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Friday, December 6, 2013
Combo txs (meds,therapy)-late dx.Aspie(72yrs)
After serious overlapping lifelong PTSDs,then my mother`s death 4 yrs ago when I was 68 (multiple unresolved issues w/her & finding out she was a full Borderline; I`m the oldest child), my mental physical breakdown - that included the overwhelming return of undertreated chronic Lyme D.(3 co-infections)sent me right into long overdue psychiatric therapy, ongoing. After 3 years of this,we peeled down to my probable case of Asperger`s,; we`ve been exploring ever since & that dx becomes clearer & clearer, but as yet no special meds to help me. Done much reading, self-exploration & remembering multiple aspects of a stunted childhood. At first so glad to have a name for all that ("on a clear day...."). But am left with a deep set of psychosocial disabilities, difficulty following through, huge annoyance w/not being able to access what holds me back, confusion, repeated mistakes,& all with a high IQ. The Lyme complicates the CNS fogginess/frustration. I am becoming even less social; my in-their-40`s daughters sympathetic & don`t know how to relate to me; late teens granddaughters have been mostly kept from me/hardly know me. I am very sad, undecided undirected & occasionally given to suicidal ideation. Used to be optimistic but am losing that too. I feel medication(s) might help; my therapist knows nothing about what might be good meds for me.Presently, for Lyme D, am taking Tyl 3, 30 mg, Lorazepam 1 mg for sleep, Clonazepam 1 mg for nerves & 40 mg Benicar for BP, all sparingly. Plus several amino acids, B`s, C, APA, N-Acetyl L-Cysteine, cal/mag/D3,2 pro- biotics (after and w/ 3 1/2 yrs of antibiotics for Lyme), OM 3,and other supplements. Any suggestions about a med to lower depression/anxiety, clear my brain.? Where to begin? what kind of Dr. to see? I`m also at poverty level, on Medicare (no HMO)having lost a lucrative pain mgt.practice to Br Ca (now in complete remission 12 years). Many other health/imbalance complications throughout my life,but phys. strong still and seeming healthy to others. The dark side of Asperger`s is hitting me lately w/a sense of having totally messed up my life & now have minimal guidance & little structure for my talents. Any help and guidance very much appreciated. Is there a directory of Drs.who can deal with adult Aspies? I live in N.CA one hr. N. of San Fran.Need a Dr.who accepts Medicare; pretty expensive for me to go into the city (live in a semi-rural county). Thank you so much. (I`m female BTW), living alone which I prefer, but am lonely. Conundrum. Also low self-esteem; always helping others, don`t know much about asking for help or making lasting friends. I don`t think I`m as far along the spectrum as Temple Grandin but not too far off. Thanks.
Diagnosing Asperger syndrome is a very tricky thing to do in older adults, given that the diagnosis is in part based on confirmation of the presence of the syndrome from a very early age. The other complicating factors you mention make it even trickier.
There are at this time no medications specific for treating Asperger syndrome. Research is ongoing, but the treatments available today are symptomatic only: treat anxiety associated with it, treat depression associated with it, treat obsessive behaviors associated with it, etc. The general guidelines for treating these associated symptoms are not known to markedly differ in Asperger syndrome.
It sounds like depression is a significant contributor here, and if you can find a clinician who sees adult autism patients, that would be helpful for Asperger syndrome. A good place to start might be the local Autism Society of America chapter, as they will be better versed in local resources.
David Q Beversdorf, MD
Assistant Professor of Clinical Neurobehavior and Neurology
College of Medicine
The Ohio State University