Autism and Stress

Greetings Earthlings! 🙂

Stress- it’s hard to escape it in the modern world; even more so for an autist.

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Ordinary day to day life can be very stressful to navigate. Such simple things as responding to an email, dealing with crowds, sensory triggers and social interactions can be completely overwhelming. The thought alone of these seemingly innocuous situations can be incredibly stressful for an autist.

In my case, just the mere idea of driving in Dublin city centre for example majorly stresses me out- I have genuinely told my friend that if his directions landed us there I would get my car towed and grab a taxi 😛 Any unexpected scenarios, detours or maneuvers in my car will leave me hot under the collar, praying out loud for help to keep from freaking out!

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But are there any scientific reasons why autists are more predisposed to stress?

Interestingly, autists show signs of greater biological stress than their neurotypical peers. In particular, studies have indicated that autists have higher levels of stress hormones than neurotypicals. As I’ve previously discussed, stress hormones such as cortisol and adrenaline are released in response to stressful situations from the hypothalamic–pituitary–adrenal axis or HPA axis. This is a complex interconnecting network that comprises the hypothalamus, the pituitary gland and the adrenal gland (i.e. HPA) to control our response to stress- a network that is hyperactive in autists.

Following exposure to a stressful situation, stress hormone levels should return to normal, however, research has shown that stress hormone levels tend to persist in autists, which can make us more susceptible to stress related outbursts and meltdowns. In other words, we’re constantly living in a state of fight or flight.

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Long term activation of the stress system can lead to a number of health problems such as poor mental health, weight gain, sleep issues, digestive and cardiovascular problems to name but a few- many of which are regularly comorbid with autism.

In addition to this, studies have shown that autists have higher levels of oxidative stress in the body. Oxidative stress occurs when there is an imbalance between anitoxidants and free radicals (unstable oxygen atoms that can damage cells causing illness and aging – not so fun fact, free radicals are thought to contribute to hair greying) in our bodies. Several studies have indicated that antioxidant enzyme levels that regulate free radicals in the body may be altered in autists. As such, oxidative stress has been linked to the appearance of autistic symptoms such as language delay in previous studies.

In addition, as with prolonged exposure to stress hormones, oxidative stress may also contribute to the development of cardiovascular disease and mental health problems such as depression. Worryingly, heart disease and suicide are among the leading causes of mortality for autists, with studies indicating that the average autist lives 16 years less than their neurotypical peers! 😲  In addition to this, research suggests that psychological stress may worsen the symptoms of ASDs.

Therefore, as for everyone, it’s very important for an autist to find ways to manage their stress levels for both their long term physical and mental health.

Hope you enjoyed this post dear Earthlings! 🙂

Have a lovely weekend!

Aoife

Autism and Mental Health

Greetings Earthlings! 🙂

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? 😲

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 😲

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 of 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! 🙂

Until next time!

Aoife

 

 

Autism Management- Cognitive Behavioural Therapy (CBT)

Greetings Earthlings! 🙂

Today I’d like to briefly examine one of the most commonly recommended therapies for autism management- cognitive behavioural therapy or CBT.

So let’s all lean back in our chez long as we dive in! 🙂

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First off, what exactly is CBT?

Originally designed as a treatment for depression, CBT is a form of psycho-social intervention (i.e. counselling/psychotherapy) that is widely used to help improve mental health. Unlike other forms of therapy, CBT focuses on developing coping strategies to target our problems and to change unhelpful patterns in emotions, attitudes, negative behaviours,  and thought patterns.

In other words- CBT aims to change negative ways of thinking or cognitions in order to improve behaviour.

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As a result, CBT is widely used to treat anxiety, depression, eating disorders, OCD and a range of other psychological issues- many of which are co-morbid with an ASD diagnosis. It’s thought that CBT can be a particularly useful tool to treat anxiety and to help develop emotional recognition in autists.

CBT was personally recommended to me following my initial diagnosis in order help me to better understand autism and to conquer my social anxiety.

So what did I make of it?

Well, being honest (as we aspies must be 😛 😉 ), my opinions are slightly mixed regarding CBT. Whilst initially I found it helpful as it taught me a lot about autism and the reasons behind my behaviours, after a time, I felt that I didn’t really need it- especially given that I was in my twenties and had already overcome many of the challenges associated with ASD’s. In many ways, simply knowing and understanding Asperger’s Syndrome was enough to assuage much of the mental anguish I had inflicted on myself for being different 🙂

Nevertheless, I did find it beneficial to have a neutral party to talk to in those first initial months post diagnosis. It’s quite a lot to take on board, so it was nice to have that outlet to help guide me through the fog.

All in all, I felt that perhaps CBT may be better suited for a younger person with autism in helping them to develop lifelong coping mechanisms that will enable them to thrive. Had I better understood myself earlier in life through CBT intervention, many things could have been so much simpler 🙂

So if you think CBT may help you or your child, why not give it a try- get out your phone, book an appointment and take a seat on that couch (it’s surprisingly comfy 😉 )

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Enjoy the weekend everyone! 🙂

Aoife

Discussion:Women & Autism

Greetings Earthlings! 🙂

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! 😛 ).

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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 😉 )!

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 🙂 ). 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!! 😀 ). 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! 😛 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 😛 :

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

Finally, as previously 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)  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, ‘Autistic Disturbance of Affective Contact’ (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 ASD’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 took “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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