psychotic - Emergent Divergence

Jun 5 2023

Creating Autistic Suffering: The AuDHD Burnout to Psychosis Cycle- A deeper look

This article was co-authored by Tanya Adkin and David Gray-Hammond

Monotropism is a theory of autism. It is used interchangeably as a theory and also a trait that describes a style of attention. It suggests that Autistic people tend to have singular but highly detailed tunnels of attention, as opposed to spreading their attentional resources across multiple subjects (Murray, Lesser & Lawson, 2005). It has succeeded where other theories have failed by offering an explanation for every element of Autistic experience. In this sense monotropism is the only universal theory of autism.

One could consider it the “engine” of Autistic experience. Whereby every other part of Autistic experience can be traced back to monotropism in some way. It is at the core of our experience.

Emerging research is showing that both Autistic and ADHD people strongly identify with many aspects of monotropism as a way of describing their experience (Murray & Hallett, 2023). More on this can be found at this virtual presentation. It comes as no surprise then that monotropism is of significant importance to those who identify as both Autistic and ADHD, termed AuDHD.

Psychotic phenomena is another shared experience for many Autistic and/or ADHD people. 34.8% of formally identified Autistic people have experienced psychosis with up to 60% of Schizophrenic people also showed traits of autism (Ribolsi et al, 2022), In terms of the cross-over with ADHD, 47% of those diagnosed with childhood onset of schizophrenia experienced attention differences and hyperactivity in childhood, and in a sample size of 100 adults with psychosis, 32% reported attentional differences in childhood (Levy et al, 2015).

From this we can see that there is a significant overlap between the AuDHD experience and psychotic phenomena. When we look at this through the lens of monotropism, it begins to make more sense.

Monotropic Split

Monotropic split refers to a very specific type of attentional trauma experienced by monotropic people who are regularly exceeding their attentional resources (Adkin, 2022) in an effort to meet the demands of living in a world designed for non-monotropic (polytropic) people. It inevitably leads to burnout.

Atypical Burnout

Autistic burnout refers to a state of exhaustion created by using up all of your internal resources.

“Autistic burnout is often used by autistic adults to describe a state of incapacitation, exhaustion, and distress in every area of life. Informally, autistic adults describe how burnout has cost them jobs, friends, activities, independence, mental and physical health, and pushed them to suicidal behavior.”
Raymaker et al (2020)

Because Autistic burnout is described as a state of exhaustion, one would assume, that for many Autistic people observationally it can look like depression, and as such tools are being developed to differentiate between the two. However, exhaustion does not always mean that you are bed-bound, observably tired, and, indeed, displaying observable traits of depression. Many people with depression do not fit typical criteria, which is then referred to as high-functioning depression (useful!).

This is likely because the medical model has some sort of obsession with observable, diagnosable, traits. Many Autistic people are unable to stop and burnout. This may be because they are also ADHD, they may have interoceptive differences resulting in alexithymia and a lack of recognition of tiredness. They may simply have to work or raise children.

This may look like meerkatting and hypomanic behaviour (Adkin & Gray-Hammond, 2023) in addition to loss of skills and reduced tolerance to stimulus (Raymaker et al, 2020).

Meerkatting

Lovingly dubbed “meerkat mode” by Tanya due to the heightened state of vigilance and arousal it presents, it involves constantly looking for danger and threat. It is more than hyper-arousal, Tanya believes that it is actually an overwhelmed monotropic person desperately looking for a hook into a monotropic flow-state.

This is not just sensory hyper-arousal, it is the tendency of monotropic minds to seek out a natural and consuming flow-state to aid recovery from burnout and/or monotropic split. Because of the heightened sensory-arousal and adrenal response that comes with it, monotropic flow becomes difficult to access, leading into monotropic spiral.

Monotropic Spiral

Tanya’s original concept of Monotropic spiral results from the inertia of monotropic flow. It may involve obsessive-compulsive type occurrences of rumination about a particular subject of experience that pulls the person deeper and deeper into an all-consuming monotropic spiral. Associative thinking that starts connecting this to anything and everything, seemingly like an ever increasing black-hole (Adkin & Gray-Hammond, 2023; Gray-Hammond & Adkin, 2023).

This can lead to the development of apparent loss of insight into ones own mental state and reality as described by the general population.

Psychotic Phenomena

Monotropic spiral is not psychosis. It is rather the vehicle that carries the person into psychotic phenomena, and maintains its inertia. Much like a star collapsing on itself, the resultant black-hole sucks in everything in its vicinity and is all-consuming.

A person experiencing monotropic spiral may lose insight and their sense of Self, compounded by a decoupling from shared reality. People can experience hallucinatory events, especially when alexithymic, making it difficult to differentiate between external sound and one’s own internal monologue. We can experience paranoia and rejection sensitive dysphoria to the point of delusion, it’s unclear where the line between this and fully fledged psychosis lies. We can also experience catatonic events and extreme lability of our mood, ranging from suicidally depressed to overtly manic and elated.

This may be why criteria for conditions such as schizophrenia and bipolar are so frequently met in the psychiatrists office. In a world that traumatises us by design, these phenomena may not be as atypical as we are led to believe.

Concluding thoughts

Are we looking at three separate occurrence that commonly happen together, within an observational model? Or are we looking at chronically stressed and burned out monotropic people, that due to the infinite possible interactions with an individual person’s environment, may observationally appear distinctively different?

Perhaps then we should stop thinking in terms of:

Autistic person + Environment = Outcome

instead considering:

Monotropic person + Environment = Outcome

Chronic stress or stressful life events have long been studied as a key contributing factor for the onset of psychotic phenomena (Philips et al, 2007) but the occurrence and impact of stress for monotropic people is vastly different, but it is not yet widely understood. This is because of the lack of training and rampant neuronormativity in mental health services (Gray-Hammond & Adkin, 2022); the antidote to which is neurodivergence competence (Gray-Hammond & Adkin, 2023).

Instead, we keep throwing money in the wrong direction and leaning on carcerative care to make the problem go away. If we can’t see it, it doesn’t exist, right? Seems to us like we should just fix the environment. Maybe that’s our “rigid” black and white thinking.

References

Adkin, T. (2022) What is Monotropic Split? emergentdivergence.com

Adkin, T. & Gray-Hammond, D. (2023) Creating Autistic Suffering: What is atypical burnout? emergentdivergence.com

Gray-Hammond, D. & Adkin, T. (2023) Creating Autistic Suffering: CAMHS kills kids. emergentidvergence.com

Gray-Hammond, D. & Adkin, T. (2022) Creating Autistic Suffering: Neuronormativity in mental health treatment. emergentdivergence.com

Gray-Hammond, D. & Adkin, T. (2023) Creating Autistic Suffering: Autistic safety and neurodivergence competency. emergentdivergence.com

Levy, E., Traicu, A., Iyer, S., Malla, A., & Joober, R. (2015). Psychotic disorders comorbid with attention-deficit hyperactivity disorder: an important knowledge gap. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 60(3 Suppl 2), S48.

Murray, F. & Hallett, S. (2023) ADHD and monotropism. monotropism.org

Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139-156.

Phillips, L. J., Francey, S. M., Edwards, J., & McMurray, N. (2007). Stress and psychosis: towards the development of new models of investigation. Clinical psychology review, 27(3), 307-317.

Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., … & Nicolaidis, C. (2020). “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: Defining autistic burnout. Autism in adulthood, 2(2), 132-143.

Ribolsi, M., Fiori Nastro, F., Pelle, M., Medici, C., Sacchetto, S., Lisi, G., … & Di Lorenzo, G. (2022). Recognizing psychosis in autism spectrum disorder. Frontiers in Psychiatry, 13, 768586.

Tanya Adkin 0 Comments

Jun 4 2023

What is unique about being Schizophrenic and Autistic?

I have previously written about the significant intersection between autism and schizophrenia and the relationship with psychosis in a broad sense. It is a widely undiscussed area despite the fact that many people experience it. I have also discussed what it is like to be schizophrenic; recently people have been asking me how my psychosis presents.

For this reason, I thought it would be good to discuss some of what I have found unique about my relationship with Schizophrenic experiences and my overall relationship with this particular aspect of my neurodivergence.

Hallucinations

I experience auditory, visual, olfactory, and tactile hallucinations. What does this mean?

Auditory Hallucinations
- These are sounds and voices that others do not hear. I can hear voices speaking to me and discussing my actions. A typical experience might be hearing voices coming from televisions and radios, but I also hear voices that sound like someone speaking next to me.
Visual Hallucinations
- These include perceptions of visual things that other can not see. Some that can occur for me are moving or breathing walls, people (such as a woman in a black dress), and insects.
Olfactory Hallucinations
- This means that I smell things that are not in existence in the environment. I can often smell tobacco being smoked where no one is smoking, or flowers that are not present.
Tactile Hallucinations
- This typically manifests as the feeling of things crawling over my skin.

Delusions

My most common type of delusion is persecutory delusions, although I have experienced grandiose delusions as well.

Persecutory Delusions
- These are delusions where we believe that someone or something intends to do us harm. I have believed that I am trapped in a computer simulation by someone trying to delete me, that microchips have been implanted in me that are broadcasting my thoughts, that my food is being poisoned, and that my loved ones have been replaced by doppelgangers.
Grandiose Delusions
- This is typically a belief that there is something uniquely special and important about you. For me, this manifested as a persistent and Obsessive belief that I had unified quantum mechanics with the physics of gravity and relativity.

Mood

I experience depression and hypomania. Depressive episodes are crippling and may see me sleeping for days on end. Hypomania episodes make me feel hyperactive and take risks. One particular example of my hypomania resulted in me having to be locked in the house to stop me from leaving the country.

What makes my experience unique?

Psychosis is incredibly difficult to camouflage, but due to being Autistic I was already adept at projecting an acceptable version of myself (I highly recommend this article by Tanya Adkin on masking). Professionals largely do seem believe it is possible to mask psychosis, but I managed it.

I also have a great deal of insight that is typically not seen in schizophrenia. Most of the time, I am aware that I am hallucinating or having paranoid or delusional thoughts. It is only in full-blown episodes that I lose that insight and become consumed by the neurogenerated reality I am experiencing.

This presented an issue in receiving correct diagnosis. Many professionals refused to accept that I was experiencing psychosis and would often gaslight me into questioning my own experiences.

“Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40”
National Alliance on Mental Illness (NAMI)

Despite my recognised onset of psychosis being at the age of 18, it took me until the age of 32 to be formally diagnosed. The full name of the diagnosis is too long to remember, but it is effectively the schizophrenia equivalent of PDD-NOS. One psychiatrist commented that he wished a diagnosis of “atypical Schizophrenia” existed for people such as myself.

I would also note that I was experiencing depressive traits and hallucinatory phenomena from a much younger age, but it was largely ignored and overlooked by professionals. I often wonder if this was the build-up to what emerged in my late teens.

We need professionals to recognise these unique experiences. Had my psychosis been addressed earlier, I may not have turned to drugs and alcohol for relief. Much of my suffering could have been avoided.

I am happy with my life now, but still have some anger for the experiences I have had at the hands of professionals. We need people to speak out, and inspire a paradigm shift in the recognition and support of Autistic and psychotic people.

For more writing on my experiences of psychosis and madness, please consider purchasing a subscription to my substack.

David Gray-Hammond 0 Comments

Jun 3 2023

Autism and psychosis: The elephant in the room

I am Autistic and ADHD, some might affectionately refer to me as AuDHD. However, to think that these two diagnostic categories tell the whole story of my neurodivergence is to miss out on a significant part of my experience of our shared reality.

The truth is, I don’t always experience our shared reality. My name is David, and I’m Schizophrenic.

Psychosis rarely makes it into the discussions of “mental health awareness”. In fact, most people view those like me as dangerous and incapable of taking part in the world. Many assume that people like me spend their lives in psychiatric facilities, taking part in unstimulating arts and crafts and therapy sessions. Some may think of us as criminally insane, restrained in a room, while having medication forcibly given to us.

While not totally inaccurate, I have spent time as an inpatient, and a lot of us are regular people with regular lives.

You might be asking yourself where my being Autistic and ADHD fits into this all. In this study they found that nearly 35% of formally identified Autistic people showed indications of psychosis, with up to 60% of Schizophrenic people showing Autistic traits. Statistics like this indicate that psychosis and Schizophrenia are an important point of discussion that is in no way being discussed.

To an extent, I understand why. The neurodiversity movement has done a lot of work to position itself away from things traditionally viewed as “mental illness”. It does, however, demonstrate the ableism and saneism that is present in the Autslistic community.

The fact that I experience madness is a part of my neurodivergence. Schizophrenia is neurodivergence, just like autism and ADHD. Like ADHD, many of us take medication to help us perform to the demands of neuronormative society. Just because psychosis and schizophrenia are viewed as mental illness, does not mean that it is mental illness.

The Autistic and otherwise neurodivergent community could do a lot to support people like me. By embracing us as neurokin rather than treating us as an undiscussed intersection, we become empowered to break free of the chains of the pathology paradigm. Is that not what we all wish for?

I know that out there, many people like me keep themselves contained and quiet. We need to dismantle the stigma and saneism in our community so that people can be openly psychotic without fear of being rejected, criminalised, or even killed. More often than not, the biggest risk we present is to ourselves.

I love the Autistic community. The things I have learned during my time among you all reach further than merely affirming neurodiversity. I have come to understand that things such as atypical burnout are inextricably linked to the development of my psychotic experiences. This is the good that open communication can affect those of us for whom reality is malleable.

The time has come for people to stand true to who they are. It’s time for psychotic people to open up the conversation and support each other into a liberated future. All I ask is that my Autistic comrades give us the space and compassion to do so.

To read more about my experiences of madness and schizophrenia, please consider purchasing a subscription to my substack

David Gray-Hammond 1 Comments

May 12 2023

Creating Autistic Suffering: What is Atypical Burnout?

This article was co-authored by Tanya Adkin and David Gray-Hammond

The literature around Autistic burnout is in it’s infancy with regards to academic papers, most of what exists comes from lived experience and blogs written by Autistic people themselves. The first academic paper on Autistic burnout was written by Raymaker et al (2020).

This paper describes Autistic burnout as:

“Autistic burnout is a syndrome conceptualized as resulting from chronic life stress and a mismatch of expectations and abilities without adequate supports. It is characterized by pervasive, long-term (typically 3+ months) exhaustion, loss of function, and reduced tolerance to stimulus.”
Raymaker et al, 2020

The following image from the paper shows how life stressors and barriers to support culminate in the outcome of burnout for Autistic people.

Typically the Autistic person in question will still have multiple demands in their life that require cognitive resources, despite having little to no resources left to give. Life goes on, as they say.

Burnout is widely understood and reported to be misdiagnosed in Autistic people as depression (Raymaker et al, 2020). This isn’t without basis; burnout can look like stereotypical features of depression such as not being able to attend to day-to-day life and losing one’s enthusiasm for things that used to be enjoyable. People experiencing burnout can struggle to get out of bed, although this is not necessarily a defining feature.

We are moving towards a measurement of Autistic burnout, although it is still in it’s very early stages. Papers such as Arnold et al (2023) suggest looking at things like issues with memory, emotional numbness, and difficulty communicating; all of which are usually taken as features of depression. It’s easy to see where the difficulty in differentiating arises.

The key difference in our opinion is that while burnout can lead to depression, it does not start there, and is rarely responsive to typical treatments for depression. Autistic burnout starts with monotropic split (Adkin, 2022) over a sustained period of time. Burnout recovery can take months or even years, and the recommended course of action is usually to remove as many demands as possible, and recharge through interest-led activities.

As Autistic people, we naturally live as demand free as possible. We do this because whether we are aware of it or not, we have to account for the distribution of our cognitive resources.

So, what happens if we can’t stop?

There are many reasons that an Autistic person may not be able to stop and recover; we may not be able to sense our exhaustion (due to interoceptive differences), masking (it may not be safe to practice authentic expression, it may not even be conscious), responsibilities such as child care, work, and home management. We may have co-occurring ADHD.

What we should try and remember is that burnout is not necessarily a set of observable traits that conform to a checklist. It literally is the result of going into an energy deficit on a regular basis.

Atypical Burnout

The use of the word atypical is not to create a neat category for an observable form of burnout. What we are referring to is burnout that might look different to the typical “depressive” understanding. In our experience it is not at all rare or atypical. We come across this time and again.

What atypical burnout can look like is being stuck in a hyper-aroused state, Tanya often affectionately dubs this as “meerkat-mode”, she describes a meerkat-type nervousness, constantly on the look out for danger, unable to focus and self-regulate creating the need for constant co-regulation with another person, and a fear of being left alone. This is sometimes misinterpreted as attachment disorder because of the childs perceived over-attachment to a parent or safe person. We often see this type of response from children and young people in traumatic school environments for extended periods of time.

This is usually accompanied by significant changes in sensory needs, especially interoception. This can result in a loss of sense of self, and reports of voice hearing. Individuals in this state appear to struggle to differentiate between our own thoughts and something external to their own being. This may be related to the high rates of occurrence of psychosis amongst Autistic people (Varcin et al, 2022).

It would be important at this point to mention monotropic spiral. We may internalise beliefs that seem negative and/or delusional in nature. We can seem stuck in a loop that drags us deeper into these internalised notions.

Rituals and routines can become more pronounced and seemingly compulsive, this is usually in an effort to create some attentional resource and ease an overloaded monotropic neurology.

There is a growing under-current in various circles questioning the validity of the diagnosis of Emotionally Unstable Personality Disorder (formerly known as Borderline Personality Disorder). We know that this is commonly misdiagnosed in Autistic people (Fusar-Poli et al, 2022). We also know that there is a huge amount of sexism involved in the identification of EUPD; women out-number men 3 to 1 in the diagnosis of EUPD (Bjorkland, 2006).

When we reverse that lens, men out-number women 4 to 1 in the formal identification of autism (Rynkiewicz, 2016). Considering the high co-occurence of ADHD and EUPD (Philipsen, 2006) and the well-known co-occurrence of autism and ADHD; is it possible that we might be looking in the wrong direction? Could many of these people be experiencing a protracted, atypical, Autistic burnout?

Or is it just a big coincidence?

References

Adkin, T. (2022) What is monotropic split? Emergent Divergence

Arnold, S. R., Higgins, J. M., Weise, J., Desai, A., Pellicano, E., & Trollor, J. N. (2023). Towards the measurement of autistic burnout. Autism, 13623613221147401.1

Bjorklund, P. (2006). No man’s land: Gender bias and social constructivism in the diagnosis of borderline personality disorder. Issues in mental health nursing, 27(1), 3-23.

Fusar-Poli, L., Brondino, N., Politi, P., & Aguglia, E. (2022). Missed diagnoses and misdiagnoses of adults with autism spectrum disorder. European archives of psychiatry and clinical neuroscience, 272(2), 187-198.

Philipsen, A. (2006). Differential diagnosis and comorbidity of attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) in adults. European archives of psychiatry and clinical neuroscience, 256, i42-i46.

Rynkiewicz, A. (2016). Autism spectrum disorders in females. Sex/gender differences in clinical manifestation and co-existing psychopathology (Doctoral dissertation, PhD Dissertation. Retrieved from Medical University of Gdansk Bibliography Database 2016).

Varcin, K. J., Herniman, S. E., Lin, A., Chen, Y., Perry, Y., Pugh, C., … & Wood, S. J. (2022). Occurrence of psychosis and bipolar disorder in adults with autism: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 134, 104543.

Tanya Adkin 3 Comments

Nov 24 2022

(Mis)perceptions of reality: Autism, psychosis, and my quest for objective truth

For as long as I can remember, I have been preoccupied with the difference between truth, and mistruth. Long before my psychosis began, I wanted to know how the things we held to be true could be proven as objectively true; it seemed to me that truth was in the eye of the beholder.

Six months after my 18th birthday, I discovered that my reality was a shifting and changing experience.

The problem with psychosis is that you don’t know it is happening. You literally experience an alternative reality. What this taught me was that things I held to be true were entirely subjective, which brought me to the realisation that everyone’s interpretation of truth was subjective.

Consider the boundary between truth and mistruth. It is abstract, a non-entity. Said boundary is entirely built from the collective experience of humanity, an experience which is in itself subjective.

Where those experiences intersect and agree, we label it objective truth. How then can we construct truth from a mind such as mine? One in which reality is a malleable and fluid thing. My Autistic Self has been preoccupied with this for many years, and truthfully I am still searching for answers.

Perhaps, then, it is reasonable to argue objective truth in terms of Descartes? “I think, therefore I am”. Of course this is made more complicated by the after-the-fact functioning of consciousness; and yet, I have often found myself drawn to a sort of solipsism during times of crisis.

Thus, we are left with the only thing I can hold to be objectively true from moment to moment. That my sense of identity, my experience of Self, at any given moment, is the only thing I can hold to be true. An identity that itself is constructed from interactions with my (mis)perceived reality.

So, when I argue the importance of community-connectedness, I am going beyond minority stress models, and beyond social reciprocity. For me, the communities I interact with, and the individuals that I speak with, are directly constructing my truth.

That is why the Autistic community is so vital to me. They have built the only thing that I know to be true.

David Gray-Hammond 3 Comments

Jul 12 2022

Autistic people and the burnout-psychosis cycle

Trigger Warning: This article discusses burnout and psychosis

While it is evident to myself and my colleagues that Autistic people have a predisposition towards psychotic phenomenon, it seems to be a relatively new discovery to many of the mental health professionals I have talked to. Research that is non pathological in this area is sparse.

Despite this, acute psychosis and psychotic conditions seem to be emerging in the Autistic community (anecdotal, based on experiences of myself and colleagues). Some might suggest this is due to the increased stress that we have faced since 2020.

I feel at this point it is important to discuss a phenomenon I have been witness to in both myself and others. I refer to this as the Burnout-Psychosis Cycle.

To begin with, we will look at the infographic I recently posted to the social media page I run.

The burnout-psychosis cycle

Once something places us into a state of burnout, Autistic minds seek to return to their natural state of monotropic attention tunnels. We hyperfocus.

We then get caught in an attention tunnel regarding something that is traumatic to think about, unable to shift our focus from that attention tunnel. This causes distress. Tanya Adkin refers to this as a monotropic spiral.

As we become dysregulated, our sensory experiences also become dysregulated. This is where we may start to have hallucinations, and experience emotional dysregulation such as paranoia or mania. This is the psychosis part of the cycle.

Unfortunately, psychosis leaves the person burnout, starting the cycle again.

In order to break this cycle, we need to ensure that the burntout person has the time and space to engage their attention tunnels within their special interests. Things that will bring them joy and recover their spoons.

It is possible to break the cycle through the treatment of the psychosis, but medication doesn’t generally help burnout.

More research is needed in this area as this is based on anecdotal evidence, rather than peer-reviewed research. Autistic people need to speak loudly about this where and when it is safe for them to do so.

The ramifications of becoming psychotic can be serious. People experiencing psychosis may put themselves in danger, or rarely, endanger others. It may be necessary to detain the individual and have them admitted to an inpatient facility.

While these facilities have their place, it is not a positive experience for many Autistic people, and can add to the burden of trauma that led to the cycle starting in the first place.

When working with Autistic individuals, we need to be holistic in our approach and consider all the factors co tri using to burnout.

Until we do this, we will not be meeting their needs.

David Gray-Hammond 4 Comments

Jun 8 2022

Coping with psychiatric medication when Autistic

For many of us, medication is a necessary part of life. For a huge portion of the Autistic population, that medication is prescribed by a psychiatrist.

Psychiatric medication can be a troublesome topic, psychiatry itself is a relatively young discipline, and can often be found to be neuronormative in nature. It relies on the idea that the human mind can become ill and require medicine to fix it, and yet no test can definitively prove the presence of this illness in the body. It seems logically absurd, and yet, mental health issues can cause immense suffering.

One of the most stressful parts of taking these kinds of medications is finding the right one. Each person brings a different neurology to the table, so when using psychiatric medications, which by their nature act on the brain, it is important to remember that there is no “one size fits all” approach. Each person will have a different experience with medication, and this issue is compounded when you consider the Autistic population, for whom little to know research is done on the efficacy and safety of medications.

This moves us neatly onto my next point, which is side effects. Autistic people often experience rare or paradoxical reactions to medications in my experience. A recent medication change for me actually turned the skin on my hands blue! This is why I always ask my psychiatrist to take the harm reduction approach of start low, go slow. In other words, start with the lowest reasonable dose, and very slowly titrate the dose up. I find that for me, this has helped me avoid many of the less tolerable side effects, and better tolerate the ones that I do get.

An interesting point raised by twitter user @lilririah is access to food. Many of these medications rely on the idea that people can eat regular, healthy meals. Something that prescribers should consider is that the world over is experiencing a huge rise in the cost of living which is having a huge impact on the disabled community at large. Telling someone they have to eat when they take their medicine can essentially be the same as telling people that they can not take the medicine. When the world is trying to decide between heating or eating, a life or death decision over important medications is not going to help their anxiety.

Once you have overcome all of this, there is the issue of maintaining the treatment. Medication comes with a lot of stigma that many of us internalise, and some people simply do not want the medication in the first place. While personal choice is important, and should come from an informed position, prescribers need to do more to help people maintain a healthy relationship with their medication. When you consider the Autistic and ADHD bodymind, it is easy to see how remembering to take a set dose at the same time every day could become problematic.

Assuming all of this isn’t an issue, there is one more problem I want to discuss. Sometimes medication just stops working. Sometimes we can be stable for years, and out of the blue, we fall apart. It is the unfortunate truth of psychiatric medication. This is why we have to be willing to go over this battle time and time again to stay balanced. I personally struggle with this part. I often wish for a magic pill that would make my psychosis go away forever, unfortunately, that does not exist. Besides, mental health is part of who we are, good or bad, it plays a role in our experience of the world.

Whether your mental health is in a good or bad place, we all have something to give to the world, we are all important in our own way. It’s easy to lose sight of that when you have grown up Autistic, constantly being invalidated and told that everything about you is wrong. I want to assure you that the world is better for having you in it, and the battle is worth it.

Stay strong.

David Gray-Hammond 1 Comments

Jun 1 2022

Where psychosis and autism meet: The bitter pill to swallow

I am Autistic.

I also have a psychotic condition.

One might wonder why these two things are even related, and yet they share an intimate relationship.

As an Autistic person, I have a monotropic bodymind. I hyperfocus into a subject, and find it very difficult to switch tracks, even when those tracks are taking me barrelling towards those I love, or towards the cliff edge.

Some may have heard of the term “monotropic spiral”. This, to me, describes the way the Autistic bodymind can falk down a rabbit hole of looking into a topic, regardless of where that rabbit hole may lead.

In the same field of concept, the psychotic bodymind obsesses over it’s delusions and constructs a reality. It does this (in my experience) because it feels unsafe.

Why might an Autistic person feel unsafe? There are a million answers to this question, and I only have so much storage space on this website.

The psychotic bodymind uses something called “confirmation bias”. This is where it seeks out evidence to support a conclusion it has already reached, and then to avoid cognitive dissonance, effectively shreds all evidence to the contrary.

Throw away comments, subtle changes in body language and microexpressions, tone of voice. They all get twisted by the mind into something that is not real. This can be further complicated if you are the type of Autistic who struggles to read intent and emotion in other people.

The truth of the matter is, recovery is complicated for Autistic people. We are monotropucally focused on fine details, but when psychotic will often misinterpret them.

It is vital for this reason that early intervention psychosis teams have a good grounding in Autistic experience because it plays a huge role in the roadmap of the psychotic experience.

And, oof!

If you think that your executive function is bad as an Autistic, consider then tackling that while auditory and visual hallucinations are disrupting your reality.

It is not pleasant.

David Gray-Hammond 0 Comments

Apr 30 2022

The weight of recovery

As many of you know if you have followed this website for a period of time, I am in recovery from addiction and psychosis. I have spoken extensively of my experiences from when these things were in an active state for me, but today I want to zoom in on the experience of recovery.

Recovery.

Aptly named because it is a time when you try to recover your former self, you try to recover a time before all the shit hit the fan. While a hopeful title for such a period of time, it is perhaps the hardest part of the mental health cycle.

When you start to recover, you are left with the pain you may have caused, the guilt, the shame. There are times during recovery when quite honestly it’s quite difficult to love yourself. You are left with the questions that may never be fully answered.

It is a lonely time that can weigh on your mind a great deal.

What if the damage done is irreparable? How can people trust me again? Am I worthy of the love I have received?

While the burden can be shared with others in the recovery community appropriate to you, the burden is ultimately yours. We are the ones who have to decide to make a difference, which in the case of things like addiction and psychosis can be incredibly challenging; how can I decide to get help at a time when I don’t understand how ill I am?

For many of us, all we have is the wreckage of the life we once hoped for. Taking it’s pieces and trying to rebuild.

But hope is not lost. Because we can find ourselves again. While we carry the scars of our former battles, they stand testament to our victory over the immense pain and suffering that befell us. The people that love us are there, we just have to shine a light in the dark, whatever that may look like in our life.

Please don’t lose hope. You can find yourself. You can recover what wad lost.

Although life may be different to how it was before, I promise it can be a beautiful thing. Choose to carry the weight of recovery, and emerge a stronger you.

David Gray-Hammond 0 Comments

Sep 8 2021

[Feature] Paranoid Schizophrenia: A story in pictures

In this post, I will be showcasing the artwork of Blake Jackson, diagnosed with paranoid schizophrenia.

Blake draws pictures of his psychotic experiences, and it is my hope that you will all learn from these pieces of art.

Beauty of the Beast- multi-coloured lines in the background. Their image is of a cloaked figure with a rams skull for a head, holding up a skeletal arm as if to shush the viewer.

This piece is called ” Beauty of the beast”

This creature first appeared to me around two years ago. It would perch itself on the end of my marital bed. Simply stare at my wife and I and occasionally snort to make its presence known. It terrified me so much I couldn’t sleep. It does appear to me still but not as much as it would have but believe me that is still too much.

The smile- a firey portal is in the background with a silhouetted figure emerging. The figure has no facial feature save for a monstrous smile containing many sharp teeth.

This piece is called “The Smile”

I refer to them as the shadow creatures. They are very tall in appearance, I would say around the 7 ft mark. They attach themselves like a parasite to its host and will suck the life force from the human theyve chosen. They manifest through the strange rectangular portals.

Tardigrade- the back ground of this image contains brown, black, and grey splodges. The main image is of a white tardigrade with it’s head turned backwards. It has two small black eyes, and a smile similar to that of “the joker” containing sharp teeth.

This piece is called ” Tardigrade”

I will often see this one scurrying across the ceilings. When spotted it will stop dead in its tracks, like when you see a spider and it seemingly stops, aware that you’re looking at it. It has full control of its neck and can do a complete 180⁰ turn to stare directly at you.

“Transformation”

Shes a seemingly innocent elderly Chinese lady to begin with. Has an issue of watching us through the windows of our home. Its only when she enters into the house that she transforms into this creature. Can be found hiding under the children’s beds just waiting.

“Poison”

I have had a real issue surrounding food and drink thats not prepared by myself or ive not watched over during the making process. I’ve had the very real belief I was being poisoned and the hallucinations surrounding drinks can range from warning symbols appearing in the drinks to just outright green bubbling liquid where there should be coffee. I tend to make it myself now or my wife will test it for me if she can see im uncomfortable.

“No drinks available “

For quite a while I had believed, after seeing, there was an octopus living in my kettle. The cephalopod had , for some reason, chose this new home to live in. It disrupted my coffee drinking as I would have to check to make sure it wasn’t real.

“The plague doctor”

There are two of these that follow me. They’re sort of like yin and yang. Good and evil. The white one is good and makes conversation with me and helps me to achieve goals. He even assisted me in the birth of my youngest son, having delivered him myself. The black one is evil, he doesn’t speak only taps his finger on the door and beckons me to come outside. His aim is to get me into the woods and for me to hang myself.

“Crocodile Nundee”

Originally started as a dream, but have since seen her and her sisters congregating in crowded areas and blessing the crowds as they walk by. They mainly like to do their hail Mary’s on the rosaries. If you get too close they can get a little snappy.

Sad- background consists of rainbow coloured lines. Main image is of a sad clown in black and white.

“Sad”

This is bobo the clown. He first appeared to me around two and a half years ago and has to be the most miserable clown there is. He has a completely lacklustre laugh and a broken horn. His effort is that of someone who has lost complete hope and is a pit of despair. He will pop out around corners hooting his broken horn at you.

Blake Jackson is a paranoid schizophrenic, he was diagnosed at the age of 30 but had experienced symptoms throughout his late teens and 20’s. He turned to drugs and alcohol to cope with the stress of having hallucinations but has been sober from these for many years now. He has developed a coping mechanism through the medium of art. He depicts his hallucinations and delusions in his artwork. Blake is a proud father to 6 boys which he and his wife Gemma take care of.

David Gray-Hammond 1 Comments

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