Please advise - 11year old brother with ASD - anxiety and medication?

Avoid medication that young.  It has far too many side effects and his brain is still developing. Anxiety medication might be a possible route, but be aware that it is addictive and coming off it is likened to worse than coming off crack.  I use it, but a quarter of a tablet once in a while.  its good for acute anxiety problems.  Im not sure going hardcore into SSRI's would be a good idea either, at a young age. But in the US they seem to hand out Prozac to young children like smarties, so maybe its possible, but im not sure I would.  I've had them in the past and the side effects were worse than the depression.  Also due to long half lifes, they take months to come off and trying to do it cold turkey can be very bad.  The likely outcome of giving a person prozac is you end up with a zombie that is tired all the time and will probably just stop functioning completely.  That was me after 3 months on it. Sertraline and Citalopram were about the same.  You could try St Johns Wort if hes not taking anything that interacts with MAOI drugs.  It has a similar uplift, but its an OTC you can buy in most supermarket supplement aisles.  Its what I used to use after I was fed up with being a zombie and went looking for something I could use on occasion and then stop.  It gives a mood uplift, has some anxiolytic effects and helped with my OCD a little.  i used to take them for a couple of days then stop once the crisis was over.  My GP suggested I tried them.  Might be a possible route to try before you bring out the heavy guns.

Limit his screen time and maybe block youtube if that is the main problem.  Also explain that the vast majority of stuff you find on youtube is complete cr*p and not factual.  Maybe point him at interesting but not anxiety invoking stuff like Discovery documenaries or documentaries in general, but try and supervise what he watches.  If it doesnt help then id block youtube.  I suspect the digital world really doesnt help people with anxiety.  Everywhere you go you find negative stuff.  My brother only allows his children, one is 11, 1 hour of screen time a day and its supervised.  No phones until they get to 16 (but he said he wasnt against giving them say an old nokia as an emergency phone).

I hate to say this, but he will never be normal by the average NT's idea of normal.  He will either be high functioning or maybe not.  With some luck he may meet someone and get married and have children.  I have two siblings that I know have various levels of (undiagnosed) ASD and both have a wife and kids, also a good degree and masters, houses and a good life.  Many people with ASD have a good life.  I really wouldnt worry about that so much.  Also he doesnt need to worry about that.  No amount of medication will ever grant him normality like you see it and it would be morally and ethically wrong to force medication on someone to make them fit your definition of what they should be like.  They are not you.  It would be best to let him evolve as an individual.

Hi, 

My son is 11. He suffers from anxiety too. He was referred to camhs. The waiting list is long so had a few sessions with a charity called believe to achieve. They helped him to express how he felt. He made things like, happy balls, worry boxes. He can also jot things into a diary when he feels down. 

My sons anxiety gets quite bad, He refused to go outside at all for the first 4 weeks of the corona virus of fear he would get the virus. I had to electively home school due to the pressure of the SATS ( then they closed the schools - im still having to homeschool full time )

It depends on your brothers abilities and things he likes ( you know him best) My son loves superheros and ps4, so I use his toys to get him to tell me how he feels and whats worrying him through his toys during play. He gets very anxious when asked direct questions. 

I personally dont want my son on any medication so will try alternative therapy until nothing else works. But that's just my opinion,not the right one, just a preference for now! 

Children with autism may have a delay with processing bereavement, so he may be grieving, maybe speak to your GP especially since you've mentioned your brother has expressed concerns regarding losing other family members and seeing your Dad. They may be able to do a counselling referral.

This website has some fantastic information about effective communication. Since i've changes my approach with my son, I have really noticed a difference. 

Can I also mention,  for me, living with high functioning autism is hard and it is emotionally difficult at types. I worry about him all the time, life is a roller coaster, an amazing roller coaster. but a roller coaster ;)

However, my sons qualities are brilliant. He is honest, kind, to the point, funny and extremely knowledgeable about marvel and dc.

I wouldn't change him. Autism makes my son who he is him, if I take that away, I take his personality away.

Remember, autism is a lifelong condition, you may see your brother at times improve, but he will probably always need some form of support from you.

You dont mention your age, i know it can be difficult for siblings. Remember, you are doing a fab job at supporting your brother. Remember to find time to look after your own wellbeing. 

I'm glad you invited opinions and views on your post, and i hope this helps.

It might be worth reading your post again and really think about what you're saying. You write about "improvement" and your desire for your brother to be "normal" and i don't think that is fair. You may not mean it, but your tone sounds like your brother's anxiety is having an impact on you, and that is the real issue.

Anxiety is a human response to a perceived threat, or uncertainty. And with so much happening at the moment it would be understandable that your brother's behaviour may be changing. With so much out of our control it may be his OCD increases. Also, can I say that horror stories and tales of the supernatural are actually scary stories to process! You said that when you explained to him about the story, that helped, and it may be there will be much more that needs explaining as life develops and other fears crop up. Anxiety is not something that goes away, it is something we learn to understand or work through, to echo Anthony it really should be a last resort. If medication is considered, it would take away the side effects but your brother would still need support to understand and work through his fears. If there are concerns for his mental health, then you should speak with a medical professional.

I feel like you need to understand that your brother may not fit the mold of what you think happiness and normality looks like, and he certainly doesn't need the pressure of feeling your disappointment. How do you know a life without marriage and children wouldn't be remarkable. Have a read of the stories of the spectrum on the NAS website, and see how different and wonderful people are. Support your brother, understand how you can help him thrive however he wants to, and learn how to safely manage your own feelings. 

It’s hard to say really, everyone is different - there are clear traits of anxiety on your description above but it could be more complex especially with ASD and the trauma of losing your dad in the mix too. Have you looked online for self help anxiety work? It’s a starting point at least until medical services return to normal. 

Thank you for your response. I understand.. I'm against it too but it feels like speaking to him/therapy might not be as effective as he falls back into this.. Does this seem like a classic case of anxiety or something more?

Medication whilst an option should never be the first port of call because it’s can cause a dependency - there is a lot of self help guides for anxiety which may be a starting point and talk based therapies even they are back up and running is something I would recommend - the problem is that everyone is different and deals with anxiety differently - the most important is to be supportive and understanding - because sometimes the biggest help can come from the simplest gestures.