One of the biggest drawbacks of having Asperger Syndrome is the temper meltdowns that come with it. Life on the autism spectrum means, for all of us, a nervous system that is set on “red alert” 100% of the time: you know that smoke alarm you have outside your kitchen door that goes off every time you make toast? Yeah, that’s us.
Little things that other NT/not-on-the-spectrum people don’t even notice make me crazier than a cat in a bag: the sound of the fan on my computer when a program is installing; sudden noises; someone touching me unexpectedly; the sound of someone whistling, snapping their fingers, or jingling their keys; the sounds of people chewing loudly or licking their fingers or clicking gum; the feel of a label or a seam in my clothing….
When I was about 7 I had a massive morning-long screaming battle with my father, who was trying to stuff me into a pair of new denim jeans. Even now, tight clothing, or anything that flutters or dangles or clings at my neck, will make me break out in a cold sweat.
Many of us, myself included, learn to manage this hyper-reactivity simply as a matter of survival in the adult world. My nervous system calmed down somewhat as I grew older, and as I matured and entered university and the working world, I was very motivated to blend in and act more like my colleagues: ripping my shirt off in the newsroom because a label was itching my neck was pretty much out of the question.
In the last year and a half, however, I’ve noticed some alarming “symptom creep”, probably due to hormonal fluctuations related to the fun, fun phase of life called perimenopause. It started with increasing moodiness and irritability, and initially I was able to dial that back with a couple of herbal supplements, Vitex among them.
I worked harder at modulating my (increasingly awful) moods: I got out my old Cognitive Therapy workbooks and looked at those; I made sure to get exercise and sun and fresh air every day; I did yoga; I avoided annoying people and situations as much as I could. I even got to leaving inspirational notes to myself on mirrors, cupboard doors and so forth.
But a few weeks ago I realized I was basically living in “crisis management mode”, more or less existing from one meltdown to the next. If I wasn’t having a meltdown, I was either uneasily anticipating the next one or just recovering from one.
So with a heavy heart, I made an appointment to see my family doctor. She prescribed blood tests to make sure my thyroid, B12 and iron levels were all right. She recommended some mindfulness and meditation exercises to calm my nervous system down, and then, since she knows very little about Asperger’s, suggested I go see M., my Asperger specialist, and bring her his recommendations.
Long story short, M. was as alarmed as I was. “The joy seems to have gone out of you,” he said, which made me sad. He, too, recommended mindfulness and meditation exercises, and then to my surprise (and horror…) told me that many people on the autism spectrum are helped by subclinical doses (i.e., much less than normal) of a drug called Cipralex (it’s called Lexapro in the United States). There is ample research, he said, that it helps dial back some of the irritability that is the hallmark of Asperger’s.
I took this recommendation, and his other remarks, back to my family doctor and took my first dose of Cipralex at lunch that day.
Typically, these sorts of drugs (selective serotonin uptake inhibitors, or SSRIs) take several weeks to get fully into your system and do their magic, but I began to feel calmer after just a couple of days. Partly this could be the “placebo effect” (you think it’s helping, so it does); partly it could be the mindfulness reading and practice I’ve been doing; partly it could be just the fact of finally getting help with all of this.
Whatever the reason, though, it’s like the “mad wild horse” I’ve been living with for months now has finally been quieted. Instead of it plunging around and my trying vainly to grab the reins and calm it down, it’s just… standing there. Quietly. Blowing steam gently out of its nose and munching grass.
It’s the strangest feeling, like something has been almost physically cut out of me. I drop a fork on the floor, say, and there is no urge to scream and swear and rampage around the apartment. The computer gets noisy and I simply shut it off and go do something else. It is the strangest thing ever, like a fever breaking.
The downside, though (and there always is one, when you put chemicals in your body) is a bit of a sedated feeling: today, Day Six, I feel like I have a mild case of the flu. I’m very, very tired and dragging myself around the house a little bit. However, I’m confident that this, too, will pass as my system adjusts to the new regime.
And frankly, this is a really small price to pay for longed-for peace and quiet.
I must add a few caveats here: I am not a big advocate of simply medicating undesirable behaviours out, for any reason. I think of drugs as an absolute last resort, to be used only after lifestyle changes and therapeutic interventions have failed. Also, what works for one person will not necessarily work for another — for whatever reason, Cipralex seems to work for me right now, for my specific symptoms and chemical makeup and body type.
As with all medical decisions, talk to your doctor and/or a specialist first and rule out any other conditions that may be causing a sudden onset or return of symptoms.
I will keep you posted as this experiment goes on.