People, including health professionals, almost invariably associate Autism, or Autism Spectrum Disorder (as per current scientific terminology), with childhood. Autism was once compared with childhood psychosis. In fact, the term ‘autism’ was first coined to describe the primary concept of schizophrenia! This, unfortunately, led to the much ‘stigmatized impression’ of ‘an odd and difficult’ child with poor communication who was ‘lost in his/her own world’. Several movies have had dramatic portrayals of autism in adults. These may have further strengthened the prejudice around the word “autism”!
Autism, a neurodevelopmental disorder, mostly starts manifesting during early childhood, but as science has established lifelong changes in the human nervous system, the same applies to Autism spectrum disorders, including its changes over time and variable presentations. However, both the presentations and its challenges could be much different for people who were identified with problems of Autism in early childhood when they grow up, or for people first diagnosed with Autism Spectrum Disorder.
Along with much-increased chance various psychiatric illnesses (from schizophrenia, mood disorders or OCD, in comparison to the general population), neurological problems like epilepsy, complex neurocutaneous syndrome, like tuberous sclerosis are common in people with autism, a manifestation of which could be prominent at later age. Other chronic medical problems like diabetes mellitus, irritable bowel syndrome, inflammatory bowel disease are more prevalent as well, with life long morbidity and complications out of them. So along with the communication problems and other psychiatric illnesses, these physical illnesses needed to be taken care of closely, which, unfortunately often gets overlooked.
Diagnosed as adult-onset autism:
Features of autism can be first time detected during adulthood which often perceived as oddness/weirdness but stem mostly from communication difficulties of behavioral patterns. Though various parts of a language improve with time in people with ‘subtle’ autistic signs can continue to have their ‘altered speech’ which might be perceived as dull and monotonous by others. Though it might shock you, but both excessive devotion to single specific work (be it a musician or a painter) or an overconfident individual with minimum family life (think of your ‘nerd’ boss who spends 8 am to 8 pm daily at office, always glued to his laptop!) can be actually having autistic features, which, other than impairing social situations( might be portrayed as neglecting the partner or less interested in romantic involvement) could be of beneficial also for single interest with minimal distraction in life!
How and what can family or friends do maximum for their near ones with such problems. Well, understanding, support, and adjusting. These three probably narrate best as a caregiver’s role; though all three need tailoring and optimization for a specific individual. Over concern or critical comments, both being part of ‘expressed emotions’ can jeopardize interpersonal relationships adding further morbidity with distress. Accepting the individual the way he/she is, is probably the best for any single person on earth, be it with or without autism.
What we can do?
Both adult-onset (or diagnosed) autism and adults with childhood autism might need short term or persistent professional help through several modes. Other than addressing various mood, anxiety symptoms through specific and appropriate psychotropic medications, various types of counseling techniques like supportive therapy, couple therapy of cognitive-behavioral therapy might turn very useful as per respective and definite indications.
Clinical research has persistently shown the compromised quality of life for adults with autism problems, as expressed by individuals too. By 2019, life is already quite tough even with maximum possible communicative modes, then you can expect how it would be for people who find it difficult in the communication itself. Help-seeking is less stigmatized by now, and we all have definite responsibilities to decrease it further, for a better and more acceptable tomorrow.
– Dr. Tanay Maiti
Pscychiatrist, AIIMS Bhubaneswar