Saturday, 5 January 2019

Autism & Depression

Depression, like Autism, isn't just for Christmas, y'know.
You can't dump it in a lay-by after it peed on the carpet once too often, or return it to the pound because it's keeping you awake at night.
Well, you can try,  but it'll sniff you out and find its way back to you, and probably cheerfully hump your leg because it's so happy to be back where it belongs.

"My love for you is toxic and inappropriate, but whatcha gonna do?"

Depression and Autism go together like a match made in a dystopian heaven; even if you've never experienced Depression before your child's diagnosis, the odds of you getting up close and personal with it afterwards are high to probable.  If you're a betting person, you could probably afford to put a week's wages on it.
It's pretty typical to go through the grieving process in the first couple of years after Autism replaces your Orla Kiely interiors with toughened plastic and boil-washable furnishings; your life will never be the same again, and your future dreams have been swallowed up by murky uncertainty.
It's a heck of a lot to process.

Depression is part of this adjustment to a different path, when you relinquish your old life for an unknowable future... and there's no avoiding it; you'll never overcome it unless you go through it (massive cliche alert, but there's always a grain of truth in cliches).
This is the first, and biggest, mistake people make with their Depression; you can't shake it off by pretending it's not there.  It's a desolate, painful experience so naturally our spinal reflex is to do everything we can to avoid it.  We don't enjoy pain.

Trying to silence it with booze, drugs or any reckless adrenaline-seeking is an obvious reaction, but only serves to drive the pain deeper (and it will emerge in some shape or form down the line)... and  may gift you with the extra problem of an addiction to add to your List of Life Woes.  It's much wiser (but less easy) to allow the Depression in on your terms; to own it, name it and get to know it.

But who in their right mind would welcome it in, listen to it, and see what it has to say?
There's actually a a world of wisdom to be gained from meeting Depression head on, and either curing it or learning to assimilate it into your life.
What used to be called a 'breakdown' is a wonderful description of the desperately raw process of stripping who you thought you were down to your solid core;  everything unnecessary is scorched away and you are left with a clean base from which to grow again.
When you channel your energy into dealing with your Depression rather than avoiding it, you're taking responsibility for it, and overcome playing the victim into the bargain.  This in itself is worthy of self respect.

The funny thing is that we don't always recognize it when it arrives, though; Depression is not always tears, wailing and gnashing of teeth (although it can be that too)... sometimes it appears as a sucking void in your core that makes you feel hollow and frozen inside.  It can make you feel like you're separated from the rest of the world by three feet of glass, and that you're watching yourself go through the motions of existing but you're not really present.  It can surface as panic attacks, social anxiety or phobias... but these are all just different faces of the same illness.

In a weird kind of way, I was lucky that myself and Depression were old pals long before my son's diagnosis; I didn't have the double whammy of having to learn to deal with Autism and my own mental illness at the same time.  My familiarity with it actually helped me hugely in the early days of Fin's diagnosis.
And it's left me in a position that I can offer a few ways to help you through it.

Winston Churchill famously referred to his Depression as his "black dog";  this is a great metaphor.  What's important is that you claim it as your black dog; there's no point in complaining that it's an unwanted mongrel that grief (or dodgy genes, or past traumas) left you as a gift, or that you can't seem to get rid of it no matter how many vodka and tonics you sling at it.
It's yours to deal with; even if it's mangy and smells like a wet carpet, give it a name and own it.

Talk to someone you trust.
Your GP should be your first port of call, and you can talk about medication and/or counselling in a professional way... but ultimately it's having people you know and love to confide in who make the deepest difference.  Unfortunately, you will come across unhelpful comments like "but you look fine" or "what do you have to be depressed about" etc but you'll quickly learn who's there for you, and who'd rather dowse themselves in petrol and play with a box of matches than discuss your pain.  It's a pretty brutal way of figuring out who your true friends are, but that's not a bad thing in itself.  You need to surround yourself with a tribe of like-minded people, and even if that tribe is smaller than before, at least you'll know they have your back and will always have your  best interests at heart.  Life is too short to waste on falsehood anyway.

Prolonged Depression causes shrinkage of the Hippocampus (part of the limbic system in the brain that regulates emotions and is a key player in Depression), which was an exciting (if that's an appropriate word) find to prove the biological basis of the illness.  This points to a future hope of finding ways to repair this damage; already there is tentative hope that antidepressants and physical exercise will reverse this atrophy (although there is no medical consensus on this yet).  While most people subjectively know that medication and exercise helps their Depression, it's hugely important to know that there's a biological basis for this.  The next time someone tells you that your Depression is all in your head, you can reply "why, yes it is... in my Hippocampus to be exact".  Then you have my full permission to flip them your middle finger.  In fact, I insist on it.

Alcohol (even fairly modest amounts) causes pretty devastating damage to the Hippocampus, so if you're serious about taming your black dog, you need to consider cutting way back, or giving up.  This is not welcome news when a few glasses of something is all you have to give you a few hours respite from the weight of reality.  When you pine for Malbec with all the angst of a lovesick teenager, you're in trouble (which is why, after Dry January, I plan on limiting wine to a couple of glasses on a Saturday night).  There is plenty of evidence to show that abstinence aids recovery of the Hippocampus in a pretty dramatic fashion, so this in itself will help bring your misbehaving mutt to heel.

There is no shortage of research to support using aerobic exercise, in addition to medication, to treat Depression.  Even though you might rather paint yourself with treacle and streak through a den of hungry bears, there is no doubt that exercise works.  And if you exercise outdoors you'll get two for the price of one, as exposure to sunlight has been shown to regulate mood.  Starting is always the hardest part, but even the act of putting one foot in front of the other is affirming, and is literally a step in the right direction.

Establishing a routine is a great way to work though the really dark days, when the only thing to motivate you is completing what's next on the list.  It's almost ridiculous in its simplicity, but a written schedule helps you focus on days when light is only a memory.

It's worth trying hard to eat well when you're in the horrors, as fluctuating sugar levels have been shown to affect mood.  It's wise to avoid processed food high in sugar, and to steer towards food high in protein, complex carbohydrates and 'good' fats.  Eating at all can be difficult (just as over-eating can be an issue) so anything you can manage ideally should be aimed at regaining your wellbeing.

Finally, as well as talking to trusted friends, it's worth considering seeing a counsellor.  Sometimes it's helpful to talk out past traumas, to help re-frame them from your current point of view.
It can also help to learn to recognise negative thought loops, and to break them down.  A huge lightbulb moment for me was when a counsellor told me "just because you think it, doesn't mean it's true"... while that may seem  obvious to many, it was a game changer for me, and it took ten weeks of Cognitive Behavioural Therapy for me to learn it.  I've never been accused of being a fast learner.

So, if you can tame and cure your Depression, that's fantastic (and utterly doable).... if you can't, then it's possible to assimilate it into your life and to manage it.

The key is talk, talk, and then talk some more.

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