Sunday, July 29, 2007

Tantrums and Emotional Meltdowns with AS. Are we there yet? Are we there yet? Are we there yet?

Although, she usually says it with a bit of a twist downward at the end, so she sounds like, “I’m bo-ored.” Generally, we can expect it as soon is she is up for the weekend or any school break. We, with AS or ADD, LIKE our routines, to put it mildly, and my daughter is no different. The itchy, uncomfortable, flushed feeling is a very big problem when our routine is changed or different. The ick chemicals that flood our system in response to over or under stimulation, is difficult to shake and waking up with the dread of it hitting is, at times, unbearable.
My grandmother used to say she had ‘sit-it-is.’ When we have a large, unstructured task ahead of us (i.e., house to clean, chores to do, paper to write, etc.), we tend to get overwhelmed with the ‘getting started’ part of the equation, often waiting until the last second and trying to cram it all in OR being unable to ever get started. A typical day for me, prior to Adderall, on a weekend: ‘I need to clean the house, get groceries, and then we will have time to play.’ However, I couldn’t seem to figure out where to start, so I would have a cup of coffee and just watch ‘a few minutes’ of (whatever mindless drivel might be on). A few minutes might lead to several, leading to an hour or more, at which time I would be frustrated with myself. The initial ‘sit-it- is’ is hard to overcome, but the ensuing SIT-IT-IS is almost impossible to overcome. Therefore, anxiety, depression, self-loathing, or apathy can swoop in.
It is no wonder that many adults diagnosed with Attention Deficits or Asperger’s Syndrome are first diagnosed with depression, anxiety, or other mood disorders. I graduated high school in May, turned 18 in June (many, many years ago), and left for the Air Force in July. Growing up, my routine included school, chores, sports, church activities, etc. I managed my parents’ kennel, and had a very busy schedule and routine (comfortable fit). Then, I graduated and my sister needed to learn how to manage the kennel. Therefore, I had no chores, no school, no general activities, and my routine was GONE, ALTERED, CHANGED! Argh! I remember, I actually tried to sleep for that entire month or so, prior to leaving for basic training.
The emotional difficulty and nasty chemicals that flood our bodies in response to under or over stimulation (for you Neurotypicals (NT), who may not understand, it can be compared to that horrifying feeling you might have getting a call in the middle of the night, and realizing that your teenager didn’t make it home yet, or at other times, similar to that rush of adrenaline or fight/flight chemicals you might get if you slam the brakes on, barely missing the deer that just ran in front of you unexpectedly), are real, and we really feel them, however, they don’t dissipate as quickly as they might in NT’s.
When our daughter first announces, “I’m BO-ORED,” her little face appears somewhat pale, and her little eyes have dark circles under them. She is hypo-reactive to stimuli, so constantly has to fidget, pick, argue, tip, or otherwise seek the stimulation she needs to overcome the sit-it-is chemicals. She is, in essence, seeking a fight to feel better inside. When she says “bored” she is actually describing an aversive, frustration which is exhausting and overwhelming. Our daughter has, generally, two emotional labels when she is not feeling whippy, they are ‘bored’ or ‘mad.’ Mad feels better than empty, hurt, frustrated, embarrassed, etc., so the fight she is looking for, is a coping mechanism rather than a naughty child.
What works?
Everyone is different. Our son is hyper-reactive to stimuli, so is very easily overwhelmed by sights, lights, sounds, touch, taste (of the feel of food), and therefore, his response to the lack of routine or change is to burrow! He blocks off the windows and spends free time burrowed under blankets, in sleeping bags, or other ‘close’ spaces. His response to a change in furniture (even just moving a couch), has been, “You broke it! Put it back!” Every time I have moved with him, I have had to go into his ‘new’ room, paint, decorate, and arrange furniture exactly the way of his old, or he won’t sleep in it, EVER.
With Miss Lili, quick interactive activity, with structure and a written schedule to the day is helpful. If I can get her engaged, BEFORE the chemicals can wipe her out, she quickly regains color, happily complies with directives, and is generally our delightful little girl. As I have mentioned before, you cannot discipline away a disability. Therefore, grounding her will not wash out the ick chemicals, spanking her will not improve her attentiveness/stimuli, sending her to her room cannot override the feelings we experience biochemically. Quick interactive games to engage her may include: Slap Jack, tossing a ball or bean bag, Speed Game, Nonsensical wordplay, dictionary search, math quizzes, Sudoku, or other. If I am too late, and she just can’t get past those horrible feelings, a deep pressure hug (at first she resists, but within a few seconds her body relaxes), and defining the moment, “Lili, you are not mad at (fill in the blank) right now, you have that feeling we get. Let’s try breathing together.” She generally screams back, “I FEEL FINE,” then flees to her room and slams the door. (Embarrassment to us is also like the late night terrifying phone call-feeling (hot, sinking pit in the stomach, flushed face, top of head feels heavy pressure, etc.), so it is best to let us flee with our dignity.) She generally flits back down the stairs with a smile, within 30-45 seconds. I don’t bring it up for at least a half an hour, but will then say, “Those feelings, yep?” She looks sheepish, and nods affirmatively.
For adults, a good defense against the under-stimulated, itchy feeling is a treadmill. 30 minutes of cardio exercise increases the serotonin and improves mood dramatically. Those of us with AS and ADD tend to struggle with sleeping at night. Our brain races as our body ‘comes to rest.’ The body replenishes it’s feel-good chemicals during REM sleep, so those of us who have difficulty with sleep start the day at a disadvantage! Incorporating daily exercise boosts those feel-good chemicals, and helps smooth the emotional rough spots. Omega-3 fish oil is VERY helpful for those of us who are hyper-reactive to stimuli, as well.

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