Help for Adults with Asperger's

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Hello everyone. I have a 26 year old son who I believe may have Asperger's. He is against getting a formal diagnosis because he can't see how it would help. In fact he fears that even seeing a therapist will result in him obsessing about his problems. He is very depressed and as of late has had OCD that is off the charts. He does not have a job at this time and has been living back at home for the past year after living away from home for three years before that. We subsidized his rent & expenses for a portion of that time. I don't see him getting a job until he has addressed some of these symptoms. He asked that I contact the forum and get some feedback on the advantages of getting diagnosed. I am also looking for some kind of assistance for him because we are having a hard time paying for his general medical care, much less therapy. I posted this thread in the Parents section first but realized that this may be a better place to post.

in my opinion the best help is self help. you can always put your trust in a therapist who may or may not effectively apply cognitive behavior therapy-- the only known effective treatment for difficulties resulting from traits on the autism spectrum. you can effect the same type of changes in your thinking on your own as long as you become very knowledgeable about the strategies.

as a starting point, to answer the question of "where do i even start?" you can read about the subject, and become familiar the clinical experts' opinions. in doing so, you become empowered over the actual weaknesses you possess by becoming capable of observing them. you also gain more power by recognizing the things which are strengths, and learning how to leverage them to succeed when facing difficulties.

Thank you so much for your excellent reply. I will ask him to read your post.

Heh. Well, when I started obsessing about AS, I went from being homeless and sleeping on people's couches to being a college student doing undergraduate research in gene therapy. So obsession may not be a bad thing.

Seriously, though, an adult AS diagnosis can help. You can access things like academic assistance in college (they let me take my tests in a quiet room by myself, with a camera watching, instead of with the class, for example). You can get help finding a job; there are vocational rehab offices in pretty much the whole of the US and most other countries too. Therapy is all well and good; but with AS, what you need most are basic skills that'll let you take care of yourself and support yourself, and the accommodations necessary so you can use your talents to get a job or get through college. It's a matter of learning things. The AS is permanent; it can't be removed; and there's no good in making it your goal to be normal. Better is trying to be a competent, well-educated autistic person.

Give me the accomadations I will need in college, and a scolorship and give me a scolorship to vet school (perferably anywhere but UC Davis, Cornell or Texas A&M) and help me find a job at a zoo or something when it's all said and done and there, you've helped an adult with AS.

In the meantime, you can buy an MLP custom.

If he does have sever OCD, he should get that addressed before all else. There are two forms of treatment for OCD, medication, and cognitive behavioral therapy, and they are often used concurrently. Very severe OCD usually warrants hospitalization in an inpatient OCD treatment program. There are two that I know of. One at UCLA's Semel Neuropsychiatric Institute, and the other at McLean hospital on the east coast. There may be more.

Most of the medications used to treat OCD are SSRI's. On rare occasions, however, antipsychotics may be used as their sedative effects can cause an apathy that works as a type of cognitive behavioral therapy.

On the rarest of occasions, for individuals who do not respond to medication or aggressive in patient treatment, a cingulotomy may be performed. The goal of this is to simply get the patient to respond to medication. It only has a 30% success rate. Thankfully most people respond sufficiently to less drastic treatments and it would be very unlikely that the quality of your son's life would not improve with treatment.

Concerning the AS, there is little in the way of resources for adults with AS. I believe some adults would benefit from explicit instruction in socialization.

Except that when you go to an inpatient ward, you learn skills designed to help you survive in an inpatient ward. Not so much for skills that are useful in real life outside the hospital. If at all possible, stay the heck out of the hospital and only make use of it to keep you alive when you're in immediate danger.

CBT and similar therapies can be useful for OCD. Finding a reputable therapist who won't confuse autistic special interests with OCD obsessions could be difficult, though. There aren't too many that are experts on both.

Agreed that the OCD really needs to be addressed; it causes distress and creates a barrier to learning.

But it seems to me that somebody stuck at home without a job and without something useful to do has more of an environmental problem than anything else. I talked to a gerontologist a while ago who mentioned that this is something you often see in elderly retired people: No job; their friends have passed away; their families have lives of their own; so they're spending the day sitting and doing nothing and after a while they show all the red flags of depression. Some doctors just treat the depression with medication and don't realize that these people's environment makes it very difficult for them to find any worth in life, because they don't have any sense of purpose or belonging anymore. The solution in most cases isn't antidepressants--it's to find some way these folks can do useful things and engage in purposeful activity, anything from social clubs and charity work to private hobbies. When you're eighty-five and you've outlived everyone, apparently it's very easy to feel you've got no purpose in life. It wouldn't surprise me that this kind of thing can happen to younger people, too.

I agree with you completely. When psychiatrists also did psychotherapy it was actually fairly difficult to get a prescription out of them until they felt compelled enough that it was warranted and your problems were not environmental.

I feel that for depression, most anti-depressants perform no better than placebos because they can only treat depression as a result of a neurological mechanism and not depression due to environmental factors, and most depression they attempt to treat with them is a result of environmental factors.

I also feel medication for OCD could be more effective if it was actually designed to treat OCD, however I don't believe any of them were, and most of them were primarily designed to treat depression and just happened to be somewhat effective in treating OCD.

The first question I ask is, is your son aware that there is an issue and if so, does he want to get help? If he is not on the same page or does not understand that there is a problem, any therapy will be an uphill battle.

Therapy is very hard work. It helps if he is at least open to the idea of discussing what he is experiencing in a therapeutic setting.

Take good care and I wish you all the best of luck in reaching healing outcomes.

Just a note, I also have very obsessive thoughts and behaviours mixed in with compulsions. I am not dx with OCD but the traits have been put down to some disabling symptoms of my AS dx. Not all people with AS experience O's and C's to the same degree. It is all part of a spectrum.

Mics

Well, the problem with any therapist is how good they are. A good therapist can really help. A mediocre or poor one can make things worse.

The only "treatment" for AS is coping strategies and adaptation techniques. Recognizing the symptoms and learning how to best "take charge" so that you control them more than them controlling you. How effective this is varies from person to person...depending on how pronounced their symptoms are.

I agree with the "self-help" angle largely because I have nobody near me qualified to Dx AS in adults, so getting formal help isn't an option. I learned to cope with many of my symptoms slowly by trial and error before I even knew about AS. Once I learned about AS, I've had an easier time making improvements because now I understand what I'm dealing with rather than blindly guessing.

I also understand the hesitancy for getting a formal Dx. Even if your AS is bad enough that you won't be able to escape it's negative impacts on your ability to get a good job or career, etc., being labeled is a dual-edged sword. It can open doors to some opportunities reserved for the handicapped, it can get you access to needed assistance, but it does label you, and society does judge by labels.

In my opinion, the person has to WANT to help themselves. I don't think it'll do any good if he doesn't want the diagnosis himself.
For me getting a diagnosis would help tremendously to explain why I do the things I do and once I know that I can teach myself and others how I need to deal with it to minimize those behaviours. It would give me ALOT of answers to alot of my life-long problems and quit making me think that I SHOULD be able to control myself and stop getting angry and confused as to why I can't.

The other reason is for my children and family (and extended family). It's apparently genetic so my entire family would benefit from knowing that it does run in our family and could help others who may be experiencing similar problems but are covering it up well like I did for so many years. They'd be aware of the possibility when they have new babies so they can watch for signs and be able to help their child early on. One side of my family has a lot of undiagnosed mental health issues that no one ever bothered to get diagnosed. Maybe if they did someone would have been aware of my problems as a child instead of me figuring it out when I"m 38 years old on my own.

He doesn't necessarily have to tell ANYONE about being diagnosed UNLESS it will help with getting disability or special help at work. Professional help can likely give him useful tools on how to minimize his behaviours. Maybe enough to have a regular job where no one would have to know he has AS. Just depends on the severity I guess.