Tag Archives: autism

More on Autism

11 Apr

So I’ve mentioned before that both my case manager and the therapist wanted to have me evaluated to see if I fell on the Autistic Spectrum.  This was due to a variety of issues including my Sensory Processing Disorder, issues with eye contact, problems with socializing, and falling a lot.  With Kaiser’s evaluation system that took like 3 months to go through I was found not to have an ASD because I did not present symptoms as an infant, though I met enough criteria currently and had since a child.  This has been upsetting me a lot.  Transferring to UC Davis, I still haven’t made any connections and while I don’t need to have a lot of friends and to be honest am not interested in having a lot of friends, I would like to have one or two.  I never seem to say the right thing and I can’t figure out people.  My case manager went to a training about a week ago now and she said a lot of females on the spectrum are misdiagnosed with Borderline Personality Disorder or Bipolar because Autism is about not being able to control your emotions.  I have both.  She said if it’s any something she thinks I’m somewhere on the spectrum and that they need to train Kaiser doctors better.

I know several autistic young adults.  I found this on the internet the other day:

What do you think the most common cause of premature death is among adults of typical or high intelligence with autism spectrum disorders? It’s suicide.

A large study was recently published in the British Journal of Psychiatry that examined the risk of death among the 27,122 persons diagnosed with autism spectrum disorders in Sweden when compared to age-matched controls. One significant finding from the study is that on average, persons with autism die sixteen years sooner than would be anticipated.  The finding we’ll examine more closely is that adults with autism and no intellectual disability are over nine times more likely to commit suicide when compared to their age-matched peers. Unlike the general population, in which men are significantly more likely to commit suicide than women, women with autism were at higher risk of suicide in this study than men.

Last month’s study isn’t the only signal that persons with autism are especially vulnerable to suicide.

  • study of 10-14 year-olds with autism reported that 70% of kids with autism also had at least one mental health disorder such as anxiety, ADHD or depression, and 41% had at least two comorbid mental health disorders. Of those with ADHD, 84% received a second comorbid diagnosis.
  • Kids with autism were 28 times more likely to experience suicidal ideation than age-matched peers without autism in this study.
  • In a study of 374 adults with Asperger’s Disorder, 66% of 367 respondents self-reported suicidal ideation, 127 (35%) of 365 respondents self-reported plans or attempts at suicide, and 116 (31%) of 368 respondents self-reported depression. Adults with Asperger’s syndrome were nearly ten times as likely to report lifetime experience of suicidal ideation than individuals from a general UK population sample, and more prone to suicidal ideation than people with one, two, or more medical illnesses, or people with psychotic illness.

Why might suicide represent such an enormous problem among high-functioning persons with autism spectrum disorders?

They’re more likely to experience social isolation and lack social supports. In the fall of 2014, we shared this anonymous post from a college student describing her experience of trying to attend church as a person with autism. Imagine how the challenges she describes would impact her day to day life outside of church.

High-functioning kids with autism are significantly more likely to become victims of bullying when compared to their peers with autism and intellectual disability. It’s become socially inappropriate to ridicule persons with an obvious disability…less so when the disability isn’t so obvious.

They’re more likely to experience difficulties with executive functioning that may translate into a greater risk of acting upon suicidal impulses, more difficulty employing effective problem-solving skills and more difficulty self-regulating emotions. Learn more here about the challenges persons face with executive functioning challenges.

Their propensity to become very fixated on specific thoughts or ideas may intensify suicidal thoughts, or result in more difficulty letting go of feelings of hopelessness when they occur.

http://www.keyministry.org/church4everychild/2017/4/4/the-suicide-epidemic-among-high-functioning-persons-with-autism

PS I’ve been more suicidal with less friendship and more lonely lately.

Adults on the Autistic Spectrum

2 Feb

It’s been one of those days, one of those weeks.  Where I’m frustrated that I don’t have an ASD diagnosis because I didn’t fit the criteria as a kid.  It’s been fucking with my functioning this week.  I’ve messed up a few social cues.  And I’m curious.  I have some Aspergers followers out there or people on the Spectrum that “cope” and appear normal enough.  I don’t mean this to come off rude, I know they took aspergers out of the DSM5 thats why I want to cover aspergers and the spectrum but I’m mostly referring to more of the higher functioning people who for lack of a better word pass as normal most time.

That’s me.  And I know the goal after you get an ASD diagnosis is therapy to help cope with daily living and be able to live productively, get social skills, don’t have meltdowns, learn to deal with sensory issues, etc. etc.   I just don’t understand that if I was forced to do this as a kid because of a chaotic home environment how I can’t have the diagnosis.  I essentially learned most the skills they try to teach out of necessity.  Now on my own, I’ve regressed a bit plus I’m managing a bunch of other shit so honestly I don’t have the energy for all that normative passing stuff.  But I’m still upset that the doctor won’t give me the diagnosis because as a child I didn’t meet the criteria till i was 11 or so.

 

Thoughts?

Somewhere between anxiety and panic

16 Sep

I hadn’t thought about the ASD evaluation in awhile because right on it’s heels followed the gender issues. I was very upset that I didn’t get an autistic spectrum diagnosis pretty much because I didn’t meet all the symptoms when I was young and I was a helpful child; although I doubt my mom through in her drinking problem. But I was even helpful before then. It seems all my symptoms appeared in my teenage years and though they impair my functioning mostly social and like regular things since I wasn’t showing symptoms since a baby I’m not autistic. The evaluator said I should be happy, I think he’s an asshole. I’ve never prossessed how I really felt about it because of gender stuff pushing to the center. But when your body and mind don’t work like most of societies it’s hard.
Most the research in ASD is in children. I think that eventually there will be a delayed diagnosis or adult diagnosis ASD. Just like when society thought kids couldn’t have mood disorders and adults would grow out of their attention disorders. 
If any of my followers are on the spectrum or with mental illness in general. How do you cope with big transitions like moving out? Responsible for all your adult daily activities now (shower, teeth brushing, cooking, cleaning)? And scariest socializing?

A Rising Crisis in our Nation, A Call To Action & A Mother’s Perspective

7 Oct

A good read, this happens all to often!

RaisingJordan

In light of Mental Illness Awareness week, I wanted to share our story in regards to a personal interaction we recently had with law enforcement here in Vancouver, Wa.  This is the letter I wrote after our encounter and one that our local NAMI is working to share on a higher level because it is such an incredibly important issue and one that we cannot continue to be ignore.

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As parents, we all dream of having perfect, healthy, beautiful, and one day, successful, children. We rarely, if ever, stop and think that the magnificent child we held in our arms the day they were born could one day have a severe neurological malady, or a pervasive developmental disorder. We are certainly not thinking that in some cases, these disorders will cause them to melt down, or scream at us with the lung capacity of a maniacal banshee- during which time…

View original post 2,714 more words

What would you do? Stigma and Specific Mental Illnesses Part 1

19 Aug

Part 1: Stigma, Crime and Certain Mental Illnesses

Stigma is a very big thing in the world of mental illness.  People are speaking of movements such as “mad pride” where people are not ashamed of mental illness but feel a sense of pride in it and get involved in advocacy.  There is also the “hearing voices movement” which has alternative perceptions of people who hear voices that don’t automatically mean you have a psychotic disorder (usually schizophrenia) and your outlook is not good.  The movement suggests we look at voices in different ways to see if they have something to teach us or see how our relationship with our voices effect our lives.

I live in the US and haven’t heard much about “mad pride” other than blog posts from those in other countries.  I also hadn’t heard about the “hearing voices movement” until I heard from fellow bloggers in other countries.  I know that there are people in the US who belong to such movements or different theories on mental illness, but it took quite a bit of research to find it and the population is much smaller here in the US.

Here we have crimes created by “crazy people.”  The rare times mental health awareness, treatment, or prevention comes up here is when the media lets us know of another heinous crime committed by someone who is/was suspected to have a mental illness.  Obviously when that is the framework the discussion turns to how we are violent, how to keep guns away from us, and how some of us are pure evil.  There is rare empathy of family members who tried to get their loved one’s treatment before these crimes took place, but most times they also take a piece of the blame.  A crime is committed and the first thing to do is trace back if there is any potential this person had a treated or untreated mental illness, because of course no sane person would commit this type of atrocity.

People piece events and interviews together.  Suddenly people remember how they were acting “odd” some people interviewed will even say they seemed “dangerous,”  “needed help,” or even mentioned/implied the violent actions that took place.  Every once in awhile you will hear about how they themselves or friends or families members tried to help them get treatment, and for some reason it was ineffective.  Most people however that make these statements never did anything to intervene, because after all no one wants to upset a “crazy person” who might take it out on you instead.

The common “crime disorders” include: schizophrenia or some other psychotic disorder, bipolar disorder, autism, personality disorders such as Borderline Personality Disorder or Antisocial Personality Disorder and sometimes substance abuse problems (though many don’t consider this a mental disorder.)

If you had to explain to someone that you had a mental disorder, which one would you choose?  If I say I am schizophrenic or have psychotic symptoms, they will think I am violent like the Colorado shooting.  If I tell them I am bipolar they may also think I’m violent and unpredictable because of my mood swings.  What about autism, maybe then they will think that I don’t understand empathy and think it’s okay to kill elementary school children?  Of course, everyone knows that people with personality disorders can’t be changed that is just who they ARE.  As for substance abuse problems, many think that the person who is addicted made a choice at some time and don’t offer any sympathy for the outcomes addiction can cause in a life.

Maybe, I’ll choose something people can understand better…. Yeah, I have Depression.  Everyone sort of knows how depression is, we have all been sad before of course.  The only bad thing people could say about me if I said I have depression is that I’m lazy.  I’ll take that any day over violent, unpredictable, lacking empathy, choosing to be ill or it just being part of who I am and a lost cause.  Maybe Obsessive Compulsive Disorder (OCD), people think they are kinda quirky… it won’t bother them if I think I need to wash my hands 50 times a day… it’s just my hands doesn’t have anything to do with them.  I can explain it by finding some quirk or weird behavior they have and trying to relate.

To be continued…..

Stigma, Celebrities, and Certain Mental Illnesses

Myself, Stigma, and Certain Mental Illnesses

My thoughts on the DSM 5

7 Jun

There has been a lot of controversy last month about the release of the DSM 5, which is a manual that is used in the US to diagnose mental disorders and code them for insurance coverage.  The terms you hear like OCD, Bipolar Disorder, Autism, Schizophrenia, etc are found in this manual with criteria that must be met, background information, and other important information about the disorder.  The 5 in the DSM 5, means this is the 5th Edition (more or less, there was a DSM IV TR which was a Text Revision.)  And the DSM stands for Diagnostic and Statistical Manual of Mental Disorder.  The first edition was publish in 1952 and the last publication before this new edition was in 2000.  There has been a lot of things that have changed since 1952 in regards to recognizing and treating disorders, classifying disorders in similar “families” like Major Depressive Disorder, Dysthymic Disorder, Bipolar Disorder, and Cyclothymic Disorder which fall into the Mood Disorder category or family.  Changes in how disorders are named such as Manic Depressive Disorder which is now Bipolar Disorder and Aspergers Syndrome which is now an Autistic Spectrum Disorder.  The removal of disorders when culture and society changes, examples are Homosexuality and Gender Identity Disorder (if you considered yourself transgender, you could have been diagnosed with this.)  The number of disorders has also changed as things have been removed and other disorders added, much more being added.  Another reason for the increase in disorders is the fact that some disorders that professionals have found to be prevalent in the population which were before thought of as under an umbrella diagnosis; an example of this is the new skin picking disorder and hoarding which were formerly thought of as sub types or symptoms under Obsessive Compulsive Disorders.  So now that you have a little history on the DSM and how and why they make changes I will explain what I think of some of the new changes both ones that are controversial and others which may have not gotten as much press.

One of the biggest stories was when Thomas Insel, the director of the National Institute of Mental Health (NIMH) publicly stated that their orginization would no longer be using the DSM for their research methods.  He went on to say:

Patients with mental disorders deserve better. But what exactly is better? What alternative do we have to categorizing patients according to their symptoms? Where are the hard data, the blood test, the biopsy, the EKG for diagnosing troubles of the mind?

Insel wants the government funded agency to instead focus on symptoms that may be part of different disorders rather than specific diagnosis and a focus on evidence based tests.  For example, allowing people with depressive symptoms that may be diagnosed with different diagnosis (example: Major Depressive Disorder or Bipolar Disorder) to participate in the same research studies in hopes to find brain based research that ties to the symptom of depression.  With this hypothetical new knowledge, researchers believe they could make better medications that could target specific symptoms; and maybe even later see (as in brain imaging or gene sequencing, etc) differences between agitated depression and say catatonic depression to make specific medications for those symptoms.

My response to this is:  That I think this idea is great in theory but that we haven’t made any head way in it in the past.  I think we should definitely try to find evidence based tests that can help us recognize symptoms and disorders and help with effective treatment. However, I think we aren’t there yet and to change the entire focus on to biological research of specific symptoms is just not possible at this time.  In my opinion they should spend some time researching based solely on symptoms, some time on disorders as they are classified now, and other time figuring out how and why the treatments that do work work.  I also believe that him being in such a public figure and some would assume spokesperson for the NIMH that he would be careful what his opinion is and how the words he says may be taken.

An excerpt from an interview with NPR:

FLATOW: Well, what is your problem? Tell us what your problem – why you’ve decided to not use that book so much.

INSEL: We’re not saying that clinicians shouldn’t use it. One way to think about this is DSM is really what we have, along with ICD, but those are really for the bedside. And I’m talking to an audience in the biomedical research community that’s at the bench, not at the bedside, most of the time.

And so, for the bench, we’re looking for some way to do just what Jeff Lieberman said a moment ago: finding a way to deconstruct these classifiers and to say hey, yes this is what we currently call schizophrenia. This is what we currently call autism spectrum disorder, but perhaps that’s not one problem, but multiple, five, six, seven, eight different diseases that are contributing.

Let’s do the science without the presumption that it’s a single disease. Let’s do the science with the assumption that we have to actually pull this apart and begin to understand the subtypes if we’re going to get to more selective treatments

Which kind of reinforces my point of being careful with his words, because he is specifying here he meant it just not be used by researchers but as you can tell people assume he means everyone even mental health professionals. Also another reason I am in favor of the DSM is that it puts common names to groups of symptoms that lead to some understanding, though obviously not perfect.  If my therapist, case manager, psychiatrist, and primary care physician are talking and here the term Borderline Personality Disorder or Depression they have a general idea and understanding.  Also, hearing a diagnosis helps your problems seem real and meeting others with similar disorders can create a sense of community and support- things like this happen daily at support groups for things like OCD, addictive behaviors, and even non-specific diagnosis, but symptoms like codependency, grief, or specific stressers.

 

The removal of Aspergers Syndrome from the DSM where there are now Autistic Spectrum Disorders.  With this topic I go both ways in some regards.  Aspergers Syndrome is commonly refereed to a less severe version of Autism or high-functioning Autism in some cases, I don’t like this and never have.  When you say your child has high-functioning Autism you are implying that most Autism is low-functioning- I think with the symptoms that would normally classify you for a diagnosis of Aspergers Syndrome now falling on the Autistic Spectrum many more people will use terms like high-functioning and low-functioning to determine where the person falls on the spectrum.  I prefer terms in severity, duration, and intensity that have less stigma attached to it.

 

Another big issue the change in grief or bereavement in the diagnosis of Major Depressive Disorder.  Prior to the DSM 5 bereavement was an excluding factor, meaning that if you had the symptoms of Major Depressive Disorder for 2 weeks or more you could not meet the criteria on a bereavement exclusion.  There are a couple things that could over ride this that I didn’t learn about until reading this from a post on World of Psychology:

An exception could be made only in certain cases; for example, if the patient were psychotic, suicidal, or severely impaired

I think allowing bereavement to be added is a positive step.  I believe some people who may have a predisposition to Depression may get their illness triggered by a loss, in a similar way drug use can trigger schizophrenia in people who are predisposed.  Also bereavement affects everyone different, you can tell by the quote above some reactions that can happen.  Also many people need therapy services when dealing with the loss of a loved one and just because you get a Depression diagnosis doesn’t mean you have to take medication it could get you eligible for counseling services that may not be covered unless you have a diagnosis.

I am happy about the removal of Gender Identity Disorder from the manual this year and think it’s a great step for the LGBT community, especially youth who are more susceptible to be diagnosed and treated for this disorder.

I approve of gambling being added into the section on Addictive Disorders, I have seen first hand the damage a gambling addiction can have on people and am glad with the addition people more people will be treated and covered my insurance.  Some people fear with this inclusion of an addiction being based on a behavior that eventually other behaviors will be added like internet addiction or video game addiction- I am not sure if this will happen or not but people should focus on the now rather than speculating about the future.  If the internet or video gaming becomes a prevalent and disabling addiction that it may be added at a latter point and I think both those descriptions can apply to gambling addiction.

I have talked in a prior post about my views on the addition of Disruptive Mood Dysregulation Disorder (DMDD) to stop or redirect childhood bipolar diagnosis, I also talk about the personality disorders not being changed at this time and a little about the changes in the Autistic Spectrum.

Resource: On the Spectrum

25 Apr

I recently read an article on zite the other day about mental illnesses being on a spectrum.  Honestly, what caught my eye was this graphic below that was in the article.

spectrum

 

The article talks about looking at mental illness from a dimensional method.  The graphic above shows overlap in certain symptoms belonging to certain disorders.  Example the first grey arrow is about cognitive impairment and goes from Mental Retardation, Autism, Schizophrenia, and a small bit into Schizoaffective disorder.  There are four main symptoms clusters (the grey arrows) shown in the graphic above with showing 5 different disorders.  After each small quote from the article, I have explained my experiences in relation to the quote.  This information is spot on, at least in my case.  The last paragraph quote best explains the graphic above and the link to the full article can be found at the bottom of this post.

But even as walls between conditions were being cemented in the profession’s manual, they were breaking down in the clinic. As psychiatrists well know, most patients turn up with a mix of symptoms and so are frequently diagnosed with several disorders, or co-morbidities. About one-fifth of people who fulfill criteria for one DSM-IV disorder meet the criteria for at least two more.

I usually have two Borderline Personality Disorder and Schizoaffective Disorder, though sometimes it is broken down into Borderline Personality Disorder, Mood Disorder NOS (Not otherwise specified) and Psychotic Disorder NOS.

These are patients “who have not read the textbook”, says Steve Hyman, who directs the Stanley Center for Psychiatric Research, part of the Broad Institute in Cambridge, Massachusetts. As their symptoms wax and wane over time, they receive different diagnoses, which can be upsetting and give false hope. “The problem is that the DSM has been launched into under-researched waters, and this has been accepted in an unquestioning way,” he says.

Also applies to me, if you look under my menu bar DSM IV-TR you can see the diagnosis I have received in the past.  I have often talked about my symptoms morphing and another way to describe them would be waxing and waning.

Psychiatrists see so many people with co-morbidities that they have even created new categories to account for some of them. The classic Kraepelian theoretical division between schizophrenia and bipolar disorder, for example, has long been bridged by a pragmatic hybrid called schizoaffective disorder, which describes those with symptoms of both disorders and was recognized in DSM–IV.

One of my current diagnosis, for a long time I was diagnosed with varieties of Bipolar disorder.

And in 2010, Craddock and his colleague Michael Owen proposed the most radical dimensional spectrum so far, in which five classes of mental disorder are arranged on a single axis: mental retardation–autism–schizophrenia–schizoaffective disorder–bipolar disorder/unipolar mood disorder (see ‘Added dimensions’). Psychiatrists would place people on the scale by assessing the severity of a series of traits that are affected in these conditions, such as cognitive impairment or mood disruption. It is a massively simplified approach, Craddock says, but it does seem to chime with the symptoms that patients report. More people show the signs of both mental retardation and autism, for example, than of both mental retardation and depression.

And this best explains the graphic at the beginning of the post.  For the full article click here.

More autism speculation

24 Apr

I’m always wary when I hear new news about autism.  I know a lot of different people have different theories on why autism diagnosis have risen so much in recent years, and I understand the yearning to search for answers.  With the Rubella outbreak going on right now and the recent news that skipping that MMR vaccination did not in fact help prevent autism, I’m reluctant to share news but this could be something that in the future holds to be true, so I shall pass it along.

 

I’ve read this from a couple sites but just am using one for the reference if you’d like to read the whole thing.  It just came out that the medication Depakote also known as Valporic acid when taken by pregnant women may increase the incidence of autism.  They are saying especially in the first 3-4 weeks of pregnancy.  Depakote/Valporic Acid is a medication commonly used to treat seziures, mood disorders, and migraines as well as other things.

Here is the link and I’m sure if you search you will find more articles and news on it.

DSM 5 Has been Approved

1 Dec

Today the DSM 5 has been approved and will be published sometime in May of 2013.  There have been a couple controversial items being discussed with the new updated DSM- 5, which is used in the US to diagnose mental disorders.  Some of the interesting information just released in a statement by the APA are as follows:

Autism spectrum disorder: The criteria will incorporate several diagnoses from DSM-IV including autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder (not otherwise specified), into the diagnosis of autism spectrum disorder for DSM-5 to help more accurately and consistently diagnose children with autism.

This refers to the controversy of the diagnosis of Asperger’s also know as “High functioning autism” which will now be dropped from the new DSM 5.  However it is said that individuals who met criteria for Asperger’s will fit criteria on the Autistic Spectrum Disorder.  The APA is also saying this new umbrella diagnosis will help individuals get services that weren’t always available in some states due to the diagnosis of Asperger’s over Autism.

Disruptive mood dysregulation disorder will be included in DSM-5 to diagnose children who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year. The diagnosis is intended to address concerns about potential over-diagnosis and overtreatment of bipolar disorder in children.

DMDD, Disruptive mood dysregulation disorder, has been criticized since some people believe that children experiencing “tantrums” which many people believe are a normal stage of development will be incorrectly diagnosed and possibly medicated.  There hasn’t been any information I’ve seen on how DMDD will be treated but one reason for it as stated above is because of the possible over-diagnosis and over treatment of childhood bipolar disorder, which is primary treated with medication.  Some people think kids are being over diagnosed and therefore over medicated and hope this new diagnosis will prevent that.

Personality disorders: DSM-5 will maintain the categorical model and criteria for the 10 personality disorders included in DSM-IV and will include the new trait-specific methodology in a separate area of Section 3 to encourage further study how this could be used to diagnose personality disorders in clinical practice.

There has also been a lot of talk about changing the personality disorders.  One proposed change was the naming of Borderline Personality Disorder to emotion dysregulation disorder which did not happen.  Another proposed change was the “trait- specific methodology” mentioned above.  This was the splitting of criteria into main categories and then having specifics under the categories.  These specifics would sometimes meet criteria for different disorders and would be rated on a number scale indicating severity.  This was meant to help professionals recognize the specific traits in disorders which may need more attention for treatment.  An example is borderline personality disorder, which has 9 different criteria therefore many different ways of presenting itself in individuals.  The proposed system would show that one individual may deal with impulsivity more than the other criteria when another may not even meet that specific criteria.  The trait specific stuff will be in Section 3, so it can be studied to be possibly included in the next update.