Tantrums Prozac 24/11/2007 Michigan 8 Year Old Asperger's Patient Misdiagnosed With Depression: Becomes Worse on Prozac Summary:

Paragraph 7 reads:  "My brother's case involved a misdiagnosis of depression when he was 8 years old. In the third grade, my brother began to express suicidal thoughts and was put on Prozac. But the anti-depressants only agitated his problems. He began to put on too much weight, a common side effect of his medication. He stopped smiling in his school photos and started throwing screaming tantrums in class. A few years later, he was diagnosed with Asperger's, a condition my parents had never heard of, but after a little research, immediately recognized as accurate. The diagnosis didn't solve my brother's problems, but it explained them."

        
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My family's syndrome

By Jessica Vosgerchian: Assistant Magazine Editor on 11/21/07

My mom called me earlier this semester to tell me that my brother had gotten in trouble again. This time for a new indiscretion - he had stayed out too late with friends on a school night.

"I'm just so happy," my mom said.

We both were. For years, the idea that my brother could be punished for being too social had seemed impossible.

For my brother, a 17-year-old with Asperger's syndrome, the road through adolescence has been more than bumpy. It's been landmine laden. Asperger's is one of several lesser-known autism spectrum disorders that are beginning to penetrate the sphere of public recognition. The growing recognition of such conditions is due in part to research done at the University of Michigan. University psychologists diagnosed both my brother and dad with Asperger's syndrome about eight years ago.

Asperger's isn't easily identified, even by those familiar with the autism spectrum. Its distinct symptoms are expressed in small, ambiguous aspects, like my brother's incapacity to wear jeans because of a hypersensitivity to texture. Unlike more severe and better known conditions like Down syndrome, Asperger's affects social skills, not intelligence quotient. My very intelligent brother can explain to you everything from how a crab layers plankton on its claws to the scientific explanation of the effect of brass knuckles - he just won't look you in the eyes when he does.

It's now thought that one in 100 people have autism. Much of that 1 percent of the population is like my brother. They're the weird, loner kids in elementary school classrooms, the spazzes, the abrasive know-it-alls: people whose conditions are often misunderstood by society or misdiagnosed by the medical community. Instead of receiving treatment and support, children with autism spectrum disorders are often designated as the classroom lost cause or given misguided attention.

My brother's case involved a misdiagnosis of depression when he was 8 years old. In the third grade, my brother began to express suicidal thoughts and was put on Prozac. But the anti-depressants only agitated his problems. He began to put on too much weight, a common side effect of his medication. He stopped smiling in his school photos and started throwing screaming tantrums in class. A few years later, he was diagnosed with Asperger's, a condition my parents had never heard of, but after a little research, immediately recognized as accurate. The diagnosis didn't solve my brother's problems, but it explained them.

Asperger's is thought to be largely hereditary and to manifest almost exclusively in males. My father had himself evaluated after Tyler was and found out he has the condition as well. My 77-year-old grandfather has not been evaluated, and vigorously contested that he has Asperger's when I accidentally suggested the idea at a family dinner last year. But we're all certain that he, a self-described "space alien," bequeathed the genes.

The funny thing about my dad's diagnosis is he's one of the most affable people you could hope to meet. My father has an incredible ability to assimilate into any social arena. He is just as at home at the neighbors' United Auto Workers pig roast as he is at a wine tasting with regional executives. But he attests that he experienced a lot of my brother's issues when he was growing up, including the same anxiety and frustration. My father can socialize with anyone now because he has spent years studying how to. It's kind of like how people who learn English as a foreign language often speak it best.

My father has the grammar of conversation down, but he still struggles with the deeper meaning. He knows what to do, but he doesn't necessarily understand why he should. The main characteristic of Asperger's is a lack of empathy. Typical people intrinsically know what is expected of them in social situations because they imagine what they would expect if they were in their companions' positions. It's not the case for people with Asperger's. They don't try to perceive the desires of others until later in life, when it's explained to them that they should.

For my brother, missing this crucial link in the stages of social interactions makes getting along with teachers and peers difficult. School's prerogative is proper socialization. Most kids learn quickly to play a certain way during recess and to leave the teacher alone when she's wearing a "Goddamnit-I-need-a-cigarette" scowl. Given my brother's condition, it's no wonder his academic history is littered with snapped pencils, bruised bullies and office referrals.

Living with a father and a brother with Asperger's had its social consequences for me, too. Though I don't have the syndrome, I exhibit what experts on the subject call "ghosting" effects, less embellished expressions of a syndrome's symptoms. I don't always follow through with social conventions like greeting friendly acquaintances and making small talk. I have trouble with eye contact and massaging unpleasant truth. I've been called cold, blunt and unapproachable.

It makes sense. I grew up in a house where everyone could be home and not say a word to each other for hours. That affection would come in sporadic bursts rather than a regular program seems natural and in many ways preferable. But the social customs of Asperger's men are often hell for the women who love them. Since my parents got divorced and I left for college, my mom has only my brother for company at home. She tells me she's lonely. She talks to the cat. My mother has friends and a committed boyfriend, but she's starved at home for the light small talk properly socialized people require.

Asperger's syndrome hinders a person's ability to navigate society, but an initial lack of empathy in childhood doesn't mean less ability to connect personally with others. My brother and father are the two most loving men I know. My mother knows my brother loves her because he comes upstairs and sits to play his Gameboy near her sometimes. It's not a conventional expression of affection, but it's sincere. What if all of society operated by this Aspergian social code? Silicon Valley supposedly does. I imagine how honest and unbound by etiquette the social circles of Microsoft must be. It might be an improvement. For one thing, in Asperger's society, you don't talk unless you have something to say. And honestly, more people should try it.

-Jessica Vosgerchian is the assistant magazine editor