5:00am on a Tuesday
I wake up with the request from the nurse, who entered our room, to sit up and have my blood pressure monitored. She asks about my pain and for a moment I forgot what she was referring to…
Oh, yes, now I recall…the scar on my wrist. I received 11 stitches for the self-inflicted deep tissue damage I have done with my pocket knife with the serrated blade.
‘I am okay, thanks, it doesn’t hurt that much.’ I say in my croaky morning voice.
It was my second night of well deserved rest. I have never slept more than 4 hours a night my entire life.
I get up, have breakfast, take a shower and wait for my appointment with the Psychiatrist to talk about my situation.
After a cup of coffee the nurse informs that he is waiting for me in the consultation room and I finish my coffee before I enter the room. I felt it was the polite thing to do.
We did not share any small talk, and he started asking questions: ‘Tell me, did you read up on Autism as we discussed?’.
I confirm and he doesn’t say anything. I look at his face and I look at his hands and I look at his body language and I gather that he is probably waiting for me to elaborate.
I recite what I have read the day before:
What Is Autism?
Autism, also called autism spectrum disorder (ASD), is a complicated condition that includes problems with communication and behavior. It can involve a wide range of symptoms and skills. ASD can be a minor problem or a disability that needs full-time care in a special facility.
People with autism have trouble with communication. They have trouble understanding what other people think and feel. This makes it hard for them to express themselves, either with words or through gestures, facial expressions, and touch.
People with autism might have problems with learning. Their skills might develop unevenly. For example, they could have trouble communicating but be unusually good at art, music, math, or memory. Because of this, they might do especially well on tests of analysis or problem-solving.
More children are diagnosed with autism now than ever before. But the latest numbers could be higher because of changes in how it’s diagnosed, not because more children have a disorder.
Autism Signs and Symptoms
Symptoms of autism usually appear before a child turns 3. Some people show signs from birth.
- A lack of eye contact
- A narrow range of interests or intense interest in certain topics
- Doing something over and over, like repeating words or phrases, rocking back and forth, or flipping a lever
- High sensitivity to sounds, touches, smells, or sights that seem ordinary to other people
- Not looking at or listening to other people
- Not looking at things when another person points at them
- Not wanting to be held or cuddled
- Problems understanding or using speech, gestures, facial expressions, or tone of voice
- Talking in a sing-song, flat, or robotic voice
- Trouble adapting to changes in routine
Some children with autism may also have seizures. These might not start until adolescence.
Autism Spectrum Disorders
These types were once thought to be separate conditions. Now, they fall under the range of autism spectrum disorders. They include:
- Asperger’s syndrome. These children don’t have a problem with language; in fact, they tend to score in the average or above-average range on intelligence tests. But they have social problems and a narrow scope of interests.
- Autistic disorder. This is what most people think of when they hear the word “autism.” It refers to problems with social interactions, communication, and play in children younger than 3 years.
- Childhood disintegrative disorder. These children have typical development for at least 2 years and then lose some or most of their communication and social skills.
- Pervasive developmental disorder (PDD or atypical autism). Your doctor might use this term if your child has some autistic behavior, like delays in social and communications skills, but doesn’t fit into another category.
Exactly why autism happens isn’t clear. It could stem from problems in parts of your brain that interpret sensory input and process language.
Autism is four times more common in boys than in girls. It can happen in people of any race, ethnicity, or social background. Family income, lifestyle, or educational level doesn’t affect a child’s risk of autism.
Autism runs in families, so certain combinations of genes may increase a child’s risk.
A child with an older parent has a higher risk of autism.
Pregnant women who are exposed to certain drugs or chemicals, like alcohol or anti-seizure medications, are more likely to have autistic children. Other risk factors include maternal metabolic conditions such as diabetes and obesity. Research has also linked autism to untreated phenylketonuria (also called PKU, a metabolic disorder caused by the absence of an enzyme) and rubella (German measles).
There is no evidence that vaccinations cause autism.
Autism Screening and Diagnosis
It can be hard to get a definite diagnosis of autism. Your doctor will focus on behavior and development.
For children, diagnosis usually takes two steps.
- A developmental screening will tell your doctor whether your child is on track with basic skills like learning, speaking, behavior, and moving. Experts suggest that children be screened for these developmental delays during their regular checkups at 9 months, 18 months, and 24 or 30 months of age. Children are routinely checked specifically for autism at their 18-month and 24-month checkups.
- If your child shows signs of a problem on these screenings, they’ll need a more complete evaluation. This might include hearing and vision tests or genetic tests. Your doctor might want to bring in someone who specializes in autism disorders, like a developmental pediatrician or a child psychologist. Some psychologists can also give a test called the Autism Diagnostic Observation Schedule (ADOS).
If you weren’t diagnosed with autism as a child but notice yourself showing signs or symptoms, talk to your doctor.
There’s no cure for autism. But early treatment can make a big difference in development for a child with autism. If you think your child shows symptoms of ASD, tell your doctor as soon as possible.
What works for one person might not work for another. Your doctor should tailor treatment for you or your child. The two main types of treatments are:
- Behavioral and communication therapy to help with structure and organization. Applied Behavior Analysis (ABA) is one of these treatments; it promotes positive behavior and discourages negative behavior. Occupational therapy can help with life skills like dressing, eating, and relating to people. Sensory integration therapy might help someone who has problems with being touched or with sights or sounds. Speech therapy improves communication skills.
- Medications to help with symptoms of ASD, like attention problems, hyperactivity, or anxiety.
Talk to your doctor before trying something different, like a special diet.WebMD Medical Reference
© 2019 WebMD, LLC. All rights reserved.
My Psychiatrist looks at me and says: ‘Did you recognize anything about yourself?’.
‘Not really, no.” I say.
And I continue talking to him about why I did not see myself as having a problem and I don’t understand why I am in the hospital and I start talking about how since my childhood I felt that life was an adventure although challenging at times and how I had a wild imagination and I really loved watching movies and I could memorize the dialog and I loved physics and mathematics and how things worked and how I read encyclopedias and was fascinated by how flowers grow and how ants build their nests and the feather of a bird was something I would study for hours and I couldn’t sleep at night because I wanted to know everything and my brain had a buzzing sound when I was 5 years old and I used to rock myself to sleep at night and I didn’t like the clothes my mom bought me and I hated apples, I REALLY hate apples and the TV was always too loud and I could smell my mothers cooking from hundreds of meters away and I could never see when people were angry and got into a lot of trouble without meaning to because I was completely caught up in my own world and I would climb to the top of trees because I liked the way it swayed in the wind and I loved to swim because I enjoyed the sensation of water on my skin and didn’t understand why I had to stay in school because it was so easy and I wasn’t allowed to answer all the questions all the time…
The Psychiatrist smiled, he nodded and said: ‘You just spoke at length about various things after I asked you one question. ADHD is the next topic for you to read about please. In addition, you made eye contact once and the tonality of your voice never changed which leads me to suspect that you are on the spectrum. Let’s look at trying to treat some of the symptoms you currently have and see how you react with some medication. Are you okay to try it?’ he asked.
‘Sure…’ I said.
He prescribed something for serotonin levels to stabilize and something for dopamine levels to stabilize. He said it helps for people with ADHD and major depression.
‘Excuse me?’ I said, ‘I don’t have depression, I love life!’ I exclaimed.
‘Sir, you tried to commit suicide a couple of days ago. The wound on your arm is still bleeding. You have major depression even if you frame it in your mind as “adventure”. I know it’s difficult to see it in yourself, understand it and accept it, but I will help you. Let’s get the nurse to clean your wound again, get you the medication and I suggest you take it easy the rest of the day and please read up on depression and ADHD and some more on Autism Spectrum Disorder. I will see you again tomorrow.’ he said and got up to go and speak to the nurse.
She cleaned the wound, gave me my medication, I read articles on Autism and Depression, I had lunch, I read some more, I had dinner, I took a shower, read more, took my medication and went to bed and started thinking about Autism, ADHD and Depression and fell into a deep sleep…