So like, I wanted to write about my experiences with medication for a number of reasons.
- Because I’m hyper-aware of my body/cognitive processes, I can describe the differences between how it feels to be on vs. off medication in a lot of detail.
- Because, in the pantheon-zoo of kinds of autistic people, I fall within the subset of autistic people whose autisticness results less from a family history of classically autistic, non-verbal people or classically “Aspie” types, but from the combined effect of family histories of mood disorders, extreme neuroticism, eating disorders, ADHD, learning disabilities, and other things more peripherally related to “classic” autism. This means that medication plays a larger part in my life than it probably does for many “higher-functioning” or highly verbal autistic people.
My current medication regimen involves two meds: a high-dose stimulant (for ADHD), and an SSRI (for everything else). I like to joke that I have one prescription for each side of my family. I’ll talk about my experiences with each prescription below.
Emma + Stimulants: [I want to give a lot of context to this, because the discussion around stimulants and ADHD symptoms and autism is a delicate one.]
I have a family history of ADHD-type things that are totally independent of my family history of autism-type things. I also have really, really severe ADHD. Like, “Look, squirrel!”, no-short-term-memory, constantly moving, emotionally impulsive, ridiculousness. My psychologist specializes in ADHD, autism, LD things, and she considers me one of the most severe ADHD people she’s ever seen. I’m hardcore. When I don’t have medication, I literally get into cars and forget to close the car door behind me. I broke the door off my dad’s car this way. I can’t concentrate on anything that isn’t a concrete task, I’m vaguely avolitional, and when I do feel motivated to do something, it’s with a manic intensity that insists I do that something RIGHT NOW. Probably the most upsetting part about being off medication, for me, is this feeling of completely unshakeable unease and dysphoria. Nothing ever feels “right” or “calm” or “comfortable.” It’s like the feeling you get when you’re really bored with some task but can’t get out of it, and you’re just bursting to do anything but this thing you have to do. Except I feel that way all the time, even when doing things that, on a more abstract level, I know that I enjoy and want to do.
The first time I tried a stimulant medication, it was summertime, because my doctor at the time wanted to make sure that it actually helped me function/feel better as a person, instead of just making me better at sitting still in school (sign of good doctor). I took a medium-sized dose, and waited. After a little bit, I went up to my mom and said “Mom, I think it’s working. I feel different. What should I do?” She responded with “Well, given that I’ve asked you like 5 times today to unload the dishwasher, how about unloading the dishwasher?” And I said “Okay.” And then I went and did that. And then I went back to her and said “Now what?” And she said “Well, did you unload the dishwasher?” And I said “Yeah, I’m done.” And she went to look and see if I’d done it, and when she saw the dishwasher unloaded, she just went “Holy shit.” I was sixteen at the time.
In general, when I am on medication, my mind is much clearer and more solid than it is normally. I have the motivation to do things, and the focus to see them through. I can maintain some semblance of internal speech without it spilling over and turning into me talking to myself out loud. I can actually focus my eyes on an object or point in my field of vision, which I can’t really do without medication. I feel more comfortable in my body, and have much better fine motor coordination. The world feels much less overwhelming in a number of ways. However, since it also heightens my awareness of what’s happening in my head (like giving my brain better resolution), it can also make unpleasant sensory/cognitive things I’m aware of feel more intense. Basically, for me, getting a stimulant prescription probably saved my life. I am reliant on my prescription, to a certain extent. My very fast neurochemical metabolism, and the high doses I need to take, have made my life with insurance and doctors kind of a ball of stress. But that’s a story for another day.
Emma + SSRIs:
I got an SSRI prescription for the first time about 5-6 months ago. After a few days of taking it, I just went up to my mom and was like “Is this how normal people feel all the time?” And she was like “I mean, I don’t really know? Yes? Maybe?” And I was like “If this is how normal people feel all the time, you’re all assholes. That’s so unfair.” When this conversation occurred, I was only three or four daily doses in, and I was taking 1/4 the size prescription I have now. That’s how goddamn dramatic it was. When I was going to get prescribed an SSRI, I went to Wikipedia to look up things about the medication I’d be taking (because I do that). I basically cracked up when I saw the page for it, because every single diagnosis that my medication is used to treat is a diagnosis that I’ve either had, or that I have a family history of. I have a parent who’s also mildly Aspie, and who I am very similar to, and this parent and I have matching SSRI prescriptions.
I don’t know how precisely to describe the way it affects me yet. The most noticeable thing is the way it just cuts through my “panic mode” and helps me feel secure enough so I can deviate from my routines when necessary without being terrified, and so that I can recognize better when I’m reacting compulsively/impulsively to stress. It’s very interesting to me how it works differently for different people who are supposedly using it for the same things: the parent of mine who has the same prescription I do says that it makes them feel much more connected and engaged with other people, whereas previously they felt very isolated and detached from the world around them. This makes sense to me, because said parent struggles much more with depression and social detachment, whereas I struggle more with anxiety/OCD, and social anxiety. It also is very reassuring that I know I’ll be able to take it for a long time without having to worry about it stopping working.
This is a picture of me on a school trip in seventh grade. We’re on a subway train, and I’m holding on to the over-head bar thing. My friend took this picture from above, so my arms look disproportionately big. I’m wearing a lime green T-shirt, and my hair is super long.