Anxiety to ADHD to Autism

Blog Post #1

I've always known I'm different. I've never cared. I didn't hide my interests from others because I didn't want to be with people who I couldn't share my joys with. For the most part, I had friends because we both played video games or because we both loved animals.

When I was 20, I went to my first appointment with a psychiatrist. I recognized that there was anxiety in my body, that I held tension in my shoulders, though I couldn't really tell why. All I knew was that there was medication to help me with it, and I sought it.

I also had severe problems with accepting and understanding "enough." People would call this perfectionism, but the thing was that I wasn't striving for perfect. I knew perfect was an unattainable idealogy. However, I always tried my hardest and only put my best self forward, even if it meant losing sleep or skipping a meal to finish college assignments (contradictory, I know). It wasn't that I wanted to get straight A's; it was like I couldn't tell myself to just turn in an incomplete assignment and get that few hours of sleep my body needed — in fact, this idea wouldn't even occur to me until a couple years later. I followed written instructions (assignments) word for word and to completion.

Anyway, a year passes, and I've found a comfortable dose of an SSRI medication that helps my symptoms of anxiety and depression — though I've never considered myself depressed, the medication did help me with some things (I'll get to this in another post later). I began noticing differences in myself from my peers that lead me to believe I am neurodivergent, things that I couldn't connect to anxiety or depression, since these were treated. Like I said, I have always known I was weird and different, but now I knew that there could be something beyond "I just am".

(Background: Two years ago/a year before my psychiatry appointment, my significant other(SO) was diagnosed with ADHD. Because of this, I was partially familiar with neurodiversity. However, up until my exploration of my own neurodiversity, I only really paid attention to things that pertained to my SO, so I didn't see much that I could relate to. But, and honestly I don't remember exactly how (likely social media), I learned that ADHD often presents differently for women...

Image from Sandstone Care

ADHD is branched into three categories: hyperactive, inattentive, or both. Women often are more inattentive type, while men more often present hyperactively.)

I could relate more to inattentiveness. Overall, the things that I noticed chronically in myself the most were forgetfulness, difficulty maintaining prolonged focus, interrupting, and fidgetting in the form of skin picking & nail biting. For example, at least once a day, I would leave something important behind or forget about a task I had planned for the day.

After documenting these ADHD features for a month, my psychiatrist felt confident to diagnose me with ADHD and start me on medication. For about 6 months, I tested different medications to find the one that helped me best. Stimulants were not for me (this will also be it's own blog post later).

I spent most of my 21-year-old and 22-year-old life content with my medication and how it helped me, but not entirely sure of my diagnosis. Something just wasn't clicking. I didn't entirely see myself in the ADHD community, not even if I was solely inattentive type.

One thing that really stood out to me was my immediate reaction to my diagnosis and the stimulant medication. For my SO, and for many other ADHDers (as I had joined an ADHD facebook group to learn about others' experiences), the diagnosis was like a huge-weight being lifted off their shoulders, like they took off their "neurotypical colored glasses" and were able to look back at their life and everything made sense. Similarly, taking a stimulant for the first time was a life-changing experience. I often heard/read ADHDers exclaiming "this is what it's like to have a normal brain?!" I couldn't, even mildly, relate to either of these experiences.

My ADHD diagnosis seemed like it could make sense. It certainly applied to the things that were noticeably bothering me at the time of my diagnosis. I could look back at some things in my life and apply it to ADHD forgetfulness, like often forgetting my lunch box during grade school. However, I still didn't really feel a relief.

When I took the stimulant for a couple months, it didn't feel different from the nonstimulant (for the most part), and I didn't really feel any different from myself off of ADHD medication. Sure, it was helping me where I needed it to, but I never found myself feeling elated, like my brain was a puzzle and the pieces were properly, finally, put together.

As I approached my last year of college in the fall of 2022, I started to reflect on my "ADHD" features and compare them to autism. Was I bad at staying on tasks because they weren't related to my special interests? For as long as I could remember I always had the same interests (dinosaurs, animals, reading, dragons) and even my music taste had never changed or gone through "phases". Was I a "perfect" student because my brain loved the routine of courses? Was I stimming as a way to comfort myself while masking (even if I didn't know I was masking)?

I started taking all the online quizzes on autism that I could and read extensively on articles about autism in women, special thanks to Embrace Autism. I joined Autistic groups. I watched videos on autism. I followed autistic spokespeople.

From there (and this is where I made a mistake), I decided I wanted a psychological evaluation to get a professional opinion and the "right" diagnosis. I went in blind. I went in without an arsenal. I trusted a flawed system. (All of this to be discussed in my next post.)

The psychologist stuck very closely to the books, which basically means if you're "low level/high functioning" and not a white man/boy, you're likely to be misdiagnosed. This practicioner was quite positive I wasn't autistic, but even after multiple interviews and evaluations, they could not diagnose me with anything specific. I received three "unspecified" disorders.

For a while, I caved in. Sometimes, I could look at the experience and think something didn't go right, but for the most part, I just kept myself pushing through the world. Whenever I came up with something like "shouldn't hyperfocus be part of my diagnosis", I'd always have something to shoot myself down with like "this psychologist was younger, they would be using the most up-to-date information".

I graduated summa cum laude a few months later, and for a couple months after that, I holed up in my apartment reading books and watching my savings dwindle. In some ways, I was the happiest I had ever been; I hadn't been able to read for pleasure in years, and now I was going through a book every few days. In other ways, my body was screaming that something wasn't right, that I had been ignoring it for too long. I was tired. All the time. No matter what I did.

I started a journal. I wrote down everything about myself that seemed neurodivergent. Most things were just bullet points with tidbits about me; some I would date and describe specific events/interactions. Here's some:

• extremely small social battery

• cannot lie

• stimming (bouncing leg, hair pulling, self-cleaning)

• don't really feel emotions. alexthymia?

• often quotes movies/shows for humor

• clumsy

• forgetful**

• 5/12 changed my shirt because I didn't like it touching my armpits

About a month after I turned 23, I made my first appointment with a therapist. I specifically searched for a therapist experienced with autism, and I found even better, an autistic therapist. At my first appointment, I shared some of my journal with the therapist, and my experience with my evaluation.

My therapist recognized my need for validation and community and confidently told me I was autistic. They referred to our traits, our community, how we process, etc. I remember hurriedly pressing the end call button, closing my laptop as this warm, swelling feeling emanated from my chest, and bursting into tears of joy.

I am autistic.

Relief.