Son with ASD with social anxiety and severe depression in his late twenties never goes out

Sorry if you feel I was being a bit judgemental.

I'm very conscious that I've been incredibly lucky, and I'm not being false about that. Yes I've had to struggle. But I don't have dyslexia, and it isn't obvious (I don't think so anyway) and I've found ways round it.

I had to do a lot of conscience searching whether it was a good idea to tell people I was helping whether I had the diagnosis myself, and didn't. It really isn't a condition that allows you to say "look at me - I managed". And also I have generally found that people on the spectrum don't feel comforted by other people's experiences.

You may be right about reversability. I'm possibly a bit over anxious not to feed some public sector areas that it is just about "pulling yourself together". I think for some people the mix of traits is just too overwheming.

I was hoping the original poster Angelequilting would come back and tell us more. I was trying to reinforce her concerns by flagging up the difficulty.

Has any of this dialogue helped or are there answers you seek that go beyond this? Angelequilter has no doubt explored many possible ways forward, and what is valuable here is parent or carer's insight into finding remedies. With me "sticking my oar in" (weird metaphor) I may have scared off parents with similar experiences from contributing to this thread.

I was quoting the consultant psychiatrist who diagnosed me. He is entirely mainstream and not a quack.

I don't think I suggested that anything would be easy or anything about the ultimate destination. I was trying to suggest that the direction of travel could be reversed and that his fate is not sealed and that he is not condemned to a life of social anxiety and depression. Social anxiety and depression are not part of autism, they are the products of the social failures and social isolation that frequently follow in an autistic life that has gone off the rails.

Longman, you go out every day because you chose to do that. You are not destined to do so. You make that choice. The subject of this thread is making a different choice because he believes that he cannot do otherwise. He has had enough bad experience with dealing with the world that that choice makes most sense to him at this point. Persuading him that the balance can be tipped will not be easy but NHS professionals should be able to achieve that.

People do emerge from this hermit/reclusive state, the autism is permanent but the consequential morbidity does not have to be.

I cannot agree with that hypothesis. Environment and personality play their part, but the combined forces of the different manifestations of autism are the major factor.

I worked in academic disability support in a university, and have also been involved in many committees in both local authority and health camps. I've therefore seen and been involved with a fair few adults on the spectrum.

Even in a benign environment, and with a strong personality and an admirable lot of fight some people are just overwhelmed by the impacts of their autism. What you are arguing makes light of autism by suggesting they can easily put it right - just as bad as all those woolly headed professionals making out that their course of treatment in teens will solve all the problems in adulthood.

What is making it tough for many people with autism is just the sheer number of quacks out their extolling the virtues of beneficial therapy, or the right medication, and it will all go away. And if this doesn't work its the fault of the individual concerned for not making the right effort to make proper use of the generosity of spirit of the quacks.

Autism is cruel. You can be very intelligent, and able, and a fighter. But you can do little if it strongly impacts on your facial expression and mannerisms, if you have tics or stims, if you have marked dyslexia depriving you of written communication as well as verbal, if you just cannot overcome the social barriers, or if the burden of difficulties pushes you down the path of depression. That isn't just environment.

There isn't enough understanding of the complexities of autism. There are just too many professionals out there who think it is down to whether you try hard enough.

You can believe that fixing the immediate social environment can change the path of someone's life with autism. The spirit of your intention wont make a jot of difference to a lot of people out there for whom life is a very real struggle.

There is a nature vs nurture debate to be had here. Is it in this person's variety of ASD to be doomed to the life he is living or has the cumulative effect of his interaction with his very particular path in life made him into a hermit? The consultant that diagnosed me said that "the morbidity is determined by the environment" for people with ASD. If we end up in a hostile social environment we will become very affected, if we have a benign environment then you can have a totally different life. In my experience, different managers and company cultures have had marked positive and negative influences on my wellbeing.

I believe that fixing the immediate social environment can change the path of someone's life. Changing the way that people interact with the individual, controlling the number of people that he has to interact with, changing the choices that he has to make etc etc. Training him on how to make choices for himself, identifying triggers and stressors. there are ways of changing his trajectory.

I would like to think it possible but I'm wary of generalising. The severity of autism seems to hang on certain combinations of traits, and seems to become more adverse geometrically rather than linearly, as the spectrum concept implies.

Therefore I'm wary of suggesting that such intense introversion and isolation is atypical - a certain combination of traits really will create these circumstances. It happens often. What concerns me is that the professionals don't seem to understand this as autism, and treat the patient for secondaries like depression.

Some people really do get stuck this way primarily as a direct consequence of their autistic make up.

It is rather that the system fails to recognise this. The Triad is too vague on this one.

I just hope recombinantsocks is right about NAS being able to advise on an intervention. The sad fact about local authorities is that they still tend to provide for autism only when it is accompanied by learning disability. If he isn't affected in that way, he may get little help from the authorities.

I think it useful to separate the autism/Aspergers itself from the consequences that often ensue from uncontrolled and unmanaged autism. The triad gives a diagnosis but it does not encompass all of the things that go wrong with in human psychology if the autism isn't managed to some extent. Autism predisposes us to solitary behaviour but this does not have to get out of control and turn into hermit like behaviour. If it does get out of hand,as it has here, then it takes an extra effort by those around the individual to unpick some of this behaviour. His behaviour isn't good for him and it isn't irredeemable. He will always have his autism but the hermit like behaviour can be dealt with.

He needs to be taken in hand by the local mental health autism specialists and social workers, You need to find out who this is in your area and get them to get on with it. He is a vulnerable adult and there is a duty of care in the local authority and local health trusts to resolve this situation. Ring the NAS helpline for advice on how to get the ball rolling. They deal with situations like this and they have staff on the ground who will help identify and coordinate the required interventions.

There are threads on the forum that talk about this and there are people here who have emerged from it.

It is possible to live a much better life than that with Aspergers/autism. Longman is an example and I seem to have survived over the years but it has been touch and go at times. I have had help from local mental health staff and they have helped me significantly in keeping my bearings in an often harsh and uncomprehending world that we find ourselves in.

Do not give up, it does NOT have to be the lifestyle that he has found:-)

This is one of those areas where the Triad of Impairments fails to describe autism (well its not a blueprint for living with autism but a diagnostic tool, but it is shoved out all the time as if it explained all behaviours),

The best the Triad can come up with is "prefers to spend time alone rather than seeking the company of others".

Yet one of the commonest reported characteristics of someone on the spectrum is just this - fiercely private, not leaving his bedroom - that's not a mere preferred solitude - its something a whole lot more harmful to all parties.

I've got it at the fairly 'mild' end, or manageable. I live alone, and I don't find company easy to deal with. But I do get out and about every day, and I'm not permanently stuck in one room. The Triad in this instance seems to describe me perfectly. It completely fails to account for your son, and countless other sons and daughters described on here.

There are so many autism characteristics that don't get discussed by the professionals, because they don't fit the standard model of the Triad. Yet this is the real area where we need professional help.

Fear of company of any kind tends to be negatively reinforced. Spiralling anxiety continually deepens depression. The need for routine and sameness becomes more and more of a dependancy.  And seeking alcohol as an escape seems widely reported for autism.

But you wont find this on the NAS web pages - either in About Autism or Living with Autism.