Dealing with Severe Mood Swings in Kids on the Autism Spectrum

“My son has autism (high functioning, age 11) and is referred by his doctor with the chief complaint of “severe mood swings, rule out bipolar disorder (BD).” In the past, he was treated for ADHD with stimulants with mixed results. I’m concerned about his “flipping out” whenever he is asked to do something he does not want to do. I have a history of depression and anxiety, and his dad had a drinking problem. There is no history of BD in his first- or second-degree relatives. Are my son’s rapid mood swings a sign of ADHD, autism, BD, or another disorder?”

It’s not uncommon for a child with High-Functioning Autism (HFA) or Asperger’s (AS) to experience frequent mood swings (i.e., an emotional response that is poorly modulated and does not fall within the conventionally accepted range of emotive response). Overwhelming emotions can take over, and the child will use some type of coping mechanism (at an unconscious level) to deal with them.

The trigger for a mood swing might be the result of a very minor incident (e.g., sensory sensitivity) or something much more upsetting (e.g., withdrawal of a privilege). Also, many mood swings last until the youngster is completely drained of his negative emotions.



The child’s mood swing may result in behavioral outbursts, destroying or throwing objects, aggression, anger and rage, self-injury, and problems that interfere with the child’s social interactions and relationships at home and school. These responses can occur in seconds to minutes or hours.

In my practice, the most frequently asked question by moms and dads is: “What do I do when my child can’t control his emotions?” When severe mood swings occur, the first response is to ensure the safety of all concerned.

Of course, mood swings are not planned, but instead are most often caused by elusive and puzzling environmental triggers. When the “shift in mood” happens, everyone in its path feels pain – especially the “special needs” boy or girl.

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's
 
Parents can expect their HFA or AS child to experience both minor and major mood swings over incidents that are part of daily life. Many parents have a hard time knowing how their child is going to react about certain situations. However, there are many ways to help your child learn to control his emotions. Let’s look at just a few…

When Your HFA or AS Child Experiences Severe Mood Swings:

1. Put safety first: Attempt to softly hold your son physically, unless he is one of those youngster that doesn’t like touch. Each HFA and AS youngster reacts to mood swings differently. Some will like to be held, others will want to be left alone. So, try holding your son gently if he will let you. If he becomes agitated, let go as long as no one will get hurt.

2. Don’t throw gas on the fire: Avoid threats in the heat of the moment. The moment you make unreasonable threats of punishments in hopes of scaring your son into compliance, you are not talking about the topic anymore. For example, if the parent says something like, “If you throw that again – you’re going to go to bed early tonight,” then the youngster may start to fight the early bedtime, and the original problem doesn’t get resolved – instead, now there are two problems.

3. Give a signal: Teach your son to respond to your "signal" (e.g., a hand motion) to stay composed. Give that signal as soon as he starts "fussing " about something.

4. This is not about you (the parent): As difficult as it may be in the heat of the moment, don’t take your son’s strong feelings personally. A parent may feel aggravated and personally attacked when the youngster explodes. Statements such as “I hate you” is not actually a personal statement. What your son is really saying is “I hate being out of control of my emotions.”

5.  Use distraction: As soon as you notice your son exhibiting the signs that his mood is about to take a turn for the worse, try to distract him. In order to be effective, the distraction has to be of interest to him (e.g., suggest to him "let's take a walk" or "let's play Pictionary").

6. Provide a “feelings vocabulary”: Teach your son to talk about how he feels. Give him a language to express his emotions. If he is too upset to talk or doesn't have the vocabulary to express his emotions, ask about the feelings relevant to the specific situation (e.g., "Do you feel angry… let down… afraid?"). When your son expresses the feelings behind his distress (e.g., anger, anxiety), suggest some other ways to look at the same event that may not be so anger- or anxiety-provoking. The thought "It's not fair" is a big anger-arouser for many young people on the spectrum. If that is the case with your son, ask him, "Do you feel you are being treated unfairly?" When he answers the question, listen and don't rush to negate his feelings.

7. Catch the mood swing in its early phase: Slow down the process by saying, "O.K. We need a minute to think about this." If your son is gearing-up for an emotional vomit, you can slow things down by giving him some feedback (e.g., "I can see you're starting to get upset. Can we talk about it first?").

8. Think in terms of “limits” rather than “punishment”: Set limits that your son will find reassuring. A limit is not a punishment. Limits may help your son learn how to slow himself down. HFA and AS kids find the “setting of limits” very soothing. They need to know that the parent is in control – because they feel so out of control!

9. Pretend you are a mirror: Reflect your son’s emotional state. You could say something like, "I can see how annoyed you are. Can you tell me what made you feel this way?" (Note: "What" is always more important than "Why," because it asks for specifics. Your son will probably never know “why” he gets upset. And if you ask, he is likely to say, “I don’t know!!”).

10. Establish a “judge-free” zone: Let your son express his negative feelings without judging him. What would you do if every time you were angry or hurt, some tall scowling adult looked down on you and said, "Stop feeling that way," or "Don’t talk to me like that." Rather than calming down, you may decide to act-out your anger even more.

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's
 
11. Issue appropriate consequences: If your son refuses to be distracted or engaged in dialoguing about his distress and starts shouting or getting aggressive, impose appropriate consequences. Have these consequences in place to serve as a guideline (i.e., you have discussed them with your son beforehand and written them out for future reference). Armed with a list of consequences (which preferably consist of withdrawing privileges), you should encourage your son to choose such alternatives as doing something else, walking away, or talking about his feelings rather than acting-out.

12. Don’t try to put a lid on it: As long as no one is going to get hurt, let the mood swing run its course. This is hard for parents to do – but it’s very crucial. An HFA or AS youngster who is full of raw emotions will not know how to manage them. But he may feel somewhat soothed by your calmer presence. Then, you get back to the business of “talking it out.” Talking things out (after things have calmed down a bit) teaches your son to use his words to deal with negative emotions rather than using physical aggression. However, don't extend your son’s emotional state with too much discussion. If he is feeling out of control or in a rage, too much talking will not help – in fact, it may prolong the problem.

13. YOU take a time-out (if safety is not an issue): Keep your emotions separate from your son’s behavior. While there are occasions when it is important to tell your son how you feel, entering into his emotional state with your own negative emotions will only worsen the problem. Take a deep breath, speak calmly, leave the room, and give yourself a few minutes to gather your thoughts.

14. Acknowledge the effect your son’s mood swings have on you: Many HFA and AS kids will calm down if the parent acknowledges their impact. For example, you can stop and say, "I've stopped the car (or "I’m off the phone"), and you have my full attention. What don't I understand?" Sometimes kids just need to vent to a listening ear.

15. Seek professional help: If you see a repeated, chronic pattern that you can't figure out, seek the help of a therapist. If your son’s destructive behavior escalates and becomes increasingly difficult to deal with, and if nothing works over a period of weeks or months, there may be an underlying issue that needs professional assistance.

HFA and AS kids guided toward responsible emotion-management are more likely to understand and manage unpredictable mood swings directly and non-aggressively and to avoid the stress often accompanying them. You can take some of the bumps out of understanding and managing severe mood swings by adopting some of the parenting techniques listed above.

==> Videos for Parents of Children and Teens with ASD


COMMENTS:

 • Anonymous said… Bipolar is over diagnosed in the Autistic population due to a severe overlap in symptoms/tendencies, and an adolescents' inability to self manage the hormones and sensory issues associated with Autism will not make this any easier. It is already a tumultuous time. I agree with the above, seek out care from someone with a Biomedical background before simply medicating (this is coming from Mama of a teen Aspie - but myself have been diagnosed with BD which is now being reassessed)
• Anonymous said… Have him assessed for OCD. It had many traits and sub traits. I had no idea how to communicate with my sin for years without him"blowing up" , turns out the OCD thoughts were literally driving him crazy.
• Anonymous said… In this article and many others it says to seek professional counseling. We have tried many counselors who claim to "specialize in autism, Asperger's," but really have no clue. How do you find a counselor that really deals with autism?
• Anonymous said… WOW my son is 9 and he is getting angrier when I ask him to do things, homework. Chores sounds like you found such great help!!!!
• Anonymous said… Your describing my son his 10. We've got our first appointment in three weeks with CD. Is your son like this at school aswell? Or is it mainly only directed at you?
• Anonymous said… Don't let docs put him on SEI's though. Contact a company called Neuroscience. (I went through my chiropractor) and they will do a brain chemistry test to determine which levels are "off". Then they recommend supplements for him to take to correct it. My son had been on them for almost 2 years now. He is a completely different, confident and mostly calm teenager. I'm so grateful.
• Anonymous said… It probably bores him and he doesn't see the point. That is what my son said to me once. Or he could be worried he won't do it right? Also at 9/10 hormones start kicking in. My son's OCD started flaring at 10.
• Anonymous said… My son is 9 he gets so angry at me when I ask him nicely to do chores, homework, rinse off his plate, etc. I just don't understand it - it's getting worse. Aspergers is so challenging!!!  ❤ Your not alone!!!
• Anonymous said… Sounds like PDA, my son has it too. Also 11yrs old. It's VERY tricky but try to get ways to work around the "order" you are giving. For example, if it's bath time, I wouldn't tell my son to go and bath... I wil give him an option so that it looks like it was "his choice" and he feels in control of the decision... I would just ask him...."what would it be tonight... bath or shower?" (I'm blessed to have both) Then he would choose, and that's what he sticks too. I sometimes do it with food as well. I will give him 2 options, and I would make sure one of the options is actually less desireable so that he unknowingly chooses what I actually wanted to give him. I will add that this method does not ALWAYS work... but then I would just improvise and use a reward technique or something. Good luck! Xoxoxo
* oh my, great timing for this article! Our 11 year-old had major meltdown, precipitated by our not using the right words, ie. notebook instead of binder, and more. He said, he was feeling physical pain over it, as stomach pain, then frustration grew until he was pulling his hair, screaming, and then head-butted wall. He ran to his room and cried it out for 5 minutes. I waited another 10 and knocked, He was all over it-- completely calm, open to discussing and compliant. As tho it never happened. Amazing. (I, on the other hand, am still upset!) We'll talk more today, about tips in this article to implement in hopes of avoiding another self injurious explosion. Thank you, Mark
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