Finding Myself

I have been fighting my brain since I was 8 or 9; that's about how old I was when I first journaled about feeling like my brain was wrapped in a fog and I just couldn't even THINK, let alone act. That started a long road of knowing that I was different from the people around me but not knowing why. I became very introspective, which just fed into my anxiety. My teenage years and first romances sparked a rollercoaster of highs and lows, and I started experiencing physiologic symptoms with my anxiety. A fight followed by my long distance boyfriend ghosting me would result in a day of vomiting followed by 2 days of sleeping. Severe stress/anxiety would result in the loss of 3 functional days. I began to recognize the pattern and identify signs; being unreasonably chilled was the first major sign that I was entering crisis territory.

Then I went away to college, and a new pattern emerged. Fall semester, when I was rested, I was on task (as long as the task was semi-interesting), and I consistently earned Dean's or President's list. Spring semester I was consistently exhausted and putting out minimal effort, having trouble passing my classes. This pattern, plus some issues with one of my roommates, led my college therapist to suspect bipolar 2 and start me on my first SSRI (Paxil). All this medication did was make me less anxious about my executive dysfunction, and in some ways made me more volatile because I was less concerned with what was expected of me; I also got vertigo with it, so I weaned myself off and discussed a different medication with the school nurse practitioner, which was fruitless. Since I was responsible for getting my own food, I did a lot of low effort same eating. Spring semesters also involved a lot of sweet instant dopamine foods; one year it was pints of ice cream every week, another it was box made red velvet cupcakes by the dozen. I knew it wasn't good for me, but the comfort helped me function at least a little.

Then, my senior spring semester, a friend gave me some of their Adderall and a whole new world opened up. My thoughts were clear and organized, not fogged over. I had functional paper ideas that I was able to complete. One of my professors even asked to use one of my play analyses in his future classes. So that was it, ADHD was the answer. After returning home, I did research and tried to implement better coping skills for ADHD on my own. Then, when I found myself still struggling to keep everything together and had a few near accidents due to disassociating while driving, I went to a counselor. Ultimately we were not a good fit, but she did go through a brief DSM-IV checklist with me, and made my symptoms fit the checklist. I took that to my primary care physician and got my very own prescription for Adderall. After a few months, she decided she wasn't comfortable prescribing it long term, so I went looking for a clinic for both counseling and medication management (I still firmly believe that both in tandem is the best management of any mental health situation as long as you have the right connection with both your counselor and the prescriber.) I found a clinic near my work and established care. I went into counseling with high hopes, but these did not last very long; the medication management seemed similarly farcical. The counselor did not seem to understand anything I was expressing; one session in particular, I had just finished explaining how my reactions to situations are dependent upon multiple variables and it was difficult to give a set answer to one of his questions, and his response was "why are you so rigid"...that was the day I knew our professional relationship was over. That, plus I was being charged incorrectly, for a session length I neither wanted nor ever agreed to. The provider in charge of medication management was no better; in regard to the Adderall, she would have prescribed whatever I asked for. When I went in due to a spike in anxiety (that ended up being related to my birth control), she ASKED ME WHAT I WANTED. There were no suggestions on her end, no collaboration, just asked me what medications I wanted. My bachelor's degree in psychology did not warrant that amount of leeway. So I became even more disillusioned and dropped both the medications and counseling for a while; I had no faith in their ability to help guide me, and it was more expensive than I could keep up with. I kept trying to cope and learn on my own, but I was struggling. I was also a manager in charge of recruitment, interviews, hiring paperwork, training, continuing education, etc and my executive dysfunction was not helping at all. So I finally did some research and found an office 1.5 hours away that did neuropsychological testing; I wanted to know once and for all what was going on.

I went in and met with an intake counselor, and we reviewed my goals and concerns; then she scheduled me with the assessor. What I was intially told was likely going to be an extended process over 6+ sessions, ended up being condensed into half that. The outcome, I was told, was not actually ADHD but more generalized anxiety and disproportionate processing abilities (my verbal processing in the 97th percentile and my visual memory/processing just above deficient). I didn't feel like this was the whole answer, and even raised some concern with a new counselor that the results were skewed because psychology is a special interest of mine, which means I would appear to be more focused on it. This was kind of acknowledged but not really pursued, and therapy continued to focus on my anxiety as the primary diagnosis. I was working long hours and under immense levels of stress at work, so anxiety was what was primarily on the surface. I took on a new role which involved traveling, which meant therapy had to be put on the back burner; I was back on my own coping skills. At least with traveling, I had more space - both physical and mental/emotional - to exercise my coping skills, there was no one to silently judge me when I slipped into gremlin mode. I traveled on my own for 1 year, and then COVID - 19 hit and my travel position was dissolved. Back to home I went, back to a space not truly my own with its unspokent expectations and triggers.

I started a new job and seemed to be settling in ok despite some initial hiccups; but then I began to notice an increase in fatigue, which made no sense. I finally had a set schedule, which meant my sleep schedule had the time to be more regulated and consistent; I didn't have any managerial stressors anymore, I was just a tech screening patients. I should have been less tired and stressed, not more.

I also started having more lower back pain and pain in my SI joint, so I went to my primary care doctor. We got scans, which showed progression of arthritic changes, and I went to an orthopedic doctor. With the orthopedic doctor I was able to discuss some of my more general musculoskeletal concerns, and he recommended going to rheumatology. I also started PT for my SI joint dysfunction; my right SI joint had officially decided it was no longer going to participate in its assigned tasks and just start fusing itself together. After a 4 month wait, I was finally able to get in with a rheumatologist; after a long discussion of my chronic life long symptoms and a physical exam, he said "so you are hypermobile, you have IBS, and a little autonaumic dysfunction, you need to work out more". Which, great, I finally knew the source of some of my pain and hand issues, but that didn't solve how I was supposed to work out, when climbing stairs makes me feel like I'm going to pass out, but ok.

During all of this, I had been trying to get established with another therapist, because I became pretty sure I'm autistic. I didn't go straight back to my last therapist due to commute; I tried a different telehealth therapist and it was a disaster. He completely dismissed my autism concerns, assigned me a $30+ workbook for anxiety (knowing I don't have much extra money), and then had his schedulers schedule me for 3 months worth of follow up visits at a time I was unavailable due to my work schedule (and we had discussed this during our appointment). I cancelled all the upcoming appointments with him that I had never agreed to, and kept looking for another therapist.

Then, a ray of light; I learned that my previous therapist had started doing telehealth visits, so I scheduled with her. In our first visit back, I brought up my concerns, and she thoughtfully considered them (which is what a therapist is supposed to do). She sent me a checklist that had been compiled specifically towards autism in females, and so much of it resonated with me that it was shocking. In our next meeting we reviewed the checklist, and she went over my previous testing again; we concluded my suspicions were correct -- I am autistic.

After 31 years of wondering what was wrong with my brain, and why I couldn't function like other people despite trying my hardest, I finally had an answer. I was not at all surprised by the diagnosis, but I was relieved.

Of course, I now have a lot of retraining and adjusting of expectations to do. I do a lot of masking to hide my autism, and it takes a lot of energy. My new job had me masking to meet the expectations of over 20 new people every day, on top of masking in front of my managers and coworkers; it was no wonder I was so functionally exhausted at the end of the day.

2 years later, it feels like I struggle just as much as before. I still don't know how to identify myself or adequately present my needs. I have a new job, that in theory is slightly less people facing, but the expectations are not very clearly set and that is even more stressful. I don't even know where to begin with that conversation, because I appear so "high functioning" that no-one knows there is an actual issue until I start to meltdown - by which time it's too late. I have a lot of internalized ableism that makes it harder to accept and work with my dynamic disabilities - both mental and physical. And how can I expect someone else to believe that I need accommodations when I can't consistently accept that about myself?

I know that it starts with me; I have 33 years worth of ableistic and neurotypical expectations and self-beliefs that I have to work through and deprogram. I also have 33 years of masking to peel away, to find who I actually am behind my curated persona. It helps to see people I can identify with speaking their truths on the internet; it's what inspired me to write my story down. Hopefully it won't take me another 33 years to fully accept who I am; or indeed even find out who I truly am.