Link Between ASD and Substance Abuse

An interesting article from Psychology Today appeared on my Facebook wall today:

Autistic Symptoms Make Higher Risk For Substance Abuse

Which apparently doesn’t mean people with an autism diagnosis:

‘As you would expect, previous research shows that people with autism tend to have low rates of substance abuse – the preference for low risk and avoidance of social situations means less drinking or drug use. But new research from the Washington University School of Medicine found the opposite: in their study of 3,080 Australian twins, people with symptoms of autism were more likely than people without symptoms to abuse alcohol and marijuana.’

So I think this article is saying that people toward the lighter end of the spectrum, as opposed to those with HFA, are at a higher risk of substance abuse issues.  It’s been observed that Asperger syndrome has a higher risk percentage of mood disorders than the neurotypical population.  One in three people with an Aspergers diagnosis will experience depression in their lifetime, as opposed to the one in five in the general population.

People with mental illness do tend to self-medicate.  A mental illness diagnosis reduces your life expectancy by up to twenty years and no, it’s not because of suicide.  The biggest killer of the mentally ill population are diseases acquired through smoking.  Also significant causes of death are cardiovascular diseases and diabetes.  Diseases acquired through various forms of self-medication.

Me, I have an addictive personality.  At any given time I indulge in a number of obsessive behaviours but as we know I am a hotbed of assorted psychological malfunction.  To blame my behaviours solely on any one of the conditions would be disingenuous.  Labels are useful tools for getting help but not always for treatment – rather than worrying about what was causing my obsessive behaviours the most helpful approach has been to address the psychology behind the behaviour (hello DBT.)  That way we can break the cycle and form some new ones.

So what does this mean for people on the spectrum?  It’s important to remember that association is not the same as determinism.  If you have a higher risk for substance abuse, that does not mean that you will be a substance abuser.

Like how I have bipolar disorder which means I have a life expectancy of 60.  That does not mean I’m going to drop dead on my 60th birthday, it means I have to take care of myself.  I don’t smoke.  I need to eat better and exercise more.  But also accept that there are no guarantees in life – I could walk out my door and get hit by a car tomorrow.

Be mindful of your own behaviour.  Acknowledge when your lifestyle changes and be honest with yourself as to why.  So you don’t socialise as much as you used to.  Why is that?  Maybe you’re under a lot of pressure at work right now and having to stay back long hours for a while?  Fine.  Or has your confidence slipped?  Do you not feel as close to your friends as you once did?  And do you find yourself reaching for the bottle more and more now that you’ve got more time sitting on your own in front of the tv?

Changes in weight, sleep, lifestyle should always be examined.  It’s not always going to be a cause for alarm, life is about change after all but change is not always positive and not always necessary.

Take care of yourselves

Mac

Advertisements

The Rehab Diaries Week 4 – Holiday Time is Over

 

2015-02-19 16.47.53

 

Finally, I got to see the new doctor.  He was a pleasant character and after a few leading questions I found myself pretty much telling him my life story, including how I had applied for medical school this year, and missed the UMAT cut off for my school of choice my just a couple of points.

He was supportive, saying that he had several patients who had gone on to careers in medicine, and some much older than me.  He tried to decipher my doctor’s notes – apparently he has typical doctor’s handwriting – and it appears that he eventually intends to supervise me onto 100mg of Zeldox, which would indicate 2-3 more weeks of rehab.  He told me that he would be putting it up to 60mg this week.

When mum picked me up for leave that afternoon I passed on that information and her reaction was one of despair.  How could I be there for a month?  Don’t my doctors understand the havoc I am wreaking on my family yet again? Thanks mum, real helpful…  (Actually I’ve been there for five weeks before but I think this admission will top that.)

If last week was the week of agitation, this week is the week of anxiety.  I’m still experiencing racing thoughts, racing through everything I could possibly be anxious about.  Just leaving the hospital makes me feel so ill.  BF and I were going to the beach last week but that’s out of the question now.

For some reason thinking about moving home is triggering me badly.  It’s just the whole moving process being such a pain in the butt, I just want it over with.  We’ve been going to my place to get bits and pieces and that’s so hard.  For some reason being in my suburb is giving me anxiety over the fact that it’s a super rough area.  Which it is, but I’ve lived there for two years and never been broken into or had any such trouble from the residents.  The drama stayed out of our house and on the street but still I can’t help agonising.  It sucks.

I’ve been catastrophizing something dreadful.  My mind latches onto a dreadful idea, and I can’t relax until I’ve been able to confirm it.  For example, while I was on leave one morning I became convinced that someone had gone into my room and stolen my contraceptive pill.  Which is ridiculous, right?  That’s a horrible thing to do and I haven’t even talked to the other patients enough to infuriate someone to the point where they would do that.  But I couldn’t let it go.  I ended up calling the nurses’ station and making one of the nurses check that it was in my drawer.  Which it was.

I’ve had many ‘ideas’ like this.  When I have them I make sure to tell the staff so that my irrational thinking is going on record because this needs to stop.  Of course the fact that I’m aware that these thoughts are irrational bodes well for me but it’s still eating me alive.

And then to add a poisonous olive on the side of this paranoia laced anxiety cocktail, I woke up one morning and the double doors between ward one and two had been thrown open.

Holiday time is over.

“Oh yes, we’re back to normal functioning this week.  Prepare for fifty thousand admissions.”  My nurse confirmed cheerfully as she brought my morning tablets.

I later found out that this number is actually closer to seven.  Admissions generally happen two days of the week, so they were able to stagger the patients coming in.

The advantage of course is that all the staff are running at full capacity, including the therapists.  Group therapy is back.  I gave groups another chance, and the first one I went to left me feeling positive – the therapist allowed us to check in, so the self pitying ramblers were not allowed to talk over anyone or hog the air time.

I’m certainly not above talking too much, and it’s something I’m very self conscious about; I’ve noticed in group therapy that those who talk the most tend to apply the skills the least and I can’t possibly be the only one.  I always cringe and swear I’m going to pass ever time they start going around the circle to check in but let loose when it’s my turn.  Those damn therapists sure know how to ask leading questions.

I was also eagerly awaiting the return of my therapist this week to finally start unpacking all this anxiety but my excitement was premature.  I saw her once before she had to go on leave for a week for surgery.  LAIM.  Am I going to get any kind of decent interpersonal therapy before I get discharged?

We’ll find out next week I guess.

Mac

 

There’s No Wrong Way To Feel On Valentine’s Day

VALENTINES DAY IS STUPID!

Hm, mature.  Why is it stupid?

It’s just a conspiracy by Hallmark!

Well Jesus wasn’t resurrected to sell chocolate, and Christmas day was a political move by the Roman Empire to satisfy the Christians and the pagans, what’s your point?

You can’t just have one day to show how much you care.

Ah, I remember who the last person I heard say those exact words was.  The guy who cheated on his girlfriend with me and convinced her that I’m just a crazy stalker when she cottoned on (I’ll save that sordid tale for another time.)

Well k, (since when are we on speaking terms anyway?) I can’t help but wonder if it would be a colossal ask even for a seasoned player like you to pick up a vulnerable girl a decade your junior every single day of the year.  You know, just to demonstrate how much you clearly respect and care for your partner.

There’s just so much pressure.

You don’t know what’s expected of you?  Here’s a novel idea, how about you talk to your sweetheart?  I hear this communication business does wonders for relationships.  There’s no such thing as a stupid question as far as expectations go.  Don’t ever assume – hurt feelings are based on assumptions.

You’re just making single people feel inadequate.

Um, WUT.  Explain.

By being all lovey-dovey up in our faces.

Well, yeah.  I’m in love and love spending time with him.  This day gives me another excuse to do that, and a reminder to appreciate what we have.  Notice that this is about two people – me and him.  Why would you insert you into that?

It just makes me…sad.  Angry but mostly sad.

Aha, progress!  And is it my fault?

No, it’s everywhere.

Yeah it is.  Ok you so you’re sad.  And there’s a lot of this, uh, lovey-dovey trigger around today making you sad.  That sucks.  But why does it happen?

Pft isn’t it obvious.  I’m alone.

Oh come on, unpack that a little further.  Owning your feelings is the first step to healing.

I feel like a failure.  Like people think that there must be something wrong with me because I don’t have someone.  I want a partner so bad it’s pathetic.

Don’t call yourself names.  Why are you pathetic?

Why do I need to rely on someone else for my happiness?  That’s why I’m pathetic.  I want people to believe that I’m happily single.  And I should be, shouldn’t I?  If I can’t make myself happy, how will I be able to satisfy someone else?

Whoa, that’s deep.  Be careful thinking in ‘shoulds’ I once had a psychologist tell me that behind every adult temper tantrum, there’s a ‘should’…anyway, you raise a valid point, it’s important to establish independent identities as adults separate from x’s partner who participates in x’s hobbies and hangs out with x’s friends.   But just because you can get by as a single person, doesn’t mean you’re obligated to like it.  You could be perfectly capable of supporting yourself and pursuing separate interests and still prefer the particular companionship that comes with a long term relationship, the same way that some people are truly better off single.  It’s not pathetic, it’s the way you are.

What I’m saying is…there’s no wrong way to feel.  There’s a wrong way to manage and express those feelings sure, but you’re not pathetic feeling sad on Valentine’s Day.  Lots of people do.  I am.

Excuse me, you have no right to be sad.  You have a boyfriend.

Well if the annual dedication to relationship bliss is a trigger for you despairing over your singledom, don’t you think that it might also be for those in abusive relationships?  Or relationships that are on the rocks?  Wouldn’t it be a painful reminder of the shame and disappointment that comes with trying to come to terms with all of that?

I’m not throwing my boyfriend under the bus, he’s awesome.  But I have a lot of emotional baggage from encounters from other men – an example of which I pretty much spelled out above – that I’m still struggling to work through.   Even though BF and I love spending time together that is always hanging over us, intruding on my thought process.  It’s eating me alive.

So what do you do?

I just…sat with it.  I’ve realised that I’ve got to let myself be sad and acknowledge that that’s what I am.  Otherwise the sadness turns into anger and unhelpful actions.

Like saying Valentine’s Day is stupid huh?

Ha, yes.  Something like that.

What you felt, isn’t pathetic.  It’s valid.

If you are feeling sad, let yourself be sad.

If you are feeling lonely, let yourself be lonely.

If you are feeling grief over a lost or dying relationship, allow yourself to feel grief.

It’s tempting to push down your feelings with anger and acting out but it’s not helpful.  There are far more constructive ways to distract yourself then shitting on everyone who is minding their own business enjoying the day.  Date yourself.  Date your friend.  Throw and anti-valentine or gal-entine party, as long as it’s fun spirited.

And for the love of God stay off social media, it’s all smoke and mirrors.

Mac

The Rehab Diaries Week 3 – Oh so quiet, just not in my head.

 

 

justmymind

 

My brain is resisting sleep.  Getting out of bed is hard but getting in is harder.  My anxiety is so restless even though I’m on more than ever before.

I was bouncing off the walls.  A good proportion of my dad was spent pacing back and forth.  I was hiding in my room to avoid human contact.  Even though the ward was closed and there were hardly any patients in, as we know I still found everything and anything to be irrationally enraged at.

My trichillomania had been triggered as it often is in times like this but bizarrely instead of pulling out my own hair, it has been transferred onto my boyfriend.

“Can you talk to the doctor about this?”  He asked jokingly, pointing to his scabbed up face.  I cringed.  Once he put it out there it seemed to be no joke at all.  Popping his zits is something I do a lot – be honest ladies, you know you do this – but my attacks on his face had gotten harsher.  Patches of hair from his beard were missing too, as I kept saying I “just want to get rid of the weird hairs.” I had to keep checking for grey hairs, or split hairs, or hairs thicker or thinner than the others.  And if I found one, it had to go.

BF had been saying that he wanted to meet the doctor to get a better understanding of my illness.  I asked the doctor if him sitting in for a bit was ok, which he agreed to but once the door closed, stage fright struck.  We asked BF if he had any questions and he kept saying he didn’t know.  After a few minutes of this I grew impatient and threw him out.

The doctor was sympathetic to my claims of elevated mood from the previous week, even though it was maddeningly settled that day so he couldn’t observe it in consultation.  He admitted that the increased melatonin may have overshot the mark and scaled it back to 25, increasing my zeldox by another 20 at night because previously when I had been taking 20 morning and night I always needed a nap at midday.

My med woes were not over however, as later that night a nurse came running into my room absolutely beside herself.  “It’s no good, Mac.  We’ve messed up your cycle.  You need to start used protection because if you get pregnant because of me, I’ll never forgive myself!”

She explained that there had been a communication issue regarding the dispensing of my contraceptive pill.  A few days after I arrived another nurse gave my pill back to me and told me to manage it myself.  I thought that was fair enough.  But that night, I saw a little Yaz in with my normal pills.  Silly me just assumed without questioning that they’d changes their minds.

Apparently it hadn’t been recorded that I was managing it myself, so depending on which nurse was doing the medication rounds, some nights I was being given the pill, and some nights I wasn’t.  And stupid Mac was just swallowing whatever she was given without checking.

After apologising profusely she launched into a lengthy lecture about safe sex that left us both ruffled and red-faced.  Do I have access to condoms?  Will BF wear one?  Will I make him wear one?  Can we abstain?  Is it hard for him?  Hard for me?

I’m going red again just thinking about it.

Her concerns turned out to be unjustified as I got my period a few days later.  Maybe that explains my mood.  I’ve had to deal with all the delightful extras that come with that, including the cramps.  My cramps are nasty at the best of times, and the only thing that really helps is heat.  Unfortunately heat packs are not allowed due to the risk of self-harm so the staff loaded me up with panadeine and I had several hot showers a day.  The temperature of the showers is set to a maximum of pleasantly warm so we can’t burn ourselves.

On the increased zeldox my brain became settled enough to make one major decision – I have decided to move back in with my parents.  My health has been so bad for so long I’ve had to get real about what I actually need and at this point I feel like living in my parents’ house is the best option.

The configuration of the house will have to be changed to give me acceptable independence.  My parents have tasked me with working it out and it has shown to be a good way to keep my mind active.

New year’s eve fell on this week and it had me really worked up.  Maybe because it was so hot, maybe because my mum and I had an argument over the way I cleaned the bathroom on leave but I was ready to go without dinner – and let my boyfriend do the same – after I called around several take out places for dinner to find they were all closed and had a ‘fuck this I’m done’ moment.

After a pep talk from mum I called one more place – which was open.  My anxieties about traffic and crowds were completely unfounded, while the restaurant was located in the middle of town it was deserted when we got there at 5.30.  And the pizza was fantastic.

I’m not really one to get worked up over FOMO, so I wasn’t keen for grandiose new year’s plans and BF is the same.  But I was a little bummed about not being able to do the midnight kiss.  See, normally the clinic doors lock at ten so we have to be back by then when we’re on leave.  The staff were willing to make an exception for new years eve but legally we had to be back by midnight.

So we went to 9pm fireworks which were fantastic…so fantastic that I had a brief seizure!  I’m epileptic, even though my seizures are very rare I am changing meds at the moment so it’s not that big a deal.  I notified the staff when I got back to the hospital and that was their impression as well.

My doctor was off for the rest of the week and I was supposed to see one of the others but I didn’t realise that he works on a different schedule to mine, who works Tuesdays and Fridays.  The fill-in works Mondays and Thursdays so I went out all New years day thinking I would be seeing him on Friday, but no deal.  Oops!

With only the one tablet being increased it’s not that big a deal; they can’t bring it up faster than once a week anyway.

I would have to wait until the next week to see him, when the ward opened again…how would I be handling that?  You’ll have to wait until the next instalment to find out.

Mac