INTEGRATIVE + ONLINE PSYCHIATRY + HOLISTIC HEALTH

huge hurricane over florida - hurricanes, depression, and recovery

Hurricanes, as the recent Florence, demonstrate the extremes of nature

with massive destruction and disruptions of lives. The full impact of the storm forced people and communities into survival mode.  The process of recovery, the rebuilding of homes and lives begins as the storm moves and resides. For some people, the aftermath of the storm is a time of reflection, self-assessment, prospect taking, and possibly personal transformation.

Mary* was a young a single mother, divorced, living just above the poverty line, with a thirteen-year-old daughter.

With her new waitress job, she was able to move into a small rental cottage near a scenic local river. It was the first time she felt some security. She now had a place to call her own, where she could store her meager belongings. Her daughter settled into a new school.

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36229017 - perspective of wood bridge in deep forest crossing water stream and glowing light at the end of wooden ways; Copyright: khunaspix / 123RF Stock Photo

Escalating mental health, emotional or related health issues may signal the need for mentoring or guidance.

When help is needed, it can be difficult to find the outside expert support you need. Developing your own personal self as a resource can also be a challenge.

A person in distress often recognizes that their customary coping mechanism and level of support are inadequate. The dependence on learned ways of dealing with adverse life events often does not help for an overload of stressors and emotional turmoil. The experience for some is like being entrapped in a swirl of thoughts, painful emotions and images. Before distress reaches too high a level, is the time to reach out to others for help and guidance.

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African woman doctor checking patient's blood pressure -Copyright: rocketclips / 123RF Stock Photo

High blood pressure (BP) can be alarming when found during a medical visit or at any other time.

High blood pressure readings may be a wakeup call to take affirmative steps for your health. Natural holistic approaches, and integrative treatments, whether you are on medications or not, can help lower BP and bring benefits to important areas of your life, health, and wellbeing. Unnecessary medication use can carry the risk of falls, hip fractures, and drug-related mental and physical side effects; and more frequent visits to doctors’ offices and hospitals. A significant proportion of the U.S. national health care expense goes to treating high blood pressure. Inaccurate blood pressure measurements lead to overdiagnosis of hypertension, treatment, and use of unnecessary medications (1–4).

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scared businessman is falling into office chaos, Copyright: nomadsoul1 / 123RF Stock Photo

People with attention, focus, or ADHD difficulties can be at a disadvantage in work, academic, and social situations.

ADHD (Attention-Deficit Hyperactivity Disorder or also referred to as ADD – Attention Deficit Disorder), when diagnosed, allows for a workplace or school accommodations under ADA laws (American Disability Act).  Many with less apparent attention/focus (including ADHD) problems may not be considered impaired or disabled, even though they struggle to maintain focus and attention. When someone with focus or attention issues is in a positive fit with their life situation – operating within their capacity, they are often creative, talented, and productive citizens.

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Meditation, mindfulness, happiness - zen garden with massage stones and waterlily

Meditation, Mindfulness, or Introspective Practices

have well proven their value in holistic mental health work for mood, anxiety, addiction, and health issues. Meditation can be an essential tool for happiness and mental health. Enhancement of longevity and decrease in brain aging has also been demonstrated as an added benefit. In many other areas, there are proven benefits as in work, school, athletic performance, sleep, and creativity. The mere awareness in meditation – that thoughts and emotion are of a changing and transient nature – is enlightening for those felt imprisoned by harsh negative thoughts and emotions.

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huge hurricane over florida - hurricanes, depression, and recovery

“Hurricanes, Depression, and Recovery” article is a story of one person’s tragedy from severe depression and hurricane losses. Experiencing a larger force of nature brought him not only to a deeper understanding of his life but to healing and recovery. The hurricane calamity also affected the multitude of people living in the same destructive path. The devastating hurricane or a storm can be compared to depressive illness: both need a path to recovery. A story presents one man’s journey of despair and loss, to redemption and healing.

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53669229 - beautiful colorful butterfly sitting on female hand, close-up - thyroid gland is like a butterfly in the anterior region of the neck

The Thyroid Gland (Butterfly Shaped), Autoimmunity, Mood, and Health

The association of mood, thyroid dysfunction, and autoimmunity is a possible contributing and treatable element in mood disturbances. Integrative Psychiatry encourages looking beyond labels, symptoms, and diagnosis. An integrative approach cautions against premature jumping to treatment with what is favored, familiar, or expedient. Integrative Psychiatry fosters awareness of complexity and the possible presence of underlying and correctable factors.

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addictions, OD with pills

addictions, OD with pills

Current statistics show the immensity and seriousness of unrecognized substance abuse disorders and addictions.

An integrative psychiatry perspective looks beyond labels, symptoms, or a few illness characteristics to find understanding and positive treatment options for addictions.

Several questions arise about addictions.

  • Who is addicted and how is addictive illness defined?
  • Who is at risk?
  • How does addiction become a destructive disease with health and social consequences?
  • What are the indicators and early signs of addiction?
  • What are integrative psychiatry approaches to addiction, brain change, and neuroplasticity?
  • What resources are available if substance use is a problem?

How serious is the problem?

In a 1999 substance abuse survey, 14.8 million Americans used illicit drugs at least once during the prior month. About 3.5 million were dependent on illicit drugs, and an extra 8.2 million were dependent on alcohol. Only 8.1% of people with alcohol use disorders actually receive needed treatment. An estimated 30% of primary care patients with alcohol use disorders did not receive treatment. In 1992 alone, the total economic cost of addictions, alcohol, and drug abuse was estimated to be $245.7 billion – including:

  • Expense of treatment and preventive programs
  • Related health care costs
  • Reduced job productivity and loss of earnings
  • Increased crime with resulting personal and public costs
  • Social welfare needs

An addiction epidemic now exists to heroin, morphine and other prescription opioid pain relievers.

In the past decade, pain medicine prescriptions, like opiates, have increased 300%. It is estimated that two million people in the United States have substance use problems – most are from opioid pain relievers. About 26% of individuals, who are prescribed opioids for pain, develop opioid use disorders (Dr. Mercola, 2016).   “In 2015, 52,404 Americans died from drug overdoses; 33,091 of them involved an opioid and nearly one-third of them, 15,281, were by prescription,” (Mercola, 2017); (SAMHSA); (Elinore F. McCance-Katz, MD, Ph.D., 2015).

Physicians and dentists in the past were taught to treat pain with drugs, which are now known to cause addiction. Patients were led to believe that pain would be controlled with a low risk of future addiction. As a result, we are now in a national healthcare crisis. In North Carolina, since 1999, more than 13,000 individuals have died from pain medication overdoses. Last year, North Carolina dispensed nearly 10 million opioid prescriptions (DHHS Secretary Mandy Cohen, MD, 2017).

“Since 1999, opioid overdose deaths have quadrupled, and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet, the amount of pain reported by Americans has not changed. Now, nearly 2 million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C. As many as 1 in 4 receiving long-term opioid therapy in primary care settings struggle with opioid addiction.” (LETTER FROM THE SURGEON GENERAL, 2017 – The Surgeon General’s Call to End the Opioid Crisis)

Addiction to refined carbohydrates, sugar, is now a major costly health crisis, contributing to obesity, diabetes, heart disease, and other significant health issues. Though a major problem, it is often overlooked, especially with the massive marketing of the sweetened products and their ready availability – as in soft drinks, and at many food outlets and restaurants. Some of the characteristics of sugar addiction are similar to cocaine addiction.

Addictions defined.

The American Society of Addiction Medicine, 2017 (ASAM) defines addiction as a “primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.” Addictions present characteristically in several ways:

  • Pathologically pursuing of reward and relief by substance use and other behaviors
  • Inability to consistently abstain
  • Impairment in behavioral control
  • Craving
  • Diminished recognition of significant problems with one’s behaviors and interpersonal relationships
  • Dysfunctional emotional response
  • Cycles of relapse and remission

The Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) from the American Psychiatric Association replaced the term addiction with “substance use disorder.” The replacement was done because of the term, “addiction’s” uncertain definition and possible negative connotations. Also, it was felt that “substance use disorder” would be a more neutral term and describe a wider range of dysfunction, from mild to the severe state of “chronic relapsing compulsive drug taking and alcohol use.” However, the word “addiction” is still commonly employed in the USA and other countries where there is the persistence of severe substance abuse problems.

The DSM-5 describes alcohol and opioid in a similar manner as both are considered “use disorders with a problematic pattern of use leading to clinically significant impairment or distress.”

The manifestation is demonstrated by at least two significant occurrences within a 12 month period:

  1. The substances are taken in larger amounts or over a longer period than was intended
  2. There is a persistent desire or unsuccessful effort to cut down or control the substance use
  3. Lots of time is spent in activities necessary to get the substance, use the substance, or recover from its effects
  4. Craving or a strong desire to use the substance
  5. Continued use, despite having persistent or recurrent social or interpersonal problems, caused or exacerbated by effects of the substance
  6. Important social, occupational, or recreational activities are given up or reduced because of the substance use
  7. Recurrent substance use in situations in which it is physically hazardous
  8. Continued use despite knowledge of having a persistent or current physical or psychological problem that is likely to have been caused or exacerbated by the substance
  9. Tolerance, which develops, is defined as a need for markedly increased amounts of the substance to achieve the desired effect. Also, there is the occurrence of a diminished effect with continued use of the same amount of the substance
  10. The withdrawal shows the characteristics withdrawal syndrome for the particular substance
  11.  Related substances are used to relieve or avoid withdrawal symptoms (American Psychiatric Assoc. Publishing 2013) (DMS-5)

There are many factors that can increase the risk of developing an addiction.

A family history of addiction can increase the likelihood of substance use disorders in relatives. A National Co-morbidity Survey showed that individuals with a mood disorder are 2.3 times more likely to have a substance use disorder than those without a mood disorder. For bipolar disorder, there is 9.7 addiction, depressiontimes greater chance of having alcohol dependence and 8.4 times higher chance of having another type of drug dependence problem. Trauma-related conditions, as the experience of a traumatic childhood or adult life events, are found to be a common substrate in addiction illness. Attention deficit (ADHD), anxiety, obsessive-compulsive, and schizophrenic disorders are associated with higher rates of substance abuse. Recognition and treatment of any condition that can potentiate or put one at risk for addiction need attention as soon as possible (see reference and resource page).

There are early warning signs of drug and alcohol abuse.

  1. Increased drinking or use of other drugs
  2. Changes in job or school performance
  3. Changes in attitude and mood as depression, irritability, suicidal threats, or actions
  4. Unexplained changes in eating, sleeping habits, physical appearance, physical complaints, blackouts, or temporarily memory loss
  5. Behavioral problems as dishonesty, sexual promiscuity, and stealing
  6. Change in relationships especially with new friends known to drink or use drugs
  7. Alcohol on breath, slurred speech, staggering, appearing spaced out
  8. Missing alcohol, medications, or money from around the house
  9. The presence of drug paraphernalia as pipes, pill boxes, etc.

Recognition, early interventions, and treatment are critical.

The goal would be to reduce pain and suffering and the staggering cost to society. Because addictions can switch, all types of addictions need early recognition and intervention. Examples would be compulsive eating, gambling, the Internet, computer, sexual, and pornography addictions (see Addiction Reference and Resources page); (Hugh Myrick, MD, 2016).

There are valuable screening tools and questionnaires that are available to identify addictions. The AUDIT for alcohol (WHO) and the SBIRT (SAMSHA) for alcohol and substance abuse are helpful (Marc Schuckit, MD, 2014).

It is useful to learn how the brain develops, perpetuates addictions, and how it can heal itself. There are robust mechanisms in our nervous systems and brain that serve positive purposes. Theses critical brain operations are for survival, food, shelter, reward, gratification, and reproduction. The same processes are also the miraculous pathway for the achievement of success and accomplishments. Misdirection can occur however into debilitating addiction and substance use disorders (William Yvorchuk, MD, 2015).

New findings in brain research give promise for successful addiction treatment.

The brain can adapt, change, and lay down new neurocircuitry (nerve pathways).  Less used neurocircuitry are removed in a healing and regenerative process. Information is needed about the brain’s operations, functioning, and influencers. The application of gained knowledge in neuro research can lead to positive treatment outcomes. The goal would be for prevention, restoration of health, and addiction recovery.

“Neuroplasticity” is the descriptive name for the ability of the brain to change. This process represents the changes that can occur with training and to positive addiction treatment programs. Change in neurotransmitter patterns can result in new positive habits and behaviors. The training, repetition of positive experience in supportive social settings supports these brain changes (Ron Parks, MD, 2016); (Frank Lawlis 2015).

Other approaches as trauma-oriented therapies as EMDR and Spiritual Emergence are potentially valuable additions to treatment programs. The Center for Spiritual Emergence,  as an example, aims to help people live to their fullest potential. A transpersonally-based, systems-oriented, body-centered, and trauma-integrated approach is provided to foster healing and spiritual emergence from spiritual emergencies, mental health issues, and substance use disorders. The physical, emotional, mental, social, and spiritual dimensions of patients’ concerns as well as health and wellness are addressed as a pathway to wholeness.

Integrative and comprehensive approaches to addiction treatment are essential.

A thorough approach to addiction treatment looks at environmental, child to adulthood influences, psychosocial factors, trauma, and neuro-developmental issues. The importance of how other factors affect brain processes and human behavior need continuing investigation.

An intervention or treatment program can be set-up once a qualified individual or program completes an addiction assessment. An Integrative Psychiatrist and Addiction Specialist addition to the treatment team is recommended as there is a high degree of co-existing problems. Co-existing issues may need attention before addiction treatment can be successful or sustained. Treatment needs to be done for contributing medical and mental health concerns. Areas of concern may be nutritional, hormonal, allergy, immune, metabolic problems, trauma, behavioral, psychological, or emotional related conditions. Early medical interventions may look at nutritional deficiencies, inflammation, digestive, hormone, or metabolic problems as insulin resistance, early diabetes, or thyroid problems. Deficiencies of minerals or vitamins such as magnesium, copper, zinc, amino acids, essential fatty acids, B6, B12, or folic acid all can be corrected with appropriate assessment. (see Ten Holistic Steps for Mental Health)

Integrative psychiatry and addiction programs may include:

  • Education
  • Counseling
  • Psychotherapy
  • Inpatient rehabilitation
  • Outpatient programs
  • Partial hospitalization
  • Halfway houses
  • Cognitive behavioral therapy
  • Motivational interviewing
  • 12-step  programs
  • Mutual help groups
  • Mind-body-spiritual and sensory-based therapies
  • Natural complementary therapies

Possible medication augmentation can be considered, especially when other interventions are not successful. Drugs that help reduce cravings and relapses are most effective for opioids and tobacco. The medications currently available are only moderately effective for alcohol and minimally useful for stimulants, cannabis, inhalants, other substances (Petros Levounis, 2015).

If you, or a significant other, such as a spouse, friend or employer, see early signs of addiction, do not ignore, as you may inadvertently be a contributor to the severity of the problem.

With the dramatic rise in death from heroin overdoses and the devastating effects of both drugs and alcohol on individuals, families, and children – addiction is a problem that can’t be ignored. Seek help and information for both recognition and treatment of addictions to prevent serious consequences.

Find resources locally, in your community, or on the Internet. Seek out or consult with:

  • Health care providers or your primary care physician
  • Addiction specialists, treatment centers, or programs
  • Integrative psychiatrists or, holistic health practitioners
  • Twelve step programs as Alcoholics Anonymous or Narcotics Anonymous
  •  Other resources as listed under addictions on our Resource page (see below)

The Substance Abuse Mental Health Service Administration (SAMHSA) can be contacted 24 hours a day at 1-800-622-HELP

By Ron Parks, MD & edited by Shan Parks

Questions:

What would be your first step if addiction is a concern for you or a significant other? Comment below.

References & Resources:

See: Addiction References & Resources

Steps to Health

Ten Holistic Steps for Mental Health

by Ron Parks, MD & edited by Shan Parks

Steps to HealthTake the steps for your emotional, mental, and physical health.

The failure to get positive results can be from following an inappropriate program for your needs. Consider exploring some complementary or alternative options that can bring positive improvement. The goals of broadening your personal program would be for you to regain optimal health, fitness, and well-being.

The following 10 step can begin your journey:

  1. Review available information on holistic or integrative strategies for health improvement or illness recovery.

I encourage you to seek more information. Participate in making choices in any areas concerning your health, especially when there are needs for treatment or intervention. Being proactively involved is essential to improving your health.

Find educational materials or services that may be available from either your current health care providers or in your community. Other sources of information may be from trusted and reliable media sources as the Internet, blog sites, or from printed materials.

  1. Choose preferably Integrative Medicine, Psychology, Psychiatry, or Holistic Therapy Programs.

Get the help you need. Consultations with other medical or health care practitioners especially those with a more holistic and integrative orientation are recommended.

Rather than a narrow focus, addressing only a few symptoms or one aspect of the entire person— an active, validating, caring, and holistic approach helps the whole person. Selection of a broader, integrative program is essential, in my opinion, for optimal progress and improvement.  Click on the following:  Integrative psychiatry, medicine, and holistic therapies

refuge, journey to fullfilment, health

  1. Be open and receptive to integrative care that looks at underlying causes, triggers, and risk factors.

The goal would be to eliminate or reduce any contributors that interfere with you being successful with your health and well-being goals.

Significant, “co-occurring” problems in your current life or from unresolved past issues, if unrecognized, may interfere with your health recovery or with your ability to make progress towards your health goals.Some areas that may be missed or ignored, in your health care evaluations or program, that may need attention, are:

  • interpersonal conflicts, recent divorce, or failed relationships
  • stress overload
  • lack of skills as with planning and time management
  • job, career loss, or a financial crisis
  • a move or loss of home
  • the death of a significant other or loved one
  • auto accidents, recent surgery, or hospitalization for a serious illness or injury history, history of other traumas, traumatic stress disorder symptoms, traumatic brain injuries
  • early life abuse, neglect, sexual abuse, rape
  • emotional or mental health issues as anxiety, panic, fatigue, depression, bipolarity, ADHD, obsessive-compulsive problems, developmental issues, Asperger’s
  • drug, alcohol abuse, or addictions
  • eating disorders and obesity
  • unrecognized health and illness related problems
  1. Choose natural alternatives and a healthier lifestyle, as this is often the better and safer choice for you to reach your goals.

Embracing a healthy lifestyle will decrease health problems and offers you the opportunity for improved health and longevity. Awareness and support of the mind, body and spiritual dimensions are essential for wellness, healing, and prevention of illness.

Receive the benefit of support from a holistic practitioner, a group, an educational program, a teacher, or a coach. You are entitled to have the guidance and services needed to feel better and to do better!

  1. Begin a healthy diet and nutrition. Choose:
  • more whole and plant-based foods
  • organic foods when possible
  • avoid process foods with sugar and chemical additives
  • eat vegetables, beans, whole grains (preferably gluten free), greens, fruits, nuts, healthy fats (as avocado, olive oil, fats in nuts and seeds)
  • if not vegetarian, when possible, choose organic, free range chicken, beef, or fish from a healthy ocean or natural unpolluted water source

Get advice from a holistically oriented nutritionist or health coach. Instead of using prescription and over-the-counter medications which are frequently used to treat symptoms – when drugs are not indicated (check with your holistic health care provider first) – consider natural alternatives and the taking of nutritional supplements such as vitamins, minerals, digestive enzymes, amino acids, essential fatty acids, and herbs. Research first and get good advice from a trusted resource or a holistic health care provider.

 

assorted vegables

  1. Exercise is crucial in maintaining health and promoting wellness and illness recovery.

Different types of exercise are encouraged per preferences and ability. Extensive research on exercise has confirmed its value in reducing risks of:

  • heart disease
  • hypertension
  • mood disturbance
  • cancer
  • dementia
  • obesity
  • diabetes
  • stress and sleep related illness

Only exercise to your capacity. If you are just not sure where to start or if there is any potential for stroke, heart attack, or other adverse consequences — get an exercise prescription or advice from a health care provider or a personal trainer.

swimmer, exercise

A variety of exercises in your program will give you the best overall training effect and prevent boredom:

  • biking
  • walking, running, biking, and hiking
  • weight training
  • dancing, aerobic classes
  • swimming
  • yoga
  • qigong
  • tennis and other individual or team sports

Any active movement is helpful and beneficial. There are calming, stress reducing, focusing exercises — like meditation, which can be a fantastic addition to you and your program.

  1. Optimize and improve your poor sleep or insomnia.

Avoid getting into sleep debt or sleep deprivation (not getting enough sleep). Sleep disturbances have been associated with significant medical problems:

  • obesity
  • diabetes
  • accidents
  • poor work, and school performance
  • mood disturbances

Sleeping dogA good start is to reduce stress, over-stimulation, and activity overload. Do meditative or deep relaxation exercises. Improve moods, reduce anxiety and worry. If there is significant mood or anxiety problems, see an appropriate healthcare professional or therapist for assessment and treatment if indicated. See Dr. Parks’ articles at http://ronparksmd.com/ on related topics. If daytime sleepiness or history of loud snoring occurs, see a sleep specialist — as a sleep disorder as sleep apnea may need to be recognized and treated. See, Sleep Disorder article.

  1. Have a thorough evaluation by an integrative healthcare provider if there is any possibility of other hidden health issues.

These may compromise your recovery or interfere with reaching your health goals. Sometimes imbalances in the body can result in illness or health compromise. Lab work or testing may be indicated as diagnostic tests for:

  • allergies, anemia, diabetes, heart disease, infection
  • hormonal imbalances as found in thyroid, adrenal, ovarian, or testicular problems
  • auto-immune or inflammatory illness
  • early cancer
  • nutritional status tests for deficiencies in vitamins minerals
  • elimination diets or digestion function tests
  1. Check out for environmental factors that may play a role in health and disease.

Overload, sensitivities, or reactivity, to or with toxic environmental substances and chemicals can impair health or hinder recovery. These may be present in air, chemical fumes (perfumes, pesticides, industrial chemicals), soil contamination, or in use of certain pesticides or food additives. There is a growing concern about the use of genetically modified foods.  Visit American Academy of Environmental Medicine.

landscape, fullfilment, completion, wellbeingToxicity in the environment can include “toxic” or irritating relationships, excessive noise, intrusiveness, or disruptions by others as in your workplace or where you live.

Other toxic situations may be the lack of a quiet sleep or rest place, excessive electronic or radio-frequency disturbances and exposure (TV, radios, cell phones, microwave).

Consult with reliable sources of information and with an integrative health care provider who has expertise in the areas of environmental health.

  1. Recognize the importance of spirituality in your life.

Study, reflect and apply the wisdom from the great world spiritual, religious philosophies, and practices. Allow your personal faith to be an important part of your transformation into a more positive state of health, well-being, and illness recovery.

Water Lilly SpiritualityWhen stuck, for example, in states of depression or despondency — when traditional mental health service used alone have not helped — surrounding oneself with an inspirational support group can bring about a release from stifling patterns of personal thoughts and beliefs. Shifts can occur towards a better emotional and spiritual attunement and adjustment to life’s demands and conflicts.

Positive outcomes happen in many different types of religious or spiritually oriented support or practice groups. Finding healthy activities – that bring joy, purpose, fulfillment, meaning, and gratification to your daily lives – can open the doors of the spirit and promote health.

QUESTION – COMMENTS:

What would your first step be to improve your health or recovery?

aspie traits, diversity, goldfish

aspie traits, diversity, goldfishInstead of Autism Spectrum Disorder (ASD) or a person with Asperger’s syndrome, some have a preference to be seen as an “aspie” person or as one that has aspie traits. Looking at the diversity of features found in aspie individuals,  some will only have a few and others will have many of the traits and characteristics. Often there is a preference for a positive name or identifier when a person has some unique differences. A name is preferred that brings forth a response from others that would focus on potential, meaningful affirmation, acceptance, and accommodations.

Words or names can be helpful or hurtful.

Will aspie be a positive identifier, an ennobling and uplifting expression, in our vocabulary, or will it end up in the wastebasket of other derogatory terms as nerds, egg heads, geeks, and other words that are demeaning?

From High Functioning Autism Spectrum to Aspie Traits

In 2013, the American Psychiatric Association published the Diagnostic and Statistical Manual, Fifth Edition, known as the DSM-5, and intended this as a manual for the diagnosis of mental disorders. Before DSM-5, Asperger’s Syndrome was the diagnostic label. It referred to individuals with a qualitative impairment in social interaction and communication with repetitive and restricted behavior. Now in a positive way, this is sometimes referred to as “aspie traits’.

The new DSM-5 changed the diagnostic name to Autism Spectrum Disorder (ASD or referred to as high-functioning autism spectrum). The essential features in DSM-5 for ASD were: persistent defects in reciprocal social communication and social interaction, and restricted repetitive patterns of behavior, interests or activities.

The DSM-5 is a Diagnostic text and sourcebook for the clinician. It is an aid with the categorization of different mental health disorders. The level of the impairment and severity of illness are also represented.

Observed weaknesses, symptoms, and behaviors are categorized by diagnosis per the manual’s criteria. It helps qualify people for insurance coverage. It can be important in qualifying for services or programs as vocational rehabilitation. The DSM-5 can be a guide for research and population studies. It defines clusters of symptoms, traits, attributes, and clinical presentations. A condition once classified or named, in the DSM-5, is an aid to the clinician. A diagnosis can help in the selection of a matched research-validated treatment protocol.

Shifting to a Positive Focus on Strengths, Skills, Acceptance, and Accommodations

Once diagnosed, the individual becomes a person with Autism Spectrum Disorder (ASD) – before DSM-5 this was known as Asperger’s Syndrome. The labels of illness – thought of value in medical research and treatment – can also be the basis of stigmatizing a group of people – as sick defective or impaired. The label can misplace the focus of the potential or strengths of an individual. Acceptance of their differences and advantages needs to be the emphasis.

The diagnostic criteria for ASD are also the defining characteristics of many people that have comparable traits, which do not want to be stigmatized or treated with arrogance by others. They reject the negative inference of being a diagnostic label, an illness, or a defective population.

Looking at the diversity of features found in aspie individuals,  some will only have a few and others will have many of the traits and characteristics. The expression of a developmental or genetic trait can afford significant advantages without any associated impairments. Another side of the spectrum shows the expression of many developmental problems, autism spectrum impairments or disabilities.

To be assigned a diagnosis or a disease label can contribute to a “poor self-concept of being defective” vs. being a person to be respected and seen for potential as having unique talents and worthiness. An association with an illness or diagnosis can lead to discrimination from others. High functioning aspie individuals can still experience:

  • non-acceptance and non-support as in social networks, families, organizations, and in job settings
  • inadequate resources as in the community or educational systems
  • rejection by peers, discrimination, bullying
  • problems in getting through school, finding work, establishing a career, or suitable relationships
  • economic disadvantage, hardship, isolation, and disfranchisement

Aspie individual need support and assistance,

just as those diagnosed with ASD or Asperger’s Syndrome do. “They need to be informed and learn the secrets of typical social understanding and require help to negotiate through the social world that surrounds them. The challenge may be more comfortable for aspies than for those with Asperger’s Syndrome as a direct result of the people who surround them”.*

See Attwood paper “Aspie Criteria”*

As a consultant in medical and psychiatric facilities, conflicts arose between staff and patients.

Patients would have difficulties interacting with their peers or staff. If problems following the guidelines of the unit occurred, difficulties would ensue.  The staff’s expectations were for each patient to behave and interact as expected. Individuals involved in conflicts did not take well to correction or admonishment. Incidences could escalate, from agitation to combative, aggressive, or destructive behavior. The staff could be reactive with more verbal or aggressive behaviors than needed.

The perceived offending person was often diagnosed with official labels.  Some were:

  • attention deficit hyperactivity disorder (ADHD)
  • personality disorder
  • conduct disorder
  • antisocial behavior
  • schizoid, or schizophrenia
  • bipolar disorder or depressive disorder
  • social anxiety or obsessive-compulsive

These were some of the tried intervention:

  1. isolation of the involved individuals
  2. recording of the inappropriate actions
  3. options considered were unique behavioral treatment plans, consequences, or medications

When a careful history was taken on identified offenders, developmental issues or traits were found associated with high functioning autism spectrum, an Asperger’s profile, or a person with significant aspie traits. These characteristics would then be considered as an important influence on the conflicts that occurred between peers or with staff. Some of these individuals identified had other exacerbating problems as:

  • trauma history
  • prior life events
  • early life in a disruptive home environment
  • early life abusive or neglectful significant others
  • drugs and alcohol abuse
  • traumatic brain injuries

Other existing problems like – ADHD, obsessive-compulsive disorder, anxiety, and depression – can improve with behavioral or other treatments.

Aspie traits include – no significant intellectual impairment – with possible difficulties in:

  • social skills
  • social communications
  • ease of social engagement
  • reciprocal conversation
  • perceptiveness, empathy or intuitiveness
  • social cue recognition
  • executive functioning
  • information processing
  • passionate interests in certain specific areas

Aspie characteristics may be helpful for some; however, this can be a problem for others.

Positive characteristics can be strengths for success and contribution. Negative characteristics may contribute to rejection and discrimination. Several significant traits together can be problematic. Difficulties may occur in daily functioning, work, and related social activities.

Education anDiverity on yellow tulipd instruction to all participants involved can improve a conflict situation. A more positive therapeutic milieu can develop in the physical and social setting. The education would include a discussion about individuals and their differences.

Negative traits would be viewed in a constructive manner and not as a defect or a “pathology.” Aspie attributes have a positive potential to contribute to the group. Recognition of differences in social interactions, interpersonal communications, and behaviors is a start on the path toward acceptance, flexibility, tolerance, and non-discrimination.

Individuals with these traits can develop low self-esteem, defensive, reactive type of behaviors.

This results from repeated experience of:

  • rejection from their families and peers
  • failures in the educational system
  • bullying, rejection, and discrimination
  • unemployment and lack of access to necessary programs and accommodations for their needs
  • exclusion from many social setting
  • lack of mental health and educational support services
  • lack of appreciation for their differences and potentials
  • lack of tolerance, acceptance, and support

Aspie traits in an organization can also lead to conflicts.

In a medical setting, this could be with other staff members as well as with some patients. High achievers in any field can have successes because of their unique aspie attributes. The same people, however, may appear to others as having negative characteristics as being:

  • demanding
  • poor listeners
  • arbitrary in their decision-making
  • over-talkative, rambling, intellectual thinkers
  • to cut people off, interrupting, or change the subject
  • to have a strong belief or attitude that they are right
  • to be scrupulous or a perfectionist
  • to be obsessive compulsive about completing things in a valued way,
  • to be impatient, rude, or arrogant
  • to be a bully or tyrant
  • not to be a team player
  • odd in mannerisms

People with aspie traits might tend to:

  • become irritated when distracted from their work or conversation
  • feel that ordinary social conversation or small talk is irrelevant
  • prefer to work alone or to be alone with their activities and projects
  • less comfort or interest in the usual social encounters than a neuro-typical person (a person without aspie traits that represent most of our population)

Persons with aspie traits contribute and gain respect in organizations for:

  • high intelligence, reliability, persistence, open-mindedness
  • positive work ethic, honest, follows the rules
  • determined, original or unconventional in problem-solving
  • creative abilities, technical skills, verbal skills
  • getting to the point and forthrightness even when not tactful or in their self-interest
  • aware of details and errors that others don’t see
  • able to absorb and keep significant amounts of information
  • self-motivated, independent learners, able to generate novel solutions
  • the ability for spending time alone for research and completing projects
  • a perfectionist can perform repetitive tasks with precision and commitment
  • willingness to learn social skills which a not natural for them
  • ability to tolerate rejection and frustration to complete work
  • sees the best in everyone even though it sometimes backfires, reliable as a friend
  • the sense of social justice and fairness, advocate for the oppressed, bullied, and disadvantaged

Conflicts can arise between staff members and a person with aspie traits.

Resolution involves interventions such as team-development-work along with focused education about:

  • communication differences
  • the uniqueness of personalities
  • tolerance and acceptance of difference

Consideration is to bring in a consultant who is knowledgeable about aspie individuals for training. If an individual of concern has aspie characteristics, but in addition, a history of other significant co-occurring colored pensils diversityproblems as noted above – earlier life trauma for example – would be a candidate for focused therapy work in that area.  Use of an executive-functioning-coach can be essential if executive functioning is a major difficulty.

People with aspie traits need to be recognized for their strengths and contributions.

With their talents and genius, they are able to do complex tasks as well as complete projects. They are able to complete tasks which other neurotypical people (those who do not have the aspie traits) either couldn’t do or have failed.   Peoples’ differences are essential for the survival and success of a group or organization. It takes a team with diversity.

Talented people with unique traits make our society function. The person who can see the big picture can come up with novel strategic ideas and solutions to the problem. The person that can stay on task can bring a project to completion. They can get past small failures or distractions to get things done. An accepting and supportive culture stops discrimination with training and education where needed. These principles apply to couple’s relationship work as well. Acceptance and understanding of each partner’s strengths and weaknesses comes first. Then a successful relationship that operates in a complementary fashion can ensue.

There is much evidence that aspie traits are genetic.

You often find these characteristics in other family members. Early life experiences or environmental influence can affect these characteristics or traits as well. There is great diversity in presentation and features seen in the aspie population. Performance and levels of functionality will depend on each person’s pattern of development. Adaptation to a “neurotypical” population (the majority of the population that does not have the aspie traits) is a challenge where acceptance is lacking. Successes with societal participation, work, independence, and social integration comes with support and education.

High functioning aspie individuals can have difficulties or disabilities. The degree can depend on the presence of other co-occurring problems or debilitating conditions. There may be the need for significant support, specialized programs, and sometimes medication.

BOB’S STORY:

Bob*is a highly-paid staff in resource development at a high-tech software company. He had difficulty finding and keeping a job. At age 38 he discovered that he had an aspie profile. Bob was intelligent and had admirable skills – especially in the tech areas. He related well to others that had similar interests. He lacked executive skills, as in organization and time management. It would take him forever to complete any of – what he deemed – important projects. He would misplace important papers and be easily distracted. His self-esteem was low. He had experienced rejection and discrimination at prior jobs and during his school years.

Bob found an employment advisor who worked with aspie clients. First, there was a referral to an executive-functions-coach, who helped him plan his time. Time blocks were set up to help him organize his work schedule, allowing him to get all his priorities accomplished.  He learned how to avoid procrastination, and how to break large tasks down into doable chunks. He became better at prioritizing, starting a task, focusing and finishing. He began to use a planner to organize things. With his employment advisor, he worked on presentation and interview skills.

He chose companies where his unique skills and aspies were accepted and valued. His current company was a good fit, and he thrived there. He made some friends in his new organization. These new friends shared some of his interests and even some of his “aspie” traits.

*To protect confidentiality, the above is a composite of some clinical experiences and does not represent an actual person or any prior patients.

High functioning individuals that are not impaired by aspie traits or co-occurring problems, have the potential for:

  • gifted intellectual problem-solving
  • coming up with needed creative solutions
  • ability to think outside of the box in original ways
  • leadership and advancing knowledge in the area of interest.

Their strengths need appreciation and support. Recognition and encouragement are needed throughout childhood, in school, organizations, and the community. They can be the person that comes out with a money-making product that saves an industry. They could be the general that wins the war. They could be a surgeon and master mechanic that can fix things and save lives.

An aspie individual may need support and guidance from their employer.  Job expectations should be clear. Help with interpersonal skills to aid effective and cooperative teamwork is important.  Help with organizational skills, time management, and priority setting is also valuable. Successful employment or career opportunities offers the many potential benefits –  an increase of income, improvement of self-esteem, offering a place to apply talents and abilities, and provide a setting to develop a positive social network. Help is available from resources as the Job Assistance Network (JAN) that offers help with work accommodations or Vocational Rehabilitation Services – see resources below.

Whatever the name, label or diagnosis one chooses –  or with which one best identifies in their search for meaning, help or support, whether Autistic Spectrum, High Functioning Autism spectrum, Asperger’s Syndrome, or Aspie – is fine and supported by me. In this article, I wanted to explore and to get a better understanding of the different names and classifications. My intent was not to offend anyone or to undermine any individual’s beliefs regarding their learning and struggles to either comprehend or understand this complex area. This article was a little Aspie lengthy and Aspie loaded with some of my bias, but it is all about sending some love and support to all that want to know more about this
topic, for those who have been confused about some of the terms and labels used, or for those who have personally struggled with some of these issues.

Resources:

The Asperger / Autism Network (AANE) A positive presentation and understanding of Asperger’s are available in several articles written by staff on the ANNE website –  which works with individuals, families, and professionals to “help people with Asperger Syndrome and similar autism spectrum profiles build meaningfully connected lives.”

Following is a quote from the ANNE website with a link on “Neurodiversity”:

“Diagnostic labels, by nature, define disorders and tend to ignore the strengths, gifts, and adaptive benefits of the individuals diagnosed. In contrast to this, the Asperger constellation of traits has more recently been described as the product of natural variations in human neurology that lead to differences in individual experiences, sensitivities, and perceptions.

It is not necessarily a neurological “dysfunction”; rather, it is evidence of “differently” functioning neurology. “Neurodiversity advocates propose that instead of viewing this gift as an error of nature . . . society should regard it as a valuable part of humanity’s genetic legacy while ameliorating the aspects of autism that can be profoundly disabling without adequate forms of support” (Silberman, p. 470*). Just as the natural world thrives through a web of diversity, offering up a range of valuable interconnected attributes, so does humanity”.  http://www.aane.org/neurodiversity/

Job Assistance Network (JAN)

“The Complete Guide to Asperger’s Syndrome” by Tony Attwood an excellent resource and review

Been There. Done That. Try This!: An Aspie’s Guide to Life on Earth

“Aspie Criteria” – A helpful article by Attwood.

NeuroTribes – The Legacy of Autism and the Future of Neurodiversity” by Steve Silberman – important book, excellent read, and resource for an in-depth history, present and future overview of the Autism Spectrum and Asperger’s, written by a very talented journalist and a New York Times bestseller.

What is Asperger’s Syndrome? – article by Atwood

Asperger’s from the Inside Out by John Carley – a helpful book, for Asperger adults.

GRASP – Global and Regional Asperger Syndrome Partnership – a good resource – an organization run by people with Asperger’s and Autism Spectrum Disorders, to help their peers with programming to increase the independence of Autistics and individuals with Autism Spectrum Disorders.  They have established workshops, social events, and groups, and helped increase the visibility of ASD adults within society with emphasis on Community-Based Outreach and Individual Self-Advocacy – advocating for Individuals on the Spectrum.

Autismspeaks.org – Another source of information on recognition and understanding Asperger’s.

Take an online Asperger’s screening test, as the AQ test, if interested at any of site linked below:

http://aspergerstest.net/interpreting-aq-test-results/

https://www.autismresearchcentre.com/arc_tests

https://www.aspergerstestsite.com/75/autism-spectrum-quotient-aq-test/

To contact or for more information go to:

http://ronparksmd.com/

Thank you for your interest and review of this article,

Article by Ron Parks, MD and edited by Shan Parks

QUESTION – COMMENTS:

How does “aspie” traits related to you, your family, or your work? Comment below.

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