Suicidal ideation and the autistic mind - part 1

Written in 2019

A 2014 study of autistic adults in the UK found a staggeringly high correlation between autism and suicidal ideation. The study found that 66% of autistic adults reported experiencing suicidal ideation, with 37% reporting suicide attempt(s). This was significantly higher than the prevalence of suicidal ideation in the general population, with or without co-morbid mental health conditions (autistic adults without depression were less likely to experience suicidal ideation than autistic adults with depression, but more likely than the general population [if my interpretation is correct]). Additionally, “high-functioning” autistic people are more prone to suicidal ideation than “low-functioning” autistic people. Other statistics suggest that 70% of “high-functioning” autistic women live with suicidal ideation, 50% attempt suicide, and 10% succeed.


Some research has gone into why this might be, but I can tell you from my experience that our thinking styles feed a lot into suicidal ideation, to the point where it is almost normal to think about suicide on a regular basis (at least that is my experience). When we feel trapped in a world that's not set up for our neurology there's only one way out, one way to escape that isn't masking and suppressing our natural behaviour. Some research touches on the fact that masking can feed into suicidal ideation and I have to say this agrees with my experience. As “high-functioning” autistic people tend to be maskers (at least it's one of the traits that people consider to be an indicator of function) it's no surprise that we're more prone to suicidal ideation.


When I spend a lot of time masking, suppressing my internal instincts and performing (like a circus seal but without the flappy flippers)* in public, and especially when I am then told “you don't seem autistic/you're good at hiding it” I feel like there's never going to be a time or a place where I can be myself and not have to put the needs of others first. I feel like the rest of my life is going to be this mad performance, like I'm in some dystopian world where I'm being observed continually, and judged for everything I do and say.


The world doesn't want me as I am. I can't keep up the facade well enough all the time to deflect the experienced of being unwanted. Therefore the answer is to leave the world.


My brain goes straight there because I am quite an extreme thinker – by which I mean my brain tends to go for the most extreme option first, and I have to consciously work to bring my thinking back to a more realistic plane. It's an example of black-and-white thinking – we tend not to be great at nuances especially “in the moment” and although I can challenge some of this thinking it's very very hard and a very conscious process.

This means that I frequently have thoughts of suicide and I frequently find myself thinking that everyone would be better off without me around. I've learned to challenge this with evidence, relying on the fact that there are people who need and want me around and that it would be terribly unfair to them if I left the world, so I stay. This doesn't abate the thoughts completely, but it makes them manageable.


So, if it's manageable, what's the problem, exactly? I mean, I'm managing it aren't I? Coping? Well, yes, I am coping, just about. The amount of mental effort that goes into challenging these extreme thoughts on a regular basis and into staying in the world is exhausting. This is on top of masking, trying to filter out sensory over-stimulation, communicating, moving without falling over my own feet and trying to lead some semblance of an independent life. Can you start to see why I often feel life would be easier if I didn't have to live it?


At my lowest ebb I found my body taking over from my brain, and my feet started walking me out into the path of an oncoming lorry. I realised, pulled myself back and fell apart. Once I had worked out what had happened, and started to process all of it I knew I needed help. This was before I was diagnosed, so it was incredibly scary because I didn't fully know why it happened or what was going on in my head. I was scared of myself. Scared of what I might do without my own involvement.


Finding out that this disconnect was probably a result of alexithymia was a relief. It showed me that I wasn't losing touch with reality, per se, but that I wasn't fully connected to my emotions and therefore didn't appreciate how much my mental health had declined. I was too busy trying to work and deal with people for hours at a time (on top of poor physical health) that there was no processing room left for emotions. I'm trying to work on getting better at identifying my emotions and dealing with them before they become a serious problem, because I never want to be scared of myself again.

Read part 2 here.

*I can't balance a ball on my nose either.

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