For adults with Autism, anxiety and medication are managed differently which also applies to co-occurring diagnosis like ADHD, depression, and mood disorders (irritability, aggression and meltdowns). Equally important is the Food is Medicine Movement bolstered by Nutritional Psychiatry. Let’s dive into the various ways we can manage how we feel.
WELCOME BACK TO ANOTHER EPISODE OF YOU DON’T SOUND AUTISTIC WITH BLAKE AND RACHELLE. BLAKE IS AUTISTIC. RACHELLE IS NOT.
You Don’t Sound Autistic is a mental and emotional health awareness podcast. Each week we do our best to represent both neuro-perspectives and talk about the continual discovery process of life on the spectrum. Our goal is to illuminate, uncover and transparently discuss life with multi-diagnosis and through a multi-generational neurodivergent lens. We follow an open and unscripted conversational format.
After reading this summary, listen to the podcast to hear additional insights and stories told only on the podcast.
Depression and Serotonin (3:06)
A collective review of depression research published in 2022 aims to validate or invalidate current causal associations between lower Serotonin levels and depression. The results of this comprehensive review of the major research on serotonin shows there is no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity.
- Most studies found no evidence of reduced serotonin activity in people with depression compared to people without
- Methods to reduce serotonin availability using tryptophan depletion do not consistently lower mood in volunteers
- High quality, well-powered genetic studies effectively exclude an association between genotypes related to the serotonin system and depression, including a proposed interaction with stress.
- Belief in the “chemical imbalance” theory of depression and serotonin was found to shape consumer belief that depression is lifelong and can only be treated with a dependency on antidepressant medications
- Surrendering to the belief of the “chemical imbalance” theory leads:
- Higher pessimistic outlook on the outcome of depression
- Negative expectations about the possibilities of self-regulation of mood (1)
- Lower motivation to seek natural, food-based or even movement-based alternatives for treatment
Autism and Abilify (7:10)
Aripiprazole, otherwise known as Abilify, is a second-generation antipsychotic and is approved to treat irritability (aggression, self-injurious behavior and severe tantrums) for autistic individuals as well as for:
- ADULTS: Schizophrenia, mixed and manic states of Bipolar I Disorder and as an adjunctive treatment for major depressive disorder (MDD).
- TEENS: Schizophrenia (aged 13-17)
- CHILDREN & TEENS: Manic and mixed states of Bipolar I Disorder in children and adolescents (aged 10-17 years) and Autism Spectrum Disorder (aged 6-17 years) (2)
Children, adolescents and young adults taking antidepressants for MDD and other psychiatric disorders are at increased risk of suicidal thinking and behavior when compared to placebo.
GABAPENTIN (8:00)
Gabapentin is an anticonvulsive medication originally used as a muscle relaxer and anti-spasmodic medication. Currently Gabapentin is used for postherpetic neuralgia, partial seizures and moderate to severe restless leg syndrome (RLS). It also has off-label use for:
- neuropathic pain, fibromyalgia, amyotrophic lateral sclerosis (ALS)
- bipolar disorder
- postmenopausal hot flashes
- essential tremors, generalized tonic-clonic seizures
- anxiety, depression, resistant depressant and mood disorders
- irritable bowel syndrome (IBS)
- alcohol withdrawal
- postoperative analgesia
- social phobia
- insomnia, post-traumatic stress disorder (PTSD)
Serious reactions can occur including suicidality and depression. Tell your doctor if you’re feeling new or worsening symptoms. Adverse Effects of Gabapentin can be found here. (5)
Personality impacts of adhd, anxiety, depression or mood disorder meds (9:55)
Some express they feel changes to their personality while on medications that lessen their creativity, sense of humor and overall “spark” of life.
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Gamma-Aminobutyic Acid (GABA) (12:33)
GABA is a neurotransmitter and has sedative and calming effect which can improve mood, promote sleep and reduce anxiety or anxious feelings. GABA-rich foods include:
- Cruciferous vegetables (broccoli, cabbage, cauliflower, brussel sprouts)
- Beans (lentils, soy and adzuki)
- Walnuts and almonds
- Sweet potatoes and peas
- Tomatoes
- Spinach
- Mushrooms
- Sprouted grains
- Rice (particularly brown rice)
- Chestnuts
- Fermented foods like kefir, yogurt, tempeh, kimchi)
- Oolong and white teas
- Shrimp and halibut
Cardiovascular exercise like running, jogging, hiking or walking at least four times a week has shown to increase GABA levels. A session of Yoga is a great way to cool down, stretch and boost GABA production after cardiovascular exercise. (4)
Nutritional Psychiatry (15:00)
“Primary Care Physicians (PCPs), Cardiologists and oncologists now understand that what you put into your mouth at each meal strongly influences your overall health.” according to Psychiatrist, author, and organic farmer, Drew Ramsey, M.D. In his book, Eat to Beat Depression and Anxiety – Nourish Your Way to Better Mental Health in Six Weeks, Dr. Ramsey adds neuroscience and momentum to the Food is Medicine movement.
- Improve brain-cell health and growth
- Reduce Inflammation
- Cultivate and healthy microbiome
- All of which contribute to our mental well-being
Start with your doctor recommended treatment plan. And know that your mental health can be improved by changing your diet and using foods or whole-food based supplementation to feed your brain.
temperature regulation changes (26:40)
Have you ever noticed how specific your preferences are in regards to temperatures? External temperature is an easy conversation topic depending on your geolocation, season and access to air conditioning. Internal temperature regulation and the underlying regulatory mechanisms are less understood. (2) Some influences include:
- Medication
- Stress & the Fight or Flight Response
- The Vagus Nerve
- Cortisol and Adrenaline
- Age
- Time of Day or Diurnal Variation
- Exercise or Physical Exertion
Memory Storage, Organization & Recall Changes (34:11)
Sometimes communication issues and conflicts stem from a lack of proper memory storage, mental organization and/or memory recall. These challenges can make collaborative and problem-solving conversations feel more like a fight than a road to a good solution. Start asking, “Do you remember what you did originally?” then build up.
A surface list of factors that can influence memory storage, organization and recall include:
- Medication
- Sleep Debt or poor sleep
- Stress and Anxiety
- Depression
- Thyroid Issues
- Vitamin B12 Deficiency (MTHFR gene mutation??)
- Alcohol Abuse
Anxiety of Undecided Transitions (36:42)
Asking for upgrades to your daily life, then taking steps to implement those changes often requires waiting periods that can’t always be pushed or controlled. It’s easy to get in our own way and start feeling pessimistic about life’s timing which leads us to focus on what we lack instead of what we have already while waiting for more to arrive. Notice if you find yourself thinking things like:
- “Everyone always forgets about me”
- “I never get what I want”
- “I’m not qualified for the (opportunities) I really want”
- “They don’t want me because I’m different”
- “What did they want that I don’t have?”
Nutritional Aspects of Mental Health (38:40)
The brain-gut connection continues to confirm the important of eating for mental and emotional health. What we eat with either nourish or diminish our brain-gut-heart-inflammatory health. Diet directly impacts organs like:
- Liver (fat and alcohol metabolism)
- Kidney (salt and filtration)
- Pancreas (sugar and insulin)
- Brain (neurotransmitters, hormones and amino acids)
- Gut (digestion, histamine and immune system)
- Skin
- And More
Evolution of community terminology (49:10)
As our understandings develop and more neurodivergent adults are lending their voices to social and medical research, our terminology for neurodivergent terminology will also transform. Here are a few terms that are now considered socially expired and outdated because they fail to inclusively and properly respect neurodivergence.
- “High-Functioning” as it relates to Autism Spectrum Disorder, ADHD and Depression
- Asperger’s Syndrome – now Autism Spectrum Disorder
- Pervasive Developmental Disorder (PDD) – now Autism Spectrum Disorder
- ADD – now ADHD Inattentive or ADHD Combo [Hyperactive + Inattentive)
As this list grows, we’ll update it to reflect our continued evolutionary progress. Be gentle if you hear people get this wrong as not everyone has been exposed to the new terms or the reasons why these terms are no longer used.
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References:
(1) Moncrieff, J., Cooper, R.E., Stockmann, T. et al. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry (2022). https://doi.org/10.1038/s41380-022-01661-0
(2) Blankenship K, Erickson CA, Stigler KA, Posey DJ, McDougle CJ. Aripiprazole for irritability associated with autistic disorder in children and adolescents aged 6-17 years. Ped Health. 2010 Sep 29;4(4):375-381. doi: 10.2217/phe.10.45. PMID: 21359119; PMCID: PMC3043611.
(3) Chang RB. Body thermal responses and the vagus nerve. Neurosci Lett. 2019 Apr 17;698:209-216. doi: 10.1016/j.neulet.2019.01.013. Epub 2019 Jan 8. PMID: 30634012; PMCID: PMC7061531.
(4) Streeter CC, Whitfield TH, Owen L, Rein T, Karri SK, Yakhkind A, Perlmutter R, Prescot A, Renshaw PF, Ciraulo DA, Jensen JE. Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. J Altern Complement Med. 2010 Nov;16(11):1145-52. doi: 10.1089/acm.2010.0007. Epub 2010 Aug 19. PMID: 20722471; PMCID: PMC3111147.
(5) Yasaei R, Katta S, Saadabadi A. Gabapentin. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493228/