Dual diagnosis and autism.

Its been perhaps seven years since our adult son with autism, Adrian, was dually diagnosed as having a major depression as well as his autism. In his depressive state, he gets into rages, stomps his feet, attempts to bang his head on the floor, bite himself, and in the worst cases, bite others. As a 40 year old man who is about 200lbs and six feet tall, it can take a great deal of effort to control him during these rages.

Over these last few years Adrian has had drug therapy to reduce these rages, as well as "PRNs" to be administered to him to calm him down after a rage. Recently, these drugs seem to have been effective in that during the rages he makes ineffective efforts to bite others. Last night, for example, without warning he got into one of these rages and tried to grab my arm to bite me. I was able to shrug these efforts off and to redirect him to relax and calm down while Anne found the PRN pill.

Holidays with Adrian used to be fun times. In the 80s we would go camping in our trailer with Adrian and spend several weeks touring parts of the States and Canada. Now holidays are a period of time where my stomach is in knots as we watch everything we say or do as we wait for the next explosion. Adrian traditionally spends a week at our home for Christmas. Nowadays it is a tense time as we count down the days to when he returns to his group home.

He came to stay with us on Wednesday. We have had two incidents so far, and there are three more days before he goes back. Its not a most enjoyable season. And, there is the next holiday coming up in June that we traditionally have with him. In that holiday we usually take him to a resort within one or two days car travel of Ottawa. Plane travel is out of the question now. We dread the reaction during plane travel to a rage outburst by Adrian.

We also are very much on edge when we take him to visit his brother, sister-in-law and his nephew and niece. His nephew is beginning to ask questions about his Uncle Adrian and why he rarely talks.

As we get older, we feel less able to continue to share our lives with our son. Physically, we have less strength, and emotionally we are drained. Its a dilemma. How do we balance our safety and that of others against the need for Adrian to be with us and to be part of the family? Can we reduce the amount of time we spend with him without feeling overwhelming guilt? Should we even consider that? This is a topic we will have to discuss in the New year with the staff at his residence, and with his psycholgist.