#diagnosis

[bisexualseraphim]

With how RFK has been speaking about autistic people and his plans for them, I don’t want to hear FUCK against self-diagnosis ever again when shit like this directly demonstrates what formal diagnosis can lead to — and there is worse to come, I guarantee. An autistic person’s choice to not be put on a Eugenics Hitlist is pretty fucking valid I’d say actually

[autiebiographical]

I was diagnosed as autistic during a 2 week stay in a psychiatric ward. Many other autistics are diagnosed after hitting autistic burnout or completely melting down.

My hope is that less and less autistic people need to hit rock bottom just to discover they're autistic.

[pixierainbows]

April 1st: What age did you find out you were autistic? If you have a diagnosis, what was the diagnosis process like, if you can remember it?

Pixie not remember much . Was very young when first recognized as “ not normal “ .

It was suggested to have Pixie evaluated by professionals in Pixies First elementary school . Parents refuse to listen and never admitted something maybe “ wrong “ ( Other than Pixie be deliberately “ bad kid “ ) . Or that Pixie might need more ( real , actual ) help .

Forget when . Guardians got Pixie professionally evaluated ( though nobody had any doubts about Pixie having autism by then ) . Professional Confirm/diagnose Pixie with level 3 high support needs autism . And . Speech therapist diagnose Pixie with severe expressive language disorder ( nonverbal ) , from autism .

Both professionals ask lots questions , so very many questions … Pixie think guardians answer most questions .

Was really nice to have experiences finally believed by . Not just professionals what only see Pixie very short time . But also ( more importantly , to Pixie ) by . Chosen family what live with Pixie for so much long time .

Pixie not evil , not born bad , not demon possessed , not Wicked changeling . Just autistic .

[one-time-i-dreamt]

I was getting diagnosed by Dr. House.

My next dream I was making out with doctor House.

The next night I had another dream where I was making out with Dr. House.

[klarathenerd]

"Why are you celebrating the fact that you got diagnosed with [DISABILITY/DISORDER]?" I think you're missing the point here.

Being diagnosed means that you finally can see why you have always acted in this certain way, and not only could you change your habits, avoid certain thing that harm you, and take medication to improve your state in life, but also find a community that feels the way you have for years and accept you, and others, for who you and they are.

Being undiagnosed on the other hand is a BRUTAL experience. you are expected to do so much as a seemingly neurotypical person, that you know you cannot do, but are unsure of why. For all your life you were always alone or constantly bullied and yelled at since people see you as an outcast, and even you yourself are confused and ashamed about why you act this way, and could lead into much more serious actions like self harm or ever suicide.

Going to a psychiatrist and getting diagnosed gives you SO many benefits by simply knowing that you have a certain conditions. While it is hard to live with said conditions (I would know, I was diagnosed with Autism), it is harder, to live without knowing that you have it (Plus most of the issues we have with our conditions is just society and The System™ being ableist towards it.)

[semiplural]

Psychiatry and the Assumption of Absolute Diagnosis and Treatment

I'm not here to pull my punches, so let's all be honest about the state of things as a system on the internet. I don't care if you're traumagenic, endogenic, whatevergenic, "fuck the labels, we're just here". You can spell your pain points out in detail, be honest about the shit you deal with, show all the suffering in the world, be a perfect textbook presentation of The Suffering, Disabled Multiple who sees themselves as more trauma than person-

and still, the second you say it's not hell on earth, show signs of trying to live with each other better, or find even a speck of joy or interest in your life despite whatever pain you're dealing with, that's reason enough for strangers to turn on you. Liking your systemmates and getting along well is reason enough for strangers to say you have "narcissistic involvement". You're just a trauma response, not a person. Your self-understanding is wrong- no, I don't have proof, I just have theories. Proof would be unethical. You understand.

You don't exist unless you're actively on fire, suffering as your brain burns down to ashes that all hate your guts, and treating all of that as a horrible disease that needs curing to make you normal again. And if you are diseased, then "you really need to stop having symptoms, it's not good for you. Get some help. Go to therapy. You're too crazy to understand yourself accurately."

It's not just us. I see it happen time and time again, played out the same way across a dozen different websites, slowly driving us all mad as we rip each other to shreds to appeal to strangers who see all of us as broken murderer stereotypes. It doesn't matter why you exist. It doesn't matter what you deal with or how happy you are. Someone, somewhere, is going to find a reason to punch down and go for the throat. Someone is going to justify it using psychiatry's medical model of the mind.

In a community so centered on medicalizing every little experience, no matter how mundane or common, I look around and get really fucking worried about some of what I see: the sheer amount of sucking up to people who think we don't exist in the first place is disturbing.

My friends get asked if they want to kill people when they open up about being plural. We get threatened with incarceration, eviction, and the loss of our livelihoods. People like us get their kids taken away from them, get denied the ability to enter other countries, have their autonomy taken away time and time again for the crime of being a little too different. We're called imaginary, insane, violent, confused, and a thousand other words that all add up to, "we don't see you as worthy of the same respect as us."

And yet, we're all stuck on this idea that some of us are more acceptable than others, and that casting off the people you disagree with will save you from the people who see all of us as exactly the same level of crazy and dangerous.

Appeal to nitpicky strangers all you want, but someone out there is going to hate your guts for existing in a way they disagree with, and they're not going to see you as being on their side if you join in and beat up your friends. Sanitization just kills us from the inside instead of the outside.

So screw whatever fears we had of being a little too unhinged on this blog, I'm opening up the can of "honest thoughts about psychiatry" to talk over some thoughts around the mental healthcare industry. Want to go off in our inbox or comments about how much I suck for having opinions? Skip it and block us. You'll save us both time.

Psychiatry is a Mixed Bag

I'll start by porting over some thoughts from a conversation we had today that sum things up decently well:

I'll make the argument that decisions about what's best for someone's life aren't always best left up to a professional who does not live that life or necessarily share their values about what makes a life rewarding, worthwhile, and meaningful. Some people seek mental healthcare because becoming more normative fits their ideas of living a good life. Other people feel harmed by that pressure to outsource their decisions about their life and identity to mental health systems, or they may fundamentally disagree that one has to be "normal" to be happy and successful in life. The psychiatric system can be very helpful to some people, very harmful to others, and anything in between to plenty more folks. I don't think that psychiatric care should be forced on someone just for having unusual ideas about themselves that aren't causing them or other people concrete harm in their daily lives. I think that as much as possible, it should be left up to them whether they want to seek that kind of support, and that even in cases where there is a risk of harm to self or others, it needs to be handled a lot more respectfully towards that person than it often is. There's a reason that there are movements of people speaking out against psychiatric abuse and mistreatment- the industry has its problems, just as it has its merits, and those problems have hurt people just as much as not seeking support has hurt other people.

We approach a lot of things from a vaguely psych-abolitionist perspective, especially me. This shit needs reform at minimum. Keep that in mind.

Sometimes Western psychiatry helps people. Antidepressants saved our life in high school by giving us just enough of an emotional prop to work on fixing the root cause of our depression at the time. Antipsychotics let our friends work and live independently. Therapy helped us learn how to process a shitload of trauma and fear around things as mundane as blue rubber bands. We've picked up some tricks from clinical textbooks.

Sometimes psychiatry's absolute dogshit. A psychiatrist suggested taking the door off our bedroom and never giving us a moment of privacy as part of treatment. Another one told our mom that we just needed to play outside more when the problem was that we were self-injuring to cope with trauma (nevermind that we spent all day outside already). A therapist told us to "just stop thinking bad thoughts" instead of helping us figure out why we were in pain.

We know people who called emergency services, then were handcuffed, sedated, and institutionalized during a crisis. We know people who were medicated against their will, had their trauma dismissed as a factor in their pain, had their actual concerns ignored in favor of what the clinician wanted, and had psych wards deny them human contact or companionship when all they wanted was a hug. We know people who were diagnosed, then had those diagnoses weaponized by everyone in their lives to take away their autonomy, credibility, and independence. We know people pushed to use modalities that weren't available to them, or that did concrete harm to them in the past.

Psychiatry isn't all bad. But some of the shit that goes on isn't right.

Psychiatry isn't Universal

Even if psychiatry didn't have its issues, it's not universal. Some folks live in areas that do have Western mental healthcare, but they lack the means to access it. This shit isn't always free or cheap. Even if it's available, some folks can only access mental healthcare based on paradigms now considered to be harmful or unhelpful under the Western model.

Some folks have access to different takes on mental healthcare that aren't "take Prozac" or "talk in a therapist's office for an hour a week". Different medications, no medications, physical interventions, understandings of mental illness that look nothing like the DSM. The Western model of mental illness isn't the only way to make sense of suffering.

Some folks have access to healing modalities, spiritual and cultural interventions, and other approaches that don't pathologize their experiences as "diseases" or "disorders" in the first place.

Some folks have no access to any form of mental healthcare whatsoever.

Despite that, the internet's first response to someone struggling is to toss them, "you need to see a therapist", "get diagnosed or you're faking it", or suggest that they go on meds to get rid of their suffering like any of that is a readily-available magic cure for all suffering and abnormality. Every weird experience is pathological. Every pathology should be fixed with Western treatments and understandings.

Sanity isn't Universal Either

Of course, there's one true standard of what's sane and what's insane, and symptoms never happen outside of disorders. Everyone knows that. (Immense sarcasm.)

Yeah, that shit isn't universally true at all. Weird shit happens to people all the time outside of a diagnosis. Even in Western countries:

6-15% of the general population hallucinates without meeting criteria for a diagnosis

Millions of people believe in ghosts, and a sizeable portion believe that they've directly encountered a ghost at some point in their lives

Some writers hear the voices of their characters and find that they can act with autonomy

An ACE score of 1 or more is typical in the United States, and a full quarter have a score of 3 or more. If you're curious what an ACE score corresponds to, here's a questionnaire. Most people do not see themselves as traumatized despite this.

I could pull more examples of "normal" people being crazy (conspiracy theories, anyone?), and I'm sure you could too.

If all of these people have the right to understand their experiences outside of the medical model, then why don't we? Why the insistence that a subjective experience has to be diagnosed to be real to you in the first place?

What if you don't live in a culture that treats your experiences as a disorder in the first place? Even if you do, what if you'd rather use another paradigm to understand your life? Where's the space for that on an internet that assumes that the only truth is a diseased and diagnosed one?

There are other ways to understand your "weird" experiences that aren't in the DSM. Even if you do make use of the DSM or ICD, you still have access to these other paradigms.

Things to Think About

The medical model didn't appear out of thin air. Diagnoses in the DSM and ICD didn't manifest in isolation either. Have you ever asked yourselves who decides what's normal? Why do they get to decide that, and who benefits? Who suffers? Who is disproportionately affected by the concept of diagnosis, and why is that the case? Where do we get these diagnoses from, and what value do they offer? Who do they offer it to? Who is it denied to, and why?

Take a minute, think on it. Work out how the medical model helps you, how it hurts you, and how you want to relate to it. It's worth your time to get both sides of your story around the medicalization of your experiences.

If you find it useful, great. Roll with that. But don't assume everyone else feels the same way.

I'll gladly recognize your right to take meds, go to therapy, use diagnoses, and take whatever else you want to take from the medical model. I want there to be space for everyone else who'd rather walk a different path or hold a different understanding- space to let them exist and be heard.

[liskantope]

I think I've run across a good writer who thinks on my wavelength in terms of the "gentrification of mental illness / neurodivergence", and he wrote an excellent essay criticizing a recent book of Devon Price (a blogger/writer/activist I've run across and felt critical of for years; once known as "E. Price", they wrote that famous "Laziness Does Not Exist" post which I made an effortpost about way back in my days of Wordpress blogging and going on about low-agency vs. high-agency goggles). To be fair, I should say, Jon Machnee's post is an excellent review of Price's book modulo the fact that I haven't read Price's book.

Here is a passage I find particularly striking, even if it's purely anecdotal:

Recently, I attended a BBQ at my sister’s house. She knew I had nothing on that weekend and wanted me to work the grill so her and her friends could hang out in peace. I obliged, as any good brother would, and was surprised to learn that her whole friend group had autism. I have spent the better part of 12 years talking with, studying, and researching autism, and while I know you can’t diagnose or undiagnose someone at a party whilst also grilling hotdogs, I would bet my entire life savings that not a single one of them had an actual autism diagnosis or would get one if they were assessed. At one point, they told me that my sister, who does not have autism but does have ADHD, was the most autistic of the group. One of them even asked me what I thought of Price’s book and expressed how much it meant to them. This is particularly funny in hindsight because a few month later my sister reported that not only did they not have autism, but when they went to talk to a professional about it, they became distraught upon learning that they weren’t even remotely close to meeting any of the criteria. Apparently after the BBQ, some of my sister’s allegedly autistic friends asked her what was wrong with me, and she had to inform them, and I quote, “Oh, he has, like, real autism.”