Daring to Defeat Depression

Over the last week I've been approached to write posts on a number of subjects, Communication Skills, Cures, Confidence, all of which I am very excited to share my thoughts on but not this week. I've had a terrible week. Actually I've had a terrible month! I've really wanted to try and highlight as many positive aspects of autism in my posts as I can, but this week I'm going a different direction. I got thinking about why I started this blog. I wanted to share MY experiences. Good, bad, whatever, just my experiences, this week they've been really appallingly bad, so this is what you get to read about today.

Depression and anxiety aren't exclusive to autism, and some on the spectrum don't suffer from this at all, but it is very often something people with autism face, I'm one of them. Depression is a tiring and frustrating beast to face. We rarely openly talk about it and it still today comes with stigma and fear attached. It occurred to me that I would feel at ease posting a blog about having a cold or flu, a broken bone or a migraine. Mental health concerns however somehow feel more personal and harder to talk about. Why should this be the case? I wanted to face the fear and talk to you about it right here in my blog this week.

I didn't know how to talk about or explain how I experience depression and anxiety so I simply wrote how I felt during one particularly bad night this week. It's not neat and tidy, grammatically concise or detailed. It doesn't need to be, it is simply how I felt. I want to give the full picture in my blog, both good and bad, so here we go.

            Autism can be relentless.....

            meltdowns rolls into meltdowns,

            my senses burning, my brain imploding ,

            this hurts.....

           

            I'm so tired,

            but I carry on,

            questions, decisions, guilt,

            why is it so hard to say I need help?

            and this hurts....

           

            You ask who's at fault?

            who's to blame?

            we talk about it, talking for hours,

            but this hurts.....

           

            the adrenalin flows and my insides burn,

            guts twisted in knots,

            head pounds,

            this hurts....

           

            You say it's my fault,

            that I'm weak,

            to man up,

            ....but this hurts..........

           

            I can take some meds,

            numb the senses,

            shut out the world,

            it still hurts......

           

            I see your pain,

            I see your frustration,

            I see the hurt I cause you,

            and it hurts....

           

            why am I so wrong,

            so bad,

            so selfish,

            to sometimes want this to all stop

            .....because it hurts?

            breathe in

            three

            two

            one

            breath out

            and relax

            tomorrow will be a better day?

Tomorrow was a better day this time, but each day one person dies every 40 seconds because it wasn't a better day. Suicide is the biggest killer of men under 50 in the UK, let's all play a part in reducing this statistic and talk about mental health. There is still a stigma about mental health issues that MUST be removed. Depression is a silent killer and is no more a choice than any physical illness so let's treat it the same and be open about it's affects and find a way forward together.

If you need to talk today or have concerns about someone you know then here are some phone numbers for you:

UK: Samaritans 08457 90 90 90

Republic of Ireland: 1850 60 90 90

USA & Canada: National Suicide Prevention Lifeline 1-800-273-TALK (8255)

Australia: Lifelink Samaritans: 03 63 31 3355

For a larger list of countries visit http://www.suicide.org/international-suicide-hotlines.html 

I Know There's People Worse off Than Me

Today’s school meal was grisly mince slop served with dry potatoes with the texture of shoe insoles. I’d lost my appetite and gingerly prodded at this mess until it had been concealed beneath the remnants of the potato.

‘Starving children in Africa would be thankful for that lunch!’ exclaimed the dinner lady.

I pondered this comment. Did the school really send my leftovers to Somalia? How did they get it there? Would it not be cold and inedible by the time it arrived?

The problem was that I simply didn’t understand the sarcasm and the real meaning behind her statement. Instead of understanding that she was telling me to eat the food and be grateful that I actually had food, I could only summarise that this food was actually sent there and therefore I should always leave a portion for them at every meal.

Not quite the affect this dinner lady had in mind but a common attitude encountered.

The sentiment behind the message here is simple; My dislike of the food is far less important when in the perspective of someone who had no food and would be thankful for the vile slop I was turning my privileged nose up at.

Clearly there are times when it’s helpful to step back and see things in perspective, but other times it’s down right dangerous. It’s not the times we have a small gripe about the quality of the food here, It’s when there is something else, something more serious going on.

The recent tragic death of Robin Williams should highlight an important lesson for us all. Mental Illness can affect anyone, regardless of circumstance. On the surface it would be easy to ask what Robin Williams had to be depressed about. Was he living with abject poverty, war, starvation, severe disability…..? No he didn’t, but that’s not the point. Depression and feeling depressed are two entirely different things. Depression is an illness and should be treated as such. I can’t possibly speak into the circumstances that spiralled so tragically for Robin Williams but I can share my experience of depression.

I have at times struggled with severe depression. It comes and goes, but is something that I know I am likely to face again in the future. The struggles of living with autism create a particularly challenging set of circumstances for me that can act as a trigger and this comes hand in hand with periods of both depression and anxiety. I will be covering both of these subjects in more detail in later posts. Both anxiety and depression are treatable and manageable but need proper support. There is a vast difference between feeling a bit depressed and having chronic depression, the same can be said for anxiety.

At times like this it would help to see the bigger picture right? This is an attitude that is so very common and one that stirs anger in me and makes me seethe. But why? What could possibly be wrong with a reality check on our own place in the world and a reminder that in fact our problems aren’t as bad as they could be?

Let’s start by looking at the inconsistencies of the perspective.

By picking this apart there are a number of glaring holes in the argument. The first one we come across is how inconsistent it is. To my logical brain using a linear perspective like this removes an ability to express any personal feeling at all. So there is someone worse off than me? What if I was that person, there’s still someone worse off than me! At what point can I just get some support without being compared.

It also has to work both ways.

If I cannot be sad because someone has more to be sad about then logically I also cannot be happy because someone else has more to be happy about than me.

It makes support conditional.

One of the frustrations about mental illness is that it doesn’t make sense. If I’ve got depressed then there isn’t a logical list of reasons why. It’s simply that I’m depressed. Withholding support because I haven’t ticked enough boxes to justify to you why I’m unwell is downright dangerous.

Let’s look at this as if it was a physical issue,

I tell you I have a headache. You refuse to give me a pain killer as someone 5000miles away has a brain tumour.

This sounds ridiculous, but is it any different to the time I had an anxiety attack and took medication to calm myself and was told, ‘you’ll feel much better if you remember that you live in Britain, think about the poor people in Iraq, they’ve really got something to have anxiety about!’

Comparing unrelated issues

So I can’t have anxiety because I don’t live in Iraq? This to me was as obscure as saying You can’t have anxiety because there are no goats on the moon. It’s just unfathomably unrelated in my little mind.

It also had an underlying message.

‘Your illness is selfish’ I heard. I care deeply about injustices in the world and would love to help in any way I can, but this isn’t linked to my day to day life. Back in the school canteen I could only rationalise that the school would be sending the leftovers to the starving children. After all, why else would they tell me about them. What difference does my lunch choice have on a starving child. Indeed what difference does my anxiety have on a troubled Iraqi?

Now I’m older and able to tell that this doesn’t have anything to do with these suffering people in far off lands, we can get back to the issue I was complaining about….

Withholding support

I’ve always been taught to tell someone if I have a problem. Depression is very difficult to talk about, especially if you are going through it. So complaining that I don’t like my school lunch is trivial but what about alerting someone to a growing depression? How do you tell someone effectively that you are struggling? Who do you tell?

The times I’ve had the response given to me that my problems are insignificant in comparison just make things worse. It gives the clear message that my very real issues are of no importance. At an already vulnerable place this extra kick isn’t helpful. Is that the message you are wanting to convey?

A Better Response

For me I benefit being allowed to vent on occasion. Often simply having a good moan can help me to put things into perspective myself. Just be there for me, allow me to talk and offer advice if you can. What to you might seem like a silly or minor issue may be a major concern for me. Allow me to process this myself – it is not your place to judge this for me.

Mental health concerns are a serious issue and if you or someone you know may be struggling please contact and talk to someone in a position to help. Don’t put it off and don’t be afraid to talk about your concerns.

If you need to talk or have concerns about someone you know then here are some phone numbers for you:

UK: Samaritans 08457 90 90 90

Republic of Ireland: 1850 60 90 90

USA & Canada: National Suicide Prevention Lifeline 1-800-273-TALK (8255)

Australia: Lifelink Samaritans: 03 63 31 3355

For a larger list of countries visit http://www.suicide.org/international-suicide-hotlines.html 

Autistic Meltdowns - A Timeline to disaster!

TRIGGER WARNING - This post describes in detail an autistic meltdown - please do not read further if this may act as a trigger

The autistic meltdown is possibly the most feared, misunderstood and daunting aspects of ASCs. This will be the first of number of posts exploring this topic as it has been by far the biggest topic I've been asked to write about, but it is probably one of the hardest. Why? Well it is such a huge and complex topic, is fuelled by so many elements and labelled with terms that are often misleading to a neurotypical audience.

So I guess the best place to start is to give a basic explanation my understanding on what is actually occurring in the body during a meltdown cycle and the different elements at work. 

Living in a neurotypical world us aspies have a battle on our hands every day just to get by. With sensory and communication difficulties even the simplest tasks can become problematic and require levels of 'translation' in our heads. The constant mental gymnastics can sometimes get just a little too much and every so often the brain has a quick break. It is like a computer crashing. You've got too many windows open and things slow down, the more you click the worse it gets until it freezes then reboots. This is like what our brains do. It comes back on line, de-frags itself then away you go. I will try my best to describe the effects of average meltdown for me.

Timeline: 3 DAYS TILL MELTDOWN

The first signs I am heading for a meltdown usually start to occur a long way in advance. At the stage we are starting our journey into the meltdown together I have already noticed the warning signs and we are 3 days away from the meltdown. I don't yet know exactly how long I've got but I know it's imminent so I need to start preparing. I've learned the importance of spotting the early warning signs as a surprise meltdown can be catastrophic. My brain is beginning to get tired and 'glitch'. This is a sign I need to reduce it's load and fast. A few things have happened in the week leading to this point, a busy week at work, disturbed sleep, argument with a friend, nothing too daunting to have caused alarm but I've now started to get irritable about things vastly out of proportion. A random and un important issue is playing on my mind and I'm losing my temper about it. My ability to act neurotypical has dropped and a few people have commented on this. I'm struggling to follow my daily routines and I've noticed that I'm not eating properly, keeping up with housework, keeping personal hygiene in check etc (did i brush my teeth this morning? I've not done the ironing, when am I going to do the ironing? Oh no, I forgot to have dinner!). This quickly escalates and simply trying to process what needs to be done vs what is irrelevant becomes a major task. I start to cancel things from my diary and prepare as I know what is coming next....

Timeline: 1 HOURS TILL MELTDOWN

Clearing the diary and allowing a few days to let my brain rest should have returned me to normal by now, but not this time. A few tricky commitments have remained. A friend has been unhappy about me cancelling plans, noise from a neighbour is triggering sensory overload, someone cut me up on the drive to work. My ability to respond correctly has now vanished and my brain is approaching it's capacity. I feel a wave of emotion and confusion vastly out of proportion to the situation. As I have started to loose the ability to filter and process information whatever this 'final straw' has been is probably now the focus for the meltdown. Although the meltdown has technically started I have enough time to get myself somewhere safe and this is my priority as I know I've reached the point of no-return.

Timeline: 10 MINUTES TILL MELTDOWN

My brain is beginning to go offline. My speech has become repetitive and obsessive. Due to the fast breakdown of my cognitive function, all the emotion, fear, frustration etc is being projected on this single trigger. The supermarket having run out of my favourite brand of cereal, my friend turning up late or the TV show I was about to watch being cancelled isn't the real problem, and I know this - but my ability to express anything at this stage is fast decaying so I'm stuck in a loop of venting at some random issue. (This is why it can be mistaken so easily for a temper tantrum).

Timeline: MELTDOWN HAPPENING - CODE RED CODE RED!!!!!

My brain has now gone offline. This is the most dangerous stage of the meltdown, but only lasts a few minutes. During the brain freeze stage I simply cannot process the information around me. It is scary and confusing. I simply cannot make sense of anything going on. Sound is painful, my vision is blurry and more importantly for you - At this stage I don't know who I am, who you are or where I am! If am still talking, it will have reduced to a loud repetition of words. (this is not conscious, it's like a record being stuck)

My body is trying to be helpful and released an enormous surge of adrenaline into my bloodstream. This is to protect me while I'm not able to cognitively function. As in the classic anxiety attack this is to facilitate the fight or flight response and becomes a huge factor in the immediate aftermath.

Timeline: 10 MINUTES INTO MELTDOWN

After shutting itself down, the brain has now started to come back on-line. But it doesn't happen all at once. Things go in one of three directions from this point on....

Route 1: I have retained enough cognitive function to put in place a helpful solution to the adrenaline overload. Either by regulating breathing, walking around the block, using a punch bag etc or by using sedatives to allow me to sleep through the re-boot.

Route 2: An internalised response (What I call a shutdown). The extreme reaction has turned inwards and I am shaking or rocking like in a seizure, I'm unresponsive and vacant, very hot and clammy and my breathing has become wheezy and stilted. I've either collapsed right where I was stood or I've positioned myself in an inexplicable place (under the bed, in a corner etc) probably as a subconscious means of protecting myself. This is the most frequent type of meltdown I experience. It WILL resolve itself fast if you let it run it's course. I will not die, suffocate, pass out etc, please try not to panic while this is happening, in reality it looks far worse than it is.

Route 3: An externalised response. The extreme reaction has turned outwards. This is the loudest and most daunting response. The adrenaline is being released in pure violent force, aimed directly at whatever the stimulus that caused the overload to occur was. The danger isn't for you (Unless you do something unhelpful like grab me or shout in my face - but even someone not experiencing meltdown may react badly to this!) The real danger is to me as one of the effects I'm experiencing is the almost complete loss of my sense of pain. This can clearly result in some nasty injuries if I'm somewhere unsafe. The only real factor that turns a meltdown loud and violent is the source of overload still being present. Remove this and it will quickly run it's course. I will be doing everything I can to get away from the source of overload. It is important that you help me do this or get out of my way. Unless you can directly help, you will be a hindrance. Do not expect logical communication from me even if you are helping me. Remember that autism seriously affects my ability to communicate and at this moment in time I have very little cognitive ability. It the source is too much noise, get me somewhere quiet. Too much light? Get me somewhere dark. Simple. If it's you, then go away! This may sound blunt, but my inability to communicate 'please leave me alone for a few minutes to calm myself' has resulted in very blunt and out of proportion requests from me for you to back off. By the time I've reached meltdown I don't have the luxury of being able to communicate, you do! Please use it wisely, leave your hang-ups at the door and give me the space I desperately need at this point in order to recover safely.

Timeline: 1 HOUR SINCE MELTDOWN

The meltdown has subsided and the adrenaline has left my system but now I face a new hurdle. The extreme affects of the meltdown have caused my blood sugar levels to drop dramatically. I need sugar fast. I carry glucose syrup for this reason. I am also experiencing a wave of extreme exhaustion. I need to sleep for a while. I may have simply fallen asleep wherever I am. Please leave me be unless I'm somewhere unsafe, I will move when I'm ready. In the following hours I may go through the cycle again a number of times, like an earthquake and it's aftershocks.

Timeline: 1 WEEK SINCE MELTDOWN

By this stage, a week later, things have stabilised. Now is the time to repair any damage that has been caused. I am likely to have been off work, missed appointments and social commitments. Perhaps I have people to make amends with or people to thank for their support. After a big meltdown like this I always try to do this personal evaluation. Unfortunately the medical input regarding meltdowns is at best lacking and at times dangerously incompetent so personal insight is the only real means of improving things for the next time it happens, and having a meltdown is the only time I can gain that insight.

Thanks for reading and I hope this can be of help in understanding this subject. This has been a very difficult post to write and one that can be expanded upon much further. Please feel free to comment on your own experiences with meltdowns.