Autism and Mental Health

Greetings Earthlings! ๐Ÿ™‚

Did you know– autistic children have higher levels of depressive symptoms and are 28 times more likely to have thoughts of suicide than their neurotypical counterparts? ๐Ÿ˜ฒ

bitmoji1256098968In recent years our awareness of and willingness to tackle mental health issues has increased significantly, however, the autistic community is often forgotten in our discussions.

Mental health issues such as OCD, anxiety, depression, eating disorders, ADD, psychosis, personality disorders and bipolar disorder are frequently co-morbid with ASD diagnoses, but aside from OCD and anxiety, you will rarely hear about these other issues in relation to autism. In fact, such mental health issues can even obscure ASD diagnoses in higher functioning autists as clinicians often diagnose the co-morbid condition without seeing the underlying ASD.

This is a particularly big issue for women on the spectrum as experts have found that we tend to exhibit greater depressive symptoms and higher anxiety levels than our male counterparts as we tend to internalize and ‘mask‘ our struggles. Moreover due to differences between male and female presentation of ASD’s and male bias in the development of the diagnostic criteria, women with autism are often misdiagnosed as having mental health issues, but the root ASD continues to evade.

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But are there any scientific reasons why mental health issues are so prevalent among autists?

A recently published study has suggested that perhaps the gut may influence an autists mental health. As gastrointestinal issues are often co-morbid with an ASD diagnosis, and as the microbes that live in the gut can have an influence on the brain and behaviours, it has been proposed that perhaps a “dysbiosis” or imbalance in gut microbes may have an influence on an autists mental health ๐Ÿ˜ฒ

Interestingly studies have also identified an overlap between the genes that cause schizophrenia, bipolar disorder and autism wherein certain points on these genes encode proteins that are involved in the formation and strength ofย synapses (which act as chemical bridges between neurons) suggesting that these disorders may act through a similar neurological pathway. Moreover, dysregulation of neurotransmitters (biochemical messengers in the brain) has also been implicated in depression, anxiety, bipolar disorder, ADHD and autism (as we have discussed in multiple previous posts) indicating further neurological overlaps.

In short, it seems that the biological basis of both autism and mental health issues are intertwined, which could explain why so often the two walk hand in hand.

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Hope you enjoyed this post dear Earthlings! ๐Ÿ™‚

Until next time!

Aoife

 

 

Autism Management- Fidget Spinners

Greetings Earthlings! ๐Ÿ™‚

So today I’m going to take a look at the latest craze- Fidget Spinners. I couldn’t take more than 50 steps in Dublin the other day without someone trying to sell me one! ๐Ÿ˜›

So what exactly are they?

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In case you’ve been living under a rock, Fidget Spinners are a handheld device where the centre is held between your fingers and you spin the device. They come in all shapes and sizes and are designed to relieve stress.

Here’s a video discussing them and some of the crazy things that people have been using them for:

But what have Fidget Spinners got to do with autism?

Whilst they may have only surged in popularity in recent months, Fidget Spinners were actually invented in the 1990’s to help people who have trouble focusing, such as those with ADHD, anxiety and autism, to channel excess nervous energy and stress into the spinning device. The thinking is that by diverting the excess energy into a physical action, this frees up certain areas of the brain from distraction, allowing you to better pay attention. It is also thought that fidgeting can relieve the brain of negative and obsessive thoughts.

But do they really work?

Opinions are polarizing as to whether or not they actually help. There is very little scientific evidence to support these claims. Of the studies that are out there, most focus on general fidgeting such as foot tapping, where it has been shown that movement can help to maintain alertness and improve working memory, but there are no studies specific to the Fidget Spinner itself.

Some experts warn that these toys may actually prove to be even more of a distraction for people with attention disorders.ย In theory, the toys occupy the hands so that you can focus your mind on the lesson (like stress balls), however, experts believe that the visually pleasing spin of the blades could add a further element of distraction.

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For teachers, they are proving to be a distracting nightmare in the classroom with many banning the device.

As opinions are divided, I decided to get one for myself and, pardon the pun, give it a whirl ๐Ÿ˜‰

There is definitely something oddly satisfying about holding the device between your fingers as it whirs into life, and there have been several moments where I’veย felt the addictive urge to spin it throughout the day.

However, I did not find it soothing from an anxiety perspective. In fact it actually really annoyed me when it would stop spinning and I would have to get the rotors spinning again! ๐Ÿ˜› I also found that it didn’t substitute as a calming “stim” and that I still reached to fidget with my necklace whilst I was using the Fidget Spinner!

That being said, autism is a spectrum where no two are alike. The Fidget Spinner may not work for me, but it could still be a nifty little tool to help manage ADHD and anxiety in another autist ๐Ÿ™‚

So by all means, go on! Give it a spin!! ๐Ÿ˜‰

(I have got to stop with these terrible puns… ๐Ÿ˜› )

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Aoife

Autism 101- ADHD

Greetings Earthlings! ๐Ÿ™‚

So today I’m going to be talking a little bit about-

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Haha! Sorry about that! ๐Ÿ˜› Although fun story- genuinely stopped mid conversation to cry “SQUIRREL” when out with a friend recently! ๐Ÿ˜‰

Yes that’s right, today we’ll be talking about ADHD in autism- also known asย attention deficit hyperactivity disorder.

ADHD is commonly diagnosed in autists (in the region of 29-83%), causing such difficulties as impulsiveness, over-activity and poor attention.

There are 3 main types of ADHD:

  • Inattentive ADHD (formerly known as ADD (attention deficit disorder))-ย This can manifest in a number of ways such as aย lack of attention to detail, losing things, organizational problems, making careless mistakes, having trouble completing tasks and struggling to sustain attention.
  • Hyperactive-Impulsive ADHD-ย Signs of hyperactivity and impulsivity include restlessness, excessive talking (Guilty!) fidgeting, interupting others, impulsive descisions and activities etc.
  • Combined Inattentive and Hyperactive-Impulsive ADHD

Personally, I would have really mild combined ADHD tendencies. In addition to my sometimesย impulsive nature, I have a habit of zoning out of lessons and conversations, sometimes even films, books and TV shows for brief moments, completely lost in my own thoughts.

I can be pretty easily bored and distracted!

Half the time I’m not even aware of it happening. I could be reading a page in a book one minute, and suddenly find myself halfway down the next page, without any idea of what I was supposed to have taken in! Other times I find myself in a room in the house unsure as to why I came in as I hopped onto another train of thought mid action! I often have to repeat tasks over and over in my mind to ensure I don’t forget them.

My mind just completely wanders off…

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But somehow I’ve always managed to hide my inattention. It never really posed a problem at school. Teachers knew I was away with the fairies, but could never seem to catch me out when pressed! ๐Ÿ˜› I suppose my deductive skills must have learned to compensate for my temporary lapses in concentration! ๐Ÿ˜‰

Top Tip: Studies have suggested that playing video games may be beneficial to improving concentration in ADHD.

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Just because concentration can be a struggle however, does not mean that you can’t concentrate.

Interestingly, there occurs a concentration paradox in ADHD and autism known as hyperfocus- an intense form of concentration where you are completely absorbed by a task, something that I like to call “The Zone”. I’ll write a separate post on hyperfocus at a later stage ๐Ÿ™‚

Aoife’s Top Tip: Applying specialist interests to tasks can encourage concentration. Last year I was struggling to write an essay for college, I found an angle that allowed me to write about Eurovision and suddenly I couldn’t stop writing! ๐Ÿ™‚

In addition to my lapses in focus, I can also be a little bit hyperactive. Now, hyperactive doesn’t necessarily mean bouncing off the walls like a child high on sweets, it can also mean abnormally active.

I am quite a restless individual. On the outside, I may look like I’m staring at a wall, in my mind I could be designing a cake, a knitting project, writing a story or drafting a hypothesis. I once spent a train ride visualizing, staging and arranging a musical based on the music of My Chemical Romance!๐Ÿ˜‚

I always have this need to be productive, even if it’s as simple as building my trophy collection on the Playstation or binge watching a TV series.

My brain never turns off!

If I’m excited enough, I do bounce around the place on occasion too ๐Ÿ˜‰

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But what’s going on in the brain that interrupts our concentration?

It is not clear what exactly causes ADHD in the brain, but remember neurotransmitters? (Inside the Autistic Brain,ย Autism 101-Sensory Processing,ย Autism 101- Digestive Problems)

Most current models point to low levels of the neurotransmitters Dopamine and Noradrenaline. Pathways involving these chemical messengers project to the striatum and prefontal cortex of the brain- areas which are responsible for executive functionย (i.e. memory, planning, organization, behaviour control etc.). If these neurotransmitters are out of sync, this will have an effect on these functions. As neurotransmitters are also dysregulated in the autistic brain, this would explain why ADHD so commonly occurs in autism.

ADHD, like autism, can’t be cured, but it can be treated with cognitive behavioural therapy (CBT) and medication in severe cases, however, the side effects of medical treatment for ADHD have been controversial, and long term usage studies have yet to be completed.

However, like autism, ADHD need not hold you back in life. Some of the most successful people in the world have ADHD, such as Sir Richard Branson, Justin Timberlake, Simone Biles, will.i.am, Russell Brand, Ryan Higa, Jamie Oliver, Jim Carrey and Solange Knowles ๐Ÿ™‚

So to conclude Earthlings-

Wait! What was I saying again?! ๐Ÿ˜‰

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Have a good weekend guys!! ๐Ÿ˜€

Aoife

Autism and Driving

Greetings Earthlings! ๐Ÿ™‚

Soooo….driving…

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Wouldn’t be high on my list of favourite activities I’ll admit! ๐Ÿ˜› Stressful roundabouts, merging onto busy roads, idiot drivers, getting lost, the noise of hitting a pothole- it can be a lot for an aspie to handle!

My coordination issues did not make it the easiest of tasks to get the hang of, that’s for sure!

Coordinating pedal movements and gear changes, difficulties with spatial awareness, not to mention the stress and anxiety of learning to drive on country roads (Irish country roads tend to be narrow, winding, and full of potholes! ๐Ÿ˜› ) made this a highly frustrating experience!

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I never could understand why I found it so hard to get the hang of driving when my sisters took to it so easily, but after I got my diagnosis, my struggles began to make a world of sense!

Driving would not be the first thing to come to mind when someone pictures the struggles an autist faces. In fact it’s a requirement in some countries that your ASD diagnosis be listed on your drivers licence if it impacts your ability to drive safely– you can even be fined in the event of an accident if it’s not stated on your licence!

Studies among autists actually report more traffic violations than in neurotypical groups, however, this may relate to our tendency to be more honest than our neurotypical peers ๐Ÿ˜› ๐Ÿ˜‰

This doesn’t mean that autists shouldn’t drive, but it’s something to be aware of.

So how exactly does autism impact our driving?

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  • Impulsivity Autist’s are naturally more impulsive than neurotypicals. This can impact our driving by causing us to make poor driving decisions on impulse. It has also been reported that this impulsivity may influence speeding behaviours
  • Sensory integration/processing issues– Driving involves a huge amount of sensory input. Listening to the engine, watching the road, spatial awareness, not to mention unexpected road noises and unpleasant smells from the outside- it can be a lot for the autistic brain to process when moving a vehicle
  • ADD & ADHD- Autists can get distracted quite easily…on busy roads where lot’s of things are happening, your focus can sometimes waver. If there’s a cute dog nearby, I have been known to take my eyes off the road…raw (2)
  • Spatial Awareness & Coordination Autists often have issues with these which can make it difficult in positioning the car on the road, parking and navigating gear changes.ย Spatial awareness was one of my greatest obstacles when first learning to drive. I always seemed to be veering towards the nearest hedge…When I first got my car, I was practicing driving around the house with no problems, aaannd then I decided to change direction- BIG mistake! My poor spatial judgement caused me to nicely scratch the car on the edge of the dog house…before getting it stuck on some cement blocks at the oil tank! Caused a mini shutdownย which made my sister think I had run the dog over I was so incoherent!! ๐Ÿ˜› ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย  ย ย fghd.png

Top tip for parents and instructors: PATIENCE!!!! Learning to drive is much more difficult for autists so don’t be too hard on us for when we don’t get it straight away. We’re already beating ourselves up for our slow progression; getting frustrated or annoyed with us will only make it worse.

Here’s a useful little leaflet about driving tips for those with Asperger’s syndrome:

https://www.nasherts.org.uk/wp-content/uploads/Driving1.pdf

Aoife’s Top Tip- Get a Sat Nav.ย They really help to take the edge off when stressed about driving to new and unfamiliar locations. If you mess up, it will recalculate and send you right in the end ๐Ÿ™‚

Having autism may initially make learning to drive difficult, however, you will get there in the end ๐Ÿ™‚ After two years of stressful practice, I passed my test first time and drive everywhere now.

The freedom you gain from this skill is worth the fight ๐Ÿ™‚

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Aoife

Impulsivity and Autism

Greetings Earthlings! ๐Ÿ™‚

In continuation from the previous post exploring curiosity and autism, today we’re going to take a look at impulse control in autists.

Many people with autism report issues with impulsivity.

All my life I’ve struggled with this issue. Too often I’ve felt like Didi in ‘Dexter’s Laboratory’, dying to know what the button will do and being unable to keep myself from pushing it! ๐Ÿ˜›

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As a child I was highly impulsive. I never knew when to stop eating, would impulsively give up on a book halfway through in favour of another (at one point I had 9 books on the go!) ย and when overwhelmed I would often try to run away.

During one particularly interesting meltdown I began to impulsively throw all items that my mother had given me out of my bedroom window (which is a storey high I might add), whilst my sisters in the room below gleefully retrieved them, each determined to claim ownership…Clear example of black logic at work! ๐Ÿ˜›

So why do we struggle with impulsiveness?

Impulsivity in autism can be explained by deficits in what is known as executive functioning.

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Don’t worry- it’s not as complicated as it sounds! ๐Ÿ˜›

Executive functioning is simply a broad umbrella term referring to the mental processes involved in cognitive, physical and emotional self control. Examples of executive functions include planning, memory, cognitive flexibility (the ability to adapt thinking to new and unexpected situations) and most importantly response inhibition– aka the ability to suppress unnecessary or inappropriate actions.

But what causes these deficits in executive functioning?

Many autists also suffer from attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD), both of which have an effect on executive functioning and impulsivity. I’ll explore these disorders at a later stage ๐Ÿ™‚

Experts believe that ASD’s share a common genetic basis with ADD and ADHD, indicating that genetic mutation may be at the heart of these deficits in executive functioning.

Impulse control can be quite challenging at times (it’s a real struggle not to run squealing to every single puppy I encounter for a cuddle! ๐Ÿ˜› ๐Ÿ˜‰ ) but as I always say, it is by no means a cause for despair.ย You will eventually learn control with time ๐Ÿ™‚

Granted I can still be quite impulsive at times- feeling the urge to curl up asleep on the floor like a dog in company (an urge I feel quite a lot! ๐Ÿ˜› ), wondering what it would feel like to step on hot ash/coals or wanting to draw designs all over my face with makeup; the difference being that now I am able to choose whether to ignore or act upon an impulse ๐Ÿ™‚

Well…for the most part! Still haven’t fully cracked compulsive eating…or maybe I just don’t want to! ๐Ÿ˜› ๐Ÿ˜‰

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Enjoy the weekend everyone! ๐Ÿ™‚

Aoife

Autism on Screen- Snow Cake

Greetings Earthlings! ๐Ÿ™‚

In continuation from the previous post, today I’m going to have a look at a female character with autism in the 2006 indie romantic-comedy drama (that’s a LOT of genres! ๐Ÿ˜› ) ย ‘Snow Cake‘.

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As discussed in my last post, gender bias is often an issue when it comes to women on the spectrum. Autism is viewed as a predominantly male condition, and as such this is reflected in Hollywood portrayals of autism.

Weโ€™ve all heard of โ€˜Rain Manโ€™, but โ€œRain Womanโ€ is rarely seen.

Snow Cake‘ is a really interesting example of this seemingly rare portrayal of autistic women on screen.

Starring Sigourney Weaver and the late Alan Rickman, ‘Snow Cake‘ explores the unusual relationship between Linda (a woman with high functioning autism) and Alex- a man who comes to visit Linda after her daughter Vivienne is killed in a car accident in which he was involved. Feeling guilty that he survived the accident, Alex set’s out to meet Linda and bring her some gifts that Vivienne had bought prior to her death, finding himself reluctantly drawn into her world.

You can view a trailer for this film below:

Before I get into the discussion of this, there is one line in the film (that can be seen in this trailer) that stands out for me:

I know all about autism- I’ve seen that film!”

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Granted, this line was likely included as a slight from the screenwriter, (a parent to an autistic child), towards public perceptions of autism, buuuutttt it does reinforce the importance of not believing everything Hollywood tells you of autism- something that one need bear in mind as to the portrayal of autistic women in this film in particular.

In terms of scientific portrayal of autism, the film gives a fairly accurate depiction of the symptoms.

BUT!

There is one major flaw…

Linda displays mostly male characteristics of autism!!

This is a common problem in on screen portrayals of autistic women as much of the information available to actors refers to male experiences of autism. For example, Diane Kruger was advised by a man with autism for her portrayal of Asperger’s syndrome in the series ‘The Bridge‘. When AS was featured in an episode of ‘Grey’s Anatomy‘ many years ago, a behind the scenes featurette revealed that the actress based her performance on a boy she knew with autism!

For her role in ‘Snow Cake‘, Sigourney Weaver conducted a lot of research into the role and was actually coached by a woman with autism- Ros Blackburn. Aside from her endearing eccentricities however, the character of Linda does not differ greatly from other films featuring male characters.

The problem here may lie in the script for the film, as screenwriter Angela Pell is mother to a boy with autism, and her writing would have been heavily influenced by her experiences.

However, the film does provide a good reflection of the reality of autism in that Linda is not a savant or overtly intelligent as is often over-represented.

In addition to this, Alan Rickman interestingly chose not to research autism ahead of filming in order to accurately reflect the reactions and frustrations that an outsider would experience in an encounter with an autistic individual, adding a further dimension of realism to the film.

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All in all, gender issues aside, ‘Snow Cake‘, while not the most riveting of films (wasn’t my cup of tea) does paint quite a realistic picture of life with autism.

Happy Friday everyone! ๐Ÿ™‚

Aoife

Discussion:Women & Autism

Greetings Earthlings! ๐Ÿ™‚

Today, I’m going to discuss a very important issue within the autistic community- gender bias and the misdiagnosis of women with autism.

If I asked you to close your eyes and picture a person with autism, the majority of you will have pictured a man (most likely Dustin Hoffman! ๐Ÿ˜› ).

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The current ratio for male to female diagnosis of autism is estimated at 4:1 as the condition is thought to be rarer in women; however, many experts now believe that this figure may be as low as 2:1.

So why the discrepancy?

Did you know: Women with autism present differently to males on the spectrum?!

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Yep- as neurotypical men are from Mars and women from Venus, so too are autistic men and women from entirely different planets (maybe Krypton and Daxam for the DC nerds out there ๐Ÿ˜‰ )!

So how do women with autism differ from men?

For starters, several neurobiological studies have shown distinct anatomical differences between the male and female autistic brain (which I will explore in a separate post at a later stage ๐Ÿ™‚ ). Girls with autism are thought to have more active imaginations than boys and participate more in pretend play, often creating elaborate fantasy worlds (I had a particular penchant for this. My sister and I created an elaborate world for our teddies each night, so elaborate that our star couple had their own imaginary portable mansion when we went on holidays!! ๐Ÿ˜€ ). Reports also indicate that women have lower levels of restrictive and repetitive behaviours than men.

Evidence has also shown that women are better at recognizing emotions than males, almost as well as their neurotypical peers in fact, and demonstrate signs of better attentiveness in social situations.

As a gender, women are more socially inclined than men, and so female autists feel a greater need to make an effort socially.It is expected that women should be more social than men when it comes to communication, and as a result, we are often held to greater social standards. I can’t count how many times a teacher/my mother pulled me aside to advise or chastise me for my social ineptitude! ๐Ÿ˜› It was thought that I struggled, not because something was wrong, but that I simply didn’t try hard enough socially. Had I been a boy this would not have been the case.

One of the biggest differences between men and women with autism is the tendency among women towards social mimicry. Girls are particularly adept in masking their symptoms through observation of their peers, obscuring them from the view of parents, teachers and medical professionals.

I’m particularly guilty of doing this. For example, when someone asks ‘How are you?’, I honestly don’t know how to respond! Should I just say fine? Should I reciprocate the sentiment? Should I detail the many ways my life sucks at present?! Three of the simplest words in the English language and I struggle to respond! I eventually developed a mental phrase card in my head for common questions like these so that I would have a standard answer when called for, and 90% of the time you pass for a functioning human being! Other times you get caught off guard and situations like this happen ๐Ÿ˜› :

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My life is full of these little social coping mechanisms, which I’ll expand on separately at a later stage ๐Ÿ™‚

Finally, as previouslyย discussed, when it comes to specialist interests, female autists tend to have interests resembling those of their neurotypical peers (horses, Harry Potter, soap operas, Justin Bieber etc.), which can additionally hide them from view. Psychologists have also noted a ‘mothering’ tendency among peers of autistic girls, taking autists under their wing and adopting them into a social group. This further creates an illusion of social functioning for teachers, allowing these women to further slip beneath the radar.

As a result of all these differences, women are diagnosed much later than men, (men on average are diagnosed in childhood (~7 years); women as teenagers or adults) ย if at all.

But why it it only now that these gender differences are emerging?

Gender bias in autism can trace it’s lineage to the original observations of both Leo Kanner (described autism) and Hans Asperger (described Asperger’s syndrome) in the 1940’s. In Kanner’s work,ย โ€˜Autistic Disturbance of Affective Contactโ€™ (1943), Kanner observed a group of 8 boys, but only 3 girls with autism. Hans Asperger on the other hand, exclusively observed groups of boys, believing that AS was uniquely male! As a result, AS was not described in women until the 1990’s!!

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I know!

Consequently, the diagnostic criteria for autism has been largely based on the male model of the condition, and as such, many women like me have slipped under the diagnostic radar.

Due to our inherent talent for social mimicry, women with autism unknowingly find themselves hidden from view. The warning signs that are obvious in males are not always visible, and as a result thousands of women go un-diagnosed, or worse still are misdiagnosed.

Mental health issues such as OCD, eating disorders, ADD, bipolar disorder, anxiety and depression are frequently linked with ASDโ€™s and are particularly prevalent among women.
Experts believe that women with autism tend to internalize their autistic symptoms, leading them to exhibit greater depressive symptoms and experience higher levels of anxiety than male autists.

Women are frequently mis-diagnosed with mental health issues, whilst the underlying root ASD goes unnoticed.

The internet is filled with stories of these women who spent years in mental anguish without receiving the one diagnosis they needed. I recently came across an article where it tookย “10 years, 14 psychiatrists, 17 medications and 9 diagnoses” before a 21 year old girl got her autism diagnosis! You can read the article here: (https://spectrumnews.org/features/deep-dive/the-lost-girls/).

Researchers and clinicians have in recent years begun to adapt the diagnostic criteria to better serve autistic women, but there is much work still that needs to be done.

Rain Man‘ has dominated for too long- we need now to focus on “Rain Woman”.

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Aoife

 

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