Friday, May 11, 2012

Managing Mood Swings



Marisa was having an unusually bad week. She cried over things from the past ... things she missed doing perhaps a year ago or even 5 years ago. She cried over missing a friend. She cried over missing camp, since she had outgrown it and was not going to return this summer to the warm familiar surroundings she had come to know as her summer place for the past 8 years.

What was I to do! I sympathized and assured her that there were new and exciting things that would replace the familiar, comforting memories of her camp life and all that it entailed. This  included friends and counselors she adored from far away places.

"I want to visit on visiting day!" she would say. "That will make me happy?"

"If you want to travel 5 hours to visit for an afternoon, we can arrange that if it's so important to you," I said. I realized that it didn't pay to make her feel more unhappy than she already was. After all, things could change over time, why not set her mind at ease? Maybe we would visit, but then again, maybe there would be some summer activity in her schedule that would make her want to change her plans to visit camp, and opt for the new activity instead.

There are always reasons for the mood swings Marisa has. At this particular time, I knew that premenstrual hormonal changes most likely played a roll in her turbulent feelings. At times like this I would go to the calendar and help her understand her emotions by pointing out the time of month and explaining to her that some of her sadness was related to that. It often would help her to get her feelings under control. At least there was an explanation for the onset of sadness, but hormonal mood swings could be a big problem out in a public setting.

For example, a month ago Marisa had a tantrum at her dinner club, because she arrived late and didn't get a chance to sit next to the friend she wanted to sit with. Someone else had already claimed the seat. She couldn't control the emotions and frustration she was feeling. She lost control and her anger and disappointment erupted in piercing screams in the restaurant where other patrons were gripped with fear at the scene that erupted. Some might say that people should understand and be accepting of the problems related to people with disabilities such as autism. Still, that doesn't make it okay.

I said to Marisa, "If you want to be able to be out in a public place among other people enjoying a meal, then you have to manage some self control. You can't use the excuse that you have autism. You can't use the excuse that you have PMS either. You need to earn the right to be out there in public enjoying all the things that neuro-typical people do."

When Marisa was little, I helped her manage self control by earning points towards a special reward. It was a strong motivator for her, but now as a young adult, she and I had come to  an agreement. We both agreed she was grown up enough to realize that earning money from her jobs was a strong enough incentive to behave properly at work. Likewise, she agreed that controlling her behavior in public situations was important, if she was to be able to participate in fun activities.

"You lost control and scared everyone in the restaurant including your own dinner friends and the counselor in charge. Now you'll have to work hard to regain their confidence in you," I explained.

I considered the restaurant incident to be a disappointment. It was to Marisa as well. She was sorry for having displayed the outrageous outburst that frightened everyone in the restaurant. But there was more to the incident than disappointment. It was also an opportunity to learn and grow from.

PMS most likely played a role in the tantrum that erupted that day, but it wasn't fully to blame. Marisa had arrived late to the restaurant. She was never happy to be late anywhere. Being late had been my fault. Granted, we need to manage our disappointments. Things don't always go perfect and smoothly, but at least it helped explain the outburst. Nevertheless that didn't excuse it, but it helped to talk it over with Marisa, so that she could better understand the things that contributed to her lack of control and perhaps learn to manage it better next time.

"No matter how bad you feel, and no matter how angry you are, it's never okay to have a tantrum in public. It doesn't solve anything and will only make things worse. You risk losing privileges when you lose control. You're allowed to be disappointed, but have to learn to accept that."

"I'm so sorry!" she said. "I'm not a baby. I can't have a tantrum!"

"Nobody's perfect," I reminded her, "but you can do your part to be the best you can be! Think things out, remembering that there are always consequences for what you do. Tantrums are never the solution to a problem."

"I'll try harder next time!" was her response.

I hoped that talking about the incident helped prepare her for the next disappointment she might be faced with. Learning to accept the good and bad in life makes us all stronger for having the experience. When Marisa is faced with another disappointment, I hope she will be better able to accept the challenge and rise to the occasion.