Content warning: This piece discusses suicide, suicidal ideation, and self‑harm, which some readers may find distressing. Please take care as you read, and feel free to skip sections if needed.

This isn’t an easy write, and I feel strange writing it, but it definitely needs to be put out there for better understanding.

Last week, I was booked for a big project on Friday morning; however, I had a back injury on Monday, which really threw my week. This caused a lot of internal problems as I didn’t think I was going to be able to make it. 

The slightest change in my pattern is very hard for me as an autistic individual, especially ones that have high focus. This had been planned for a long time and would take a lot of masking and major focus (especially now due to my physical injury). I knew the morning would be tough, but it’s a project I am very passionate about, and it will help a lot of people. I had to really debate cancelling, but this would have been just as devastating for me as changing the plans would have possibly caused a meltdown anyway – dammed if I do, dammed if I don’t!

I decided not to cancel and hope my back pain would ease up with medication, which it did. I knew I still would have been in a lot of pain from it (but it was manageable). After any event such as this, I would have had days of mental burnout and physical rest, so I felt the risk was worth the reward. 

I was dreading it; I didn’t sleep much the night before due to anxiety (rehearsing conversations in my head, masking, preparing myself mentally), and the discomfort of my back didn’t help – I average 3 to 4 hours maximum anyway. Still, that night I had less than usual.

A few hours earlier, in the morning, when I was getting ready, I received an email that changed some major plans for the project. To someone who is non-autistic, this would have been ok and wouldn’t have been a big deal. For me, this triggered a massive meltdown. I tried to mask it at first, but I couldn’t process the change – especially after so much focus and pushing myself through the injury. 

What makes this harder to cope with is that I always explain to anyone I deal with how communication is key, and last-minute major changes are not easy for me to deal with. Although these situations can’t always be avoided, they can still impact me in such a bad way.

I had to cancel!

The meltdown put me into a state of suicidal thoughts (as suicide ideation is something I struggle with), and I even started to plan it in the hours that followed. I have not been in that bad of a meltdown in a long time. No amount of talking can help, as all my sensory system is on high alert – talking actually makes it worse. My brain and thoughts are rushing so fast that I feel that I am on the edge of insanity, and suicide becomes an option – this is what I have experienced as far back as I can remember, even as a child. 

In these situations, I cannot even ring an ambulance or for support as I have to explain something that isn’t logical, and they don’t have the experience or understanding to tackle this – I know this from past experiences! The thought of having to explain it adds to the sheer fear, as I have endured it before, and it’s only added to the trauma and makes it worse – So it’s simply not an option!

In this situation, all I want is for my mind to stop rushing at the speed it is, and I can bring rational and logic back to focus. 

It’s like you have just been told a family member has died, an elephant is sitting on your chest, whilst standing in the middle of a motorway with cars speeding past with people shouting directly into your head… X10! This isn’t fleeting; this goes on for hours on end. Logically, do you think talking would help in this situation? 

I have learned not to tell people I am in this state, as they think that if you are suicidal that talking will help. Talking in that state is the last thing I need – to add extra information to process when you can barely think a straight thought, let alone trying to describe it to people who don’t have any general understanding. It’s not something logic plays a part in or discussions help. 

The only way I know how to slow it down (which is not even something I enjoy now) is drinking alcohol, and fast! To slow down the mania in my brain. No medication helps, talking makes it worse, masking around people I know makes me feel even more detached and like I’m on show. While I’m not recommending this, and no, it’s not ideal, but in that state of mind, it’s survival.

The impact of alcohol has the benefit of slowing down my racing thoughts and nullifying them so they are easier to process and also less intense. What a lot of people say is that the hangover in the morning can make them feel worse, but for me, it is not the case. The mental burnout from the rushing thoughts and then the tiredness of masking whilst drinking leaves me in a state of exhaustion. This, for me, is far better than going through the insanity before – and far less dangerous. Again, this is not something I suggest, and I know it’s not good for me, but what’s the alternative? 

For now, I feel flat and mentally I am drained, but in that state of mind, it is beyond describable how bad it is, and you just want it to stop, which is why suicide becomes that escape – it really is that extreme! 

It’s not like depression or a low, which is what everyone seems to think with the same ‘I’m here if you need to talk’ approach. As caring as that is meant to be, it actually makes things far worse, as it only backs up the isolation and how much people don’t understand or grasp what I am experiencing. 

I am 46 years old now, and after a late autism and adhd diagnosis, understanding how I have coped with this over the years has started to make sense. 2 decades in the mental health system under the diagnosis of bipolar, then to finally have the understanding that I am neurodivergent helps. This helps in the sense that I can put things in place to prevent these meltdowns myself in my own environment. I can only ask people to make reasonable adjustments (which is only ever clear communication), and if they don’t listen, then it’s inevitable that it will happen despite my best efforts. 

The problem is, I don’t think people truly understand the impact, despite my explanations and why I say clear communication for me is key. The incident on Friday was the straw that broke the camel’s back – it’s a result of continuous masking and fighting despite a lack of understanding, and this is the reality. 

The older I get, the harder it is to manage. The psychiatry system refuses to see me despite my and my GP’s persistent requests. The services I have seen are not equipped to handle cases like mine – I get sent back to my GP with do not re-refer. The services I have been with often tell me that they learn more from me and apologise, but the research and understanding simply aren’t there yet!

I keep battling the best way I can, but one day I might not make it – but it won’t be through lack of fighting! Anyone who knows me personally will back up that day in, day out, I fight not only my personal struggles but against the many systems that don’t make reasonable adjustments to support change in society – this includes the NHS. 

For many of us autistics the term ‘talk to someone’ simply doesn’t cut it. I’ve been speaking for years about this, and I am lucky to be here after multiple suicide attempts, which have left serious damage to my body and mind. When are we going to start looking at this generic approach differently, not just from a neurotypical perspective? 

I don’t know the answer, and yes, talking will help some people. But what about when it’s sensory with trauma and talking in suicidal states makes things worse? What do you do then? When everytime you mention it, you get the same generic response about talking, which just proves the lack of understanding and makes you feel like an alien and more isolated. When will it be on society to change and adapt rather than the individual struggling? When will we choose prevention rather than reaction… or too late?

Surely the statistics show that we aren’t getting better on this topic, and talking alone (even for non-autistics) isn’t working? Why do we as a society keep repeating the same approach, expecting a different outcome? Why isn’t it the frontline that autistic individuals without intellectual disabilities are up to 9 times more likely to die by suicide? What is being done to tackle this, if it’s not even mentioned when we talk about this suicide epidemic? The services that are put in place to combat this need to do better because, at the moment, we are fighting a losing battle, and I could have easily joined that statistic on Friday.