Autism and Eating Disorders

Greetings Earthlings! 🙂

This week I’d like to talk about a very common issue, particularly for women with autism- eating disorders.

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As discussed previously, mental health issues are quite prevalent among the autistic population. Because of this, many autists can go un-diagnosed as co-morbid mental health issues often mask the root autism diagnosis. This is particularly true of eating disorders for female autists where doctors will diagnose an eating disorder, but due to social masking tendencies will often overlook their autistic traits.

In fact this should really be one of the first things that doctors should assess when patients present with eating disorders as numerous studies have shown that there is a higher prevalence rate of autism in patients diagnosed with eating disorders (up to 20%). Evidence indicates that patients presenting with anorexia nervosa, bulimia nervosa and binge eating disorder (BED) have greater numbers of autistic traits than the general population.

Autists will often not benefit from conventional treatment for disordered eating so it is critical that it is identified early.

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So why are eating disorders so prevalent for those on the spectrum?

The reasons are varied, but tend to be either psychological or sensory related:

Psychological:

Some people on the spectrum develop eating disorders as a means to fit in, to attain the kind of figures that they see in magazines and perceive to be “perfect” or “normal”. Others develop eating disorders as a means of control, where the routine and rigidity can be a source of comfort to an anxious mind running on overdrive (interestingly this may have a scientific basis as starvation decreases levels of serotonin, which is heavily involved in anxiety and is often elevated in autism). Moreover, if exercise or particular foods become specialist interests, an autist may obsess and inadvertently develop a disorder as a result.

In some cases an eating disorder may be a simple matter of mind blindness where an autist simply does not understand that their eating behaviours are abnormal or dangerous.

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Sensory:

Sensory issues are commonplace for autists both with and without an eating disorder. An autist may be sensitive to different tastes, textures and smells which can make for a very restrictive diet depending on the severity. In some cases, eating may be so stressful that they may not eat very much at all to avoid an unpleasant sensory event.

For further information about autism and eating disorders you can check out the link below for advice and support:

https://www.bodywhys.ie/understanding-eating-disorders/key-issues/autism-eating-disorders/

Hope you enjoyed this post dear Earthlings! 🙂

Enjoy the weekend!

Aoife

Pica and Autism

Greetings Earthlings! 🙂

This week I’d like to briefly talk about an aspect of the autistic spectrum which you may not be familiar with- pica.

So what exactly is pica?

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No not that guy! 😛

Pica is a type of eating disorder where a person has an appetite for things that are not considered to be food such as dirt, dust, chalk, hair etc.

It’s often seen in pregnancy however, almost 25% of autists display signs of this behaviour.

Thankfully I’ve never really had any weird cravings like that, however as I child I did like to eat toothpaste on occasion…what can I say Aquafresh just looked too much like sweets!! 😛

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Those red, white and blue stripes were just too tempting! I even think I used to recreate this Werther’s Original ad in the mirror pretending the toothpaste was the sweet! 😂

Anyway less of my weirdness, back to pica!

Joking aside, pica can be very serious if the substance that is ingested is toxic such as lead or if the item can cause an intestinal obstruction like hair ingestion.

So what does the science have to say? Why is this behaviour found in autism?

There does not seem to be one uniform cause of pica, however, pica has been associated with nutrient deficiencies (such as iron) and is thought to be the body’s subconscious way of replenishing the missing nutrients, which would be consistent with the often restrictive nature of an autists’ diet.

It’s also thought that pica may be a sensory response to stimuli in autists to relieve stress, anxiety, pain and discomfort or the item simply has a pleasurable texture. Pica may equally be interpreted psychologically as a means of seeking attention.

Science aside, experts say that the cause of pica may simply be that the autist is unaware that they are eating an item that is unconventional/unsafe.

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That’s all for this week Earthlings, hope you enjoyed this post! 😀

Have a great 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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