A parent asked: “Is it normal for a teen with Asperger’s to become increasingly angry, irritable, and almost violent while also becoming more suicidal? These behaviors don’t seem connected to Asperger’s.”
A great question! First, however: It’s imperative that children or teens who seem depressed, or who talk about suicide or not wanting to live, have in place a mental health team—a therapist plus a psychiatrist experienced in working with children with Asperger/autism—who can offer treatment and also help parents decide whether the child needs to be hospitalized. Please see below for more on this topic.
But to address the question about whether or not this combination of feelings is typical with teens with Asperger’s, the answer is yes. As they become teenagers, it’s very common for our children with Asperger profiles to become more anxious, and even seriously depressed, as new social and academic pressures increase their stress levels. Keep in mind that most teens experience turmoil—and that our sons and daughters are less developmentally ready than neurotypical teens to handle the multiple challenges of their high school years. With less awareness of their feelings than other teens, and fewer strategies for resolving their problems, they may act out, or vent their worries in hostile speech, withdrawal, surliness, or refusal to engage or co-operate.
Even before adolescence, our children’s stress levels tend to be higher than average. You are correct that Asperger’s itself doesn’t cause the changes you are seeing in your teen’s mood and behavior—but the continuous struggle of living in a world not built for people with an Asperger profile—a world they often find confusing, frustrating, or disappointing—and a world in which people often misunderstand or even mistreat them (e.g. rejection, teasing, or bullying by other students, or sometime even by teachers)—takes a toll on a teen’s mental health. Even children who previously seemed able to cope can be pushed beyond their limits when both the interior hormonal world and the external social scene suddenly change, shaking up their sense of familiarity, security, control, and mastery.
An additional source of stress for teens is worrying about their future. They hear classmates talking about dating, college, or future careers. They may have unrealistic fears about what will happen after high school, and unrealistic expectations of themselves. For example, one boy finally revealed his worry that immediately after graduation he would be expected to move out of the house and get a full-time job. He had no idea how he would do that, and naturally he was terrified. His parents did not realize their son had such a distorted and harsh view of what high school graduation would mean. He did not realize that his parents expected to provide help for many years to come, and would be glad to discuss his concerns and together develop some realistic plans.
While other high school students facing such pressures and worries may be able to find relief and reassurance by drawing upon deep reserves of self-esteem, or through close relationships with family members and friends, our teens with Asperger profiles often have fewer emotional/social resources. Also, if much of their self-esteem has depended upon academic achievement, that too may falter as academic demands intensify in high school—or as teens become more aware of the importance of areas where they feel less competent.
Seek Help from Mental Health Professionals and from AANE
The teen years can be hard for everyone in the family, but you don’t have to struggle through them alone. Well-trained, experienced mental health professionals, AANE staff, and other parents in the AANE community can accompany and support you and your family on your journey.
Does your teen have a good therapist and psychiatrist in place? If not, please contact the teen’s pediatrician, or contact AANE about how to find and vet professionals in your area. Both of these professionals should have extensive training and experience working with children and teens with Asperger profiles/on the autism spectrum—since our children’s body chemistry and mental health issues differ from those of neurotypical children/teens. As a parent, you do not want to be alone when assessing how much your child or teen is at risk. You need to be able to consult the teen’s therapist and psychiatrist.
We recommend that a teen who seems highly anxious, despairing, or seriously depressed, including teens who talk about suicide, be evaluated for possible medication (or changes in medication), at least on a temporary basis. If a pediatrician has been prescribing anti-depressants, anti-anxiety medication, or other psychotropic medication for your teen, consider seeking a second opinion from a psychiatrist very experienced in prescribing medication for teens on the spectrum.
An AANE staff member (we are also parents) would be glad to speak with you about your teen’s situation. One hour Parent Coaching sessions are available (which can be expanded to a series of four). You and your coach can meet in-person at AANE’s Watertown, MA office if you live close enough, or otherwise by phone or over Skype. It’s fine for another parent (or adult relative) to join the conversation. Please see schedule coaching sessions.
Getting Started for Parents of Teens (article)
Welcome to the Teen Years (video)
Types of Help for Complex Children and Teens with Asperger Profiles (checklist of possible interventions)
“Transition in Action” video series
Preparing for the Transition to Adulthood articles by Michelle Garcia Winner