**The Mental Health Thread**

I hate being socially anxious, went for a family meal and instead of being relaxed and enjoying, I am aware of the people around me and feel like I am in a vice , all tensed up, no idea where to look , I glance at people on other tables and damn they are looking at me so I stare at the table.
Undiagnosed autism? If I hadn't been driving I would have had a few drinks to numb it

I get that all the time and it's related to in part my Dyslexia but also diagnosed anxiety. And there is a clear reason for why I feel that way now based upon some events in my past.. primarily severe bulling at school and some fairly traumatic events at work. As they say, the body keeps the score.

So I think it's very important to recognise isolation and try and "force" yourself into situations where you are around people, assuming you are physically able to do so.

Constant isloation is effective to torture. I.e being locked up with no access to anyone. According to my therapist she see's this in lots of people, particuarly those older or those with severe anxiety. For example I work from home, don't have any friends or family nearby and moved back to the UK from abroad a year ago. I can go days without talking to anyone or seeing anyone. That, if you have anxiety is going to simply make things even worse. Forcing yourself to go for a daily walk, go to the shops for 5 mins, interact with people is a MUST. Humans are social animals, no matter what certain feel prefer, and it does have a very profound impact on certain people if they are removed from interaction with people on a daily basis. It makes a massive difference to me, that's for sure.
 
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One thing that confuses me if I am autistic is that I can read expressions really well especially if someone dislikes me I find expressions crammed full of information, this is the opposite of autistic isn't it ?

It's a very broad spectrum, and it's not so much the obvious expressions like dislike, but the micro-expressions.

No one can diagnose you over the internet, but I know you've mentioned some other behaviours on here before that make me think it's worth getting a professional opinion.

I remember you saying that you avoided socialising with people at work and out and about, and that you sat facing the wall in a pub because you couldn't cope with facing people. It reads like you have a lot of problems with being perceived, which is another feature of autism.
 
One thing that confuses me if I am autistic is that I can read expressions really well especially if someone dislikes me I find expressions crammed full of information, this is the opposite of autistic isn't it ?
I find this more relatable. I have ADHD (waiting to find out if AuADHD) and actually I read social cues very well and have learned how to navigate neurotypical socialising more from a cognitive perspective. Autism comes in many flavours and the spectrum is pretty broad. While struggling socially is pretty typical, it is actually not always the case (so many factors involved). In cases that are not especially severe or typical, the clinical side of diagnostics is still coming up to speed.
 
Was just going to post "it's a spectrum"
My son has autism & ADD, he can be the most empathetic (to a fault) person or "I think X therefore anyone who disagrees is wrong", it's fun to try and handle, see a lot of myself in him but I've had many years to do the usual masking/coping strategies which works but can be mentally exhausting, the social battery thing resonates with me & I vey much have a public me and a 'real' me.

If anyone has private medical (yeah, priviledged I know) then CBT can help, although will never fully fix anything. My experience with SSRIs is meh, made me a zombie, excercise was great but covid and the move to working from home killed my ability to easily access a gym and I've let it slip.

Sometimes the worst part is knowing what you need to do but being unable to, it just adds more anxiety on top of the problem.
 
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Constant isloation is effective to torture. I.e being locked up with no access to anyone. According to my therapist she see's this in lots of people, particuarly those older or those with severe anxiety. For example I work from home, don't have any friends or family nearby and moved back to the UK from abroad a year ago. I can go days without talking to anyone or seeing anyone. That, if you have anxiety is going to simply make things even worse. Forcing yourself to go for a daily walk, go to the shops for 5 mins, interact with people is a MUST. Humans are social animals, no matter what certain feel prefer, and it does have a very profound impact on certain people if they are removed from interaction with people on a daily basis. It makes a massive difference to me, that's for sure.
I agree - I can get into 'monk mode' and disappear from social interaction for a long stretch of time, but I recognise it induces more social anxiety when I invariably have to reemerge and actually is important from a mental health perspective. I have an arbitrary 2-3 day rule to get social contact and have sort of engineered a minimum into my life.
 
Was just going to post "it's a spectrum"
My son has autism & ADD, he can be the most empathetic (to a fault) person or "I think X therefore anyone who disagrees is wrong", it's fun to try and handle, see a lot of myself in him but I've had many years to do the usual masking/coping strategies which works but can be mentally exhausting, the social battery thing resonates with me & I vey much have a public me and a 'real' me.

If anyone has private medical (yeah, priviledged I know) then CBT can help, although will never fully fix anything. My experience with SSRIs is meh, made me a zombie, excercise was great but covid and the move to working from home killed my ability to easily access a gym and I've let it slip.

Sometimes the worst part is knowing what you need to do but being unable to, it just adds more anxiety on top of the problem.
A neuro affirming therapist (one trained to work with ND people is pretty helpful). I have generally found the NHS lacking when it comes to CBT (cookie cutter NT flavour limited to 8-12 sessions and it takes 18 months to get even that!) I resisted meds for a long time but eventually took the plunge and did not regret it. Having said that, I would try pursue diagnostics as that would inform the psychiatric aspects greatly if that's something you want to pursue.
 
Tried an ADD diagnosis privately, was sent a shortish survey, lots of asking about school experiences and was told I don't have it, I absolutely disagree but doing the same again through the NHS would be years away, as mentioned I've got to the point of it being something I consciously manage so although I do manage its tiring.

CBT was interesting, good points, but as I think 20 steps ahead for everything I ever do I knew what the person was wanting me to say and it was all stuff I already knew, so for me it was more reinforcing what I knew but actually practicing some of it is tricky.

My son was prescribed some ADD meds but didn't want to take them (£100 down the drain) - I can see why some people take them with no diagnosis but I'm far too bloody sensible to try them :D
 
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While struggling socially is pretty typical, it is actually not always the case

Every autistic person will struggle with socialising unless their social circles include only other neurodivergent people. Wherever you are on the spectrum, it will always affect the way you interact, communicate, learn and behave around others.

How they present to the world and the coping/masking strategies they have learnt doesn't mean it isn't still a struggle for them.

A good example of that is someone like Chris Packham, he seems fine when he's presenting TV shows, but if you watch the documentary he did, he still struggles enormously in social settings and he's someone at the very high end of the spectrum who's had a lot of exposure.
 
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Every autistic person will struggle with socialising unless their social circles include only other neurodivergent people.

How they present to the world and the coping/masking strategies they have learnt doesn't mean it isn't still a struggle for them.
I agree it is common, but I would not say 'every'. Also agree that it is helpful if their social circle includes other ND people, but it doesn't have to be every single person. For example, in academic research, there is a high proportion of people on the spectrum - one example of someone who only recently discovered they were autistic was not finding social situations a struggle, more just that they were draining.

What you say about coping/masking is something I very much relate to myself (albeit not so much with social challenges so much as executive function ones from ADHD). People assume it is easy but underestimate the time/energy/strategies required to cope and appear 'normal', whatever that is.

I agree with your example - just saying that there are many presentations that already don't fit the clinical picture from 10 years ago.
 
I agree it is common, but I would not say 'every'. Also agree that it is helpful if their social circle includes other ND people, but it doesn't have to be every single person. For example, in academic research, there is a high proportion of people on the spectrum - one example of someone who only recently discovered they were autistic was not finding social situations a struggle, more just that they were draining.

Some form of social dysfunction has to be present for a diagnosis, doesn't it? I'd also say that finding every social situation draining is a struggle in itself, probably because of all the masking they do every time. Although the latter can also be the case for someone who's just very introverted.
 
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Some form of social dysfunction has to be present for a diagnosis, doesn't it? I'd also say that finding every social situation draining is a struggle in itself. Although the latter can also be the case for someone who's just very introverted.
Yes. Was just making the point that there are different flavours/severities and there are cases of those with ASD who do not struggle with socialising (especially if it is a preferred situation to them). In the case of the example I mentioned above, the person does not struggle in situations where they have common interests and easy topics for discussion - more just that the typical forms of socialising with different people are draining (but not a struggle in terms of causing anxiety or not knowing what to say). That could also be down to introversion, but hard to say how much of that attribute relates to the ASD. A Venn diagram makes it hard to know what to attribute certain struggles to - also something I find myself.
 
Yes. Was just making the point that there are different flavours/severities and there are cases of those with ASD who do not struggle with socialising (especially if it is a preferred situation to them). In the case of the example I mentioned above, the person does not struggle in situations where they have common interests and easy topics for discussion - more just that the typical forms of socialising with different people are draining (but not a struggle in terms of causing anxiety or not knowing what to say). That could also be down to introversion, but hard to say how much of that attribute relates to the ASD. A Venn diagram makes it hard to know what to attribute certain struggles to - also something I find myself.

Being anxious or not knowing what to say isn't the only way to tell if they're struggling. Autistic people often don't realise they're struggling as Alexithymia (the inability to recognise or describe their own emotions) is common and they often aren't aware of when they've done something "wrong" in a social situation, so they can walk away from it thinking it went okay or even good.

Although it varies in severity, I think every autistic person struggles in some way in social situations, even if that struggle is just the mask they have to put on every time to 'fit in'. If the only time they don't struggle is when they have a common interest or an easy topic to talk about, then they are severely limited in the number of social situations in which they won't struggle.

Social deficits are a big part of the diagnostic criteria for autism. So someone with no struggles socialising would be very unlikely to meet the diagnostic criteria, I think.

It's also possible to be bad at social interaction and not realise it. For example, they might be talkative and think they don't have any problems because of that.

Criteria A of the DSM:
There are 3 symptoms one must have for a diagnosis to be made:
  1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
  2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
  3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
 
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Being anxious or not knowing what to say isn't the only way to tell if they're struggling. Autistic people often don't realise they've done something wrong in a social situation, so they can walk away from it thinking it went well or even okay.

Although it varies in severity, I think every autistic person struggles in some way in social situations, even if that struggle is just the mask they have to put on every time to 'fit in'. If the only time they don't struggle is when they have a common interest or an easy topic to talk about, then they are severely limited in the number of social situations in which they won't struggle.
Agree with all of those points in principle. The line of reasoning that social deficits are part of the diagnostic criteria and therefore everybody with ASD struggles socially is pretty reasonable. I would just add that the manifestations of ASD are so diverse that there is a strong possibility of outliers.

It also depends how you define 'struggles'. For example, there is research that suggests that some individuals with ASD can manage socially quite effectively in preferred contexts - so on that count it depends if you define the narrowing of preferred social situations as a struggle in of itself. The academic example above is never really in an environment where they struggle socially (according to their perspective) because academia is a preferred environment, has many ND people that are relatable, common topics are a default and their life pretty much revolves around their career.
 
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It's a tricky one because if he's autistic then it's just going to lead to burnout because he's constantly masking and thinking about how he's going to behave around others. Neurotypical people don't really need to think too much about socialising, much of it comes naturally (Micro-expressions, tone of voice, body language, when to speak, etc), and areas they lack can be learned rather than masked.
Absolutely, if there is a condition that is driving the isolation then that of course is a different thing. I wasn't speaking to any poster in particular, just laying out my experiences and letting folks take whatever they can from that, that is relevant to them, and of course pointing out that what they might be going thru, a lot of folks will have an empathy and understanding.

I meant to add in my prior post that another thing I've found is that I hate to talk about myself, I really don't find myself all that interesting, and am certain that people won't do so either. So I'm more than happy in a conversation when the other person/people are driving the interaction and I'm just giving it the odd confirmational nod/look. I think there might be a correlation (for some at least) between poor social interaction skrills/desires and low self esteem.
 
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Makes me so sad to hear so many people feeling like they don't want to be here anymore :( I've had a fleeting thought of it when I was younger but it was when my dad was fighting and losing his cancer battle. I knew I didn't want to end things. I definitely recommend going to GP as soon as possible or contacting one of the other support lines like Samaritans etc in the interim.

I said for 10 years that I didn't think counselling was for me. Then GP referred me to it and it ended up being a big help to me, like a weight lifted off my shoulders. I did it again after my dad passed and unfortunately I'm now in a place where I feel like I need it again. If I had the spare cash I would pay but money is tight at the moment so I self referred to the NHS talking therapies. I'm doing a 5 week stress webinar whilst I'm waiting to be able to have CBT/counselling. Thankfully last session is next week so hopefully I don't have much longer to wait.
Do have a good look around in your area, there may be low-cost counselling services around. I work for one who's fee start from £20 a session but I was working at an agency that was only charging £10 a session. There's a lot of places out there who are in it to help people rather than make money!
 
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