Asperger's and Medication for Meltdown/Panic Attacks

Diazepam is usually only prescribed for one month due to addiction problems. The dosage is usually reduced over a period of time to reduce withdrawal symptoms.

In trying to reduce my anxiety levels I learnt about the different types, and the difference between fear and anxiety. In fear the danger is unambiguous and imminent. Pathological fear is seen in specific phobias.

In anxiety the threat perceived is less certain. Excessive anxiety results in GAD (General Anxiety Disorder) and panic disorder. Panic attacks are sometimes described models of acute fear. Panic disorder, including apprehension of further attacks, is considered better modelled by anxiety.

It is important - IMHO - to understand the difference between fear and anxiety and different models of anxiety as the neural circuitry involved is, whilst not completely dissociable - distinct in some respects. This has ramifications when trying to propose effective treatment.

Chronic activation - which is characterised as activation not due to a specific imminent threat - involves heightened amygdala - dorsomedial prefrontal cortex (dmPFC). Exaggerated activation in response to an unpredictable threat involves the insula. This is quite a simplification of neural circuitry involved. The diagram below is more comprehensive.

There is considerable overlap of these neural circuits with other difficulties such as depression and some components of executive function, such as working memory and motivation, both often dysfunctional in autistic individuals. So any treatment that targets these areas and their connectivity to visceral and bodily regions affected by anxiety can have added benefits.

Panic attacks induce the physical symptoms of increased heartbeat, fast shallow breathing and perspiration. It is unfortunate that your son has found meditation to be of no benefit. The ability to control my breath, and subsequently, heart rate, has been the biggest factor in helping me move froward. It does take practice and application. I know these can be difficult. I use a visualisation process. I place a small statue in front of me. I study it intensely for a few minutes and then close my eyes and try to visualise it in all its detail. I keep at it until I can recall it accurately. I then turn it 90 degrees and do the same. Eventually, I am able to see it in my mind’s eye as if I was viewing it in a VR application. Obviously I don’t do this all in one sitting, I keep at it for once or twice a day until I achieve my objective. Whilst I do this I practise my abdominal breathing. This means I am sort of meditating at the same time. Increasing one’s working memory is useful as it is an important component of executive function and consequently motivation. If one sits properly while doing this, it can act as a good way into meditation. Another way to learn proper breathing techniques is to join a yoga or Qigong or Tai chi class that embraces teaching the correct breathing during the exercises. Physical exercise helps a lot.

Another way to combat anxiety is by stimulating the vagus nerve: https://www.psychologytoday.com/gb/blog/the-athletes-way/201905/longer-exhalations-are-easy-way-hack-your-vagus-nerve. There is a gadget that has recently come on the market to stimulate the vagus nerve: https://www.psychologytoday.com/hk/blog/the-athletes-way/201711/will-stress-busting-vagus-nerve-gadgetry-be-game-changer Serotonin is manufactured in the gut and the vagus nerve is thought to facilitate the transport of serotonin to the brain via the gut-brain axis.

Anti-depressants are certainly available. I take a small dose of venlafaxine to supplement my meditation and exercises. But obviously, your Son would need to talk to his GP about the options available.

If you would like any further information, don't hesitate to ask. I know how debilitating this condition can be. Graham

Diazepam is usually only prescribed for one month due to addiction problems. The dosage is usually reduced over a period of time to reduce withdrawal symptoms.

In trying to reduce my anxiety levels I learnt about the different types, and the difference between fear and anxiety. In fear the danger is unambiguous and imminent. Pathological fear is seen in specific phobias.

In anxiety the threat perceived is less certain. Excessive anxiety results in GAD (General Anxiety Disorder) and panic disorder. Panic attacks are sometimes described models of acute fear. Panic disorder, including apprehension of further attacks, is considered better modelled by anxiety.

It is important - IMHO - to understand the difference between fear and anxiety and different models of anxiety as the neural circuitry involved is, whilst not completely dissociable - distinct in some respects. This has ramifications when trying to propose effective treatment.

Chronic activation - which is characterised as activation not due to a specific imminent threat - involves heightened amygdala - dorsomedial prefrontal cortex (dmPFC). Exaggerated activation in response to an unpredictable threat involves the insula. This is quite a simplification of neural circuitry involved. The diagram below is more comprehensive.

There is considerable overlap of these neural circuits with other difficulties such as depression and some components of executive function, such as working memory and motivation, both often dysfunctional in autistic individuals. So any treatment that targets these areas and their connectivity to visceral and bodily regions affected by anxiety can have added benefits.

Panic attacks induce the physical symptoms of increased heartbeat, fast shallow breathing and perspiration. It is unfortunate that your son has found meditation to be of no benefit. The ability to control my breath, and subsequently, heart rate, has been the biggest factor in helping me move froward. It does take practice and application. I know these can be difficult. I use a visualisation process. I place a small statue in front of me. I study it intensely for a few minutes and then close my eyes and try to visualise it in all its detail. I keep at it until I can recall it accurately. I then turn it 90 degrees and do the same. Eventually, I am able to see it in my mind’s eye as if I was viewing it in a VR application. Obviously I don’t do this all in one sitting, I keep at it for once or twice a day until I achieve my objective. Whilst I do this I practise my abdominal breathing. This means I am sort of meditating at the same time. Increasing one’s working memory is useful as it is an important component of executive function and consequently motivation. If one sits properly while doing this, it can act as a good way into meditation. Another way to learn proper breathing techniques is to join a yoga or Qigong or Tai chi class that embraces teaching the correct breathing during the exercises. Physical exercise helps a lot.

Another way to combat anxiety is by stimulating the vagus nerve: https://www.psychologytoday.com/gb/blog/the-athletes-way/201905/longer-exhalations-are-easy-way-hack-your-vagus-nerve. There is a gadget that has recently come on the market to stimulate the vagus nerve: https://www.psychologytoday.com/hk/blog/the-athletes-way/201711/will-stress-busting-vagus-nerve-gadgetry-be-game-changer Serotonin is manufactured in the gut and the vagus nerve is thought to facilitate the transport of serotonin to the brain via the gut-brain axis.

Anti-depressants are certainly available. I take a small dose of venlafaxine to supplement my meditation and exercises. But obviously, your Son would need to talk to his GP about the options available.

If you would like any further information, don't hesitate to ask. I know how debilitating this condition can be. Graham