Aspie meltdown or something else??

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I don't know if this is the right section to post this question, so if you see it in another section, please pardon....

I'm the mother of a 20 year old son that I think has AS, but I'm not entirely certain, as he refuses to go to any doctor unless it's in the midst of a crisis/meltdown. School professionals while he was in grade school through high school have suggested he might have AS. All the website info I find leads me to believe it likely is that he's got AS, as do conversations with people in various AS support services...... all but one problem....

When any of your loved ones with AS have been in the middle of a meltdown, have they seemed, for lack of a better term, delusional? Talking odd stories or about concepts and fears that do not make sense to anyone but a science fiction writer or him?? For instance, last night, I had to call 911 for an ambulance for him... When his friends drove him home, he began to act "weird, as if he was on lsd" according to them, and they were having a difficult time talking him into getting out of the car. When he got inside, he started to tell me how "everything was right with the world, and you were supposed to pick me up from her house, but then they just brought me home"...then proceeded to tell me something about saving the world, and time being interconnected with the roads in town and now I "have to drive back to his friend's house then back here to make it all right again"...when the answer was no, he escalated into a full on panic and some very odd ramblings about his father not being real, the character from The Ring, completing some unspecified supernatural task, ...and some other unintelligible things . Of course when speaking with the EMT's, he was aware of time and date and answered them with no troubles.......

I really need to know if this is at all heard of within the AS spectrum...if it is part of an AS meltdown. If so, in hindsight, I could see how this might have been avoided... I feel as if I'm flying blind.

In my understanding, a meltdown looks like a breakdown, a tantrum, or a withdrawal. It sounds to me like your son was in control, but not in reality? That sounds different to me, based on my limited experience, but it is difficult to know if I'm reading your description right.

Tracker's book, free for download at ASDStuff.com, has a good breakdown of what I understand to be a typical meltdown.

MaKin, I don't have any personal experience to help you with other than this: when we were dealing with suicidal threats, our therapist suggested taking our son to the local Children's ER RIGHT THEN. We are fortunate in that the ER there is extremely reasonable, and they talked to all of us for a while, gave us some resources, but left admission (which they told us comes with medication) up to us.

What I learned from this that I think is applicable here: if he will only go in crisis, have a crisis plan ready to make sure he gets the help he needs THAT MINUTE. It may mean setting something up with a psychologist or psychiatrist who can meet you at the ER. I'm no doctor, but it seems to me that what you're describing needs professional attention to sort out (though, I'd screen your professional ahead of time and try to find someone who will get to the root of the matter before recommending medication or treatment.)

There are many different disorders that come with delusional thinking, I don't think AS is one of them (though sometimes kids with AS can get stuck on an idea they are convinced is logical even when it isn't, which can seem delusional; or they can have difficulty communicating the difference between fantasy and reality)...however, I'd want a professional to tell me whether he's actually delusional or whether this is some kind of communication/stress thing.

i dont think ive ever seen delusional behavior or thoughts in a meltdown, however i do see something similar to what you are describing here.

sometimes thinking can be so rigid that when a course of action is not followed, the ONLY thing that can make it right is to go back to where the course altered and complete it as intended. my 5 yo autie has had meltdowns triggered like this. in his mind, we must do a, b, and c, in that order. if we do things out of order, he may cease to function, and sometimes things just cannot continue until the correct order is restored. it could be a sequence of events or a single action, but what he believes should be done is what must be done to maintain equilibrium. i do a bit of this myself, and am very rigid in how things are done. when it happens for me, its an uncontrollable feeling of things just being WRONG. nothing makes the world right except what should have happened in the first place. if i dont fix it, it could bother me for days on end.

i wonder if the anxiety and stress that your son is feeling is driving him to grasp at any reason, no matter how illogical or extraordinary, to explain the feelings he is having. the delusional stuff isnt really the norm, but the cause and resulting meltdown is pretty typically autistic. the intended course was altered, and it threw him off, hence the not wanting to get out of the car because that would even further alter the course. he requested the course be corrected, that you drive him back to the friends house then drive him home, and you refused, and then the meltdown escalated.

have you asked your son about the things he was saying?

Thank you lovely people for replying!! I'm not sure if it's delusional thinking, or if it's as azurecrayon said "i wonder if the anxiety and stress that your son is feeling is driving him to grasp at any reason, no matter how illogical or extraordinary, to explain the feelings he is having". in order to set everything right in his order of how the world should be.
He's anything but in control and reasonable in such a state. I'd best compare it to a 7 year old who doesn't want to go to bed who comes up with any reason to convince his parents that he needs water, or the boogie man is under the bed, but after given water, and an under-bed inspection, the boogie man is in the closet, or in the drawers and if the desire to stay awake is still not met, starts more emphatically adding to these stories and self-imposed fear and spiraling into a panic.
But, he's 20, and in the United States that poses the problem of me not being able to do anything but request him to seek help.......which seems apparent to everyone but him.
What worries me is how quickly the local medical center is to make the blanket diagnosis of psychosis or schizophrenia as they suggested once, and the treatment seemed to do much more harm than good for my child. I can't see him hurt any more.
I'm not saying that the possibility of what he's going through is not something other than AS, but with him fitting the spectrum so much as he does, I would like to help keep him by being as informed as can be.

It seems those crises happen on days when he's not getting what he wants/expects. The day following his latest meltdown and subsequent all nighter to the er, he awoke pleasant as ever and randomly requested me to buy him a video game as if not one thing out of place had occurred. o_0

...and added thank you to DW_a_mom, I've skimmed through the book a bit before reading it entirely and came upon a section which answered another question of mine... Why does he seem more Aspie now than other times? . and the example he gave about persons who've pushed themselves too hard for too long which causes them to have a nervous breakdown which is often mistaken for psychosis fit my son's experience.

If it is a one time occurrence, I might be worried and watchful, if it happens more than that, I would be searching for doctors I could trust and be open to their diagnosis.

I have a friend from high school. I was one of her few friends. She was very smart (went on to a highly competitive engineering program) and actually very nice, but odd. Knowing what I know now, I would say she she had definite AS traits, but probably not enough to be officially diagnosed. She does have a history of mental illness in her family. Her mother has paranoia schizophrenia. Long story, but when we were very small, her Mom thought there was an underground in our very small town and they were out to get her. She decied the superintendent of schools was the head of it and she shot out the windows in the church he went to. Thankfully, it was during the week and no one was there. Our whole childhood, my friend was convinced this was why most people didn't like her. However, I doubt most people our age knew about it as I had never heard of it until she told me about it herself. She also told me about other things her Mom believed like that someone had come into the garage one night and had painted the pinstripes on her car or that people would come in at night and change the pictures around on the wall. The funny thing was, I went to their house all the time and her Mom always seemed perfectly normal to me. My friend was terrified of becoming like her Mom.

Fast forward a couple of decades. My friend's older sister had a great life. She married a lawyer, she became a nurse and they had 2 kids. She had some kind of breakdown though and talked her husband into letting her stay with her Mom back home for awhile. He agreed. She committed suicide. As for my friend, she worked in chemical engineering for about a decade. She married a guy I thought suited her perfectly as he was a bit socially awkward as well. He was an engineer too. They had one son together. At some point after she had her son, my friend seemed to start having a breakdown. Over the years, I was always the one to call her and catch up, but she seemed to love it when I did call and stay on the phone forever. At this point, she acted very starnge when I would call. Finally, after a couple of years, she said she wanted to tell me something and she wondered if she could really trust me. The way she asked was very odd. She then admitted about her breakdown, said she was barely sleeping at this time and said the reason she acted odd when I called is that she was convinced that my husband was working for the government and keeping tabs on her. Now, in reality, this would be impossible as I only talked to my friend maybe 2-3 times a year and we exchanged Christmas cards. I lived several states away and while my husband does work for the government, he works in banking, not law enforcement. She said she was on meds for bipolar. She said her sister had been experiencing the same problems she was when she killed herself. I can't help but think it sounds more than bipolar and a bit like her Mom, but I am not around her frequently enough to know.

I am fairly new to all this too. My son is only almost 10. I do see him not always understand another person's point of view or motives and at times the reasoning he assigns them is incorrect. I have never seen him act delusional or like he was on lsd. His meltdowns can be triggered by incorrect thinking like getting angry at a sibling and just "knowing" they did it for xyz, when I was there and could see that the sibling wasn't provoking at that time and then him not believing me. Since this would usually happen during a period of stress and when he was emotionally charged anyway, my trying to explain that his assumption is wrong, would send him into a meltdown of being overcome by emotions, but even then he doesn't seem out of it. It is more like he a volcano that had been building and finally errupted. He wasn't in the mood to be challenged or it was "the straw that broke the camels back" so to speak. I will say for my son, his meltdowns are an interesting state of out of control, but in control. He is emotionally charged and letting off steam, but he knows not to throw things of become physically violent. I have seen him appear to think about it, but then control himself. Also, his meltdowns do not last long. If he gets the break he obviously needed, he always returns, says he is sorry and talks calmly about how he should have handled it differently.

It may be AS or it may be more. If it is happening frequently though, I would see what you could do to have him checked out. He may want answers and help too.

Hi there -

Let me 1st say that each of us and each of our children are different. What I will tell you about my sone is just one example and may not fit you at all.

My son is 11, and has a very difficult time at school.

One evening, I was walking him to the bath and he was kind of pre meltdown agitated. He was trying to walk with his shirt covering his eyes, and he bumped into the wall. He started screaming bloody murder, screaming stop hurting me, stop hurting me. After about 20 minutes of this I asked him who was hurting him (since I wasn't touching him), and he told me the man with grey hair and needles in his eyes. He was screeaming as if really in pain.

I was so frightened that I started videoing this with my cell phone, worried someone would call the police thinking that Ds was being hurt.

After about an hour, he seemed himself (I booked an appointment with the neurologist). Three weeks later it hapened again, this time at school. He didn't scream about being hurt, but he was hallucinating, this lasted 20 minutes and then he was fine. The school called and told me that he was psychotic and I started looking at inpatient treatment options.

Well, I took him to the neurologist, and in a panic, showed him the video. The Dr. said DS was absolutely NOT psychotic and this was called a dissassociative spisode with hallucinations. What he said was that the stressors in my son's life were greater than his ability to cope. He was internalizing them rather than having an external meltdown. I asked if we should ess with the meds, he encouraged tapering off of them.

His advise was to remove the stressors, and so we have. DS has been better than ever. No meltdowns, less medication than ever, he's doing really well.

These episodes were the scariest things to me, I think what the DR said was the difference between psychosis and not, is you don't have 30 minutes of psychosis - that's something else.

Good luck

Good to know; glad to see there are doctors out there who do something other than run for the pill bottle.

I think videoing the episode is a brilliant idea, too.

(re-reading the above I realize it comes off as snarky and I did not intend for it to; while I appreciate meds as necessary I think a doctor who considers things carefully is worth his weight in gold.)

While not displacing the ASD possibility, the event you are describing is not a meltdown.

You are describing you son trying to explain a theory or belief which is highly improbable and does not follow the customary beliefs or interpretations of reality of his peers or his culture. This is known in psychology as a delusion and while it might not be a sign of anything to worry about, it is not directly related to ASD.

I was videotaping to protect myself, as his screaming was really scary. I had no idea how brilliant I was! Actually, it sure turned out to be helpful because without that, I don't think that I would have trusted that the DR could possibly understand what I was talking about. Because he saw DS with his own eyes, and talked me off the ledge, I was able to hear him.

I agree that it is nice when a Dr really explores what is going on, rather than giving more meds. Although, this Dr. is pro med, he really provides good care and I trust him.

I was worrying at first that there would be more episodes and that the Dr was wrong, that DS really was psychotic. But, noting has happened. He's been great. I mean, bumps in the road, but great.

i'm not sure if he really believed what he was saying or not. when i brought it up to him later, he said "why would i say that? that's crazy".... so for all i know, he was grasping at any reason to set his world right?
he's not one to be very open and have deep discussions, unless it's a topic he's very interested in, or it might actually be less complicated and convoluted trying to get him to help himself or let us help him. (i use that phrasing for lack of knowing how else to say it) i want my son to be his most confident, to be secure in himself, and able to handle the world before him.
what i've discovered is that despite the name for whatever he's got or is going through, using all the advice for Aspie families to help us through the rough patches is making our home a much nicer place for all of us.

Today might not be so easy, though... i just got back from the e.r. with chest pains. thankfully it wasn't a heart attack. they said if my heart wasn't so healthy, it would have been o_0

Hello Makin

I guess I should start by discussing terms. Because your question is, is this a meltdown, or what? So, lets get some terms straight first.

1. A meltdown is a reaction to extreme stress which induces uncontrolled emotional reaction. Generally meltdowns just take whatever emotion your feeling and 'super charge' it to the point where anxiety becomes panic attacks, and frustration becomes aggressive violence. These generally last anywhere from a few minutes to a few hours. If left to calm down, they tend to be 20-30 minutes at the most. If you continue to provoke the person, then that is when you get the hour long meltdowns, but those are usually very rare.

2. A nervous breakdown (as I write about in the book) generally refers to a long term regression where a person loses previous skills, or develops severe problems with anxiety, functioning, etc. Generally, this lasts for months at least and it is brought on by years of over-exertion.

3. A psychotic break is a short term loss of conscious mental functions. The person basically starts dreaming while awake and as you know, dreams don't make a lot of sense. Signs include rambling, disconnected, irrational, delusional ideas (i.e. talking about lord of the rings characters, claiming things exist when they dont or vice versa). Hallucinations can also occur. It can sometimes seem like the person is in a trance. This sort of reaction can be caused by certain drugs (LSD, PCP) or by extreme duress/stress.

4. Psychosis, is defined as a long term break with reality. It is the same symptoms as a psychotic break, but it doesn't come in 30 minute bursts. It is a continuous effect which will last for years if not medicated.


So, all that to say, I don't think your child is dealing with Psychosis or a nervous breakdown. Those effects generally last for months at least, and if your son was fine shortly afterwards, I think that rules them out. What you likely experienced is a stress induced psychotic break. Lets put it this way, if you remember my lovely chart from the book, I ranked meltdowns from 1 to 6. 1 being fine, 6 being meltdown. What can occasionally (but rarely) happen, is you get to an extreme meltdown which could best be thought of as a 7 on that scale. When you reach 7, you get some really bad stuff happening.

There might be disassociation, depersonalization, hallucinations, psychotic breaks, uncontrollable animalistic rage (directed at anybody or anything in the vicinity), or other such things. Generally, it isn't uncommon for the person to have no recollection of this event afterwards. Because they were for all intents and purposes, unconscious. If the person does recall the event, it usually can be very difficult to deal with and possibly cause Post Traumatic Stress Disorder.

Most of the time the meltdown doesn't get this far, but if exacerbated by some outside force, it is possible. I can link you examples of parents posting about this in the past, but I don't think that would be entirely proper. If other parents wish to share their stories I will let them post at their own discretion.

Now, I can't say that this is what happened for certain. I don't really know anything about the events leading up to the problem you experienced, so I can't really tell whether or not it was truly a meltdown. But I do know that what you have described is not inconsistent with extreme meltdowns, and is not evidence in and of itself for psychosis. If your son has meltdowns or near meltdowns often, then it isn't unreasonable to conclude that this was merely a meltdown that went too far.

The good news is that if this is a meltdown (which seems likely from the limited information that you have posted) then it can be dealt with effectively via some of the methods that I write about in the book. Such as better understanding and appreciating stress levels, having relaxing time, avoiding external stimulation when already overwhelmed, etc. It is entirely possible that your son was already over-stressed and doing poorly when he went out with his friends, and the extra socialization, excitement, and stimulation he received while out is what pushed him over the edge. In which case this problem could have simply been avoided by him learning to recognize his limits and just stay at home that night.

Really, I think that if your going to have much luck helping your son your going to need to sit down with him and talk about this with him and convince him to start taking care of himself. You really can't enforce anything on him at his age, and you shouldn't try to either. As I mentioned in the book, the best solution is for the autistic person to be the one who takes charge of their own lives and deals with their problems. And as such, it isn't really your job to fix the problem, as more it is your job to convince your son to fix his problem for himself. Beyond that you can provide support, help, advice, encouragement, and information. But you really can't do this for him.

So, my advice is as follows: Talk with your son, tell him your concerns, see if you can get him to deal with his problems himself. Also, give him the link to Wrong Planet so he can meet other people like him. Beyond that, feel free to recommend to him any books that you think might help.

MaKin,

My daughter is 8 so she is younger than your son. However, I have experience with the delusional meltdowns you are describing. Tracker alerted me to your post because what your son is doing is very similar to how my daughter can act in meltdowns. I have an old thread on the types of meltdowns she would have-I'll try to locate it and post a link.

Anyway, when my daughter has what I consider a "grand mal" meltdown she can go one of two ways: she can become fight or flight primal animal-violently aggressive, breaking objects, knocking down things, hitting herself and me, and nothing I can do will calm her down. I just have to isolate her from as much stimulation as I can and let it play out on its own. The second type that can happen is that she can disassociate as Tracker mentioned-she becomes spacey, weepy, confused, and can say things that don't make sense. She has said "you're not my mom, where's my mom?". She has also asked for my grandmother who passed away in 2006. She can talk about vague things that happened years ago. Lately when this happens she will go on and on about how she is "bad" and "stupid" and how she can't get her mind to work right. She can't be reasoned with during these times. She doesn't look at me when she is in this mode. I just give mild reassurance to let her know I am there. It can take anywhere from 5-45 minutes for her to come out of it. When she comes out of it she is exhausted and sad and very apologetic.

From seeing her do this for years I think it is a sort of neurological "storm" in the brain. They reach overload and instead of the reasoning brain shutting down like with the primal violent meltdown, the brain separates from reality and fires erratically. Sometimes she has no recollection of the events after they occur. My daughter can go from fine to one of these storms in seconds with what appears to be only a very mild stressor (think of the straw that broke the camels back).

My daughter is diagnosd with AS but I can tell you sometimes I question that diagnosis. If you saw the books on my bookshelf you would see I have researched every possible syndrome that could include these types of mental breaks. My daughter sees a Psychologist weekly and I chart the highs and lows. It is possible she has a comorbid that we haven't uncovered yet but in my non-professional opinion I believe these brain "storms" are part of the neurological differences that make up her AS.

Here are some threads to check out of me dealing with the meltdowns:


http://cdn.wrongplanet.net/posts129085- ... 109c420829

http://cdn.wrongplanet.net/posts142051- ... 101b5fc393

http://cdn.wrongplanet.net/posts135173- ... ca87228f2b