Regular physical aggression, out of the blue

Don't know if this is any use:

http://hpi-vb.com/4-steps-to-find-your-lifes-passion-and-reduce-stress/

http://the-great-learning.com/stress_burnout_regeneration.htm

It's a bit "new agey" but I'm sure there are nuggets of wisdom and common sense in there.

Hi 

Thanks everyone.I value your comments. they have made me think hard. I have booked another appointment with the psychiatrist. I feel my son may have some 'flashbacks' of things that may have upset him a few years ago whilst he was living with his father abroad. the trouble is he cannot communicate his anxiety/ fears etc. if you ask him anything he will say something random nothing to do with the question. His communication just revolves around his echolalia (repeating what he has heard) We all try to reasure him when he has a 'meltdown' that he is safe, loved etc. he remembers alot from his childhood and often will say something related to that i.e what a particular teacher said to him or another child, but says very little about his life since. He mentions things that happened before he went abroad aged 16 but very little since. He was living with his dad from 16 until 4 years ago. He is 26 now. his violent aggression started 5 years ago (the reason I managed to get him back). Its complicated I know but it really upsets me that i cannot get to the bottom of what his thoughts and fears are and get him to understand whatever has frightened him is all in the past.

Ah I must have misunderstood. I've heard of existential distress where someone with a terminal condition gives up on life. I suppose it could apply to people on the spectrum.

That's what I meant when I suggested existential stress.  It builds up and needs a release valve every so often.

Just as a matter of personal theory (rather than anything official) look for cumulative factors.

People look for immediate causes of a meltdown, but apart from his not being able to identify a cause, he may be under long term stress above which quite small things trigger a meltdown ("last straw" - but that's just my theory).

There may be things he has misunderstood a while back or a sense of grievance at something that he cannot resolve, and he may be going over and over things trying to work it out. There may be multiple long term issues like this. So he ends up using a lot of mental energy trying to sort out problems that NTs might have sorted quickly, or just forgotten about.

Bear in mind there are people around who, knowing someone is on the spectrum and could get anxious, will feed him misunderstandings just to see his reaction. And he may not appreciate figurative references like "I'll kill you if you don't stop doing that" or "ten years off your life if you tell a tale about someone" (which an irish lady said to me once and it worried me for a decade).

Lots of little things that an NT would get over quickly can really affect people on the spectrum long term.

It may be worth making a few gentle enquiries about whether any things are causing him concern that he'd feel he wanted to talk over, or if he won't with you, someone else who he is more likely to open up to. Just telling it to someone may sort out a lot.

It is worth pushing to get him checked further by the psychiatrist to rule things out, but being up and down in mood and talking to himself can still all be part of autism, it doesn't mean he is hearing voices or anything.  People with autism are very sensitive to environment and small stresses could push his mood up or down.

Hi Thank you for the reply and advise. my son is violent against others including me (anyone in his path when he loses control) his environment is as autism freindly as we can make it and all steps are being made on most levels re over and under stimulation. he does go through severe mood changes but can have reverse mood swings in the same day, within hours i.e. can be upset/ crying and later laughing/ elated. He also talks to himself in different voices.

They are most likely meltdowns, which the vast majority of autistic people are prone to.  It does not mean he is bipolar or schizophrenic.  If he was bipolar he would have manic highs and deep lows and if he was schizophrenic he would be hearing voices or having delusions and extremely paranoid.

Medication does not get rid of the cause of meltdowns and unless he needs medication for specific reasons such as to reduce anxiety he should not be on medication for being autistic (it says this in the NHS NICE Guidelines).  Autism is a neurological disorder not a psychological one, although there can be co-morbid mental health issues that need treating.

Meltdowns are a release of stress, if there are no specific triggers that you can see it means either he is unable to identify the triggers (he might have alexithymia) or it is just existential stress being released.

Before medication, the first thing you need to do is look at his environment.  Is there noise that others may think is not problematic but to an autistic person is?  Is he bored, lacking in routine?  Are people placing demands on him?  Are people speaking to him in a non-concrete way and making him stressed because he is failing to understand their meaning?  Is anyone teasing him?  Has anyone taken anything from him?  Are his clothes comfortable and well-fitting?  Is his sleep OK?  Is his diet OK?  Is socialising pressure being put on him?  There could be all sorts of things which haven't occurred to you (or that he has self-realisation about) that are bothering him.

Medications can be harmful to autistic people as we are more sensitive to side-effects.  Be sure he really needs the medication and it is the right one if he does.

BTW when you say his rages are violent, is he harming anyone or himself, or threatening to?  I know a grown man raging can appear scary but it's not violent unless he is destroying property all around him or harming anyone.