Adults with ASD and Social Anxiety Disorder

Social Anxiety Disorder (SAD), also called social phobia, is diagnosed when individuals become overwhelmingly anxious and excessively self-conscious in everyday social situations. ASD (high functioning autism) adults with SAD have an intense, persistent fear of interacting with others (especially in groups). They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.

It's normal to feel nervous in some social situations. For example, going on a date or giving a presentation may cause that feeling of butterflies in your stomach. But in SAD, everyday interactions cause irrational anxiety and self-consciousness.

While many ASD adults with SAD realize that their fears about being with others are excessive or unreasonable, they are unable to overcome them. Even if they manage to confront their fears and be around others, they are usually very anxious beforehand, are intensely uncomfortable throughout the encounter, and worry about how they were judged for hours afterward.

SAD can be limited to one situation (e.g., talking to others, eating or drinking, writing on a blackboard in front of others, etc.) or may be so broad that the individual experiences anxiety around almost anyone other than close family members.

 

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Symptoms—

Emotional and behavioral SAD signs and symptoms include:

• Anxiety that disrupts your daily routine, work, school or other activities
• Avoiding doing things or speaking to others out of fear of embarrassment
• Avoiding situations where you might be the center of attention
• Difficulty making eye contact
• Difficulty talking
• Fear of situations in which you may be judged
• Fear that others will notice that you look anxious
• Intense fear of interacting with strangers
• Worrying about embarrassing or humiliating yourself

Physical SAD signs and symptoms include:

• Blushing
• Cold, clammy hands
• Confusion
• Diarrhea
• Fast heartbeat
• Muscle tension
• Nausea
• Shaky voice
• Sweating
• Trembling or shaking
• Upset stomach

Worrying about having symptoms:

When adults on the spectrum have SAD, they realize that their anxiety or fear is out of proportion to the situation. Yet they’re so worried about developing SAD symptoms that they avoid situations that may trigger them. This type of worrying creates a vicious cycle that can make symptoms worse.

When to see a doctor:

See your doctor or mental health provider if you fear and avoid normal social situations because they cause embarrassment, worry or panic. If this type of anxiety disrupts your life, causes severe stress and affects your daily activities, you may have SAD or another mental health condition that requires treatment to get better.

Feelings of shyness or discomfort in certain situations aren't necessarily signs of SAD, particularly in kids. Comfort levels in social situations vary from individual to individual due to personality traits and life experiences. Some people are naturally reserved and others are more outgoing. What sets SAD apart from everyday nervousness is that its symptoms are much more severe, causing the  individual to avoid normal social situations.

Common, everyday experiences that may be difficult to endure when the ASD adult has SAD include:

• Being introduced to strangers
• Entering a room in which individuals are already seated
• Initiating conversations
• Interacting with strangers
• Making eye contact
• Ordering food in a restaurant
• Returning items to a store
• Using a public restroom or telephone
• Writing in front of others

SAD symptoms can change over time. They may flare up if you're facing a lot of stress or demands, or if you completely avoid situations that would usually make you anxious, you may not have symptoms. Although avoidance may allow you to feel better in the short term, your anxiety is likely to persist over the long term if you don't get treatment.

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Causes—

Like many other mental health conditions, SAD likely arises from a complex interaction of environment and genes. Possible causes include:

• Brain chemistry: Natural chemicals in your body may play a role in SAD. For instance, an imbalance in the brain chemical serotonin may be a factor. Serotonin is a neurotransmitter that helps regulate mood and emotions, among other things. Individuals with SAD may be extra-sensitive to the effects of serotonin.
• Brain structure: A structure in the brain called the amygdale may play a role in controlling the fear response. Individuals who have an overactive amygdala may have a heightened fear response, causing increased anxiety in social situations.
• Inherited traits: Anxiety disorders tend to run in families. However, it isn't entirely clear how much of this may be due to genetics and how much is due to learned behavior.
• Negative experiences: Kids who experience teasing, bullying, rejection, ridicule or humiliation may be more prone to SAD. In addition, other negative events in life, such as family conflict or sexual abuse, may be associated with SAD.

Risk factors—

SAD is one of the most common mental disorders. It usually begins in the early to mid-teens, although it can sometimes begin earlier in childhood or in adulthood. A number of factors can increase the risk of developing SAD, including: 

• Environment: SAD may be a learned behavior. That is, the ASD person may develop the condition after witnessing the anxious behavior of others. In addition, there may be an association between SAD and moms and dads who are more controlling or protective of their kids.
• Family history: You're more likely to develop SAD if your biological moms and dads or siblings have the condition.
• Having a health condition that draws attention: Facial disfigurement, stuttering, Parkinson's disease and other health conditions can increase feelings of self-consciousness and may trigger SAD in some individuals.
• New social or work demands: Meeting new individuals, giving a speech in public or making an important work presentation may trigger SAD symptoms for the first time. These symptoms usually have their roots in adolescence, however.
• Temperament: Kids who are shy, timid, withdrawn or restrained when facing new situations or individuals may be at greater risk.

Complications—

Left untreated, SAD can be debilitating. Your anxieties may run your life. They can interfere with work, school, relationships or enjoyment of life. You may be considered an "underachiever," when in reality it's your fears holding you back, not your ability or motivation. In severe cases, you may drop out of school, quit work or lose friendships. SAD can cause:

• Hypersensitivity to criticism
• Low self-esteem
• Negative self-talk
• Poor social skills
• Trouble being assertive

SAD can also result in:

• Excessive drinking, particularly in men
• Isolation and difficult social relationships
• Low academic achievement
• Poor work record
• Substance abuse
• Suicide

Preparing for a doctor’s appointment—

You may start by seeing your family doctor. After your initial appointment, your doctor may refer you to a mental health provider who can help make a firm diagnosis and create the right treatment plan for you.

What you can do:

• Ask a trusted family member or friend to be present for your appointment, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down all of your medical information, including other physical or mental health conditions with which you've been diagnosed. Also write down the names of any medications you're taking.
• Write down any symptoms you've been experiencing, and for how long. SAD often first appears in your teens. Your doctor will be interested to hear how your symptoms may have waxed or waned since they began.
• Write down questions to ask your doctor.
• Write down your key personal information, especially any significant events or changes in your life shortly before your symptoms appeared. For example, your doctor will want to know if your social anxiety seemed to be triggered by a promotion, meeting new individuals, or another new work or social demand.

Questions to ask your doctor at your initial appointment may include:

• Are there any other possible causes?
• How will you determine my diagnosis?
• Should I see a mental health specialist?
• What do you believe is causing my symptoms?

Questions to ask if you are referred to a mental health provider include:

• Am I at increased risk of other mental health problems?
• Are effective treatments available for this condition?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?
• Is my condition likely temporary or chronic?
• With treatment, could I eventually be comfortable in the situations that make me so anxious now?

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In addition to the questions that you've prepared in advance, don't hesitate to ask questions at any time during your appointment.

A doctor or mental health provider who sees the person for possible SAD may ask:

• Do you avoid activities in which you are the center of attention?
• Do you drink alcohol or use illegal drugs? If so, how often?
• Do you ever have symptoms when you're not being observed by others?
• Does anything seem to make your symptoms better or worse?
• Does fear of embarrassment cause you to avoid doing things or speaking to individuals?
• Have any of your close relatives had similar symptoms?
• Have you been diagnosed with any medical conditions?
• Have you been treated for other psychiatric symptoms or mental illness in the past? If yes, what type of therapy was most beneficial?
• Have you ever thought about harming yourself or others?
• How are your symptoms affecting your life, including your work and personal relationships?
• When are your symptoms most likely to occur?
• When did you first notice these symptoms?
• Would you say that being embarrassed or looking stupid is among your worst fears?

Tests and diagnosis—

When you decide to seek treatment for SAD symptoms, you may have a physical exam and your doctor will ask a number of questions. The physical exam can determine if there may be any physical causes triggering your symptoms. Answering questions will help your doctor or mental health provider find out about your psychological state.

There's no laboratory test to diagnose SAD, however. Your doctor or mental health provider will ask you to describe your signs and symptoms, how often they occur and in what situations. He or she may review a list of situations to see if they make you anxious or have you fill out psychological questionnaires to help pinpoint a diagnosis.

To be diagnosed with SAD, an individual must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Criteria for SAD to be diagnosed include:

• Persistent fear of social situations in which the individual believes he/she may be scrutinized or act in a way that's embarrassing or humiliating.
• These social situations cause you a great deal of anxiety.
• You avoid anxiety-producing social situations.
• You recognize that your anxiety level is excessive or out of proportion for the situation.
• Your anxiety or distress interferes with your daily living.

SAD shares symptoms with other psychological disorders, including other anxiety disorders. Your mental health provider will want to determine whether one of these other conditions may be causing your social anxiety, or if you have SAD along with another mental health disorder. Often, social anxiety occurs along with other mental health conditions, such as substance abuse problems, depression and body dysmorphic disorder.

Treatments and drugs—

The two most common types of treatment for SAD are medications and psychotherapy. These two approaches may be used in combination.

Psychotherapy:

Psychological counseling (psychotherapy) improves symptoms in most individuals with SAD. In therapy, you learn how to recognize and change negative thoughts about yourself. Cognitive behavioral therapy is the most common type of counseling for anxiety. This type of therapy is based on the idea that your own thoughts — not other individuals or situations — determine how you behave or react. Even if an unwanted situation won't change, you can change the way you think and behave.

Cognitive behavioral therapy may also include exposure therapy. In this type of therapy, you gradually work up to facing the situations you fear most. This allows you to become better skilled at coping with these anxiety-inducing situations and to develop the confidence to face them. You may also participate in skills training or role-playing to practice your social skills and gain comfort and confidence relating to others. Your mental health professional may help you develop relaxation or stress management techniques. 

 

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First choices in medications:

Several types of medications are used to treat SAD. However, selective serotonin reuptake inhibitors (SSRIs) are often the first type of medication tried for persistent symptoms of social anxiety. SSRIs your doctor may prescribe include:

• Fluoxetine (Prozac, Sarafem, others)
• Fluvoxamine (Luvox)
• Paroxetine (Paxil)
• Sertraline (Zoloft)

The serotonin and norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor) also may be an option for SAD.

To reduce the risk of side effects, your doctor will start you at a low dose of medication and gradually increase your prescription to a full dose. It may take up to three months of treatment for your symptoms to noticeably improve.

Other medication options:

Your doctor or mental health provider may also prescribe other medications for symptoms of social anxiety.

• Anti-anxiety medications: A type of anti-anxiety medication called benzodiazepines may reduce your level of anxiety. Although they often work quickly, they can be habit-forming. Because of that, they're often prescribed for only short-term use. They may also be sedating. If your doctor does prescribe anti-anxiety medications, make sure you try taking them before you're in a social situation so that you know how they will affect you.
• Beta blockers: These medications work by blocking the stimulating effect of epinephrine (adrenaline). They may reduce heart rate, blood pressure, pounding of the heart, and shaking voice and limbs. Because of that, they may work best when used infrequently to control symptoms for a particular situation, such as giving a speech. They're not recommended for general treatment of SAD. As with anti-anxiety medications, try taking them before you need them to see how they affect you.
• Other antidepressants: The person may have to try several different antidepressants to find which one is the most effective and has the fewest unpleasant side effects.

Don't give up if treatment doesn't work quickly. The ASD adult can continue to make strides in psychotherapy over several weeks or months. And finding the right medication for your situation can take some trial and error. For some individuals, the symptoms of SAD may fade over time, and medication can be discontinued. Others may need to take medication for years to prevent a relapse. To make the most of treatment, keep your medical or therapy appointments, take medications as directed, and talk to your doctor about any changes in your condition.

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Lifestyle and home remedies—

Although SAD generally requires help from a medical expert or qualified psychotherapist, the individual can try some self-help techniques to handle situations likely to trigger symptoms.

First, consider your fears to identify what situations cause the most anxiety. Then gradually practice these activities until they cause you less anxiety. Begin with small steps in situations that aren't overwhelming.

Situations to practice may include:

• Asking a retail clerk to help you find an item
• Calling a friend to make plans
• Eating with a close relative, friend or acquaintance in a public setting.
• Getting directions from a stranger
• Giving someone a compliment
• Making eye contact and returning greetings from others, or being the first to say hello
• Showing an interest in others — ask about their homes, kids, grandkids, hobbies or travels, etc.

At first, being social when you're feeling anxious is challenging. As difficult or painful as it may seem initially, don't avoid situations that trigger your symptoms. By regularly facing these kinds of situations, you'll continue to build and reinforce your coping skills. The following techniques can help

one begin to face situations that make him/her nervous:

• Adopt stress management techniques.
• Focus on personal qualities you like about yourself.
• Pay attention to how often the embarrassing situations you're afraid of actually take place. You may notice that the scenarios you fear usually don't come to pass.
• Practice relaxation exercises.
• Prepare for conversation. For instance, read the newspaper to identify an interesting story you can talk about.
• Set realistic goals.
• When embarrassing situations do happen, remind yourself that your feelings will pass, and you can handle them until they do.

Avoid using alcohol to calm your nerves. It may seem like it helps, but in the long run it can make you feel more anxious.

Alternative medicine—

Certain supplements may help relieve anxiety, although it isn't clear about how much they help or what possible side effects they might have. Some supplements used to treat anxiety include:

• Vitamin B and folic acid: These nutrients may relieve anxiety by affecting the production of chemicals needed for your brain to function (neurotransmitters).
• Valerian: Most commonly used as a sleep aid, valerian has a sedative effect and may also relieve anxiety.
• Kava: This herb is reported to relax you without making you feel sedated. Some studies have linked kava to liver problems, so it isn't a good idea to take it if you have a liver condition, drink alcohol daily or take medications that affect your liver.

Talk to your doctor before taking herbal remedies or supplements to make sure they're safe for you and won't interact with any medications you take.

Coping and support—

Some coping methods that may help ease your anxiety include:

• Doing pleasurable activities, such as exercise or hobbies, when you feel anxious
• Eating a well-balanced diet
• Getting enough sleep
• Joining a group that offers opportunities to improve communication and public speaking skills, such as Toastmasters International
• Joining a local or Internet-based support group
• Reaching out to others with whom you feel comfortable

Over time, these coping methods can help control your symptoms and prevent a relapse. Remind yourself that you can get through anxious moments, that your anxiety is short-lived, and that the negative consequences you worry about so much rarely come to pass.

Prevention—

There's no way to predict for certain what will cause someone to develop an anxiety disorder in the first place, but the person  can take steps to reduce the impact of symptoms if anxious:

• Avoid unhealthy substance use. Alcohol and drug use and even caffeine or nicotine use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a support group to help you.
• Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
• Keep a journal. Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.
• Prioritize your life. You can reduce anxiety by carefully managing your time and energy.

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Best Comment:

This is very true, other people can't see that it's a constant battle before, during and after. THis is totally draining. However I think it's vital that Aspergers be diagnosed for a person first before SAD can be addressed. I was treated for SAD which made it worse because they made out I was behaving irrationally, had I known I had Aspergers it would have been OBVIOUS why I feel and act like I do. The reason we suffer from SAD is because of people who don't accept us and don't tune in to our needs.

The Logical ASD Brain versus the Intuitive NT Brain

Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

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==> Living With Aspergers: Help for Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism  

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder

The Difference Between the Male-ASD Brain and the Female-NT Brain

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==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism

How the Symptoms of ASD [level 1] Differ in Women Compared to Men

RE: "How are the symptoms of autism spectrum disorder different in women as compared to men?"

The symptoms of ASD in ladies are not hugely different from those in guys. However, females on the autism spectrum are more likely to camouflage their symptoms. 

 

Common forms of camouflaging include preparing jokes or phrases ahead of time to use in conversation, mimicking the social behavior of others, imitating expressions and gestures, and forcing themselves to make eye contact during conversations.

While both men and women with ASD can camouflage their symptoms, it appears to be more common with the ladies. This could explain why they’re less likely to be diagnosed. Studies suggests that, compared to guys, ladies with ASD have less of a tendency to become hyper-focused on a subject or activity, but have more emotional problems (e.g., depression, anxiety).

Generally speaking, females who have ASD are different, not in the core traits of the disorder, but in how they react to the disorder. They tend to mask their social and communication problems in specific ways that are different from the guys on the spectrum. As a result, ladies are often under-diagnosed, or diagnosed with a different disorder. In either case, many of them struggle to cope with their symptoms without the benefit of needed resources and support.

Studies show that ladies with ASD are different from female NTs in how their brains analyze social information. Amazingly, the brain of a woman with ASD is more like the brain of an NT male than that of an autistic male.

Early in life, females with ASD show a greater desire to connect with others. Their interests are more similar to those of NTs. They are more likely to engage in pretend play (characteristic of girls, in general). Also, they are less drawn to repetitive behaviors. Even though they may not be as socially active as NT girls, they often have intense friendships with girls who provide compassion and guidance in social situations.

Girls, and later grown women, often develop coping strategies that cover-up the trouble they have “fitting-in.” They often use imitation or imagination, identifying with other female role-models in an effort to learn how to “act” socially. They figure out the best way to remain undetected by studying social situations and practicing appropriate ways of behaving.

Being well behaved and compliant at school furthers the development and refinement of social skills for these young girls. As a result, they stand out less than boys with ASD. Girls on the spectrum tend to overcome or hide their deficits. As they develop and mature, such deficits appear less pronounced and cause less difficulty for them, in general.

Unlike many autistic guys, ladies with ASD tend to prefer one-on-one social interactions and single friendships (often close and intimate). Although they may have difficulty in group situations, they can be very good at relating directly to one person. They tend to be less solitary than guys with ASD, and are more likely to seek out relationships with the opposite sex, moving towards long-term romantic relationships.

Women on the autism spectrum are more sensitive to emotions in others than guys with ASD. Ironically, the desire in autistic ladies to connect is frequently painful as they encounter ASD-related social and communication problems. 

Loneliness is a common complaint amongst these women. More than 65% of adults with ASD report suicidal thoughts - of this percentage, 77% are females. Clearly, ladies on the spectrum think, feel and act differently than their male counterparts. But it’s different - not necessarily better.

Women are often under-represented in individuals who have a diagnosis of ASD when higher IQ is factored in. This means that of those with a higher intelligence level, women are less likely to be given a diagnosis of ASD. This may be because women with higher intelligence can use their intelligence to develop coping strategies and to learn ways to navigate their life experiences despite their ASD symptoms.

Even within the range of average intelligence, autistic women are often able to display more socially acceptable and functional skills in their social interactions as compared to autistic men. This may be due to how these women can learn to imitate those around them - even when social skills don’t come naturally.

One theory of the differences between autistic men and women (related to restrictive and repetitive behaviors) is that women often have “fewer” of these types of behaviors – and they have “different” types of these behaviors. The restrictive or repetitive behaviors of women may not be noticed as much – and may appear more “socially appropriate.” Autistic women also have limited interests, but these interests appear to be socially acceptable, and therefore are less noticed as a symptom of ASD.

In summary, men and women on the autism spectrum differ in the following areas:

• as IQ increases, women are less likely to be diagnosed with ASD, which may have to do with their ability to develop coping strategies to manage their life experiences despite having the disorder 
• at a young age, women on the spectrum seem to have more motor deficits, but fewer communication deficits 
• men are diagnosed at a 4:1 ratio when compared to women 
• autistic women often display fewer - and different - types of restrictive or repetitive behaviors as compared to men, and these behaviors are less noticeable to others

 
Emotional, Social, Physical, Behavioral, and Cognitive Traits that Women with ASD May Exhibit:

1.    Abused or taken advantage of as a little girl, but didn’t think to tell anyone
2.    Allergies and food sensitivities
3.    An emotional incident can determine the mood for the day
4.    Analyze existence and the meaning of life
5.    Appearance of hearing problems, but hearing has been checked and is fine
6.    As a little girl, it was hard to know when it was her turn to talk
7.    Aversion to answering questions about themselves
8.    Becomes overwhelmed with too much verbal direction
9.    Calmed by external stimulation (e.g., soothing sound, brushing, rotating object, constant pressure)
10.    Can’t relax or rest without many thoughts

11.    Chronic fatigue
12.    Come across at times as narcissistic
13.    Confused by tone of voice, proximity of body, body stance, the rules of accurate eye contact, posture in conversation, etc.
14.    Constipation
15.    Conversations are often exhausting
16.    Daydream a lot
17.    Deep thinkers
18.    Desires comfort items (e.g., blankets, teddy, rock, string)
19.    Diagnosed with a mental illness
20.    Didn’t participate in class

21.    Difficulty:
•    filtering out background noise when talking to others
•    making and keeping friends
•    transitioning from one activity to another   
•    understanding directional terms (e.g., north, south)   
•    understanding group interactions
•    with fine motor activities (e.g., coloring, printing, using scissors, gluing)
•    with loud or sudden sounds

22.    Dislike being in a crowded mall, crowded gym, and/or crowded theater
23.    Don’t simplify
24.    Don’t take things for granted
25.    Dreams are anxiety-ridden and vivid
26.    Easily fooled and conned
27.    Eating disorders
28.    Emotions can pass very suddenly or are drawn out for a long period of time

29.    Escape:
•    by playing the same music over and over
•    into other rooms at parties
•    regularly through fixations and obsessions
•    routinely through imagination, fantasy
•    through a relationship (imagined or real)
•    through counting, categorizing, organizing, etc.
•    through mental processing
•    through the rhythm of words

30.    Everything has a purpose
31.    Everything is complex
32.    Excellent rote memory
33.    Exceptionally high skills in some areas and very low in others
34.    Experience multiple physical symptoms
35.    Experience trouble with lying
36.    Extreme anxiety for no apparent reason
37.    Feel as if missing a thought-filter
38.    Feel extreme relief when they don’t have to go anywhere or talk to anyone

39.    Feelings:
•    of being misplaced and/or from another planet
•    of confusion and being overwhelmed
•    of dread about upcoming events and appointments
•    of isolation
•    of polar extremes (e.g., sad/happy)

40.    Feels the need to fix or rearrange things
41.    Find it difficult to understand manipulation and disloyalty
42.    Find it difficult to understand vindictive behavior and retaliation
43.    Find norms of conversation confusing
44.    Find unwritten and unspoken rules difficult to grasp, remember, and apply
45.    Food obsessions
46.    Frustration is expressed in unusual ways
47.    Generalized Anxiety
48.    Had imaginary friends as a little girl
49.    Have a continuous dialogue in mind that tells them what to say and how to act when in a social situation

50.    Have had bouts of depression
51.    Highly intelligent
52.    Hold a lot of thoughts, ideas, and feelings inside
53.    Honest
54.    Imitate friends or peers in style, dress, attitude, etc.
55.    Imitate people on television or in movies
56.    Immune challenges
57.    Intolerance to certain food textures, colors or the way they are presented on the plate (e.g., one food can’t touch another)
58.    Irregular sleep patterns
59.    Irritable bowel

60.    Knowing they have to leave the house causes anxiety
61.    Lack in coordination
62.    Little impulse control with speaking
63.    Make friends with older or younger females
64.    Many and varied collections
65.    Mastered imitation
66.    May have a very high vocabulary
67.    May need to be left alone to release tension and frustration
68.    Misdiagnosed
69.    Monopolize conversations

70.    Naïve
71.    Numbers are calming (e.g., numbers associated with patterns, calculations, lists, etc.)
72.    Obsess about the potentiality of a relationship with someone
73.    Obsessively collect and organize objects
74.    OCD
75.    Often drop small objects
76.    Often get lost in their own thoughts and “checks out”
77.    Often sound eager and over-zealous or apathetic and disinterested
78.    Often harbor guilt for “hibernating” and not doing “what everyone else is doing”
79.    Over-interest in certain subjects

80.    Perfectionism in certain areas
81.    Philosophize
82.    Poor muscle tone, double-jointed
83.    Practice/rehearse in mind what they will say to another before entering the room
84.    Prepares themselves mentally for outings and appointments, often days before a scheduled event
85.    Prolific writers drawn to poetry
86.    Question place in the world
87.    Question the actions and behaviors of themselves and others
88.    Reveals intimate details to strangers
89.    Search for right and wrong

90.    See things at multiple levels, including their own thinking processes
91.    Sense of humor sometimes seems quirky, odd, or inappropriate
92.    Sense of pending danger or doom
93.    Sensory Issues
94.    Serious and matter-of-fact in nature
95.    Share in order to reach out
96.    Survive overwhelming emotions and senses by escaping in thought or action
97.    Tendency to overshare
98.    Tends to either tune out or break down when being criticized
99.    Tics

100.    Trained themselves in social interactions through readings and studying of others
101.    Transitioning from one activity to another is difficult
102.    Uncomfortable in public bathrooms
103.    Unusually high or low pain tolerance
104.    Visualize and practice how they will act around others
105.    Walks without swinging arms freely
106.    Wonder who they are and what is expected of them
107.    Worry about what is eaten

Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living With Aspergers: Help for Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism  

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder

Correcting Social Deficits: Tips for Aspergers Adults

One of the most characteristic symptoms of Aspergers and High-Functioning Autism is a deficit in social behavior. Many reports written by researchers have described this problem, and it is thought by many to be the key defining feature of Aspergers. The social problems can be classified into three categories: socially indifferent, socially awkward, and socially avoidant.

1. The socially indifferent Aspie:

• does not seem to mind being with people – but at the same time – does not mind being by himself
• does not seek social interaction with others (unless he wants something), nor does he actively avoid social situations

It is thought that this type of social behavior is common in the majority of Aspergers adults. One theory is that they do not obtain 'biochemical' pleasure from being with others. Beta-endorphins (an endogenous opiate-like substance in the brain) are released in the brain during social behavior. There is evidence that the beta-endorphin levels in people with Aspergers are elevated, so they do not need to rely on social interaction for pleasure. Some research on the drug called “Naltrexone” (which blocks the action of beta-endorphins) has shown to increase social behavior.

2. The socially awkward Aspie:

• desires romantic relationships, but does not have the skills to find and keep a partner
• does not learn social skills and social taboos by observing others
• is self-centered
• lacks common sense when making social decisions
• lacks reciprocity in interactions, since conversations often revolve around self
• may try very hard to have friends, but can’t keep them

3. The socially avoidant Aspie:

• avoids virtually all forms of social interaction

In childhood, the most common response in the socially avoidant individual is having a tantrum or running away when someone tries to interact with him or her. As infants, some are described as arching their back from a parent to avoid contact. For many years, it was thought that this type of reaction to their social environment indicated that the person with Aspergers did not like - or was afraid of - people. Another theory (which is based on interviews with Aspergers adults) suggests that the problem may be due to hypersensitivity to certain sensory stimuli (e.g., some said that a parent's voice hurt their ears, some describe the smell of their parents' perfume or cologne as offensive, some describe pain when being touched or held, etc.).

In addition to the above three types of social deficits, the social cognition of adults with Aspergers may be lacking. Recent research has shown that many Aspies do not realize that other individuals have their own thoughts, plans, and points of view. They also appear to have difficulty understanding other people's beliefs, attitudes, and emotions. As a result, they may not be able to anticipate what others will say or do in various social situations. This has been termed “mind-blindness.”

Treatment—

1. Biomedical: Naltrexone is usually not prescribed to improve social interaction; however, research studies and reports have often indicated improved social skills when given Vitamin B6 and magnesium, and/or dimethylglycine (DMG).

2. Sensory: If the problem appears to be due to hypersensitivity to sensory stimuli, sensory-based interventions may be helpful (e.g., auditory integration training, sensory integration, visual training, and Irlen lenses). Another strategy would be to remove these sensory intrusions from the person's environment.

3. Social-Skills Training: A major goal of social skills training is teaching Aspergers adults about the verbal and nonverbal behaviors involved in social interactions. There are many Aspies who have never been taught such interpersonal skills (e.g., making "small talk" in social settings, the importance of good eye contact during a conversation, etc.). In addition, many of these individuals have not learned to "read" the many subtle cues contained in social interactions (e.g., how to tell when someone wants to change the topic of conversation or shift to another activity). Social skills training helps a person with Aspergers to learn to interpret these and other social signals, so that he or she can determine how to act appropriately in the company of other people in a variety of different situations.

Social skills training makes the assumption that when individuals improve their social skills or change selected behaviors, they will raise their self-esteem and increase the likelihood that others will respond favorably to them. Aspies learn to change their social behavior patterns by practicing selected behaviors in individual or group therapy sessions. Another goal of social skills training is improving the person’s ability to function in everyday social situations. Social skills training can help the person to work on specific issues (e.g., improving one's telephone manners) that may interfere with his or her job or daily life. 

==> Living With Aspergers: Help for Couples

Difficulties with "Theory of Mind" in People on the Autism Spectrum

Research reveals that adults with ASD (High-Functioning Autism) appear to have trouble using theory of mind to make moral judgments in certain situations. Specifically, the study found that adults with autism spectrum disorder were more likely than neurotypical subjects to blame someone for accidentally causing harm to another person. 

 

This shows that the judgments of people with ASD rely more on the outcome of the incident than on an understanding of the person’s intentions.

For example, in one scenario, James and a friend are snowmobiling in an area known for loose snow. The friend asks James if he should take an easterly route around a row of pine trees. James has just read that avoiding the west slope is the safest way to go, and so he tells his friend that it should be O.K. to head east. 

 

The friend takes off in that direction and starts an avalanche which quickly overtakes him and buries him alive. In this scenario, the researchers found that adults on the spectrum are more likely than neurotypicals to blame James for his friend’s death – even though James believed the slope was harmless.

Most kids develop theory-of-mind ability around age 4 or 5, which can be demonstrated experimentally with “false-belief” tests. For example, a youngster is shown two dolls, “Jane” and “Barbara.” The experimenter puts on a skit in which Jane puts a marble in a basket and then leaves the scene. While Jane is away, Barbara moves the marble from the basket to a box. The experimenter asks the child where Jane will look for the marble when she returns. 

 

Giving the correct answer (that Jane will look in the basket) requires an understanding that others have beliefs that may differ from our own knowledge of the world – and from reality. Previous studies have shown that kids with ASD develop this ability later than neurotypical kids.

 

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder

Individuals with autism often develop compensatory mechanisms to deal with their difficulties in understanding the thoughts of others. The details of these mechanisms are unknown, but they allow the person with the disorder to function in society and to pass simple experimental tests (e.g., determining whether someone has committed a societal “faux pas”). 

 

However, the scenarios used in the study were constructed in a way that there is no easy way to compensate for impaired theory of mind. The researchers tested 13 ASD adults and 13 non-ASD adults on about 50 scenarios similar to the snowmobiling example above.

On researcher used the same hypothetical scenarios to test the moral judgments of a group of patients with damage to the ventromedial prefrontal cortex (VMPC), a part of the prefrontal cortex (where planning, decision-making, and other complex cognitive tasks occur). 

 

Those patients understand other people’s intentions, but they lack the emotional outrage that usually occurs in cases where someone tries (but fails) to harm someone else. For example, they would more easily forgive someone who offers mushrooms he believes to be poisonous to a friend, if the mushrooms turn out to be harmless. 

 

==> Living With Aspergers: Help for Couples

While some ASD adults are unable to process mental-state information and understand that other people can have innocent intentions, the issue with VMPC patients is that they could understand information but did not respond emotionally to that information. Putting these two pieces together could help neuroscientists come up with a more thorough picture of how the brain constructs morality.

Previous studies have shown that theory of mind appears to be seated in a brain region called the right temporoparietal junction (TPJ). In ongoing studies, the researchers are studying whether ASD patients have irregular activity in the right TPJ while performing the moral judgment tasks used in the study.

 

 

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder

==> Living With Aspergers: Help for Couples

==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism

 

COMMENTS:

•    Jumpygran …I recently said to my AS husband that I didn't like the trousers he was wearing, particularly as he was wearing a shirt which clashed with the colour. He bit my head off, saying "well you bought them". Yes I did buy them but I now dislike them! He always seems to respond to such comments with a "blame", rather than a simple "Oh, why is that?", or similar. He is unable to explain why he does this ie does he feel under attack. Any other NT had this?
•    Unknown…Oh yes. It is the blaming. My aspiring always has to find someone or something to blame. My husband would see saying what he chose to wear unacceptable as an attack. He can not take criticism of any kind. He either gets mad and attacks back or feels so bad about his discision(i think) and leaves the area discouraged. Whatever happens it is a lose,lose situation. I guess we can only pick our battles wisely.
•    Jack …Oh yes, you're never allowed to change your mind!
•    Sushin …So true! You can't change your mind, they just don't understand if you do. You loved that dress when you bought it 3 years ago, didn't you? How come you don't love it anymore? It's still the same dress! Now that I found out about A/S I can understand that my husband and I are just wired differently. So, instead of yelling at him trying to explain that I just changed my mind about it, which he never understood anyway, I smile and say: you'll never understand women, sweetheart! That makes him laugh... although he'll never understand how it is possible for me to hate something that I once loved! Things have improved a lot since I know about his condition, but some days things are still really hard. He finds me fussy, which I am not, and hard to please, which I am not either. And I have to be extremely careful about what I tell him, and how I tell him, because he often feels under attack.
•    Unknown …OMG - this totally makes sense. My 17 yo son with A/S blames people ALL the time, and is always tattling on people. Now I know why the symbol for ASD is a puzzle piece... trying to understand him is like trying to put together a puzzle. It's nice to have one more piece in place.

Post your comment below…

How to Avoid Meltdowns: Calming Strategies for Adults on the Autism Spectrum

“As a young adult with ASD (high functioning), I know what it feels like to have a meltdown. It’s no fun. It turns my emotions and day upside down. Before a meltdown, I start to feel like something is wrong. Then, I quickly get anxious, and I tense up. I get so overcome by the stress that sometimes when I respond, I sound outraged, aggravated, and a bit mean. But it's one of those things I sometimes can't control. Sometimes I cry, sometimes I get mad and throw something. After the meltdown passes, I usually do something to help me get my mind off of what just happened (for example play games on my phone), because if I keep thinking about it, it only gets worse. My question is: what can I do to help myself avoid meltdowns or at least make them less intense?”

In order to understand what calming strategies will work for you, you first need to determine what things stress you and have some understanding of the context in which you “melt down.”

Here's a basic plan:

1.  Recognize the physical signs (e.g., muscle tension) and the environmental triggers (e.g., transitioning from one activity to the next) that indicate you are becoming distressed, and intervene immediately. Redirect yourself to an alternative activity, something that you enjoy.
2. Remove yourself from the area where your meltdown is beginning to build-up steam and go to a “safe zone” (i.e., a place that feels calming to you). For example, if you begin tensing-up while sitting in the living room watching the news, go outside on the porch for a few minutes and breathe deeply 10 times while visualizing a pleasant scene or activity.

The main idea here is to:

• (a) get your body in to a different location,
• (b) get fresh oxygen to your brain (when we are anxious, our breathing becomes very shallow, which in turn sends a message to the brain that there really is something to be upset about),
• and (c) get your mind on to pleasantly distracting thoughts (e.g., visualizing that Cancun vacation you took last year).

This may seem like an overly simple process in order to deal with what is a very challenging issue. The key is to be consistent so that you will always know what is coming. A meltdown usually takes several minutes to build-up. Use this to your advantage. 

 

You don’t want to wait more than a few seconds to start your plan of action. Waiting just 3 minutes before intervening may be too long. Once a meltdown is up and running, the only option then is to simply ride out the storm.

You can (and may have) developed a habit of melting down. You can also develop a habit of initiating a relaxation response!

==> More on meltdowns can be found here...

More resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living With Aspergers: Help for Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism  

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder

 ==> Cassandra Syndrome Recovery for NT Wives

Adults with ASD [Level 1]: The Strong Points

Too often, the microscope is focused on all that is wrong with adults who have an Autism Spectrum Disorder [ASD]. Yet, these grown-ups actually have much to contribute to families, friendships, and the workplace than the general population recognizes.

It’s quite true that there are thousands of strengths associated with ASD. Any attempt at a list is going to stereotype these individuals, but here are four strengths that come to mind:

1. It’s a cliché by now to say that some adults with ASD [High-Functioning Autism] have higher than average intelligence, but that doesn’t make it any less true. Some Aspies are downright smarter than just about everyone else out there, and some are quite aware of it and aren’t afraid of telling others about their level of expertise in a particular field or subject.

2. Many ASD adults have a wonderful sense of humor that demonstrates a truly unique way of viewing the world. Whether it’s the humor found in someone making the same mistake over and over, or the hilarity found in seemingly irrelevant details of social situations (e.g., how loud someone is breathing while at the dinner table), neurotypicals can learn a lot about how to appreciate details in life that they never would have noticed without learning from their friend on the spectrum.

3. Another strength is the fact that the individual with autism is going to tell the truth about something, whether you like it or not! Perhaps he has something figured out that you don’t – and he isn’t afraid to tell you. Perhaps the answer to a problem is obvious to him, and it’s annoying how slow the neurotypicals are to figure it out -- and he isn’t going to hide that annoyance.

Maybe it’s a case of just being brutally honest with you when your new haircut looks ridiculous. But the honesty that the PERSON ON THE SPECTRUM possesses is refreshing. In this pretend world of political correctness, contrived so-called “reality television,” and unrestrained commercialism that we all live with on a daily basis, it’s really cool to have someone just tell it like it is every now and then.

4. Many people with ASD have an absolutely uncanny ability to focus. Sometimes this manifests in inconvenient ways (e.g., a youngster focusing only on the irrelevant details of a learning situation, and therefore having difficulty with learning the bigger picture). But just as often, this manifests in an ability to solve problems that would stump the neurotypical.

For example, one Aspergers employee helped engineer the dependent relations between hundreds of different components of a software system. The problem was that, not only did it require a huge amount of focus, but a huge amount of focus over a long period of time, because every detail that was changed in the system caused hundreds of other small changes in the ways all the other components of the system depended on one another. This "Aspie" accomplished in a few days what the company expected to take several months.

Without question, the autistic brain operates differently. Most people with ASD are better at detecting changing sounds, detecting visual structures, and manipulating 3D shapes. Too often, employers don’t realize what employees on the spectrum are capable of, and assign them repetitive, almost menial tasks. But most are willing - and capable - of making sophisticated contributions to society, if they have the right environment.

 

 

Hear it from a child: 

 

 

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder

==> Living With Aspergers: Help for Couples

==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism

 

COMMENTS:

•    Anonymous said… This is why Aspies can accomplish so much!
•    Anonymous said… I think we accomplish so much because we have focus also when I get a problem to solve my brain continues to work on it while I am doing other things. So I can be doing something which would, ordinarily would not be related to the problem I am working on but I get one of those eureka moments. I think in 3D and can construct things in my head and then build it. I often change things as I go but i have a head start simply because of how I think.
•    Anonymous said… Story of my life, people just don't realise what I am capable of.

Please post your comment below…

When You Want to "Talk" and Your Spouse with ASD Wants to Leave

“My husband with Asperger syndrome was so affectionate and loving in the first few years of our marriage. But over the years he has drifted away from where we started. I still love this man, but now I find that most days I feel so alone in my own house. We live like college roommates at this point, we just coexist with no real exchange of intimacy. When I try to talk to him, he just leaves – walks out, and that’s the end of it. PERIOD! Is this common for a man with Asperger syndrome? Could he be cheating on me? Do they just fall out of love as their spouse ages? Do they change their mind about their commitment level when children enter the picture? I have so many questions I don’t know where to begin.”

It’s such a paradox when the neurotypical wife gets to the point where she has numerous unresolved issues that relate to her ASD husband that she feels compelled (for good reason) to complain loudly and angrily in a desperate attempt to simply get her point across and to get him connected to her - and to be a team player in the relationship! 

There was a “team spirit” back in the day in the early going of the relationship, but through the years, the team spirit got lost. Now it’s like, “I’m here, and you are over there. What happened to ‘us’?”

But here is where it becomes a paradox: The more she expresses emotion, especially troubling emotions, and gets loud, assertive - and even aggressive and demanding, the more he shuts down and withdraws both cognitively and emotionally. This, in turn, exacerbates the problem and extends the period of time that any resolve to the relationship problems can occur.

The wife, by nature, is the nurturer and wants the relationship to grow and deepen with increasing intimacy and bonding over time. The ASD husband, who is not as interested in a deeper social and emotional connection due to his developmental disorder, and whose social-emotional brain is less developed compared to his logical brain, often finds that “going deeper” into the relationship requires skills that he does not have.

I hear this phrase so often from these men: “I really try to make her happy, but it doesn’t matter what I do, it’s never enough. I’m always in trouble with her.” This mind-set creates a negative cycle that looks similar to this:

• he feels like he is always in the doghouse
• this causes him to feel highly unsafe in the relationship
• this in turn raises his anxiety
• which then increases his search for anxiety-reduction techniques
• and unfortunately, the techniques include disconnection, detachment, and often isolation; in many cases, his wife has become his major source of stress

Of course, this cycle results in the neurotypical wife feeling unloved and abandoned, which then increases her sense of desperation - and an even stronger drive to reestablish the connection and bond with her husband. And it’s at this point the cycle just starts all over again.

So now the question becomes, “What can be done?”

In working with couples over the years, I’m finding that there is no “magic bullet” when the division between the two parties has reached this level of severity. However, a good “first start” in healing the relationship involves teaching the husband on the spectrum some simple social skills, as well as devising a tailored communication strategy for the couple that is (a) sensitive to the ASD husband’s anxiety, and (b) sensitive to the NT wife’s need for emotional reciprocity. 

Every couple is unique though, and as such, there is no “one-size-fits-all” when it comes to creating an effective communication style or problem-solving method.

Examples of some simple, yet super effective social skills that can be taught include:

• The art of paraphrasing what was heard
• Reflective listening
• Non-verbal communication
• Learning how to pay attention to body language
• Identifying and replacing negative thoughts and self-talk
• Assertiveness
• Asking open-ended questions
• and other general conversation skills …just to name a few.

Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living with ASD: eBook and Audio Instruction for Neurodiverse Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by ASD

==> Online Group Therapy for Couples Affected by Autism Spectrum Disorder

 ==> Cassandra Syndrome Recovery for NT Wives

==> ASD Men's MasterClass: Social-Skills Training and Emotional-Literacy Development

==> Videos to help you understand your partner on the autism spectrum...  

 

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...

The Overly-Developed Logical Brain in High-Functioning Autism and Asperger's

Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living With Aspergers: Help for Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by Asperger's and High-Functioning Autism  

==> Online Group Therapy for Couples and Individuals Affected by Autism Spectrum Disorder

 ==> Cassandra Syndrome Recovery for NT Wives

==> Videos to help you understand your partner on the autism spectrum...  

 

==> Click here for more information regarding how your HFA partner's brain is wired...

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.

==> Living With Aspergers: Help for Couples

==> Skype Counseling for Struggling Couples Affected by Asperger's and HFA