Alcohol: An Autistic Masking Tool?

CW: discussion of suicide

Sometimes it feels inevitable with a brain like mine, stuck on a loop of worry and terrified of everything. Standing in line at the grocery store and hearing it all at once. But I have always been a great problem solver. When I realized I could give this sensitive brain a liquid buffer, that it was as easy as pouring it over ice and choking it back, I thought I’d found quite a practical solution.

You call it “substance abuse”, I call it my best educated guess.

And it started tasting better, the more I drank. Soon I wasn’t choking. The bitterness felt good, like a cut that stings but reminds you that you’re alive. Like endorphins on the tail end of pain. It was the only time I felt calm, a sort of relief. It still is.

I could tell you stories, but the truth is, I don’t remember much. I don’t think I was a very good person at the height of it all — alcohol tends to distort your morality. Bad ideas glisten in a drunken sheen. They shatter all around you, glitter and cut.

It took me fifteen years to try sobriety, and I only did it because I thought it would ease my depression. Because one night in bed I was wasted and crying, texting my friend about how much I wanted to die, and he texted back, you’re scaring me.

It is scary, especially considering that autistic people are 7 times more likely to commit suicide, and there are no autistic-specific suicide hotlines (and if there were, truly, it would be text-based. Phone calls are a nightmare).

There’s barely any support for autistic adults at all. Typing “autism therapy” into Google will get you endless pages of services aimed at teaching children how to perform neurotypical behaviors, a practice which directly contributes to trauma, self-harm, and suicidality in adulthood.

The depression got slightly better when I stopped consuming a depressant everyday (go figure), but the anxiety has been the same since I was an agoraphobic six-year-old. Without alcohol to hold my overactive nerves steady, The Fear took over.

There are lots of things I can’t or won’t do anymore, when I don’t drink. In many ways I think I was more “functional” back then. I know, heavy drinkers say things like that, but really — I held down a job by drinking. The most money I ever made in a year (which was still below average income for the US), I made by drinking heavily through my shifts.

I made friends by drinking. Alcohol gave me dating and adventures and sex. Without it, all of these things are much harder, some of them impossible. I don’t leave the house very much anymore. In a lot of ways I became a more autistic person when I got sober.

In one of the only books I could find on this topic, Asperger’s Syndrome and Alcohol, co-author Sarah Hendrickx writes:

“We have a suspicion that many people do not know they have AS because their drinking hides it and ‘normalizes’ them.”

She notes that, when asked how they dealt with social situations, autistic people who did not drink said they simply avoided them. She proposes that drinking may grant some autistic people access to the social world, where they can practice social skills and learn to mask.

In a 2020 study on a sample that was “predominantly female, late diagnosed, and well-educated”, participants reported that they drank because alcohol made verbal communication easier. The researchers concluded that, counter to studies which previously suggested autistic people are never motivated by social factors, “..social facilitation may be the strongest motivation for autistic adults to drink heavily.”

This was certainly true for me. As a teenager, I could not deal with the school day sober, but despite being under some kind of influence on a daily basis, I also managed to get through it with average grades. In college, I drank heavily (among other substances), worked a job, took a full course load, and still somehow managed to make the Dean’s List every semester.

I was very good at pretending I was okay while frequently having what I assumed were panic attacks, which I managed to hide from everyone until I started dating an exceptionally supportive partner in my early 20’s, who became the first person I ever allowed to see my meltdowns. (To this day I can count these people on one hand — People Who Have Seen Me Meltdown is a highly exclusive club.)

I didn’t consider that I was autistic because of alcohol, and I didn’t consider that I was an alcoholic because alcohol was not hindering my functioning — in many ways it was facilitating it.

This is called “self-medication”, and it’s something most people do with alcohol to some degree, although it seems to be somewhat different for autistic people.

In the book Drinking, Drug Use, and Addiction in the Autism Community, the authors quote a memoir by Tim Page, a Pulitzer Prize winner who was diagnosed autistic late in life, in which he describes a horrible time where he got sober and was consequently unable to leave his house. He writes:

“Once I returned to wine again, it felt as though I had reintroduced a central solvent that my body chemistry had been missing for the better part of a year. I am not inclined to repeat the experiment.”

Substance abuse treatment in the US has been based around abstinence for a very long time, and I’m sure many sober people may consider what I’m suggesting here to be sacrilegious. But as an exvangelical, I have no interest in abstinence of any kind, and the religiosity of 12 Step programs has never been appealing. The practicality of harm reduction resonates far more with me.

If I am able to manage my drinking and use it as a tool, is it still wrong to self-medicate? What good is abstaining if I can no longer “function”? Can I learn healthy coping skills and still use the less-healthy ones sometimes when I need them?

I have started to think about alcohol the way I think about masking, the exhausting practice of performing neurotypicality (the two are very closely linked for me, after all).

It’s not necessarily good for my health, but sometimes there are no other ways to get through a situation. I no longer think it’s realistic to expect that I can fully “unmask”, when it’s a process that’s so automatic at this point, it’s woven into the fabric of who I am.

In her memoir, author Sarah Kurchak writes:

“I don’t have a mask I can remove, I have a multiheaded, deeply embedded parasite. It’s probably killing me, but it’s also kept me alive, and I don’t know how much of it I can remove and still survive.”

Maybe it’s more realistic to learn how to manage my masking (and drinking), to do it only when necessary, and to make the goal not complete abstinence, but the least possible harm to my health.

I respect sobriety. I respect that it’s the only option for many people, that it saves lives. But does it save mine? It’s not going to get any easier being sensitive in this fucked-up world, and as a firm believer in autonomy, I always tell people to use the tools they need to get by.

However controversial this stance may be, the fact remains that alcohol has been a very useful tool for me, and now that I understand myself, my limits, and my motivations for drinking, it feels far easier to manage.

What seems more important to me than abstaining completely from alcohol is understanding myself. In Hendrickx’s book, co-author Matthew Tinsley tells a harrowing story about how he drank himself into cirrhosis before he was hospitalized and discovered he was autistic in his 50’s.

The illuminating power of self-discovery is a common theme in autistic memoir, and in this particular sense, I think the root of the issue goes far deeper than the drinking — it’s the confusion and pain that comes from not understanding who you are and what supports you need.

I would not have had similar revelations without sobriety, as alcohol was a huge part of my own mask. Ironically, when I got sober and went to see a psychologist with my suspicions about being autistic, she brushed them off and diagnosed me with substance use disorder instead.

“You wouldn’t have done so well in school,” she said, which is hilarious, considering that I used alcohol as a means to do so.

It’s quite common for practitioners to believe that substance abuse precludes a person from an autism diagnosis, especially if they’re not keeping up on their research.

Older studies that looked at autistic people and addiction found little correlation, which created a stereotype that we are pure and innocent beings who are incapable of doing drugs. But these studies mainly looked at autistic people who had high support needs and lived with caregivers, which meant they didn’t have access to peer groups where they could encounter substances and couldn’t easily acquire any for themselves.

More recent studies have found that this idea of purity doesn’t hold up when looking at autistic people who are late-diagnosed, or what is often referred to in the literature as “high functioning” (though much controversy surrounds this term).

This group actually experiences higher rates of addiction than the general population and higher rates of suicide, too, which makes sense to me. Greater masking abilities have been linked to worse mental health outcomes.

If you’re able to work and live on your own, but you’re pouring alcohol on your suffering everyday to get by, you’re going to burn out. It’s not a sustainable way to live, and hopelessness can set in, because you’re not struggling enough to be diagnosed (you have a job, after all.. /s), but you’re definitely struggling more than everyone else you know, and you have no idea why.

There is some kind of tragic irony in the fact that using alcohol to get through life can simultaneously prevent you from knowing yourself and exclude you from accessing appropriate support that could help you develop less destructive coping mechanisms. I am consistently amazed at how seldom mental health providers seem to ask why. They stop at the symptoms and don’t dig for the root causes.

This is can be harmful, because the most common treatment methods for substance abuse are based in support groups and cognitive behavioral therapy, both of which can be inappropriate for autistic people who are socially anxious and have perseverative cognition (I know neurotypicals tend to think CBT is a gift from God himself, but many of us find it extremely unhelpful.)

What’s really helped me need less alcohol are sensory-based techniques — designing a “sensory diet” for myself, understanding what triggers and what soothes, and setting up my life in a way that accommodates my needs (like not forcing myself to endure unnecessary situations that require extensive masking and will make me want to get drunk).

Discussing alcoholics’ reasons for drinking, chapter 2 of the AA bible says “..in their hearts they really do not know why they do it.” But I can’t relate to this, because I know exactly why I drink now, and the answer for me is controlling the factors that trigger my drinking. I fear I would not have learned these things about myself if I had been referred to a 12 Step program.

Autistic people aren’t angels. We can be alcoholics, we can take drugs, and we can break rules.

Drinking alcohol and doing drugs should not preclude someone from an autism diagnosis — on the contrary, these should be red flags that something else is going on, and should encourage deeper inquiry.

Autistic people are people; don’t deny us the humanity of being flawed.

writer + digital artist focused on disability, queerness, and culture | they/them

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