The REALLY bad meltdowns-how do you handle them?

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Mama_to_Grace
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01 May 2011, 10:19 pm

My daughter can go a while between the really bad meltdowns and then I find she is having them almost daily sometimes. I have had all sorts of "advice" from therapists on how to handle them in the moment. I have tried putting her in a bear hug (she escalates even more), trying to verbally calm her down, redirection, or just letting her "have it out". Today she was highly agitated all day. She has been almost "manic" for a week now but today it was really bad-she was verbally abusive, antagonistic, aggressive with me, weepy, and volatile. When I prompted her for a shower she became enraged but complied, while screaming and shouting in the shower. When she came out she kicked me and yelled at me for no reason (except that I forced her to shower). I said nothing, thinking she would calm down. She went into her room and began escalating further-mumbling under her breath. She began really crying saying she "feels bad" and she "wants it all to stop" and then began violently hitting herself.

When these bad meltdowns occur, I can't quite figure out what to do "in the moment" to help her. Does she just need to be left alone to get it out? What about the fact that she's hurting herself? Is it antagonizing to try to soothe her and redirect at that moment? Is it better to acknowledge her pain? Tonight I just let her go through it until she calmed-but this seemed wrong. She is almost 8, SO YOUNG, too young to be experiencing this level of misery.

Earlier today I asked her if she was mad for some reason. She doesn't communicate her "feelings" well at all. She usually just says "I feel bad" or "I don't feel right". How do I discover what is at the root of her discomfort when I have so little to go on except for a week of irritability? It feels like an impossible riddle to solve.

She did actually calm down after a while and we did her favorite thing-looking at her photo albums of her baby pictures. For some reason that is very calming to her and she finally went to sleep-exhausted.

If anyone has any suggestions I would appreciate it.



Chronos
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01 May 2011, 10:46 pm

Mama_to_Grace wrote:
My daughter can go a while between the really bad meltdowns and then I find she is having them almost daily sometimes. I have had all sorts of "advice" from therapists on how to handle them in the moment. I have tried putting her in a bear hug (she escalates even more), trying to verbally calm her down, redirection, or just letting her "have it out". Today she was highly agitated all day. She has been almost "manic" for a week now but today it was really bad-she was verbally abusive, antagonistic, aggressive with me, weepy, and volatile. When I prompted her for a shower she became enraged but complied, while screaming and shouting in the shower. When she came out she kicked me and yelled at me for no reason (except that I forced her to shower). I said nothing, thinking she would calm down. She went into her room and began escalating further-mumbling under her breath. She began really crying saying she "feels bad" and she "wants it all to stop" and then began violently hitting herself.

When these bad meltdowns occur, I can't quite figure out what to do "in the moment" to help her. Does she just need to be left alone to get it out? What about the fact that she's hurting herself? Is it antagonizing to try to soothe her and redirect at that moment? Is it better to acknowledge her pain? Tonight I just let her go through it until she calmed-but this seemed wrong. She is almost 8, SO YOUNG, too young to be experiencing this level of misery.

Earlier today I asked her if she was mad for some reason. She doesn't communicate her "feelings" well at all. She usually just says "I feel bad" or "I don't feel right". How do I discover what is at the root of her discomfort when I have so little to go on except for a week of irritability? It feels like an impossible riddle to solve.

She did actually calm down after a while and we did her favorite thing-looking at her photo albums of her baby pictures. For some reason that is very calming to her and she finally went to sleep-exhausted.

If anyone has any suggestions I would appreciate it.


Is she on any SSRI's? Because those can generally make meltdowns and rages worse.
Since she can't seem to articulate what is bothering her, I'm willing to bet that it's really just the stress people with AS endure in the face of every day mundane things that NT's don't think much of. The shower, for example is a simple, "everyday" mundane type thing yet for people with AS this is a massive transition because...

1. You have to stop whatever it is you are doing, or were planning to do and it can be very difficult for people with AS to switch modes of mind, especially to something they don't like doing.

2. You have to get undressed after you were already dressed, and you might have realized by now what a laborious process it is for a child with AS to get dressed.

3. You have to enter the shower process, and then after you have acclimated yourself to that, you again have to make a transition out of it. This involves drying off and getting dressed, which can be stressful in itself.

I think children with AS generally feel like they are being harassed and micromanaged constantly.

Why don't you ask her "Do you feel like you constantly have to do these things that are stressful to do, like get dressed and shower and so on?"



psychohist
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02 May 2011, 1:02 am

Mama_to_Grace wrote:
She did actually calm down after a while and we did her favorite thing-looking at her photo albums of her baby pictures. For some reason that is very calming to her and she finally went to sleep-exhausted.

I think you did exactly the right thing. You left her alone so she could calm down, then did something enjoyable with her.



techn0teen
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02 May 2011, 1:52 am

When someone is having a meltdown, it is often due to sensory overload. Talking or touching them will only worsen it because those are sensory.

Sensory overload and extrasensory issues can have a specific trigger but often times are random.

I know I cannot talk about my feelings when I am having a meltdown, and I am high functioning. It is like someone zipped my mouth closed. If a person pesters me to talk, I cannot comply so then I either cry or start yelling.

You should talk to her about having a hand signal when she feels overwhelmed. Say something like, "If you have the bad feeling, raise your hand." I find it easier to do a simple hand motion instead of speaking.

Have a "safe spot" with barely any sensory input for her to relax in. Her room seems like a good spot. Make sure there is a safe spot at school too.



Mama_to_Grace
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02 May 2011, 12:49 pm

Chronos wrote:
Is she on any SSRI's? Because those can generally make meltdowns and rages worse.
Since she can't seem to articulate what is bothering her, I'm willing to bet that it's really just the stress people with AS endure in the face of every day mundane things that NT's don't think much of.


She is not on any meds. It has been suggested that I try mood stabilizers (anti psychotics)-however I am not confident in this approach. Our prior med trials ended in disaster, and caused more side effects that quickly outweighed any benefits.

The problem is: I have reduced the demands on her so extremely that she is just barely functioning. She enjoys vegging in front of tv, and does it A LOT and any attempt to get her to try something new or get out of the house causes extreme protest. So, imagine a day of doing pretty much nothing except we did an art project together, we pretended that we had a cleaning business and cleaned the house a bit (she likes to carry a walkie talkie and give me jobs to do) :lol: , we mowed the yard (she enjoys walking behind me as I mow) and the rest of the time she watched tv. But her "mood" was agitated all day.

Once she is getting into "angry meltdown mode" it seems nothing can reverse or derail what's coming. I don't know if she would be able to do a hand signal-it seems she goes into fight or flight quite rapidly.

I am wondering if the "not feeling well" is anger/anxiety. It is almost a constant for us. Many times a day she says this. Sometimes she says her stomach hurts, sometimes she says her head hurts, sometimes it's that she feels nauseous and when she goes into a meltdown she wretches like she is going to throw up.

I am deeply bothered by the self harm-it's almost unbearable for me to do nothing when that occurs.



Chronos
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02 May 2011, 7:26 pm

Mama_to_Grace wrote:
Chronos wrote:
Is she on any SSRI's? Because those can generally make meltdowns and rages worse.
Since she can't seem to articulate what is bothering her, I'm willing to bet that it's really just the stress people with AS endure in the face of every day mundane things that NT's don't think much of.


She is not on any meds. It has been suggested that I try mood stabilizers (anti psychotics)-however I am not confident in this approach. Our prior med trials ended in disaster, and caused more side effects that quickly outweighed any benefits.

The problem is: I have reduced the demands on her so extremely that she is just barely functioning. She enjoys vegging in front of tv, and does it A LOT and any attempt to get her to try something new or get out of the house causes extreme protest. So, imagine a day of doing pretty much nothing except we did an art project together, we pretended that we had a cleaning business and cleaned the house a bit (she likes to carry a walkie talkie and give me jobs to do) :lol: , we mowed the yard (she enjoys walking behind me as I mow) and the rest of the time she watched tv. But her "mood" was agitated all day.

Once she is getting into "angry meltdown mode" it seems nothing can reverse or derail what's coming. I don't know if she would be able to do a hand signal-it seems she goes into fight or flight quite rapidly.

I am wondering if the "not feeling well" is anger/anxiety. It is almost a constant for us. Many times a day she says this. Sometimes she says her stomach hurts, sometimes she says her head hurts, sometimes it's that she feels nauseous and when she goes into a meltdown she wretches like she is going to throw up.

I am deeply bothered by the self harm-it's almost unbearable for me to do nothing when that occurs.


When I was about 7 I had a thing for TV. I'm pretty sure I've seen just about every episode of "The Jeffersons". I do remember some scuffles over the amount of TV I watched but once it was off I didn't seem to pay much attention to it.

If you pull her away from the TV in the middle of a show or between shows she'll probably have a full on melt down. It might be more conductive to distract her before she even gets the TV on. I'm sure there is something she likes to do more than watch TV. For example, horseback riding maybe.

I think I would have your daughter's thyroid checked because that can cause anxiety or restlessness, and it's fairly easy to treat. Have them do a complete thyroid panel with anti-body test.



anni
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02 May 2011, 8:36 pm

Up until about the age of 8, I found that running a bath and giving my son a bath was the best solution for meltdowns. I don't know whether it was the water, or the relative sparseness of the bathroom which helped the most, but I had the cleanest kid in Australia for a while there :)

After that, which coincided with the time in life he started to want privacy in the bathroom, which I respected, I gave him tools for dealing with anger and frustration. I kept old phone books for him to rip up, and told him it was okay to get angry, to stamp his feet and to punch his mattress as hard as he could until the feelings were dealt with. I think it's important that our kids learn that their emotions are valid and it is okay to express them, no matter what they are. However, there are appropriate and inappropriate ways to express anger. It's not ok to punch your sister, but it is ok to punch your pillow. We practiced together, deep breathing and screaming while we punched pillows and mattresses and tore up old phone books and magazines! Then when the feeling passed, we cleaned up the mess if there was one, and did something nice together.

Our kids experience a tonne of frustration that other kids and adults are often oblivious too. Never make light of it, even if it seems like a storm in a tea cup to you. My son got laughed at one day in class for answering a question from his own bizarre perspective and the teacher cracked up laughing too, and he was completely mortified and humiliated. Luckily the teacher found it so amusing that she told me about what he'd said and the reaction, not realising how cut he was over it. He lost a lot of confidence that day, and it took him a long time before he ever offered to answer a question again.



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02 May 2011, 8:38 pm

im going through the exact same thing .. we're starting week 3 now. i thought today my son was out of his "funk" but apparently not.

this is what we've tried:
calming space. we've painted his closet into something he liked. in fact, he started the painting project and asked us to finish it into what he wanted. we made it nice and comfy.. thai chair, touch-light. when my son gets angry, we give him his nintendo and it's used as a distraction to calm himself. this WAS working for a couple of months. i think with anything, we have to adapt. we also talked about this when he was calm.. things he could do when he was in the "red zone". it worked really well.

so for you, find a calming space. can you use her closet? when she's in a rage, give her the photo album.. but don't say a word. too much talk overloads her and escalates the problem. plan ahead and talk about what you can do to help her that way when she's in the "moment", you don't have to say a word. ask her what will help. get her involved. it may not work the first few times. in fact, the nintendo/closet idea didn't work for the first week or so. i kept using it. at first, he would play with it on his bed because he didnt want me to "have my way" by going into his closet.. even though it was initially his idea. after a while, he went in there himself. the mural is pretty cool! you could even have her name it.

i would advise you against med route. in my experience, we tried all sorts of meds and it just made those rough days last a lot longer!! !! what could be, now and again, will be a regular situation you don't want to get yourself involved in. trust me.

try the photo album. it s worked already.



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02 May 2011, 9:44 pm

Chronos wrote:

When I was about 7 I had a thing for TV. I'm pretty sure I've seen just about every episode of "The Jeffersons". I do remember some scuffles over the amount of TV I watched but once it was off I didn't seem to pay much attention to it.

If you pull her away from the TV in the middle of a show or between shows she'll probably have a full on melt down. It might be more conductive to distract her before she even gets the TV on. I'm sure there is something she likes to do more than watch TV. For example, horseback riding maybe.

I think I would have your daughter's thyroid checked because that can cause anxiety or restlessness, and it's fairly easy to treat. Have them do a complete thyroid panel with anti-body test.


The tv is definitely her calming thing-she's agitated most days in the car on the way home from school-complaining about all that was horrible-then she gets home and turns on the tv and sort of spaces out. It's her thing. It has bad points and good points. In a way I liken it to a person from Russia (or some remote foreign place) moving to US and watching tv to learn the culture. She watches tv and watches interaction between characters and usually asks me "why did they say that?" or "why did he do that?". In this way it can be helpful. BUT things on tv are not reality and this is the problem. There is satire and over dramatized events. She thinks these things are "normal". Today she stomped on a girl's hand at school. When I showed up the girl had an ice pack and was going on and on about "how dare she". When I asked my daughter why she did this she said "I didn't think it would hurt her". And upon further questioning she thinks the girl is PRETENDING to be hurt. I think this comes from tv-not showing the reality of things.

She only watches G rated shows but still-it has it's problems. She also likes to watch Food Network which has been good. She has a great interest in cooking, likes to test new recipes at home, and now wants to be "chef" when she grows up.

She has an appt next month. I will see if they will test her thyroid. Thanks for that advice. I've often heard people with ASD have chronic stomach and headaches-that's why I've never rigorously pursued that there might be a medical reason. She has been prescribed Prevacid for this reason.



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03 May 2011, 9:41 am

Mama_to_Grace wrote:
I am wondering if the "not feeling well" is anger/anxiety. It is almost a constant for us. Many times a day she says this. Sometimes she says her stomach hurts, sometimes she says her head hurts, sometimes it's that she feels nauseous and when she goes into a meltdown she wretches like she is going to throw up.

To me this screams anxiety. I mean this is all stuff I experienced as a kid (though I would not have been able to use the word anxiety then, I just felt sick or bad) and even still do as an adult when the anxiety gets too much, all three of those symptoms together - it's just so textbook.



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03 May 2011, 3:54 pm

Mama
Would she respond at all to some physical activities that might help reduce her stress so it comes out in a controlled manner instead of building up and exploding like a boiling teapot? Say after some TV time, doing yoga or some sensory diet activities, stretching, lifting or pushing heavy objects... I get my little guy to help me carry the loaded laundry basket down the stairs to the washing machine and stuff the clothes in (we have a front load washer so he can easily reach). I'm just trying to think of some physical things that could help her work out that stress as it sounds like it manifests so physically in her body. LIke ripping up the phone books, that's a good one I need to put in my repetoire! Maybe you could give her a stress ball or something similar she could squeeze while she is watching TV, actually maybe you could offer her something like that as soon as she gets in the car after school so she can immediately start working out those frustrations. Telling you about the difficulties she had at school is probably really important for her but I also wonder if it causes the downward spiral in her mind to keep going down instead of leveling out. Is there any activity she could do in the car on the way home that would distract her mind from replaying all the bad things that happened to her during the day?

I hope you find something that helps, I know you have been struggling so much to find some relief for her.



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03 May 2011, 5:43 pm

Mama_to_Grace wrote:
[
The problem is: I have reduced the demands on her so extremely that she is just barely functioning. She enjoys vegging in front of tv, and does it A LOT and any attempt to get her to try something new or get out of the house causes extreme protest. So, imagine a day of doing pretty much nothing except we did an art project together, we pretended that we had a cleaning business and cleaned the house a bit (she likes to carry a walkie talkie and give me jobs to do) :lol: , we mowed the yard (she enjoys walking behind me as I mow) and the rest of the time she watched tv. But her "mood" was agitated all day.
.


There is nothing wrong with watching television. Or "vegging out". Crud I'm on the internet most my life. My dad was a big video gamer and I use to play video games with him.
You like go out and socialize, she likes internal activities. Big woop. I'm tired of people who sit there and force people into new experiences. I like to do what I want to do and I don't see why people have to hate on it. I will experience new experiences, when I want to.

Have you ever considered maybe she wants to escape? Having to go to school, and then being and feeling weirder than everybody else. No one accepts you for you. Or respects your opinions. Books, television, video games, are all a world to escape.

I understand wanting to be on the computer and on the television. Its where I don't have to face the world. I already faced the world today, went shopping. That's good enough for me.

Shouldn't that be good enough?

I went to school today, I faced the world. I'll do my homework. But then I'll go to where I like, my imaginary worlds.



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03 May 2011, 8:21 pm

Yes, I realize that she is escaping by watching tv. I appreciate that. However, it's sort of a "black hole" that sucks her in-and it causes her to withdraw into that hole more and more. I don't want to push her to do things that she finds unenjoyable but how do you know you don't enjoy something until you give it a try? Her anxiety causes her not to want to try something that might be something enjoyable. I don't want the anxiety to win. I've seen anxiety take over and severely limit a person's life. Given the choice they would not choose that-I think it would be good for her to stretch her comfortable limits-as much as she can without falling apart. I am trying to figure out where those limits are but I fear I am just allowing her to escape into a world that may be really, really hard to get out of.



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03 May 2011, 10:28 pm

Mama_to_Grace wrote:
Yes, I realize that she is escaping by watching tv. I appreciate that. However, it's sort of a "black hole" that sucks her in-and it causes her to withdraw into that hole more and more. I don't want to push her to do things that she finds unenjoyable but how do you know you don't enjoy something until you give it a try? Her anxiety causes her not to want to try something that might be something enjoyable. I don't want the anxiety to win. I've seen anxiety take over and severely limit a person's life. Given the choice they would not choose that-I think it would be good for her to stretch her comfortable limits-as much as she can without falling apart. I am trying to figure out where those limits are but I fear I am just allowing her to escape into a world that may be really, really hard to get out of.


Let her do it on her own time when she is ready?

I didn't go to my first amusement park, until 16.

I still had the experience. Just later in my life.



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03 May 2011, 11:03 pm

Hi, my son is 12 now and hearing you say that your daughter say's "I don't feel right". Is something I used to hear constantly, but now only occasionally, thank goodness. :)
My son has been diagnosed with generalized anxiety disorder and is on a very very low dose med, just enough to take some of the edge off his worries and still allow him to try and work threw what ever is bothering him, if he can.

In the past what I have tried and it hasn't worked for my child when in full blown meltdown, is holding him or getting to close. His senses are already maxed out.

What has worked more often than not is speaking firmly with him and trying to prove logically (in a way he will understand) that what ever his fears are they are not as bad as he is imagining. My son tends to work him self up, sometimes talking himself into a meltdown. As soon as he would say "mum I don't feel right" that was my cue to help him sort it out, if I could.
Often he may just be feeling a little down as we all do (I'm sure considering the pressure to fit in our kids are under, it is much worse and more often) and just that initial feeling of being a little down will cause him more panic and stress, feeling blue but not understanding why can be frightening.
What has helped now (we have very few meltdowns) is before school and after school are down time. If he wants to veg in front of the tv or the pc or a game he can for as long as he needs to, there is no interaction from me unless he initiates it. Having been at school all day where he is forced to interact with others is all just far to much. For us now as a family it's not about the quantity of interaction but the quality. I am getting much more meaningful interaction now than ever before, because the pressure is off. Of course as an NT parent I want much more time with my kid, I want what others have, but I know what I do get now is priceless and has far more meaning.
Because I allow J my son to have so much down time now, he is in a much better space to be able to try things that in the past he would have avoided or melted down over. Another way to reach your child as I have with J is to take an interest in what ever it is they are doing. I will openly admit I'm a newb at most pc games, he will spend ages relishing in pointing out how silly I am and helping me understand. Admittedly some of it bores me silly and I can't always follow, but that's ok because I'm sure the house work and shopping etc bore him to death.

As to the really bad meltdowns, I would let her know that you still love her and that if she can think of anything you can do to help her feel better you will, and then I would give her the space she needs and drop any immediate expectations you may have had.

I would also look at what is going on at school that may be raising her stress/coping levels. Good luck not sure if anything I said has helped.


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youngest 12yrs =dx'ed ASD, ADHD,OCD,GAD and tourettes.


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04 May 2011, 8:34 am

The problem with TV is it can take a half-hour out of your life that you might both need.

We did an end-run around this problem with the "Schoolhouse Rock" DVD - it's a series of educational shorts that kids like anyway, and they're about 4 minutes each.

Another thing to think about - my son often "hurts" himself - it looks scary, but I've come to realize that he isn't really putting himself in danger (he "strangles" himself, but stops short of actually cutting off his oxygen, he hits his head against the wall - but stops if it actually hurts him.) I don't think he consciously has that much control, just that the normal life-saving automatic responses do kick in a bit. Try backing off and observing her carefully to make sure she's safe when she's self-harming, and then you can decide if isolation works for you - it works for us (and I've found if I'm not in the room, my son doesn't tend to hurt himself.) For us, isolation, isolation, isolation. DS decides when he's calm enough to come out (though sometimes I offer a gentle reminder because he can get distracted, too.)

I'm so sorry, Mama, hang in there. Also remember that some of this stuff is developmental, so it can be a matter of hanging on until she figures out how to handle it herself (not to say that finding help isn't important.)