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      Depression, Mental Health and Crisis Support   06/04/2017

      Depression, Mental Health and Crisis Support   Depression and other mental health difficulties are common amongst people on the autistic spectrum and their carers.   People who are affected by general mental health difficulties are encouraged to receive and share information, support and advice with other forum members, though it is important to point out that this exchange of information is generally based on personal experience and opinions, and is not a substitute for professional medical help.   There is a list of sources of mental health support here: <a href="http://www.asd-forum.org.uk/forum/index.php?showtopic=18801" target="_blank">Mental Health Resources link</a>   People may experience a more serious crisis with their mental health and need urgent medical assistance and advice. However well intentioned, this is not an area of support that the forum can or should be attempting to offer and we would urge members who are feeling at risk of self-harm or suicide to contact either their own GP/health centre, or if out of hours contact NHS Direct on 0845 4647 or to call emergency services 999.   We want to reassure members that they have our full support in offering and seeking advice and information on general mental health issues. Members asking for information in order to help a person in their care are seeking to empower both themselves and those they represent, and we would naturally welcome any such dialogue on the forum.   However, any posts which are deemed to contain inference of personal intent to self-harm and/or suicide will be removed from the forum and that person will be contacted via the pm system with advice on where to seek appropriate help.   In addition to the post being removed, if a forum member is deemed to indicate an immediate risk to themselves, and are unable to be contacted via the pm system, the moderating team will take steps to ensure that person's safety. This may involve breaking previous confidentiality agreements and/or contacting the emergency services on that person's behalf.   Sometimes posts referring to self-harm do not indicate an immediate risk, but they may contain material which others find inappropriate or distressing. This type of post will also be removed from the public forum at the moderator's/administrator's discretion, considering the forum user base as a whole.   If any member receives a PM indicating an immediate risk and is not in a position (or does not want) to intervene, they should forward the PM to the moderating team, who will deal with the disclosure in accordance with the above guidelines.   We trust all members will appreciate the reasoning behind these guidelines, and our intention to urge any member struggling with suicidal feelings to seek and receive approproiate support from trained and experienced professional resources.   The forum guidelines have been updated to reflect the above.   Regards,   The mod/admin team
JeanneA

MRI result

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JeanneA   

Hi, Glen had an MRI recently and results came back today, it was all clear, nothing showed up, I am of course very pleased and relieved but I honestly thought something would show up to explain why Glen hits the right side of his head with such force, so it's back to square one. Glen is still having on-going assessments hopefully someone will come up with something.

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JeanneA   

Just a thought but if there is any other parent on here with a their who hits themselves particularly their head with force please let me know, have you any ideas why they do this, is it just their way of trying to communicate? That's the only thing I've come up with. Or is it just something an autistic person has to do as a sensory need. Any ideas, I would really appreciate it. thanks.

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That's a huge relief for you Jeanne.

 

I hit myself in my head sometimes and yes when the police had attended they saw me do it out of frustration trying to communicate to someone over there radio to a man from mental health criminal justice team which was getting me triggered and frustrated. It is a way of trying to communicate how its making me feel and that's how I can express myself but is not in the appropriate way.

Edited by Special_talent123

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Mihaela   

That's very good news, Jeanne! :)

 

I've hit myself on the head in similar situations. It's a sign that I'm totally frustrated at how I'm being treated and misunderstood. At such times, I simply can't find the words.

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JeanneA   

Thank you so much for your replies, it does seem like hitting yourself is a sign of frustration trying to communicate how you are feeling.

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I used to do this alot but not just walls, it was doors, floors and anything hard. i found i did it when the communication broke down and i was getting mad. I thought what can the wall or floor apart just give me a headache.

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JeanneA   

Thanks for what you've said it does make a lot of sense. Glen is doing a little better than he was he had a reasonable weekend. The propranolol has really helped lower his pulse rate which was over 100 and is now down to a more normal 70. They are hoping the propranolol with help with his aggression, time will tell.

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I hit my head still sometimes out of frustration and as discussed, to show an emotion that im not quite fully understanding or can communicate effectively.

 

I used to do this so much more when I was young

 

regarding propranolol, I take this and helps with the frustration cycle that surrounds elevated heart rhtyem, but doesn't seem to work when the stress comes from mental stresses. I have diazepam for when I gets really bad. I am aware of controversy surrounding diazepam, but for my loved ones I take it so I don't get aggressive, its a last resort

 

I also take amyltrptiline which seems to help reduce my obsessive thoughts which often leads to anxiety attacks

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JeanneA   

Thanks very much for your comments. Glen is still quite aggressive so not sure if the propranolol is really helping with that. He is also very anxious. Glen's been taken off diazepam, he just has lorazepam as a PRN.

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Sally44   

I'm glad the MRI didn't show up anything.

 

From all the comments made, and my experience with my own son - it sounds like it is a combination of frustration relating to internal or external things, anxiety and problems communicating or being understood - or getting totally overwhelmed - or a combination of all those things.

 

My other thoughts are that when someone [with ASD], child or adult, gets upset/angry etc the support staff or parents etc tend to try to talk to or touch the person. I have watched programmes when children are having meltdowns and parents are hugging and holding them UNTIL they calm down.

 

I always found that doing that made my son worse. What he actually needed was LESS. So no talking, or touching. We learnt to make a statement to him such as "We/I can see that you are very upset/angry/made. You need to got to your room to calm down."

 

I know this may not be something you can do with Glen. But if there is any way that they can get somekind of winding down/calming routine that he can use on a daily basis? Could he be taught to use other things such as a boxing bag to vent is frustration?

 

And staff says he gets aggressive. If there were no adults standing directly in his way, would he trash his room? Is there a predictable build up to his frustration/aggression, or does it happen within seconds.

 

Sometimes the upset/aggression becomes a kind of routine in itself. Ie. Glen gets frustrated. Staff try to intervene. That makes him even worse and aggressive.

 

I read a book some time ago about inappropriate behaviour being a learnt way of communicating. For example a child used to get angry and kick his dad. When he kicked his dad he would gets his dads individed attention. And after the upset his dad would read him a story in bed. So he had learnt that if he kicked his dad he would get attention from his dad and get a story read to him. So is Glen getting something out of his aggressive behaviour without anyone realising it?

 

When Glen gets aggressive what do staff do. Do they try to restrain him?

Edited by Sally44

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Livelife   

Unless there is a danger of serious harm in my opinion it's best to leave the person to calm down on their own, that's at least my experience the people try to restrain you touch you or tell you to calm down the worse the meltdown became.

It's never easy to decide and sometimes for their own good restraint is a good idea to prevent injury but unless that's the case as my assessor who diagnosed my autism said it's a good idea just to let them blow themselves out that was her advice to my partner.

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JeanneA   

Hi, I attended a CPA meeting at the hospital yesterday, it was very positive. The O.T.'s and speech therapist are devising a plan which includes a means of communication and sensory diet for Glen. Their main aim is to provide Glen with appropriate coping strategies to lower his anxiety levels and hopefully reduce the number of incidents of physical aggression and self-injurious behaviours. Glen had a sensory session on Tuesday and really enjoyed it.

 

Glen has trashed his room lots of times when he lived at the care home and yes it does happen very suddenly often without no warning. He has broke his door at the hospital and the water cooling machine. What staff have found can help Glen is at these times holding his hands or stroking his hands, it calms him down, but no you can't hold/hug him, staff are aware of that. So many times through the years I've wanted to just hug him but I know that I can't as it could make the situation worse.

 

It is best to leave Glen in his room if he's had a melt down, he does calm down most times.

 

I do agree Sally Glen could well be getting something out of his aggressive behaviour, professionals involved with Glen have always said that they have felt that he is always in 'control' of the situation. Yes Glen gets very frustrated and anxious he always has been like that.

 

The hospital have definitely made progress with Glen since he's been there, he now gets dressed every day, whereas at the care home he hadn't got dressed in nearly a year. Glen has all his meals in the dining room or garden and not in his bedroom. I did not agree with the care home staff letting Glen have all his meals in his room I think that made him more isolated than ever from everyone else. I am pleased what the hospital staff have achieved in 2 months.

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Mihaela   

I couldn't help picking up on this idea of always wanting to be in control. It's the main feature of Pathological Demand Avoidance (PDA) syndrome - which is a special type of autism, usually associated with Asperger's. The triggers that can cause meltdowns often involve being told by others (especially those closest to them) to behave in a certain way. It can be very minor thing such as asking a small favour. The effects of these triggers can't be handled in the same ways as AS sensory triggers, and the only way to get anywhere is to use a range of different strategies, which isn't at all easy. I have a friend who has it. Anything at all that's seen as a demand can trigger a meltdown or sudden change of personality, such as aggression or defiance. Her meltdowns are of the silent type and happen when she feels out of control. Asking favours of her can only succeed if done in a very subtle way, that doesn't make her feel that a demand has been made of her. During meltdowns the worst thing you can do is to try and hug her, but a hand on her shoulder doesn't have the same effect. In time it all passes, and once she feels back in control, she's her usual self again.

It's good to hear that Glen's making some progress. Slow but sure.

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Sally44   

Yes we wondered about PDA for our son when he was much younger because he struggled with any demands and did not respond well to routine as other children with ASD seemed to. Now it appears it was mainly due to a speech disorder, sensory issues and anxiety rather than PDA

 

And it is the Elizabeth Newson Centre in Nottingham that established this other branch of autism. And I suppose like everyting else, children/adults can have a mixture of this and other diagnoses.

 

Might be something to consider?

 

If staff think Glen is 'controlling', what do they believe he is getting as the reward for this control? Is it a 'predictable outcome'. Sometimes it can be as simple as that. Glen knows that if he does a, b and c that x, y and z will happen. And that might be more anxiety reducing than not knowing what to do or say or what the outcome of any interaction could be.

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Interesting, when I was younger when I was happy before a family member died that dulled my emotions(or at least the good ones) I used to have a base happy feeling but if someone like my mum moaned at me I would thump my head against a table or punch my head, not hard enough to cause huge damage, barely hard enough to hurt(hurt as in like when you bump your head rather than just a touch) or if I was upset lets say I met a girl and someone butted in and flirted with her (often talking down to me in the process) I would go home and not cry but get damp eyes and punch walls again not with huge force but enough to feel or I grew to punch pillows or a sofa a lot(knowing I could use more force)

 

I have mild aspergers so I suppose like mentioned its partly control based, not in the traditional sense but if I have had a busy day and lived with parents(I dont though) and my dad told me that I had to get changed and wash before getting dinner I would argue that I am too tired and I will do it later, even if arguing was harder than doing the task I didnt want the stress of doing something so arguing and backing down means I dont have to use that energy moving about its the same reason I could be excited for weeks or months about something such as a party(or freshers at college) then when it came round I would be too tired to move, if I was forced to move I would get angry so its a no win situation

 

But as I say I have mild aspergers so I am aware of all my actions(though may blank out right and wrong)

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