Aspergers and OCD

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Hi everyone. This is my first time posting. My 12 year old son has high functioning autism and over the last couple of years developed OCD. The OCD is really severe right now. He is afraid of contamination and his washing rituals take many hours out of his day, particularly the night time ones. He gets to bed SO late and then can't sleep because his mind is so active. Often at night he has what I can only describe as OCD-induced anxiety attacks. Sometimes he doesn't even remember them afterwards. When this OCD anxiety kicks in he gets nasty and noncompliant. It is really taking a toll on our family. He is on 100mg of Luvox but I am not sure how much it is helping!

Do any of you have experience with this?

It is very common for AS kids to have many other conditions. Please do check it is similar to classic OCD as you likely mentioned or obsessive behavior (emotional rigidity). Classic one has more medical treatment options and therapy. But the emotional rigidity is more difficult to deal with. Wish you all the best.

I don't claim to be a doctor, so take it for what you think it's worth, but Luvox is an SSRI, which, by the manufacturer's own recommendations is not to be prescribed to any patient under the age of 25 (because the human brain is not fully developed until then).

SSRI meds have a known history of causing side effects including severe irritability, agitation and psychosis, not to mention homicidal rages and suicide in teens and even adults.

When these medications were introduced, the FDA was well aware that they caused these side effects in approximately 10% of all patients, but decided to approve them anyway, believing 10% an acceptable margin, without of course, being able to foresee that within a few years, Doctors would be passing them out like candy, and prescribing them to patients who should never be taking them in the first place.

Again, don't take my word for it, I encourage you to do your own research. But the recent onset of the behaviors you describe and the fact that you say he has these episodes and doesn't remember them - that's just not normal, even for someone with High Functioning Autism.

Article: Psych Meds Drove My Son Crazy

He should be receiving cognitive behavioral therapy for the OCD. It's just as, or more successfull as SSRIs without the nasty side effects. It might also help him to understand the nature of OCD and what actually causes it.

A very simplified version is as follows.

He touches something and the primitive part of his brain known as the basal ganglia, tells him that his hands are dirty and gives him the urge to wash them by causing them to "feel" dirty" So he washes his hands. In a normal brain, the frontal lobe observes the hands have been washed, and tells the basal ganglia "Ok,the hands have been washed" and the basal ganglia says "Ok!" and stops sending the "wash hands" signal.

In OCD, the connection between the basal ganglia and frontal lobe is damaged. The frontal lobe observes the hands have been washed, but when it calls back to the basal ganglia that the hands have been washed, the basal ganglia doesn't get the message. So the basal ganglia keeps sending the "wash hands" signal and enlists the amygdala, which sends a signal of fear and anxiety to try to provoke the person to obey the basal ganglia. The person washes their hands over and over to appease the basal ganglia and stop the anxiety, and the feeling that their hands are dirty, but the basal ganglia never really gets the message that the hands have been washed, so washing the hands becomes more frequent and elaborate and futile.

CBT seeks to teach the person how to override the basal ganglia and amygdala.

This involves teaching the amygdala that if the person doesn't wash their hands, nothing bad happens. To do this, the person must refrain from washing their dirty feeling hands and simply let themselves experience the dirty sensation for a while. This is done under the guidance of a therapist until the person can do it themselves.

For compulsive hand washers, I think it's good to have rules when the hands can be washed and how, but the person must be willing to learn to be compliant in this.

For example, I wash my hands when...
1. First wake up.
2. Before I eat or prepare food.
3. After I use the restroom.
4. After I get off the bus.
5. When I actually get something on my hands.
6. Before I go to bed.

Sometimes these things are combined. For example. I may wake up, use the toilet, and then wash my hands, and eat breakfast. Or I may wake up, use the toilet, take a shower, which will constitute washing my hands, and then have breakfast.

At each hand washing. I wash my hands once, with soap if available, and in a normal manner in a normal period of time. If my hands still feel dirty after that I make myself life with it. I walk around with my hands feeling dirty until I have a valid reason to wash them again.

Over time, my amygdala gives up, and turns to my basal ganglia and says "Dude, you're over reacting, piss off and leave everyone alone, and the basal ganglia does.

It's not easy to do but can be learned with the guidance of a trained CBT therapist who specializes in OCD.

Like Chronos said, CBT is a good idea. He can learn to catch his unhelpful thinking styles like catastrophizing ("Ohnoes, contamination, it's the end of the world/I'm going to get ecoli!"), disqualifying the positive ("I haven't washed my hands 200 times today so everything must be contaminated by now"), "should" statements ("I should wash my hands 200 times"), all-or-nothing thinking ("I either wash them 200 times or not at all because it won't work if I don't wash my hands 200 times") etc.

I just want to chime in and say that i have two kids with ASD and also OCD. And, boy, when things are bad, you're right, it takes a real toll on the family!!

We have found that a combination of therapy and medication works for them. The therapy helps explain to them what's happening in the brain.. like, knowing that there is a reason we feel anxiety, but knowing that sometimes the worry part of our brain will take over a bit too much.

I know this original post was from back in July, so I hope things have already calmed down for you!! <3

Also wondering if a med change is in order. IF the your child is still doing rituals and unable to sleep while medicated, the medication isn't working. Mine take Zoloft and it works quite well... again, while also using some coping mechanisms learned in therapy.