15% of autistic people have jobs

My two daughters (17 and 28) and one of my sons (21) have autism, so I was following this thread out of interest, but this comment made me sit up.

I was diagnosed with ADHD four years ago (aged 52 at the time), after over a decade of recurrent depression. A change of psychiatrist and thus a fresh pair of eyes resulted in a different line of questioning and, ultimately, a formal assessment for and diagnosis of ADHD. 

What BvL wrote above is precisely the line I have been pitching to my employers. Over the last year or so, I have been having periodic episodes of sickness absence with severe IBS symptoms. Both my boss and I are very keen to get this sorted out, to which end I got an urgent referral to gastroenterology and I will be going to hospital early tomorrow morning to get scoped at both ends.

However, I don't expect them to find anything wrong, physiologically. I had the same problem a decade ago and was admitted to hospital for four days, during which time they conducted every test imaginable and found nothing wrong, leading that particular gastroenterologist to diagnose stress-induced IBS. Particularly given that all my recent blood results were normal, I'm expecting the same again.

Whilst excluding any physical cause will be reassuring on one level, it will also present me with a dilemma. If this is indeed stress-induced IBS, there is no treatment available for that. Similarly perhaps to happyhornet, I am highly productive when left alone to get on with my job. Unfortunately, the nature of my current job (I am a lecturer in nursing, teaching primarily mental health but also module lead for an all-field second year module) is fragmented and chaotic and rarely, if ever, affords me time to work uninterrupted. My neurotypical colleagues struggle with this as well, but in general are better able to manage, whereas I become overwhelmed. 

Assuming my instincts are correct, and my periodic episodes of illness are stress-induced, I anticipate a conversation with my boss about restructuring my workload. Fortunately for me, my employers are very sympathetic (given that they're all either nurses or AHPs by background), so in my case I think I might be able to carve out a role for myself that allows me to bring my strengths to bear and minimise the inherent disorganisation I have been dealing with for two years, since I left the Army and joined the university. I will probably shift across onto a research contract rather than a teaching contract. That won't preclude me from teaching (which is the part of the job I love), but it will release me from being at the beckon call of hundreds of students and allow me to focus on specific projects. I have two masters degrees and a PhD, but for my current day job that's almost meaningless, because the demands of the job deny me the chronological time, headspace and lack of interruption necessary to use those qualifications to good effect.

So in the wider context of the employability of neurodiverse people, I would say that if employers can find work that matches such people's talents and abilities, then everyone wins. More neurodiverse people would find employment and more employers would benefit from people with particular talents. Not 'super-powers', but talents the equal of neurotypical people, just different talents that might offer new perspectives and contribute to increased overall productivity.

Hi TSM

I alluded to that, briefly, in what I wrote, when I noted that, "My neurotypical colleagues struggle with this as well, but in general are better able to manage, whereas I become overwhelmed."

One of the biggest problems across the entire panoply of mental health and neurodevelopmental conditions is the fact that the symptoms are common across humanity. Diagnosis is therefore based on the frequency, intensity and duration of the symptoms. Everyone feels sad sometimes, or anxious about something, or otherwise distressed, but those feelings will pass. For those for whom they don't, it is reasonable to offer some help.

My mother in law died a few weeks ago, and so a lot of my family are displaying symptoms which, in isolation, might indicate depression. However, most if not all will return to normal (whatever 'normal' is) in due course, i.e. they would not attract a diagnosis of depression.

So whist I recognise your observation that, "It's shit, but it's just life", I feel obliged to observe that when the frequency, intensity and duration of the 'shit' becomes disabling, something is demonstrably amiss.

If you genuinely want an answer to that question, I recommend you watch the video BvL posted a while back. Prof Simon Baron-Cohen is an internationally recognised authority on Autism and answers your question. To a certain extent it's obvious. As we have learned more about autism and ADHD, it has become easier for clinicians to recognise. He refutes the idea that they have become more prevalent, but that they are now more recognised and easier to diagnose. The problem that is floating around on social media at the moment is one of self-diagnosis. Too many people consulting 'Dr Google' and deciding that their traits (which we all have) add up to them being autistic (or having ADHD). 

Another observation, which again I alluded to in my original post, is 'what is normal?', which is probably worth a separate thread, but briefly when I began my nurse training in 1989, we were told we were not allowed to use the word 'normal', because what right had we (as healthcare professionals) to impose our sense of 'normal' on other people. That's something we should perhaps ponder in all aspects of socio-politics? 

You called?

I routinely teach about psychopathy in my work as a mental health lecturer.

I think you make a good point. There do have to be boundaries to behaviours and conduct that relate to what is accepted as normal and reasonable, however that does not preclude us from assisting those with such conditions from learning adaptive ways of managing their condition. A problem only arises when those boundaries are too rigid and inflexible. We can't afford to adopt an attitude of 'be normal...or be gone!'

Psychopathy/sociopathy is interesting, particularly in fields such as business and politics, because such people's ruthlessness and lack of empathy often propels them into senior positions (DJT, for example). Similarly, those with neurodivergent conditions, under the right circumstances, can rise to equally prominent positions of authority in their field. Einstein is widely believed (including by Prof Baron-Cohen) to have been autistic and the scholarly life lent itself to him being able to bring his genius to bear. How much genius - or simply exceptional talent - are we overlooking if we try and force autistic square pegs into the round holes of society and employers' expectations?

I think that is close to what Prof Baron-Cohen was intimating. The difficulties arise when we seek to specify what is 'normal' and thereafter socially or physically isolate those outside our specified norm. In particular, he was speaking at the first symposium of the Evolutionary Psychiatry Special Interest Group of the Royal College of Psych, and his central hypothesis was that there may be evolutionary reasons for neurodivergence.

Perhaps the reason why neurodivergence is problematic is that evolution is multifactorial, and societal influence has a role to play as one of those factors. If there is a neurobiological reason for this evolutionary divergence, have we stifled and suppressed it through our pursuance of agreed societal norms?