Erin Fitzgerald, a staff member of HDI is wearing a blue flannel and holding a washboard to make music. they are on a blue background with HDI's logo in the top left.

“All people offer perspective that is valuable to the rest of the world.” HDI Staff Erin Fitzgerald speaks on their experience with Neurodiversity and mental health

The following article discusses suicide, which some readers may find distressing. 

Erin Fitzgerald could always see the signs that she was different growing up – the tools to recognize how simply didn’t exist yet.  

“I grew up in an era where mental health was talked about very differently from how it is talked about today. There are some similarities and holdovers, but a lot of differences too,” Fitzgerald, who also identifies as queer and uses she/they pronouns, said. “In the 70s and 80s, I do not remember any conversation around mental health or counseling that did not feel totally pathologized. I do not remember myself or anyone else getting referred to talk with someone or getting assessed for something based on how we were doing or how we were feeling inside. I would only hear about mental health if someone were seen as causing a problem for other people, or seen as a problem themselves.”  

Fitzgerald also grew up in a household with a parent who was diagnosed with a severe mental illness, who did not have the same options for support and resources that exist today. “It makes me sad to think about this, because my dad struggled quite a bit and had a hard time finding the right kind of support,” she shared. “He ultimately died by suicide, which is an all-too-common scenario when people do not have the support that they need to address their mental health issues. I cannot help but wonder if he were living in a different time, and if he could have found the kind of support that exists now, how things might have gone differently.”  

Fitzgerald, who works with HDI as the CTP Coordinator with HDI’s Supported Higher Education Partnership, has had her own journey with mental health. She has had family that struggled, has worked as a support provider, and has sought support from the system as well. She was given multiple diagnoses before finally being assessed for autism and sensory processing disorder as an adult.  

“It wasn’t until some years later that I even heard the term ‘Neurodiversity,’” Fitzgerald said. “That really clicked some things in place for me. It was a turning point for me to think about the way I was wired as being a neurotype and an identity, and not a problem to be solved or a thing to be fixed.”  

For Fitzgerald, this was a revelation – and a total reversal of how anything related to mental health was treated in the past.  

But the signs were always there, and looking back, Fitzgerald sees them clearly – both in how it’s affected her view of the world at large, and how it’s affected her view of something deeply important to her – art.  

“It is interesting – I think that way my brain is wired has always affected my view on the world as well as my art. But I have not always been in good touch with what that wiring was,” Fitzgerald said. “So only in recent years do I feel that I am able to understand the degree to which that affects my view of the world, and how that is portrayed in art.”  

comic from spectrum with four squares. the top left has a person wearing a hospital gown holding their head with text reading, "Sometimes it takes a crash..." the next square show a person laying face down with text that says, “…to find a landing…” the next shows that person crouching on the ground with one foot on the floor, with text that says “…to find your footing…” the final square shows that person wearing a grey t-shirt and pants standing an a podium with a rainbow flag behind them with text reading, “…find your place.”

That’s a big part of how Fitzgerald relates to the world. Art, she said, is an essential part of her life.  

“When it comes down to it, art is the primary way that I process information and emotions. This has always been true, and not just with visual art. Music, writing, theater, any kind of creative expression – it all helps me to process things,” Fitzgerald said. “Consuming it, creating it, engaging with it, talking about it – all of these actions are extremely important to me. I can’t imagine life without being swirled up in the arts on a regular basis.”  

Today, Fitzgerald creates a cartoon called SPECTRUM that explores the multiple aspects of her journey and identity. She started the project after attending a class with Lynda Barry – somewhat accidentally, she noted.  

“I did not go there to learn cartooning specifically, but after the workshop I started drawing cartoons every day. I did not set out to draw a cartoon called SPECTRUM, or to cover specific topics such as Neurodivergence and Queerness. But that is what kept coming out on the page, so that is what I went with,” Fitzgerald said. “I have been drawing SPECTRUM cartoons ever since, and it has been a great tool for me to further process the world around me and to think more deeply about my interactions within it. It has also turned out to be a good tool for having conversations with other people around those subjects.”  

Cartoons like SPECTRUM are relevant to an emerging field known as Graphic Medicine, one that Fitzgerald says is still finding its identity. But it’s one she finds exciting for its diversity in application and accessibility. Graphic Medicine is, explained simply, the intersection between the realms of graphic arts (such as illustration and comics) and health and medicine. This can take many different forms, which is part of the appeal. It also does something that is central to a lot of work that Fitzgerald does – gives a voice to more people to share their experiences.  

“I was drawn to this field for many reasons,” Fitzgerald said. “The part of this field that is most appealing to me is the fact that engaging with and creating graphic works can increase understanding of topics such as overall health, medicine, mental health, identity, and community engagement. It can intersect and therefore help connect people and ideas from all different disciplines and perspectives.”  

Fitzgerald also notes that the principles of graphic medicine are in line with those of Universal Design and Universal Design for Learning in a few key ways – in giving people additional tools to communicate and understand concepts related to health and medicine, and in giving a voice to people receiving supports – allowing everyone the chance to learn together. In addition, graphic formats provide context and color to raw data, adding images and stories to the numbers.  

Fitzgerald is also working on a wordless graphic memoir called InQuest, which documents her perspective about the mental health system. She hopes the project will help increase understanding of that system from the perspective of people who have navigated it from the other side. “The message I find most important from that project is this: the perspective of a person experiencing a mental health crisis is valid and meaningful, and should not be dismissed,” she said. More information about that project can be found here

A spectrum comic that has someone not in frame ask, “So…can you tell me about your strengths?” A person that looks nervous responds, “Well I don’t mean to brag…but my amygdala is huge.”

Today, Fitzgerald works with people with intellectual and developmental disabilities (IDD) as they attend college – something that has only recently become an option for many. That, Fitzgerald says, is because people have historically not included the voices of people with IDD in conversations about higher education.  

“I think this is partly because of that tendency in our society to separate people into categories based on what we are told they do or don’t know, or can or can’t do,” she said. “If we want to be truly inclusive, we need to see everyone else as a partner in this journey, and not only in a specific role of expert or learner. That is how we got here, so we need to expand our own perceptions as we continue to build the way forward.”  

In general, that is a uniting factor in a lot of what Fitzgerald does – working to ensure that voices of all people are heard and valued in the process.  

“One of the main things I want people to understand about mental health and IDD is that all people offer perspective that is valuable to the rest of the world. In our society, we tend to put certain perspectives up on a pedestal as being more important, and putting other perspectives in a category as being less valued,” she said. “We tend to separate people into categories of those with expertise to share, and those who need that expertise. That is oversimplified and can be quite dangerous. It is important for us to recognize the value in all human perspective, and to stop pathologizing everything that is outside of the norm. I think we have come a long way in this, but we still have a long way to go.”  

Read Fitzgerald’s ongoing comic, SPECTRUM, here

“I hate being treated like an emergency waiting to happen.” UK student Bailey Patterson speaks on her experience with suicide and wanting to help others

The following article discusses suicide, suicidal ideation, miscarriage, and sexual abuse, which some readers may find distressing. 

Bailey Patterson was 4 or 5 when she began struggling with suicidal thoughts. 

“Things like ‘I wish I’d never been born,’ ‘I don’t want to be here,’ ‘I wish I would die,’” Patterson, a senior Interdisciplinary Disability Studies major at UK who identifies as multiply disabled, said. “Those thoughts progressed as life threw me more curveballs, where I was pretty actively having suicidal thoughts probably every day of my life when I was in middle school and high school. Still, I would never have a plan, it was just pretty aggressive thoughts.” 

That lasted until she was 16, when a friend had experienced a traumatic event for which Patterson felt responsible. Her mother interrupted her first suicide attempt shortly after that.

Patterson is not alone in struggling with suicidal thoughts. According to the American Foundation for Suicide Prevention, suicide is the 11th leading cause of death in the US. The World Health Organization reports that it is the fourth leading cause of death among 15 to 29-year-olds. The CDC reports that 12.3 million American adults have serious suicidal thoughts and 1.7 million attempt suicide. In 2022, 49,449 people died by suicide. 

Patterson considers herself chronically suicidal, but stresses that suicide is a complex issue. Mental illness is often a component of it – according to the National Alliance on Mental Illness, 46 percent of people who die by suicide have a known mental health condition – but Patterson stresses that there are other extenuating circumstances. She remembers her first stay as an inpatient in a mental health facility. The only other patients in her ward were girls, ages 12 to 17.

“There was a really common thread about gender-based violence,” she said. “Several of the girls on the ward had been sexually abused by older men.” 

Patterson noted that she thinks this ties into a major factor in suicide that is commonly overlooked.

“There’s this narrative in popular culture that if someone is suicidal, it’s because they don’t see the value in their lives or they’re depressed, and you can do this that and the other to make it go away. You can take long walks and you can eat healthier and you’ll feel less depressed,” she said. “For many people, the cause of the suicidal thoughts or the depression is the situation they’re living in. There are people living in current abusive situations that they feel they have no way of escaping from, there are people who are dealing with interpersonal violence or abuse, there are people who are homeless, there are people who are in poverty, there are people who are experiencing systemic interpersonal racism and sexism and bigotry. Those things are not things that you can walk and eat better to get rid of.”

That means that addressing those issues will help also help address the risk of suicide among marginalized populations. Patterson believes that addressing those issues while promoting mental health will do a lot to solve the problem.  

“I feel like if we understood that and worked towards those goals while also keeping in mind personal wellness and self-care and things like that, that would be a big help,” she said. “A lot of people are overlooking some of the greatest causes of distress that are leading people to be suicidal.”

She also remembers difficult times and experiences for both her and the others she met during her two inpatient stays. Among them, she particularly recalls a patient with a fear of needles being given medication by injection against her wishes when that patient felt there were other ways to administer similar medication and another woman on her second trip to inpatient services who had been pregnant when she was checked in and miscarried after being given a medication early in her stay.

That experience awakened in Patterson a desire to help others with the same struggles. Now, she channels that into standing against abuse and the loss of autonomy in psychiatric settings. Currently, Bailey is a Student Informatician with SPHERE at HDI, Officer of the Disabled and Ill Student Coalition, and an activism and research advocate in the Mad Pride and Psychiatric Survivors movements.

“The feeling of solidarity with these other with these other people who were also experiencing something similar to what I was in the moment, being there, hearing their stories changed my life,” she said. “That was the first moment where I thought ‘this is important and I want to do something about this for the rest of my life.’”

Helping others is one of the ways in which she deals with the frequent thoughts of suicide that she still experiences – and feels like she will always experience. 

“I manage, like a lot of us do,” she said. “Take it one day at a time and try to take care of myself as best I can, but I do not foresee a life for myself where I do not feel suicidal in some degree most days of my life. That’s probably just the way it is for me. That’s something that I’m going to have to continue to manage for the rest of my life, and I think that’s ok.”

She’s found a few coping mechanisms that can help when the thoughts get particularly bad. 

“One of the things that I do is I try to imagine a time in the future where I am happy,” she said. “That can be really hard, especially when you’re very depressed, but I have a couple of things in my mind, scenarios where I could be doing this thing that would be a happy moment for me. I try to really picture it and stay in that moment…then I try with all my might to believe that could happen for me one day. That’s my best coping mechanism thus far.” 

And if someone close to you is struggling with suicidal thoughts, Patterson stressed that one of the best ways to help is to keep treating them like a human being. 

“Anyone who hears that their loved one is going to have emotions that come up for them, but I think the number one thing you can do is not freak out,” she said. “You should be there, and you should attend to the problems…I sometimes get the feeling that we are treated like a danger. I hate being treated like an emergency waiting to happen. I think the best thing you can do is just be calm and present for that person and realize that the person speaking to you is the person you’ve known.”

Warning signs of suicide may include: 

  • No longer participating in things they enjoy
  • Feeling sad all or most of the time
  • Talking about dying or wishing not to be alive
  • Feeling hopeless or feeling like one has no purpose
  • Withdrawing from social groups or saying goodbye
  • Giving away important items

If you are struggling with suicidal thoughts, help is available. You can call the suicide and crisis lifeline at 988 or text SAVE to the Crisis Text Line at 741741. Both services are free and available 24/7. If someone is in immediate danger call 911 or go to your local Emergency Room.

This article represents the opinions of the author and interviewee, not that of the University of Kentucky. 

“Mental health isn’t a one-size fits all.” Austin Nugent speaks on her experience with OCD and how it may look different from what you think.

What do you think of when you think about OCD, or obsessive-compulsive disorder?   

Is it someone who has to obsessively organize their whole book collection by author? Or someone washing their hands, over and over and over for fear of catching an unknown disease? 

According to Austin Nugent, a Disability Program Administrator at HDI, even if you’re not completely wrong, you only have a small piece of the puzzle.  

“I think the most common misunderstanding is that mental health is one-size fits all, so if you have obsessive compulsive disorder, it’s going to look a certain way, like you see in the movies,” she said.  

For Austin, OCD doesn’t look like washing hands over and over again, or counting the number of times she closes the door or quadruple checking that the stove is off. It is intrusive thoughts caused by a sensation, image, or idea. These triggers are often perceived as insignificant by others, but for Nugent, her OCD attaches meaning to her intrusive thoughts leading to a great deal of distress. She gets stuck on things needing to be ‘just right’ like a conversation, the organization of a closet, the texture of food, or the formatting of a document.  

If things don’t meet the expectations of her OCD, she will seek reassurance, avoid particular situations, or perform mental rituals like ruminating for hours or days, or over explaining and correcting to alleviate her anxiety or discomfort. To most people, it may not even be noticeable that she is caught in an ‘OCD cycle.’ But for Nugent, it’s very real.  

“People often think I appear to be fine, so therefore I must be fine,” she said. “No. My brain is on a constant loop. My heart is racing, and I am super clammy and sweaty because I am on the verge of a full-fledged panic attack about something that happened two hours ago that most people would probably find very insignificant, like a typo in an email or a twitch in my eye.”  

A fear of what has happened is just one of the ways her anxiety manifests. It can also present as a fear of what-ifs.

“I also get uneasy about things that don’t happen, like someone saying something one way instead of another, convinced that I must be a ‘bad person,’” she said. “I know the twitch in my eye is probably because I’m tired, and someone not responding in a certain way is not indicative of my worth, but OCD will do all that it can to convince me otherwise.” 

But it’s not all a challenge, she noted.  

“Although OCD can cause me a lot of anxiety and be very time-consuming, I have learned to be proud of my journey, as I also find benefits and strengths in having OCD,” she said. “For example, it makes me incredibly detailed-orientated and very organized.” 

For Nugent, Mental Health Awareness Month is a reminder for others that for her, it isn’t confined to just a month. She is always aware of mental health, and the need to prioritize her mental health care.  

“Mental health awareness is a daily occurrence for me,” she said. “I need to pay very close attention and be very aware of my mental health needs constantly…if not, my OCD will rear its head and intensify, and then that ends up affecting every area of my life. Once I get in an OCD cycle, it can be very difficult for me to disrupt the cycle and move on with my day .” 

But Mental Health Awareness Month is also an opportunity. People who don’t have mental health conditions can get great benefits out of being mindful of their mental health and wellness.  

“Therapy is valuable for everybody,” she said. “It does not matter if you have a mental health condition or not, we all can benefit from having a toolkit of strategies when we’re in a rut.”  

She also encouraged people to learn more about mental health and challenge stereotypes. 

“There is so much misunderstanding around mental health,” she said, adding that just because it doesn’t look like it does in the movies doesn’t mean it isn’t real. “Don’t discredit anyone because they don’t fit the mold that you have in your mind of what OCD or anxiety or schizophrenia is supposed to be.” 

This article represents the opinions of the author and interviewee, not that of the University of Kentucky.  

Austin Nugent reflects on her experience in therapy, misdiagnosis, and the importance of finding a therapist you trust

Austin Nugent remembers the moment when someone first suggested she try therapy. 

“I was in Europe, and I called my mom from a four-star hotel on all-expense paid trip…and I called my mom from the hotel bathroom crying,” Nugent said. “She’s like, ‘why are you crying? Why are you so anxious? You’re on this once in a lifetime trip, and you’re still anxious.’ She was like, ‘When you get back, you’re going to therapy.’”

With help from her mom, Austin started seeing a therapist after she graduated college. However, she was still apprehensive to accept, and advocate for her mental health wants and needs. It wasn’t until she was talking to her brother, who has Down syndrome, when she realized that her mother might have been right. 

“I kind of had this a-ha moment…I would always talk to him about wanting to make sure he had pride in his disability, that concept of disability pride, owning his needs and feeling validated that he is human,” she said. “Somewhere along the way of having these conversations, I was like, ‘I feel a sense of hypocrisy because my needs are not being met.’”

Austin initially received a diagnosis of generalized anxiety disorder (GAD). At the time, that made sense to her. After all, in general, she was anxious. But it was not the right answer – not really. She would spend seven years in treatment for GAD before realizing that wasn’t the answer. Then, after an obsessive-compulsive disorder (OCD) specialist presented a case, Austin’s husband suggested that she revisit her diagnosis. Nugent contacted that specialist, who diagnosed her with ‘moderate to severe’ OCD. 

“I kind of had an identity crisis,” she said. “For the past seven years, I’d been the girl with generalized anxiety disorder. What do you mean I don’t have that? What do you mean that’s all been a lie?”

On top of that, the most common therapy for GAD, cognitive behavioral therapy (CBT), can be counterproductive to OCD treatment. That meant that not only did Nugent change her treatment plan to OCD therapy, she also had to spend time unlearning much of what she had learned in her previous treatment. 

“Everything I am feeling is still the same, but the way we approach it is so different,” she said. “There was a point where I really struggled with being angry at the mental healthcare system. It wasn’t anyone’s fault, but the fact that I had been misdiagnosed for so long…to know I’d spent seven years feeding my OCD and making it that much more intense meant it was that much harder to get a grasp when I finally received my diagnosis.”

Nugent says it can be difficult to find high-quality holistic mental healthcare: care that takes into account all of a person’s needs. There’s a shortage of mental health professionals, and by the time people seek help, they may have already hit a crisis point. 

And there are times when it’s difficult to tell when a condition is a symptom of something or just a general emotional response. People without mental health conditions can also experience periods of anxiety and depression. 

Nugent also stressed that people should not be afraid of medication. 

“My therapist was trying to open my eyes to the idea of medication,” she said. “I was so resistant. I was like ‘I don’t need meds,’ because of that stigma around medication. She explained that taking medication for a mental health condition is no different than if you have a broken foot and you put a cast on it and you use crutches until your bone is stable enough to walk on its own…that’s no different from mental health medication. It’s helping support your brain until you can develop those coping mechanisms and strategies to do it on your own.”

While it’s important to build coping strategies, it’s also important to have a support network. Sometimes that takes the form of an encouraging friend or partner, and sometimes it’s something as simple as having a pet to snuggle with. 

One of the most important aspects of having a support network is a therapist you can trust. Just like other relationships, not every therapist will be an ideal fit. Nugent says it’s important to trust your instincts. 

“I think we as humans, to a degree, know if something is helpful or if it’s maybe just filling time and space,” she said, adding that sometimes, “finding the right therapist, one that you feel comfortable with, yet is going to challenge you, can be difficult.” 

“I cannot tell you how many times I’m in a therapy session and I am so clammy, my heart is racing, because we’re actually unpacking and trying to work through what I need to work through,” she said. “That is uncomfortable. Behavior change and facing our anxiety is uncomfortable. If it felt good, we’d be more willing to do it.” 

But in the end, Nugent stressed that everyone’s journey looks different.

“There is no right path on a mental health journey,” she said. “It’s certainly not a linear path.” This means that there’s also room for people to cut themselves some slack if they have a rough day.

This article represents the opinions of the author and interviewee, not that of the University of Kentucky. 

Thoughts from HDI’s Glen Jennings On Autism Acceptance Month

This April, we recognize Autism Acceptance Month. This is a month where we celebrate what autistic people are capable of and work to support mainstream acceptance of autistic people. But it’s also a time to recognize systemic obstacles to autistic people. 

And there are many. 

Think about the ways in which society has a normative model of social interaction, and all the ways in which someone who cannot follow that model might be at a disadvantage. If you’re in a job interview, not making enough eye contact to satisfy your interviewer may put you out of a job that you’d otherwise have, but forcing eye contact is often difficult for autistic people. Even against an otherwise equal neurotypical candidate, an autistic applicant is at a disadvantage through no fault of their own. Once in a job, work environments can be uninclusive. Office social structures can be difficult to navigate, office politics can leave us at a brutal disadvantage, especially among autistic people with customer-facing jobs. Factors like this are likely just one part of the reason autistic people have a catastrophically low employment rate. 

Though the social aspects of autism are the most visible to neurotypical people, there are a host of other ways that life in the workplace and beyond is challenging. Sensory issues can make it difficult to navigate the world. I always have at least two pairs of polarized sunglasses close to me because bright sunlight is hard to see in and gives me a massive headache. The general noise of loud environments with a lot of conversational buzz can quickly become overwhelming. And fluorescent lights – which are used in many offices, schools, or grocery stores – can cause headaches. Staying under them for too long is physically exhausting for me, and there are many times in my life where I’ve had no real choice but to do so. 

We navigate a world that was not built with us in mind. Acceptance Month is about moving towards one that is. 

But while that discussion is important, I think we shouldn’t end the conversation there. 

As an autistic person, I feel like I also have a lot of joy to celebrate this month. 

The national view of autism has, despite these obstacles, changed radically in the since I was diagnosed almost 25 years ago. And as someone who’s so fond of pointing out that autism isn’t all doom and gloom, it feels wrong to point only to the areas where we face obstacles. 

So I want to celebrate how far we’ve come. How people are more educated about autism in this day and age than ever before. And that only leads to better outcomes for autistic people – fewer obstacles to diagnosis, which have historically been many especially for women and people of color, more acceptance and understanding and wider access to accommodations and resources. 

The fight isn’t over, but we’ve made incredible progress. 

And more than that, I want to celebrate community. An incredible autistic community has formed over the past few decades, focusing on self-advocacy and embracing our authentic and autistic selves. 

We see the world in unique ways, we have special interests that allow us to love and appreciate the world around us with such depth, and we can bring such unique perspectives and sensibilities to the world. 

And the more we obliterate those obstacles, the more autistic people will grow to recognize and accept the potential they have. And by accepting that potential, you get a better world – whether you’re autistic or not.

This month, we celebrate autistic people. This month, we work for a future where autistic people feel heard and included, and where people value us like they would anyone else.

This article represents the opinions of the author and interviewee, not that of the University of Kentucky.