Are you an adult with High-Functioning Autism or Asperger's? Are you struggling emotionally, socially, spiritually or otherwise?
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Help for Anxiety & Depression: Tips for Adults on the Autism Spectrum

When an individual with Asperger’s (AS) or High-Functioning Autism (HFA) has depression and/or anxiety, high-intensity cardio may seem like the last thing anyone would want to do. But once the affected person gets motivated, high-intensity cardio can make a big difference. Research on anxiety, depression and high-intensity cardio shows that the psychological and physical benefits of this form of exercise help reduce anxiety and improve mood.

The links between anxiety, depression and high-intensity cardio aren't entirely clear — but it can definitely help you relax and make you feel better. High-intensity cardio may also help keep anxiety and depression from coming back once you're feeling better.

High-intensity cardio probably helps ease anxiety and depression in a number of ways, for example:
  • Doing something positive to manage depression and anxiety is a healthy coping strategy. Trying to feel better by drinking alcohol, dwelling on how badly you feel, or hoping depression and anxiety will go away on its own can lead to worsening symptoms.
  • Meeting high-intensity cardio goals or challenges, even small ones, can boost your self-confidence. Getting in shape can also make you feel better about your appearance.
  • High-intensity cardio may give you the chance to meet or socialize with others. Just exchanging a friendly smile or greeting as you jog around your neighborhood can help your mood.
  • High-intensity cardio increases body temperature, which may have calming effects.
  • High-intensity cardio reduces immune system chemicals that can worsen depression.
  • High-intensity cardio releases feel-good brain chemicals that may ease depression (neurotransmitters and endorphins).
  • High-intensity cardio helps you to take your mind off worries. It is a distraction that can get you away from the cycle of negative thoughts that feed anxiety and depression.

The term "high-intensity cardio" may make you think of running laps around the gym. But this form of exercise includes a wide range of activities that boost your activity level to help you feel better. Certainly running, lifting weights, playing basketball and other fitness activities that get your heart pumping can help. But so can less intense forms of cardio, such as gardening, washing your car, or walking around the block. Anything that gets you off the couch and moving is exercise that can help improve your mood.

You don't have to do all your cardio at once either. Broaden how you think of cardio and find ways to fit activity into your routine. Add small amounts of physical activity throughout your day (e.g., take the stairs instead of the elevator, park a little farther away from your work to fit in a short walk, consider biking to work, etc.).

Doing just 20 minutes of high-intensity cardio a day for three days a week can significantly improve depression and anxiety symptoms. But smaller amounts of activity — as little as 10 minutes at a time — can make a difference too. However, bear in mind that it will take less time exercising to improve your mood when you do more vigorous forms of exercise, such as running or bicycling.

Starting and sticking with a high-intensity cardio routine can be a challenge. Below are some steps that can help. Check with your doctor before starting a new cardio program to make sure it's safe for you.
  1. Figure out what's stopping you from exercising. If you feel self-conscious, for example, you may want to do your workouts at home. If you stick to goals better with a partner, find a friend to work out with. If you don't have money to spend on expensive cardio equipment (e.g., a treadmill), do something that's virtually cost-free, such as walking. If you think about what's stopping you from exercising, you can probably find an alternative solution.
  2. If cardio exercise is just another "should" in your life that you don't think you're living up to, you'll associate it with failure. Instead, look at your cardio schedule the same way you look at your therapy sessions or medication — as one of the tools to help you get better.
  3. Talk to your doctor or other mental health provider for guidance and support. Discuss concerns about a cardio program and how it fits into your overall treatment plan.
  4. Figure out what type of physical activities you're most likely to do, and think about when and how you'd be most likely to follow through. For example, would you be more likely to do some gardening in the evening or go for a jog in the pre-dawn hours? Go for a bike ride or play basketball with your kids after school? Do what you enjoy to help you stick with it.
  5. Give yourself credit for every step in the right direction, no matter how small. If you skip a cardio workout one day, that doesn't mean you should just quite because you can't maintain your cardio routine. Just try again the next day.
  6. Your mission doesn't have to be jogging for an hour five days a week. Think realistically about what you may be able to do. Tailor your plan to your own needs and abilities rather than trying to meet unrealistic guidelines that you're unlikely to meet.

Living With Aspergers: Help for Couples

8 Things Every Neurotypical Woman Should Know About Her Aspergers Partner’s Brain

An Aspergers (High-Functioning Autism) man's brain varies tremendously over his life span, quickly contradicting the image of the emotionally-distant, self-absorbed “nerd” that circulates in mainstream consciousness. From his task-oriented personality to his “excessive” need for time alone, here's what women need to know about their partner's mind:

1. “Men with Asperger (AS) and High-Functioning Autism (HFA) are non-committal,” the refrain usually goes. But this may be one of the largest misconceptions about these men. The “fear of commitment” is most likely to occur before men hit 30. After that, most AS and HFA men focus mostly on providing for their families (of course, some have a harder time with commitment than others – a problem that could be genetic).

2. “AS and HFA fathers don’t really bond with their children.”  This is another myth. While many of these fathers may occasionally (and unintentionally) give the impression that they are not very interested in “bonding” or spending quality time with their kids (which is due to mind-blindness issues), most will tell you – categorically – that they love their kids more than anything or anyone else. They just have difficulty conveying that love in a meaningful way.

3. “AS and HFA men embrace chain of command.” True! An unstable hierarchy can cause these men considerable anxiety. An established chain of command (such as that practiced by the military and many work places) gives them a sense of control in an otherwise chaotic world.

4. “AS and HFA men have no empathy and are more focused on solutions than feelings.” Yes and no! While many studies suggest that females are more empathetic than males, this is not entirely true. The empathy system of the AS/HFA male brain DOES respond when someone is stressed or expressing a problem – but the task-oriented, "fix-it" region quickly takes over.  As a result, these men tend to be more concerned with fixing a problem than showing solidarity in feeling.

5. “AS and HFA men are hard-wired to check-out other women.” Maybe. While often linked to aggression and hostility, testosterone is also the hormone of the libido. And ALL men (not just those on the autism spectrum) have six times the amount surging through their veins as women. Testosterone impairs the impulse-control region of the brain. While it has yet to be studied, this may explain why men ogle women as if on "auto-pilot." However, most AS and HFA men forget about the woman once she is out of their visual field.

6. “The AS/HFA man is immature for his age.” Of course! He has a “developmental disorder” after all. This simply means he is emotionally and socially lagging behind his peers. But even “late-bloomers” develop a significant element of experience and wisdom over time.

7. “Men with AS and HFA don’t show their emotions.” False. While women are usually considered the more emotional gender, infant boys are more emotionally reactive and expressive than infant girls. Adult men have slightly stronger emotional reactions, too – BUT ONLY BEFORE THEY ARE AWARE OF THEIR FEELINGS. Once the emotion reaches consciousness, most men adopt a poker face. When young, males likely learn to hide emotions that culture considers "unmanly."

8. “AS and HFA men are vulnerable to loneliness and anxiety.” Unfortunately, this is spot on. While loneliness, depression and anxiety can take a toll on everyone's health and brain, AS and HFA men seem particularly vulnerable. These males tend to “reach out” less than neurotypical males, which exacerbates the emotional problems and the toll it takes on their brains' social circuits. Living with women is particularly helpful for AS and HFA men. Men in stable relationships tend to be healthier, live longer, and have hormone levels that decrease anxiety. Having “time alone” to de-stress is also especially beneficial for men on the spectrum.

Living With Aspergers: Help for Couples

Asperger’s Adults and Panic Attacks

Adults with Asperger’s (AS) and High-Functioning Autism (HFA) are often prone to anxiety, which in extreme situations can lead to panic attacks. A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, the sufferer might think she is losing control, having a heart attack or even dying.

Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if an individual has had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, she may have a condition called panic disorder. Panic attacks were once dismissed as nerves or stress, but they're now recognized as a real medical condition. Although panic attacks can significantly affect quality of life, treatment can be very effective.

Panic attacks typically begin suddenly, without warning. They can strike at almost any time —driving the car, at the mall, sound asleep, or in the middle of a business meeting. Panic attacks have many variations, but symptoms usually peak within 10 minutes. The sufferer may feel fatigued and worn out after a panic attack subsides. Panic attacks typically include a few or many of these symptoms:
  • Abdominal cramping
  • Chest pain
  • Chills
  • Dizziness
  • Faintness
  • Fear of loss of control or death
  • Headache
  • Hot flashes
  • Hyperventilation
  • Nausea
  • Rapid heart rate
  • Sense of impending doom or danger
  • Shortness of breath
  • Sweating
  • Tightness in your throat
  • Trembling
  • Trouble swallowing

One of the worst things about panic attacks is the intense fear that another one will occur. The sufferer may fear having a panic attack so much that he avoids situations where they may occur. He may even feel unable to leave his home (called agoraphobia) because no place feels safe.

AS and HFA adults who have any panic attack symptoms should seek medical help as soon as possible. Panic attacks are hard to manage without assistance, and they may get worse without treatment. And because panic attack symptoms can also resemble other serious health problems (e.g., a heart attack), it's important to get evaluated by a health care provider if the individual is not sure what's causing her symptoms. It's not known what causes panic attacks or panic disorder, but these factors may play a role:
  • Certain changes in the way parts of the brain function
  • Genetics
  • Major stress
  • Temperament that is more susceptible to stress

Some research suggests that the body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared itself for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's not known why a panic attack occurs when there's no obvious danger present. Symptoms of panic disorder often start in the late teens or early adulthood and affect more females than males. Factors that may increase the risk of developing panic attacks or panic disorder include:
  • Death or serious illness of a loved one
  • Experiencing a traumatic event (e.g., an accident or sexual assault)
  • Family history of panic attacks or panic disorder
  • History of childhood physical or sexual abuse
  • Major changes in one’s life (e.g., the addition of a baby)
  • Significant stress

Left untreated, panic attacks and panic disorder can result in severe complications that affect almost every area of life. The sufferer may be so afraid of having more panic attacks that he lives in a constant state of fear, ruining all quality of life. Complications that panic attacks may cause or be linked to include:
  • Alcohol or substance abuse
  • Avoidance of social situations
  • Depression
  • Development of specific phobias (e.g., fear of driving or leaving the house)
  • Financial problems
  • Increased risk of suicide or suicidal thoughts
  • Problems at work or school

If you have had signs or symptoms of a panic attack, make an appointment with your physician. After an initial evaluation, the physician may refer you to a psychiatrist or psychologist for treatment. Here's some information to help you prepare for your appointment and what to expect from the physician:
  1. Ask a trusted family member or friend to go with you to your appointment, if possible, to lend support and help you remember information.
  2. Make a list of your symptoms, including when they first occurred and how often you've had them.
  3. Write down key personal information, including traumatic events in your past and any stressful, major events that occurred before your first panic attack.
  4. Write down medical information, including other physical or mental health conditions that you have and the names of any medications you're taking.
  5. Write down questions to ask your physician (e.g., Do I need any diagnostic tests? Is it possible that an underlying medical problem is causing my symptoms? Is there anything I can do now to help manage my symptoms? Should I see a mental health specialist? What do you believe is causing my symptoms?).
  6. Write down questions to ask your mental health provider (e.g., Are there any brochures or other printed material that I can take home with me? Are there any self-care steps I can take to help manage my condition? Do I have panic attacks or panic disorder? For how long will I need to take medication? How will you monitor whether my treatment is working? If you're recommending medications, are there any possible side effects? If you're recommending therapy, how often will I need it and for how long? What can I do now to reduce the risk of my panic attacks recurring? What treatment approach do you recommend? What websites do you recommend visiting? Would group therapy be helpful in my case?).

A physician or mental health provider who sees you for possible panic attacks or panic disorder may ask any of the following questions:
  • Did you experience significant stress or a traumatic event shortly before your first panic attack?
  • Do you avoid the locations or experiences that seem to trigger an attack?
  • Do you exercise?
  • Do you use caffeine, alcohol or recreational drugs? How often?
  • Does anything in particular seem to trigger an attack?
  • Have you been diagnosed with any medical conditions?
  • Have you experienced significant trauma — such as physical or sexual abuse or military battle — in your lifetime?
  • Have you or any of your close relatives been diagnosed with a mental health problem, including panic attacks or panic disorder?
  • How do your symptoms affect your life, including school, work and personal relationships?
  • How often do you experience fear of another attack?
  • How often do your attacks occur, and how long do they last?
  • How would you describe your childhood, including your relationship with your parents?
  • What are your symptoms, and when did they first occur?

To help pinpoint a diagnosis for your symptoms, you'll likely have several exams and tests. Your physician or other health care provider must determine if you have panic attacks, panic disorder or another condition (e.g., heart or thyroid problems) that resembles panic symptoms. You may have any of the following:
  • Psychological self-assessments and questionnaires
  • Inquiries about alcohol or other substance abuse
  • Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG), to help determine how well it's functioning
  • An evaluation by your physician or mental health provider to talk about your symptoms, stressful situations, fears or concerns, relationship problems, and other issues affecting your life
  • A complete physical exam

Not everyone who has panic attacks has a panic disorder. To be diagnosed with panic disorder, you must meet these criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association:
  • At least one of your attacks has been followed by one month or more of ongoing worry about having another attack; ongoing fear of the consequences of an attack, such as losing control, having a heart attack or "going crazy" or significantly changing your behavior, such as avoiding situations that you think may trigger a panic attack.
  • You have frequent, unexpected panic attacks.
  • Your panic attacks aren't caused by substance abuse, a medical condition or another mental health condition, such as social phobia or obsessive compulsive disorder.

For some AS and HFA adults, panic disorder includes agoraphobia (i.e., avoiding places or situations that cause you anxiety because you fear not being able to escape or get help if you have a panic attack). If you have panic attacks but not a diagnosed panic disorder, you can still benefit from treatment. If panic attacks aren't treated, they can get worse and develop into panic disorder or phobias.

The goal of treatment is to eliminate all of your panic attack symptoms. With effective treatment, most people are eventually able to resume everyday activities. The main treatment options for panic attacks are psychotherapy and medications. Both are effective. Your physician likely will recommend one or both types of treatment, depending on your preference, your history, the severity of your panic disorder and whether there are therapists with special training in panic disorders in your area.

Psychotherapy is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them.

Cognitive behavioral therapy can help you learn through your own experience that panic symptoms are not dangerous. During therapy sessions, your therapist will help you gradually re-create the symptoms of a panic attack in a safe, supportive setting. Once the physical sensations of panic no longer seem threatening, the attacks begin to resolve. Successful treatment can also help you overcome fears of situations that you've been avoiding because of panic attacks.

Your therapist may suggest weekly meetings when you begin psychotherapy. You may start to see improvements in panic attack symptoms within several weeks, and often symptoms decrease significantly or go away within several months. As your symptoms improve, you and your therapist will develop a plan to taper off therapy. You may agree to schedule occasional maintenance visits to help ensure that your panic attacks remain under control.

Medications can help reduce symptoms associated with panic attacks as well as depression if that is an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:

Benzodiazepines- These mild sedatives belong to a group of medicines called central nervous system depressants. Benzodiazepines may be habit-forming (causing mental or physical dependence), especially when taken for a long time or in high doses. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Niravam, Xanax), clonazepam (Klonopin) and lorazepam (Ativan). If you seek care in an emergency room for signs and symptoms of a panic attack, you may be given a benzodiazepine to help stop the attack.

Selective serotonin reuptake inhibitors (SSRIs)- Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. SSRIs approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).

Serotonin and norepinephrine reuptake inhibitors (SNRIs)- These medications are another class of antidepressants. The SNRI drug called venlafaxine hydrochloride (Effexor XR) is FDA approved for the treatment of panic disorder.

If one medication doesn't work well for you, your physician may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms. All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Talk with your physician about the possible side effects and risks.

Researchers have explored a number of natural remedies as possible treatments for anxiety disorders, including panic disorder. Small studies over 10 years old indicate that an oral nutritional supplement called inositol, which influences the action of serotonin, may reduce the frequency and severity of panic attacks. However, more research is needed. Talk with your physician before trying any natural therapies. These products can cause side effects and may interact with other medications. Your physician can help determine if they are safe for you.

While panic attacks and panic disorder benefit from professional treatment, you can also help manage symptoms on your own. Some of the lifestyle and self-care steps you can take include:
  1. Avoid caffeine, alcohol and illegal drugs. All of these can trigger or worsen panic attacks.
  2. Get physically active. Aerobic activity may have a calming effect on your mood.
  3. Get sufficient sleep. Get enough sleep so that you don't feel drowsy during the day.
  4. Join a support group. Joining a group for people with panic attacks or anxiety disorders can connect you with others facing the same problems.
  5. Practice stress management and relaxation techniques. For example, yoga, deep breathing and progressive muscle relaxation — tensing one muscle at a time, and then completely releasing the tension until every muscle in the body is relaxed — also may be helpful.
  6. Stick to your treatment plan. Facing your fears can be difficult, but treatment can help you feel like you're not a hostage in your own home.

Living With Aspergers: Help for Couples