Comorbidities and Autism

April is Autism Acceptance Month. I'm spending this month sharing even more about how my brain works and my experience as an autistic person. (I'm just one autistic person. Please don't consider my experience THE autistic experience.)

"You're not autistic. You just have anxiety." 🙄

Comorbidity, or the simultaneous presence of more than one medical disease/disability, is pretty common in Autism. Some common comorbidities with autism are ADHD (commonly written as AuDHD), anxiety, and depression.

I don't have ADHD, but I do have anxiety and depression. It makes sense. I grew up thinking there was something wrong with me and was constantly surprised by people being upset with me (and taking revenge) for no apparent reason. Why wouldn't anxiety and depression develop?

I also grew up in an unstable, abusive home, which means I navigate CPTSD. Oh, and I have premenstrual dysphoric disorder, which is a fancy way of saying once a month survival is my only function.

That's right y'all, in this comorbidity lottery, I get to shout "Bingo!" 😭

Having one doesn't cancel out the others. Humans are complex. And existence is rarely ever a dichotomy. It's often more of a spectrum (ha!).

A reader asked me recently how I know when PTSD affects me, how do I know when it's flaring up versus my other comorbidities.

I'm not entirely sure I do, but maybe this analogy will help:

Imagine for a moment that autism is a car I'm driving along a highway. Obviously the analogy isn't perfect; I can't exactly park my 'tism. But stay with me...

Anxiety might be all the obstacles I have to navigate on that road, specifically the other cars around me, people passing, cutting me off, moving lanes without signaling, honking, etc. Their vehicles can be all shapes and sizes, going various speeds, with numerous expectations of how I should behave on the road and interact with them.

Depression is the weather. Maybe it's foggy or raining. Maybe the sun is out. It just depends on the day. If it's a PMDD day, that's hail. It's time to get under an overpass to wait it out.

CPTSD is the road. Sometimes the road is smooth, and I can go just fine. Sometimes the road is gravel, and I have to slow down. Other times it's bumpy and cracked, and I'm wincing or cursing with each pothole.

Usually, my PTSD episodes flare up in October and February. And, while I've been searching for alternative routes with intense self-care (perhaps more on that in future issues), I will still find myself having to take that same road eventually because October always comes. Maybe this time I'll miss that one awful pothole or maybe my construction crew will have healed that particular road. It's getting better every year. But it's gonna be a while.

Regardless of all this, I'm still in the driver's seat—with or without road rage. The trick is to honor how my car works. I no longer force it to function on the wrong kind of gas or drive with an empty tank. And I never ignore the check-engine light. Now that I know my make and model, I have the bandwidth to plan ahead: decide on a lane that gives me the right-away, get tires that fit, put on tunes that help me enjoy the ride, and make sure I'm carful (😉) whom I'm letting be a backseat driver.

Regardless of your comorbidities (or lack thereof), safe travels.

Think my car analogy is weird?

Ellie Middleton compares late diagnosis to trying to be a PC your whole life and then suddenly learning you're a Mac.

Love that analogy too!

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