Dr. Gwynette: Hello and welcome to episode five of the Autism News Network Podcast. My name is Dr. Frampton Gwynette here at the Medical University of South Carolina, and I’m joined today by a very special guest named Josh Miller. Welcome Josh.

Josh Miller: Hello.

Dr. Gwynette: Thank you for being here today. We have some exciting topics to cover and I wanted to thank our audience for joining us. Josh and I have known each other for a long time and he has given his time today to tell us a little bit about his world with autism. Josh, just to start out, do you remember how old you were when you first got the diagnosis?

Josh Miller: Be honest with you, I don’t. I know I didn’t talk till four, but I’m pretty sure the doctors were noticing something was wrong before that. You got to keep in mind, I’m 32 years old. This would’ve been right at the, either, real late ’80s or early ’90s. Autism back then definition was you were either low functioning, the stereotypical kid head banging against the wall.

Dr. Gwynette: Right.

Josh Miller: Or you just didn’t have it at all. There was no gray area. It was almost like being pregnant, you either wore or you’re not.

Dr. Gwynette: Gotcha. I guess receiving the diagnosis, was it kind of confusing it at one point?

Josh Miller: Well, I mean from what my mom tells me, because like I said, I have no recollection. I can’t talk. But, I have no memory of it. But anyway, she remembers, she told me that the doctor came and he’s like, “Well he’s got autism. Good luck with that.”

Dr. Gwynette: Man … That was the way it was back then. As you mentioned, you started talking when you were about four. For our audience, children who are developmentally on time typically say their first word by about one, and will say a combination of two words by about age two. Then at age three they’re using two to three word sentences. To not talk by age four, that was a pretty significant delay. You had a lot of ground to make up there. Did you do speech therapy or any other therapy?

Josh Miller: Through the elementary school. I went to Fishburne at the time in Hanahan.

Dr. Gwynette: You remember?

Josh Miller: Vaguely.

Dr. Gwynette: What was it like in elementary school for you?

Josh Miller: I mean, the only thing I remember about speech therapy, because I have … The only thing I remember about speech therapy is one of the students was wearing Jurassic Park shoes.

Dr. Gwynette: Do you remember-

Josh Miller: They were making a noise. That’s the only thing I remember about that. Then from what my mom tells me, I don’t really remember too much. But I know I constantly had a tendency when she would drop me off to run out into the middle of the street, and the Fishburne parking lot it was very small. Right there on a sharp curve… The principal was always running after me, that and my mom.

Dr. Gwynette: Because you would be like running [crosstalk 00:00:03:13]-

Josh Miller: Yeah. I didn’t want to go into the building.

Dr. Gwynette: Okay man. It was not a pleasant thing for you.

Josh Miller: School really wasn’t, as a whole. It just, it really wasn’t. I’ve managed to block a lot of it out just because it’s unpleasant. But yeah, it really wasn’t.

Dr. Gwynette: If it’s okay, I was going to ask like was it like bullying or was it teasing?

Josh Miller: I didn’t really … I mean I didn’t really get bullied too much until we moved to Alabama because my parents got divorced. I didn’t really take the divorce too well. That’s when I started trying to commit suicide. This was back when I was in … I don’t know. This was five, sixth grade. Fourth grade.

Dr. Gwynette: Okay. Even as a youngster, you’re experiencing a lot of depression and anxiety.

Josh Miller: Well, the divorce brought a lot of it out. I had a crazy father, so he may life, part of my language hell. That didn’t help. But, let’s see, what was I saying? But that was my first instance of bullying because when I was playing on psych medicine I ballooned up. Because that’s a side effect, unfortunately, of psych meds.

Dr. Gwynette: You had some weight gain.

Josh Miller: Why did the kids in Alabama were making fun of me, that I’ll have no idea because Alabama is a very poor state. Just about every other kid there was overweight.

Dr. Gwynette: [crosstalk 00:00:04:44]. Right from the get go, you’re in an elementary school, middle school, and you’re getting a lot of difficulty from peers getting teased and bullied. Was it difficult for you to make friends coming up?

Josh Miller: Yes and no. I mean in middle school I had the easiest time because I mean I would be able to … I don’t know. I mean I would play tag with the kids there, but I never went to anyone’s house because I just couldn’t do it. I didn’t really have a really, really bad time with bullying until I’d say I went into high school. Right at the ninth grade.

Dr. Gwynette: Yeah. Throughout your life you’ve had difficulties with being depressed and being anxious. Can you take us through like one of those cycles? What’s it like for you when you experience it and how do you pull yourself out of it?

Josh Miller: Well, I mean, just like lately I’ve been dealing with a lot of depression, anxiety. My go to thing every time I would feel this way would be to … The stress would get so much because, to me, I consider depression like a black hole. It slowly pulls you in until you get to the point of no return to where it just sucks. You can’t get out of it. Usually my point of no return would be I would try to commit suicide in one form or another because just the emotions and everything was just too much. But ever since I’ve had the TMS treatment, I haven’t really … I mean there are times I … Not think about I’m going to do this and that, but the thoughts will quickly cross into my mind. Like, I wish I wasn’t alive. But I’ve trained myself to, as soon as I notice that, I pull up. Almost like an airplane going down, I managed to pull up, try not to dwell on it. I credit the TMS, mainly, for that.

Dr. Gwynette: TMS is transcranial magnetic stimulation and so you had that, and that is an FDA approved depression treatment using a magnet which is placed on top of the skull. You respond to that pretty robustly.

Josh Miller: Yeah, because … I mean there’s no medicine in this world is a cure all, there’s no magic wand unfortunately. But what that did for me is that allowed me to be able to notice things when I go into a nosedive, I start to notice it earlier on before I get to the point where I’m wanting to take a bunch of medicine to opt out. That’s where I really credit it because like now I’m depressed, and lonely, and anxious. But I’m able to catch myself to keep from crashing.

Dr. Gwynette: Exactly. You and I have had a lot of conversations about when those moments are coming, a lot of times you try to distance yourself from others so that you don’t kind of drag them down with you. Can you take us through that thought process?

Josh Miller: Well, I’ve always struggled with friends because I mean at the end of the day, I am my own worst enemy.

Dr. Gwynette: Aren’t we all? You’re in good company there.

Josh Miller: I’m not a happy person. No matter how much I wish I was, I mean, I could be in paradise and I would inadvertently find something that I don’t like about it. I’m always the glass half empty, versus the glass half full. When I started to feel that way I don’t want to drag people down with me because I have two brothers, and neither one of them talks to me. Pardon my language, but I made their life hell. Inadvertently because I unfortunately took up a lot of the attention that my mom had because of my autism. Because my mom’s a single mother there’s only one of her. They unfortunately got the short end of the stick, if you will.

Dr. Gwynette: Do they still … Do you feel like they actively hold it against you or do you feel like it’s kind of unspoken?

Josh Miller: No, they hold it against me.

Dr. Gwynette: That’s a shame. We do see that as siblings that you need a lot of support as well because typically the individual with autism is kind of like the “identified patient”. And they get a lot of resources and attention. But it really is a condition that affects the entire family, and the whole family needs support. But they haven’t to this point, reached out for any support. Sounds like.

Josh Miller: Well, I mean my brother … I don’t want to talk too much about him. But he’s got his own issues and I mean it’s unfortunate. I always love him, and always will. But unfortunately because of my autism, he got … I required more attention, and my mom at the end of the day is only one person.

Dr. Gwynette: Yeah. Making friends and keeping friends is something-

Josh Miller: About where we were.

Dr. Gwynette: You’ve had to work on that over your life.

Josh Miller: Because when I start … That’s where I was going with my brother. Because of that, my autism, that’s why I’m not … That’s why it’s hard for me to accept and be proud of my autism like these other people are. Because you know, a lot of people will say it’s a gift and everything. But to me from my own personal experience I’ve seen what it can do to the family as well. It’s not all rainbows and butterflies, like on the Big Bang Theory.

Dr. Gwynette: Right.

Josh Miller: There are some … Just like with any mental health type thing, there’s always a dark side to it. I mean, with anything. That’s why I have a hard time accepting it because I feel like I’ve done a lot of damage to my family. I feel like I took a lot of the attention that my other siblings needed. And because of that, because of the way it hurt my siblings, I don’t want to hurt other people because I feel like I’m an empath. I take everyone’s emotions into myself, I don’t want to hurt other people. When I get to notice myself on a spiral, I just want to … I tend to alienate people because they got their own problems. Especially other people with autism. I don’t want to drag them down with me. Almost like a drowning person in the seat constantly grabbing someone and then they end up killing the other person.

Dr. Gwynette: Exactly. It’s a very selfless thought to think, “Okay, if I’m going to go down, I don’t want to take people with me.” You and I have talked sometimes too about how … Let’s say, I think about the Jewish community, because let’s say there’s a death in the family. I’ve watched Jewish families come together, and sit Shivah for days at a time to support the family who’s lost a loved one. To talk, to eat, to cry, to hug, and to pray together. We really are all social beings, and yet with autism there’s a tendency maybe when things go poorly to try to distance oneself rather than reach out for more support. Do you feel like that’s … That you’re hesitant to reach out for support when things are not going well?

Josh Miller: I mean to other friends. I mean not to medical professionals, but to nonmedical professionals. Bear with me. I hate when my mind thanks faster than my mouth can speak. With medical professionals’ no, I don’t push them away. But with other nonmedical people like friends or acquaintances, yes. I do tend to push them away because I don’t want to hurt him by … Because I have a tendency to … I feel like, maybe it’s in my head, but I have a tendency to suck people down with me because I’ve done it with my brothers. But you know, I don’t want to do that to other people.

Dr. Gwynette: Yeah. We had mentioned before in a previous podcast, complete the sentence if you can remember, a friend is someone who knows all about you and …

Josh Miller: Chooses to stick around with you or something like that.

Dr. Gwynette: Yeah, they like you anyway. I think that’s been a hard sell for a lot of the folks I work with is saying you, you are loved, you are cared for, you do have a support network because they’re so used to being alienated and people giving up on them. It does take time to kind of learn that you do have a group.

Josh Miller: Well me personally, I mean, I’ve had a unique life. Most people … When you get to be my age of 32, you’ve had experience of being friends and everything. Usually you’ve learned those skills through grade school. But for me, because of my unique upbringing, I was constantly in and out of the psych hospital. It’s hard to make friends when … Because kids, especially back then, really didn’t understand it. They don’t want to be friends with the different kid that just disappears for two weeks. Between that and because I was constantly in and out, I didn’t really learn the skills to learn how to be a friend that most people have.

Dr. Gwynette: Right.

Josh Miller: Now I feel like I’m playing catch up at 32.

Dr. Gwynette: Exactly.

Josh Miller: I mean there’s a lot of things that people do like, like date and stuff like that. They have their first girlfriend in high school. I’ve never experienced that because again, I was an emotional wreck. I was too busy with dealing with that to have friends or even a relationship.

Dr. Gwynette: Yeah. Individuals develop at different times and like you said, now you’re in a phase of your life where you’re beginning to realize the importance of friends and making friends. You’ve also done quite a bit of school. I know some of your experience has been very positive, and some has been as positive. Do you want to take us through some of the ups and downs of your school career? Especially in college.

Josh Miller: Well I mean for college it seems I’ve had a hard time with going into a physical building because when I would go into a physical building, or college building, all schools seemed to look alike on the inside. You have the top, the stereotypical standard white tile floors. And this ceiling that looked like tiles but they’re kind of styrofoam like things.

Dr. Gwynette: Sure.

Josh Miller: They all look the same on the inside. It just seems like when I see that, I instantly get flashback of being in high school. Then I’m on edge like a cat getting ready to attack, mostly afraid that the kids are going to start pushing me again. I have that emotional flashback to where I feel like I’m that small little kid because I didn’t hit puberty yet when I went to ninth grade. I was a little, little kid. Among all these other teenagers that were going through puberty. I just have that emotional flashbacks, so I had a hard time. It was a distraction because all the energy of trying to focus on schoolwork was being diverted for that flight or flight response.

Dr. Gwynette: Just making it, making it through the system.

Josh Miller: Because of that I got overwhelmed with emotions and I usually had to drop out. It seems like lately the only thing that seems to work is I’m taking classes online for medical billing and coding. I’m going to be honest with you, I’m not really a fan of it. But the classes for anything does 100% online is limited. I went with it because my mom said that I’d be good at it.

Dr. Gwynette: Well, as our audience can clearly tell academically there are no real challenges for you. I think it’s other challenges like you said, like the environment of the school. Maybe the schedule, a new building, dealing with people either in the hallway or in the classroom with the teachers. Also dealing with your own expectations.

Josh Miller: That’s another thing because I have a 4.0 grade point average right now.

Dr. Gwynette: That’s awesome.

Josh Miller: But in my mind it’s almost like I have a stereotypical tiger mom, if you will, on my shoulder. Like, “Well you had a 97 that could have been a 98.”

Dr. Gwynette: Right.

Josh Miller: I don’t know why I have that expectation. My mom is not like that. I mean, she’s not. But for some reason I see something and I could have done better. I don’t know why. And that stresses me out.

Dr. Gwynette: These high expectations, where do you think those come from?

Josh Miller: I don’t know, to be honest with you. I’ve always had it my whole life. I mean, even in grade school, I would … I’ve always wanted to do these extravagant, and when it was time for us to do a project, I couldn’t do a simple project. I had to go all out. I mean, then I had it all in my head like it was going to look like this movie production thing. But I had a tendency to procrastinate because I get overwhelmed. I would always wait till the last minute, and I mean literally the night before. We would all get stressed out trying to do it, you know? It never quite worked out in my head. The finished product was not what was in my head. But I don’t know where it comes from. Just like I love to write, but I can never get past the plotting outline of the story because in my mind when I’m plotting it, it has to be perfect. I don’t know why, but it does. I get so stressed out trying to make it perfect that I get stressed out, burned out and overwhelmed. And have to take a nap because I just spent all my energy. It’s really bad.

Dr. Gwynette: Well, I think that’s where the autism comes into play because there’s this feeling kind of rigid, an all or nothing type of thing. Maybe some perfectionistic qualities there. Then in the end that exhaustion from being so stressed out about it. Then I think if you do take a break from, in that case, the writing and say, “I’m going to just take a break from it and put it down for a little bit.” Well there’s a sense of, I failed.

Josh Miller: Exactly.

Dr. Gwynette: I failed to realize the dream. That’s what we’re, of course, trying to reverse here at the Autism News Network is say, “Okay, let’s not think about all the things that we’ve … Projects we’ve stopped and dropped. But let’s think about the ones that we finished.” Here you are today cutting the podcast. I wonder if any of your high school classmates have ever cut a podcast?

Josh Miller: I don’t know.

Dr. Gwynette: Probably not.

Josh Miller: I don’t know. I mean, I think I went to school with the smokes guy, the baseball player. I think I went to school with him. I’m sure he’s done a podcast or two. But if he’s the person I’m thinking it was, because I blocked a lot of that out. But-

Dr. Gwynette: Do you ever have people tell you that you have a lot of courage?

Josh Miller: My mom tells me that. I know you’ve told me that, but I’m going to be honest with you. I don’t feel it. I mean, again, I feel like there’s stuff in my life I could’ve done better and I don’t see it as courageous.

Dr. Gwynette: Well, to give our audience just a little glimpse of why Josh is courageous. I mean, to me courage is like when you’re afraid to do something, but you do it anyway in spite of your fears. Josh does that every day. He has overcome a tremendous amount, even just to be here today. I know there was a lot of stress and anticipation of this podcast, and I think it’s going incredibly well.

Josh Miller: It is.

Dr. Gwynette: Congrats on that.

Josh Miller: Thank you.

Dr. Gwynette: Tell me about in the job or in the workforce, you’ve had a few different jobs, some of which you loved. And some-

Josh Miller: I’ve had one. No, I’ve worked at two. The second one was very short.

Dr. Gwynette: Was one the museum or-

Josh Miller: No, that was just something an old friend was doing. His wife didn’t really want it. He wanted it. He was someone like me to the extent where he had these grandiose ideas in his head and it was hard to make it a reality. That and his wife was really being difficult on it because she didn’t want it.

Dr. Gwynette: What was the other job you had?

Josh Miller: The jobs I’ve worked at was on … I worked for a short time. I worked for a year. That was the longest I’ve ever worked at Dollar General. That lasted a year.

Dr. Gwynette: What’d you do there?

Josh Miller: I stocked. For me it was hard because I like a clear cut job where a beginning and an end, you know. With stocking there’s no end to it.

Dr. Gwynette: Right.

Josh Miller: I mean there’s always more product to put on the shelf. There’s no light at the end of the tunnel because there is no end to that tunnel.

Dr. Gwynette: It’s like a mail carrier where you feel like no matter how good I do today, it’s always going to be something else tomorrow.

Josh Miller: That was stressful. That, and the fact that the specific store that I worked at, we went through I think five or six store managers in one year. Which was unheard of.

Dr. Gwynette: Wow.

Josh Miller: Every time he had a new store manager, they had their own individual idea of how they’re going to make it better.

Dr. Gwynette: That change. Yeah.

Josh Miller: It was hard to keep up because I don’t really like change too much.

Dr. Gwynette: That’s right.

Josh Miller: I mean, I feel like if you wind me up, tell me exactly what I have to do, I’ll do it. As long as it has a beginning and an end. It was hard to do that there and I got burned out and had to quit.

Dr. Gwynette: Yeah, exactly. We’ve covered some really important topics and talked about family, you talked about anxiety and depression. How is it that despite the ups and downs, what is it that you hang your hat on that gets you out of bed every day and says, “Hey, I’m going to give it another shot.”

Josh Miller: Well, I mean, my mom’s got a lot on her plate right now. I don’t want to … I feel like if I opt out that would be too much for her. I’m not suicidal. But you know, that’s one thing that gets me out of bed to. It’s just, believe it or not, I do have hope. I want to believe that one these days, I’ll have a friend. And eventually a girlfriend. That’s pretty much what helps me get out of bed, just I have to have hope that eventually it’ll change.

Dr. Gwynette: Absolutely. I believe it will and I believe through all your hard work and perseverance and just your incredible courage, and your attitude, that you’re a huge inspiration to a ton of people. I think people you’ve met in person, but also hopefully our audience as well here on the Autism News Network Podcast. I think we’re going to wrap it up there. That’ll do it. But Josh, will you come back and see us again?

Josh Miller: Yeah.

Dr. Gwynette: We would love that. We can get into other topics, and I know you had touched on earlier the South and Mental Health. That’s almost a whole podcast to itself, isn’t it?

Josh Miller: Yeah. I feel like the two best things that for people who don’t know about the South, want to know what it’s like. I mean, watch Prince of Tides and King of the Hill. Because I feel like those two things explain the South, especially Prince of Tides, and mental health and how the South has dealt with it incorrectly.

Dr. Gwynette: Yeah, exactly. We’ll plant that seed for the future and hopefully have you come back another time. Josh, thanks so much for being here.

Josh Miller: Thank you.

Dr. Gwynette: All right. That concludes episode five of the Autism News Network Podcast, and we hope to talk to you again soon. Thank you.