Is extreme tiredness normal?

Hi misskittykat,

I am sorry you are having problems with your daughter's schooling.  I totally understand, I pulled my son from school at the end of yr 6 and we got lucky that the loal high school has a unit for him.  It is ideal really, as they are so understanding.  At the moment he can only manage 4 mornings a week, but hopefully when the sertraline kicks in, he will feel able to cope with more, when he is less anxious and suicidal.

As far as Tony Attwood goes I like the book, Been there, Done That try this is good.  I also have a book by a different author called Parenting a child with Aspergers, 200 tips and strategies, by Brenda Boyd.  This is brilliant and you can just dip in and out

Hi Darkside,

I had to reduce the sertraline back to the first dose of 25mg.  I think she must be very sensitive to it - we'd had a month of the extreme tiredness and it didn't look like it was going to pass.  The consultant suggested dropping back to 25mg because we'd noticed a difference when she first started taking it with things like her concentration.  She was suddenly able to sit and read for an hour rather than read a sentence, get up, fidget then go back and read the same sentence!  The one thing I have noticed though, she has put on a fair amount of weight since being on it.  I'm not sure if that's because of less fidgetting or lack of exercise but being a short girl, its going to hit her fragile self esteem if I'm not careful.

My friends daughter also takes it.  She's not on the spectrum but suffers from severe anxiety at school during the exam period.  She's doing well on it.  I think everyone has different reactions and I have my fingers crossed that your boy's is a good one.

You are very lucky to have a school with a unit.  My daughter is currently out of school.  We moved last year and the she couldn't cope with the new, very large school (1800 kids!) so is currently dual registered for some online schooling and has a tutor come to the house once a week, soon to be upped to twice.  I'm hoping to get her statemented so that she can have a choice of schools but the best school for her in this county is 24 miles away.

I haven't read any of Tony Attwood's books - I'm currently doing an OU degree so have to do a lot of reading for that but once the exam is over in June, I'll have four amazing months to read the pile of books accumulating on my kindle!  Do you have a favourite?

Yeay, mmisskittykat, it is wonderful to find someone els whose child is on sertraline.  My young man has just started his for panic attacks, self harm, stress and suicidal thoughts.  How is your daughter getting on?  

He has been on the medication for 5 days now and i am already beginning to get glimpses of my son back.  I read the side effets leaflet and then binned it.  The side effects are minimal there is in most cases a 1 in 1000 chance of getting even the mild symptons.  If the children really aren't coping on it they can be transferred to prozac, but it is not as affective.  

Our psychologist did mention that it an make the children lethargic, but that this will pass.  My son has a processing delay as well, but there are ways that the schools can take this in to account.  for example if he has a test the shool will take him in to a room he is comfortable with with his teaching assessment, and then they give him longer to do the test.  (last time they even gave him chocolate millk and a pizza!!)

Have you read the books by Tony Attwood? he is brilliant

I'm rubbish at the quotes thing!

Daisygirl, I also meant to say, I see what you are saying about taking longer to recover.  That makes so much sense.  Its taken her 7 years to get over my break up with her father!  I have so much to learn.  I'm thinking now that maybe I should have accepted that she needed time and not medication to get over all the changes that had upset her so much.  I really wish I'd had a diagnosis for her earlier.  

Lastly, professionals are not all the same, just because someone has a medical degree and calls themselves an expert in autism does not mean they are. Also a lot of psychiatrists are under pressure from spending cuts, time constraints etc. and popping pills is a way to see a problem the  patient present with reduce, without any investigation of the underlying causes. [/quote]

To be fair to the consultant, he wasn't overly keen, asked us to think about it first and did say that she would need to see CAMHS to work on the underlying cause.  I think maybe I felt pressured from my family and school to consider medication.  I don't even like to take paracetemol so the thought of giving my daughter medication scared me.  My sister works with people with severe learning and behavioural difficulties and she's very pro drugs so its been fed into me for a while that medication is the best solution.

I know she was bullied at school a little but I've always sorted it out pretty quickly however I do know, that just before she refused to go anymore, there was an incident with a boy who had picked on everyone, not just her, plus he'd assaulted a teacher, destroyed property etc and it had scared the living daylights out of her.  We were told that he was likely to be expelled but of course that made no difference to her.  

Apart from the tiredness, she's thriving at the moment, no school for 4 months, one to one with a tutor once a week and visits to school once a week after school has finished for the day.  I can't imagine ever sending her back now.

misskittykat said:

I took my 13 yr old daughter out yesterday to meet friends that we haven't seen in ages.  It was a long day for her (train journey there and back) but we spent 5 hours with our friends, several having lunch, another 45 minutes stop for tea/cake as we were all aware that she couldn't cope with walking about for hours on end.

She really struggled to get through the last 2 hours.  I've never been one for staying in all the time so she is used to doing this sort of thing but she used to have so much more energy and get up and go.  It made me think over the last year and I can see that the extreme tiredness has been creaping up on us. 

It could be normal teenage hormones or her medication (she's been on Sertraline for 2 months) or is it because her sensory processing disoder is more extreme now?  Just wondered if others suffer or their children suffer and was there a time when things were better and if they are likely to get better?  I'm worried that she will become a recluse and lost contact with the outside world completely.  I'm still pretty new to this (diagnosis in Feb) and although I've been aware of her differences for a long time, am only just begining to 'get it'.

My lad is exhusted at the end of every day. He comes home from college and normally has to sleep several hours before he can continue with his study, then we have to go through the process of waking him which takes some time. He's always been this way. Maintaining concentration and dealing with the sensory overload at college takes every ounce of his energy from him and gives him frequent migraines, which exhuast him still further. For this reason he has become a recluse. This past Summer he ventured out to see a friend locally, a couple of times, but this isn't his usual pattern. He has DCD & hypermobile joints and falls constantly, so when he came back he black and blue and was in considerable pain. It laid him up for a couple of days afterwards.

Pushing him out the door is essential to him maintaining contact with the outside world, but it comes at a painful price to him. I think you just have to accept that for some these things require tremendous effort. Even effort for the body to stay upright in my sons case, but also mental effort. Perhaps a balance is key, however, the only balance we know is that he needs regular rest. Bare in mind that many on the Spectrum do get there, it just takes a lot longer.

Take Care,

Coogy xx

Has there been any attempt to understand the panic attacks?

As Longman says, bullying is very common. I too was bullied at school and was a school refuser (before being home schooled), and selectively mute.

I have no experince about the learning disabilities side, but the use of a medicine for panic attacks without understanding why they are happening is not good practice. One thing is that children and young people with autism often find it very difficult to decscribe what it is that is causing them distress, also they can take a long time to get over things, and it is very importent that they are not rushed into things just because it is inconvenient for school/family/professionals. The difference between coming to terms with a problem in their own time and being rushed is absolutely huge. Rush someone with autism and they will have a problem for ever, let them come to terms with it and they will gain confidence.

Lastly, professionals are not all the same, just because someone has a medical degree and calls themselves an expert in autism does not mean they are. Also a lot of psychiatrists are under pressure from spending cuts, time constraints etc. and popping pills is a way to see a problem the  patient present with reduce, without any investigation of the underlying causes. There is a truth in psychiatry and psychology that a lot of problems simply go away in time, and using drugs gives the patient/patient's family some sense that they have helped. Unfortunately for other problems the drugs just cover up what is really going on and the dose just gets bigger, or the prescription goes on for ever. I am not saying that this is the case for your daughter, but just to be aware of it.

Were the panic attacks on leaving the house induced by anxiety about anything happening at school. it is important to check for bullying. The kind of bullying might be perceived by teachers as just ribbing, but if everyone in the class is picking on you because you have behavioural issues, or taking advantage because she is slower, or playing on any sensory overload issues, that could make her scared of school.

Most people on the spectrum were bullied at school....me included...my sensitivity to loud noises and sudden movements meant I was easily wound up as entertainment, especially when the sudden movements were just on the periphery of my field of view.

Schools seem to be pretty universally blind and dumb on this kind of bullying.

Longman, I've never looked at like that, I was always told she had a learning disability but everyone that spends one to one with her knows she's actually very bright and has an amazing visual memory just not good at the processing side of things.

DaisyGirl, she's on it for panic attacks which were stopping her from even leaving the house.  It helped especially in the begining.  I read the side affects in the pamphlet bit didn't do any research online because she was pretty desperate for help at the time and I couldn't see any other option but to try it.  I wasn't aware it could make the sensory processing worse.  I'll have a look into it and discuss next time we see the consultant.

Thanks for your comments Intenseworld.  I try to put myself in her shoes but its getting through to everyone else. 

misskittykat said:

I asked her today and she said that when the three of us were talking, she kept getting lost, trying to keep up with the conversation so what you've said makes sense.  The last EP said that she is still processing the first part of the first sentence when the teacher had moved on to maybe the fourth or fifth sentence.  I thought that was just part of her learning disability rather than part of being on the spectrum?

That is definitely an autism trait.  I find it very exhausting to follow multiple contributions to conversation and if someone is talking to me 1-2-1 and there is noise of other people conversing nearby (or any other noise) it really stresses me out and I can't focus on what they are saying as the other hubbub just destroys my ability to focus.

Agree with Daisy Girl, but also to follow up on OP's observation about keeping up with the conversation. It is one of the aspects of autism most often seen by the public.

Because you miss out on so much non-verbal information, you have to rely on the spoken language. That means you are still sorting out what was said earlier, and can easily miss things coming later.

The comedy series Porridge had an occasional character who was way behind in the conversation. And there are other comedy characters with a similar difficulty.

Two analogies here. If you are reading a technical book or a book that is otherwise stodgy to read, you may have to keep going back to earlier paragraphs if you cannot follow the thread. Your daughter needs to understand the thread, so cannot just skip to the next bit of what the teacher is saying.

Also, emoticons (smileys) were introduced for text dialogue, whether texting or on chat rooms on the web, simply because misunderstandings arise because written language on its own has multiple meanings. Your daughter has no real life emoticons (nor can she generate them to help convey to others what she means).

This is not learning disability, though it may amount to that in its effects, as it slows down absorption of information.

Teacher's should give pupils on the spectrum written summaries to help them bridge continuity gaps.

Sertraline is well known for making some people who take it like zombies. Have you read the (considerable) list of side effects that are associated with this medicine? The side effects could make her difficulties with sensory processing worse.

Why is she taking it? Autism is a lifelong condition, any mental health issues people with autism have are caused by an environment that is unsuitable for them. There is no need to medicate people with autism as a consequence of a diagnosis of autism. I do not know of any reason to prescribe it for any form of learning disability either.

I asked her today and she said that when the three of us were talking, she kept getting lost, trying to keep up with the conversation so what you've said makes sense.  The last EP said that she is still processing the first part of the first sentence when the teacher had moved on to maybe the fourth or fifth sentence.  I thought that was just part of her learning disability rather than part of being on the spectrum?

I get this too Longman, I start zoning out if my brain has had enough.

Just trying to cope/ compensate in social situations can be tiring - you have to work a great deal harder at many things that come naturally to NTs.

I tire in social situations, often fairly quickly - start yawning even, and find it harder to look attentive. I find it hard to keep my eyes open, and harder to follow the conversation. It obviously shows, as people complain.

It is hard to explain to people that it is something that normally happens and can they bear with it, particularly as I avoid disclosing I have aspergers.

Ironically, because I have to try so hard to pay attention and follow dialogue, people seem to think I'm a good listener....that is until it becomes more apparent I'm losing connectivity and even nodding off.

I think it is experienced by others on the spectrum, both from reading about it and talking to others. However it is hard to say, as this is one of the many areas of day to day life that isn't covered by the simplistic triad of impairments.

Mental exhaustion can make you feel physically tired, so even if someone hasn't physically pushed or exerted themselves it can have the same effect.  I don't think raging hormones help either.

Thanks Intenseworld, that made interesting reading.  She has been through a period of big changes in the last 10 months as well as hitting full on puberty.  

It doesn't help that she's a poor sleeper either.  

I have Asperger's and I suffer with extreme tiredness, it's called Aspie burnout:

http://musingsofanaspie.com/tag/burnout/

The more an Aspie pushes themselves or the more others push them, to be normal and do what others do as if they don't have Asperger's, the more burnout affects us.