Cipralex: Calming the “wild horse” of Asperger meltdowns

The Aspie nervous system.

The Aspie nervous system.

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….

DIe, pants, die!

DIe, pants, die!

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.

Hell no.

Hell no.

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.

Everything's great. Thanks for asking.

Everything’s great. Thanks for asking.

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.

Whoa, Meltdown. Whoa, boy!

Whoa, Meltdown. Whoa, boy!

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.

Yours calmly,

A.G.

 

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10 thoughts on “Cipralex: Calming the “wild horse” of Asperger meltdowns

  1. Hi

    This is good information but I need help connecting the dots. Who is M? What is an Asperger specialist? A psychiatrist? A psychologist? A ….? How do I get one? Do I need one? I live in Hamilton Ontario. I am a 40 year old woman. I was diagnosed last month… and I am not finding any !@##$%* roadmap for how to do this with any level of grace or competence. Please help.

    • Hi Kathy,
      Contact the Asperger Society of Ontario and they will be able to help you find someone to talk to. Here’s their contact page: http://www.aspergers.ca/contact-us/

      An Asperger specialist is someone (usually a psychologist) who knows a lot about Asperger Syndrome & helps people who have Asperger’s. “M” is a way of talking/writing about my specialist without revealing his name (privacy issue).

      There are many books & websites that are helpful as well: Tony Attwood’s book “The Complete Guide to Asperger Syndrome” is very good, as is John Elder Robison’s “Look Me in the Eye,” which tells of how he grew up with undiagnosed Asperger Syndrome. He wrote a second book called “Be Different” which is excellent too.

      Have a look in my “Resources & Links” section and see if anything there is useful. https://aspergercafe.wordpress.com/resources-information-links/

      And be patient with yourself. It will take a while to get used to your new diagnosis (it took me a few years, really!) but it will come.

      Best,
      A.G.

  2. Hi A.G.

    Thank you. I just needed to know that “M” is a psychologist. I had already read the books you suggested. Be Different was my first book and is still my favourite. Out of interest, why do you suggest reading? Everyone I speak with/email seems to start with a reading list for me. I am wondering what you think the outcome of reading should be.

    The Asperger’s Society of Ontario which my diagnosing psychiatrist also suggested has been a disaster. They suggested that I contact my MPP to advocate for services for adults — since they mostly focus on childen and are charitable organization. Basically, they did not answer my questions directly (or at all) and after three exchanges I gave up trying to get them to understand. It wasn’t worth the tears and frustration to move half an inch forward. I hope they treat parents better than they treated me.

    thanks again

    • I have found that if you contact the Social Worker at your local hospital you may get some direction to professional help in your area. Sometimes as humans we want answers asap…so the reading can cause frustration. It is always good to have supportive people around us and know we are loved. We are never alone because so many people are dealing with the same situation. Finding a support group is always helpful. A medication can help but your M.D. must write for it after you meet. Don’t give up there are many answers out there for us all.
      Do you have any hobbies or interests like painting or yoga? Do you like to listen to music? The love and compassion in the world will help you.
      Dona

  3. Hi A.G.
    My grandson has aspergers since he was 3. He’s now 15 and his doctor has just diagnosed him as having anxiety disorder. She wants to give him cipralex. I believe from the dates on this blog that you would have been on the medication for a year now. I have some questions if you’re still moving forward. How long have you been taking cipralex? Did you experience the side affects for a long period? Do you find it’s been effective? Has it improved your outlook?
    Please let me know as its a big decision to make for my grandson.

    Thx
    Barb

    • Hi Barb,

      You’re correct — I’ve been on the Cipralex for a year now. It’s a sub-clinical dose (which is often best for ppl on the spectrum for some reason) and it has been a godsend. No side effects that I can detect, although for the first week I was on it, it made me extremely sleepy. My family doctor immediately noticed a difference, and I have noticed that I am not nearly as prone to rage or tantrums. I can just let things slide off me, rather than getting extremely upset about little things.
      That said, different drugs work differently in different people. I’m female & much older than your grandson. Drugs also can have serious side effects in teenagers, which I’m sure your doctor knows.
      But if he’s really struggling, it might be just the thing. Try a VERY low dose first and that might do it.
      Please let me know how it goes.
      Best,
      A.G.

  4. Thank you for this post AG – my son, age 11 has Asperger’s, just entered middle school and is having terrific anxiety and sudden boatloads of aggressive behavior. I know he’s in fight of flight mode. In the absence of being able to flee, he is challenging and fighting everyone but family, I am upping OT and exercise, and increasing his sleep and reading, but we may need to start him on 5 mg of Lexapro in the morning per his excellent pediatric Neurologist (one of the best in Texas). Your post made me feel a little better – albeit a momma bear scared for her cub – chiefly of side effects. I just want to help him. From my heart – thank you for sharing yours. You have a wonderful way with the pen and are a strong voice for the many brilliant people on the spectrum. Sending you a dove from Austin, Texas.
    FKE

    • Thanks for your comment — I hope the Lexapro helps your “cub”! You might want to consider having him take it in the evenings, though — it has a very strong tranquilizing effect for the first two weeks or so, which might result in Cub sleeping through his morning classes. 🙂
      Thank you for the dove. :))))
      -A.G.

  5. Thank you so much for writing this! I’ve recently been diagnosed and am fighting through finding my way towards stability. Reading this post and seeing the suggestions of books, better habits and your valuable insights has given me a much needed boost of confidence moving forward. I’m tired by the ‘wild horse moods’ and was considering lexapro, so the info you’ve shared about your experience has been helpful and I’m extremely grateful for it. Thank you! 🙂

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