Autistic Meltdowns

This is a blog written on the subject of autistic meltdowns. I have an autistic 9 year old and have been recently diagnosed myself at the age of 40. An autism meltdown occurs when the autistic person becomes so saturated with sensory overload, be it from sounds, lights and smells, or emotions like anxiety, frustration, sadness or anger that the brain literally cannot cope anymore.

Try to imagine driving along a busy road in a foreign country.  You are having to engage all your senses and concentration to keep going safely, as you do not have the instincts to follow the rules of the road that the other drivers follow naturally. You are probably quite tired and overwhelmed by this. Suddenly you come upon a traffic jam. While sitting there you attempt to open the windows but they are jammed shut, the air in the car is stifling and hot, the volume knob on the radio is broken so the sound is blaring and all around you people are honking their horns and shouting at you in a strange language you can’t understand. The sun is in a position in the sky where it is shining directly in your eyes and you have no sunshade You are parked near an industrial plant pouring out a stomach churning smell and unable to escape due to the other cars all around you.

A neurotypical person could probably take some measures to deal with this; shutting their eyes, sipping some water, taking a layer of clothing off if possible and taking some deep, slow breaths through their mouth to try and slow and regulate their heart rate. The person with autism cannot do this. Their central nervous system cannot process the stimulus the way a neurotypical person can. In times of high stress or anxiety a person’s autonomic nervous system (ANS) produces cortisol and related hormones. These are the hormones which cause the ‘fight, flight or freeze’ response in a person. The autistic person cannot regulate themselves when this response occurs and will react in a different way to a neurotypical person.

They may shut down or withdraw, becoming difficult to get responses from, as they retreat into themselves to protect themselves from what their body is perceiving as a threat. This can often be seen as anti social behaviour or petulance if they are quiet and withdrawn, seeming unwilling to engage, or responding with minimal verbal expression. This is not the person being uncooperative or unapproachable, but a self defence mechanism. The brain is trying to respond to an overwhelming flow of stress hormones and sensory overload and is mentally removing it by throwing up walls to protect itself.

Alternatively they may experience a range of outburst behaviours. They may shout or scream, or cover their ears or eyes. They may lash out at people about them or attempt to hit, scratch or bite themselves, or throw things that are at hand.  They may attempt to soothe themselves by stimming (a self stimulatory behaviour) that could be physical (such as pacing, rocking, flapping or jumping) or verbal (word or phrase repetition). They could be frozen in one spot or may even attempt to run away. No two people will experience a meltdown in the same way, and even in one individual meltdowns can vary depending on the triggers.

A meltdown is not a tantrum. This person is not doing this to elicit a behavioural response. Whilst children with autism (or adults for that matter) can experience tantrums as equally as somebody who is neurotypical, a meltdown does not have a desired response, the behaviours are not considered and cannot be soothed in the same way, as the behaviour is not self aware but a response to the hormones flooding the body, and the overwhelming stimulation the brain is experiencing and is much, much harder to regain control over.

Helping a person having a meltdown may need to be done in a variety of ways depending on the cause and the person. Removing the stimulus is usually the best bet, and making sure they are safe. The meltdown will often continue while the stimulus remains present. With decreased awareness someone having a meltdown or a shutdown could injure others or themselves both on purpose or accidentally. My daughter does not deliberately hurt herself in a meltdown, but often can hurt herself accidentally if she hits her head or body on something hard when she is thrashing about. When she has a meltdown I will try to get her to a quiet place, away from people and noise, getting her ear defenders on if I have them. If I can get to her quickly enough a tight hug can help applying what is called ‘deep pressure’ and stroke or rub her arms, legs or back. This will slow down the input from the autonomic nervous system, allowing the parasympathetic nervous system to engage and begin to calm her. I will either play her her Disney music or just making shushing noises or quiet reassurances that I’m there and she is ok.

If she can gone beyond that she will fight if I try to do this, and can hurt me or herself. At that point, as hard as it is I have to try not to touch her and just provide a quiet reassurance that I’m there. It’s hard not to pull her in close to me for comfort, but at that point the sensations of touch on top of all the other sensory input overloading her nervous system is unbearable, about the most I can usually manage is to gently stroke her on the leg or arm.

My meltdowns often take the form of a shut down. I may seem withdrawn, anti social, ‘moody’ or unapproachable, but inside my head serial explosions are going off and I am fighting the urges to lash out, throw myself against things and hit my head or body, or to simply run away. My only self defence is to pull into myself and minimise my contact with the world. I will either lie quietly, often curled up staring at the wall, or speak in short or one word answers – my brain too exhausted to articulate itself properly. When this happens I may want total solitude or I may still want to be around people, but in a quiet place with no demands on my nervous system. Simply allowing me time alone or talking to me quietly in a quiet place and allowing me to express my stress and frustration without judgement and demands can help. Stimming can often help, I like to play with a fiddle toy or rub my feet together.

There is simply no point in getting angry, shouting or making demands of a person having a meltdown, as it is adding to the fight or flight response in the autistic person and overloading them even more. I am totally far from perfect when my daughter melts down, and even though I understand the place it comes from I have shouted from frustration or stress, or the fact I have missed the cues and cannot understand where the meltdown has come from. Sometimes I shout as this is also causing me to feel overloaded. The screaming can be painful to my ears. However when I can, I do try to modulate my response by remembering she cannot modulate hers. Her ability to process things is impaired so I may not get a fast answer or a sensible answer. I have to be the one to control my response.

As she calms I have sensory soothing tools to hand to help her regulate herself. Her favourite, aside from her Bear-bear, is her sequin cushion, one of the ones with reversible sequins. I tend to stroke them one way and she will smooth them back. If you get a chance to try one of these I recommend it. I find it deeply soothing myself. She now has a snap on sequin bracelet to allow us to do this out and about without toting a large cushion about. If she does stim I don’t interfere. Never stop a person, autistic or otherwise, from stimming – either during a meltdown or at other times. These stims – such as rocking, flapping or repetitive sounds or movements are designed to calm, soothe and regulate. (I will be blogging on stimming at a later date). The only time I would step in would be if she was hurting herself, either self harming or at risk of hitting herself off some thing – at which point I would try to redirect her as gently as possible. If she’s overly hot and I can I will try and cool her off.

Once it’s over the person who is having the meltdown will, in all likelihood, be completely exhausted as all the adrenaline that has been flooding their body will dissipate. It’s a tiring thing to happen, made worse if tiredness was already a precipitating factor. Give them some space and some quiet to rest. Monkey is usually quite receptive after a meltdown to lying in my lap just resting while we talk quietly. To be honest I’m usually exhausted too from the stress of dealing with it and the down time is good for me too.

Hopefully this blog will spread awareness of why a person melts down and the best ways to help them. However, it is important to note that *you* cannot help someone else if your own fuel tank is on empty, so take the time to look after yourself. A meltdown can affect everyone involved even if the meltdown is internal. You cannot pour from an empty cup.

Until next time look after yourselves and each other

TBB

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