Meltdowns and tantrums: know the difference

I’m vexed at how the word “meltdown” is being slowly hijacked by the general population, and used to describe someone having a massive tantrum. Let’s be clear right from the start: an autistic meltdown is not a tantrum. Not even remotely. Not ever.

A tantrum is defined by Chambers (12th ed.) as “a sudden fit of childish, uncontrolled bad temper or rage”, and has the synonyms: temper, rage, fury, storm, outburst, fit, flare-up, blow-up, scene, paroxysm, paddy, and hissy fit. A tantrum is what people (aged two onwards) have when they’re angry about not getting their own way.

Meltdown (in the non-nuclear sense) hasn’t made it into Chambers yet, but online sources define it as “an emotional breakdown” (The Free Dictionary), “a very fast loss of emotional self-control” (Merriam Webster), and “an uncontrolled emotional outburst or a mental collapse” (Oxford Dictionaries). Synonyms include: freak-out, crack-up, fit, disintegration, collapse, tantrum, hissy fit, breakdown, angry, and crazy.

Sigh.

What is a meltdown?
Firstly, let me tell you again what a meltdown is not: it is not a tantrum, a hissy fit, or a mere loss of emotional control – any emotions I experience are the result of the meltdown, not the cause of it. In reality, it goes much, much deeper than that: a meltdown is a processing failure, like when a computer becomes overloaded with too many instructions, and goes haywire. A meltdown is a loss of cognitive control – I can no longer think. If we use the analogy of an epileptic fit as a hardware problem, a meltdown is the software equivalent.

What triggers a meltdown?
Many of my stress-triggers are the same as neurotypical people’s (anxiety, fatigue, illness, hormones, low blood-sugar, conflict, overwork, etc.). Then add the autistic stressors that neurotypical people somehow filter out: noise (particularly sudden loud noise), bright lights (particularly flashing ones), visual clutter (e.g. too much mess, traffic, people), frenetic activity, unwanted physical contact (including from my own clothes), any change or disruption to normal routine (including expected change, like going on holiday or redecorating), having to socialise (including with friends), all the noise in my head, etc. Throw too many of those at me at once, and I just cease to function.

Sometimes, it might look like the meltdown has been triggered by my not getting my own way, e.g. disruption of my plans; but in that case, the need to work out how to manage my day differently from how I’d planned (in order to accommodate someone else’s plans), on top of all the other things I’m trying to manage, becomes the final processing-request that freaks out the computer. It’s not that I’m unwilling to engage with the idea, I just can’t process it. Not at the same time as everything else.

What does meltdown feel like?
For me, the only emotions I feel during meltdown are extreme frustration, panic and fear. I am not angry – not in any way.

I’m frustrated by not being able to function properly (often because I’m failing to understand something, or make myself understood), panicked by being overwhelmed, and I’m scared because I can’t work out what just happened, what is happening now, and what is going to happen next. It’s not just that I can’t think straight – I can’t think at all. To begin with, the words I speak might stop making sense. I might roar, scream, shout, swear, and/or cry. I might pace about, and rarely I might throw things or hit things (only things, never people) – but even then… even if I appear to be in a rage… let me say this again: I am not angry.

Alternatively, I might go straight to the secondary stage (which I call ‘shutdown’ – like when a computer freezes altogether), where I can no longer work out how to speak or move. In this stage I curl up in a ball and become mute. I’ll probably close my eyes, put my fingers in my ears, and want to cover my head. I’m trying to shut it all out.

So you see, a meltdown is not a tantrum, and a tantrum is not a meltdown. They are totally different things. This is not to say some autistic people don’t have tantrums too, but it’s vitally important to know the difference.

A tantrum is a hissy fit, where the person is acting out his/her feelings of being hard done by. A meltdown is a loss of executive function brought about by cognitive overload, or in more simple terms – I’m temporarily unable to do anything that involves thinking, i.e. reason, remember, plan, problem-solve, or perform tasks: there is only chaos in my mind.

How to help me during meltdown (any hopefully other aspies too)

  • Please don’t panic – meltdown is a temporary state (like an epileptic fit), and I will recover.
  • I don’t need a doctor or medication – all I need is peace, quiet, and time.
  • If possible, get me to somewhere quiet – preferably with subdued lighting or no lighting at all. I will recover most quickly in silent darkness!
  • If there is a window, please close the blind/curtain.
  • Please do not touch me – very important (although for some people a hug will be calming).
  • Please ask other people to stay away, and try to ensure no one comes bursting into the room.
  • Please ask “what can I do to help?” but don’t press for an answer; many of us become mute in meltdown.
  • A glass of water will probably be welcome.
  • Please don’t offer or ask me anything else more complicated – I won’t be able to process the question.
  • You are dealing with a highly intelligent adult, so please resist any temptation to speak in a sing-song voice.
  • Please stay with me if you can, but at a distance, and please don’t try to make small-talk; this will seriously delay my recovery.
  • Bear in mind that once recovered, I will be exhausted, humiliated, and embarrassed, and will probably just want to go home. This is okay – once I’m functioning again, I’m perfectly safe to leave on my own.
  • I might not be able to express my thanks effectively at the time, so please don’t be offended if I simply walk away. I will be enormously grateful for your care and understanding.

This is a very personal subject, and one that’s close to my heart. Thank you for reading to the end.

©Leigh Forbes


Related posts
Living the Nightmare
Assaulted by the Detail
What’s Wrong with Labels?
It’s no Excuse

Autism Awareness Day – collected tweets

What’s Wrong with Labels?

People can’t help but label other people. Our fundamental labels of “friend” or “foe” are essential to basic survival, and the rest lead on from there. Subconsiously, we are asking ourselves “is this person going to hurt me?” or “is this person someone I want to become acquainted with?” or “is this person a potential partner?” In order to answer these questions, and calculate the potential threat-levels posed by other people (on all kinds of levels), we first work out how well they match with us: we look at their education, the way they speak, their ages, their clothes, their jobs, their interests, etc. And we label them in our minds. Ask anyone to describe the person sitting next to him, and he’ll say something like, “she’s thirty-something, brown hair, well dressed, middle manager…” or whatever. He can’t describe her (to himself or to other people) in any other way. He has to use labels.

The problem arises when people apply the wrong label. And I fall foul of this as much as anyone else: a mother at my children’s former school spoke in a particularly clipped manner, which I interpreted this as snobbery (the wrong label). I disliked her just for that reason. When someone told me she was foreign (the right label) – a fact that had been impossible to see through her impeccable English accent – my whole attitude towards her changed.

So, having said all that, some people worry that I allow myself to be defined by the “autistic label”. On the basis that I’ll never stop people sticking labels on me, I much prefer to be called “autistic” than all the other descriptives I’ve had stuck on me over the years.

So, there’s nothing wrong with labels, but there’s a awful lot wrong with the wrong labels.

Typical Autistic Characteristics How Society Choses to Label Them How Society Could Label Them
Uncoordinated cackhanded restricted proprioception
Keeping oneself to oneself unsociable private
Stimming retarded harmless
Doesn’t get the joke thick differently humoured
Laughs more loudly than others annoying gets your joke
Says the “wrong thing” rude mistaken
Identifies ways to improve critical useful
Doesn’t understand teasing oversensitive differently humoured
Prefers not to make eye contact guilty retiring
Likes routine and organisation awkward organised
Free thinking dissenting thinks outside the box
Keeps odd hours creepy polyphasic
Wears comfortable clothing scruffy self-caring
Interested in detail pernickety attentive
Uncertain of how to interact standoffish shy
Interested nosy interested
Trusting gullible trusting
Honest tactless trustworthy
Sticks to the rules dogmatic law-abiding
Keen to share ideas opinionated contributing
Happy to talk about interests boring sharing
Prone to anxiety weak has a lot going on
Likes to plan ahead fussy organised
Wary of others paranoid bullied
Hypersensitive to light/noise/etc. intolerant amazingly tolerant

Please help by not perpetuating negative terms, but by encouraging the positive terms instead.

Online Tests for Asperger’s syndrome

Having once been through the agonies of wondering if I were “aspie enough,” I’ve written a brief article about online tests, in particular the Rdos test. I’ve included a number of Rdos graphs to illustrate how varied results can be, even amongst formally diagnosed aspies. I’ve also included a neurotypical graph, to show just how different it looks on the same scale!

The page is here: Online Tests.

A Mild Form of Autism?




This tweet was prompted by an incident at an autism-awareness event last month. Towards the end of proceedings, I spoke to the assembled company about Asperger’s syndrome being a hidden disability, and how my already considerable difficulties were worsened by society’s expectations of normality. I said I wanted people to understand that, just because I look normal and can (for short, exhausting, periods) put on a performance of normal, there is nothing mild about having Asperger’s. There were calls of agreement from the audience, an autism-friendly round of applause, and I went back to my children – their little faces glowing with pride that their mummy had stood up and spoken.

Next up was a woman who had a son with severe autism. Bristling, she spoke about how severe her son was, yes, very severe, and how you might see the two of them around town, and how you couldn’t miss him because he was so severe… Something inside me died. Even to me, it was clear I had offended her, about which I was mortified, but she had misunderstood me; she thought I was saying all forms of autism are the same, and that I thought I suffered as much as her son. I confess, I nearly burst into tears on the spot.

I hate conflict, and in particular, any division within the autism community; but there is a division, isn’t there? Right there: the devision between people with severe autism and people like me. I can see why their carers think I’m so very lucky: I can talk, I can drive a car, I am married and have children (and a realistic hope of grandchildren). I even have a job. What more could I possibly want?

For the next three hours I considered giving up autism advocacy. I questioned how someone with my lack of subtlety can possibly get across something as important as autism awareness to the general community? Hell, I couldn’t even get it across to the autism community. But a pep-talk from an aspie friend put me back on my feet; I took out my phone, wrote that tweet, and Twitter completed the rescue.

So, sure, Asperger’s syndrome can be considered mild when compared with severe autism. It can be considered mild in the same way as losing a leg can be considered mild compared with paraplegia. But do we refer to amputation as a minor injury? Do we go around telling amputees, “count yourself lucky you’re not paralysed”? No. We do not.

That severe autism exists, does not make my life any easier. And nor do my struggles detract in any way from the enormous difficulties facing severely autistic people and their carers. I’m a huge fan of positive thinking – I can talk, I can drive a car – and being positive helps me in so many ways. But it does not cure me. However lucky I might be in comparison with other people, I still struggle with my own, very real, issues.

So, please, don’t take what I say, then add a “yes but…” and list all the things that could be worse. Please just hear me: I’m not saying there is no severe form of autism, just that there is nothing mild about having Asperger’s.

Detailing the Big Picture

This morning I did well. The small girl’s tooth is hurting, and I needed to tell her teacher about it.

Okay, here’s the backstory: many of the small girl’s baby teeth came through calcified, meaning the top layer of hard enamel is soft in places (like chalk), and wears away easily. The upshot is, regardless of how much care she takes of them, her baby teeth (particularly the molars) are rotting before they fall out. Fortunately, her adult teeth are coming through strong and well-formed, so the problem should not last forever; but in the meantime, she has a chronic problem with her teeth.

Earlier this year, one of her molars became infected. She developed a “gum boil” (where the infection bulges out of the gum below the tooth), which mercifully relieves some of the pain, although causes its own discomfort. The dentist said we could pull out the tooth, or “jolly it along” until it falls out of its own accord. The small girl is only seven, and this tooth is not due to fall out until she’s eleven, but he and I both felt we wanted to keep it going as long as we could. He packed a disinfectant-steeped wadding into the cavity and filled it. After a course of antibiotics the gum boil, the pain, and the worst of the infection had vanished. But we were warned it would return.

Six months later, her tooth has became infected again, the gum boil has reappeared and the pain has returned. So, yesterday, we went to the dentist again. He took us back round the decision-making loop (we’ll have to do this at least half a dozen more times over the coming years), but the original “jollying along” plan still looked like the best. He replaced the disinfectant wadding, refilled the tooth and told us to come back when it flared up again.

This morning, the gum boil has gone down, and her pain is less, but she has a bad taste in her mouth from the disinfectant (it will take a few days to wear off), and it’s distracting her.

As an aspie, I find it almost impossible to pick out those details that are important to other people, especially when I don’t have time to think about it: I’m unable to tell instinctively what someone else wants or needs to know. But this morning, like I said, I did well. We had already arrived in the playground before the small girl asked me to speak to her teacher. With no time to prepare, my brain wanted to tell the whole story, as above (because that’s actually much quicker for me than weighing up individual points and trying to second-guess how much value the small girl’s teacher will attach to them); but I stopped myself. Despite the whirling explanation in my head, I managed to say only the words in bold. Didn’t I do well?!