Tag Archives: case manager

More on Autism

11 Apr

So I’ve mentioned before that both my case manager and the therapist wanted to have me evaluated to see if I fell on the Autistic Spectrum.  This was due to a variety of issues including my Sensory Processing Disorder, issues with eye contact, problems with socializing, and falling a lot.  With Kaiser’s evaluation system that took like 3 months to go through I was found not to have an ASD because I did not present symptoms as an infant, though I met enough criteria currently and had since a child.  This has been upsetting me a lot.  Transferring to UC Davis, I still haven’t made any connections and while I don’t need to have a lot of friends and to be honest am not interested in having a lot of friends, I would like to have one or two.  I never seem to say the right thing and I can’t figure out people.  My case manager went to a training about a week ago now and she said a lot of females on the spectrum are misdiagnosed with Borderline Personality Disorder or Bipolar because Autism is about not being able to control your emotions.  I have both.  She said if it’s any something she thinks I’m somewhere on the spectrum and that they need to train Kaiser doctors better.

I know several autistic young adults.  I found this on the internet the other day:

What do you think the most common cause of premature death is among adults of typical or high intelligence with autism spectrum disorders? It’s suicide.

A large study was recently published in the British Journal of Psychiatry that examined the risk of death among the 27,122 persons diagnosed with autism spectrum disorders in Sweden when compared to age-matched controls. One significant finding from the study is that on average, persons with autism die sixteen years sooner than would be anticipated.  The finding we’ll examine more closely is that adults with autism and no intellectual disability are over nine times more likely to commit suicide when compared to their age-matched peers. Unlike the general population, in which men are significantly more likely to commit suicide than women, women with autism were at higher risk of suicide in this study than men.

Last month’s study isn’t the only signal that persons with autism are especially vulnerable to suicide.

  • study of 10-14 year-olds with autism reported that 70% of kids with autism also had at least one mental health disorder such as anxiety, ADHD or depression, and 41% had at least two comorbid mental health disorders. Of those with ADHD, 84% received a second comorbid diagnosis.
  • Kids with autism were 28 times more likely to experience suicidal ideation than age-matched peers without autism in this study.
  • In a study of 374 adults with Asperger’s Disorder, 66% of 367 respondents self-reported suicidal ideation, 127 (35%) of 365 respondents self-reported plans or attempts at suicide, and 116 (31%) of 368 respondents self-reported depression. Adults with Asperger’s syndrome were nearly ten times as likely to report lifetime experience of suicidal ideation than individuals from a general UK population sample, and more prone to suicidal ideation than people with one, two, or more medical illnesses, or people with psychotic illness.

Why might suicide represent such an enormous problem among high-functioning persons with autism spectrum disorders?

They’re more likely to experience social isolation and lack social supports. In the fall of 2014, we shared this anonymous post from a college student describing her experience of trying to attend church as a person with autism. Imagine how the challenges she describes would impact her day to day life outside of church.

High-functioning kids with autism are significantly more likely to become victims of bullying when compared to their peers with autism and intellectual disability. It’s become socially inappropriate to ridicule persons with an obvious disability…less so when the disability isn’t so obvious.

They’re more likely to experience difficulties with executive functioning that may translate into a greater risk of acting upon suicidal impulses, more difficulty employing effective problem-solving skills and more difficulty self-regulating emotions. Learn more here about the challenges persons face with executive functioning challenges.

Their propensity to become very fixated on specific thoughts or ideas may intensify suicidal thoughts, or result in more difficulty letting go of feelings of hopelessness when they occur.

http://www.keyministry.org/church4everychild/2017/4/4/the-suicide-epidemic-among-high-functioning-persons-with-autism

PS I’ve been more suicidal with less friendship and more lonely lately.

A needed update

11 Jan

Things are going well.  I’m into my 3rd day of the new quarter here in college.  I already like it much better than last quarter.  Taking more classes I thrive as the structure helps keep me accountable and busy- last semester there was just too much down time.  I bought a binder to begin wearing this year, when it came in the mail and I saw it I was like “Yikes!” it looked so small, especially around the stomach area.  I’ve been wearing it for 4 days now; usually only the first half the day while I’m in my classes.  There is some discomfort when walking and I can’t slouch, which may be a good thing.  But I really like the way I look.  I want to buy a few more, as I just bought one since they are sort of expensive and I wasn’t sure how I’d take to it.  The thing is it’s really hot, which is fine in this rainy wet weather we are having now, but what happens once hot summers come?  I also found new boxer briefs that don’t ride up and practically become like woman underwear.  I bought 4 more mens shirts and my dad just gave me some more money for the month.  I think I’ll buy another couple shirts.

 

My classes this semester are 2nd quarter Greek, 4th quarter Spanish, New Testament in Greek, Upper Division Writing, and Gender, Language and Society.  There are 5 classes but the New Testament class is just one hour, once a week.  I also have an ungraded connection that meets once a week around the common interest of being a Future grad student.  I’ll be pretty busy this quarter.

Counseling will probably be cut to every other week so I can go to gender group, also because I’m doing well right now.  If I start to have problems we may change apps to Friday or I may go later on Wednesdays and skip Gender group sometimes.  When I see the therapist at the end of the month I’m going to ask her AGAIN about when I will have a consult with the gender therapist, I know I was in crisis in November and then in December she had to cancel because she was sick but I’m running out of patience.  I just found out today my psychiatrist has a reminder set to have a phone appointment with me on the 20th, then we will talk about reducing the Latuda we had to increase at the end of November because of the psychotic symptoms.

Safety plans in place

20 Nov

Safety plans in place, and I guess I got my psychiatrist all worried.  So I saw my case manager on Friday and told her legit what was going on, and also that I was NOT going to go to the hospital.  I told her I told the therapist what was going on but not how bad it was, because she doesn’t know me as well and probably would’ve hospitalized me based on my symptoms.  I wrote my psychiatrist a message earlier in the week about my symptoms and he talked to my case manager and the therapist and he’s all freaked out and made an appointment for me next Friday.  My case manager was talking about how he was invested in me and worried, lol.  I think he’s just frustrated we found some meds that finally worked and now they’re now working again.  My sister is holding on to my extra pills, so I don’t have them at my apartment- I’ve been extra suicidal so that’s part of me trying to be safe.  I also put a Trans crisis line in my cell phone.  My case manager reminded me she’ll be off this week for thanksgiving, but to feel free and call for an emergency appointment the next week and she’ll get me in.  Although I gave my sister the extra pills, I put in my chart some extra PRN of Latuda (my anti-psychotic) and Valium in case the voices get to bad and I need to calm down.  Just 3 more weeks of school to get through.  Then 5 weeks of vacation, and I don’t care if I have to go to the hospital then- I mean I prefer not to but it’s a hell of a lot better than missing finals.  Hopefully during winter break the symptoms let up, or I can adjust.

Quiet

7 Nov

It’s been interesting lately.  And of course by interesting I mean a combination of hard, no one knows what is going on, and yet I keep my head above water.  I’ve given hints, but some family reads this and I worry what they will think- but I started this for me.  About a week ago my nephew was born, about a week and three days ago I started to transition in wearing male clothing and bought boxer briefs and switched my jeans into male ones (though I’m still having trickiness with sizing.)  The voices came back soon, they said the baby was going to die unless I went back and stopped making my changes.  The voices were the back 1s, the voices that used to be the constant companions, not the episodic side voices like usual.  Also the back 1s in the past have been positive, negative, neutral, or narrating so this was interesting that they came back for this to take a stance.  I didn’t listen and added coping skills and increased my anti-psychotic.  Unfortunately it was during midterms, otherwise I may have just went into hospital for respite/relief.  I had actually taken extra Latuda the night before and morning of a Greek midterm and managed to still get a B, with double dose in me and active voices.  My case manager thinks the voices are back because of my sister having the baby and that they want ME to hurt the baby and that’s not the case, that’s probably come from side voices.  All my midterms are done, 2 B’s and an A; I didn’t try hard so I’m happy with my grades.  I’m not very motivated, when not in class, at a club or workshop; I’m usually sleeping.  I’ve been home weekends a lot, I don’t know if that’s better or worse, it prevents me from sleeping the weekend away.  This weekend is my birthday, most my family is gone anyways, so I’m going to visit 20 somethings friend.  Since I told my case manager about the voices I know it’s going to slow down transitioning, medically wise and I really don’t want to tell the therapist because I don’t have as good a relationship with her and it’s harder for me to tell her this is two separate things- even though I’M SURE they are.

Today… and no this will not take all the blame

15 Sep

Today I had a counseling appointment and even though my case manager doesn’t really want to address the gender identity issues she today said that my self harm was a result of gender identity and sexuality issues.  I was quick to point out I was self harming before those issues came to light and for other reasons.  I often worry about people taking my biological disorders and my situational life happenings and screwing them up and trying to put something where it doesn’t belong.   I did mention that yes I did self harm on my breasts because I hated them; but I self harmed for a slew of other reasons before I hit puberty (when gender issues came on) and before I met PK (when I started discovering my sexuality).

I’m thinking about using a new name with my new gender variant expression, when I start transitioning more, a nickname my sister has given me that is my initials.  Before I do that though, I want it to be okay with her as it is her nickname sort of and I don’t know how she will feel about being gender variant and I don’t feel right about taking a nickname she gave me and using it; if she takes the transition really badly.  I need to feel her out.  I’m not good at feeling people out.

Illegitimate 

29 Jul

Do you sometimes feel illegitimate or your diagnosis means less than because it isn’t paired with the typical diagnosis. Than your case manager tells you that you weren’t washing your hair just to act out and you know distinctly it was because of the sensory issues. If it was to act out, why would you allow family members to wash it in the sink. Would those be the people you were acting out against?

I feel without the comirbid ASD diagnosis my SPD is less legitimate especially as an adult. I know there are few adults with SPD. And I know I meet the symptoms and criteria. I just don’t have melt downs, I do shut down. I’ve found coping strategies. And I feel I have to ignore my issues and sensitivities because people will now say they are less legitimate. Family always has, except for knife sharpening; cuz they can see how that would bother almost anyone.

Another day in the life of a complexly mentally ill person.

Out with it

22 Jun

Why I asked/my case manager pushed for the Autistic Spectrum Disorder evaluation:

  • I was just in October of 2015 diagnosed with Sensory Processing Disorder, even though I have had sensory issues that have made functioning on different levels difficult for as long as I can remember.
  • Problems with eye-contact
  • Don’t shake hands or high 5 because I don’t like people touching the palms of my hands; I just kinda stand there if I don’t know them.  Backwards high 5 people I do know, and have recently became more of a hugger
  • Clumsiness/ motor skills; I fall a lot, and my case manager says I walk funny
  • Bad communication skills in general
  • Awkward social skills
  • Most my life have had one or two friends except high school
  • Will not use the phone, usually have my mom pretend to be me and make calls for me
  • Very small group of things I like to eat and places I will eat those food at and thats all I eat over and over again, don’t try new things.
  • Won’t eat yogurt, jello, cottage cheese, or things with a similar consistency (SPD)
  • Wearing same clothes, like smell and worn-out-ness of already worn clothes.
  • Won’t wear certain fabrics, closed toe shoes, socks, or gloves unless necessary (SPD)
  • Won’t wash, lotion, antibacterial soap, sunscreen or let most liquid touch my lands; occasionally lick them when they feel dry (SPD)
  • Loud music (like at clubs/bars) makes my eyes blink and head spin (SPD)
  • Flashing lights do the same (SPD)

Boundaries and fear

3 Jun

A few days ago me and my dad got into it.  It was just like every other time.  It was over something petty, it involved him calling me names, screaming at me and cussing at me.  But there were a few things different this time.  I didn’t cry hysterically immediately in front of him, I didn’t automatically apologize for all of my behavior to placate him.  And when he said he was sorry, I said if he was sorry, maybe he should try to work on trying not to do this anymore.  When he said it was because he loved me and he cared about me, I flipped internally- hello the definition of abuse.  I said there you go again the “old dog” and “just the way you are” and then I ran off to my room and started crying.  This type of behavior has been going on since I was a child, minus me sticking up for myself somewhat.  And it just really clicked what it was, what it is.  And I don’t understand how he can justify it as “love” and “care.”  After I stood up for myself I was practically shaking in fear, I’m still somewhat afraid but it’s been 3 days so it’s mostly subsided.  My case manager thinks I’m afraid I’m going to hit him or lash out in anger towards him.  Really I’m afraid of retaliation from him, not that he’ll hit me.  I don’t think he’d do that, but more sudle emotional ways or something.

Gender identity

25 May

Gender identity has still been swirling round in my head and it won’t slow down. I even went to look at our local Gender a health Center’s website today. Thinking about setting up an appointment to talk to a counselor there. You may ask “Marci, Why would you do that? You already have a case manager and a therapist!”  Yes, I do and I saw the therapist yesterday and I didn’t bring it up much because I didn’t think we had enough time to talk and I knew it’d just leave a big puzzle till next month. I’ve brought it up a little with my case manager and I think she thinks it’s me who doesn’t want to talk about it. I just think she doesn’t have any knowledge in it. That’s why I was looking at the gender health center. I guess I’ll ask her tomorrow at our appointment. 
Anyways. There were some intake forms so I printed them out and began to fill them out. I also talked a little bit to my trans blogger friend. I don’t think I’m cisgender but I don’t think I’m transgender either. I guess that leaves gender queer which I don’t like the term. I really want my breasts gone or reduced but then what happens if people start referring to me as male?  I’m already not that girly. I thought I’d be okay with it, until the person on Facebook used the male possessive pronoun (his) based only off looking at a picture of me. 
Filling out the forms I’ve also realized this is something that has gone back to puberty, which is 15+ years. People say I have time and I understand that. And I deinetly don’t want to make rash decisions. But this isn’t something new that just came up. And now that I’ll be living out on my own I feel like I have more sovereignty over my body so I can make more decisions or at least explore what I’d like to do. 

I’m also not clear on my sexuality and as I’m getting older I think I need to be clear where I stand if it’s true that I don’t need a partner than that’s fine but if it’s just some stage right now. I’m going to be pissed when I’m 40 and trying to find someone to settle down with. It’s true I’m happy how I am right now for the most part, I feel satisfied. It just seems strange. Like is this really a thing?

A Whole Lot of Stuff

8 May

Yesterday was the NAMI Walk here is a picture of my 2016 Team:

NAMI 2016 Team

Biggest team yet with 23 participants, 4 of which were children and 2 of which were dogs.  It rained so it was a good turnout of my 31 people registered.  I met my fund raising goal of $1,500.  The highest amount I’ve raised in all 4 years too.

goal met!

My ASD (Autistic Spectrum Disorder) Evaluation  is set for May 24th so we’ll see what happens I also have an appointment with the therapist that day and it’s a week after school ended.  Me and my case manager have decided to go to meetings once every two weeks because I’m doing good but that might chance with the loss of structure from summer and some realizations I had when talking with some Autistic friends.  I’m set to receive to more AAs this semester, Associate Degrees or 2 years degrees one in Foreign Languages and the other in LGBT studies (Lesbian, Gay, Bisexual and Transgender).  I’m not going to either commencement ceremony but for my LGBT studies one I am going to a more informal Rainbow Graduation and 20 somethings friend is going.  I only invited 3 people, my sister and family friend couldn’t go both are traveling.

I signed my commitment thing to go to UC Davis and will be going to their transfer day this Friday and touring student housing and making my decision when I get home I plan on filling out the forms and putting my deposit down for student housing.  My financial aid finally went through and I’m relieved I won’t be paying that much for college so if my unpredictable parents do something stupid I’m still okay.

Things are good but I’m exhausted from yesterday.