Thursday, July 10, 2025

Self Care 105: Understanding a Lovedone with Possible Autism Spectrum Disorder

 Dear Friend,

I know your heart is full of questions — the “whys” about your adult child’s challenges, their difficulty with responsibilities, and why things seem so hard for them when others seem to manage. These are not easy questions, and they come from a place of deep love and concern.

I want to gently remind you that the recent diagnosis isn’t a label to define or limit put on your child. The diagnosis is not a bad news. It’s a tool — one that brings clarity, understanding, and, most importantly, a path forward to empower your lovedone. It helps us see not what's wrong, but what kind of support is right that can bring the best possible outcome - because we care.

Your child is not broken, insane, disabled, or a burden. They are not a shame or a disappointment. They are human — just like all of us — navigating life with their own unique wiring. Autism doesn’t make someone less. It just means their way of experiencing the world is different, not abnormal. They may not be able to run the business we dream them having, to pursue a career, or have a family of their own. With understanding and the right support, many adults with autism spectrum disorder or ASD go on to live happy, fulfilling, and independent lives. Your role isn't to fix them — it’s to help them build a life that fits them. And they can thrive in it. 

You are not alone in this. Your love, patience, and openness mean more than you know to your lovedone. One step at a time, this journey can become one of growth, hope, and even joy. 


๐Ÿ’Œ THERE IS HELP AVAILABLE:

When you are ready for a session with me just send me a personal message on Messenger Jiji Harner

Here is more information about my services: https://safeguardmentalhealth.org/

 


ADULT AUTISM AWARENESS CHECKLIST

๐Ÿงพ Here is a Way to Assess (For Parents and Family Insight)

Purpose: To help recognize behaviors and traits that may indicate undiagnosed autism in adults.

If you or your adult child shows many of these traits, consider seeking a professional help.


Social Communication & Interaction

  • Difficulty starting or maintaining conversations
  • Talks “at” people more than “with” them
  • Struggles to understand tone, facial expressions, or sarcasm
  • Avoids or has trouble with eye contact
  • Difficulty forming or keeping friendships or detached and disinterested or wants to be liked but unable to sustain relationships.
  • Prefers solitude or one-on-one interactions
  • Appears emotionally flat or unresponsive in social situations

Behavioral Patterns & Interests

  • Has one or a few intense, narrow interests
  • Becomes very distressed by changes in routine or plans
  • Repeats behaviors, movements, or phrases (e.g., pacing, hand movements, repeated sayings)
  • Needs to do things “just so” (rituals or fixed order)
  • Over- or under-reacts to sensory input (e.g., lights, sounds, textures)

Daily Life Functioning

  • Needs frequent prompting or encouragement to complete basic tasks
  • Struggles with time management, planning, or staying organized
  • Has difficulty living independently (e.g., cooking, budgeting, cleaning)
  • Finds holding a job or completing tasks very challenging
  • Easily overwhelmed by everyday stressors or decisions

Emotional & Mental Health

  • History of anxiety, especially around social settings
  • Episodes of depression, shutdown, or emotional withdrawal
  • Appears passive or compliant, avoids expressing needs
  • Has a hard time recognizing or expressing emotions (alexithymia)
  • May seem "out of sync" emotionally with others

๐Ÿง  WHAT TO DO IF MANY BOXES ARE CHECKED

  • Understand that diagnosis can bring clarity, validation, and access to the right support.
  • For Formal testing: such as the RAADS-R, ADOS-2, or Autism Spectrum Quotient (AQ).

 

DIAGNOSTIC CRITERIA

๐Ÿง  1. DSM-5-TR Diagnostic Criteria for Autism Spectrum Disorder (ASD)

In DSM-5 and DSM-5-TR, Asperger’s Syndrome is no longer a separate diagnosis. It is now considered part of Autism Spectrum Disorder (ASD) with no language or intellectual impairment (essentially aligning with what was previously known as Asperger’s).

To be diagnosed with ASD, the individual must meet all A criteria and at least two from B.


A. Persistent deficits in social communication and social interaction, currently or by history (must meet all three):

  1. Deficits in social-emotional reciprocity, e.g.:
    • Failure of normal back-and-forth conversation
    • Reduced sharing of interests/emotions
    • Difficulty initiating/responding to social interactions
  2. Deficits in nonverbal communicative behaviors, e.g.:
    • Poor eye contact, body language, facial expression
    • Lack of understanding of gestures or tone
  3. Deficits in developing, maintaining, and understanding relationships, e.g.:
    • Difficulty adjusting behavior to suit various contexts
    • Trouble making friends or showing interest in peers
    • Preference for solitude or one-sided social interaction

B. Restricted, repetitive patterns of behavior, interests, or activities (must meet at least 2):

  1. Stereotyped or repetitive motor movements, use of objects, or speech
    (e.g., hand-flapping, echolalia, lining up toys)
  2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns
    (e.g., extreme distress at small changes, rigid thinking, same route/daily schedule)
  3. Highly restricted, fixated interests that are abnormal in intensity or focus
    (e.g., obsessively collecting data, fixated on niche topics)
  4. Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects
    (e.g., indifference to pain/temperature, fascination with lights/textures)

C. Symptoms must be present in the early developmental period

(even if not fully recognized until later in life).

D. Symptoms cause clinically significant impairment

in social, occupational, or other important areas.

E. These disturbances are not better explained by intellectual disability or global developmental delay.


๐Ÿงฉ What Happened to Asperger’s Syndrome?

  • Asperger’s now typically refers to “Level 1 ASD” (requiring support, without intellectual or language delay).

 

๐Ÿ” In Case You Wonder If Your Lovedone has Other Mental Health Condition. Here is a Differential Diagnoses (Other Conditions to Rule Out)

It’s important to distinguish ASD from other mental health or developmental conditions that may present similarly:

 

DIFFERENTIAL DIAGNOSES (OTHER CONDITIONS TO RULE OUT)

Condition

Similarities

Key Differences

Social (Pragmatic) Communication Disorder

Social difficulties

Lacks repetitive behaviors/restricted interests

ADHD

Inattention, impulsivity, social awkwardness

Does not typically involve restricted interests or insistence on sameness

Intellectual Disability

Developmental delays

In ASD, social difficulties exceed general developmental delays

Schizoid Personality Disorder

Social withdrawal

SPD lacks early developmental signs and repetitive behaviors

Avoidant Personality Disorder

Social anxiety and avoidance

Driven by fear of rejection, not confusion or disinterest

Obsessive-Compulsive Disorder (OCD)

Rituals, rigid thinking

OCD rituals are anxiety-driven and ego-dystonic (unwanted)

Schizophrenia Spectrum Disorders

Flattened affect, social withdrawal

ASD begins in early development and lacks psychosis/hallucinations

๐Ÿ’ฅ Common Comorbid Conditions with ASD

Many people with autism also experience co-occurring (comorbid) mental health or neurodevelopmental disorders.

๐Ÿง  Neurodevelopmental:

  • ADHD (very common overlap)
  • Learning disabilities (math, reading, writing)
  • Dyspraxia (motor coordination difficulties)

๐Ÿ˜Ÿ Anxiety Disorders:

  • Generalized Anxiety Disorder (GAD)
  • Social Anxiety Disorder
  • Panic Disorder
  • Specific Phobias
  • Often due to sensory overload or fear of social failure 

๐Ÿ˜” Mood Disorders:

  • Major Depressive Disorder
  • Persistent Depressive Disorder
  • Bipolar Disorder (less common but still possible) 

๐Ÿง‍♂️ Personality Disorders (more in adults, often co-diagnosed if masking or trauma present):

  • Avoidant Personality Disorder – due to chronic social failure or bullying
  • Schizoid Personality Disorder – often misdiagnosed instead of ASD
  • Obsessive-Compulsive Personality Disorder – due to rigid thinking patterns
  • Borderline Personality Disorder – in cases with emotional dysregulation and trauma.

๐Ÿ’Š Others:

  • Sleep disorders
  • Sensory Processing Disorder (not in DSM-5, but common in ASD)
  • Eating disorders, especially ARFID (Avoidant/Restrictive Food Intake Disorder)

 

 

SUMMARY FOR PARENTS & CLINICIANS

Area

What to Consider

Diagnosis

ASD includes what was formerly Asperger’s; key signs must be present from early life.

Functional Impact

Even high-functioning individuals may struggle with daily living, relationships, and employment.

Comorbidities

Depression, anxiety, ADHD, and sometimes personality disorders are very common.

Support Needs

Vary from person to person – some need minimal support, others substantial assistance with daily life.

Assessment

Best done by a psychologist, psychiatrist, or developmental specialist using structured tools (e.g., ADOS-2, RAADS-R).

 

๐Ÿงญ Step-by-Step Plan for Your Family or Lovedone Supporting an Adult Child with Possible Autism Spectrum Disorder (ASD)


๐Ÿ› ️Step 1: Awareness & Education

  • Learn about autism in adults, especially traits that differ from childhood presentations.
  • Understand autism is a neurological difference, not a failure of character, motivation, or upbringing.
  • Share resources with other family members to build a supportive and nonjudgmental environment.

Step 2: Observe & Document Concerns

  • ๐Ÿ“ Keep a simple behavior or functioning journal over 2–4 weeks:
    • Communication challenges
    • Sensory sensitivities
    • Rigid routines or intense interests
    • Emotional outbursts, shutdowns, or disinterest
    • Executive function struggles (task completion, organization)

๐Ÿ“Œ Tip: Use the awareness checklist from earlier as a starting point.


Step 3: Initiate a Supportive Conversation

  • ๐Ÿ—ฃ️ Choose a calm, private time to share your observations.
  • ๐Ÿงก Use a non-judgmental tone:

“I’ve noticed you’ve been having a really hard time with [work, relationships, tasks]. I recently learned about how autism can show up differently in adults — and I wonder if it’s something we should explore together?”

  • ๐Ÿค Offer your support and presence during the process.

Step 4: Seek Professional Evaluation

  • ๐Ÿ“ž Harner Mental Health Services at https://safeguardmentalhealth.org/
    • Uses tools like the ADOS-2, RAADS-R, or Autism Diagnostic Interview-Revised (ADI-R)
  • ๐Ÿงพ Be prepared with:
    • A written history of behaviors and challenges (even from childhood if available)
    • Family observations
    • School records (if accessible)

Step 5: Build a Support Plan Post-Diagnosis (or Regardless of Diagnosis)

Even if no formal diagnosis is made, support and accommodations can still be life-changing.

Focus on:

  • ๐Ÿ› ️ Executive functioning support: routines, planners, reminders, coaching
  • ๐Ÿ  Life skills training: cooking, money management, hygiene, transportation
  • ๐Ÿ’ผ Employment coaching or autism-friendly job programs
  • ๐Ÿง  Mental health treatment: therapy for anxiety, depression, or trauma
  • ๐ŸŒ Connecting with other autistic adults or autism-informed communities

Step 6: Adjust Family Dynamics & Expectations

  • ๐Ÿงฉ Accept their neurological difference; reduce pressure to be “normal”
  • ๐Ÿ‘‚ Listen actively, without trying to fix everything
  • ๐Ÿง˜ Build patience around meltdowns, shutdowns, or emotional withdrawal
  • ๐Ÿ’ž Help them feel safe and accepted at home, especially if the outside world is hard to navigate

Step 7: Empower Independence Over Time

  • Start with small, achievable goals (e.g., make one meal a week, apply for a volunteer role)
  • Use visual tools, reminders, or reward systems
  • Celebrate progress over perfection
  • Consider involving a life coach, occupational therapist, or social worker
Here is a video that might be helpful for you 
What happens to children with autism, when they become adults? | Kerry Magro | TEDxMorristown  
What you should know about raising an autistic child | Patty Manning-Courtney | TEDxAustinCollege https://www.youtube.com/watch?v=LawBw9gbv_w


I hope this gives you enough to think about
 - just message me to set up an appointment

Self-Care 104: Overcoming Health Anxiety When Thoughts of "What Ifs" are Surging

 Dear Friend,

You have been asking me repeatedly if the thoughts you have about your health are accurate. If your doctor really sees or understands what is really going on. Can you really even to the lab result when it is negative and you feel unwell and something really is wrong. You have tried many doctors and been to many laboratories but still not convinced and the thought of “what if… causes you to panic."

 

Understanding Health Anxiety:

When worry about health takes over, most of us get concerned when we feel a strange ache or a bump that wasn’t there before—it’s natural to care about your health. But for some people, this worry becomes constant and overwhelming. That’s where health anxiety—previously called hypochondriasis—comes in.

 

So, What Is Health Anxiety?

        Health anxiety is when someone becomes excessively worried that they’re seriously ill, even when medical tests show nothing is wrong. Every small symptom—a headache, a twitch, a sore throat—can feel like a sign of something dangerous. And even reassurance from doctors often doesn’t ease the fear for long.

It’s not about faking illness or being dramatic. People with health anxiety truly feel something is wrong. Their minds are caught in a loop: noticing a symptom, imagining the worst, seeking reassurance, and feeling relief—until the worry returns.

 

Why Does It Happen?

Health anxiety isn’t a choice. It can come from:

  • Past experiences with illness—either personal or someone close to them.
  • Personality traits like a tendency to worry or perfectionism.
  • Stress or trauma can make the brain more sensitive to bodily sensations.

 

Over time, the brain starts interpreting harmless signals (like a muscle twitch) as threats. The more we focus on these signals, the more anxious we become, and the stronger the symptoms may actually feel.

 

How Does It Affect Life?

Living with a constant fear of illness can be exhausting. People may:

  • Avoid hospitals or even hearing about diseases.
  • Constantly searching about your symptoms online, which often fuels more panic.
  • Visit doctors frequently—or avoid them altogether.
  • Struggle to enjoy daily life because the fear is always lurking.

It’s not just about worry—it can affect relationships, work, and overall peace of mind.

 

The Good News: It’s Treatable

Here’s the hopeful part: health anxiety is very treatable. With the right support, people can learn to trust their bodies again and quiet the anxious thoughts. Treatments like Cognitive Behavioral Therapy (CBT) help change the patterns of thinking that feed health anxiety. Mindfulness, stress management, and sometimes medication can also help.

            You don’t have to “just live with it.” Many people who once felt stuck in a cycle of fear have learned to break free and feel better.

 

ILLNESS ANXIETY DISORDER (IAD)

๐Ÿ“‹ DSM-5 Diagnostic Criteria:

To be diagnosed with Illness Anxiety Disorder, the following must be present:

  1. Preoccupation with having or acquiring a serious illness.
    – The worry is persistent, even when there are few or no physical symptoms.
  2. Somatic symptoms are either not present or are only mild in intensity.
    – If there are symptoms, they do not explain the level of anxiety.
  3. High level of health anxiety.
    – The person is easily alarmed about their health status.
  4. Excessive health-related behaviors, such as:
    • Repeatedly checking the body for signs of illness, or
    • Avoidance (e.g., avoiding doctor visits or hospitals out of fear).
  5. Illness-related fears persist for at least 6 months,
    – But the specific illness feared can change over time.
  6. The illness preoccupation is not better explained by another mental disorder, such as:
    • Somatic symptom disorder
    • Panic disorder
    • Generalized anxiety disorder
    • Body dysmorphic disorder
    • Obsessive-compulsive disorder

 

๐Ÿง  Here is how you can differentiate if what you are experiencing is Illness Anxiety Disoder or Somatic Symptom Disorder

 

Feature

Illness Anxiety Disorder (IAD)

Somatic Symptom Disorder (SSD)

Somatic Symptoms

Mild or absent

Prominent and distressing

Main Focus

Fear of having/getting a serious illness

The symptoms themselves (pain, fatigue, etc.)

Health Anxiety

Very high

May be present, but anxiety is about symptoms more than disease

Behavioral Patterns

Repeated checks, reassurance-seeking, or avoidance

High levels of medical use, worry about symptoms

Duration

6 months or more

6 months or more (though symptoms may vary)

Example

"I’m sure I have cancer, even if the test says no."

"This pain is ruining my life—why won’t it go away?"

 

 

๐Ÿ’Œ THERE IS HELP AVAILABLE:

        When you are ready for a session with me just send me a personal message on Messenger Jiji Harner 

       Here is more information about my services: https://safeguardmentalhealth.org/



                                                           Photo by Rejen Bosquit



 CRISIS PLAN WHEN HEALTH ANXIETY IS SURGING AGAIN

๐Ÿ›‘ STEP 1: Pause & Breathe (Mindful Awareness)

Instruction:
           Sit comfortably. Gently close your eyes. Place one hand over your heart and one on your stomach. Breathe in deeply through your nose for a count of 4… hold for 4… and exhale through your mouth for 6.

 

Prayer Whisper:

            "Lord, quiet my thoughts. I inhale Your peace… I exhale my fear."

 

Bible Verse to Meditate On:

            “Be still, and know that I am God.” – Psalm 46:10


๐Ÿ™ STEP 2: Acknowledge the Present Moment

Instruction:
             Say out loud or in your heart:

                   "Right now, I feel anxious. My mind is racing. But I choose to stay here in this      moment with God, not in imagined fears."

Prayer:

           "Father, You are here with me in this moment. Not in my past, not in the future. Help me to be fully present and to trust that Your Spirit is within me, calming me."

Bible Promise:

            “The Lord is near to the brokenhearted and saves the crushed in spirit.” – Psalm 34:18


๐Ÿ’ก STEP 3: Declare God's Control Over Your Health

 

Out loud, declare God’s authority:

"God is in control of my body. He knit me together. Nothing escapes His eye or care."

Prayer:

          "Lord, You are my Creator. You know every cell in my body. You are not surprised by my condition. I surrender to Your perfect plan for my health. Help me trust You completely."

Bible Verse:

           “For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.” – Jeremiah 29:11


๐Ÿง  STEP 4: Release the Need to Understand Everything

Acknowledge the tendency to fear what you don’t understand. Then release it.

             "I don’t have to understand everything. That’s not my job. I trust the One who does."

Prayer:

        "Father, calm the whirlwind in my mind. I lay down the 'what-ifs' and 'maybes.' I choose to rest in the truth that You know what I do not. I lean not on my own understanding."

Bible Verse:

          “Trust in the Lord with all your heart and lean not on your own understanding.” – Proverbs 3:5


๐Ÿ‘จ‍⚕️ STEP 5: Trust the Doctors God Has Provided

Pray over your care team and release fear of misdiagnosis or error.

Prayer:

         "Lord, You have placed trained professionals in my life to help me. Give them wisdom. Let me trust that You are working through them, and that I don’t need to be afraid of what I imagine. Anchor me in the truth, not my emotions."

Bible Verse:

          “Let the wise hear and increase in learning, and the one who understands obtain guidance.” – Proverbs 1:5


๐Ÿ›ก️ STEP 6: Declare Your Safety in God’s Hands

Place your hand over your heart and declare:

            "I am safe. I am held. I am not alone."

Prayer:

           "God, I declare that I am not forsaken. Your Spirit comforts me. Even now, I am being healed in ways I may not see yet. I accept where I am. I release panic. I receive peace."

Bible Verse:

          “Surely he took up our pain and bore our suffering... by his wounds we are healed.” – Isaiah 53:4–5


๐Ÿ•Š️ STEP 7: End with Stillness and Gratitude

Spend 1–2 minutes in silence. With each breath, silently thank God.

               “Thank You, God, for Your peace… for Your healing… for Your presence.”

Prayer:

             "Thank You, Father, for hearing my prayer. You are in control. I trust You with my body, my mind, my doctors, and my future. You are good. Amen."

Bible Verse:

            “You will keep in perfect peace those whose minds are steadfast, because they trust in you.” – Isaiah 26:3


 

๐ŸŒฑ Practice This Daily or As Needed

This prayer and grounding method can be used whenever fear arises. You don’t need to “feel” peace to receive it — just show up, breathe, and let God's truth settle into you.

  

๐Ÿง  JOURNAL YOUR RESPONSE AS YOU FACE YOUR HEALTH ANXIETY


๐ŸŒฑ 1. Externalize the Problem

You are not a problem – the anxiety is.

รผ  It sounds like ‘Health Anxiety’ has been showing up in your life a lot lately. When did it first start trying to take over?
or

รผ  Let’s call that constant worry ‘The Voice of Illness Fear.’ What kind of things does it say to you?


๐Ÿ” 2. Name and Describe the Anxiety

Let personify this thoughts so we can understand how it behaves.

รผ  If this health fear had a personality, what would it be like? Pushy? Clever? Sneaky?

รผ  What tricks does it use to convince you something’s wrong?


๐Ÿงญ 3. Explore the Effects of the Problem Story

รผ  When the Illness Voice gets loud, what does it stop you from doing?

รผ  How has it impacted your relationships, sleep, or confidence?

รผ  Even when anxiety has real influence—think about the last time you have the power to push it back.


๐ŸŒŸ 4. Find Exceptions to the Problem

รผ  Identify moments when you resisted or wasn’t overwhelmed by the health fears.

รผ  Was there a time recently when the Illness Anxiety started creeping in, but you handled it differently?

รผ  Have there been moments when you were able to say, ‘I’m okay,’ and move forward?

รผ  Do you feel confident or having inner strength to face the automatic thoughts.


✍️ 5. Reauthor the Story

รผ  So if we were to rewrite your story, how would you describe yourself? Maybe as someone who’s learning to trust their body again?

รผ  What do you want your relationship with your health to look like in 6 months?

รผ  Do you find yourself not just coping but rewriting how you relate to your health anxiety and your identity?


๐Ÿ’ฌ 6. Strengthen the New Story

รผ  Would you like to write a letter to your past self from this stronger version of you?

รผ  What advice would the calmer you give when the Illness Voice tries to take over again?

  


HERE IS A TIP ON WHAT TO SAY AND NOT TO SAY- IF YOU ARE CARING FOR SOMEONE WITH ILLNESS ANXIETY DISORDER: 

๐Ÿซถ 1. Be Non-Judgmental – Don’t Minimize Their Fear

What NOT to say:

  • “It’s probably nothing.”
  • “You worry too much.”
  • “You’re just imagining things.”

Even if well-intentioned, these can feel dismissive. For someone with IAD, the fear is very real, even if the illness isn’t.

What TO say instead:

  • “That sounds really scary for you.”
  • “I can see how hard this has been.”
  • “Your mind is trying to protect you—even if it’s overdoing it right now.”

๐ŸŽฏ How to do it:

  • Acknowledge their emotions first, not the facts.
  • Validate their experience before trying to offer comfort.

Example:
“It must be exhausting to feel on high alert all the time. I believe you’re really feeling this.”


๐Ÿ” 2. Be Curious, Not Corrective – Use Open-Ended Questions

Avoid jumping in with:

  • “You’re fine—stop Googling symptoms.”
  • “There’s no point worrying.”
  • “You already saw the doctor.”

.

Try asking:

  • “What does the anxiety usually say to you when you feel that symptom?”
  • “What makes that symptom feel scarier some days than others?”
  • “Have there been times when the fear passed more quickly?”

 

๐ŸŽฏ How to do it:

  • Use a gentle, curious tone, like you're trying to understand their experience.
  • Avoid trying to “fix” it. Help them explore it instead.

Example:
“When the chest pain started today, what went through your mind? What was the Illness Voice saying?”


๐ŸŒฑ 3. Celebrate Small Wins – Reinforce Progress

Don’t say:

  • “You only didn’t check your pulse for an hour. That’s not much.”
  • “You still seem anxious.”

That discourages progress and reinforces perfectionism, which can fuel anxiety.

 

Instead, say:

  • “You didn’t check your symptoms for 30 minutes? That’s awesome!”
  • “You noticed the anxiety and still got through your day. That takes strength.”
  • “You were able to pause and breathe—that’s a big deal.”

๐ŸŽฏ How to do it:

  • Catch and name the small victories—especially when they resist a compulsion or tolerate uncertainty.
  • Keep your tone positive and affirming, even if the win seems tiny.

 

Example:
“You made space for that anxious feeling without reacting to it immediately—that’s a big step. That takes real courage.”


๐Ÿ’ฌ In Summary:

Principle

What You Do

What You Say

Non-Judgmental

Validate their feelings

“That sounds really overwhelming.”

Curious, Not Corrective

Ask open questions

“What was going through your mind when…?”

Celebrate Small Wins

Praise progress, however small

“That’s a huge step—great job noticing and pausing.”