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Aged 59, undiagnosed ASD, how can I help him?

NAS68102

Hi everyone

The story to this point is long but I'll try to condense it.

I've been with my husband for over 20 years and knew him for 10 before that. I've been convinced for a long time that he has asd and other people (including some health professionals) over the years have asked him whether he is, aspergers being mentioned. Until now has always vehemently opposed the notion and become agitated and angry when I've tried to broach the subject until now. However, his mental health has deteriorated to such a point that I think he's finally given in to the idea.

He's self employed and works from home, except he hasn't had any work for a while now as he is unable to engage with anyone whether on the phone or using eg Skype. He doesn't go out except to sometimes pick up one of our children (teenagers) in the car - the only thing he can cope with as it's a controlled environment with no contact needed with other people.

He was forced to go out a few weeks ago because the home delivery prescription service he uses (so doesn't have to engage with eg pharmacy staff) became overloaded so he had to go to a chemist to collect the prescription. No-one else was allowed to collect it for him (I don't know why). This trip didn't go well which is nothing unusual. He doesn't cope with pleasantries so invariably things get off to a bad start. He was asked some questions, they didn't like the way he responded and the store security guard was called over. He has completely stopped making eye contact with people in these circumstances which also throws them.

He has been type 1 diabetic for many years which necessitates regular engagement with the NHS. He now cancels appointments and does everything he can to avoid engaging with the system. Obviously this is not good. 

He's finally given me permission to contact one of his consultants. I'm waiting for her to get back to me - I have said it's urgent due to his mental health. He won't let me speak to his GP. So...although the consultant  deals with his diabetes  I was hoping to get some support from her in terms of a way forward re his mental health - I have to be his advocate as he can't engage with the world at the moment. He tried to go in a shop but his anxiety went into overdrive because not everyone was keeping 2m apart and the uncertainty of the situation was intolerable. He shut down completely and wasn't able to move or respond to concerned staff.

I'm hoping that given his diabetes and other health conditions, including a respiratory condition I can organise a shielding letter for him a) because of his co-occurring physical conditions and b) the thought of eg having to collect his prescription in person again is sending his anxiety through the roof and he needs that pressure taken off.

I'm not really sure what to ask everyone on here except do you think I'm taking the right approach and do you think a diagnosis is possible at this late stage? He did actually try to raise it with his GP about 2 years ago but the GP told him he wasn't autistic and thumped his desk hard as he said it Disappointed.

  • Hello, I don't really know what to say but you seem such a nice partner, I just wanted to say hello and wish you all the best This forum is a great help so I would encourage you to ask away if other things crop up. 

  • in reply to NAS68102

    I wish you the very best with this situation. 

  • in reply to Senor

    Thank you. I've now spoken to his diabetes consultant and she has said that she also tried to broach ASD with him, so it was no surprise when I told her about the current situation. She is going to speak to the psychiatrist attached to the diabetes clinic who my husband has seen before. When he saw the psychiatrist, she raised ASD but at the time my husband would not accept it as a potential diagnosis. I'm hoping that now he accepts it, it won't be too difficult to get the diagnosis.

  • in reply to MDC

    Thanks MDC. Yes, his anxiety is very bad.

  • I am a retired autistic GP and would be happy to converse with him. I realise the difficulties, but things can get worse and I feel the most helpful thing is talking and understanding it all.

  • in reply to MDC

    I'm guessing that the diabetes consultant might be a bit more receptive than his GP. I suppose she has known your husband for a while, and, as MDC says, she is likely to be aware of the correlation. She might be a good way to initially broach the subject, and perhaps gain contact with other receptive consultants. The fact that your husband has agreed to you contacting her perhaps indicates that he has some confidence in her ability to see things from a different perspective. From everything you have said, this is clearly not something to be easily dismissed by a GP having a busy 'off' day.

    I've had about 5 years of seeing just how resistant GPs and some specialists can be in more than one country . But as luck would have it, my current GP has experience in his own family. But even then, I only raise the issue with him when it is extremely relevant to my current situation. He says he thinks of it as a bit of a gift, but I'm also aware that he might well be under considerable strain himself, I also have the slightly different problem of some family who really don't want to know about it at all.

    One GP suggested I should take up meditation and forget the subject. Well, I do sort of practice it already. But for me self-identification has been a constructive experience. He somewhat grudgingly recommended I meet his psychiatrist friend. The shrink was obviously at pains to shut down my self-identification completely by calling it General Anxiety Disorder and reactive depression. I rashly and very reluctantly agreed to start on Sertraline, but dropped it almost immediately as it left me feeling   even   further   distanced  . I also reckon that the years since have conclusively proved that I have nothing to gain from anti-depressants. I note that depression is always something I have quite quickly shifted myself by my own efforts.

    But obviously, that is not true for everyone. We are all very different, and so need to have a real say in our own approach. A neurologist, contacted on a different (but perhaps connected) issue also fobbed me off by talking about Alzheimer's and Parkinsonism. She said no way right now for those two, and I agreed; but got somewhat ticked off by her ignoring a very significant issue. I concluded that my partner had somehow alerted her not to talk about ASD. And also conclude it is a completely untouchable subject concerning adults in the country where I live. An eminent local psychologist specialising in sleep disorders (which I was experiencing at the time) just used his receptionist to fend me off by saying he had no time for expat clients. And I have been too long out of the UK to even just contact a GP when I am at home for a few weeks. Again, I got no further than a receptionist. So I went for a private UK diagnosis. (I was also accepted for a private diagnostic session in two other countries.) No regrets about that move! I am unlikely, though, to ever again cross the threshold of any of those practices that tried to divert my own efforts.

  • There seems to be a correlation between diabetes and autism. It also runs rampant in my family. 

    I think you're already doing all the right things, he's rather shielded from stressful factors. I guess you should get somebody to get his work running again, since he's not capable of intitiating, but he'll probably pick it up once it's real and needs to be done. That might be a shift to the better if he could get his mind focused again and forget a bit about the situation. He seems to have lots of anxiety. 

    Medication that works very well for me is escitalopram, reduces anxiety and allows to have a more neutral position in dealing with people. Before I was a lot more suspicious and that would offset conversations to my disadvantage. Like a selffulfilling profecy, if your behaviour makes it clear to somebody that you don't trust him or her, you will also get a defensive respons. Your husband seems to have this very bad, so medication might be necessary.

    A bit of advice to him from me would also be that if he made it this far in life, he should start seeing himself as somebody who won the race and can now enjoy the bonustime of some extra laps, relaxed. It really changed my life to be able to think like that, and I still get lots of things done..