ASD + Bipolar + PTSD = Confusion

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[I apologize for the long post. Not looking for advice, just 'sharing', for what it's worth. Feel free to ignore.]

Whenever the topic of 'faking autism' comes up, I react badly. It's something I want to get closure on, because it's certainly not my intent to cause any kind of trouble here on WP.

So here's the thing.

As a kid, I truly did exhibit many signs of mild ASD, particularly as it tends to be expressed in females. I was shy, found group activities impossibly overwhelming, and could only function in a quiet, structured group setting. (Craft time was okay, free play was a chaotic nightmare of sensory overload.)

Couldn't pay attention at story time, spaced out and went off into my own world. My grandmother taught me that it was impolite to walk on my toes in front of other people, and that I needed to smile, and say the right things. (Hello, how are you, I'm fine, thank you.) She did an excellent job of training me to 'act NT'.

So there were signs of ASD early on; that's not something I'm lying about. Was it severe enough to warrant a diagnosis? These days, maybe. In the 1970's, no. I was just shy and different, and that was okay.

Fast forward to age 14, and bipolar symptoms started setting in. When other teens were having typical hormonal ups and downs, mine were on the level of full-blown mania and suicidal depression. I missed a lot of school, because I wasn't in any shape to be going. But I passed it off as 'feeling sick', because I had no understanding of mental illness.

Somewhere, deep down, I knew that my constant 'sickness' was due to stress. And I did actually feel sick, with constant stomach problems, sore throat, headaches, and exhaustion due to chronic insomnia. So it wasn't a lie, but I knew that I didn't actually have the flu, but... What other explanation was there?

And I suppose that's where my deep sensitivity about being called a liar set in. From years and years of feeling sick, physically, but not understanding that it was due to mental illness. Being essentially accused of lying, any time I claimed to not feel well enough to do something, and my mother would just sigh and roll her eyes.

Then, fast forward to 17, when I was an exchange student in Germany, and... I really can't tell you the truth of what happened there, because I don't remember. But the snatches that I do remember point to a situation in which I was being brainwashed by a religious cult, sexually molested, and a forced home abortion was performed on me.

I have never been sane since. That broke me, and college was a nightmare, a blur of dysfunction. I only graduated because my professors felt sorry for me, and excused my constant absences, and gave me a passing grade. (I was also diagnosed with Lyme disease at that time, which excused my dysfunction.)

Then came the 'real world' of adulthood, in which I've never managed to function at all. I tried about 50 jobs in my 20's, and all of them failed due to massive dysfunction in all areas of my life.

From 25 to 39, I was married, and I truly loved my husband. But I found sex traumatizing, failed to socialize with his family or friends, and finally he said he couldn't take my dysfunction anymore, so we separated.

At that point, ASD was prominent in the news, and I realized I had most if not all of the symptoms, to a severity that caused total dysfunction in all areas of my life. I got tested, by a psychologist who recommended an 'informal' assessment, since I wouldn't be eligible for any kind of disability services anyway. She said that in the case of adults, she could usually tell within 3 sessions, whether ASD was a reasonable suspicion or not. At the end of the second session, she told me she was reasonably confident that I met the criteria, just for my own 'closure' on that question.

I have never claimed to have gone through the full, official diagnostic testing process. I have never claimed to have anything more than an 'informal' assessment. I have never lied, or misrepresented my circumstances.

But it hurts when the topic of 'autism fakers' comes up, because I know that I don't fit the stereotypical male profile, and my assessment was only 'informal'. In fact, the last time this came up, I got back into therapy, and almost got to the point of being referred for an official assessment (which is still an option for me) - but then I had a complete psychotic break, and was literally too mentally ill to get my butt into the office to be assessed.

I haven't left the house since then (going on 5 months now). Which is normal for me; I live with my parents, and only leave the house a few times per year, for unavoidable medical appointments. I am not a high-functioning person, and if I'm lying about anything, it's that. Downplaying the fact that I am actually one of the lowest-functioning people on this site.

But my severe dysfunction is probably not strictly due to ASD. It's more of a PTSD thing, and possibly a Schizo thing. (I would need to be tested for that, if I could stop hiding in my room and talking to fairies. Ironically I'm too schizo to be tested for schizo, which is kind of a hilarious situation to be in.)

I have times of clarity, and other times when 'cognitive distortions' cross over into full-blown psychosis and paranoia. Stress makes it worse, and when I feel like I don't belong somewhere, I just run away, and hide.

I don't belong here, that's the truth of it. Yes, I've struggled with symptoms of ASD since early childhood, but my most severe symptoms are a factor of PTSD, and (I strongly suspect) schizophrenia.

I'm not asking for advice. I know the advice I get will be to get tested, and take meds, and stop being me. And I don't want that advice. (Nor do my parents.) I've tried that advice several times before, and the meds have made me psychotic, and suicidally depressed. I don't want that, ever again.

I've come to peace with my circumstances. I'm completely okay with hiding from the world, and talking to fairies. I'm not hurting anyone, and pressuring me about it is only going to make me retreat further into my shell. Yes, when my parents die, I might end up wandering the streets, babbling to fairies, lost in my insanity. I'm okay with that too.

But I don't want to mislead people, and I'm tired of the 'ASD faker' issue, so I concede at this point. It's not just ASD, it's something more complicated in my case - and I apologize for my confusion, in taking 45+ years in trying to figure out what the heck is wrong with me.

I just wanted to let you know I didn't ignore. I read your whole post. Feel sorry for what have happened in Germany.
I also don't think your talking to fairies is real schizophrenia. If it were, then antipsichotic drugs would help you. If they didn't, I suspect you just comfort yourself with imaginary friends.
I didn't go for official diagnosis, too. I just have a psychologist's opinion. But as it finally fitted as a key for "what has been wrong with me for my whole life?" and explained it, I accepted it.
I didn't come across accusations of "pretending to be autistic", probably didn't read the "right" topics.

I think just as long as you are honest about your diagnoses and your history, people shouldn't accuse you of faking it and if they still accuse you of lying about being autistic, f**k them.

I think some people get so hung up on labels and get so black and white about it, they judge others with that diagnoses and judge those who have the diagnoses because doctors were unsure but yet they still needed a diagnoses or because the person had symptoms but they still needed a diagnoses so autism it was and there are people out there that will try and make them feel bad. To them it all matters because they think they are misrepresenting autism and spreading misinformation so they get black and white about it and hung up on labels. I have seen people like that online.

Thank you both for the responses. Understanding ASD has certainly helped me to find effective coping strategies, but I'm coming to accept that I have certain non-ASD symptoms as well, which don't fit neatly into any category.

I'm starting to take more of an 'a la carte' attitude toward psychiatry. Just focus on dealing with my own specific symptoms, without worrying so much about how to label them.

As a friend of mine told me, It's not schizophrenia unless it's effecting you negatively in some way. Like it would be if people went off with the belief from voices in their head telling them that they can fly off a building or if you kill your parents then you can be happy. I never had that happen to me nor would I even do such a thing if one of my guys were to even say things like that. If it's not a problem for you, then there should be no cause for concern.

A lot of people assume that talking to non-physical/imaginary beings = schizophrenia when in reality it's not. I've heard from many tulpamancers, soulbonders and even my friend who have been to a therapist who didn't see any reason to send someone to see a psychiatrist because they thought their belief in the supernatural and their ability to hear voices in their heads an issue (not all therapists/psychiatrists are as mindful though).

Last edited by MariaTheFictionkin on 21 Dec 2017, 4:33 pm, edited 2 times in total.

My previous two therapists agreed that fairies aren't the problem. They actually help me to make sense of things, when I'm confused. Fairies aren't stopping me from holding down a job, or socializing with other people.

They also don't mind that people think they're 'imaginary'. They know the truth.

Schizophrenia literally means split from reality. Schizophrenics cannot distinguish reality and no reality. People who are not a schizophrenic know these are just thoughts and fantasies and their imagination.

[Edit] Ignore what I said. I don't want to get involved in something that I shouldn't. I apologize.

Just to clear up what I meant by 'schizo' and my symptoms being a 'factor of schizophrenia' -

My last therapist did want me to be tested for Schizoid PD, Schizotypal PD, and Schizoaffective Disorder, because my symptoms are severe enough to have caused lifelong dysfunction. She said some psychologists consider Schizotypal and Schizoaffective to be mild forms of Schizophrenia, so I apologize for lumping them all together as 'schizo', and not explaining that well.

She also said that PTSD and Bipolar 1 could account for my occasional bouts of psychosis, and that there's a lot of crossover between all of these conditions anyway.

Yeah schizoaffective and schizoid and schizotypical are basically on the schizophrenia spectrum but they basically mean you have symptoms of schizophrenia but not enough to be a schizophrenic. I see schizoaffective as a NOS disorder because it means you have symptoms of Bipolar or schizophrenia but not enough for either diagnoses. That is how I see it.

But yet we don't have different labels for the autistic spectrum and everyone on it is just autistic while for schizophrenia, not everyone on it has schizophrenia, weird huh?

Schizophrenia is known for longer, so it has been a bit better researched than autism.

I remember this state when my mental health was a mess. I couldn't tell what was real and what not. I stuck to objective, scientific truths about the outside world but had total confusion about my own state of mind.
I got to a therapist. I started to tell her about my childhood struggle - I just couldn't talk about the present but things that happened when I was 6 were safe enough.
She said, it all fitted the keyword: Asperger's syndrome.
Then I thought it over. It wasn't obvious. But it fitted. It was an explanation. It was the structure I was missing for all my life when trying to figure out who I am.
And then I went to my psychiatrist and told him it. And he rejected it. No, he said, Asperger's syndrome is overdiagnosed nowadays, you don't have it.
My feeling of reality fell apart again.

But as my mind become clearer and clearer, I decided he was wrong. I don't really care for DSM criteria, because they are outside-defined, they really disregard what is inside one's mind. I don't care for official diagnosis because I wouldn't get any services anyway. I care for the structure to understand who I am. The structure of autism – hard-wired lack of natural social tendencies and intuition – made me able to finally understand my traits and needs that I have been masking for all my life.

I am sure a lot of what is happening to you is about anxiety and PTSM. Autism is just a foundation, playing "normal" for big parts of your life must have made you unbearably anxious, maybe this is where the bipolar stemmed? And then the trauma broke you. But detaching yourself from traumatic reality was far more complicated when you had little knowledge of your real self because of masking and faking for years.
That's how I see you.

Thank you both for the replies, I appreciate your insights.

[EDIT: I keep trying to write something that makes sense of all this, but it just comes out as confused as before... I guess it's going to take time, and that's okay.]

I'm also ASD + PTSD + Bipolar 1. That trifecta of issues, along with gout, past stroke and hypertension, is what got me on SSDI.

I find that psychiatrists and psychologists cannot effectively deal with those of us with this trifecta. There is no book or pamphlet for this tragic combination. The professionals can easily "attack" each issue, but there is no reference for the combination. We're left out in the dark when it comes to treatment.

Mindfulness relaxation techniques are a waste of time where I'm concerned because my brain is hyper, always scanning the environs like Spider senses; it just never slows down.

As a result, I don't like bothering with the professionals. Unfortunately, I have to, otherwise the gov't will conclude I'm cured and close my case.

Thanks, Robin - sorry you're dealing with all that too.

It is a strange combination - we don't fit the 'extraverted' bipolar stereotype, but also don't fit the 'emotionless' autistic stereotype (or the treatments designed for those groups).

As for PTSD, I suspect having Bipolar and ASD makes us more likely to blunder into traumatizing situations (or become easy prey for abusers) - and then have a harder time recovering from it afterward.

I've found therapy to be helpful in times of extreme crisis, but aside from that I agree, they don't really know what to do with us. I think you've got the right approach, in 'going along to get along', but otherwise finding our own ways to deal with our issues. (Interesting that we both find spirituality helpful, but 'mindfulness' utterly pointless!)