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autism decision making hyperfocus loneliness masking obsession Uncategorized

Autism and the need to be busy all the time

In my previous blog I mentioned that in order to overcome my loneliness, I tend to make myself really busy in order to feel like I have a sense of purpose. I thought I’d unpick that a bit more.

Just to put things into context – A few weeks ago, I had a two hour exam, followed by a meeting with a charity I’m a youth campaigner, a two hour meeting for a peer research job I have followed by a meeting with an environmental group I’m part of. And then, after all that, I still had to log some hours of work. So, when I say I’m a busy person – I really am!

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I just feel like I function well in chaos. Everything I need to do is constantly whizzing round in my head. I like it like the though. It’s like my head is constantly being pulled in all directions. I don’t so much get stressed but excited. I think the emotions are very similar and my body confuses the two meaning I am not so much effected by having so much on my plate but rather in a constant state of being happy and looking forward to things.

I’ve not seen much online about hyper productivity and autism but I’m sure it must be common. In society today, I think it is extremely easy to be pulled into the trap of trying to find purpose. We are generally taught that we are valued by how we contribute to society rather than the value we give to our own lives and those closest to us. There are pressures from all round to be productive and as an autistic person, prone to take things to the extreme in order to appear normal – hyper productivity occurs.

A while back, I tried to change. I tried to do less. It didn’t go very well. I figured out that the issue wasn’t in the things that I do, it was in the way I did them. I am very prone to attempt to multitask but I think what I’ve learnt is that it is better to give my attention to one thing only, rather than multiple things at once – whether it be with studying or spending time with friends. I find that the more busy I get, the more busy I want to be.

There are two sides to the coin of being really busy and motivated to do things. It can be a bad thing. When I first started Uni, I really struggled with prioritising the things I needed to prioritise. I was clinging onto the things that had kept me busy throughout lockdown when really I should have given them up. I think that it was my way of coping with the change of moving out because it gave me a sense of normality while distracting me. I always that because I hadn’t reached burnout yet that I was fine, however I wasn’t devoting energy to the things I needed to.

So why might Autistic people be more prone to this?

Desire to fit in

I think a lot of the narrative in society, especially since the pandemic, tells us that we have to be productive all the time. Volunteering for things, even when our plate is already full. Making promises and having to rush tasks just to make it work. Being consumed by work all day every day. And then once you’re technically done with a something, you feel guilty for not doing more. It’s a vicious cycle. You judge yourself for what you haven’t done, rather than looking at what you have done. Yet being hyper productive is a way to feel worthy, fulfilled, and in control. And so you become obsessed.

Obsessive nature

A really common theme in people with autism is the obsessive nature. Obsessions give stability, security and control. Sometimes however, with people who mask a lot, we can fall into the trap of becoming obsessed with whatever is socially acceptable, just taking it that extra bit too far. Social media is definitely a place where toxic productivity festers, for example through tweets about spending the pandemic learning new skills and utilising every second. Many people focused on productivity during the pandemic. Many people felt afraid and uncertain so tried to gain control. If you are busy, you are distracted from fears of the future. It was all over – free courses online, really amazing experiences being offered online and widening access to things that we’d never have imagined doing before. But – How do you know when to stop? For me, that’s where I struggle.

Executive function

Executive function and self-regulation skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully.  I’ve seen it described as having a role similar to a conductors in an orchestra. It manages and organises each musician. Tells them when to begin, how fast or slow, and when to stop playing. I struggle knowing when to stop things and when I’ve done enough. I get hyper focused and as a driven person, take on more and more.

 Hyperfocus

I think Hyperfocus is a less talked about autistic trait. It involves a person becoming fixated on a specific thing, topic or event. It’s more than just concentration. It can mean that we are extremely productive and get a lot done. I can go all day going from one important thing to the next, sending email after email that would take other people hours to write. It seems easy because I am just in this mindset of ‘go go go’. However all this does have its draw backs in that we have less energy for other things – often the important day to day things like admin tasks or keeping on top of washing.

Something that I have used to help me with this is time blocking – assigning certain times to certain things. I find it so easy to get lost in doing something that it gets to the end of the day and I realise I’ve spent far too long on one thing to the detriment of another.

Time blocking is a time management tool that divides your day into separate blocks of time. Specific tasks are allocated to each block. 

By setting reminders on my phone, I have to move on once the time is up. At first it was really hard to do because I hate leaving things unfinished and often my brain will keep looping back to the unfinished task but now, I just view notion (the app where I keep everything on my laptop) as a second brain so I can just tell myself that it’s okay because all the work I’ve done is still there, it’s not going anywhere and I can pick up from where I left off. Changing my view to this really helped me.

I think another reason I struggled with time blocking is the fact that I work best when I want to do something rather than when I’m being told I have to do it. What I tend to do to get round that is split all the tasks that I have to do up, and then give myself options that I can choose myself for each time block.

All of this has really helped me because before, I was consumed by my work and not balancing things very well at all. I was trying to just fill every minute with ‘finishing things off’. Now, I still fill every minute but I also have specific times for things like socialising, meeting people and running. And because I have specific times for certain things, I make sure to give my undivided attention to each thing I’m doing rather than trying to multitask.

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autism decision making medical school university

Decision making as an autistic person

I really struggle with decision making. I even struggle with making simple decisions such as what flavour ice cream to get or what to have for tea. In fact, these small decisions are often the most exhausting to make and are the main reason why I rely on sameness: eating the same meals everyday, wearing the same clothes and buying the same things from the shop.

Bigger decisions, such as choosing a degree are even harder and one of the main reasons I actually chose to pursue medicine is because it would reduce uncertainty. I’d have something to pursue and a guaranteed career path at the end of my degree. In addition, it gives me a goal that every decision I make can relate back to.

I just wanted to share a quote that I came across a a few days ago that I thought was really quite profound.

If you obsess over whether you are making the right decision, you are basically assuming that the universe will reward you for one thing and punish you for another. The universe has no fixed agenda. Once you make any decision, it works around that decision. There is no right or wrong, only a series of possibilities that shift with each thought, feeling, and action that you experience.

Deepak Choprat
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It resonated with me because I used to feel very much paralysed by decision making. I think catastrophysing and overthinking all stem from the black and white thinking that is a typical autistic trait. Often, my brain leads me to think that there are only two possible scenarios: Good or bad. In reality there are many possibilities to every situation with equally as many factors to influence them. This thinking just leads to an overall snowball effect of spirallig into thoughts about what ifs. I often overthink any decision I make and obsess over what could have happened differently, as well as what I may have done wrong. Like many autistic people, I am highly self critical.

I think i’m extremely good at making logical decisions, especially when it is concerning other people which I think is in part due to being able to detach myself from the situation. I think that making decisions is all about gathering data for me. I like to research things extensively before jumping to conclusions, thus having a lot of data to consolidate my choices. If I have a lot of data, or all the pieces to the puzzle so to speak, then I am able to be confident in my choice. This could explain why I am bad at making decisions relating to any interpersonal issues as I am unable to gather sufficient data or worry that I have misunderstood and gathered the wrong data.

There is also the factor of uncertainty that decision making brings. Oftentimes this fear of uncertainty can be a driver of decision making. Autistic people struggle with uncertainty, often more than neurotypical people, so if an option gives less uncertainty, then it could be a better decision. There are so many variables in every single part of our lives. Things fail, people lose, things go wrong all the time. Sometimes for the better, sometimes for the worse. There’s only so much you can prepare for things. So much of life is unpredictable and control is just an illusion that helps us stay sane. I may feel in control of everything in my life, but a natural disaster could suddenly jeopardise it all. No matter what I do, nothing will ever go completely to plan. Which is hard to accept but that’s why I really like the above quote, because it views things in a different way.

I think additionally, one of the main issues with autistic people and decision making is our ability to deal with the consequences. This is due to being so self critical about our mistakes and ruminating over small details. We hold onto these minor things as if they are memories that should be cherished – or in my case, factors in future decision making (hence why it can be overwhelming when. so many factors come into play).

All of this indecisiveness can lead to us making good decisions, likely better decisions than neurotypical people however, neurotypical people are often able to better deal with the consequences of poor decisions and don’t waste so much of their life worrying.

Photo by Sora Shimazaki on Pexels.com

Here are my top tips for decision making:

  1. Try to remember the above quote when you are stuck in a cycle of trying to make the perfect choices.
  2. Rather than making one big decision, maybe make small choices along the way. For example, if you are making a choice about changing career, you could volunteer in that area for a while first.
  3. If making a small decision like what to cook for tea, you could either stick to the same meals throughout the week or use an app that looks at what food you have in and tells you what to make based on that.
  4. Shop online specifically for what you want so you won’t be overwhelmed by the choices available.
  5. Write a pros and cons list down and think rationally about the outcomes of each option.
  6. Try to do things that are out of your comfort zone, it may be hard at first but it will open up more opportunities in the future.
  7. Remember that nothing is permanent and there is always a way out of something if you don’t like it.

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autism breakup medical school

5 Ways to get through a Breakup as an Autistic Person

Breakups are unpleasant and the emotions they bring up are complicated. Grief, confusion, heartbreak, anger, sadness, anxiety…. All of these are normal reactions. Even if things ended well, you’re still likely to have some sort of reaction.

For autistic people, a breakup is arguably just that bit harder. A breakup brings uncertainty. and disruption. Whether it be routine, identity or even your home – everything changes. Nothing is set in stone anymore, future plans up in the air. The unknowns can seem overwhelming and leave you wanting to go back to a relationship, even if it was toxic.

You can’t start the next chapter of you life if you keep re reading the last one.

Photo by Ivan Samkov on Pexels.com

1. Don’t go searching for a quick-fix

This is going to take time. No matter what anyone says, there is no quick fix. everyone is different and processes things in their own time. It’s as much as taking each day as it comes as it is anything else. Accepting that it will take time and that you will heal is a big part of the process. It is so hard to accept that something that was once a massive part of you and your life will become a memory and it is normal to feel like you are going through a bereavement. As you grieve the loss of what you thought would be your future, think about future aspirations to replace your old ones. Use the time to pause and think about where you are in your life and what you want moving forward. There is something positive to be gained from every experience if you look hard enough to find it.

2. Try to write down your emotions and piece them together

It’s important to identify and acknowledge your feelings.Autistic people often (contrary to popular belief) experience more empathy, this means that you may have a good understanding of how your ex feels. you may feel both angry and sad for them at the same time. You may be frustrated because they hurt you but you still really care for them. It may be painful, but trying to suppress or ignore your feelings will likely make them come out in another form. Allowing yourself to feel the pain and emotions may worry you but these feeling won’t remain intense forever. Grieving is essential to the healing process and the intensity of the emotions will decrease over time. No matter how strong your grief is, it will not last forever.

3. Don’t blame yourself

There will always be ‘What ifs’. There will always be something you could have said or done but you can’t keep replaying the past – it’s already happened. Don’t dwell on who is to blame but look at things from a different perspective. This could be a good learning opportunity. It’s useful to focus objectively on what the relationship was lacking and how it failed. A chance to see where things went wrong and how you can make sure they go better in the future. You could even buy a journal specially for writing down these thoughts and feelings.

Autistic people are great problem solvers. Try and look at this as a time of self growth. Things will change in the future and to move on, you need to understand and process what happened. The more understanding you have, the more you can learn from what happened.

4. Reach out to others for support

I think this one is the trickiest for people with Autism. A lot of articles will suggest meeting with friends or making new friends however for autistic people, socialising is the last thing you want to do when you are feeling rubbish. It is hard enough in normal conditions. If it isn’t too much you could ask to meet up with a friend for a walk as it is often easier to talk to people whilst walking and not face to face. Additionally, you may feel like your ex is the only one who truly understood you and who you didn’t have to mask around – so it can feel pretty isolating and lonely. Despite this, there are a lot of people out there who can support you, whether it be family, counsellors or support groups. People who have been through painful breakups themselves are especially helpful as they know what it is like and can give you hope.You could also join a new club or group because even if you don’t make any best friends straight away, face to face contact usually helps improve your mood.

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5. Try to focus on positive coping mechanisms

During any time of high stress, it is exceptionally important to look after yourself.

  • If you struggle to stop and are constantly on the go, it may be an idea to treat yourself as if you have flu.
  • Get plenty of rest and time to recover.
  • Pay attention to what you need and don’t be afraid to say no.
  • Don’t be pressured into making any important life decisions whilst you are in such an emotional state either as you may regret them in the future.
  • Stick to a routine. This is probably one of the most important ones as sticking to a routine will help structure your day and give you purpose.
  • Avoid using Dugs, Alcohol or food as a way to cope. There are better, less destructive ways of coping. If you are an obsessive person, it may just be a good idea to avoid drugs and alcohol completely.
  • Eat, Drink, Sleep and Exercise – Everyday!

A few coping mechanisms to try

  • Eat some crunchy vegetables (strange one but it actually relieves a lot of tension!)
  • Start a new project (distraction is always good)
  • Do some volunteering
  • Write a letter, imaging you’re giving a friend advice on how to cope with the situation you are in
  • Go running

It may hurt. It may feel like the world is ending. But you’ve got this!

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autism medical school university

Autistic Medical Student

I am a medical student, and I also have Autism – two things most people might not expect to hear together. The phrase ‘doctor treating autism’ seems a lot more natural than ‘doctor with autism’.

I was diagnosed with Autism in 2016, aged Fifteen. Fifteen is quite late to be diagnosed with a lifelong condition; however, it is broadly accepted that there is a gender bias in autism diagnoses, with more males being diagnosed than females and females gaining later diagnoses. I believe that there are many flaws in both society’s perceptions of Autism and how it is viewed by health professionals. Many women go undiagnosed because they present differently to autistic men. Much of the indicators for Autism don’t take into account gender differences. Women are generally better at hiding their Autism compared to men and are simply viewed as ‘ a bit different’ or ‘shy’. For some people, living behind a facade is fine, and they get by, but for many women, it is exhausting to constantly pretend that you are someone you’re not, only being yourself when you are in a ‘safe’ place. Women get diagnosed with every other mental health condition but Autism because they are compared to the male representation. They gain labels that they don’t fit. A diagnosis isn’t for everyone but for me, it enabled me to be myself. Yes, people view you differently after diagnosis, but it was good for me; people were more understanding of my quirks, and life became a lot easier.

I thought it would be helpful to just give a bit of clarity on what Autism is.

What is Autism?

According to Autistica, “Autism affects the way people communicate and experience the world around them. Autism is a spectrum of developmental conditions, including Asperger’s Syndrome.” They then go on to list the symptoms as

“delayed or absent speech

difficulty with listening, concentrating and understanding

frequent repetition of words and phrases

taking things literally

difficulty sensing and interpreting people’s feelings

difficulty expressing feelings

over or under sensitivity to sound, touch, taste, smell or light

rituals or repetitive behaviours

disliking changes to routine

difficulty making friends and socialising”

Autistica

Some people would say that I have ‘mild’ Autism, but there is no ‘mild form’ of Autism. Autism exists on a spectrum, and all individuals with Autism have traits in common that can vary in intensity. One of my favourite quotes is,

“[So-called] mild autism doesn’t mean one experiences autism mildly…It means YOU experience their Autism mildly. You may not know how hard they’ve hard to work to get to the level they are.”

Adam Walton

It took a long time for me to get where I am today, but I’m proud of how far I’ve come, and I’m ready to work really hard at university and hopefully become a doctor.

If we think back to the above list of autistic traits, it may seem as if there is no hope for an individual with Autism becoming a professional. However, just like neurotypicals, we all have strengths and weaknesses that can be developed. I would argue that medicine actually selects for autistic traits. The above list only tells half of the story; there is also a list of more positive qualities that actually make an autistic person very employable.

  1. Autistic people usually have a greater interest in and dedication to their hobby, meaning they have great expertise. A strong work ethic and drive mean autistic individuals can progress through training programmes while minimising the effect of their personal life.
  2. Communication with autistic people can be very concise and clear. This means less miscommunication.
  3. Autistic people may have excellent attention to detail which is very desirable in some jobs. Many autistic people can easily spot anomalies, patterns, and errors. We are also very good at looking at things from different perspectives and suggesting new ideas. This is great for the problem-solving side of medicine.
  4. Autistic people are generally very self-aware and only need a few things in order to feel content. As long as there is routine and structure, we are mostly happy. This is a positive trait for being at medical school because there is a lot of self-study and time spent studying whilst others are ‘having fun.
  5. Autistic people are likely to be very reliable, honest, loyal, and committed. Because we are different ourselves, we are generally very open-minded and non-judgmental, which makes good doctor-patient relationships.
  6. Contrary to popular belief, autistic people are incredibly empathetic and develop excellent communication skills. I was really pleased when I was told that I give good eye contact by my communication skills teacher as it is something that I have worked really hard on overtime.

The issues that autistic people encounter during medical school are likely to be unrelated to the degree. However, due to the Equality Act, which involves ‘Reasonable Adjustments’, there is a lot of support out there to assist autistic students. There is also the DSA (disabled student allowance), which can help people by providing aids to studying.

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medical school Poetry university

Shifting Family Dynamics at University

I wrote the below poem after seeing my family for the first time after moving to university. It was a strange experience because I suddenly felt like a visitor in their lives. It was something out of the ordinary for them to see me. It reminded me of when we used to meet up with family members for a meal after not seeing them for a while. I did not belong to their ‘unit’ anymore. Maybe it was the fact that I just met them for lunch and a walk; maybe it will be different when I go and stay at home, but it felt so strange. I felt like I was a dead person, looking on at my old life before I moved to uni – except I wasn’t there. It was almost like a feeling of grief because it dawned on me that things would never go back to the way they were before I moved out.

I tried to personify my house in this poem because I guess growing up we assume that our house will be our home forever. And it feels like a living breathing thing full of life (or at least it does to me). There’s a strong rhyme scheme to that section too because it reflects familiarity. I wanted to repeat the phrase ‘life goes on’ because despite the fact it’s a scary concept – life does go on whether I’m there or not. I think I have a lot of insecurity about whether my family miss me, prefer things without me etc. However, I think I’ve just got to realise that this is a time of change. Things are different and not the same but, that doesn’t mean they’re not good. One period of time does not compare to the other because it’s different. Life moves on.

Grief buried in my bones,

Bones of the body that is my home.

My own –

My only permanent home.

Pulling the new experiences,

Deep into my skin,

Letting sadness evaporate

and dissipate at dawn

The old me looks on

(From the outside)

At those four walls

With their glowing white front

And their brick back

With the trees round the side

And the blinds it lacked

With its warm red walls

And uncarpeted floors

With it’s four toilets

And heavy wooden doors

The old me looks on

From the outside

Because life goes on

Missing one

I’m not there,

But i’m very aware

That life goes on

Missing one.

I wonder if they like it,

Without me there?

Whether they miss me,

Or even care?

Shifting dynamics

A time of changes

Building a new life

with a bunch of strangers

Finty Royle

Categories
graphic medical school

Blood and Nerve supply to Upper GI

Categories
graphic medical school

Innate Immunity

Just a little graphic I did on innate immunity.

Categories
medical school

5 Things I Learnt in my First Week of Medical School

1. Things Probably Won’t Go As Planned

My first week of medical school didn’t go as planned because I ended up in bed for the majority of it with freshers flu. If you are not aware of freshers flu, it’s the name given to the illness that most new students get at some point during their first term (Hence the name freshers flu). The lockdown rules were designed to stop Covid from spreading, but they also stopped people from catching other viruses. And now, freshers flu is worse than usual. I went into a lecture last week, and I’m pretty sure everyone was ill. There was a constant chorus of coughing and sniffing. I don’t think I’ve ever felt so ill, if I’m honest. I had a really high fever, blacked out at one point and had a chesty cough. It’s hard when you start Uni and are just getting used to fending for yourself, only to have to deal with illness and manage it yourself. I remember cycling home from Uni on the Monday, getting off my bike and walking into a wall. I don’t know how I’d managed to cycle home. So, I missed all my lectures, but luckily they’re not compulsory. I managed to just about drag myself out to all my compulsory sessions, so my attendance wasn’t affected. Unfortunately, I didn’t manage to go to all the events that I wanted to, but I’ll just have to start a bit late – I’m sure there’ll be lots of other people in the same position.

2. The Course Is Harder Than I Thought

I feel like I was thrown into the academic side of things more abruptly than I thought. I wasn’t expecting to have a gradient of the intensity of things to learn, but I guess, after a year of no studying, it was a shock to the system. The amount of work, coupled with being ill, was quite overwhelming, if I’m honest. I’m still trying to work out a routine because I think it could be easy to get burnt out due to the nature of the course. There are no limits to how far you can take the learning objectives, meaning it could be really easy to spend hours learning things that aren’t essential. I think that I will do this by strictly relying on the recommended resources – because they have been recommended for a reason.

3. It’s Difficult Having Friends On Other Courses

I think the biggest thing I struggle with in life, in general, is my fear of missing out, and doing medicine further intensifies this. People on other courses appear to have a lot more freedom with what they can do and when. Medicine is very demanding (and this is after one week). I can’t go out as much as other people, because I have work to do. I can’t just drop everything to go somewhere, because I have work to do. I think it is hard for some people to understand that. And it is easy for me to look at what other people are doing and feel like my degree is punishment. Like I’m missing out. Like I’m never going to be like other people. Like I’m never going to fit in. But that’s the degree. I want to be a doctor; I’ve got to put the work in. People are on different paths in life, and my path requires me to do lots of work. It’s my choice, and I chose it because I enjoy it; it’s only when I see what other people are doing that I don’t enjoy it. Comparison really is the thief of joy.

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4. Don’t Buy Textbooks

On my course, we get a big list of recommended resources. Yes, it is very inefficient and inconvenient to be lugging around books from the library and faff about taking out and returning books, but there are also many resources online. It may be an idea to have a basic set of books, I was given some by someone who had just finished their degree, and it will never hurt to have a few books on broad topics like medical sciences or anatomy. But, they are not essential. When you sign up, the various medical defence unions often give out freebies such as medical dictionaries, so you don’t need to worry about getting one beforehand.

5. You Can Still Have Fun!

I expected everyone on my course to be really serious because when you go to the interviews, that is obviously the impression you are given. But people are fun and good to be around. It might seem like there’s no time for free time, but there is. You just have to make the time. It might even motivate you to get the work done quicker! I think it is actually essential to be able to relax at certain times throughout the day. It isn’t healthy to be constantly working. So top tip: Make time for fun things.

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Poetry

A New Chapter

I’m going to start off this blog with a poem I wrote a few days ago after moving into my university accommodation.

I based the poem on the idea of changing seasons. Just like the seasons change, so do stages in life. Change isn’t bad, it’s just the natural way of life. Some people embrace change, some people resist it. Despite this, it is very much inevitable.

I debated staying at home for uni but decided it would be best to move out. Simply because it would mean pushing myself out of my comfort zone and expanding my experiences in life as well as my opinions. That’s not to say it’s an easy move, but challenges are good! Hopefully the poem below articulates this well.

With the soft rumble of the car engine,

I was left all alone in a new home.

And in the embers of the setting sun

My new life, this new chapter, had begun.

Intoxicating and soul swirling,

Is this perplexing freedom unfurling.

Wading through shadows of dusky grief,

I shall learn from the seasons and and the leaf.

A world cycling through shifting patterns of change,

The tides of discomfort and situations strange.

Unavoidable, inevitable

But very much manageable –

Time to move on.

So as the cooler air blows between the trees,

And the paths become speckled with mellowing leaves,

I will feel blessed

That i’ve experienced the seasons at their best.

©Finty Royle