Autism 101- Meltdowns

Greetings Earthlings! 🙂

Leading on from Friday’s post, I’d like to place the autistic meltdown under the microscope today.

So what exactly is a meltdown?

To an outsider, meltdowns appear like temper tantrums. You see a petulant, naughty child that didn’t get their way. Screaming, throwing things, violent behaviour- it seems like a tantrum, but the reality is very different.

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Meltdowns are described as a temporary loss of behavioural control in response to an overwhelming situation or stimulus. This can manifest physically (lashing out, kicking, biting etc.), verbally (shouting, crying, screaming) or both.

So what’s happening in the brain that causes these outbursts?

The human body increases secretion of what are known as stress hormones (e.g. adrenaline, cortisol) in response to a stressful situation. Studies have shown that autists have higher levels of these stress hormones than their neurotypical peers.

When a stressful situation passes, stress hormones should return to normal levels. In the case of autism however, these hormones persist in the body for some time afterwards. The autist is left with residual levels of biological stress which make us more susceptible to stress related outbursts.

Release of stress hormones is controlled by the hypothalamic–pituitary–adrenal axis or HPA axis, a complex interconnecting network that comprises the hypothalamus, the pituitary gland and the adrenal gland (i.e. HPA). This system controls how the body reacts to stress. Research suggests that this system is hyper-reactive to stress in the case of autism.

In particularly stressful or harmful situations, our bodies enter a heightened state of physiological stress which triggers the “fight or flight” response. High levels of stress hormones such as cortisol and adrenaline increase the release of glucose (to give a burst of energy) and increase blood pressure (to divert blood to the muscles) in order to prepare you to either fight the danger or run away from it.

This response is triggered in the case of a meltdown.

Excessive stress hormone release pushes the brain over the edge. The brain thinks it’s under attack and instructs the body to protect itself at all costs. The autist is in instinctual fight or flight mode at the mercy of their stress hormones.

Meltdowns manifest differently from person to person. When I would meltdown, it appeared as though I were throwing temper tantrums as I stood and fought my corner; other times I would run away from my trigger somewhere quiet. Sometimes I fought and then ran away.

 

My parents tried everything to get me to control my “tantrums”. Taking away toys, sending me to my room, bribery, guilt, you name it!

Bribery was perhaps one of the more successful tactics they used. My meltdowns were at their worst around the age of 6, so my mother implemented a sticker reward system. If I behaved myself, I got a sticker for the day on the calendar. At the end of the month if I had a full set of stickers I would get a present.

It didn’t really work though…I only managed maybe two months without incident, and I doubt that they were consecutive. I still think fondly of that hard earned Monkees greatest hits tape (such a Hipster child! 😛 ) and Hula Hair Barbie! 😉

Anyone else remember her?

One year, I was even asked to give up losing my temper for lent!!! 😛 I lasted about 4 weeks, had a meltdown and subsequently felt like the worst person in the world for letting Jesus down!

It seemed biology had a different plan- how naive we were! 😛

So what does a meltdown look like for me?

I like to classify the severity of a meltdown on a scale from 1 to 3:

Stage 1: These are very mild and normally pass within a few minutes. Usually these entail getting a little bit overwhelmed and starting to cry unexpectedly- often mid sentence! Think of these moments as opening the steam valve to cool the system 🙂 Maths classes for example triggered many of these mini meltdowns- I wouldn’t understand a concept or problem, get frustrated, aaaannnnd suddenly find myself choking back tears while my exasperated maths teacher attempted to break things down for me (or if this happened mid-homework I’ve been known to throw my book at the wall 😛 ).

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Stage 2: This type of meltdown is a little more intense spreading out over several minutes, hours, and if particularly overwhelmed, on and off again over days. A situation, rumination or accumulation of stress tends to set these guys off. If wound particularly tightly, something very simple may tip the scales in this case- “You don’t want to play with me? FINE!” **Core meltdown activated**! Tears flow, your chest gets tighter and breathing can be difficult. This tends for me to be a “feeling” or cathartic stage. You’re in overload and need to feel, think and process the triggers until the storm passes.

TIP: I find that reasoning and music (songs that relate to the emotion or trigger) often work well to calm you and speed up the process. Hugs are also greatly appreciated as deep pressure calms and eases stress 🙂

In this stage I find that shutdowns can also happen, wherein I struggle to speak, think and even act (an experience I’ll delve into further on Friday 🙂 )

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Stage 3: Enter the dragon! These are full scale, out of control meltdowns. Fight or flight is triggered and you are working on autopilot. The brain has been pushed too far and launches all out war. These tend to be brief, (gradually abating to a stage 2 meltdown when the adrenaline wears off), but are highly destructive. You can literally say or do anything in this heightened adrenal state. Your mind believes it’s at war and will act accordingly to protect itself. Reason is useless; scolds are futile. The real Aoife is locked outside her brain, banging on the door desperately trying to re-enter the cockpit. I’m aware that I’m out of control and want it all to stop, but am powerless to do so. Nothing can be done but wait until the door is unlocked once more.

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TIP: Anger and attempts at restraint are useless in this situation, it only fuels the fire. Remaining as calm as possible until the mist passes is key.

I know these can sound a little scary, but they do decrease in frequency with time and stress management. It takes a significant stressor to trigger a stage 3 for me anymore 🙂 Happy stage 1 meltdown’s, like hearing the Phantom of the Opera overture, can even be quite amusing! 😛 😉

Meltdowns are tricky, but easily managed when you understand them for what they are. In the years leading to my diagnosis, without knowing it, I developed methods to help ease these passing hurricanes. Deep breathing, writing out my emotions, hugging a pillow or giant teddy, talking, and praying, but most importantly music. Music is key for me personally. The melodies, the riffs, but especially the lyrics; they soothe my soul. They verbalize the emotions I’m struggling to identify and process, guiding me safely past the storm 🙂

A meltdown is not a tantrum; it is not attention seeking behaviour; believe me- no one wants it to stop more than I do.

It is a biological response to excessive stress. We have no control over it. Punishments and judgments will only make things worse. Growing up would have been so much easier had my friends, family and (most importantly) I understood this.

Love, support and understanding are critical to meltdown management.

So try not to judge that kid crying hysterically in the corner at a party- there may be far more to it than you realize 🙂

Aoife

Impulsivity and Autism

Greetings Earthlings! 🙂

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! 😛

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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!)  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! 😛

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! 😛

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 🙂

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! 😛 😉 ) but as I always say, it is by no means a cause for despair. You will eventually learn control with time 🙂

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! 😛 ), 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 🙂

Well…for the most part! Still haven’t fully cracked compulsive eating…or maybe I just don’t want to! 😛 😉

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Enjoy the weekend everyone! 🙂

Aoife

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