Wednesday, October 29, 2014

Small things matter: hunger, meltdowns, and coping skills

By Aiyana Bailin

Let me preface this by saying that I don't have a formal ASD diagnosis (just various mental illness labels), and am unsure whether or not I'd qualify for one. What I can say is that, throughout my life, I have had various small but very significant gaps in what is considered "normal" functioning for someone of my age group. Many of them are common among autistic people. Some of them were easily overcome or managed, others not so much.

I want to talk here about one that caused me quite a bit of grief before I learned how to cope with it, but which was actually quite easily accommodated once I understood it.

I'll begin by noting that I struggle with eating sometimes. My appetite varies wildly according to numerous factors from stress level to time of the month, and I can easily forget to eat altogether for the better part of a day, or more. I've been known to faint before realizing I was hungry.

I was lucky to grow up with a mother who put food in front of me three times a day, so I ate quite regularly as a child. The downside was that, when I became a teenager and began spending more time out of the house, I didn't yet have the ability to notice for myself when I needed to eat or take appropriate steps to acquire food before I collapsed.

And here we run into the real problem, which is that sometimes, when I haven't eaten recently enough, and especially in the morning before my first meal, I cannot function. I don't mean I am grumpy or groggy or poor at making decisions. I mean that, intellectually and emotionally, I revert to essentially the same level as a tired toddler. I can't make the simplest choices. I burst into tears at minor frustrations and then can't stop crying. I'm very nearly helpless, particularly if anyone asks me to do or think about anything that I can't do on autopilot.

My mother and I really discovered this shortcoming on my college tour trip. We had stayed overnight at a hostel, and in the morning we dressed and set out to find a place to eat breakfast. My mother asked me what I wanted. I wasn't sure. She questioned further, trying to get a better idea or a decision. I became mildly hysterical. I have a vague memory of standing on a sidewalk in tears, wailing "I don't know! I don't know!" over and over while my mother looked on in shock and confusion at her college-bound, nearly-adult daughter going entirely to pieces over the question "what do you want for breakfast?" I was completely out of control in what I now recognize as a meltdown.

Somehow, Mom got me calmed down and into a cafe, and I managed to order something. Within minutes of starting to eat, it felt like I returned to awareness after having been only dimly conscious of myself. I still felt shaky, but I was suddenly rational again, able to control my emotions, to think, to focus. The feeling of panic and overwhelm was gone.

"I think," I said, eventually, "it may be best if, in the future, you don't ask me any questions until I've had something to eat. You can choose for me next time, ok?"

"That sounds like a very good idea," said my mother, who was a bit emotionally exhausted herself by the ordeal.

It wasn't quite as easy as that. She's forgotten this rule sometimes, and I'm usually in no condition to remind her of it when that happens. Sometimes she doesn't know I haven't eaten recently until I melt down over something minor and she thinks to ask. Sometimes there are questions she needs an answer to before breakfast. Often, I'm fine up to a point-- I can answer certain questions better than others, or I wake up energized and am ok for a while before the need to eat sets in. Then it takes everyone, myself included, by total surprise when I suddenly break down.

I've become more adept at managing this over the years. I make breakfast plans the night before. I warn lovers and traveling companions about the hazards of questioning me before I've eaten or at least drunk something with calories in it. If we plan to dine out for breakfast (not a common occurrence), I eat a granola bar before leaving home.

Over the years, my primary tactic has become a lot simpler. Now there is always some kind of snack food on my bedside table. Usually, I admit, something with a fair bit of sugar in it-- a single-serve packet of cookies, for example, or a candy bar-- something I'm not likely to turn down even if I don't feel the least bit hungry. So I get some sugar into my bloodstream before I even get out of bed, and I find it helps me be more alert and functional in general (I've been tested for hypoglycemia, by the way, and I don't have it-- or any number of other metabolic abnormalities that have been suggested. Ultimately, though, in this case it hasn't been a diagnosis that made the difference, just finding a coping strategy). I'm sure plenty of people, including my mother, would disagree with me from a nutritional standpoint, but it works for me. And some days, it truly makes a world of difference.

Small things matter. Individualized coping strategies matter. Identifying needs and triggers can mean the difference between a horrible day for everyone and the complete opposite. It does no good to blame someone for going to pieces when they can't handle something, and it doesn't really matter why they can't handle it, either-- you just have to accept that they can't and work from there. Abilities can vary a lot with context. This story is the very simplified version-- lots of ups, downs, and variations actually occurred before this all ran smoothly. And my coping strategies still fail me at times, particularly if something interrupts my regular routine. But such failures happen less often now than they used to. Years of practice helped. Hang in there. Keep trying things until you find what works for you.


  1. Wow, I definitely relate to this :-) My experience with hunger is a little less intense than yours, but I have been known to have a mom-confounding teary meltdown when too hungry. I'm usually very aware of my hunger, so those times where it sneaks up on me always surprise me. Normally it's when I'm super engrossed in something that I forget to eat! Like you, I've learned to have a snack handy or eat something small when I expect it will be a while before I get my next meal. It's amazing what a different a little self-awareness and simple coping skills can make!

  2. I definitely relate to this too. It was awful when I was younger, in college up through most of my 30's. (I'm 42 now) I think it was worst when I was my thinnest, but could still be very bad when I weighd a lot more. It seems to have improved in the last few years, actually, but I am not sure why. My weight is actually down right now, but I handle being hungry better than I have in years. Anybody's guess, basically, as I also have had normal blood sugar readings the whole time too.