mental health super summit 2001
TRANSCRIPT
Mental Health Super Summit 2021
Depression
One in three autistic adolescents and adults have episodic depression
Exploring Depression Programme
Santomauro, Sheffield and Sofronoff (2016) JADD 46, 572-588
Characteristics of Depression Associated with Autism
•A change in the special interest to a morbid or macabre topic
•Watching movies with a theme of death and despair
•An attempt to understand morbid thoughts and deep negative inner emotions
Assessment 1: Reasons why someone who has Autism can sometimes feel sad. Tick those that
apply to you
Loneliness
Being rejected or humiliated by people at school
Being bullied and teased by people at school
Feeling exhausted from trying to be accepted and liked
Believing the criticisms of students at school
Being sensitive to the suffering of others
Depression Questionnaire
Exhaustion from always feeling anxious
Being aware of your faults and being a perfectionist
Taking corrections in school as personal criticism
Being bored at school/work
Not feeling understood by teachers and friends
Not getting the school grades to match your intelligence
Worry about whether you will ever have a relationship
Depression Questionnaire
Worry about whether you will have a successful career
Believing that past bad experiences will continue forever
Feeling constant pressure to fit in and be like everyone else
Experiencing the loss of a friendship, pet or family member
Not being able to cope with intense sensory sensitivity
Experiencing too many changes in your life
Being diagnosed with Autism
Depression Questionnaire
Getting into trouble because of your anger
Not having enough strategies to feel happy again
Not being understood by your parents
Feeling invisible at school
Over-analysing your performance in social situations
Being aware of and troubled by social injustice
Experiencing or having experienced abuse
Distress regarding gender identity
Qualities and Abilities
• Alexipersona A lack of vocabulary to describe personality characteristics is an associated characteristic of Autism
• A list of positive personality adjectives as prompts to describe personality qualities
Positive Personality Adjectives
Adventurous
Affectionate
Ambitious
Articulate
Artistic
Careful
Cheerful
Compassionate
Considerate
Courageous
Courteous
Creative
Curious
Dependable
Determined
Easy-going
Empathic
Energetic
Enthusiastic
Fair
Forgiving
Friendly
Funny
Generous
Gentle
Helpful
Honest
Imaginative
Inventive
Kind
Loyal
Mischievous
Neat
Persistent
Polite
Practical
Proud
Quick-witted
Quiet
Rational
Reliable
Reserved
Serious
Shy
Silly
Sincere
Studious
Sympathetic
Thoughtful
Tolerant
Tidy
Trusting
Wise
This is Who I Am Book: Qualities in Personality and Abilities
Personality
• Kind
• Caring
• A loyal friend
• Honest
• Forthright
• A perfectionist
• Determined
• Brave
• Humourous
Abilities
• Drawing and art
• Creating Lego models
• Exceptional long term memory
• Talented in mathematics
• Noticing details
• Expert on ……
Ring Binder or Computer Programme
• Each quality at the top of a page
• Record examples of the expression of that quality (a diary)
• Photographs, copies of reports and grades, compliments from friends and family
Ring Binder or Computer Programme• Qualities of a hero in the family or
character in a film or TV programme (e.g. Dr Who)
• Each admired quality of the hero has a page
• Add entries throughout and after the programme
• Confirming progress towards a valued personality
• The book is an antidote to depression and builds a positive self-image
Energy Accounting
• Maja Toudal: Concept of an energy bank account
• Energy withdrawals and deposits throughout the day
• Risk of energy depletion leading to depression
• Energy depletion a major cause of depression for those with Asperger’s syndrome
Energy Bank Account: Withdrawals and Deposits
Withdrawal• Socializing
• Change
• Making a mistake
• Sensory sensitivity
• Daily living skills
• Coping with anxiety
• Over analysing social performance
• Sensitivity to other people’s moods
• Being teased or excluded
• Crowds
• Government agencies
• Body shape
• Perceived injustice
• Certain people
Deposit• Solitude
• Special interest
• Physical activity
• Animals and nature
• Computer games
• Meditation
• Caring for others
• Nutrition
• Sleep
• Reading Harry Potter books
• Mental health vacation day
• Information on the Internet
• Being with pets
• Certain people
Energy Accounting
Currency: numerical measure or value of how much an activity or experience is energy draining or refreshing from day to day
Energy range rated from one to 100 for each activity or experience in the withdrawal or deposit columns
On some days, socializing can drain energy at a value of around 20 but on other days could be 100
Daily Energy Account Form
Withdrawals Deposits
Activity/Experience (0-100) Activity/Experience (0-100)
Range of Energy Depletion and Refreshment15 Year Old Girl with ASD Level 1
Withdrawals• Late to school 10-40
• Crowds 20-60
• Mum being cranky 30-100
• Friends not being nice to each other 20-30
• Friends’ own problems 20-90
• Noise in class 20-30
Deposits• Reading Harry Potter 30-80
• Dancing freestyle in bedroom 30-50
• Talking to boys at school 10-30
• Quiet time in bedroom 20-80
Balancing the Books
•Add all the numerical values in each of the two columns to see if the energy bank balance at the end of the day is in debit or credit
• If needed, schedule more energy-infusing activities into the next day or week
Alexithymia
• “How are you feeling”
• “I don’t know”
• ‘I don’t know how to mentally grasp the intangible negative emotions swirling in my mind, identify and label them accurately and communicate those feelings in speech so that you will understand’
Strategies for Alexithymia
• “I need a language for my worries”
•Using music or art to express the emotion or thought
•Poetry, lyrics and novel writing
•Reading fiction (Hermione, Harry Potter)
• Scenes from movies, passages from a book
Strategies for Alexithymia
• Typing rather than talking (email)
• Yoga and meditation
• Heart rate monitoring via sports watches
Emotional Toolbox: To Fix The Feeling
Physical Activity ToolsQuick release of emotional energy
•Personal trainer
•Physical exercise, walk, run, trampoline
•Sport (Basket Ball, golf, weight lifting) or dancing
•Creative destruction (recycling)
Relaxation ToolsSlow release of emotional energy
•Relaxation training
•Solitude
•Massage
•Sleep
Relaxation Tools
•Time in nature(walking, fishing, camping)
•Being with animals(pets, horses, birds, even reptiles and insects)
Awareness Tools: Interoception
•Mindfulness•Meditation• Yoga/QiGong/Tai Chi/Tai
Kwon Do•Awareness of bodily
sensations•Aware of thoughts and
feelings
Social Tools
• Time with a family member or friend
• Disclosure (typing, music, poetry)
• Seek advice
• Validate feelings
• Being with a pet
Social Tools: Affection
•Approval
• Intensity
•Duration
“I fail to understand why the exertion of pressure on the human body should be considered comforting."
Thoughts and Perspective
•Put the events in perspective
• Imagine what you would like to do or say
•Being calm is being smart (IQ)
Adaptive Thinking
Maladaptive
• Catastrophizing*
• Black & white thinking*
• Suppression*
• Avoidance*
* Characteristic of ASD
Adaptive
• Self-soothing
• Alternative perspectives
• Disclosure
• Positive reappraisal (optimism)
• Seeking and responding to compassion and affection
Self-affirmation Pledge Liane Holliday Willey
• I am not defective
• I am different
• I will not sacrifice my self-worth for peer acceptance
• I am capable of getting along with society
• I will ask for help when I need it
• I will be patient with those who need time to understand me
• I will accept myself for who I am
Appreciation
List at least 5 things you are grateful for
Create a collage to express the main things that you are grateful for in your life such as your:
• Intelligence
• Pet
• Parents
• Computer
• JK Rowling
• Star Trek
Special Interests
•A means of relaxation, pleasure
•Knowledge to overcome fear
•Keeps anxiety under control
•Thought blocking
•Energizer when exhausted or sad
Special Interest
• Distraction during a meltdown.
• The ‘off switch’
• Motivation and conceptualization (Dr. Who)
Sensory Tools
• Sounds. Ear plugs, headphones.
• Light. Irlen Lenses, hat, sun glasses.
•Aroma. deodorants, cleaning products.
• Tactile. Clothing.
Medication
• Treatment of a clinical depression (SSRI)
•Vasa et al (2014) : JADD 44:12
•50% had behavioural activation (increased activity level, impulsivity, insomnia, disinhibition)
Unhelpful ToolsUnhelpful tools
•Alcohol or drugs
•Self-harm: Soothing, mind/body connection, punishment, block emotional pain
•Hurting someone else
‘Depression Attack’
•Arrive unexpectedly and are extremely intense
•An emotional ‘implosion’
•A desperate need to end the despair
•Can be intense but fortunately brief
A Safety Plan for a ‘Depression Attack’
Strategies for you:
• Immediately seek practical or emotional help. This is an emotional emergency
• Try to remove yourself from the situation that triggered the depression attack
• Try not to injure yourself
• The special interest may be an ‘off switch’, distraction or barrier to intense despair
A Safety Plan for a ‘Depression Attack’
Strategies for your support person:
• Stay calm and reassuring (no interrogation)
•Not ask what is causing the distress
• Stay with you
• Try not to ‘fix the problem’
•Not move in too close without your prior approval
• Try not to be jolly
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