Introduction:
Living with mental health conditions, including Autism, ADHD, PTSD, and Severe Anxiety Disorder, significantly shapes how I interact with the world. Disclosing these challenges, even to strangers, helps set expectations and fosters understanding. It can seem like over-sharing to be this open, but it allows me to function with a bit more ease when people understand where I’m coming from. The reality is, living with multiple diagnoses can complicate how these conditions affect my behavior and relationships in ways that may not always be apparent.
I want to first write about feeling unsupported to get that out of the way. Later, there are some suggestions on helpful things you can say or do, in response to each diagnosis. Having dealt with these mental health challenges for my entire life, I’ve learned that they are not obstacles to overcome, but integral parts of who I am. While well-meaning suggestions on how to fix me may arise, I find that they often miss the mark. Instead of seeking solutions to change my essence, what truly helps is understanding, support, and recognition of my unique character. It’s frustrating when I need to remind people about my anxiety, especially when they react negatively to my need to "step away." My anxiety can be completely unrelated to them, it may be a random thought, or in many instances, I don't know the reason, I just know I need to leave where I am at that moment. Yet, they take it personally, even when I tell them it wasn't them, and they said nothing wrong. It shouldn’t be so hard to understand my limitations and boundaries. I shouldn't have to defend my autism and the quirks attributed to being autistic. I shouldn't have to fear my PTSD will make someone uncomfortable when I have a flashback or some other reaction. I shouldn't be shamed for exhibiting signs of ADHD, I have ADHD! I spent decades getting yelled at and shamed for things I couldn't help. I still exhibit the same behaviors! Another problem I encounter is seeing things so vividly that may or may not have happened. I find myself responding to people with what is in my head at the time, which may not always be the most accurate reflection of my thoughts.. Later, I might recall more information or find clarity, leading to a change in my story. That isn't fun and it makes me hesitant to share stories or to answer when others ask me questions. I don't want to be perceived as a liar! I have even told my therapist that she should ask me questions that I can respond to the following week! Finally, It’s dismissive to act as if my struggles are not real or it is something I can simply get over. I am not "too intelligent to have a mental illness." The same mental illness can affect people differently, and there are other factors to consider like support, available resources, and severity.. Which brings me to my next topic—multiple diagnoses.
Understanding the interplay of my multiple diagnoses—Autism, ADHD, PTSD, and Severe Anxiety Disorder—requires a closer look at how each condition uniquely influences my life. Each diagnosis comes with its own set of challenges and characteristics, yet they often intersect in ways that complicate my daily experiences. This complexity is not just about managing symptoms; it’s about recognizing how these conditions interact to shape my thoughts, feelings, and behaviors. In the following sections, I will explore each diagnosis and comorbidity briefly, highlighting how they contribute to my overall experience and the specific challenges they present.
Autism:
Autism manifests differently for everyone, and for me, it often involves sensory sensitivities and communication challenges. Situations that might seem routine to others can become overwhelming. Things like giving me too much information at once, unfamiliar environments, repetitive sounds like humming or tapping can quickly cause sensory overload, leading me to a sharp reaction or need to step away.
Sudden change is very difficult to process. If I am experiencing a meltdown, I can become overwhelmed with emotion that may be expressed through anger or sadness. I have a touch sensitivity with the texture of some paper and books. I have above-average intelligence, which can create a false perception that I don’t struggle, leading to misunderstandings about my abilities. I am a truth seeker, with a strong sense of what is just and fair, and I hold people accountable for their words and actions..
In relationships, this can come across as being harsh, or confrontational, when really, I'm just trying to manage my environment and my emotions. Sometimes I struggle to read social cues or respond in the 'typical' way, which might make interactions awkward.
How You Can Help:
If I say I need to step away or take a break, please don't take it personally—avoid pushing me to stay.
Be patient if I'm slow to respond or seem overwhelmed.
Try to limit sensory input (lower the volume, give me space) when you notice I'm getting stressed.
ADHD:
ADHD, for me, means difficulty with focus, organization, and sometimes even completing simple tasks. My mind is often racing with a million thoughts, which can lead to being easily distracted, restless, and forgetful. I will often say, "what?" when someone speaks to me because there is a processing delay. I typically respond with an answer before the person can repeat what was said. This can be frustrating for the other person. This isn't about a lack of effort—it's the way my brain is wired.
In social settings, I may jump from one topic to another, interrupt unintentionally, or struggle to maintain focus during a conversation. If I don’t follow through on a task or seem disorganized, it’s not because I don’t care—it’s because I’m genuinely struggling with executive function.
How You Can Help:
Be understanding if I forget something or need reminders, without making me feel guilty. Just know, I am not doing things like leaving cabinet doors open intentionally!
If I say "what?" at that moment, I honestly don't know what was said, but give it several seconds, my processor is slow, and I may actually know what was said.
Give me time to get organized or complete a task without rushing or pressuring me.
Help me break down big tasks into smaller, more manageable steps when I seem overwhelmed. I know this helps, but I often forget to apply this strategy in the moment, so gentle reminders can be beneficial.
PTSD:
PTSD can be one of the most invisible yet debilitating aspects of my mental health. Certain sounds, smells, or situations can trigger flashbacks, anxiety, or panic attacks. These triggers are often unpredictable, and I may not even realize what's setting me off until it’s too late. In these moments, I can become highly alert to perceived danger, distant, or become irritable.
In relationships, PTSD can make trust difficult, and I might seem quiet, withdrawn or afraid. It's not a reflection of my feelings toward someone, but rather my need to protect myself in moments of high stress or fear. Something that is easily handled today, may be a trigger tomorrow. It is something I cant control, and I know you don't want me to be this way—I don't want to be this way either.With this understanding, I hope to foster trust and deeper connections with those around me.
How You Can Help:
Encourage me to talk about or do things I am not comfortable with, but avoid pushing me, especially when I seem anxious. In the same vain, don't discourage me when I am hesitant.
Respect my boundaries if I need space or am triggered by something.
Try to notice when I’m becoming overwhelmed and help create a calmer environment if possible. Even ask if I would like to take a break.
Severe Anxiety Disorder:
Severe anxiety is more than just worrying; it can take over my entire thought process, making even simple decisions feel overwhelming. I live with this anxiety 24/7, and while it often isn’t rational, it exists and affects my daily life in significant ways. Social situations can be particularly difficult, as my mind races with what-if scenarios. In these moments, I might experience a full-on panic attack, leaving me feeling trapped and unable to respond to those around me. This racing mind hinders my ability to engage in conversations fully, making me appear distant or disconnected.
When anxiety strikes, my ability to function normally takes a huge hit. I often find myself pacing the floor at varying speeds, unsure of what to do or how to stop. Internally, my thoughts are running rampant, and my heart pounds. Only later, after I've calmed down, does my rationality return, and I can feel relief knowing that another crisis has been averted.
Another reaction to anxiety can be a strong urge to run or flee from the situation. After taking some time away, I can return with clearer thinking, allowing me to process the moment more effectively. Understanding this aspect of my mental health can help others see that my reactions are often not a reflection of my feelings toward them but rather a response to the intense pressure of my anxiety.
How You Can Help:
If I say I need a moment to gather my thoughts, please respect that and avoid putting pressure on me.
Offer reassurance in a calm and steady way if I seem anxious, but don’t try to "fix" the situation.
Give me space to make decisions, and don’t rush or overwhelm me with too many choices at once.
If you see me pacing the floor, ask me about it, and let me know I am pacing.
Comorbidity
Managing life with just one diagnosis—Autism, ADHD, PTSD, or Severe Anxiety Disorder—is difficult enough, but having all four, along with other challenges, creates a constant struggle. The interplay among these conditions generates a wide range of emotions that can be triggered at any moment, making it challenging to control my responses. Each diagnosis contributes uniquely to my experiences, often overlapping and amplifying one another.
Think of comorbidity like having a group of friends, each representing a different mental health condition in your life. Anxiety is that friend who always shows up unexpectedly, bringing a whirlwind of thoughts and worries. Then there’s ADHD, the energetic buddy who loves to keep things spontaneous and sometimes distracts everyone from the main conversation. Next is PTSD, the friend who occasionally brings up tough memories that everyone would prefer to forget, which can make gatherings feel heavy. Finally, there’s Autism, the friend who adds a unique perspective to the group.
Some friends get along really well, like Anxiety and ADHD, who often have a wild time together. However, PTSD can clash with both, making things complicated. Just like friendships, these dynamics can change daily; one might be more prominent or easier to manage on some days than others. Sometimes Autism helps clarify misunderstandings, while other times he can create confusion, showing just how complex our interactions can be! Understanding how these "friends" interact helps make sense of the complexity of living with multiple conditions.
For instance, my ADHD may lead to impulsivity, making it hard to stay focused in conversations, while my anxiety can create a sense of paralysis that prevents me from speaking up. Similarly, the sensory sensitivities associated with Autism can clash with the hyperactivity from ADHD, resulting in overwhelming moments that leave me feeling drained or extremely anxious. This intricate relationship means that I can’t always pinpoint what’s causing a particular feeling or behavior; instead, I just accept the fact that one diagnosis often counteracts or intensifies the effects of another. This complexity underscores the need for understanding and support, as somethings I do or say are often beyond my control.
How You Can Help:
Learn about each diagnosis on a basic level. They affect everyone differently.
Understand how one diagnosis can counter or intensify the other diagnoses.
Feel free to ask me anything—I’ll be more than happy to help you help me.
A little bit of patience from others can go a long way.
Recognize I am struggling, and offer reassurance.
Memory Function and Mental Illness
In some cases, I have an excellent memory, especially when it comes to dates and numbers. I pick up on patterns and find them both interesting and exciting. In addition, when I encounter information that doesn’t make sense to me, it lingers in the back of my mind, impossible to forget. It stays there until something finally triggers a connection, and once it makes sense, I can finally let it go and forget it. At other times, though, I struggle to recall even basic information without hints. This contrast is especially noticeable in my language learning endeavor—multiple choice is a breeze compared to fill in the blank lessons without a word bank to help. After doing some research, I’ve learned that the process of recalling information without hints, known as free recall, can be particularly challenging. Free recall is mainly handled by the hippocampus and parts of the prefrontal cortex in the brain. The hippocampus helps store and retrieve memories, while the prefrontal cortex assists in organizing and accessing them. When I try to recall something without any external cues, like remembering details about a movie, lyrics to a song or how to say, how are you?" in a foreign language, the hippocampus and the prefrontal cortex are the brain regions that work together.
On the other hand, recognition memory, which involves identifying familiar information when given hints or options, relies on areas like the parahippocampal cortex and the entorhinal cortex. These parts of the brain help me recognize scenes from a movie, sing along to songs, and study 22 languages for example, when I’m given a clue.. I’ve noticed that while I struggle with free recall, I perform quite well when I have hints, and this tendency can sometimes be seen in several neurocognitive conditions. Specialists have already confirmed my diagnoses, and it’s interesting to see the correlation between my memory and my conditions:
ADHD – People with ADHD often struggle with working memory, which involves holding and manipulating information in the short term. This affects their ability to recall information on demand, particularly without external cues. The brain's executive function, responsible for organizing and retrieving information, can be underactive, making it harder to access memories spontaneously. ADHD also impacts attention and focus, meaning if the information wasn't encoded properly due to distractions, it may be harder to retrieve later. Structured prompts or specific cues often help trigger the memory more easily. This could explain why I struggle in situations where I need to recall specific details on the spot, but with a little prompting, I can access the information more easily.
Anxiety – Anxiety impairs memory because it heightens arousal and stress, which divert cognitive resources away from proper information encoding and retrieval. When anxious, the brain prioritizes immediate perceived threats, reducing focus and making it harder to process and store details. The constant mental "noise" from anxious thoughts can block access to stored information, leading to memory lapses. Additionally, anxiety often causes emotional memory to take precedence, so while the feelings about an experience may be easily recalled, the specific facts or details are harder to retrieve. This aligns with my experience of often remembering my emotional reactions, but I find it difficult to pull up any specific facts or details about general topics.
Autism Spectrum Disorder (ASD) –For individuals with ASD, memory processing can be atypical, often relying more on recognition or pattern-based recall than free recall. The challenges stem from differences in how information is encoded, with difficulties in processing abstract concepts or social nuances. This can make retrieving information from memory without explicit prompts difficult, especially if the context isn't clear. However, when information is presented in a structured, familiar, or patterned way, it may be easier for them to remember. Context and recognition often play a key role in aiding their recall abilities. This highlights why I remember certain facts or patterns, but struggle to pull information from my mind without a trigger.
PTSD – PTSD can disrupt normal memory function through emotional and cognitive interference. In PTSD, the brain's heightened state of alertness can lead to fragmented memory encoding, meaning information isn’t stored efficiently. Trauma-related memories can dominate, making it hard to access non-trauma-related memories. Furthermore, the brain may prioritize these negative emotions over neutral or positive memories, resulting in more vivid recollection of traumatic or distressing events, while everyday details become harder to retrieve. This is why flashbacks can bring back specific moments vividly, while day-to-day recall feels sluggish or blocked. This helps me understand why I have a lot of blank spots in my memory. Things I seem to remember are negative memories and due to the trauma, positive or neutral memories can't be retrieved
Mild Cognitive Impairment (MCI) – MCI primarily affects memory by weakening the ability to recall information independently. The brain processes and stores information less efficiently than expected for age, so free recall, which requires pulling information from memory without hints, becomes more difficult. This is because the pathways for accessing stored memories begin to degrade, even though the information might still be there. Recognition, however, remains less affected since it involves identifying familiar information, which relies on different brain functions that remain intact longer. I sometimes become very frustrated when I’m unable to recall information, and I feel that my declining memory is not due to aging, but thankfully it doesn’t yet disrupt my everyday activities.
Having spoken with both neurological and psychological specialists about my memory challenges, I understand that memory difficulties like this can vary greatly, and it’s reassuring to know that what I experience isn’t uncommon given my diagnoses. This information is useful in helping me develop coping strategies that work for me.
Conclusion:
I realize this is a lot of information to process, but it’s necessary for me to share how these challenges shape my life. Disclosing these difficulties helps me set expectations with the people around me. It’s easy to let someone know that I struggle with these conditions, and knowing that others understand where I’m coming from can make all the difference. Small actions—like giving me space, being patient, and being cognizant of my struggles, along with reassuring me if you notice I'm getting anxious—can have a big impact. Living with Autism, ADHD, PTSD, and Severe Anxiety Disorder is a daily effort, but having a little support from those around me makes it more manageable.
It's funny, sometimes I find myself wondering which part of me is influencing my thoughts and actions in certain situations. Was that my Autism questioning that sentence? Or was it my Anxiety, second-guessing everything I write? Then again, maybe it was my ADHD, making me lose focus of the topic altogether. It's hard to say!
But then it hits me—perhaps it's just my PTSD chiming in, a reminder of that college professor who ridiculed my writing when I was just 15 years old.. That experience left a mark, and sometimes it resurfaces unexpectedly. It’s a wild ride—comorbidity—and a clear illustration of how each of these parts of me creates a mental health mashup.
I am who I am, but am I who I was supposed to be? I was uniquely created, with my individual traits and experiences that contribute to who I am today and who I will become tomorrow and beyond. Accepting my individuality is necessary, as it shapes my path and purpose in life. Writing and sharing my story is a testament to God's work. Ephesians 2:10 “For we are God’s handiwork, created in Christ Jesus to do good works, which God prepared in advance for us to do.”
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