Autism and ...

Suicide. Its such a ripe word, with different connotations and meanings. For some it’s weak and cowardly (these people are wrong and ought not to be ever let into your home).* For others it is the only avenue out of a lifetime of trauma. For some, for me, it’s a way of life. Something I think about every single day; a decision that I make every single day. Something that feels as normal as eating; an automatic thought like “What am I having for dinner?” or “do I need to stick some fuel in the car?” – not as common as “what is the greatest eagle?”** but you get the general idea. It was embarrassingly recently that I discovered wishing for a swift death wasn’t the default setting for all humans.

It’s an emotive but much misunderstood topic, particularly in it’s relationship to Neurodivergence.

When I was diagnosed and referred for Late Diagnosis Support it was a topic given a lot of discussion. It’s not well enough known that the facts and stats around suicide and autism are truly horrifying. It is the demographic with the highest rates - higher than those with diagnoses of Major depression, Bi-Polar or Schizophrenia. The headlines can be summarized with the following

Autistic Men are 9 x more likely to die by Suicide than general population

              Autistic Women are 13 x more likely to die by Suicide than the general population.

Autistic people make up 1% of the population but 11% of lethal suicides.

              Autistic adults are 80% more likely to have one or more co-morbid mental health challenges.

              The average life expectancy for an Autistic adult is 54 years.

Out of the group of participants in that Late Diagnosis Group I attended only one hadn’t attempted taking their own life. The rest of us had many under our belts – and for me it was the catalyst that ended up with me finally getting the correct diagnosis.

The figures are a disgrace. What I find almost as baffling is there seems to be very little understanding of why we are particularly susceptible.

I hope to provide an insiders view, as an autistic man who has attempted suicide on more than one occasion.

Whenever an individual, successfully but tragically, takes their own life, people predictably wonder why they didn’t just talk? Reach out? There are a few reasons for this.

There are few, if any, topics more difficult to broach than this great unspeakable taboo. Nobody wants to be thought of, or dismissed, as an attention seeker or a drama queen. Nobody wants to be a burden on those they are closest too. I think this is particularly true of people on the spectrum, who already feel like a burden when at their happiest. Becoming a greater one feels like a step too far. Our care for ourselves may have diminished beyond repair, but our care for others is still there. We are not so self absorbed that we forget everyone is going through their own struggles. Everyone is fighting (or snuggling) with their own demons. Nobody needs mine on top.

Another is that we frequently have asked, but nobody recognised due to our communication difficulties and processing differences. Even those who can appear highly articulate can still struggle with Alexithymia and Mutism.

From my own experience – once we have decided to take that final step. We don’t actually want to reach out any more. We don’t want to be stopped or talked out of it. We are determined to succeed. To illustrate this, on one occasion I was evidently giving off strong signals that all was not well; that the Good ship Graham was sinking. Two friends turned up at my door unannounced and uninvited. Friends from different cliques who otherwise never came into contact with each other. Both admitted that they had become gravely concerned about my mental health in the days previous. The fact was, that I had decided that I was going to end everything that very evening. Instead of admitting this, I put on an Oscar winning performance that all was well and they were over-reacting. We drank a bottle of wine, watched a movie and then they went there separate ways feeling relieved that I was back to my old, odd but usual self. I overdosed within 30mins of their leaving.

It also becomes a huge strain. If you reach out and confide in someone. They then tend to call the police if you haven’t responded to a message quickly enough for their liking. (This has happened to me).

Or when they visit, they secretly steal all your medications from your bathroom cabinet to prevent any more opportunity for ODing. With the inevitable result that it includes the meds you need to stay physically healthy. (This has happened to me).

Or they will break down your door fearing that you are lying dead on the other side. When in reality you are just having a sleep. (This has happened to me).

All in all, reaching out can feel way more trouble than its worth – especially when despair is bubbling through the marrow in your bones.

This brings us conveniently to why so many of us feel like we have despair riddled skeletons

Being born into a life where you don’t fit in is hard to put into words. How all encompassing it is, when its your entire existence and all you’ve ever known. How lonely and isolating it is; how the only chance you have is to put on a perpetual one-person performance to pretend to be normal; to become a living parody of neurotypical life learnt parrot fashion. Masking!*** Otherwise you’re othered, ignored, abused or discriminated against (both unthinking and casual or systemic and intentional). All perfect Petri dishes for the germination of trauma and depression. For me, this led to seasoning my brain with cocaine (and all its various synthetic knock offs) while marinating it in whisky (in all its delicious variations).

This constant performance is emotionally and physically exhausting, overwhelming - yet by necessity it is your base level that all interactions both personal, romantic and professional have to be sprinkled on top of. It all too frequently becomes too much. Trying to not meltdown due to the sensory stimuli in the average office – constant, chatter, lights, printers, phones and the general hustle and bustle. The stressful interactions with other humans. The actual tasks of your job. It all leaves you empty and hollow as a drum. No energy left for yourself or your own interests, too exhausted to stim; to emotionally regulate yourself. Nothing. All this equally applies to shopping, socialising and, well, everything. Then it strikes you – the best way to make it all go away is ...

Death! It was such a beguiling, sultry thought. One that, as I said became automatic.

When it remains at this automatic level, I can answer it quickly and move on with the rest of my day. But there are levels. The next level is when it becomes more persistent and repetitive, peppering your day and night with reappearances. This is more difficult to dismiss, but the “mask” I wear to fit in when outside my own safe four walls, seems to do the trick in hiding it from most. This is probably one of the reasons that the Autism stats for suicide are worse than any other demographic. We have become so adept at hiding our true selves that people don’t realise that while we are blandly discussing (insert the work topic of your choice) we can be genuinely focussing on how sweet that last breath will taste.

The next level is when it becomes all you can think about. When any other thought feels like a waste of time. When the idea of life, of your next breath feels unwanted and about as useless as trying to shove a fart back into an arse. In this phase you spend all your time, literally every second craving death the way a starving man craves sustenance or the lonely craves love. It’s all consuming, like being in love with someone that you know is bad for you and all your family and friends disapprove of. But it doesn’t matter what they think - fuck them! You only want to be in the arms of darkness. You only want what it can bring. You justify it to yourself in insidious ways, usually along the lines of “if people really understood and cared, they wouldn’t want me to be in any more pain,” or “I know some will be upset but they will come to realise it was for the best and move on,” and “It will probably be a relief not to have to worry about me any more, so I’m actually doing them a favour.”

Then there is the final level – when you plan and act upon the urges. This is where the Autism ability to research and hyper focus comes into its own. For the worst possible reasons. Typing a term like “suicide methods” into “Google” just directs you to contact details for the Samaritans. Pfft! As if that will deter you once in this head space. Being the Autism stereotype of the socially awkward IT/Science guy (Thanks a fucking bunch The IT Crowd and The Big Bang Theory) means “Google’s” best intentions are but an adorable, easily avoided little stepping stone. We/I can still find the information we crave in researching methods and statistical success rates for each one.

Finally I get to fully chemistry geek out. (No, you piss off). The brain’s sole evolutionary purpose is to keep you alive, not to make you happy. 1.5Kg of fat and protein, has evolved over millennia to prolong your existence with little more than electricity and salt. Millions of synaptic nerves hardwired to eat, sleep, procreate and pass on your genetic code. When the cheeky bastard flips on you and decides to tell you that your time has come, you are programmed to accept and act. It can be very persuasive. Certainly more persuasive than the platitudes of mindfulness or the hollowness of 6 weeks of CBT (gaslighting yourself that nothing is wrong).

After this, it usually comes down to luck with what happens next. So far, I have been lucky (or tougher than a woodpeckers beak, one of the two).****

Keep your fingers crossed for all the Neurodivergent people you know. If they tell you they are struggling, believe them.

 Footnotes

               * Suicide is not a cowards choice – it’s a symptom of severe mental illness. It’s like calling a someone a coward for coughing when they have a cold. 

              ** Trick question. All eagles are magnificent!

              *** Early research suggests that more/better masking leads to higher rates of suicide. This is why the rates for women are higher. Like most things, they are better than us men at it.

              **** It is luck 100%