“When that happens, I can then say my struggles are no longer mental and it’s not all in my head. One day, my mental illness will become physical and tangible. What was once hidden from sight will become real and visible.”
Living with an invisible mental illness is debilitating and stigmatizing, not least because your struggles are hidden from plain sight but also the chronic guilt that accompanies the feeling that your anxieties/worries/fears/depression etc are unsubstantiated. The sense of guilt is reinforced when you think that everyone is fighting their own battle or even a harder battle, in which everyone fought with courage and eventually emerge victorious while I’m the only one who remains defeated. I have heard of depressive episodes that lasted for a few weeks or months. Personally, I don’t know how that is possible for as far as I could remember, my life is shrouded by eternal clouds of blue since I was a child. Me and melancholy are one and inseparable and I was alright with that. Take away my depression and I will still be me. I never was a cheery person and I wouldn’t be me anymore without a tinge of sadness.
What’s the use of having a mouth if I choose to remain silence most of the time? What’s the use of ears if all I hear is noise and where there are more sounds in this city that annoy than sounds that comfort? What’s the use of eyes if I live my life turning a blind eye to things that drive me crazy, when I can’t see my future and even if a light does appear, it might be too glaring for my sensitive eyes? What’s the use of a heart if it belongs to elsewhere? I only hope my legs will be strong enough to carry me away when the time comes.
My dad has had an episode of heart attack recently. Looking back, it is like a prediction of how I would die. I could foresee myself in my father’s predicament, even earlier. When that happens, I can then say my struggles are no longer mental and it’s not all in my head. One day, my mental illness will become physical and tangible. What was once hidden from sight will become real and visible. And given my propensity to burst into outrage and to feed my insecurities with comfort eating, I wouldn’t be surprised if my heart decides one day that enough is enough. The question is when.
And if my legal or medical cause of death should read: heart failure. Just bear in mind that I didn’t really die because I suffered from a heart attack. Technically, yes but what I meant is my heart didn’t just decide to stop beating, there are precursors. I won’t dispute my legal cause of death, I am powerless to change that, which is why I’m writing this as a record, just so it is clear that I didn’t simply die from a medical condition, it all started with my mental condition. This, you won’t read from a medical report or in a coroner’s inquest.
First of all, depression can kill, with or without a medical physical condition. But to say that depression kills is to ignore what causes it. According to my unscientific equation, my mental disorder is a result of genetic predisposition + environmental triggers.
The unscientific equation:
Autism (genetic predisposition) + Environmental Triggers = Mental disorder
Autism as a risk factor
I’m not suggesting autism kills. Autism is however a risk factor for many issues including psychiatric diagnoses such as anxiety disorder and depression and research has shown that individuals with autism have high rates of co-occuring psychiatric disorders. This could be a consequence of living with autism. Given all the misunderstandings and stereotypes about autism and the lifelong challenge of trying to fit in (especially if one got a diagnosis in adulthood), it is of little surprise that individuals with autism are also more likely to report depressive symptoms. The fact that autism is characterised by sensory hypo/hyper-sensitivities and deficits in executive functioning increase the challenges of the autistic individual in dealing with day-to-day stress in their living and working environment. Suffice it to say, living with autism comes with a set of particular sensory, mental and neuro-developmental challenges that would have increase the risk of a person developing mental disorders later on in life.
Autism and the importance of environment
I’ve always believe that my autism and depression is largely environmental induced (and then of course I realise how lame it sounds to blame it on the environment which increases my guilt). Certainly, I’m not saying my autism and depression will be ‘cured’ in the right environment, I will always be autistic and sad regardless where I am but in the right environment, my autistic traits and depression are manageable so they don’t interfere with my day-to-day life. As Professor Baron-Cohen and Dr. Lai noted, “Diagnosis, therefore, is not just a function of the number of autistic traits a person shows, but also how they affect the person’s life.” There seems to be increasing recognition that the environment plays a crucial factor in the prognosis of autism. The Intense World Theory suggests early intervention and providing a calm filtered environment to reduce the sensory overload of an autistic child’s environment. The importance of creating a supportive, accepting and autism-friendly environment is also recognized by Professor Baron-Cohen and his colleague at the Autism Research Centre in Cambridge, UK who wrote, “support for adults with autism should target the individual but also physical and social environments to create understanding and acceptance and improve person-enviroment fit.” Professor Baron-Cohen refers to making changes in the workplace or education settings to help the person with autism cope with the sensory environment. This is an example of environmental modification at the micro-level, targeted at the environment pertaining to a person’s day-to-day setting.
HOW MIGHT THE EXTERNAL ENVIRONMENT TRIGGERS AUTISTIC TRAITS?
At a macro-level is the bigger environment pertaining to the society setting or the country one inhabits. I am reminded of ecologist John Calhoun’s experiment on the effects of population density on rats and mice’s behaviour which led him to coin the term ‘behavioural sink’ to describe the collapse in behaviour which results from overcrowding. Being one who is intensely and deeply affected by the environment I live in, I can’t help but feel like one of the mice trapped in Calhoun’s designed utopia whose outcome was inevitable destruction.
Cause of death: Human overdose
My heart is sick but it isn’t sick of life, it is sick of the people living in it. And I want this to be a record that if I died, I died from a social ill, from the effects of overpopulation and sensory (particularly auditory) overload, a result of human excesses and their vice. It is death by overdose of mankind. I died because I’m a misfit in the environment.
I don’t need a change of heart. What would really help is a change of environment. And even if I will never be happy, I still want to be in a place where there is aplenty of space and wilderness away from mankind.