and tried to ‘take over’ the executive functioning, I was about to split! After the battle for my soul, one of those three survived, and he suspects it is the true me.

He asked me to read up on Autistic Burnout and see if I can recognize myself in some of the literature.

He double checked on my prescription and told the nurse that I can stop taking the heavy sleeping pills. He prescribed an anti-psychotic which would assist me with falling asleep at night. We’ll try it, I thought. He greeted me and left.

Lunch

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I spent the afternoon reading about Autistic Burnout

‘Autistic burnout’ is the intense physical, mental or emotional exhaustion, often accompanied by a loss of skills, that some adults with autism experience. Many autistic people say it results mainly from the cumulative effect of having to navigate a world that is designed for neurotypical people.

Burnout may especially affect autistic adults who have strong cognitive and language abilities and are working or going to school with neurotypical people.

Like many aspects of autism, burnout varies greatly from person to person. Some autistic people experience it as an overwhelming sense of physical exhaustion. They may have more difficulty managing their emotions than usual and be prone to outbursts of sadness or anger. Burnout may manifest as intense anxiety or contribute to depression or suicidal behavior.

spectrumnews.org

Well, that explains a lot!

I read and read and read and read…

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Dinner

Shower

I read more and more and more and more!

Finally I felt like the past started to make sense, I kind of started to see why he had that look on his face, like he thinks I need to put my own puzzle together and he just handed me the last piece.

I had tea.

Took my medication, and for the first time felt that this day was well spent, and eventually I drifted away…

Day 7 post failed suicide attempt – roommates of a High-functioning Autistic Savant

5:00am

Nurse take blood pressure.

Breakfast

Shower

Wait…

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Nurse informs me that the Psychiatrist will only visit later that morning so I decide to take stock of the first week in this very interesting place called: Psychiatric Hospital.

The 3 gentlemen sharing my room with me has different reasons why they find themselves in this place.

Guy 1: Mid-thirties. I noticed him first when I entered the room last Sunday. Quiet, reserved, mentally occupied, does not make eye contact, watches movies on his laptop the entire time. I overheard people talking about him during meals, apparently he lost his wife recently and struggled to cope with the loss. He is being treated for depression and is receiving trauma counseling. When people die it is tough for the ones left behind…

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Guy 2: Sixties. Grey, skinny, odd demeanor like an apologetic state of being. He is addicted to pain killers and has dementia. Keeps on packing his suitcase and heads toward the front door to go home. No idea why he is there. Its his last day today, he is going to stay at his daughter’s place according to the nurse.

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Guy 3: Early twenties. Oily hair, smells like an ashtray, curses a lot, talks non-stop. He has multiple cuts on his forearms – self inflicted. He has ADHD and depression and is an alcoholic. He cuts himself to ‘feel’ something. His family is rich and his mom phones him twice a day. He told us all his life story, a couple of times. He seems to think being a rebel and a rule-breaker is something to boast about.

I wonder what they think when they look at me?

Suicide Guy: quiet, talks to no-one, reads all the time, eats alone, no eye contact, no interaction with anyone, does not attend group sessions, does not attend arts & craft sessions, never attend the support group chats, seems preoccupied, makes his bed even when the nurse tells him that he doesn’t have to, keeps his area neat and clean, keeps himself neat and clean.

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Lunch

The Psychiatrist meets me just after lunch. We start talking about how I feel with the medication. I confirm that there is less darkness and heaviness in my mind. I love being able to focus during the day. I do not feel tired.

He asks me about an observation the Psychologist made: I present with signs of Obsessive Compulsive Personality Disorder. Would I mind to read up on it and tell him next day if I recognize myself?

I accept and he leaves.

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Dinner

The Psychologist arrives. We start talking about my adult life. I was married twice, got divorced twice, I have 2 daughters – one with each of my previous wives. I have a neutral relationship with both exes, which serves in the best interest of my daughters. I am a great dad. I have worked in various industries. I have lived in more that 60 houses over 4 decades. I have lost a lot of money and I have made a lot of money. I have been rich and I have been poor. I have no friends, but I am always the life of a party at work. We talk about Borderline Personality Disorder. I still don’t see it. I have a very stoic outlook on life, and optimistic and zen. I am well spoken and have a rather high intellect. I am extremely creative but also very analytical. I am complex. He says I should take the next day off and not think about anything that happened recently.

He leaves and I have a cup of coffee.

I take my medicine and wait to fall asleep.

Take the day off? What does he mean? And as I try to overthink and over-analyze what he said I fall into a deep sleep….

Day 3 post failed suicide attempt – High-Functioning Autistic Savant syndrome

Morning

5:00am on a Tuesday

I wake up with the request from the nurse, who entered our room, to sit up and have my blood pressure monitored. She asks about my pain and for a moment I forgot what she was referring to…

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Oh, yes, now I recall…the scar on my wrist. I received 11 stitches for the self-inflicted deep tissue damage I have done with my pocket knife with the serrated blade.

‘I am okay, thanks, it doesn’t hurt that much.’ I say in my croaky morning voice.

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It was my second night of well deserved rest. I have never slept more than 4 hours a night my entire life.

I get up, have breakfast, take a shower and wait for my appointment with the Psychiatrist to talk about my situation.

After a cup of coffee the nurse informs that he is waiting for me in the consultation room and I finish my coffee before I enter the room. I felt it was the polite thing to do.

We did not share any small talk, and he started asking questions: ‘Tell me, did you read up on Autism as we discussed?’.

I confirm and he doesn’t say anything. I look at his face and I look at his hands and I look at his body language and I gather that he is probably waiting for me to elaborate.

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I recite what I have read the day before:

What Is Autism?

Autism, also called autism spectrum disorder (ASD), is a complicated condition that includes problems with communication and behavior. It can involve a wide range of symptoms and skills. ASD can be a minor problem or a disability that needs full-time care in a special facility.

People with autism have trouble with communication. They have trouble understanding what other people think and feel. This makes it hard for them to express themselves, either with words or through gestures, facial expressions, and touch.

People with autism might have problems with learning. Their skills might develop unevenly. For example, they could have trouble communicating but be unusually good at art, music, math, or memory. Because of this, they might do especially well on tests of analysis or problem-solving.

More children are diagnosed with autism now than ever before. But the latest numbers could be higher because of changes in how it’s diagnosed, not because more children have a disorder.

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Autism Signs and Symptoms

Symptoms of autism usually appear before a child turns 3. Some people show signs from birth.

Common symptoms of autism include:

  • A lack of eye contact
  • A narrow range of interests or intense interest in certain topics
  • Doing something over and over, like repeating words or phrases, rocking back and forth, or flipping a lever
  • High sensitivity to sounds, touches, smells, or sights that seem ordinary to other people
  • Not looking at or listening to other people
  • Not looking at things when another person points at them
  • Not wanting to be held or cuddled
  • Problems understanding or using speech, gestures, facial expressions, or tone of voice
  • Talking in a sing-song, flat, or robotic voice
  • Trouble adapting to changes in routine

Some children with autism may also have seizures. These might not start until adolescence.

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Autism Spectrum Disorders

These types were once thought to be separate conditions. Now, they fall under the range of autism spectrum disorders. They include:

  • Asperger’s syndrome. These children don’t have a problem with language; in fact, they tend to score in the average or above-average range on intelligence tests. But they have social problems and a narrow scope of interests.
  • Autistic disorder. This is what most people think of when they hear the word “autism.” It refers to problems with social interactions, communication, and play in children younger than 3 years.
  • Childhood disintegrative disorder. These children have typical development for at least 2 years and then lose some or most of their communication and social skills.
  • Pervasive developmental disorder (PDD or atypical autism). Your doctor might use this term if your child has some autistic behavior, like delays in social and communications skills, but doesn’t fit into another category.

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Autism Causes

Exactly why autism happens isn’t clear. It could stem from problems in parts of your brain that interpret sensory input and process language.

Autism is four times more common in boys than in girls. It can happen in people of any race, ethnicity, or social background. Family income, lifestyle, or educational level doesn’t affect a child’s risk of autism.

Autism runs in families, so certain combinations of genes may increase a child’s risk.

A child with an older parent has a higher risk of autism.

Pregnant women who are exposed to certain drugs or chemicals, like alcohol or anti-seizure medications, are more likely to have autistic children. Other risk factors include maternal metabolic conditions such as diabetes and obesity. Research has also linked autism to untreated phenylketonuria (also called PKU, a metabolic disorder caused by the absence of an enzyme) and rubella (German measles).

There is no evidence that vaccinations cause autism.

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Autism Screening and Diagnosis

It can be hard to get a definite diagnosis of autism. Your doctor will focus on behavior and development.

For children, diagnosis usually takes two steps.

  • A developmental screening will tell your doctor whether your child is on track with basic skills like learning, speaking, behavior, and moving. Experts suggest that children be screened for these developmental delays during their regular checkups at 9 months, 18 months, and 24 or 30 months of age. Children are routinely checked specifically for autism at their 18-month and 24-month checkups.
  • If your child shows signs of a problem on these screenings, they’ll need a more complete evaluation. This might include hearing and vision tests or genetic tests. Your doctor might want to bring in someone who specializes in autism disorders, like a developmental pediatrician or a child psychologist. Some psychologists can also give a test called the Autism Diagnostic Observation Schedule (ADOS).

If you weren’t diagnosed with autism as a child but notice yourself showing signs or symptoms, talk to your doctor.

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Autism Treatment

There’s no cure for autism. But early treatment can make a big difference in development for a child with autism. If you think your child shows symptoms of ASD, tell your doctor as soon as possible.

Continued

What works for one person might not work for another. Your doctor should tailor treatment for you or your child. The two main types of treatments are:

  • Behavioral and communication therapy to help with structure and organization. Applied Behavior Analysis (ABA) is one of these treatments; it promotes positive behavior and discourages negative behavior. Occupational therapy can help with life skills like dressing, eating, and relating to people. Sensory integration therapy might help someone who has problems with being touched or with sights or sounds. Speech therapy improves communication skills.
  • Medications to help with symptoms of ASD, like attention problems, hyperactivity, or anxiety.

Talk to your doctor before trying something different, like a special diet.WebMD Medical Reference

Sources: 

© 2019 WebMD, LLC. All rights reserved.

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My Psychiatrist looks at me and says: ‘Did you recognize anything about yourself?’.

‘Not really, no.” I say.

And I continue talking to him about why I did not see myself as having a problem and I don’t understand why I am in the hospital and I start talking about how since my childhood I felt that life was an adventure although challenging at times and how I had a wild imagination and I really loved watching movies and I could memorize the dialog and I loved physics and mathematics and how things worked and how I read encyclopedias and was fascinated by how flowers grow and how ants build their nests and the feather of a bird was something I would study for hours and I couldn’t sleep at night because I wanted to know everything and my brain had a buzzing sound when I was 5 years old and I used to rock myself to sleep at night and I didn’t like the clothes my mom bought me and I hated apples, I REALLY hate apples and the TV was always too loud and I could smell my mothers cooking from hundreds of meters away and I could never see when people were angry and got into a lot of trouble without meaning to because I was completely caught up in my own world and I would climb to the top of trees because I liked the way it swayed in the wind and I loved to swim because I enjoyed the sensation of water on my skin and didn’t understand why I had to stay in school because it was so easy and I wasn’t allowed to answer all the questions all the time…

The Psychiatrist smiled, he nodded and said: ‘You just spoke at length about various things after I asked you one question. ADHD is the next topic for you to read about please. In addition, you made eye contact once and the tonality of your voice never changed which leads me to suspect that you are on the spectrum. Let’s look at trying to treat some of the symptoms you currently have and see how you react with some medication. Are you okay to try it?’ he asked.

‘Sure…’ I said.

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He prescribed something for serotonin levels to stabilize and something for dopamine levels to stabilize. He said it helps for people with ADHD and major depression.

‘Excuse me?’ I said, ‘I don’t have depression, I love life!’ I exclaimed.

‘Sir, you tried to commit suicide a couple of days ago. The wound on your arm is still bleeding. You have major depression even if you frame it in your mind as “adventure”. I know it’s difficult to see it in yourself, understand it and accept it, but I will help you. Let’s get the nurse to clean your wound again, get you the medication and I suggest you take it easy the rest of the day and please read up on depression and ADHD and some more on Autism Spectrum Disorder. I will see you again tomorrow.’ he said and got up to go and speak to the nurse.

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She cleaned the wound, gave me my medication, I read articles on Autism and Depression, I had lunch, I read some more, I had dinner, I took a shower, read more, took my medication and went to bed and started thinking about Autism, ADHD and Depression and fell into a deep sleep…

Day 2 post failed suicide attempt – what is BPD?

Morning

The first morning I wake up at the hospital when a nurse come to check my blood pressure. I am still a bit drowsy from the sleeping pill and I kind of put together the room, the day, the previous day and why I am here…

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We have breakfast, I go to take a shower and get dressed for the day, not knowing what to expect.

They call me to inform me that a Psychologist is waiting for me in the consultation room. I go in and he introduces himself and tell me to sit and get comfortable. I tell him what I told the Psychiatrist the day before and he takes a lot of notes on the file in front of him.

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“Sounds like Borderline Personality Disorder to me…’ he says.

“I am not saying it is, but it sounds like it…’ he continues.

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‘Excuse me?” I ask, “my Psychiatrist mentioned Autism and said I should rest as much as I can today while reading up on Autism, what is Borderline Personality Disorder?” I continue, kind of confused but also intrigued at the same time.

He hands me a piece of paper which reads:

  • Individuals who match this personality disorder type have an extremely fragile self-concept that is easily disrupted and fragmented under stress and results in the experience of a lack of identity or chronic feelings of emptiness. As a result, they have an impoverished and/or unstable self structure and difficulty maintaining enduring intimate relationships.
  • Self-appraisal is often associated with self-loathing, rage, and despondency.
  • Individuals with this disorder experience rapidly changing, intense, unpredictable, and reactive emotions and can become extremely anxious or depressed. They may also become angry or hostile, and feel misunderstood, mistreated, or victimized.
  • They may engage in verbal or physical acts of aggression when angry.
  • Emotional reactions are typically in response to negative interpersonal events involving loss or disappointment.
  • Relationships are based on the fantasy of the need for others for survival, excessive dependency, and a fear of rejection and/or abandonment.
  • Dependency involves both insecure attachment, expressed as difficulty tolerating aloneness; intense fear of loss, abandonment, or rejection by significant others; and urgent need for contact with significant others when stressed or distressed, accompanied sometimes by highly submissive, subservient behavior.
  • At the same time, intense, intimate involvement with another person often leads to a fear of loss of an identity as an individual. Thus, interpersonal relationships are highly unstable and alternate between excessive dependency and flight from involvement.
  • Empathy for others is severely impaired.
  • Core emotional traits and interpersonal behaviors may be associated with cognitive dysregulation, i.e., cognitive functions may become impaired at times of interpersonal stress leading to information processing in a concrete, black-and white, all-or-nothing manner.
  • Quasi-psychotic reactions, including paranoia and dissociation, may progress to transient psychosis. Individuals with this type are characteristically impulsive, acting on the spur of the moment, and frequently engage in activities with potentially negative consequences.
  • Deliberate acts of self-harm (e.g., cutting, burning), suicidal ideation, and suicide attempts typically occur in the context of intense distress and dysphoria, particularly in the context of feelings of abandonment when an important relationship is disrupted.
  • Intense distress may also lead to other risky behaviors, including substance misuse, reckless driving, binge eating, or promiscuous sex. (APA, 2010)
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“Well, I will leave you to rest as your Doctor suggested, I will see you again tomorrow” he says, and say goodbye and leave the room.

I go back to my room I share with 3 other men and lie down on my bed. I read what I can find on Autism, but I also read the paper he gave me. I do not recognize myself at all when reading about BPD. Strange…

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I guess I have to wait for the Psychiatrist to clarify exactly what this means. He will only be back the next day and he has prescribed pain killers for the suicide attempt wound on my wrist, anti-depressants and more sleeping pills (which I have to take in front of the nurse so they can confirm that I did take the medication).

Afternoon

I eat lunch and read, I eat dinner and read, I take a shower and read, and I take my evening medication and sleep….