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The “Lost Generation” of Autistic Adults

By Rachel Freeman

How does autism come to be diagnosed in adulthood? What impact does a diagnosis have after decades of living with undiagnosed autism? 

Autism used to be a rare diagnosis.  Ever since the definition of autism was expanded to encompass Asperger’s Syndrome and became autism spectrum disorder, it is estimated to affect 1-2% of the population.  Many clinicians have not been taught what this diagnostic change looks like in their practice.  Because many people’s symptoms were either misdiagnosed in childhood or were not recognized at all, it has become increasingly common to receive a diagnosis of autism in adulthood. 

Autism is a developmental disorder that has to do with differences in brain wiring and is NOT a mental illness. However, living with autism—especially if it is not identified for 40 or 50 years of one’s life—can contribute to traumatic experiences and feelings of anxiety, low self-worth, and isolation.  It is those feelings, left unaddressed, which can then lead to mental illnesses such as anxiety and depression. 

The years that can pass between the time someone suspects they are autistic to the time they receive a diagnosis can leave a person feeling misunderstood, ignored and even dismissed by health professionals. The presence of other diagnoses, such as mood disorders, can complicate the diagnostic process.  Many late-diagnosed adults discover their autism in the process of receiving treatment for anxiety or depression, or while their child is being diagnosed with autism. Many people seek a diagnosis after a lifelong feeling of being somehow different from others.  

Autistic people may: 

  • Find it difficult to understand facial expressions or tone of voice 
  • Find it difficult to understand social rules and to form friendships 
  • Be under- or over-sensitive to sound, touch and light (this can range from subtle to debilitating)
  • Have difficulty regulating their own emotions, and when emotions are high, find it difficult to think clearly and make decisions
  • Like routine and order and respond to change with a high level of anxiety
  • Place a high value on honesty, to the point of being blunt
  • Appear to be insensitive to others’ feelings 
  • Appear to behave strangely at times
  • Require very specific directions when doing something new
  • Struggle to find and maintain employment, despite intelligence and work abilities

Autism symptoms can vary vastly from person to person and require different levels of support.  Resilience factors can be present that help one cope with symptoms or lessen their impact.  For instance, the way one’s parents dealt with the symptoms in childhood can have a major impact on one’s self-worth and coping ability. 

The process of being diagnosed and its aftermath can feel like an emotional rollercoaster, but it can also change one’s life for the better.  Benefits of getting a diagnosis can include: 

  • Recognizing what has been wrong all these years, and realizing it’s not your fault
  • Being able to let go of impossible struggles and reframe one’s self-identity
  • A period of self-discovery, self-acceptance and even a sense of belonging as one interacts with others in the autistic community
  • Being able to be up-front about who you are and what you need from yourself and others
  • Helping you and those close to you understand why you may experience certain difficulties and what you can do about them.  It may correct a previous misdiagnosis and mean that any mental health problems can be better addressed. 
  • Unlocking a different version of yourself that has not had a chance to develop

You don’t need to be formally diagnosed, have it “on the record,” or share that diagnosis with others in order to experience benefits.  Sometimes just knowing you have autism can help make sense of life experiences, explain what you may have previously viewed as character flaws, and lead to discovering ways to support yourself with appropriate coping skills that reduce the negative effect of symptoms on your life, while increasing the effects of autism’s gifts.   A life with undiagnosed autism can seem full of failures to achieve goals that seem easy for others to achieve.  However, when you look at what you have been able to accomplish so far despite undiagnosed autism, it can be amazing. 

It’s Back to School Time Again

Summer has been flying by and the school year will soon begin anew. This year may look different than last year did for kids. That means the stress levels for both students and parents may be higher than normal.  Covid-19 has impacted all of us one way or another.  Last year your child may have done virtual learning, in school learning or a combination of both.  Your child may feel strange about going back to the classroom if they have been doing virtual learning. Classroom sizes may be larger than last year for those who were in the classroom.  The debates still rage about masks and vaccines.   

Sports and other extracurricular activities are starting up again making schedules more hectic.  Your student may feel concern over academics, social interactions and meeting new people, adjusting to a new school or new schedule, just to name a few things.  Even if your children are excited about the new school year, they may still experience anxious feelings as they go thru the transition to new routines. They will also pick up on your stress if you are worried about it.

Some stress is normal and can be positive, but too much stress is harmful for both the physical and mental health of you and your children. How do you know when it is too much stress?  Signs to look for might include feelings of anxiety, panic attacks, fatigue, sleeplessness, stomach aches, tension headaches, withdrawal from activities previously enjoyed, or unexplained sadness.  

How can you help your children manage their stress?  Talk to them. Help your child learn to recognize the signs of stress and anxiety.  Make a plan for what to do when they begin to feel anxious about things like homework, their grades or how to fit everything into their day. Make a list of activities they can do when they start feeling stressed.  Activities to help relieve stress could include taking a break to pet the cat, calling a friend, walking the dog, listening to music, physical exercise, and so on. Choose simple, calming activities that are easy to follow through with.  Make sure they have “un-scheduled” time to relax every day.  Establishing routines such as having their backpack ready, clothes picked out and breakfast planned the night before.

By knowing how to relieve your stress and helping them relieve their stress, you can help them feel good about themselves and have a successful school year.  You are your child’s best advocate. If you or your child needs professional help in overcoming stress and anxiety, we have therapists available for your needs.

Balancing the Blended Family

Being a parent is tough.  Being a stepparent is even tougher.  When a family goes thru divorce and re-marriage things can get sticky if you are not all on the same page.  If both you and your spouse have ex-spouses and children, the complications multiply.  It will take time to make the needed adjustments to balance your blended family.

Parents are often unsure of how to handle issues within the family regarding their child in relation to the new stepparent or the ex-spouse. The stress of trying to balance schedules, parenting styles, communication styles, discipline styles and other issues can seem overwhelming.  Whether it is differences with the stepparent or the ex-spouse, it is important to work on finding common ground for the sake of the children. For the health of your marriage and family, you want to work together, not against one another.  Children often put the blame on themselves for problems between their parents.  They may have a lot of anger and confusion over the breakup or new marriage, that they do not know how to express.  

Reaching out for help in dealing with these stressful issues can make a huge difference in the life of your entire family.  A counselor can provide a safe environment for communication between the parent/s and child.  If emotions are running high, communication strained and the problems are interfering with the relationships between you and your child or spouse, it is time to seek help. 

Some steps to strengthen your family may include establishing clear rules and boundaries, keeping all parents involved, regular communication, pre-planning, and setting aside time as a couple and individual time with the children.

At Pinnacle Counseling, we work with adults and children of all ages, and are ready to help you work through the uncertainty, the frustrations, and the growing pains of a blended family.

Holiday Stress with a dash of COVID-19

Halloween was not even over and we were already seeing the commercials, the Christmas movies and the store aisles full of Christmas décor, with a bit of Thanksgiving thrown in.  The holiday seasons are marketed as a time of cheerfulness and joyful family togetherness.  But for all too many, it can also be a time of intense stress, anxiety and/or depression.   

Many have jobs that are extra stressful and busy during the holiday season.  Others have family issues that leave spending time together as anything but a joy. The recent loss of a loved one may make the holidays difficult to face.  Too many events, not enough money, not enough time, and family pressures are just a few of the problems that can make the holidays dark and dreary rather than bright and cheery.  And now we have the very real concerns about gatherings and the risks of Covid-19 to top off the Christmas melee.  

It is important to look at what is causing you to be stressed, anxious or depressed.  Understanding the cause will help you find the best way for you to cope and manage your feelings.  You may find that techniques that helped you deal with stress other years aren’t working as well this year.  That may be because this year the stress is different.  Perhaps too many social events and trying to meet everyone’s expectations was your key stressor in previous years.  Now this year you may find yourself lonely and depressed as many choose to cancel the usual gatherings.  Perhaps the death of a loved has left you alone in grief and struggling with social distancing.  Working long hours while worrying about bringing home Covid-19 to your family may be a new stressor for you.

Connecting with others can help us beat the seasonal stress and depression, but that is difficult to do in a time of social distancing.  It is important to find new ways to stay connected to family and friends.  Social media, phone calls, and video calls are a few ways to stay connected.  Getting outside and walking can be a safe alternative for getting together to visit with a friend in person.  Writing letters and cards can help you feel connected to loved ones that are far away.

If you feel that is not enough to defeat your stress and depression and you think you need professional help to overcome your holiday stress, anxiety and depression, call us to schedule an appointment.

Learning to Live with Chronic Pain

Everyone deals with pain occasionally, but chronic pain is different.  Chronic pain is defined as pain that lasts for 3 or more months.  Injuries, nerve damage, migraines, arthritis, and fibromyalgia are just a few of the conditions that can cause chronic pain.  Living with chronic pain can have very real effects on your day to day living, your sleep and on your physical and mental health.  Activities you once took for granted – getting dressed, cooking, exercising, driving a car, going shopping, working, etc. – are suddenly difficult to do.  A restful night sleep may feel like a distant memory.  You may encounter secondary health issues such as high blood pressure, depression or weight gain.

The physical and emotional toll can be great.  You may feel weary and exhausted all the time.  You may find it difficult to focus at work.  Your emotions may be taking you on a roller coaster ride ranging from discouraged, frightened, confused, angry, or depressed.  You may feel very alone and hopeless.

There are many things you can try to help you live a fuller life despite chronic pain.  Depending on the cause of your pain, methods that work for you may be different than for someone else.  

  • Nutrition – eating nutrient dense food, staying hydrated, and avoiding unhealthy foods, smoking and alcohol can all help reduce pain and improve your ability to relax and to sleep better.
  • Relaxation – using deep breathing, getting a massage, taking a bath or doing meditation can help relieve tension in your muscles and help the body to relax, reducing pain.
  • Reducing stress – like relaxation techniques, relieving stress in your life can promote relaxation and give relief from pain.  
  • Movement – when you are in pain, exercise does not sound very appealing, but even small movements have a pain-reducing effect.  Arthritis will get worse if you don’t move.  Gaining weight will cause more stress on your body and can increase pain. Walking and yoga are just two low impact forms of exercise that you can try.
  • Documenting – Keep note of your daily activities and your pain levels.  Take this to your doctor at each visit so you can both understand what is going on – what works, what makes it worse, etc.
  • Distraction – Find activities that you enjoy that can distract you from focusing only on your pain.  Find a companion to do activities with.
  • Counseling – See a mental health counselor to help you learn better coping skills and to help avoid or deal with depression.

Two of my favorite coping mechanisms are walking outdoors / enjoying nature and soaking in the tub with a good book.  What works for you?  

If you are living with chronic pain and need help to improve your coping skills, please call us at 479-268-4142.  In this time of social distancing Pinnacle Counseling is offering both TeleHealth and in-office services, following all CDC safety guidelines to protect everyone.  We are here to help!

Controlling Our Lives During a Pandemic

A few years ago I wrote a blog article about ways to control or not control our lives.  In that article, I talked about the factors in our lives that are out of our control and what factors we can control.  Never has it felt more applicable than right now.  This new, uncharted situation we all find ourselves in might leave you feeling confused, uncertain of the future, unsure of what to believe, and frustrated with it all. 


You can’t control the pandemic or all of the ways it has affected your home and work life, but you can control how your lifestyle impacts your chances of becoming infected and your mental health being affected.  We can choose healthy behaviors such as eating nutrient dense foods, exercising, getting enough sleep, social distancing, wearing a mask when you can’t avoid going out and focusing on the positives can decrease the risks.


Trying to control the uncontrollable will only create anxiety and stress in your life.  We don’t know how long this will last or if life will ever go back to being quite the same. If we don’t acknowledge the feelings that we have and deal with them, it can create unresolved anger that can then lead to depression.


By focusing on the areas in your life that you can control, you can begin a journey to better mental health.  What uncontrollable things can you let go of and where can you take control?  Unmanaged stress and anxiety can lead to feelings of helplessness, fatigue, apathy, health issues, and depression.  Managed stress gives you greater strength, more energy, enthusiasm, confidence, success and joy.


If you would like to talk to a counselor that can help you understand what is happening to you and give you some guidelines on how to cope, please call 479-268-4142.  In this time of social distancing Pinnacle Counseling is offering both TeleHealth and in-office services, following all CDC safety guidelines to protect everyone.  We are here to help!

Is My Childs Anger Normal?

Is My Child’s Anger Normal?  Intermittent Explosive Disorder

Are you wondering if your child’s emotional tantrums and anger is normal?  You aren’t alone.  Most young children have occasional temper tantrums.  It is normal for a child to become angry when frustrated or when not wanting to do what they are told.  This is especially true for younger children who are still trying to develop their abilities to recognize how they feel or how to vocalize what they feel or want.  Their only way to communicate is through their actions.

If your child is having frequent outbursts and can’t control their anger most of the time, it may be time to be concerned.  Some signs to look for are the frequency of the outbursts, the age of the child (over 7 or 8), are the actions of your child becoming dangerous to him/herself or others, is the behavior interfering with school, is the child having difficulty getting along with his/her peers, are the outbursts causing conflict within the family, is there escalating defiance at home or school?

Emotional acting out is usually a symptom of another problem.  It is important to understand what is behind the acting out.  Children with ADHD have difficulty controlling their behavior.  Children with anxiety have a difficult time coping with stressful situations. Anger may help them avoid the situation that is causing the distress.  Trauma, abuse, neglect, undiagnosed learning disorders, or other stresses may cause uncontrolled anger.  Dr. Nancy Rappaport, a Harvard Medical School professor who specializes in mental health care in a school setting says, most at risk are kids with ADHD who’ve also experienced trauma.

Intermittent explosive disorder (IED) is defined as short episodes of intense, uncontrollable anger or aggression with very little or no apparent cause.  What seems like small, inconsequential issues to others, are seemingly blown out of proportion by the child exhibiting the IED.  They may become argumentative and/or physically aggressive.  They are overcome with anger and are not able to control their behavior.  Often, after their rage is spent, they feel a sense of relief, but will also feel ashamed of their behavior.  

When dealing with a child who is having an IED episode, it is important for you to stay calm and in control.  Praise your child for appropriate behavior.  Help your child practice appropriate choices when they are not upset.  Develop a system of time outs and positive rewards.  Look for triggers and work out plans to avoid them.  There is not a specific medication for IED, but medications, including antidepressants and anti-anxiety medications can sometimes help, along with cognitive behavioral therapy.  

If your child is having frequent angry outbursts that are causing conflict within your family it is important to get professional help for your child and your family.

Domestic Violence during Covid-19

You can’t watch the news today without hearing updates about Covid-19 and how it is affecting our lives in more ways than just our chances of getting sick with it.  Cases of domestic violence have increased with more families being confined together at home in extremely trying times.  Health worries, job and  income losses, home schooling, working from home, fear of how to pay bills and provide food, the list goes on and on.  You may be dealing with one or all of these issues.  The stress takes a toll on our emotions and when in close quarters that stress can come out as anger towards those nearest to us. Though women are the predominate victims of domestic violence, children are also at risk while confined at home with their abusers.

We are told it is important to stay home and be safe from Covid-19, but what do we do if home isn’t safe?  You may feel your support system has been cut off, while emergency services, shelter systems, and social services are being overwhelmed by the pandemic.   

 The National Domestic Violence Hotline has highly trained expert advocates available 24/7 to talk confidentially with anyone who is experiencing domestic violence.  You can call 1-800-799-SAFE (7233) to speak with an advocate.  Individuals who are deaf or hard of hearing may use TTY 1-800-787-3224.  Another option for getting direct help if it isn’t safe for you to call is to use their live chat service on their website

If possible, it is beneficial for both parties to seek couples counseling before the violence escalates further. If your partner is unwilling, you can still talk to a counselor that can help you understand what is happening to you and give you some guidelines on how to cope.  In this time of social distancing Pinnacle Counseling is offering TeleHealth services.  If you are needing help, please call 479-268-4142.

Generalized Anxiety vs. Trauma Based Anxiety

Anxiety is an oversimplified word used to cover an entire group of different types of anxiety disorders. Not all anxiety is the same and neither is the treatment for them.

According to our therapists at Pinnacle Counseling, Anxiety Disorders are a group of mental disorders characterized by significant feelings of anxiety and fear. Anxiety is a worry about future events, and fear is a reaction to current events. These feelings may cause physical symptoms, such as a fast heart rate and shakiness. There are several anxiety disorders, including generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism. The disorder differs by what results in the symptoms. People often have more than one anxiety disorder.

Trauma-based anxiety is generally considered to be under the category of Post-Traumatic Stress Disorder or PTSD rather than in the group of anxiety disorders. When we hear PTSD usually the first thing that comes to mind is soldiers returning from war or victims of extreme violence such as a mass shooting. PTSD can be from a one-time event or an ongoing situation. There are many types of situations that can cause emotional and psychological trauma – an accident, natural disaster, a violent attack, losing a loved one, physical or sexual abuse, etc. Being a witness to a traumatic event, such as a horrific accident, can have as much impact as being personally involved in the event.

When we experience generalized anxiety our mind/body is responding to a fear of what might happen that may or may not be realistic. Some anxiety is normal and healthy. It helps us prepare for an unknown event, like going on a job interview or to quickly react to a potential threat. But when it is happening on most days about a wide range of situations or issues, it can start negatively affecting all aspects of daily life.
When experiencing trauma-based anxiety our body is responding based on what it already knows can happen. It has experienced the worst-case scenario and knows what can happen and no longer feels safe. Symptoms can include flashbacks, nightmares, irritability, feeling faint, sweating, shaking, panic attacks, and can result in avoidance of situations that may cause these to happen.

Many of the symptoms of generalized anxiety overlap with the symptoms of trauma-based anxiety. Common symptoms of both are lack of focus, depression, difficulty sleeping, losing interest in the things you used to enjoy, drinking or using drugs to avoid the stressful feelings and memories. It is not uncommon to experience more than one type of anxiety at the same time as PTSD.

If you have experienced a trauma and have unsuccessfully been treated for anxiety, there is hope. There are effective therapy techniques to treat PTSD. You can contact our office for an appointment to get help in managing your symptoms.


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