Expert: Trey McGowan - 3/18/2008

Question
I am a 20 yr old female who has Asperger's and in late December last year my doctor put me on Anti depression meds Doxepin for anxiety and sleeping problems and told me to go to a counselor. I am going to a counselor,but sometimes they ask me what the thoughts I am getting in my brain. I don't really know what the thoughts are that I get. Also can't understand my feelings and connect it to any thing. Lately my the medication I am on is not working, sometimes I can go to sleep and other times I can go to sleep. I'm still feeling totally anxious all the time and am really tired in the morning. What would you suggest I do, and what medication would you suggest that I go on. Thank you for your time.


Answer
Hi there, Gabby!

First off, as I am not a doctor, I can't prescribe (even casually) any other drug for you to be on. That has to be done by your doctor, or registered nurse. So while I can say a few drug names on, it is not a prescription, and shouldn't be taken as such. I can, however, give a few general suggestions and you can ask your doctor if they might be right for you.

Antidepressants, in the case of people who are bipolar, rather than just depressed, can sometimes have an unexpected effect: they can elevate the depression, yes, but they can also *over*elevate the manic episodes. This can lead to moments of anxiety and sleeping issues, and possibly other, more troublesome effects. It doesn't always happen, but it definitely does happen. So if you are having periods of anxiety while on the drug, maybe ask your doctor about a mood stabilizing drug, and whether it might be right for you.

If he is looking for one that sedates, as well as treats, Seroquel is one of the more popular ones where I used to live (in Tennessee). It is used for schizophrenia and bipolar, and seems to be effective with both.

As for the psychiatrist, I think you should definitely go and see one, but take the time to look for one who has dealt with patients with developmental disorders. If you are in or near Canada, look around for 'Dual Diagnosis' specialists. They deal with exactly that: people with developmental disorders and mental health issues. In the states, it is also called 'Comorbid Disorders', which can include alcohol and drug abuse along with mental health, so make sure that you double-check which of the specialties the individual is dealing with when you find one. The specialist should be able to help with the thought processes, and be able to work with you in a way that you can comprehend and verbally explain. Or at the very least, write down.

If you are unable to find one, I suggest bringing it up with the therapist when you go and talk to them. Explain to them that you are Asperger's Syndrome, and have difficulty understanding and expressing your feelings. While they are not specialists, many of the doctors will have had at least some training in how to deal with this, and should be able to work around it. At the very least, they may be able to work with you and help you find someone who can.

Hopefully this has been a help to you! As always, feedback, questions, comments, follow-ups, whatever, are always welcome. :)

Trey