Adult diagnosis – how does it help?

Dictionary definition of 'Diagnosis'
Image courtesy of

I began this blog to document my discovery of Canada but it has increasingly become a vehicle of self-discovery. The expat experience ignited beacons that guided me ever inward, to search more intensely the inner workings that gave rise to the outer journey.

It was in Canada that my heart once again opened to the fresh perspective offered by a different culture after my Pakistani in-laws’ terse rejection.

And it’s in Canada that, years after laboring under another label, I was finally diagnosed with Asperger’s Syndrome and the bipolar traits first exhibited by my father and sister. As any expat knows, sometimes it takes a change of scene to see the obvious.

Not too late to make a difference

You may question the significance of such a discovery at this point in my life – after all, I’ve come this far, how does knowing change anything? I wondered this myself; they’re just words, based on fallible human opinion. But used as a starting point to explore possibilities and look for clues about my behavior, ultimately, it clarified a lot.

For example, Asperger’s accurately explains my experience of humans as a frustratingly inscrutable species thanks to a difficulty inferring what others are thinking. It’s probably the reason I’m more comfortable in a new country where my deviations from expected social behaviour are attributed to my ‘foreignness’ and more quickly forgiven.

It explains my struggles processing certain kinds of information and my tendency to think via association rather than logic – one thought leads to another, which leads to another, and so on – a double-edged sword for a writer as it supplies inspiration and distraction in equal measure.

My previous diagnosis addressed none of this.

It also gives an explanation for my alexithymia (the inability to identify and describe emotions in the self). I’ve been complimented on my ability to describe the emotional ‘feel’ of a scene to the point where readers felt they were there, but this is something I can only do in print. When it comes to communicating feelings in person I’m a tongue-tied, taciturn lump – just ask my husband.

But by far the greatest gift of this new information has been the realization that it’s the wiring of my brain not a fault of my character that’s at the root of my struggles. This helps immeasurably in keeping things in perspective and learning to live with myself.

Never saw it coming

Funnily enough it was the bipolar II that was the surprise. With hindsight it’s difficult to understand how I never suspected – uncontrollable moods, depression, suicidal ideation (thoughts about/preoccupation with suicide) and a hereditary link – DUH!

But I grew up around a father with bipolar I, and because I never experienced anything like his money-spending, fast-talking, loud-laughter euphoric highs I figured I’d got the bum deal with plain old depression. When I looked backwards I saw only cycles of deep despair and numbing anhedonia (an inability to experience pleasure from normally enjoyable activities – “a falling dead of delight” as American philosopher William James once put it).

I know I’ve thrown an excess of clinical terms at you but the point is I never knew these words existed to describe my experiences. They helped me see my difficulties weren’t personal failures but actual, identified symptoms.

Information is power

Both of these conditions are lifelong companions. Bipolar in particular worsens over time if untreated, with 1 in 5 sufferers going on to kill themselves. But that knowledge gives me some autonomy in how I face them (and reinforces my deep-seated belief I should never have a gun on the premises). I’ve begun keeping a mood diary to chart patterns and timescales in my emotional landscape so I’m not constantly blindsided by my feelings (I’m using, a free online tool that records fluctuations in mood, irritability, anxiety and sleep).

I won’t lie to you, some days life seems indescribably bleak, but public perception plays a big role in making it more bearable; accurate information is crucial to combating stigma and making sure that perception is a valid one. The better we, as sufferers, can communicate our experience the faster this will happen, and realising you’re part of a ‘tribe’ gives you a voice and removes the humiliation of being a solo oddity.

And for the artistically inclined at least, there is an upside: both Asperger’s and bipolar have been linked to heightened levels of creative thought. Notable Aspergians include Andy Warhol, Glenn Gould, Carl Sagan and Temple Grandin, while bipolar luminaries count Lord Byron, Virginia Woolf, Vincent Van Gogh and Sylvia Plath and Carrie Fisher among their number.

Not only does this bequeath me an enviable aristocratic pedigree in terms of creative thought, it’s also a reminder these labels needn’t be a barrier to a productive and artistic life. Admittedly things didn’t end well for the final four mentioned above, but famous bipolar creatives ‘hanging in there’ today include Jean Claude Van Damme, Linda Hamilton, Richard Dreyfuss, and my personal hero, Stephen Fry.

Looking ahead

The bipolar/Asperger celebrity angle gets a lot of attention, but unfortunately some of the coverage is still uninformed or unbalanced in its negativity and so much valuable information about how successful people have triumphed over their conditions never makes it into the popular media.

But the times they are a’ changin’, and with more voices than ever before campaigning for greater awareness and understanding public opinion is starting to accept that these conditions don’t preclude a successful future. Getting my diagnosis was like being handed a key to my prison, not a life sentence.

By Aisha Ashraf

An autistic Irish immigrant in a cross-cultural marriage, Aisha Ashraf is the archetypal outlander, writing to root herself through place and perspective. Published in The Rumpus, The Maine Review, River Teeth, HuffPost and elsewhere, her work explores the legacy of trauma, the nature of being an outsider and the narrow confines of belonging. She currently lives in Canada.


  1. I’d never heard of alexithymia but after doing some research it sounds very familiar to me, I try so hard to talk about things with my husband but it’s like I physically can’t, things just get muddled up and I’m never sure if the emotion I think I’m feeling is ‘the right one’.
    Out of interest did you approach the dr about the Aspergers syndrome or was it suggested to you as something you might have? I’ve always wanted to discuss this with my dr but worry (probably excessively!) about looking like a hypochondriac.

    1. Because my daughter was diagnosed first it made me feel slightly more comfortable pursuing my suspicions – but only slightly. I actually wrote down a few words to use when speaking to health professionals because I felt I would be perceived as ‘jumping on the bandwagon’ or worse, trying to hijack attention and care from my child if I didn’t put myself across properly. It was tricky, but I’m glad I persisted. The ‘hypochondriac’ label also came to mind but I knew that my records wouldn’t reflect it – until my recent difficulties I’d only been to see the doctor once in four years.
      You know best how you feel – don’t let anyone tell you otherwise. Go prepared: do some research, make a list of ways in which you see the condition in yourself, and don’t feel silly about taking it out and reading it to the doctor. That’s what I did and the Dr. who diagnosed me was actually pleased that I had it all written down and to hand – it made his job a little easier.

  2. As you say knowing what is wrong is the first step to putting things in place to manage your aspergers. I know from personal experience that living with a lifelong condition can be really dark sometimes

  3. I’m so sorry that you have some bleak days, but I hope that moving forwards, your newfound knowledge about your conditions means that those days will become less frequent. As you say, at least you know it’s not your fault, and maybe you’ll now be able to work towards self-help. And such illustrious names to be in company with!

  4. I think knowing what it’s even called can help a little. The not knowing what is wrong is definitely harder to deal with. I hope you are now able to find a way to live life happily in a way that helps you.

  5. Being an expat and changing country and cultures really does open your eyes inwards. You learn so much about the new country and culture, but you learn much more about yourself. That is what has happend to me also.
    I would say a diagnosis is never too late. Only if it’s done post-mortem 🙂 It’s always good to know yourself and there are always new things to discover.

  6. This is not the first time i have experienced a slice of your succulent writing. Very informative and equally interesting from a strangers eyes.

    You are part of a tribe in so many circles and i hope you continue to get the support you need x

  7. I’m happy for you as this information means so much to you (plus I’m a fan of ‘knowledge is power’). I’m just a little uneasy with the thought that this diagnosis frees you from a sense of character failure. Surely you don’t attribute such a label to others suffering from the stigma of mental illness, right?

    1. Not at all and I’m surprised you’d suggest that given the stance I’ve always occupied against stigma.

      While I have encountered those who wield their diagnosis and the stigma surrounding it as an excuse to shirk any sense of responsibility for their behaviour, my sense of character failure arose from ignorance of my condition and the mistaken conclusion that my shortcomings (and my inability to eliminate them) were my fault.
      For example, when speaking to someone in a noisy environment I cannot filter out the extraneous sound and focus on the conversation. It’s the same on the phone, I have to have absolute quiet (it used to drive my husband bananas). I believed this was poor concentration on my part, but it’s actually poor executive function, the set of mental skills coordinated in the brain’s frontal lobe that help us manage time and attention, switch focus, plan and organize, remember details, and integrate past experience with present action.
      It’s removing that lifetime’s weight of constantly falling short that my diagnoses are allowing me to work on. Treatment for Borderline Personality Disorder was all about changing entrenched negative thought patterns – with Aspergers and Bipolar there are no changes I can make that will alter the way my brain works. I will always see things differently and I’ll always have a propensity for extremes of mood and emotion.

      1. Agreed, I KNOW you haven ‘t thought it was a character failure in others, it’s how their brain works. You thought your brain worked one way (and were dealing with it according to that diagnosis), when lo and behold it works a different way. Mind boggling – pun intended – and you’ve described so beautifully and thoughtfully how that’s affected you. It just saddens me that you EVER wondered/felt it might be a character default. So often we are hardest on ourselves while extending great mercies to others…

  8. Coming from another BPD family, I really appreciated reading this post. It’s been a long journey learning to understand the people I love. I’m also prone to depression so it’s been a journey accepting it and getting help when needed.

  9. I’m pleased to hear that you have a diagnosis. You are right, knowledge is power and now you can move forward with that information that will help you. It’s amazing how a change in life can make you look at things more clearly.

  10. Excellent article, very well written and of course knowing about and accepting the facts of any illness mental or physical are the first steps in successful treatment .

  11. Oh I love this, put a lump in my throat: “But by far the greatest gift of this new information has been the realization that it’s the wiring of my brain not a fault of my character that’s at the root of my struggles”.

    You write so so incredibly beautifully. I am so glad you are on this inner journey of self-awareness. I am on one too, and it is both enlightening and painful. It’s like you have to learn how you’re built at the age of 40+ and then finally shed the bits of your heritage and wiring (and beliefs) that don’t serve you. It must be so cathartic for you to blog your journey. Beautiful to read of.
    Liska x

  12. So sorry about your bleak days
    And I understand as I am a child of a bipolar mother and I am currently in CBT
    I talk very much thorough my blog posts

  13. It’s good to hear that you finally got a diagnosis. I think it’s such an important thing to have – it gives you more knowledge about who you are and that can only be a good thing.

Fewer than 1% of visitors leave a comment - be different, be heard, be someone with an opinion.

This site uses Akismet to reduce spam. Learn how your comment data is processed.