#14 | When Autism Comes with a +1, an Additional Mental Health Diagnosis

RESOURCES

• Free resources from The Art of Adulting are here: https://linktr.ee/lynncdavison
• Emma McAdam, Therapy in a Nutshell youtube channel 
• LivesInTheBalance.org by Dr. Ross Greene

Today's topic is what do we do when autism comes with a plus one, an additional mental health diagnosis?

I see this and watch parents worry and just feel terrible when someone gives them a second diagnosis. So let's take this and sort it out today.

Often autism does come with a second diagnosis. 

• Generalized Anxiety is one of the most common. 
• Attention Deficit Hyperactivity Disorder is also common. 
• Dysgraphia you know, hard to write. 
• Dyscalculia difficulty with math,
• Dyslexia, difficulty with reading.

All of those diagnoses we've seen. We see frequently when it comes to autism. We live with them. In fact, I just think it's a reflection of the different wiring that happens in an autistic brain.

The ones to kind of get us going though, are the ones that have scarier names. 

• schizoaffective disorders 
• bipolar disorder 
• borderline personality disorder 
• trauma 
• agoraphobia 
• And several others that make you wonder how this is going to be.

What is my autistic young adult going to face for the rest of their lives?

And it really takes us to a place where I think we just feel completely lost. We just don't know enough about those diagnoses.

We've seen some movies, A Brilliant Mind and others that talk about some of the co-occurring disabilities, or disorders or diagnoses that can come with having autism.

Let me just reframe this though, and let's decide. What does this mean? I mean, the bottom line is we can decide what it means. We have the power to decide what it means.

Let me suggest that it does not mean that our young adults are defective or broken, or that they have a chemical imbalance that causes the problem. And it's permanent, like so much of the advertising that we see on TV suggests: Well, you need this chemical to counteract this imbalance that you have in your brain.

The truth is that the health profession doesn't really know what is the cause for some of these diagnoses. They just don't know enough. We don't know enough as humans about how the brain works.

We know that there are several causes and some can be biological, some can be environmental, some can be just the habitual thought patterns that we have.

All of those things are factors that are very individual about what causes some of the behaviors that we see that we label with these diagnoses.

It doesn't mean, however, that you're not experiencing this diagnosis. It's real. It's very much real, but it doesn't mean that it's a permanent condition. 

I mean, let's look at what's happening. Let's connect and understand better with ourselves first about what's happening with us.

First, we get a plus one of these diagnoses, and we say, “No!” and we're sad. And we mourn.

You know, the fact that we've got another challenge or that our child is different in another way, or that the future is going to be more difficult for him or her or our lives. You know, I think this is clean pain, and we deserve to feel it. Frankly. I remember when I got our last child's diagnosis, it was just sad. You know, I was just hoping that life for her would be easier. We all want our children to come equipped with whatever we think is what they're going to need for life and yet I do think it's really valuable to take the time to feel that pain; to feel that sadness.

If you can do it with somebody that you know will listen, that you know will understand and give you some emotional empathy, and some cognitive empathy both. Saying it makes perfect sense that you're feeling this way. And I understand that. It's hard to figure out how to think about all this. That would be lovely. If that's just not available to you, find a place where you can mourn on your own. Write down your thoughts, just feel the feeling, cry. Feel what it feels like inside your chest, what's going on in our bodies.

I think that so often, we try to solve our problems up here, and we are only using part of the resources that we have. We also need to feel what's going on inside of our body and use the wisdom of our body to understand what's happening as well. So, I just encourage you to take the time to feel the feeling of loss. Whatever the loss is; the loss of not having something that we thought would be helpful or valuable in our child's life. Then, let's see if we can't go down that kind of a dirty path of pain. That's where we get the plus one diagnoses and we go this is my fault. I shouldn't have had that glass of wine when I was pregnant. I shouldn't have smoked. I was you know, whatever. I shouldn't have married that man. I shouldn't have had children with that person. This was my bad judgment. You know, I should have had them in therapy a long time ago. I mean, what if all the would have could have should have that results in that shameful feeling, and then we blame ourselves and we beat ourselves up and the result is that we feel defective.

The tool I'm using here is called the Steer Map. It’s how we sort out what's happening in life. It's how we solve any problem in our life. We looked at the situation. We look at the thought that we're having about that situation, the feeling we're experiencing, the actions we take when we're in that feeling, and then the result. And notice that the first is external, and the last four are internal. And so we can't do anything about the situation, but we sure can determine how we are going to watch how it's going to fit inside of us. And that's what this Steer Mapping is. This is what I teach in the Art of Adulting. It's for not only the families but also the autistic young adults so  they have a tool to sort out their thinking, slow things down and figure out what things are happening in their lives; the results they're creating.

So I really believe that this is a key skill that we can have. So just while you're processing what's going on after having that diagnosis, notice the thoughts that create blame and say, Ah, I see. This is what makes me feel small, makes me want to hide, makes me want to cry, makes me want to reject, push away from what's happening. Notice those thoughts that are causing blame. Usually there’s a story that we're telling ourselves; it can have a label like it's my fault or whatever. So just notice when that's happening, and then maybe we can shift maybe. I love that word. Maybe we can shift some of our thinking to things that might be a little bit more helpful.

Again, the situation's the same; what's happening on the outside. The thought is, I wonder what I should do. What are our options here, and that creates that I wonder thought; creates a feeling of curiosity. And we start researching options within Google of course, and we talk to people that we know and we consult with the people that are around us that support us, we consult with others moms, we go to Facebook and posted it at the Facebook pages where we are and we start to understand what's happening and figure out that’s the result. I wonder what to do and the result is tied to our thinking which is we start figuring it out.

I'm hoping that this makes sense to you that you don't expect to do these kinds of shifts all in one day. But that over time, the pattern starts to make more sense to you.

One of the my favorite person people to look at up to to consult is Emma McAdam. She has this wonderful YouTube channel called Therapy in a Nutshell. And this is a screenshot from her depression series. And it says most people completely misunderstand what a mental health diagnosis means. I just found her video incredibly helpful. So I'm going to help. I'm going to summarize what she says in it but I included in the show notes and I really want you to take time to find Emma, Emma McAdam and then use her as a resource because she's just put something in such plain language that makes sense to make sense to families.

Emma says in this video that there's a misconception that brain chemistry is the cause or that we have a character flaw. And that's the reason why we have these mental health diagnoses. That it's our brains are just creating this or we just aren't strong enough, disciplined enough, focused enough whatever the reason is, there's something wrong with us. And that's all a misconception. So please recognize that we can change our brain chemistry by how we think and act and that it's not a cause of a character flaw. What your young adult is experiencing is real, but it's not necessarily permanent. And it's not necessarily harmful either.

So let's just notice what's real here. Many of these issues can be resolved or greatly reduced when we address them with some strategies. Let's just not give up. Oh my gosh, she's got that label. He's got bipolar, he's got borderline personalities, he’s got schizophrenia. You know, they’re not just their diagnoses. And she and I both agree that medication options can be helpful and they can be a stepping stone toward reducing the impact that those behaviors have on the frequency of them or the intensity of them.

But the bottom line is that pills don't teach skills. And skills don't always work the way we want them to. And it's sometimes hard to figure out which combination of pills is right for the individual so you can get physically addicted to them. I was addicted. I had a dependency on an antidepressant that took me a year to wean myself off just a tiny dose.

So these cyclical pharmaceutical chemicals that we take, have some signs that need to be taken seriously. But it doesn't mean that we don't use them as a tool. I mean, we're very fortunate to have these tools available to us and they can help us maybe as a bridge while we're learning the skills and to better manage what's happening in our lives. So the bottom line is pills don't teach skills and please let's figure out what skills they are.

I also want to encourage you to visit anything written by Dr. Ross Green. He has been very generous online with the resources that he offers you at no charge. You can also read his books which are incredibly useful. And he argues that the assessment of lagging skills and unsolved problems that counts up underneath his name. Look for that. If you just Google Dr. Ross screen and Alsup he'll go right to his page. And he argues that what we need to do is start to notice what are the behaviors because we are not our diagnoses. What it is is just a description of the behaviors that the mental health professional is able to see and observe or others have told me the mental health professional about or they have documentation of so it's just an observation of behaviors. That doesn't mean that they permanently destined to live under the shadow of their diagnoses.

Again, we look at each of the 10 domains and figure out where the strengths are, what we're doing well, what we'd like to do next and then I encourage families to keep track of those problems as they come up, not address them at the time and come back and address them later.

There’s a link in the show notes for Dr. Ross Greene's work as well. So let me encourage you please, to come to my website, www.Lynncdavison.com and right underneath my picture is the link to download the Eight Common Mistakes that Parents Make when Systemising Self Reliance with their Autistic Adults. It's not as scary as it sounds. I mean, it's four mistakes that we make and then four things that we need to make sure that we do with our young adults. And what to do about each of those mistakes is included in this download. So please take the time to download this and see what you can learn from that. You can always unsubscribe once you subscribe to my list; not problem.

So in summary, let's just talk about when we do get a plus one diagnoses. We're going to probably go through a whole series of thoughts, some of which are going to create grief and need to feel that feeling. Don't deny it.  Feel it, let it come in and let it pass through. Some are not going to be so clean. They're going feel like this isn't fair, it shouldn't have happened, it was my fault and all the thoughts that create paralysis and blame and all the things that don't really work. Hopefully we'll work our way through those to the more helpful thoughts of let's just get curious. Let's get scientific and figure out what it is that we can do.

Next, hopefully we'll discuss the diagnosis with our child, which is again Ross Green’s approach. When we look at what the facts are first, then we ask the child and we ask our young adult “How do you think and feel about this” and we get that information on the table. Then we share with them our thoughts and our feelings too. So it's a mutual partnership here.

Then we go to the third visit to the final step which is agreeing on what the next steps are that we're going to take and checking back to see how those went and how they work. So that collaborative problem solving processes, filled with listening opportunities, and we’ll just get to know our child so much better and have even a more authentic connection with them. And, you know, be able to love them the way that we already do. All the way down to their toes but even stronger than that.

So I hope this was helpful to you and download my my best thoughts on what we need to do to help our young adults create lives they love that work. Bye for now.