It is very important that people that are close to a person with autism, to understand how invasive, confronting, uncontrollable, heavy and mentally exhausting a meltdown can be in the human brain. Most meltdowns start with an overdose of (earlier) sensory or stress overloads, which will shut down higher-order brain functions.

In a meltdown, (almost) all executive functions (like reasoning, memory, planning and decision-making) are shut down. Everything gets slower with no focus. Language is affected too and it becomes (almost) impossible to communicate adequately with others using normal structured sentences, while finding the right matching words. The brain becomes (very) chaotic because focus starts to wither. This is a moment where it becomes difficult to find a way out of the situation.

When not able to escape the situation, this neurological chaos in the brain can build up and result in a total internal cognitive shutdown or an explosive outburst, which is quite common during a meltdown. This explosive outburst may seem to come from nowhere, but it is mostly an end-result of an accumulation of sensory, cognitive and emotional overload, which may have started hours or even days earlier.

Inside the brain a meltdown is an “Amygdala Hijack” because the Amygdala (the part of the brain which is responsible for basic human instincts like emotional reactions, fear, anxiety, including our well known fight-or-flight instinct) and the neo-cortex (the part of the brain which is responsible for the higher-order brain functions like motor commands, sensory perception, cognition, spatial reasoning and language) stop working together and the Amygdala “hijacks” the neo-cortex and shuts it down immediately, with as result no more logical and rational thinking, conscious thought and sensory perception. With the loss of the executive and cognitive functions, it will become very difficult to remember current events, follow-up on the situation, solve problems, consider consequences or able to listen to reasoning.

Instead, the Amygdala will take replace logic immediately with emotions (like depression, anxiety, aggression, social awkwardness, personality changes, impulses, instincts like fight-or-flight), which will release an overwhelming emotional response, often out of proportion.

To regulate that chemical mix of adrenaline and cortisol rushing and overwhelming the brain with emotions, it is best to go towards a more receptive and sensory deprived area and offer comforting, by being compassionate and understanding the chemical process instead of being punitive.

Being proactive is the best strategy for meltdowns.

A meltdown happens in various stages of stress. More info about this can be found here.

What exactly can start a meltdown?

There are several conditions and triggers and events which can cause a meltdown.

Conditions (actions which already happened) which could lead faster to meltdowns:

Not having enough sleep or rest, being out of time, when being sick and/or having fever, when having mental or physical problems, having too many thoughts and worries in the head, not having a basic amount of structure, loosing something important, not being prepared in advance, having to process earlier meltdowns, sensory overloads, grief,  insecurities, or too many sudden (big) changes required to adapt to often in a too short timeframe.

Triggers (actions that still have to happen) that can start a meltdown is:

Too many loud/yelling/crying people around me, too much mechanical noise, forced to change fixed routines or structures, being forced to find other (less good) solutions than those which used to, lack of empathy from people when being over-stimulated, when people do not (want to) understand autism, being the laughing stock, no possibility to find a quiet/comfortable spot to retreat (while having too much sensory input), when there are too many expectations to deal with, (impossible) deadlines, things which don’t work out as they should, too much anxiety and stresses to deal with, too loud and busy construction areas, forced body contact, having to do something against my nature or principles, discussions or fights without (any) rational content or meaning, to be discriminated or (sudden) aggression, power abuse, searching something for hours and not finding it, not able to complete important tasks or responsibilities because of brain-fog or loss of focus, big and sudden changes in life or environment or routines, rude or over-pushing people, situations that can harm me, continuous mental and peer pressure, unrighteous actions by others which are not accounted for…

What are the effects of a meltdown to me and others?

The effects can be different, depending on the circumstances where it happens. Mostly I loose the important key-points of a discussion extremely fast, which forces me (mostly) to be (very) short, clear and direct with communication to others. Using this form of communication is often the only and last possibility to deliver the important key-points of a message,  before I could crash.

Being short, clear and direct often gives a rude, disrespectful or hostile impression

Being short, clear and direct often brings a rude, disrespectful or hostile impression to people that do not know the reason of this style of communication. The only purpose of such short and assertive communication style is to be maximally effective to stay to the point. It is never to be meant hostile! It makes me deal with issues as fast as possible without the possibility of miscommunication, so I can move on to an area where I can relax and crash. I feel truly sorry when it gives any awkward or bitter feeling when it happens to you, at that moment.

Depending the severity of the meltdown and how long I was exposed to a situation, the effects van vary in time and actions. Some examples of such actions (sorted from lowest to highest severity) are:

  • Talk much faster, louder or sometimes more, or become entirely mute;
  • Inability to find the right words for the right context, creating misunderstandings;
  • Speech can become chaotic, erratic, overloaded and maybe not understandable;
  • Become very anxious and insecure about myself, questioning every action/decision;
  • Unable to initiate actions or make any choice or decisions (anxiety, insecurities);
  • Fail to dare usual routines and actions like travelling, calling, cooking, etc..;
  • Make (weird) noises, murmurs or weird body movements (stimming behavior);
  • Starting to talk against myself or start to loudly verify things in a OCD/hectic way;
  • It can make me mad when too many things keep to frustrate or provoke me;
  • Sometimes a situation can make it not able to trust people or places anymore;
  • Uncontrollably forcing up the muscles that they hurt till weeks later;
  • Hit my body parts (legs, arms, chest, head) to replace sensory overloads with pain;
  • Hit my head against the wall when brain is overheated. Please try to stop/relax me.

I will never use any form of aggression to any other person, except when I need to self-defend against physical aggression, when my freedom has been taken away or at non-consensual physical body contact which cannot be stopped after warning. 

An example of what happens during a meltdown in full detail can be read here and here.

What can(‘t) I do during a meltdown? How to relax?

It is of upmost importance to not let a meltdown escalate, to go deeper in severity. A meltdown is a non-controllable chemical process (the release of hormones) happening in the brain which has to be regulated again before it can stop and return higher functions.

Follow these guidelines to control the meltdown as trusted person and not make it worse or more intense:

IMPORTANT : When not possible to stay calm yourself, tell me you are gone for a minute or two, walk away and (re)try these guidelines after your short break:

Communication guidelines:

  1. Try to relax me: bring me to a quiet area and make me feel safe/protected;
  2. Talk to me in a easy and slow way with soothing voice. Keep the talk light;
  3. Always keep calm and NEVER use any form of verbal/physical aggressiveness;
  4. DO NOT PROVOKE negative reactions, witty remarks, with nasty words or deeds;
  5. Ask questions how I am or what can be done to help me to get relaxed;
  6. Inform people around me that I have autism and apologize for it’s confrontation;
  7. Do not ask to stop/control a meltdown/reactions of it, to prevent it to escalate badly;
  8. Do not confront me with life-altering decisions, impossible situations or demands;
  9. Try to empathize, try to understand it is difficult for me. Never yell or act annoyed;
  10. Keep showing respect, dignity and a certain amount of compassion.

Practical guidelines:

  1. Get me a drink with sugar, or give my headphones with relaxing music;
  2. NEVER stop stimming behavior, EXCEPT when it could threaten my health;
  3. Never take away my freedom (the opposite of feeling safe) or belongings;
  4. Don’t expect or plan anything at this moment and take all time needed to relax;
  5. The feeling of being understood (empathize) helps a lot in dealing with a meltdown;

What happens after a meltdown?

Mostly there is that mental extreme exhaustion following up with physical exhaustion, insomnia, depression, sudden drops in immunity system, create digestive problems, render me unable to communicate adequately with unknown people for a while, make me unable to do essential things or follow-up tasks. Loosing any hunger or apatite.

Mostly, I am ashamed, depending how severe the meltdown was and if it happened in public or in private. When it happens in public I am ashamed for what people might think about the way the meltdown has occurred. I had less than a dozen severe meltdowns in public in my life, which is a comforting thought. Knocking on wood.

How long can a meltdown last/stay invasive? 

The duration and impact of a meltdown is depending on how invasive the situation was and the severity of how the situation brings a threat to personal security and freedom, well-being and/or quality of life.

A light meltdown will mostly take up to an hour, mostly depending how fast I can relax my mind. A severe meltdown can take up to hours and sometimes days (when very invasive) to recover and be fully healed from. Very invasive examples are: grief, relationship problems, heavy aggression, power abuse, huge life-changing events or extreme changes…

When having a (verbal) fight with a trusted person, it is most important to talk this out as fast as possible, advisably before the day ends.

The severity of a meltdown will only go down when I am ready to understand and cope with the nature of the situation and finding a solution to fix that situation, preferably with as least possible life-altering events and/or consequences.

When having a (verbal) fight with a trusted person, it is most important to talk this out as fast as possible, advisably before the day ends. This solves the issue itself in a most adult and respectful way, it clears out remaining confusion or misunderstandings and it makes me understand certain things better from my side. I cannot start to recover from such meltdowns when I stay in fear, doubt and/or insecurity about an issue that has happened. Finding an adequate solution in (an as short possible) time makes it faster and easier to start recovering from a severe meltdown with a considerably less amount of time to have to heal from it.

When I am in meltdown it is imperative to talk slow, precise and clear, while verifying important key-points to be understood clearly. As long as the stress hormones are flowing in the brain, it is important to avoid adding any more stress at that moment.

How to prevent a meltdown to happen?

The best way to prevent a meltdown in advance: have enough rest and sleep, have as least worries possible in order to have a good focus, not be (too) hungry or thirsty, to be prepared in advance to avoid any surprises, to keep a fixed amount of structure and order, have everything ready, to deal with insecurities as fast as possible, to have support in life-changing conditions like grief, avoid too much over-stimulation (bright lights, heavy sounds, strong smells, too much body contact (with strangers)…

To prevent a meltdown on the spot: any form of stimming, find a quiet spot to retreat before the meltdown happens, explain that changing fixed routines are invasive, (have somebody) inform about autism and the limits (talk slow and clear, ask questions), be considerate, lower expectations, find solutions to things which do not work as they should, be rational when discussing, avoid verbal/physical aggression at busy areas, avoid fights or people that abuse power or trust, avoid big changes, to not push, keep me safe…

Mostly, a meltdown can be avoided in advance by evaluating all parameters which could cause me to cope or even run away from a situation. When being in the ‘coping phase’ there is only a small amount of extra stress which could push me into the ‘bailout phase’ (which is essentially a fight-or-run response)!

It is imperative to not push myself too much over the limits when having a difficult situation. When I do push myself over those limits, it is even more important to react fast enough to the ‘bailout phase’ when the pressure gets too high, to prevent a meltdown to happen.

When I am not able to run away from a situation, the meltdown will for sure happen. When forced to stay (for too long) in a problem area (with too much sensory overload), the meltdown will happen in a much more severe state, especially if I already tried to run away from the area without success.

Stimming can delay, easen up the situation and sometimes even prevent a meltdown.

Different levels/intensities of meltdowns?

For me, there are a few levels (and intensities) of meltdowns. Before a meltdown happens, there are several stages which happen before the meltdown. These stages are represented in a five-point scale. More info about this five-point scale: here.

These are the stages which happen (sometimes rapidly) before a meltdown occurs:

  1. fine: calm, don’t know, just fine!
  2. unsure/insecure: confused, embarrassed, shy
  3. coping strategy: annoyed, scared, insecure
  4. bail-out plan: upset, mad, verbal, ..
  5. Meltdown.

When the four stages have passed and the meltdown happens, it can have several severity levels depending on the cause and duration of the situation which triggered it. These are the general levels of how invasive a meltdown can be or evolve to when not taken care of:

  1. light meltdown: when a situation can be fixed easy in a short time-frame.
  2. medium meltdown: when a situation is harder to fix and takes longer.
  3. heavy meltdown: when a situation is unfix-able with life-changing consequences.
  4. severe meltdown: when a situation is unfix-able with (as consequence) a huge impact on personal security, well-being, quality of life, or life-changing events which I am totally not prepared for.

Facts about a meltdown.

Meltdowns are totally uncontrollable chemical processes and are mostly triggered by sensory-overloads and stress.

Every person with autism will have an own way of processing information and acting upon such. Some people with autism get entirely silent, some get aggressive or violent, some will start rocking movements or other stimming behaviors. Some will start to sing a song or copy sounds which are heard in the environment.

The information above is written with my own personal experience, for some people with autism there are other routines required to prevent meltdowns from happening or to relax when being in a meltdown.

The guidelines in the chapter “What (not) to do during a meltdown? how to relax?” are quite universal to any person with autism. You will mostly not do anything wrong to somebody in meltdown following those guidelines.

Other interesting reads.

 

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