so far i already have a headache only like 2 hours after taking my first dose which is pretty noticeable for me because i like never get headaches, hoping that’s the only side effect i get

  • ReadFanon [any, any]@hexbear.netM
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    5 months ago

    Autistic people often report that SSRIs don’t work well for them and that they get more severe side effects.

    This is not always the case so don’t set the expectation that it’s not going to work for you. Also keep in mind that there’s a sampling bias here - you don’t see autistic people constantly telling everyone “I took SSRIs and it was pretty okay, nothing much to report on really” but the autistic people who have had bad experiences with SSRIs are going to be more vocal about it because that’s just how things work.

    As general advice for a person who is autistic or who suspects that they are I’d say that a low dose might well be the sweet spot for you where you get the benefits without so much of the side effects and, if you do increase your dose to do so gradually because if you happen to be unusually sensitive to the side effects like a lot of autistic people report then the typical way that you are directed to increase your dose might be too rapid for you.

    Anxiety and depression are really common for autistic people but autism often brings experiences of executive dysfunction, burnout, and catatonia which can resemble depression very closely. My hunch is that there’s a good percentage of autistic people who experience these things but they are under the impression that they are symptoms of depression and so they find antidepressants don’t work for them.

    In a similar way, symptoms of anxiety can closely resemble experiences like overstimulation and being exposed to noxious stimuli, masking, suppressing stims, and not meeting your need for stability and predicability in your environment.

    If you think that you’re likely autistic I’d encourage you to look into these things at your own pace and to approach symptoms with curiousity and a sort of scientific approach, without any preconceptions, to see if there’s a possibility that your experience might be, say, burnout rather than depression. Or that some symptoms that you experience might be better understood as burnout instead of depression. This is me speaking from hard earned experience - I was far too quick to lump all of my symptoms into common categories like anxiety or depression without really putting in the time to consider whether or not this was accurate and so I wasted a lot of time and effort trying to find the “right” treatment for my depression when half of my symptoms weren’t even depression at all.

    idk about ADHD though

    ADHD occurs somewhere around the 40% mark in autistic people. (The reverse is not true however - there’s no data indicating that 40% of ADHDers are also autistic.)

    There’s a real gap in understanding what auDHD is like and this goes all the way to research. I’m diagnosed auDHD and treated for it (so the chances of this being a misdiagnosis are extremely unlikely) and my experience of it is that the traits of both conditions sometimes mellow out the extremes but sometimes they can aggravate them or amplify them too, so it isn’t something like anxiety and depression where the anxiety tends to override the depression or vice versa, and it’s not a matter of an additional thing like having insomnia plus depression, where your mood is low and you have serious difficulties with sleep. Instead auDHD often feels like a weird blend of symptoms and traits that are often conflicting.

    I’m gonna do some shameless self-promotion and link to a post I made about my own internal experience of auDHD here. This is just my own experience, it’s not diagnostic and it’s not intended to be but you might find it interesting. If a lot of it happens to resonate with you then that’s a good indication to consider if you might be auDHD yourself.

    Obviously all of this is just stuff to consider, I’m not telling you how things are for you or trying to steer you in any particular direction; you know yourself better than some unqualified internet stranger ever could.

    • Bat [she/her]@hexbear.netOP
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      5 months ago

      Anxiety and depression are really common for autistic people but autism often brings experiences of executive dysfunction, burnout, and catatonia which can resemble depression very closely. My hunch is that there’s a good percentage of autistic people who experience these things but they are under the impression that they are symptoms of depression and so they find antidepressants don’t work for them.

      In a similar way, symptoms of anxiety can closely resemble experiences like overstimulation and being exposed to noxious stimuli, masking, suppressing stims, and not meeting your need for stability and predicability in your environment.

      i would not be surprised if that is the situation i am in, i probably have both burnout/depression and anxiety/overstimulation though

      especially when it comes to anxiety. i’ve always described and felt anxiety differently than how other people describe it, to me it’s kind of like an inability to do a task, complete freeze at the idea of doing something unfamiliar or without clear instructions. i do also experience what most of people would describe anxiety to be more like, the panicky fast heart rate inability to stay still kind of deal. but i always though of those as two different reactions to the same emotion. kind of like fight, flight or freeze situation. the first feeling just being the freeze response to anxiety while the second being the flight response to anxiety. i never thought of those as two separate things, so i just lumped them into together, but i guess it does make sense to differentiate

      if this is the case and i don’t actually have depression and anxiety and it is just autism symptoms, will medication still work?

      • ReadFanon [any, any]@hexbear.netM
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        5 months ago

        especially when it comes to anxiety. i’ve always described and felt anxiety differently than how other people describe it, to me it’s kind of like an inability to do a task, complete freeze at the idea of doing something unfamiliar or without clear instructions.

        Yeah, that definitely feels familiar to me.

        I really struggle with a lot of creative exercises and tasks that lack structure and clear purpose, where things are too open or too ambiguous.

        I hate filling out forms and I get incensed when questionnaires are worded in an imprecise way that can lead to multiple interpretations (this is a sticking point for me personally because I am hyperspecific with my use of language and I get upset that the world doesn’t automatically hold itself to the same arbitrarily high standards that I set for myself lol [but survey methodology matters, okay!?])

        If you sit me in front of a blank canvas and tell me to paint or draw something, I freeze up. Whenever I had creative writing exercises in school I’d always bomb the task because I can’t handle that level of open-endedness.

        I’ve learned ways to compensate though. If I can figure out a way to create my own objectives to provide myself with a sort of artificially-imposed degree of structure then I manage much better and I’m able to perform. It can be hard for me to engage in that process though.

        Autistic people absolutely experience an inordinate amount of difficulty with things that are unfamiliar, unexpected, or unclear.

        i do also experience what most of people would describe anxiety to be more like, the panicky fast heart rate inability to stay still kind of deal. but i always though of those as two different reactions to the same emotion. kind of like fight, flight or freeze situation. the first feeling just being the freeze response to anxiety while the second being the flight response to anxiety. i never thought of those as two separate things, so i just lumped them into together, but i guess it does make sense to differentiate

        You might be right about this. It’s something I need to explore more in myself so I can observe what my experience is while doing some experimenting with how I respond when I change up the variables to see if it lines up with a freeze response or something else for me.

        My hunch about my own experience of this is that it’s different to a freeze response. From memory, I don’t recall feeling the same physiological experience that I have from a genuine freeze response and if I seek clarification or I am able to impose my own structure or outcomes then I find that I’m able to progress whereas with a freeze response I find that there’s a lag between everything being fine and my psychological and physiological response gearing down and returning to the baseline.

        A confounding factor in this would be if you had really demanding caregivers or teachers who weren’t supportive enough when you faced these situations in childhood (e.g. a parent often yelling at you to hurry up and do what you’re told rather than showing kindness and showing a genuine interest in how they might be able to help you get started on the task). If you had a lot of that then it’s absolutely within reason to expect that you’d have a freeze response because you’ve associated those open-ended experiences with being yelled at or humiliated. This also applies if you’ve had awful bosses or abusive partners etc. later in life as well.

        if this is the case and i don’t actually have depression and anxiety and it is just autism symptoms, will medication still work?

        Honestly, short answer - I struggle to imagine many people being late-diagnosed/late self-identifying autistic to arrive at adulthood without experiencing a good deal of anxiety and depression, so I’d expect that medication will still work.

        The thing is though, I would expect most meds to work on a superficial level because your experience of anxiety and depression are responses to deeper things that the meds themselves won’t be able to affect. I guess a good example here might be a person who is experiencing really severe grief and has a sort of secondary depression that has developed from the grief - the right meds will take the edge off the depression in a lot of ways but it’s not reasonable to expect that the meds going to resolve the grief itself and unless the person gives that grief the time and space and kindness necessary to move through it, then there’s going to be a force that is producing those depressive symptoms until the grief has been processed.

        In a similar way, if an autistic person doesn’t have enough stability and consistency and certainty in their environment, for example, then there’s naturally going to be a level of anxiety that comes with that, almost certainly. Meds might be able to reduce the degree of anxiety experienced, and it might make that anxiety much easier to manage, but unless those causative factors are addressed then I wouldn’t expect meds to really “fix” things. The same can be said about overstimulation or executive dysfunction or not managing your sensory needs so well etc. and for experiences of depression/depression-like symptoms.

        Honestly if you’re going to try some meds then I think it’s a good opportunity to see how you respond to the variables being changed around - you’re bound to get some more understanding of what’s going on for you one way or another.

        If they work, that’s fantastic news.

        If they kinda work a bit but you find that you’ve tried quite a few and nothing seems to do all that much, that sucks but it’s also really valuable insight because that starts to form a picture that there’s something deeper going on for you and it would be one more indicator of something like autism being likely.

        Just as a side note, this comment has kinda been touching on a theme about how I’ve learned to approach my mental health (and neurodevelopmental disorders, since it’s important to distinguish autism from a mental health condition) and medications - I really try to be as objective as possible with understanding what my experience is, without interpretation or extrapolation.

        Once I have a good grasp of what I’m experiencing then I compare that against either the clinical description of symptoms for conditions or other people’s internal description of their experiences of things (anxiety, anaemia, ADHD, PTSD, POTS… you get the idea) and I see how closely my experience matches that.

        Then I do a pseudo-scientific approach where I make develop a hypothesis and test it against my experience (e.g. paying attention to my heart rate when I’m faced with that “freeze” experience that you have described, or maybe assessing my physiological response entirely).

        A freeze response should have noticeable physiological indicators - do mine match up with those or do they fall outside of where I predict they would be based on my hypothesis? If there’s something that I can take that reduces anxiety (e.g. beta-blockers, benzodiazepines, valerian extract) does it change my experience in line with the hypothesis or does my experience fall outside of what I’d anticipate?

        I try to control for variables as best I can and I try to repeat the “experiment” a few times over before I arrive at a conclusion, where possible. Then I make develop a new hypothesis with the benefit of the new anecdotal data I’ve gathered and I start the process over again. It’s a big process of figuring out the likelihood of things and then eliminating them one by one until you arrive at an understanding where everything seems to fit in line with what you’re experiencing.

        So for me, with regards to the freeze response hypothesis, I would predict that getting more structure or direction would result in a fairly noticeable shift as I become more regulated and less panicked but that it would still take a bit of time before I really shifted from freeze back to my baseline. I would expect to have some nervous energy so that would imply things like being a bit jittery, feeling like I physically need to shake it out, or maybe yawning as my nervous system becomes more regulated. If I were a smoker, I assume that’s the point where I’d really be craving a cigarette.

        If I don’t notice any significant changes in my physiological or psychological state and there’s no indicators of my body attempting to manage the energy from being in a heightened state, if I find that as soon as I have the necessary structure or direction I can just immediately jump into the task without any noticeable transition, then that would count as evidence against the freeze hypothesis (for me) and that I might need to observe this a few more times or that I might need to consider a different hypothesis.

        Apologies for going on such a lengthy tangent about this, but I think it might be helpful. When it comes to the more complex stuff and co-occuring conditions that can overlap or interact or resemble eachother, I genuinely think that this is the best way of figuring out what’s really going on. It can take a long time and it requires a good amount of effort but I believe that it’s worth it because of the results you can get. Also keep in mind that you’re not working at this alone - you have people around you who can help you with their own observations (be very cautious about taking their conclusions on board though, try to focus on their observations), there are professionals that can help guide you and provide you with an outside perspective as well as their own professional experience, and there’s space like this one where you can bounce ideas off of people and you can share what you’ve observed in your own experience to get other people’s input.