Depression is more frequent in those with AS than the general population, and the struggles of those with AS often contribute to the development of depression. The obvious question is, what resources are available and what do we do? First, we should not accept depression as just a normal part of AS, especially if it’s interfering with everyday life. Secondly, we need to recognize the symptoms to help as early as possible. And lastly, we need to research the supports that are available – how you can help yourself or others right now – and what resources still need much improvement so that you can call upon action in your community.
Being aware of the symptoms of depression is critical:
sleep difficulties, either sleeping more or less (insomnia, early morning waking);
changes in appetite (either more or less hunger);
weight gain or loss;
a failure to enjoy normal sources of pleasure;
sadness, guilt or hopelessness;
crying or unusual irritability.
Someone who is clinically depressed sees the world in the above ways each day. It’s important for the individual or those around to seek professional help.
Medication can help many with depression, as can Cognitive Behavioral Therapy. Although CBT is a slower process with AS individuals and needs to be adapted to their thought process. Some studies suggest neurobiofeedback can be helpful with depression and there are a few early studies of its use with ASD patients. For those who prefer to avoid medication, this is certainly worth exploring. It is best to come to your medical sessions with the knowledge of various treatments so that you can be prepared to discuss what is best for you.
It’s important to think about addressing the factors that can result in depression.
It is said that 40 million Americans live with an anxiety disorder, which is more than the occasional worry or fear. We all experience anxiety to some level. Anxiety in children is common when separated from their parents or from familiar surroundings. However there is a type of anxiety that is more severe and may be misdiagnosed. Anxiety left unchecked or treatment may become paralyzing to everyday life.
Below we’ve gathered several lists for you. What does anxiety look like? How can it manifest, when is it critical to consult a doctor and what methods are available to self calm. Here we go….
Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.
Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.
According to research from the Mayo Clinic, several types of anxiety disorders exist:
Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.
Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
Separation anxiety disorder is a childhood disorder characterized by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.
Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
Specific phobias are characterized by major anxiety when you’re exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don’t meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.
Parents should be alerted to the signs so they can intervene early to prevent lifelong complications. The American Academy of Child & Adolescent Psychiatry offers you different types of anxiety in children.
Symptoms of separation anxiety include:
• constant thoughts and intense fears about the safety of parents and caretakers
• refusing to go to school
• frequent stomachaches and other physical complaints
• extreme worries about sleeping away from home
• being overly clingy
• panic or tantrums at times of separation from parents
Depression is most common in adolescents and young adults with Asperger’s, and particularly in those with stronger intellectual and verbal skills. That means college students with Asperger’s are at a very high risk for depression. This is particularly true for freshmen, who are transitioning to the college experience. Although I’ve seen this in later years as well when students are dealing with more challenging classes, social issues, and upcoming graduation as triggers.
Let me tell you about one college student’s experience with depression:
Franklin went off to a good college based on his excellent academics in high school. However, he’d been provided with executive function scaffolding all through high school. His parents and a teacher had helped him organize his time and initiate his work. The school counselor and his parents had feedback from teachers if he was falling behind on assignments.
In college, he was on his own.
He was supposed to check in with the disability office, but he resisted being seen as needing help. Franklin had challenging classes and had taken on a very full load of five classes; he had always set his standards and expectations of himself very high. Franklin began falling behind in writing papers for his English literature class because writing was difficult and he wrote slowly. His effort was going into writing, so he fell behind on the reading. He tended to procrastinate as the pile of work grew. Franklin was embarrassed at being behind, so he stopped going to English. He also was stressed by feeling at a loss in terms of the 24/7 social demands.
As you might expect, all of this stress was a trigger for depression. In Franklin’s mind, one was either a success or a failure, and he was a complete failure.
With your summer all wrapped up, I hope you’re off to a strong fall. Speaking of fall – I couldn’t resist – are you or your family struggling? Struggling is part of being human – you’re not alone. Do you crave strategies to move past your challenges? Of course you do so let’s start with a quick definition.
What’s your #1 struggle right now?
Is it… *Never getting it all done? *Pesky thoughts nagging at you – are you doing enough? *Living in fight or flight stress? *Repeat offenders – facing the same problems over and over again? *Wishing there was another way – but not being able to see it?
What if there’s a solution right there in the struggle? It’s completely possible and just waiting for you. I say, whatever your struggle, let’s discover the way out.
You may be thinking, that’s great for other people, but not me and my family. Raising kids is no joke. It’s hard work. It involves all the things. Raising a kid on the spectrum is all the things on steroids! I’ve come to know this full on truth from every “steroid living” parent and youth.
Since they were little, you’ve been inundated with every conceivable intervention, strategy, advice, philosophy, educational approach and on it goes. They’ve been your lifeline and your achilles heel. Since we know society is on information overload it only makes sense that you, “steroid parent,”have been taxed beyond measure. I’m not pedaling snake oil or quick fixes. I don’t pretend to know what your days really look like and feel like day – after – day.
What I’m offering is a slight shift.A click on your mental and heart dial. If you’re open to a shift in your perspective, it can hold the potential for a whole new way. It’s ironic this shifting perspective deal. You know how challenging it is for your beloved child on the spectrum to shift perspective. You know the huge strain that creates. You even know how to shift around their lack of shifting.
In some ways this ability has saved your sanity. In other ways it’s been unknowingly perpetuating your frustration. You’ve learned to anticipate the needs, reactions, and overall experience within seconds. With this, you’ve got to be exhausted. It’s draining to have to figure it all out – all the time. That creates pressure. And nobody has their full set of resources (their best thinking) available while living in constant pressure.
As many as 85% of children with autism also have some form of comorbid psychiatric diagnosis. ADHD, anxiety, and depression are the most commonly diagnosed comorbidities, with anxiety and depression being particularly important to watch for in older children, as they become more self-aware. Understanding and treating psychiatric comorbidities are often far more challenging than the Aspergers/Autism itself as discussed in this edition of Top of the Spectrum News.
The diagnosis of comorbidities can be challenging because many people with ASD have difficulty recognizing and communicating their symptoms. It takes time to uncover the cause of a meltdown or aggravation but to aid you in your search, we listed the most common comorbidities below:
Top of the Spectrum News is a product of Aspergers101.
Autism, depression, anxiety, ADHD, and developmental delays often keep kids (and parents) away from church. A new study has found children with autism are almost twice as likely to never attend church or other religious services. Families of children with other disabilities are missing from the pews as well. These are the parents who grew up in the church. Whose fathers were preachers, elders, deacons and whose mothers were Sunday School Teachers and Ladies Bible Class members. These parents of children with disabilities are aching for their child to know the same love of a church family as they did.
I can vouch for this describes my family. Our oldest son has Autism. For families like mine, it doesn’t take a study to know that there are often barriers that prevent children with disabilities (and their families) from participating in worship. So what are the barriers and how can we, as parents and church leaders, accommodate by emulating Christs ministry to all?
Church is a large social gathering that in itself, difficult for anyone with autism. The service can be a radically unwelcoming, even dangerous, place for persons with ASD in ways nobody ever intends. Sensory, Anxiety, etc. It is another potentially overwhelming situation (like school, grocery shopping, etc.) that is asked of autistic kids on a regular basis. Unlike most people, they don’t leave church feeling refreshed and renewed to face the week ahead.
As he passed by, he saw a man blind from birth. And his disciples asked him, “Rabbi, who sinned, this man or his parents, that he was born blind?” Jesus answered, “It was not that this man sinned, or his parents, but that the works of God might be displayed in him. – John 9:1-3
As a parent of a child with a disability, know that you have been prepared for the road less traveled. God will not give you more than you can bear and He (the Almighty) prepared you, as he did your child, for this journey.
Below is a statement my son Samuel said when he was very young and we have it printed and hanging by our front door:
Don’t worry about the impairments that God included in this package…think about the good stuff in the package God gave you.
I would agree with Sam. As medical science begins to unravel and understand the brain and the effects of autism, we as a society and especially as the Church, should subside our fear of ‘different’ and embrace God’s beautiful design in worship together. On the other hand, parents should take note of a saying I’ve often heard Dr. Temple Grandin state: “Autism is not an excuse for bad manners.” Parents need to be cognisant not only of their child and their needs, but the ability for others to hear the sermon thus keeping the focus on God.
On Tuesday, September 17th, 2019, I was honored to have presented a lecture at my alma mater, Abilene Christian University. It was ACU Summit 2019 and my topic given: Autism and the Church today. With the overall Summit theme of “Sorrow, Hope & Joy” (a tribute to the Psalms) my heart knew (all too well) all three emotions and suspect yours does too. I offer to our Aspergers101 readers the entire presentation and downloadable tri-fold brochure if this message resonates with you or someone you love.
May you know you are never alone and as with all things…the answer resides in living like Christ. In the following presentation, we explore his teachings and apply them toward raising a family with a disability in the church today.
Below is a downloadable tri-fold brochure you may want to share with your church or autism/parent organization.
Anxiety-related symptoms are frequent concerns in children, adolescents and adults with Aspergers and HFA, which may be treatable with Cognitive Behavioral Therapy.
Anxiety is commonly found in high functioning individuals on the spectrum in particular because they have an increased awareness of their own social difficulties. This cognitive awareness may intensify their anxiety toward social interaction and promote isolation.
Recent numbers found that 11-84% of children on the autism spectrum experience impairing anxiety, while only 4.7% of all children aged 3-17 years have experienced anxiety.
Cognitive Behavioral Therapy (CBT) is a type of psychotherapeutic treatment that helps individuals recognize how thoughts and feelings influence behavior and cope with these challenges.
CBT is used to treat a wide range of issues, in addition to anxiety, including:
“The Less Traveled Path to Christ: Families, Autism and the Church Today”
Autism, depression, anxiety, ADHD, and developmental delays often keep kids (and parents) away from church. The Great Commission instructs us to go and preach the gospel to all nations, to all people … and as for those with disabilities, we must put aside our fear of “different” by first understanding the uniquely wired brain and then providing accommodation(s). Jennifer Allen will share her family’s personal journey of having a child diagnosed with autism and how the less traveled path to Jesus, though oftentimes rocky, offers beautiful vistas that neurotypicals seldom witness. This session is for the church to better understand the challenges that face these families along with suggested accommodations and especially for the parent torn about church and their children.
ACU Biblical Studies Building 1201850 Teague Boulevard
Abilene, TX 79601 – Room 120
Go to ACU Website for full information on ACU Summit 2019 or view the full ACU Summit 2019 Program here. Note: Jennifer Allen’s presentation: The Less Traveled Path to Christ: Families, Autism and the Church Today is listed on page 23.
A meltdown is scary and lonely. A change in routine can be enough to tip the scales in sensory input and cause what is titled a “meltdown” where a person with autism or asperger syndrome temporarily loses control due to emotional responses to environmental factors. They aren’t usually caused by one specific thing.
Triggers build up until the person becomes so overwhelmed that they can’t take in any more information. In previous blogs, we have addressed the complex topic of meltdowns. While the main message is to have a plan to PREVENT a meltdown, we must also be prepared if a meltdown does occur.
I will start by outlining what NOT to do. I think this is best said coming from someone that has lived through a meltdown with neurological implications. The following is an excerpt from a message from Mr. John Scott.
Meltdowns: What Not to Do
My meltdowns can be very frightening and confusing for those around me. I work very hard to appear as capable and composed as possible throughout each day, so when I finally lose it, people are shocked to see me act so “autistic.” I cry, scream, break things, flap my hands, and pound my fists against my head. I haven’t found the perfect remedy for my meltdowns, but I do know what makes them far worse…
If I am having a meltdown… – DO NOT become angry with me or raise your voice.
Autistic meltdowns may be frightening to observers, but at their most intense, they are nothing less than pure psychological torture for the person experiencing them. I feel as if I am caught in a war zone, terrified for my very life. My senses are on fire and I have very little control over myself. I may feel threatened by intense emotional displays. This is very dangerous.
– DO NOT attempt to restrain me. I understand that my tantrums are scary, as I’m well over six feet tall, but you must remember that I am far more frightened than you are. I would never intentionally hurt anyone, but if you approach me in a hostile manner, or attempt to use any force without my permission, I may lose the last bit of self-control I have.
– DO NOT ask me what is wrong. Trust me, when I’m banging my head into the wall I do not want to discuss my emotional triggers.
– Most importantly, DO NOT tell me to “snap out of it.” Trust me, I would if I could. Don’t patronize or belittle me by acting as if I could control myself if I only tried harder. This is a good way to make the situation ten times worse. You may know me from my column here on WrongPlanet. I’m also writing a book for AAPC. Visit my Facebook page for links to articles I’ve written for Autism Speaks and other websites.
I would like to add one more . . . this is not the time to say “Use your words.” As the brain escalates in a meltdown, the ability to be rational and articulate diminishes.
So now for what TO DO?
During a meltdown a child most needs the opportunity to relax. Therefore, you should respond patiently and compassionately as you support this process. Offer choices of relaxing activities, perhaps through the use of a choice board. If the person is not able to make a choice, then simply present a pre-determined calming activity. Often, this might be an activity that incorporates a strong interest [e.g. video of SpongeBob or favorite song/music].
In some cases, it might be best to offer a way out of the situation through escaping the current stimulation of the environment. Again, a pre-determined location might be another room or other safe place [e.g. chill zone, motor lab, etc.]. However, it might be difficult for the individual to transition to another location if the meltdown is at its peak.
If there are others in close proximity, then it should be part of the plan to move them to a safe place.
Most importantly, do everything possible to keep the individual safe from him or herself. If they engage in head banging, protect their head by placing a pillow or bean bag between them and the floor or wall.
As you can see, there is little to really do during a meltdown. Again, all efforts should be made to PREVENT a meltdown.
You know — those things
you react to in the blink of an eye. You’ve witnessed the crazy. Come on, you’ve
done the crazy. Why all the crazy? Can’t everyone just stop, please?!
find yourself doing the opposite of what you KNOW.
What if the whole idea of
buttons to be pushed and triggers to be set off is only a reality because there
is something inside you to be pushed and set off?
What if you were able to
get to the root of what’s really bothering you? Just now several annoying
people and situations popped into your mind. There’s no way to NOT be
triggered by them. It’s maddening and I believe you. The problem is, it’s
only a half truth — it’s not the full complete picture.
What if those people
– those situations – are actually
opportunities for you? Dare it even be a gift? Ok, stop rolling your eyes
and yelling…just hang in there for a minute.
What if the problem is a “seeing
issue?” Meaning, you just haven’t been able to see another way to engage with them. And right there, signals another issue — you already super
know the social realm is a legit challenge for you, right?
I mean, you’ve been
involved in many a program, curriculum, group, and on going conversation all
aimed at helping you bridge this gap. While these interventions certainly meant
well and were full of good stuff, they most likely also missed something.
All people have social
difficulty. On some level – with some people – with some situations. It’s part
of our humanity. So it makes sense that the people charged with teaching you
how to navigate your difficulty had difficulties, too. Guiding someone through
a difficult course requires a specific skill. It’s actually so simple that it
typically gets missed. What is this skill, you ask?
Curiosity is absolutely
pivotal because it opens up a whole new way of looking at something. In this
case, your social challenges. As in, cultivating curiosity on all the levels,
in all the ways, in all the things.
What if you could
learn a new way of engaging? What if there was a helpful strategy to
eradicate the trigger.
I’m here to tell you,
curiosity is that strategy. Yes – even if you have Aspergers.
Here’s what some curiosity
can look like in action…
Pause. Take a step back.
Ask yourself what are you actually feeling? Where else have you felt this
feeling? What’s really going on?
And if your answers are
all about them – she’s just ridiculous and he disrespected me – then it’s time
to dig deeper about yourself.
about her ridiculousness bothers you the most? Why?
about his disrespect got under your skin the most? Why?
else in life have you felt bothered like this?
These are clues to what
triggers you and why. You may be able to rattle off all the clues: the what,
when, where, why and how this came about for you. You may have some clues but
it gets fuzzy fast. Or you may have no clue. Regardless of where you are with
your clues, it looks like you’re not getting beyond them.
The triggers still have a
When someone steps on them, the ugly happens. And later you have feelings about it. You rattle off quick contradictions – you didn’t have a choice, you’re over it, they deserved it, you should apologize and make it right, you’re done, you think about making a pact you’ll never let it get to you like this again and yet, somehow it keeps replaying itself again and again in your mind, just swirling around.