Aspie menopause tips
August 15, 2019 9:04 PM   Subscribe

I've used a lot of good strategies throughout my life to cope with the problems autism causes but I seem to have forgotten them in menopause. I'm withdrawing more from the world and avoiding work (casual flexible interesting autonomous job). I need a kickstart to get back to a productive healthy life.

I've been to many health professionals, had plenty of CBT & ACT, but I have come to believe that while these have helped and I still practice aspects, they work better for neurotypicals than me. A number of compassionate and capable therapists have pushed me past my comfort zones as part of treatment, and sometimes leave me more anxious & shameful than before I saw them.

For example, if you're not neurotypicals, you know how damned uncomfortable eye contact is, and they would push me to practice things like that, which made life a living hell just so I could "fit in". I don't want or need to fit in anymore (finally in my 50s) but since I've entered menopause some things are getting much harder to deal with, like sensory overload and executive function.

Of course, the less I am in the neurotypical world, the more shameful I feel, and while I'm not yet missing deadlines or meetings, I have hit a wall where I only work 2 days a week. At this point, I am able to survive on this wage, but I have minimal superannuation, and from experience, I know, if I lose this job, I am supercrap at interviews (eye contact, selective mutism) and will never get another job.

Working more days a week would give me a safety net financially and pay for things I like doing, like backpacking, but I just don't go to work and I spend much more time in avoidance techniques and "self-medication" over and beyond the antidepressants/anti-anxiety and adhd drugs.

I don't want to live like this, because I'm not living, I'm drowning out the noise in my head (not voices, just self-talk & looping unrealistic or indefinable anxieties). I know I need to eat better, drink less, exercise more and practise self-care but it's too big to write a to do list - even thinking about all the things I should be doing makes me shutdown. It's always been my way to set up a perfect plan before I start on a project, to avoid failure. I know that is counter-productive, but even if I decide I'm just going to take a walk every day (and 4 years ago, that took so well that I was walking 20km on weekends easily) I can't start. I just can't leave my flat sometimes - it's too people-y out there, or too hot, or my weight gain means I experience extra sensory issues, and my medication gives me dry mouth so I need to take an absurd amount of water for a stroll and that means a backpack, but which backpack and would I be an idiot if I used my camelbackpack which means I have water at my shoulder even for a stroll... and ... etc ad infinitum

I don't want fly-lady. My flatmate/companion takes care of household stuff/grocery-shopping, so I should have more spoons, but I don't. Maybe I have some less spoons because I am never truly alone, but my companion doesn't work outside our home, even cleans my cat's litter tray.

If you understand being non-neurotypical, please help me work out where to start, because if I keep going the way I am, I'm afraid I will lose my client-base, and any opportunity to work.

Autism-specialist therapists for adults are rare here, and expensive. I went to rehab to deal with the drinking (cost my private health insurance $10k and lasted 90 days - was not autism-specific but the nurses were very kind, and the group therapy was great, until I started "assisting" the group leader because of all the reading I've done through self-help & psychology, where I focussed understanding the other participants who weren't as practised or as eloquent as myself).

Am I making sense? I'm bored with my life (partly) and just disinterested in making changes, though I know I need to. I have before, sometimes spectacularly, but now, I just seem to be caught in a drainhole, sucking me down and I can't fight the current.

TL, DR: menopausal autistic woman not being productive, using substances to avoid thinking and resistant to psychologists because so many already, and so few understand challenges of autism. Where do I start?
posted by b33j to Health & Fitness (9 answers total) 4 users marked this as a favorite
Btw, my insurance pays for in-hospital care but not psych visits.
posted by b33j at 9:15 PM on August 15, 2019

How well do you feel that your antidepressant is working? Absent anything else, a lot of these things are very exactly how depression manifests for me, and that seems like another angle to look at - you only mention it obliquely in the question.
posted by sagc at 9:54 PM on August 15, 2019 [4 favorites]

Seconding sagc. For some people, menopause requires medication adjustment (including antidepressant, anti-anxiety, and adhd meds).
posted by Iris Gambol at 10:51 PM on August 15, 2019 [2 favorites]

My antidepressants have recently been adjusted. But point taken.
posted by b33j at 11:01 PM on August 15, 2019

You mention adhd meds; seconding Iris, my adhd got much worse during menopause. I could barely get started on anything, let alone finish anything, until I got back on meds.
posted by wens at 4:10 AM on August 16, 2019

I'm also Aspie (and in perimenopause), and what you're experiencing sounds like how I often experience depression too, so I agree that looking into that makes sense.

But it's also how I feel when I'm just bored with my life. Often recognizing this doesn't help, because anhedonia sometimes means that nothing in the world is going to be interesting to me, but sometimes if I take some time to think about what I'd like to be doing to engage my mind, it can help me get back on track. Things I did included fostering rescue dogs, implementing a serious disaster preparedness plan, writing a research paper on some data I was working with at my job, etc.

(Also, give no f-s about what other people think. Use that Camelback; if someone asks you about it, say you're in training for your next backpacking trip. Also, if relevant: I find "lumbar bags" [fanny packs] to be better than backpacks from a sensory perspective; one of mine holds two water bottles upright.)

I'm also sometimes able to begin breaking out of this feeling by consistently doing just ONE THING every day. This helps structure my life and makes me feel like I accomplished something. For me it was usually to walk or otherwise exercise every single morning, but when things were REALLY bad, sometimes it was as minimal as brushing and flossing my teeth every morning.
posted by metasarah at 6:12 AM on August 16, 2019 [1 favorite]

HRT works well enough that I can at least go outside when it's not way too hot and humid. I'm on the minimum dose, which allows me to sleep at night, and I walk in the evenings. Hot flashes go away for some people after a few years, but my mother had them till she was 90, and sadly, I'm just like her. Get some hormone replacement so you will at least be comfortable. Also, I agree with the others regarding anti-depressants - essential for the majority of women at this time of life. Elavil will cause mouth dryness, so if you're taking that there are better choices out there. Good luck.
posted by Enid Lareg at 6:14 AM on August 16, 2019 [1 favorite]

I can only offer up the data point that I am only able to survive menopause due to HRT and an anti-depressant which, yes, had to be upped.
posted by DarlingBri at 6:57 AM on August 16, 2019

I can add that I went through (surgical) menopause and it turned my anxiety up like 500%, so that’s definitely a thing. HRT didn’t solve this for me, but new anxiety meds made it at least live-with-able.
posted by Tiny Bungalow at 9:54 AM on August 17, 2019

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