Hello, there! Hi! I am going to tell you a slow burn horror story that was 30 years in the making. No, there are no ghosts or imps or jump scares ahead, but if you found my blog for the reasons I suspect you did then it may give you the chills anyway.
I might be getting a little ahead of myself here, so let me first welcome you to my blog, my life and my accidental discovery that I grew up with ADHD + Autism... and not a single person had picked up on it! My name is Lauren, and I was born and raised in Southeast Asia, Singapore. I am in my mid-30s although kind strangers have occasionally said I can pass as twenty-something. If you don't agree, please don't tell me to my face; my Rejection Sensitive Dysphoria RSD might not be able to handle it.
For as long as I can remember, which is very far back - although the irony of being AuDHD for me is also having a shorter memory than a goldfish supposedly has - I have felt and been told to my face in no uncertain terms I was crazy, irritating, weird... that I simply did not really belong. In social situations at school or work, and among friends, I was that proverbial goldfish; I didn't know when, but I was sure I had been taken out of the water in my bowl at some point and no one had bothered to tell me. All of this was not for lack of trying, though. I (over)compensated by practicing my facial expressions in the mirror, reading extensively on body language, and memorizing lines from books or TV shows to use later on. Spoiler alert: it did not work. I faced bullying in covert and overt forms that went on through my teenage years. Skipping school became my escape; my best memories of that time are almost exclusively the periods when I could draw, paint, sculpt, write, or play music undisturbed in my room.
My first professional psychological intervention happened when I was 15. I had started exhibiting behaviors that teachers had flagged the year before, prompting my school principal referred me to a place called the Child Guidance Clinic. At the time, I did not know how therapy was supposed to work, that it is neither a linear process nor a magic cure. After the first handful of appointments where I was a wrung out towel after crying through most of each session, I told my mother I did not feel better and did not want to go back.
I began to spend hours after school at the public library to - what else? - research, in between obsessively working my way through Agatha Christie, Neil Gaiman, and Stephen King bibliographies. I found other worlds to escape into while I learned terms like clinical depression, bipolar disorder, and social anxiety. At the time, I told myself that I was probably going through an angsty hormonal teenage girl phase, although no one else I knew seemed to be having a rough time of it as I did. It didn't help that things between my parents at home were getting tense, and I reasoned that that was why I was struggling more than my peers.
Fast forward to 2010, and being in my early twenties when I found myself having the same social difficulties, only it was growing more obvious to myself and everyone around. I got honest with myself about how I was the common denominator in each situation and that I had to do something about what I was doing "wrong." I was referred to a public hospital in the east of Singapore, where I saw Dr Andy and Connie, a psychiatrist and psychologist respectively, for the next 12 years.
Within a few months of that initial appointment, I was handed two diagnoses of clinical depression and generalized anxiety disorder, and started on antidepressants and anti-anxiety medication for the first time. Over the following years, my recovery journey with Dr Andy and Connie along with other doctors and therapists, was a ride. The persistent eating disorder from my teenage years was acknowledged, I learned my problems were because of my bad personality, I turned down time and again the invitation to return to group therapy which was always overwhelming for me although I could not articulate why at the time. I thought it was just anxiety, but now I can speak about the nuances of it such as sensory overload, the pressure to rely on masking and/or scripting, uncertainty among the roster of doctors and psychologists who might oversee the session that day, what role I filled in the hierarchy of the therapy group participants, intensely self-monitoring especially to make sure I did not trigger another group participant. I was hospitalized twice for breakdowns, the second of which was at a different hospital and traumatized me so much with conditions that could not possibly promote healing and recovery. It is still difficult to speak about it today.
In 2010, I had also just landed a job at a music store I dreamed of working upwards for my career and was learning the ropes in a new environment, while figuring out the transition from teenage years to being a real grown up now. Plus, I got married on impulse to an ex, and was trying to play the role of wife, daughter-in-law, and cat mom. All of these proved to be overwhelming, and something had to give. After a couple of years, my spouse said to leave my work and not worry about bills. I held on for awhile more until I had a meltdown (at the time, I thought I was losing my marbles) and packed my locker and left in tears. Shortly after this in 2014 was when I fell into cat rescue, and then stumbled upon my current work in 2019 when there was a need to supplement the household finances.
Finally, at the end of 2021, I had a breakdown to end all breakdowns. It was a long-time coming, in hindsight, because the pandemic had made work responsibilities kick into high gear so the company could stay in business. I ended up on 35 days of medical leave which I thought was met with more frustration than the situation merited; although I was being an inconvenience while temporarily out of commission, I had also just about literally killed myself trying to be a team player with minimal support.
Anyway. This began a mental shift where I was determined to pace myself through the following year to avoid having another Epic Breakdown And Being An Inconvenience™️ to my coworkers.
By the middle of 2022, I started to feel the familiar rumblings of my brain going into that horrible place again. Unlike previous times, I was now divorced and could not flounce out of the office without so much as a by-your-leave. I had 15 other mouths that had been reliant on two paychecks that absolutely needed my one paycheck to survive. Like before, I did hold on.
If you believe in happenstance, I came to be involved in a project with a client that is involved in the disabled community. I started following several Instagram accounts to educate myself on this marginalized group because it felt social justice-adjacent which I have been long drawn to. Through various creators' content, I began to first suspect Attention Deficit Hyperactivity Disorder (ADHD) after awhile. I brought this up to Dr Andy on an appointment in September 2022.
Dr Andy brushed off my concerns and had been about to turn back to his computer to type in the end-of-session notes, when I made an off-the-cuff comment. Oh, I didn't know my (previous) diagnoses could start from 5 or 6. Dr Andy froze, turned back to me and said, "No, they don't." He then pulled up a list of screening questions I rambled through. After an indeterminate amount of time, I completed the interview, and Dr Andy said I would start on medication for ADHD. We would consult again in a month. If the meds worked, it would indicate ADHD.
Even then, I knew in my heart of hearts that this answered a lot of questions I did not know I had. The next few days were a blur of early memories coming up, crying, losing sleep, overeating to cope, and more crying. I threw myself into learning as much as I could about ADHD and how to support myself better, and learned a whole new vocabulary like executive dysfunction, low frustration tolerance, and burnout. In October 2022, ADHD was confirmed as a diagnosis along with OCD and it was a series of immense realizations. I wasn't making it up! I wasn't crazy! I wasn't not trying hard enough! How did everyone involved in my mental health care miss how much I was flailing and then attribute it to my personal flaws? I also have no other metaphor for the medication expect that it feels as though the batteries had finally been put in my brain.
The end? Not really. I did promise a horror story, and this is where the nail-biting parts really begin.
It didn't take long before I realized that there was one glaring problem I had always faced that ADHD did not have an answer for. That was my world-class ineptitude to make friends, navigate relationships, and understand social cues intuitively. I started to intensely research Autism Spectrum Disorder (ASD) - which continues to the present on a daily basis, by the way - and came to have an inkling that this was probably another crucial piece that had been missing.
Getting Dr Andy to hear me out about another missed diagnosis came with another set of challenges, unfortunately. Looking back now, I think of it as rounds of vicious shark attacks a thousand leagues below the surface where light doesn't reach while blindfolded and with my hands tied. I would not wish my experience on anyone:
I was met with impatience at first, and once again had my concerns brushed off by my doctor saying I was able to do x, y, and z, and so I could not be autistic. Later, Dr Andy would flat out deny saying he had stated this and made a non-apology by saying "I'm sorry you perceived that I said that." He subsequently told me that diagnoses have limitations and the idea of treatment for the past decade or so was to get me back to the functioning I want. It is true that there are limitations but this is when one does not realize struggling to pick up the phone and reschedule a simple appointment is a symptom, and might not think it relevant to mention in a clinical setting to receive an accurate diagnosis. A long list of anecdotes related to social struggles throughout my life that I had collated for our extended appointment around ASD was like deliberately running into a wall out of frustration but feeling no pain for the effort of the endeavor. I was told that everyone does x, y, and z at some point or another. I made several requests for a referral for a second opinion at another public hospital so I could continue to qualify for subsidized fees and kept being denied. By the time Dr Andy acquiesced to writing the referral, the miscommunication and last minute update meant I missed the appointment I had set up at the second hospital that I had already waited months for.
Then, there was the desperate googling to find a private practice where I could be assessed for ASD, specifically pertaining to girls and women and Assigned Female At Brith (AFAB) folks. The first place I found turned me down. The second one promised they had a qualified senior psychologist called Susie, although the cost quoted meant that there was added stress. For weeks, I scrimped and saved, eating instant noodles so much my hair fell out. Or that might have been the all-consuming anxiety, stress, and worry that I would have the same gaslight-y experience with Dr Andy taking its toll. I did make payment in time mostly by the grace of my mother and best friend who stepped in to help defray the cost of the assessment significantly.
Through this period, I would not return for an appointment with Dr Andy. I did not feel able to trust him to have my best interests at heart as my doctor, and I began to ration my ADHD medication even though it impaired my day-to-day functioning significantly. (For context: I was, in fact, prescribed months of medication, but was not informed that it was a controlled drug and such prescriptions last a month. If I had known, I would have taken a small loan to collect my entire prescription at once, instead of going by weeks out of monetary consideration.)
Thankfully, Susie was as well-versed in the nuances of autism in women, and I did not have to advocate to be heard and validated. I was interviewed extensively, went through observational and written/scored tests, my mother and ex-spouse were involved, and in July 2023, I held in my hands my autism assessment report. I was numb, even though I had somewhat expected it.
In the weeks that have followed, I began consultation with a new psychiatrist, Dr O, and have begun to reduce my antidepressant dose under his supervision; I suspect that I might have been exhibiting signs of burnout instead of depression and may not necessarily need two SSRI antidepressants that, according to Dr O, have put me at risk of serotonin syndrome - a risk I had not been informed of by my previous physician. The journey to get off antidepressants has been slow and steady, with the withdrawal process being a fun mix of insomnia, increased hunger, heart palpitations, mood swings, losing my balance and falling over, just to name a few. I have been unable to go back to work since as well, and will need to rely on my mother for help to get through this time; I am trying not to allow the negative self-talk at being reliant on my parent at my age get too loud.
Honestly, I have no real idea what is at the end of the detoxification from my antidepressants, but I am truly hopeful the medication I am still being prescribed will continue to help with my emotional regulation, task initiation struggles, and time blindness - crucial aspects that support my ability to have an improved quality of life. Meanwhile, I am continuing to uncover and unpack what it means to be a late-diagnosed woman with ADHD and Autism. It is surreal that this could happen to me, right here in Singapore, where I once had unquestioning trust in the medical care and health system. It might also be the alexithymia and delayed processing around these feelings that changes how I feel about my experience from day to day, most of which have been documented on my podcast, Little Missed Neurodivergence.
The podcast is a valuable way for me to cope with what I was/had been/am going through. I appreciate it if you have listened in at any time. I wrote this essay to reach more people who might need it because it has always been important to me to add to the discourse for others who might be in very similar circumstances - trying to get formally diagnosed while going up against an institution and areas of research sorely in need of updating. (This is why I fully support those who are self-identified.) I am truly sorry this is your path, too. Knowing what I know about my brain today, I am still not sure I can say I would do it all over again. What I can say, at least, is that both of my diagnoses have finally held up a mirror to this goldfish-out-of-water who once felt like she was suffocating and helped her realize she is a dolphin who can breathe just fine while joyfully breaking the surface of the ocean. And maybe being my authentic, eccentric, weird self is not so horrifying after all.
x Lauren