Anxiety and Post-Traumatic Stress Disorder
Mood disorders (depression or bipolar disorder) are commonplace mental health experiences for the general population and, especially, for people with different ways of being, including Asperger's Syndrome. Because of the pervasiveness of mood disorders, the Diagnostic and Statistical Manual compels a clinician to rule them out first. Afterward, other mental health problems, including those that may occur concurrent with mood disorder, may be considered.
Anxiety
When most people think about kids with Asperger's and mental health issues, they often think about anxiety. Anxiety is typical of many children with Asperger's because of their gentle and sensitive nature and their need to feel safe and comfortable within a range of predictability. Everybody feels nervous or anxious about certain things in their lives, but, as a parent, you know that the things you consider minor can snowball into something huge for your child. “Big world” complexities may seem beyond your child's control, and his perceptions can become exaggerated or blown out of proportion. Some kids really torture themselves, agonizing over details, particularly with regard to the future. Events like impending appointments, tests, or social activities — especially in which your child is expected to “perform” or excel — can cause him to be unable to keep things in perspective and keep anxiety in check. Your child's anxiety may also be driven by feelings of distress or guilt due to family disharmony.
You may notice your child's anxiety through his inability to remain calm, focused, and rested. He may ruminate on certain topics or request that you confirm the same information over and over again.
Essential
It's important to keep anxieties in check before molehills become mountains. Encourage your child early on to communicate his concerns to you, no matter how minor. Some kids are martyrs, believing they must suffer in silence; so if your child approaches you with a complaint, accept it as legitimate to him. You may also wish to process the day at bedtime and provide soothing assurances or a plan to make things right as part of a nightly ritual.
So what can a parent do to help an anxious child? You may very well be doing your anxious child a disservice by rushing to medicate the anxiety without first understanding its roots or providing coping strategies to help him independently relieve stress and anxiety. Strategies to quell anxiety while exploring medication will be discussed in Chapter 17.
Post-Traumatic Stress Disorder
In many instances, anxieties can escalate into post-traumatic stress disorder (PTSD) if they are not addressed. This is especially true if your child has participated in or been the target of abuse (in any form) or has witnessed some disturbing or violent event, such as a car accident.
The symptoms of PTSD may look very similar to depression, but remember that depression must be explored first. Additional symptoms of PTSD may include:
Nightmares and night sweats
Re-enactments of sexual abuse or attempts to impose sexual behavior upon others
“Clinginess” or a general sense of fearfulness
Increasing withdrawal from social activities
“Flashbacks” triggered by people, places, visuals, and smells (Your child may “replay” mind movies at this time.)
Acting out past events verbally, physically, or both
Bedwetting
Feeling unsafe or unprotected in familiar environments, or violently refusing to be in a particular environment
Complaints of feeling physically or sexually “dirty,” and desiring to bathe frequently
Illustrating a traumatic experience through writing, art, or music
Being hypervigilant, which means your child may appear to be “on guard” or easily startled
It is imperative that you support your child to the best of your ability to work toward resolving issues of depression, bipolar disorder, anxiety, and PTSD. The future of his mental health and his capacity to function as an effective contributor to his community depend upon it.
