Are You Overly-Critical of Yourself?

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Meltdowns in People with Autism Spectrum Disorder

Can an adult with high functioning autism [ASD level 1] have a meltdown just like a child with the same disorder? 

The answer is ‘yes’ – but the adult’s meltdown-behavior looks a bit different than a child’s. Under severe enough stress, any normally calm and collected individual may become “out-of-control” – even to the point of violence. But some individuals experience repeated meltdowns in which tension mounts until there is an explosive release.


The adult version of a meltdown may include any of the following (just to name a few):

• aggressive behavior in which the individual reacts grossly out of proportion to the circumstance
• angry outbursts that involve throwing or breaking objects 
• banging your head
• crying
• domestic abuse
• pacing back and forth
• quitting your job
• road rage
• talking to yourself
• threatening others
• walking out on your spouse or partner
• yelling and screaming

On the mild end of the continuum, the adult in meltdown may simply say some things that are overly critical and disrespectful, thus ultimately destroying the relationship with the other party (or parties) in many cases. On the more extreme end of the continuum, the adult in meltdown may attack others and their possessions, causing bodily injury and property damage. In both examples, the adult often later feels remorse, regret or embarrassment.

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Meltdowns, usually lasting 5 to 20 minutes, may occur in clusters or be separated by weeks or months in which the ASD adult maintains his/her composure. Meltdown episodes may be preceded or accompanied by:

• Chest tightness
• Headache or a feeling of pressure in the head
• Increased energy
• Irritability
• Palpitations
• Paranoia
• Rage
• Tingling
• Tremors

A number of factors increase the likelihood of experiencing a meltdown:

• A history of physical abuse or bullying: People on the spectrum  who were abused as kids have an increased risk for frequent meltdowns as adults.
• A history of substance abuse: Those who abuse drugs or alcohol have an increased risk for frequent meltdowns.
• Age: Meltdowns are most common in ASD individuals in their late teens to mid 20s.
• Being male: ASD men are far more likely to meltdown than women.
• Having another mental health problem: Those with other mental illnesses (e.g., depression, anxiety disorders) are more likely to have meltdowns.

The meltdown is not always directed at others. ASD adults who experience meltdowns are also at significantly increased risk of harming themselves, either with intentional injuries or suicide attempts. Those who are also addicted to drugs or alcohol have a greatest risk of harming themselves.

ASD adults who experience meltdowns are often perceived by others as “always being angry.” Other complications may include job loss, school suspension, divorce, auto accidents, and even incarceration.

If you're concerned because you're having repeated meltdowns, talk with your doctor or make an appointment with someone who specializes in treating adults on the spectrum (e.g., a psychiatrist, psychologist, social worker, etc.).

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Here's how to prepare for an appointment with a professional:

1. Make a list of all medications as well as any vitamins or supplements that you're taking.
2. Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
3. Write down key personal information, including any major stresses or recent life changes.
4. Write down questions to ask your doctor. Preparing a list of questions can help you make sure you cover everything that's important to you. 
5. Don't hesitate to ask questions during your appointment at any time that you don't understand something.

There's no one treatment that's best for adults with autism who experience meltdowns. Treatment generally includes medication and individual or group therapy. Individual or group therapy sessions can be very helpful. A commonly used type of therapy, cognitive behavioral therapy, helps these people identify which situations or behaviors may trigger a meltdown. 

 

In addition, this type of therapy teaches them how to manage their anger and control their typically inappropriate response using relaxation techniques. Cognitive behavioral therapy that combines cognitive restructuring, coping skills training, and relaxation training has the most promising results.

Unfortunately, many adults on the spectrum who experience meltdowns don't seek treatment. If you're involved in a relationship with an autistic person, it's important that you take steps to protect yourself and your kids. Any emotional and/or physical abuse that may be occurring is not your fault.  If you see that a situation is escalating, and you suspect your partner may be on the verge of a meltdown, try to safely remove yourself and your kids from the area. 

 

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