What can I do about my brother's autism problem?
He is 26 years old, still living at home and has been extremely depressed because of his condition. His conditioned has caused a lot of anxiety, and it has caused him to wash with soap a lot for some reason. And I mean a lot. We cannot watch him all the time, but he has gone through a lot of soap and hand sanitizer. This has been going on for the past few years, and his hands actually look like a 90 year old person's hands, even though he is only 26. I am not exagerating. His faced has also aged a lot because of it, and posssibly because of his stress as well.
He always stays in his bedroom very depressed all the time. Depressed at the thought of having no friends or can never get a significant other, and have a normal life like anyone else. His washing and depressed behavior has even caused him to loose his job, and it was a really good job, that payed well.
He has been going to therapy for the last few months and has been put on medication. The medication has helped him get out more, and all. But it's also causing him to do very strange things. For example, he went out and bought $400 worth of candy from a candy store that was having a sale. I do not know why he would do that. Perhaps he feels he needs to accomplish something or be more independent.
He also went to play video games at a video game competition with a lot of little kids, but it's awkward and creepy when a 26 year old man, who looks a lot older mind you... goes to an event with lots of children and tries to make friends with them, perhaps thinking he will do better make friends with kids who are more at his growth level perhaps.
So far he is still washing way too much as usual, and the medication is making him to things that is more harmful then good, even though it's getting him out of his room. Is their anything more we can do for him since the medication and therapy is a very very slow process, and we are not sure if it is actually doing any good?
Is it OCD, or autism, or both?
http://www.biobehavioralinstitute.com/v ... .php?id=38
The common factor to both is anxiety. Perhaps if he gets treatment for that as a first step, other issues can be clarified and addressed next.
Treatment for anxiety needs to be geared to the cause of the anxiety. If it is a response to environmental factors, then therapy may help. But if the cause is innate low levels of the neurotransmitter GABA, (which is not uncommonly the case in autistic anxiety, research studies have concluded so) then therapy has no effect on this.
You have to raise the levels to lower the anxiety, and there are variety of things which can do this, including but not limited to prescription drugs.
It surprises me how little the most affected populations and the people who offer therapy to them know about how low level GABA levels impact on mood and behaviour; very few therapists offering services to ASD and OCD populations seem to have any idea about it, and offer expensive cognitive-behavioural treatment that can't do anything to raise the GABA levels in the brain. So that may be a new avenue to explore. There is a lot of information on the internet (researched) if you look carefully.
What is this medication he is currently on (which doesn't seem to be helping)?
You have to raise the levels to lower the anxiety, and there are variety of things which can do this, including but not limited to prescription drugs.
It surprises me how little the most affected populations and the people who offer therapy to them know about how low level GABA levels impact on mood and behaviour; very few therapists offering services to ASD and OCD populations seem to have any idea about it, and offer expensive cognitive-behavioural treatment that can't do anything to raise the GABA levels in the brain. So that may be a new avenue to explore. There is a lot of information on the internet (researched) if you look carefully.
What is this medication he is currently on (which doesn't seem to be helping)?
Do you mean by raising the GABA-level tby taking a supplement with GABA?
My psychiatrist wants me to take an antipsychotic against high levels of anxiety and mood irregularity and I did research and found a connection between high levels of dopamin causing high levels of anxiety and high levels of dopamin being connected to low levels of GABA.
Because I don't want to take Abilify-pills I am searching for something else but since I have discovered the high-dopamin/low-Gaba connection I have not seen my psychiatrist back to ask him about that, but I don't think that he will be supportive in that.
Do you think a simple supplement with GABA can do the job?
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English is not my native language, so I will very likely do mistakes in writing or understanding. My edits are due to corrections of mistakes, which I sometimes recognize just after submitting a text.
It's quite complicated, I will try to provide more detail later on today. Taking GABA itself works for some and not for others, there is probably no harm in trying it. GABA is unusual in that it is both an amino acid and a neurotransmitter; it is the brain's calming neurotransmitter (the opposite to dopamine). Here is little general information:
https://spectrumnews.org/news/imaging-s ... in-autism/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085902/
Thank you for the links, B19.
It is very interesting.
It is also interesting per first link that GABA levels are low in the motor cortex.
I have coordination problems and very low muscle tone.
I also remeber links linking growth hormone to GABA, but I need to look it up again, but it is late now so I won't do it tonight anymore.
I also read that low level of growth hormone is linked to social isolation (= resulting from social isolation), which I think is common in autistic children (social isolation).
I have always been tiny in posture, when I was 6 years old people thought I was 3 years old.
It is worth to research it further and I guess I will give it a try.
_________________
English is not my native language, so I will very likely do mistakes in writing or understanding. My edits are due to corrections of mistakes, which I sometimes recognize just after submitting a text.
You are very welcome Eloa. I am particularly exhausted today for a variety of reasons and will post more information when this lifts, it involves sorting through a great number of papers I have in my extensive files to find the ones most likely to be useful to you, and that is time and energy intensive in a way I just am not up to right now.
In the meantime, in passing, a idea that I have been considering for some time is that the basic 'paradigm' of viewing autism as "hardwired" into neurology, which is the received idea, may be mistaken. The evidence for this is full of assumptions and reductionism, rather than definitive evidence, and the claims made for the hardwired theory are far from proven to a robust scientific standard. In science, progress is slow because we tend to find that which we chose to look for. What no-one is particularly thinking of nor looking for (except for a few outliers) is the alternative neurological possibility that autism is 'soft-wired' in - the soft wiring system of the brain is the neurological function of the neurotransmitters. The functioning of the neurotransmitters occur in transmutable patterns, they are not fixed patterns. (They are subject to minor changes every day, and major changes can also be effected). Neurotransmitters and their relative levels also interact with environmental factors; chronic stress from the environment alters the balance of the four main neurotransmitters.
When I began my own research, quite some time ago, I focused on the different patterns of electrical activity in autistic brains. I thought that was hardwired in (it may or may not be, I have no final conclusion on that to date). It seems to me that the two topics are somehow intricately related at some level which remains an intriguing field of inquiry.
Anyway, to summarise - the hardwiring theory may be wrong; and if it is and this is established one day, that will potentially empower ASD people to manage the imbalances themselves to attentuate the troublesome symptoms of ASD while retaining the advantages. It takes a long time to change paradigms, especially in ultraconservative professions like psychiatry which tend to operate on ideas seeded in the past, rather that the present and future possibilities. Personally I don't think any breakthroughs will come from psychiatry as a discipline that will ever help the ASD population; we have to look further than that IMO. But it is a lot of work and though it is a labour of love, I am becoming so tired now.
The excessive washing sounds like he has OCD in addition to his autism, regardless if its sensory issues triggering it. I suggest that he tries a form of Cognitive Behavioral Therapy known as Exposure Response Prevention(ERP) designed specifically for OCD, particularly OCD related rituals like hand washing. At least this may allow him to get control over that aspect of his life, which I am sure causes him a lot of distress and compounds his depression.
I've always differentiated between OCD rituals and autistic rituals in that OCD rituals serve no real purpose.
I'm not sure what the washing is about. Before it started happening, he had become depressed because of social isolation. Being bullied througout school, and having to deal with that, only to become an adult with no friends and no romantic opportunities. He just has us, the family and that's it, but he has been jealous of other's social and economic success.
So this loneliness and feeling inferior was getting pretty bad before the washing started. So I thought that the washing is related to that, unless they are both two separate problems that just so happened to be there, and are unrelated maybe?
Is their any medication he could be put on that could make him more aware? I mean I talked about how recklessly blowing money, and going to functions where you could come off as awkward and creepy, is not a good idea, but is their any medication that could make him more aware of things like that, in the brain?
One of the reasons why he may not be getting better any time soon, is because he has a really bitter attitude towards being socially isolated and loosing his job, because of his behavior.
He said to me that he doesn't agree with being submitted to therapy at all. He says that the world has mistreated him all his life, and that he does not owe the world any submission, for not accepting what he is.
I mean I understand because of his experience, that it could cause him to stand up for himself, but do you think it's the best attitude for him to have on all circumstances?
Just following up on my unfinished response to your query Eloa, which may be of use to the OP's brother too perhaps. You can take GABA itself - take it later in the day otherwise you may feel sleepy all day. Some people have been taught that nothing can cross the blood-brain barrier, however GABA does indeed have a pathway into the brain: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1571855/
Some other alternatives to the GABA powder or capsules are prescription drugs (Clonazepam - low dose; Xanax, Valium) supplements/herbs (taurine, inisotol, glutamic acid, melatonin, pyridoxine, Valerian, Passionflower, Skullcap) and foods high in glutamate (brown rice, almonds, whole grain oats, liver, rice bran, walnuts, whole grain wheat, oranges, potato, spinach, broccoli).
GABA is the "great calmer"; that's its specific function in the major neurotransmitter quartet. However none of the above will work if you are not deficient in GABA in the first place. I think the most effective way to check whether that is so (or not) in the first instance by taking something like clonazepam (Klonopin) 0.25mg to 0.5mg, a very small dosage, which works to raise GABA in a very short time (30 minutes). If you have good levels, you will not notice much difference if any; if you are deficient, the change even in one day can be quite remarkable.
On a cost/benefit analysis, for those hampered by autism anxiety, this may be the most efficient and least costly way to more serenity. For those with epilepsy it may have an additional benefit. I hope this is useful for you.
PS: you can take all of the supplements/herbs at the same time, they are synergistic and will have minimal effect in isolation.
So this loneliness and feeling inferior was getting pretty bad before the washing started. So I thought that the washing is related to that, unless they are both two separate problems that just so happened to be there, and are unrelated maybe?
Is their any medication he could be put on that could make him more aware? I mean I talked about how recklessly blowing money, and going to functions where you could come off as awkward and creepy, is not a good idea, but is their any medication that could make him more aware of things like that, in the brain?
One of the reasons why he may not be getting better any time soon, is because he has a really bitter attitude towards being socially isolated and loosing his job, because of his behavior.
He said to me that he doesn't agree with being submitted to therapy at all. He says that the world has mistreated him all his life, and that he does not owe the world any submission, for not accepting what he is.
I mean I understand because of his experience, that it could cause him to stand up for himself, but do you think it's the best attitude for him to have on all circumstances?
Excessive hand washing is almost a joke punchline because its the stereotyped symptom of someone who is pathologically afraid of germs ( ie an obsessive compulsive).
So thats thats the armchair diagnosis that most folks (including me) would jump to.
But you may actually be right- that his handwashing could be about something else.
It could be something like cutting, or anorexia, or like that. Those are sometimes safety valves for excessive anger. And it sounds like he has excessive anger (which I dont blame him for having).But I agree that he shouldnt let that anger stand in the way of getting help.
B19, thank you for your thorough reply.
I want to give it a try.
It has been in my mind for a while now after finding that high levels of dopamine causing high levels of anxiety and the psychiatrist said that I had high levels of dopamine.
I don't like to take prescription drugs after having had bad experiences with them (anti-depressants).
Each time I go to the psychiatrist he starts talking about Abilify, he said that I do not see the benefit of it and I don't.
I want to try other ways.
Thank you for the information.
_________________
English is not my native language, so I will very likely do mistakes in writing or understanding. My edits are due to corrections of mistakes, which I sometimes recognize just after submitting a text.
Okay thanks. I am not sure what specific medication he is on at the moment but it has been making him act inappropriately.
The medication is suppose to suppress his shame. But because of this he has been trying to get dates with legally under age girls, compared to his age. He says that since he has an IQ that is lower than the girls he goes after, that he is not the bad guy, and that he will keep doing it, and will not have others prevent him from achieving what others have, he says.
So the medication makes him less ashamed of being autistic, compared to others, but as a result he had decided to exercise a lot of pride, perhaps even suppressed self righteousness. What do you think?
nick007
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The washing sounds like OCD to me which can be a co-morbid with autism. I take Neurontin/Gabapentin for my OCD which has an effect on GABA & helps my OCD out a lot. My girlfriend takes a supplement called NAC(N-Acetyl Cysteine) that I buy off Amazon which helps with her OCD & also has an effect on GABA.
Some antipsychotics can cause impulse problems. There advertising on TV for some lawsuits against Abilify for gambling problems. I had problems with buying things when I was on that med.
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"I don't have an anger problem, I have an idiot problem!"
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