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Should You Seek A Formal Diagnosis For High-Functioning Autism?

After the question of High-Functioning Autism is initially raised, many men and women wonder, “Should I get an official diagnosis?” For some, doing their own research through books, on the Internet, through support groups and information organizations provides enough answers and the best explanation regarding challenges that one faces as well as the strengths that one possesses. Others want validation from a therapist.

Getting a diagnosis as a grown man or women isn't easy, especially since High-Functioning Autism isn't widely heard of among medical professionals. The typical route for getting diagnosed is to visit a physician and ask for a referral to a therapist, preferably one with experience of diagnosing High-Functioning Autism. If you are already seeing a professional for other reasons (e.g., a therapist because you suffer from anxiety), then you might wish to ask him or her about a referral instead.

It might be difficult to convince your physician that a diagnosis would be either relevant or necessary. So, it’s important to know how to present your case so that your doctor can see (a) why you might have High-Functioning Autism and (b) why having a diagnosis could be helpful.

Make sure the diagnosis is the only thing you are seeing your physician for. If you try to turn it into a consultation about another issue, he or she may not address it fully. A good way to bring up the subject is to mention that you have been reading about High-Functioning Autism.

Next, explain why this is relevant to you. High-Functioning Autism is characterized by something known as the triad of impairments. Individuals with High-Functioning Autism will be affected in some way by each of these impairments. The  Autism Spectrum is very broad, and any two individuals with the condition may present very differently. No one individual will have all the traits, but by-and-large, most individuals with High-Functioning Autism will have problems in several important areas.

Individuals with High-Functioning Autism may be very good at basic communication and letting others know what they think and feel. Their difficulties lie in the social aspects of communication. For example, they may not have many friends and may choose not to socialize much, they may not be socially motivated because they find communication difficult, they may not be aware of what is socially appropriate and have difficulty choosing topics to talk about, or they may have difficulty understanding gestures, body language and facial expressions.

Some of these problems can be seen in the way individuals with High-Functioning Autism present themselves. For example classic traits include anxiety in social situations and resultant nervous tics, difficulties expressing themselves (especially when talking about emotions), difficulty making eye contact, and repetitive speech.

Typical examples of difficulties with social understanding include taking what others say very literally, problems understanding double meanings (e.g., not knowing when others are teasing you), not choosing appropriate topics to talk about, finding “small talk” very difficult, and difficulties in group situations (e.g., going to the bar with a group of buddies).

Lack of imagination in people with High-Functioning Autism can include difficulty imagining alternative outcomes and finding it hard to predict what will happen next. This frequently leads to anxiety. This can present as problems with sequencing tasks so that preparing to go out can be difficult because you can't always remember what to take with you, problems with making plans for the future, having difficulties organizing your life, and an obsession with rigid routines and severe distress when routines are disrupted. Some individuals with High-Functioning Autism over-compensate for this by being extremely meticulous in their planning and having extensive written or mental checklists.

Besides the triad of impairments, individuals with High-Functioning Autism tend to have difficulties which relate to the triad – but are not included within it. These can include:
  • acute anxiety, which can lead to panic attacks and a rigid following of routines
  • clumsiness often linked to a condition known as dyspraxia (this includes difficulties with fine motor coordination such as difficulties writing neatly, and problems with gross motor coordination such as ungainly movements, tripping, and falling frequently)
  • depression and social isolation
  • obsessive compulsive behaviors, often severe enough to be diagnosed as OCD 
  • obsessive interests in just one topic (e.g., they might have one subject about which they are extremely knowledgeable which they want to talk about with everyone they meet)
  • phobias (sometimes individuals with High-Functioning Autism are described as having a social phobia, but they may also be affected by other common fears such as claustrophobia and agoraphobia)

Not having these associated issues doesn’t mean you don’t have High-Functioning Autism, but if you have any of them, you might want to describe them to the doctor in order to back up your case. However, you don't need to describe every single trait you have. Your physician may be more likely to respond if you give one good example. Once you have explained why you think you have High-Functioning Autism, you could also show him/her this article. If your physician disagrees with your argument, ask for the reasons why. If you don't feel comfortable discussing his/her decision, then ask for a second appointment to talk it through.

Diagnosis as an adult can be a mixed blessing. Some individuals decide they are O.K. with being self-diagnosed and decide not to ask for a formal diagnosis. However, for those who DO want a formal diagnosis, there are a variety of benefits:

1. Many individuals suffer the consequences of being constantly misunderstood. Often the fact that someone has High-Functioning Autism can lead to teasing, bullying and social isolation. When the individuals close to you are able to understand that there is a reason for your quirks and difficulties, it is much easier for them to empathize with your dilemma.

2. It can be fun to meet up with others who have the disorder in order to learn about their experiences and share your own. There are many support groups available. Check with your nearest Autism association. Also, you can contact others with High-Functioning Autism through the internet. You don’t have to have a formal diagnosis in order to access this support.

3. Men and women with High-Functioning Autism may need support with day-to-day living. If they are having these needs met, it may be by individuals who don’t understand High-Functioning Autism and the specific difficulties associated with it. With a diagnosis, you may be able to access specific services (if they exist in your area).

4. Many people with High-Functioning Autism have suffered from mental health problems or have been misdiagnosed as having mental health problems (e.g., bipolar, schizophrenia). They have known that they have specific difficulties for a long time without being able to explain them. A formal diagnosis can be a relief because it allows them to learn about their disorder and understand where and why they have difficulties.

5. Additionally, one may use the information derived from a formal diagnosis to:
  • Consider disclosure to family, friends and co-workers
  • Customize one's environment to be more comfortable and accommodating to the strengths and challenges of High-Functioning Autism
  • Do a life review
  • Understand why careers and relationships have - or have not - been successful
  • Find other people with High-Functioning Autism with whom to compare notes 
  • Find people who share similar interests
  • Improve on relationships and pursue better matches
  • Plot a career that matches interests and abilities
  • Plot a course through college
  • Renew or repair relationships that have been negatively affected by High-Functioning Autism
  • Request reasonable accommodations at school or work
  • Take classes part time in order to account for executive functioning and organizational deficits
  • Work differently with helping professionals with an emphasis on concrete coaching help and building of life skills rather than “insight-oriented” therapy

The bottom line is this: If you have High-Functioning Autism and don’t know, it affects you anyway. But, if you do know, you can minimize the negative impact and leverage the positive. Without the knowledge that one has High-Functioning Autism, one often fills that void with other, more damaging explanations like failure, odd, disappointment, not living up to one’s potential, etc.

Living With Aspergers & High-Functioning Autism: Help for Couples

Asperger's Adults and Winter Depression

Winter depression affects many people, but for those with Asperger's and High-Functioning Autism, this phenomenon can be even more pronounced. Winter depression is a mystery to researchers who study it. Many factors seem to be involved (e.g., brain chemicals, ions in the air, genetics, etc.). But scientists agree that individuals who suffer from winter depression have one very important thing in common: they're especially sensitive to light, or the lack of it.

Here are some quick tips for overcoming winter depression:

1. Avoid excessive alcohol consumption. Alcohol is actually a depressant. Rather than improving your mood, it only makes it worse. Avoiding alcohol when you are already depressed is a good idea.

2. Burn some candles. If you don’t have a fireplace, do the next best thing and light some candles. Then sit and watch them burn, or read a good book beside them.

3. Do something challenging. Stretch yourself in some small way every winter (e.g., take a writing class, research the genetics of mood disorders, build a website, etc.). It keeps your brain from freezing like the rest of your body.

4. Dress in bright colors. There seems to be a link between feeling optimistic and sporting bright colors.

5. Eat healthy. Avoid refined and processed foods (e.g., white breads, rice, and sugar). These foods are not only devoid of the nutrients your body craves, but they zap your energy levels and can affect your mood—causing depression, lack of concentration, and mood swings. Depressives and addicts need to be especially careful with sweets, because the addiction to sugar and white-flour products is very real and physiological, affecting the same biochemical systems in your body as other drugs like heroin.

6. Enjoy the season. Instead of avoiding the ice and snow, look for the best that winter has to offer (e.g., ice skating, snowboarding, hockey, sledding, etc.). Enjoy these activities while they last, because they’re only here a few months each year.

7. Find a hobby. Keeping your mind active with a new interest seems to ward off symptoms of depression (e.g., play bridge, sing, knit, keep a journal, etc.). The important thing is that you have something to look forward to and concentrate on.

8. Follow through with your New Year’s resolutions. There is a strong link between healthy behaviors and depression. People who exhibit healthy behaviors (e.g., exercising, not smoking, etc.) have less sad and depressed days than those whose behaviors are less than healthy.

9. Get a light lamp. Bright-light therapy, involving sitting in front of a fluorescent light box, can be as effect as antidepressant medication for mild and moderate depression.

10. Get plenty of sleep. Get 7-8 hours each night, and try to keep your bedtime and waking time consistent. That way, sleeping patterns will normalize and you’ll have more energy.

11. Get some social support. Don’t underestimate the power of friends, family, mentors, co-workers, and neighbors. Find safe people you can turn to when you’re down and need a pick-me-up.

12. Go to counseling. Counseling, psychotherapy or cognitive behavioral therapy can help you cope with depression.

13. Perform daily small acts of kindness. The best way to find yourself is to lose yourself in the service of others. A sense of purpose, committing oneself to a noble mission, and acts of altruism are strong antidotes to depression.

14. Treat yourself. Having something to look forward to can keep you motivated. Plan something that’s exciting to you (e.g., a weekend trip, a day at the spa, a party, a play, a sporting event, etc.).

15. Start and complete a project. Projects like organizing bookshelves, shredding old tax returns, and cleaning out the garage are perfect activities for the dreary months of the year.

16. Take Omega-3′s. Researchers have confirmed the positive effects of this natural, anti-inflammatory molecule on emotional health. One 500mg soft gel capsule meets the doctor-formulated 7:1 EPA to DHA ratio, needed to elevate and stabilize mood.

17. Get help if all else fails. If your symptoms are so bad that you can't live a normal life, see your doctor for medical help. Some antidepressants like Paxil and Prozac work for many individuals who suffer from the winter blues.

Coping Strategies for Adults with Asperger's

I recently asked a few of my adult Asperger’s (High-Functioning Autism) clients to tell me what has really worked for them in the way of coping strategies. Here are their answers:

Mark Hutten: “As you look back on your life, what has been your most effective coping strategy?”

Rick: “I think my most effective coping strategy has been my faith in God. I don't go to church as much as I should, or read the Bible as much as I should, but I do have a strong belief that God is with me and helps me through my trials. He has always come through for me.”

Michael: “What has worked for me more than anything else is staying in shape and working out. I try to do cardio in the morning and weight-bearing exercises in the afternoon. Staying in shape is both a distraction for me and a mood elevator, which helps me to cope with other things that come up in my day.”

Rhonda: “Well, I consider myself to be a lifelong learner. I like to read, and I keep my mind active by educating myself on new subject matter. Gaining new knowledge in an area that is new to me helps me to focus on things other than my personal problems. I also go to my local college and take classes periodically. So staying mentally sharp helps me to cope.”

Sarah: “Counseling has been the best technique for me. I come here every week. I can talk to the group about personal matters that I wouldn't feel comfortable talking about with anyone else, and you guys give me great feedback and insight. It helps me see things from a different perspective, which keeps me from taking life too seriously and taking other people's behavior to personally.”

David: “I have a couple close friends that have been a big help to me. I could probably have as many friends as I want to, but I'm not a very social person by nature. I would rather have one or two close friends than a dozen wishy-washy friends. My friends are very similar to me with regard to temperament. So we click together pretty good. We can laugh at life, which is a great stress reliever for me.”

Katherine: "What seems to help me through life in general is my job. For the most part, I enjoy my work. It brings me a lot of satisfaction. I'm preoccupied with job related matters most of the day. It seems to be a source of good stress rather than bad stress for me, if that makes sense."

Shawn: “My wife has been the best source to help me to cope. She holds me accountable, but when I have a meltdown, she usually backs-off because she knows that my meltdown only lasts for short period of time. If I'm upset, she doesn't get upset because I'm upset. She helps me to calm down. I love her very much and she's my best friend.”

Allan: “Music helps me to cope. I play several musical instruments, and it's easy for me to express my feelings as I'm playing the instrument. I can express all of my emotions whenever I am playing music. If I feel frustrated, I can play frustrated feelings in my music. If I am happy, then my music sounds happy too. It is a natural way for me to get rid of painful emotions.”

Thomas: “Probably what helps me to cope every day is to just lie down on the couch and watch a good movie with my cat. It helps me to calm down and enjoy a couple hours in the day. My cat is very playful, and this reminds me to keep it simple and make it fun. She reminds me that play is just as important as work.”

Tina: “I enjoyed cooking. Cooking new dishes is relaxing to me. I enjoy experimenting with different recipes. Cooking is kind of a hobby for me. It involves several steps ...going to the grocery and getting good ingredients ...coming home and putting the recipe together ...cooking ...and then the best part, eating it. I also enjoy experimenting with different wines. For example, red wine goes good with pasta, and certain white wines go better with seafood. So it is always fun to connect the best wine to a particular dish.”

Living With Aspergers: Help for Couples

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