In the last two months my teeth have deteriorated dramatically. The dental cost so far is over €5,000. That is more than my monthly survival budget. The damage is not from neglect. I brush, I floss, I have done both consistently for years. The damage is from stomach acid that should not be where it is, and the reason it is where it is connects all the way back to the medications and supplements I take to keep myself functional in a country that has refused to make any other accommodation.
This article is about that connection. It is also about something a neurodivergent life in a neurotypical world makes you understand directly: damage shows up in places no one tracks, and what is visible from outside is not what is happening to the body inside. From outside, I look like someone managing. From inside, the managing is itself a cascade of harm. The institutional letters that decide my disability, my residency, my recognition see only the surface. The surface is not the body.
What I take, and why
The regimen, to be specific:
An antidepressant, prescribed and covered by Austrian insurance. Without it, depression deepens to a point that is itself dangerous. With it, certain GI side effects are predictable.
Medications prescribed for ADHD and ASD-related symptoms. Each one with its own profile.
Tyrosine, an amino-acid supplement many late-diagnosed adults end up on for focus and stability. It interacts with the gut. It interacts with the other supplements. It is part of a stack I built myself, because there was no one to build it with me.
This regimen has never been reviewed by an integrated treatment team in one place. I have read more peer-reviewed pharmacology in the last five years than I ever expected to read, because there has been no one between me and my own treatment.
The cascade, mechanically
The combination affects how my stomach works. Certain medications relax the lower esophageal sphincter. Certain supplements alter gas production. The result is reflux, repeatedly. Stomach acid reaches places it should not reach. Tooth enamel is the most visible casualty.
In the last two months the deterioration accelerated. Over €5,000 in dental work has gone into stopping the immediate damage. There is no fund this is coming from. There is no insurance category that fully covers acid-erosion damage when the underlying cause is medication-related rather than caries.
So I am paying, in money I do not have, for the consequence of a regimen I take because nothing else exists.
Even the dentists can't see it
The cascade does not stop at the body. It continues into the system that is supposed to identify and stop the damage. In the last month alone I have been to dentists about ten times. Each visit I describe the symptoms clearly. I tell them what is happening: the thinning enamel, the pain increasing week by week, the mechanism: silent acid reflux from the medications and the GI cascade. I describe it precisely.
Each visit they prescribe something for pain. Or a different rinse. Or another medication to try. None of it works. The teeth keep thinning. The pain keeps increasing. The symptoms keep matching what I keep describing.
The frustrating part is not the lack of help. The frustrating part is the response: maybe that is not what is happening, maybe it is something else. I am the one telling them what it is. They don't know what to do with it. So they default to: it must not be that. A pattern they don't recognize, so the patient must be wrong about his own body.
This is the same dynamic that runs through every other part of the case. The disability assessor who saw someone who "speaks German well" and overrode a ten-year hospital report. The residency authority that said if you can study, why can't you work. The dentist who hears the patient describe silent reflux and decides it must be something else. In each case, the surface read overrides what is being said directly.
So I am left waiting. What are you waiting for? Until the teeth are completely gone, so you finally believe me?
What you can't see from outside
This is the part an autistic life makes you understand without anyone explaining it: the gap between what other people see and what your own body is registering.
From outside, I am managing. I show up. I speak. I get through the interaction. The medications and the supplements are part of the reason the surface looks the way it does. They are what make the showing-up possible.
From inside, while the surface holds, the cascade is running. The reflux. The fatigue. The slow accumulating damage in places people don't see until they fail. The cognitive variability that is itself pharmacological, not a personality trait.
And the surface doesn't hold forever. Sometimes, without warning to anyone outside, the overwhelm comes. The masking that has been doing the work for hours or days simply stops. People who have not been on this side tend to read that collapse as sudden or out of character. From the inside it is the predictable result of the system running on its own, without scaffolds.
None of this shows up in the first impression a clinical assessor has of me. None of it shows up in the photo on a residency form. The body is keeping a record that the institutional letters never read.
The choice the system pretends doesn't exist
When you don't have a therapist who actually understands autism in adults, when an integrated treatment team doesn't exist, when no one in any of the systems you have asked can construct a coherent plan with you, the choice in front of you reduces to two:
Take the medications. Depression manageable. ADHD manageable. Functional surface holds. Side effects ongoing. €5,000 in dental work in two months.
Don't take the medications. Depression deepens. The condition deepens. The danger increases. No side effects.
That is not a choice between two reasonable lives. It is a choice between two kinds of harm, with the second being more dangerous than the first. So the first one happens, every day, and the body keeps a record of it.
What would have made this unnecessary
It is worth being specific about something the medical model usually flattens: the medications are not treating autism. They are treating depression and anxiety that, in my case, are largely produced by the conditions of an unsupported life. If there were a peer community here, other autistic adults to talk to without translating myself first. If there were any kind of real support and understanding from the people and systems around me. If my rights had not been taken away one assessment at a time, the disability denied, the residency refused, the case turned away by every inclusion body it touched. If the daily discrimination, being read as Syrian first, were not the constant background. If I were not as alone as I currently am. None of those, alone or together, are extraordinary. They are the conditions of an ordinary life. With even some of them in place, this regimen, and the cascade it produces, would not be necessary, or would be necessary only in far smaller doses. The medications are substituting for what those things, present in an ordinary life, would have provided. Connection. Recognition. A country that doesn't read you as a problem before reading you as a person.
Why this article exists
The cascade is invisible from the outside. My teeth are a dental problem. The depression is psychiatry. The cognitive load is no one's department. Each one filed separately. None of it connected to: this person is autistic and ADHD, late-diagnosed, alone in a country, refused at every institutional door, and has had to construct his own treatment because nothing else was offered.
This is what happens when every door is closed. You stop asking the doors. You start treating yourself. The treatment has costs. The costs are visible in the body, the teeth, the gut, the surface that holds until it doesn't. And the original need, the support, the scaffolds, the community, is still not met.