Medication?

I feel compelled to reply only because your son?/daughter? sounds so very like myself in this emotional experience.  I am much older (37) and have yet to find a solution to the problem, although I do share the common stressor of being partway through a degree course at present (however mine is with the Open University which is somewhat more flexible and less socially oriented).  The very intense anxiety can lead to severe depression and emotional instability at times, dramatically impacting on my ability to function.

As far as medication is concerned I think I have tried most classes over the years.  The ones I have personally found most helpful have been the more sedating antipsychotics (olanzapine and quetiapine specifically) and the benzodiazapines.  However both of these have considerable drawbacks.  The former tend to cause quite considerable weight gain and sleepiness and the latter are addictive so can only be used for short periods (approx. 4 weeks at the absolute maximum).  I have not had a great deal of success with the SSRIs or even SNRIs  (which I guess are probably what you are referring to since you mention suicidality) - I have found they tend to make me quite unstable and impulsive when I begin taking them or after a dose increase, worsen my sleep and don't improve my anxiety or depressive symptoms significantly.  That being said, everybody reacts to medication differently so it is impossible to say with any certainty how an individual will respond.

A general point to bear in mind (and one that is well reported if you have an interest in ASD but often does not seem to be taken into consideration by professionals) is that those of us on the spectrum are more likely to experience side effects, increased sensitivity or idiosyncratic reactions to medications.  Therefore if this is a route your young person decides to go down start on the lowest dose possible, only increase it if it is necessary and not causing any problems and be prepared to insist that you change or come off a medication that is not working for you even if the prescribing doctor insists that it couldn't possibly be causing the side effect you are experiencing (I have actually found papers reporting the exact side effect I have previously reported linked to a specific combination of medications I was taking after two doctors had told me it wasn't possible for it to be medication related).

In terms of the mindfulness etc.  I would not necessarily rule these out as possible options if they are available.  Mindfulness requires practice and talking therapies can be more or less effective at different times depending on a whole host of factors; these things need not be a one-time-only deal.  I have been forced down the medication route largely due to the total unavailability of any form of therapy thus far, however it would not be my preferred choice of treatment.

I feel compelled to reply only because your son?/daughter? sounds so very like myself in this emotional experience.  I am much older (37) and have yet to find a solution to the problem, although I do share the common stressor of being partway through a degree course at present (however mine is with the Open University which is somewhat more flexible and less socially oriented).  The very intense anxiety can lead to severe depression and emotional instability at times, dramatically impacting on my ability to function.

As far as medication is concerned I think I have tried most classes over the years.  The ones I have personally found most helpful have been the more sedating antipsychotics (olanzapine and quetiapine specifically) and the benzodiazapines.  However both of these have considerable drawbacks.  The former tend to cause quite considerable weight gain and sleepiness and the latter are addictive so can only be used for short periods (approx. 4 weeks at the absolute maximum).  I have not had a great deal of success with the SSRIs or even SNRIs  (which I guess are probably what you are referring to since you mention suicidality) - I have found they tend to make me quite unstable and impulsive when I begin taking them or after a dose increase, worsen my sleep and don't improve my anxiety or depressive symptoms significantly.  That being said, everybody reacts to medication differently so it is impossible to say with any certainty how an individual will respond.

A general point to bear in mind (and one that is well reported if you have an interest in ASD but often does not seem to be taken into consideration by professionals) is that those of us on the spectrum are more likely to experience side effects, increased sensitivity or idiosyncratic reactions to medications.  Therefore if this is a route your young person decides to go down start on the lowest dose possible, only increase it if it is necessary and not causing any problems and be prepared to insist that you change or come off a medication that is not working for you even if the prescribing doctor insists that it couldn't possibly be causing the side effect you are experiencing (I have actually found papers reporting the exact side effect I have previously reported linked to a specific combination of medications I was taking after two doctors had told me it wasn't possible for it to be medication related).

In terms of the mindfulness etc.  I would not necessarily rule these out as possible options if they are available.  Mindfulness requires practice and talking therapies can be more or less effective at different times depending on a whole host of factors; these things need not be a one-time-only deal.  I have been forced down the medication route largely due to the total unavailability of any form of therapy thus far, however it would not be my preferred choice of treatment.