Benjamin MD (Multiple Diagnosis)
Having multiple diagnosis can come with a lot of stigma and extraordinarily little information. Many people in this situation are too frightened to come forward with education and information because of fear of retaliation and doubt.
I am no exception to this, I often am afraid to talk about everything that I have, because it is so often met with “do you REALLY have all that? You’re just seeking attention.” Trust me, I have spent my entire life avoiding attention, especially when it comes to Disability, so me coming out now so that others won’t face that same stigma is not a desperate bid for attention; it’s a life line for others like me.
I want to point out, I am saying multiple diagnosis regarding this subject, but because of medical bias and lack of healthcare access not everyone has an official diagnosis. This does not mean that these people don’t deal with these problems, it actually means they have more hurdles WHEN dealing with these problems.
One thing I have heard from just about everyone I have talked to about this topic: there is almost no education and resources on these subjects. We can barely get people to talk about Bipolar, CAP, or Autism separately, how are we supposed to find content about how they can interact and react with each other.
First, we need to talk about stigma, and medical bias. Until I had all my medical documents and diagnosis gathered together, many medical professionals didn’t take it fully seriously. Especially with Bipolar and Autism, because they affect each other so uniquely, many people would question the individual disorders. Not to mention, a lot of people suddenly come out of the woodwork with imaginary medical degrees telling you that you are faking it.
We have such a narrow view of individual disorders and diagnosis already in society, that it’s even harder for people on the whole to understand and accept that multiple diagnosis is a very real thing, and affects people even more uniquely than single diagnosis. Until we understand this and continue talking about this subject.
If we are not openly talking about this, and we continue the stigma then it will be harder for people to come forward and talk about their experiences. Not only does this negatively impact those who aren’t able to be open up about themselves, but it also fuels societal and medical barriers to proper care.
If we cannot share what we deal with, and common symptoms that come from these interactions, then how will other people recognize it in themselves and access proper care. In addition, medical professionals who are raised with a bias, and lack of information will continue the cycle with their patients; blocking access to proper medical care and diagnosis.
That is why you should not automatically dismiss people who have to self-diagnosis, as people will consistently and constantly beg for testing and people to believe them.
I want to talk about how multiple diagnosis can affect me personally.
First, we need to talk about Bipolar. As it is a mood disorder, it can chemically completely change how my brain can intake information and stimuli depending on whether I am in a depressive or manic episode. (For more information on Mania and Depression in Bipolar, check out my previous post on Bipolar.) It is so hard to plan my life and make plans with others when I don’t even know myself how much energy I’ll have each day.
When I get hit with a wave of Bipolar Depression, it can really come crashing in and ruining everything I have worked hard to build. Autism THRIVES on schedule, routine, and planning. Unfortunately, when depression hits that all can go out the window if you’re not careful. Once I am in this cycle, I continuously feel worse, or like the world around me is ‘wrong.’
At my worst, I would have extremely negative, and harmful stim behaviour to myself. That is why it is so important to keep routine and taking care of myself when I am not in these episodes. I cannot stress this enough how proper care during neutral or manic episodes will seriously dampen how bad the depressive dips are.
Feeling ‘wrong’ is an interesting feeling, since it is so hard to describe and manifests in different ways depending on whether I am depressive or manic. The proper term for this is disassociation and it is something I was not fully aware of until later in life. I always had these feelings, but would just say that I feel off, or wrong; but once I had the words for it, I could better recognize it.
Disassociation is actually a massive umbrella term. If you have ever driven somewhere and have no memory of some or all of your drive when you get to the destination; that is a very mild form of disassociation.
When I am in a depressive episode, my entire body feels wrong, it feels like my soul is lagging a couple seconds behind my body. That often means it is chilling slightly off centre to my body. My body is in a weird fight or flight response, because I feel wrong, but not in danger. It is essentially blasting all the alarms, but everyone inside is still going about their day.
If you don’t have the words for this, it is scary and feels more powerful than you. Once you know what it is, you can recognize it better and take care of yourself accordingly.
Of course, disassociation is very much present in mania as well don’t you worry about that. Except, it feels way different. Instead of my body feeling wrong, it is my eyes. It feels like I am watching somebody else’s eye view through a delayed live stream. I am behind a monitor behind my eyes detached from my body.
It is just as important to recognize and be aware of these feelings as well. This is where I am least likely to mask, and just blurt out what I think. Unfortunately, I must protect myself as well, and right now it can be dangerous in the wider world if you’re not able to mask as an Autistic person. Hopefully one day we can get to the point, but I am also a realist right now and some people just suck.
I stim a lot more in manic episodes, mostly hand stuff like moving them when I talk. I sometimes clench my hands hard to the point of hurting my hand if I am not careful, but that is more common on the depressive side. It is important to be aware of how much you are performing certain stims though, for example I mess with my hair A LOT when I am manic. To the point if I am not careful, I will start tugging hairs out.
With mania and Autism, it is important to be careful you are taking care of yourself, as it is VERY easy to not eat, sleep, or take care of yourself. Autism can already give us a hyper focus on certain tasks, but mania essentially overclocks it. If you’ve ever been solely focused on a single project, so much so that you literally work on it for 8-12 hours straight; you know what I mean.
Learn to break up your focus better when you are in a neutral mode, set up routines where you are taking care of yourself. This will set you up better for success in depressive and especially manic episodes.
One more thing I will touch on with these two interacting. I find that social interaction was so much harder because not only was I learning a different way of communicating and thinking, but I had to do so for three different states of mind. It was harder to keep up long-term friendships because social cues were already so difficult for me to learn, but also fighting my own turbulent mood at the same time.
I am a notorious flake and known for not talking to people for months on end. I work on that every day, but it does still happen.
It is also tough letting people into the depressive side of yourself, especially when you feel the manic ‘outgoing’ part of yourself is the only part they will like. In all honesty, people will love every part of you; people will also not. That is fine, as it means that they weren’t willing to love all of you, and you don’t need that.
A lesser interaction, but one that definitely has still affected me: CAP (Central Auditory Processing Disorder) and Autism. I have always had severe social anxiety directly surrounding not being able to properly hear the other person. My whole life growing up, I dreaded and feared having a celebrity moment while others dreamed of it. ‘What if I don’t hear them properly and they laugh at me???’ That is all that would go through my head, for anyone really but mainly people I looked up to.
It doesn’t just affect my social anxiety though. It genuinely does make it harder for me to control my volume. I HATE talking in movie theatres, because I’m a) expected to hear them over the movie, and b) expected to find a proper volume for THEM to hear ME over the movie.
More often than not, I am talking way too loudly, or way too quiet. Some of that genuinely does come with the fact I have a harder time comparing my own volume to the world around me, because I cannot properly hear the world around me.
I do think we need to continue talking about having multiple diagnosis. I am sick of fearing people thinking I am just attention seeking or lying because nobody could POSSIBLY have more than one diagnosis. I do not want people growing up feeling like they are alone in their feelings, or symptoms. Mental health is not just made up of simple answers, it is a massive topic with many intersectionality’s and cross-interactions.
My hope is that this gets more people listening, because people are suffering in silence without the proper words to even describe what they are feeling.
Anyway, I hope you have multiple fantastic days.