Do meds help with autistic executive dysfunction? Advice needed.

[subterraneanalien]

My 25yo DS is diagnosed autistic (used to be termed Aspergers). He lives independently but his life is getting more and more chaotic and disorganised. What makes things worse for him is that he recognises what he needs to do, sees his failings and failures (not my terms) and this adds acutely to his anger, anxiety, self-loathing and depression. He 'self-harms' by lashing out and hitting walls and things when he gets overwhelmed (he thumps his own head until it's bruised) and today I took him to A&E where they x-rayed his hand – he's broken a bone and now he's in plaster.

I feel he can't help himself effectively until he's in a better head-space, but he evidently can't get to that state of mind without help. Would medication be a good idea? If so, what, and would a GP be the best first port of call? Lovely as GPs are, they are not specialists. I'd be grateful for any advice.

I don't know of any meds which help with executive dysfunction but there are meds that help with anxiety and depression which could help him.

The GP would be his first call but he sounds like he needs a psychiatrist or mental health nurse too.

Does he live alone? There is support services to provide housing support which can help him with his everyday living skills.

Thanks for your reply Gingerkittykat. We've been encouraging him to find a counsellor for ages, he knows and agrees it would be useful to have therapy. Ironically he had a phone appointment with one this morning which he had to cancel because of needing to go to A&E.

He lives with his on/off girlfriend; it's complicated. He also lives on site with his work (market gardening) with the landowner who has his own mental health issues, so all in all a fairly toxic at worst, unhelpful/unsupportive at best, environment. I think a visit to the GP would help but I'm not confident that DS will give the full picture/ask the right questions/and be assertive enough to push for real help. I think he also has a prescription for sertroline but his executive dysfunction means he often doesn't take it.

I wish there was a one-stop-shop with the answers for my son 😢

In conjunction with psychological therapy yes. He prob has a lifetime of negative self esteem and social issues. It's appropriate.

My ds is younger though adult and more severely impacted. Exercise really really helps. I mean training not going for a walk. What about cycling a few miles every day as a start and seeing if it helps.

You could always post this in the SN chat topic

Hi, what's SN Verbena17? Thanks for your reply.

Yup goingbananas89, his self-esteem is below zero, and he doesn't think he's worthy of love or sympathy. That's why I think med help in conjunction with therapy is necessary, he needs a kick-start. I'm glad you think it might be a good idea.

Yes physical exercise is always a good idea, but he works outside all day everyday, very physical and I think 'exercise' would finish him off!! But he loves walking. He recognises beauty in the natural world and gets great comfort from it

@subterraneanalien lots of people work hard physically and go to a gym or exercise. It’s therapeutic. Personally I’d try it before drugs.

@subterraneanalien the Special Needs Chat talk topic.
there are various ones - SN Teens/young adults, SN Chat etc

https://www.mumsnet.com/talk/special_needs_chat

I'm autistic and my EF is shocking so following

I have wondered if adhd meds would help as they seem to help EF I'm adhd..