Autism and Suicidal Ideation

This is one of the hardest essays for me to write.

I made the title bold and clear so that you know what we are getting into: autism and suicidal ideation.

It’s a hard topic to discuss for many reasons. First, it’s a deeply sensitive topic that can be upsetting to many. I want to write with grace and intention so that I choose my words carefully. I don’t want to cause anyone to feel worse because of my words.

Second, it is a personal subject with which I have struggled.

Suicidal ideation is different than a suicide attempt or suicide itself. Suicidal ideation occurs when a person wishes they were dead.

Illustration by Jackie Schuld

It can look like a person thinking:

“I wish I just wouldn’t wake up tomorrow.”

“I would never kill myself, but I just wish the pain would stop.”

“I am hopeless. I will never get better, even though I try so hard. There’s no way out. I wish I could just die.”

“I’d be better off dead.”

Almost every autistic I know has experienced suicidal ideation, myself included.

When my therapy clients tell me about their dark thoughts, they always make sure to reassure me, “I would never actually do it though.”

If so many of us would never actually kill ourselves, why do we think about dying so much? What makes us wish for death? Why is it so common?

First, I have to acknowledge that I am a late-identified autistic and I work primarily with late-identified autistics. Why does this matter for the topic of suicidal ideation?

Most of us spent the majority of our lives feeling broken, othered, and off. We tried our best to externally fit into the world around us but internally felt more and more distant. We severed connections with ourselves as we tried to please the world around us so we could belong. We felt empty and lost. In such dark places, it is common to feel that death would be a better fate. I think this explains why many unidentified autistics experience suicidal ideation at some point in their lives.

So let’s now look at autistics once they know they are autistic. We might think that after having such a huge life-altering and positive realization about one’s identity, a person would never feel as low again.

Here’s the thing though: an autistic mind is a tricky beast. Instead of speaking for everyone, I will just speak from my personal experience here. When my mind begins to emotionally spiral, it’s like all it can see is the negative. My mind thinks that is the only reality. All of the good, all of the positive experiences are thrown out the window. All I can focus on is the pain and how I cannot seem to get it right. I cannot believe I am there again, after so much effort to feel better and be better.

Unfortunately, my hyperactive brain is incredibly adept at then supplying me with ample evidence of all the things I’ve fucked up and all things I cannot figure out. All the ways I am flawed. All the ways I hurt people. All the ways I am hopeless. My mind quickly thinks it will always be this way and there is no hope. It will always be this painful. I will always be this way. I cannot believe I am in such a low place again and I am so disappointed with myself. This is when I wish I could just die. That nothing will get better and I am better off dead.

Like my clients, I would never actually act on it, but the painful thoughts are still there.

It is embarrassing to admit this. I would like to say I learned I was autistic and I never had a suicidal thought again. However, that is not the truth or my reality.

95% of the time I am doing well.

However, when a meltdown hits, I forget about that 95%. I wish there was a better, more universal word for the experience. Meltdown doesn’t quite cut it because that can also refer to when a person has a nervous system overload due to sensory issues. What I am talking about is when a person emotionally and mentally implodes on themselves, feeling massive amounts of emotional pain, and their thoughts quickly get very, very dark.

I wanted to write an essay about this because I think an autistic mind is more likely to fall into a dark spiral due to the ways our minds are structured. On a positive day, our hyper-connected mind can help us to be creative and full of wonderful ideas. We can appreciate tiny details and be amused by many, many things. One idea can quickly lead to another and we get to spend a glorious day fueled by our ideas.

That same hyperconnectivity can also fuel our dark spirals. Our minds can seize on one negative thought and quickly connect to more. Our hyper-alert nervous system can flood our bodies with hormones, leading to us feeling even worse.

The point is, these dark spirals don’t happen very often, but when they do, they suck us right in.

I am writing openly about this so that my fellow autistics know it is not their fault. There is not something especially wrong or broken about you. You are not a faulty autistic. Our brains are more likely to take us on downward spirals.

I am a goddamn therapist who specializes in autism, and my brain STILL takes me on spirals.

That doesn’t mean we are powerless though. The first thing we can do is acknowledge the role of our brains. When we know the cause, we can stop internalizing so much shame and judgment. This will naturally help to alleviate the frequency and intensity of downward spirals. The more we can catch ourselves in a spiral and remember this is what our brain does, the more chances we have to step out of the spiral.

We can then learn more techniques for getting out of the spiral. For myself, I’ve learned the best thing I can do is STOP thinking. There is no way I can consciously choose to make my thoughts more positive or examine if I’m having cognitive distortions. I simply don’t have the executive functioning in the moment for that. Since I cannot control my thoughts, I have to get them to stop.

The best thing I can do is try to switch the channel in my brain by distracting myself. Sometimes if I’m lucky, there is someone around to help me do that. If I’m by myself, I try to go to sleep or calm myself down by doing activities that prevent thoughts, such as doing a puzzle while watching a show.

What works best for each of us will vary. And this is where working with a therapist or specialist will make the difference. You do not have to figure this out by yourself. If you are in the middle of an emotional spiral and cannot get out, you can also reach out to the National Suicide Hotline at 1-800-273-8255 to talk any time day or night, or if you prefer not to vocalize, the Crisis Text Line also provides 24/7 support via text message when you dial 741741.

The third thing we can do is process an emotional spiral after it happens - once we are calm and in a grounded space to do so, which is usually after a good night’s sleep. We can hunt for clues about what led up to the spiral. We can identify areas we need more coping mechanisms. We can understand why the spiral happened and release shame or other unhelpful narratives we hold. I like to do this through journaling or art making. Sometimes though, I need an outside perspective and this is when a therapist or coach is really helpful. If that is not something you can immediately access, you can turn to blogs and books for ideas.

What we really need in these moments is hope. Hope is the number one antidote to suicidal ideation. Hope that it can be better.

I believe it can, and that starts with me being open about my reality.

If you have strategies and ideas that have worked for you, please share them in the comments. Let’s work to build us up.

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