Mood Instability and Meltdowns
Some people with autism spectrum disorder (ASD) have to struggle mightily to keep themselves in control of their behavior.1,2 Whatever their level of functioning, this is not easy. Much of what is coming at them from the outside world is experienced as dismaying and intrusive, if not downright terrifying. Under the stress of all this, they may lose control. In a toddler, it gets labeled a “tantrum”; in an older child, it gets labeled a “meltdown”; in an older teen or adult high functioning enough to be out in the world on their own it may result in getting fired or being arrested. In all cases, if the person becomes aggressive to others and/or destroys property during their fit, it is a major problem. The outside world will not care much whether the person just lost control or was trying to stop some intolerable sensory input or social demand.
There is so much that can potentially destabilize a person with an ASD. Consider lack of language and an inability to communicate, broken routines, items out of order, sensory overload, and the unfathomable behavior of the human beings around them. For a person on the spectrum, life is dishing these up all day long. Is it any wonder they occasionally “lose it”? Nevertheless, meltdowns are very challenging for those around them. Depending on level of functioning, they can also be very frightening for the person with an ASD who has lost control of him or herself.
For some individuals with ASD, problems with mood go beyond frequent irritability or tantrums. They may suffer from an actual mood disorder in addition to their ASD. Bipolar disorder has been reported, although anxiety and depression appear to be much more prevalent.3,4 Higher functioning individuals may be particularly at risk for depression, especially during adolescence and young adulthood.5 Whether this is the result of a growing awareness of the impact of their own disability or due to genetic or biological predisposition is not yet known.6 Whatever the case, it is important to remain aware that mood issues should be taken seriously and carefully evaluated.
Many people with ASD have been diagnosed with, or treated for, another psychiatric condition, such as Attention Deficit Hyperactivity Disorder, anxiety, depression, or mood disorders. For more information, please see ADHD, Anxiety, and Autism?
- Finding a Mental Health Provider Experienced in Autism
- Diagnosing and Treating Extreme Behavior in Children with Autism
- When a Psychiatric Crisis Hits: Children with Autism in the Emergency Room
- New Research on Children with ASD and Aggression Article and Video
- Red Flags: When to Take Your Child with an ASD to a Psychiatrist
- Dominick, K.C., Davis, N.O., Lainhart, J., Tager-Flusberg, H., & Folstein, S. (2006) Atypical behaviors in children with autism and children with a history of language impairment. Research in Developmental Disabilities. In press – published on-line 4/3/06. Abstract
- Smith Myles, B., & Southwick, J. (1999) Asperger syndrome and difficult moments: Practical solutions for tantrums, rage, and meltdowns. Shawnee Mission, Kansas: Autism Asperger Publishing Company.
- Volkmar, F.R., & Klin, A. (2005). Issues in the classification of autism and related conditions. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp. 5-41). Hoboken, NJ: John Wiley & Sons.
- Matson, J.L., & Nebel-Schwalm, M.S. (2007). Comorbid psychopathology with autism spectrum disorder in children: An overview. Research in Developmental Disabilities, 28(4), 341-352. Abstract
- Ghazuiddin, M., Ghaziuddin, N., & Greden, J. (2002). Depression in persons with autism: Implications for research and clinical care. Journal of Autism and Developmental Disorders, 32(4), 299-306. Abstract
- Ghaziuddin, M., Weidmer-Mikhail, E., & Ghaziuddin, N. (1998). Comorbidity of Asperger syndrome: A preliminary report. Journal of Intellectual Disability Research, 42(4), 279-283. Abstract