There are no mozzarella and tomato paninis left at the Costa in Birmingham New Street station and I don’t know what to do. I ordered my coffee five minutes ago and the people behind me in the queue are making pointed sighing noises. Even with my limited skills at reading social situations, I can tell I’m fucking this one up royally.

“The chorizo one is delicious!” the barista prompts unhelpfully. I like chorizo. I continue to stare blankly at the packet he’s showing me. I can feel myself starting to panic.

“I’ll just have the coffee, please”, I blurt and push the coins over the counter.

“We’ve run out of cream too, sorry, so I used milk. I upgraded your coffee to a large for free to make up for it!” explains the barista as he passes the drink over to me, looking anywhere but my face and turning away hastily. This was clearly a gesture he’d come up with before my display over the sandwiches, when he’d been happily flirting with me; he now clearly thinks I’m mad and regrets it. Not mad in a mysterious and alluring way which I can sometimes manage to pull off, but mad in a weird way.

I fucked up, I don’t have any food and the coffee is wrong. I drop it in a bin. The hot tears that have been building up for the last few minutes spill over onto my face.

When you have Asperger’s, routines and structures are central to feeling happy and secure. Like many people with a ‘high functioning’ manifestation of the neurological disorder, I have spent most of my life carefully constructing my world to hide it. My routines and rules are stitched seamlessly into the fabric of a ‘normal’ life; always getting the same drink in bars, listening to the same songs every day as I take off my makeup, rigidly planning my meals for the week.

One of them is always ordering exactly the same thing in chain stores. In Costa it’s a small Americano with cream and a Mozzarella and tomato panini. Usually this interaction looks normal. Usually I look normal. But when I’m exhausted, stressed, or experiencing sensory overload from something like being in a crowded and noisy train station and something messes up one of my secret routines then the cracks start to show.

Routines and repetitive behaviour are one of the most well known but poorly understood features of autistic spectrum disorders. In allistic (non-autistic) people, trying to exert extreme control over seemingly insignificant details of your life or becoming extremely distressed by routine disruption is often a symptom of mental health problems such as anxiety, OCD, or eating disorders, so it’s understandable why our behaviour is frequently regarded as unhealthy or worrying. But for autistic people, routines are a positive and safe coping mechanism for dealing with an overwhelming and difficult world.

Our need for routines can make university life an extremely stressful experience after the well-known, more heavily structured environments of home and school, especially at places as demanding as Cambridge. Some of my papers involve individually contacting a different supervisor for each essay and sporadic, last minute deadlines with no consistency or regularity. Almost every student finds the papers frustrating and stressful, but when routines are central to your ability to function, this level of disorganisation and irregularity can be completely debilitating.

Last year, as a result of a particularly messy series of mistakes by the department, I had a complete shutdown. Shutdowns can happen as a result of sensory overload or serious routine breaks. Usually they’re brief, lasting minutes or hours, but in extreme cases they can last weeks. For me, they are characterised by a total loss of ‘executive function’ – the cognitive processes involved in decision-making, memory, planning and general day-to-day brain function.

When I’m experiencing a loss of executive function, extremely minor tasks suddenly become utterly impossible; I will be unable to eat for several days because I can’t decide what food to choose, or refuse to leave my room for a week because I’m not sure I’ll be able to talk properly if I bump into someone. Working is obviously impossible in this state; words don’t make sense anymore and I’ve forgotten the start of a sentence by the time I’ve got to the end of it. Unfortunately, opening my email to inform my supervisors that I can’t do the work was also impossible, so I just dropped off the face of the Earth instead.

This experience was an example of the danger of prioritising encouraging ‘high-functioning’ disabled people to ‘pass’ as just like everyone else instead of accepting our different needs and asking for the reasonable adjustments we are entitled to. Forcing autistic children to stop doing their little routines or making them feel ashamed by them may seem like a minor thing, or even helping them to integrate into wider society, but the psychological repercussions echo and snowball throughout our lives.

There is good support for students with disabilities at universities like Cambridge, but having grown up being told to repress our different needs, we associate needing help with shame and failure. Until we stop normalising this, people like me will consistently fail to access the support we need until it’s too late