_{Photo by J A Uppendahl on Unsplash}

I’m sitting in yet another new doctor’s office. This time, it’s because my mental and physical fatigue have taken a sharp turn for the worse in the last few months, and after trying a few different herbal supplements to no avail, I decided to see if there might be a physical cause.

However, after going over my medical history and medications list, which includes a phalanx of anti-anxiety and anti-insomnia medications, this new doctor claimed that one is only supposed to take psychoactive drugs temporarily and is “expected” to eventually wean off of them completely. (This is not actually true, by the way.) He went on to assert that my medications were at the root of my fatigue problems.

I’ve never had a poker face, so I’m sure that the incredulity I felt at this audacity was obvious. Using my words, I responded that because I was autistic, I had had intractable anxiety and insomnia for over half of my life, and that medication was the only way to manage these issues. I was careful to point out that I’d been taking these meds for years while my fatigue was recent. I allowed that I was on a lot of [what should be] sedative medication, with the caveat that even so, my autism-associated anxiety and insomnia sometimes broke through anyway.

I knew he would suspect the meds, so I was prepared with this rebuttal. We went back and forth, while I tried to maintain my gentle but firm insistence that my meds could only be reduced to a point, a point at which I was very close to already. Ultimately, the doctor agreed to do lab tests for all fatigue markers, so I suppose we reached a sort of detante. Or at the least, he agreed to kick the can of that argument down the road.

But something was niggling at me for the rest of the day, and it wasn’t just his assumption about my medications. What was it about the interaction that was digging into my psyche like a splinter under a fingernail? It wasn’t until after dinner that I got it, and then I got angry, and not just about the medication impasse.

He never, not once, asked about my autism.

He didn’t ask when I was diagnosed, how my medications affected it, or even why I was non-functional, as I assured him I was unless medicated for the issues that stemmed from it. In fact, the word “autism” never crossed his lips. He didn’t even argue about it; he just acted as if it didn’t exist, or if it did, it was too minor to make an issue of.

Yes, I know, not everything is about my autism. Except that everything is about my autism. It affects every single thing in my life. Medicines affect me differently. Food tastes and feels different. My senses of hearing, seeing, smelling, and tasting are hyper-sensitive. My visual processing is abominable, to the point that I am face-blind, which on top of frustrating is also embarrassing.

These are things that no medication will fix. Only the symptoms of them can be dealt with, with therapy and medication, and I’ve had plenty of both, to the point where I need quite a bit less of them. But less is not none, because medication can’t make me not autistic.

The word “autism” never crossed his lips. He didn’t even argue about it; he just acted as if it didn’t exist.

Beyond the reach of medication is how much harder I work to sound, think, feel and act normal around other people. I’ve heard “you don’t look autistic” enough to know I’ve gotten good at hiding my autism. The problem is the better you get at it, the less seriously people take you when you tell them about it, and I’m pretty sure that’s what happened here. The doctor assumed that someone who looks as “normal” as I do couldn’t possibly be as affected by their autism as I claimed to be.

I thought I was past the point of doctors implying that my issues were all in my head, but I have a sneaking suspicion that this is exactly what the new doctor thought. He likely assumed that I had diagnosed myself with all sorts of trendy internet things, of which autism was but one. That is definitely not me, but I was already on thin ice with the meds thing and I decided not to bring it up.

Trendy or no, though, my autism isn’t going away, which means my anxiety isn’t going away, which means I can’t stop taking my medications. But in order to believe that, you have to believe that my autism affects me enough to cause this much anxiety. Expecting doubt from the anxiety side, I was unprepared to be disbelieved about my autism, and didn’t realize it had happened until much later.

Much handwringing has been done in the media about how we are all less resilient than we used to be and are all over-therapeutized and over-medicated. Whether or not that’s the case has nothing to do with me. I am autistic, I am less resilient because of it, and my medicine is not just a salve for the dispirit of modern existence, but an absolute necessity.

I don’t know if I’ll be able to convince this doctor of that. I’m hoping something will show up on the blood tests and render arguments about medications moot. But if it doesn’t, me and this smug, self-satisfied jerk doctor are not going to work out.

Am I prepared for another trip through the find-a-new-doctor-who-takes-seriously gauntlet? It seems like it never ends. First my pain, then my anxiety, and now this. What does a person have to do to find a doctor who just listens?