Autism & Meltdowns
Why do meltdowns happen, and what can you do to help prevent them?
If you’ve ever experienced the overwhelming stress and confusion of a meltdown you’ll understand why they’re often considered to be one of the most challenging of all autistic behaviours.
But did you know that meltdowns are not unique to autism?
What are meltdowns?
Put simply, a meltdown is a state of neurological chaos where the brain and nervous system are unable to cope with incoming information and demands. They overheat, which causes them to stop working properly. It’s called a meltdown because it’s the body’s equivalent to what happens in a nuclear power plant when the fuel in the reactor core becomes so hot that it melts and releases energy.
During a meltdown, the pent up internal pressure builds to the point where it can cause an internal shutdown of thinking processes and language, or is released externally as an explosive reaction like anger, crying, yelling or running away.
It’s this kind of reaction that most people refer to when they talk about meltdowns, but the external reaction is just the end result of a lengthy internal process that’s going on inside where you can’t see it happening.
What happens during a meltdown?
When we find ourselves overwhelmed or in a stressful situation from which we can’t easily escape, our brain is flooded with different kinds of input – emotional, sensory and cognitive. When this is too much for it to process, it triggers the ‘fight or flight’ responses associated with panic including a rush of adrenaline that makes us want to run or yell or hit something.
This also causes executive functions like reasoning, memory, planning and decision-making to shut down. Language becomes compromised too, which makes it even more difficult to find a way out of the situation.
If demands are not reduced or the person is unable to escape the situation, this neurological chaos can build to cause either a total internal cognitive shutdown or the explosive external reaction commonly seen during a meltdown. Although this explosion seems to come from nowhere, it’s the end result of a process that may have started hours or even days earlier.
This meltdown process happens in four stages:
- The triggering event
- Explosion or shutdown
Stage 1: Trigger
This is point at which there’s an imbalance between the sensory, cognitive or emotional demands coming in and the body’s ability to handle them. A trigger can be something that either creates extra input for the brain to deal with, or reduces the person’s capacity to handle that input.
When confused for example, from too many people talking at once or social misunderstandings, the brain has to work hard to make sense of what’s happening and this can trigger a fear response that puts the body on high alert. Sensory overload or pain both increase the amount of information coming in, but are also very tiring which reduces coping capacity.
We can also have a similar response to the frustration of being blocked from getting something that we need or want. Autistic children often experience these kinds of frustrating situations, such as those created by communication difficulties. Sleep disturbances, medication and food allergies can also all reduce the body’s ability to cope, and create triggering events for meltdowns.
Meltdown triggers not only vary between people, but also for the same person across time, situations and environments. A person who can cope well with a noisy office on Monday morning because they’re rested might find that the same conditions trigger a meltdown on Friday afternoon after an exhausting or demanding week.
Stage 2: Escalation
After a triggering event has happened, if the person has no control over the amount of input coming in or no escape from the situation, the body escalates into a fight-or-flight response. As thinking becomes more impaired, defense systems are set to high alert and a snowball effect of panic starts to build.
This escalation period can last for only seconds, or it might go on for days. Sometimes the gap between the trigger and explosion can be very small, other times it is more of a slow burn. A long escalation phase gives more opportunities to intervene and potentially stop the progress of the meltdown, but it also makes it harder to identify the things that initially triggered it.
This stage of a meltdown also often triggers a stress reaction in caregivers as well, as they anxiously try to intervene to stop the meltdown from progressing. This stress then feeds into the person’s response loop and reinforces their need to panic.
Stage 3: Peak & Explosion
Eventually, if steps are not taken to reduce demands or increase the body’s ability to cope with them, the escalation builds to the point of no return called the explosive stage. This is where the internal chaos and pressure can no longer be tolerated and must be released, internally or externally (or both).
External meltdowns happen in different ways but are usually quite dramatic, reflecting the difficulty that the person is having trying to maintain control or think rationally. When this happens they might be physically or verbally aggressive, even destructive.
Internal meltdowns (shutdowns) can be a lot harder to recognize. They happen a lot more inconspicuously, and compromise a person’s ability to make decisions, use language and perform physical actions. Someone who is experiencing a shutdown might hide their face, be unable to move or just totally zone out.
Stage 4: Resolution
After the explosion or shutdown has passed, the body enters a period of restoration as it starts to cool down and reset itself. This can sometimes take a long time, even up to 24 hours.
It’s very easy to trigger further meltdowns during this time, as coping reserves are depleted and the person often feels intense physical and mental exhaustion. The level of demand which might be tolerable at other times can become intolerable after a meltdown.
Although the crisis of the explosion is over, the person might still experience some intense emotions during the recovery phase. They might feel confused about what has happened, or have lingering feelings of fear or anxiety. As coherent thinking starts to return it can also bring with it feelings of regret or embarrassment. So the recovery phase is a time for calm, reassurance and rest.
Why are some people prone to meltdowns?
Anybody can have a meltdown – child or adult, neurotypical or autistic – if they find themselves trapped in a situation that is difficult to cope with, especially those which involve frustration, sensory overload, pain or confusion.
These situations tend to happen more frequently for people who have one or more of the following characteristics:
- Hypersensitivity to sensory input
- Sensory integration dysfunctions
- Low frustration threshold
- Low frustration tolerance
- Difficulty identifying and controlling emotions
- Resistance to change
- Rigid or inflexible thinking
- Difficulty understanding cause and effect
- Executive functioning disruption
- Communication delays or challenges
- Difficulty with social comprehension
Since these characteristics are often descriptive of people with sensory processing and autism spectrum disorders, it’s not surprising that meltdowns are common amongst these groups. In addition, children are usually more susceptible to meltdowns than adults because they have less control over their emotions and environment.
If anybody can have one, how come most people don’t?
Meltdowns are about not being able to escape. If you have the means to get yourself out of a stressful situation before it becomes overwhelming, the cognitive and emotional pressure will subside. But without these means of escape the stress will escalate and the body will begin to panic, setting you on a course towards neurological meltdown.
These escape routes are things like:
- Language and comprehension – understanding others and making yourself understood
- Autonomy – the freedom to make your own decisions
- Independence – the ability to act on those decisions
- Coping and calming mechanisms – being able to soothe yourself under stress
- Motor and social skills – the ability to prevent or remove yourself from uncomfortable situations
People who don’t have access to (or control over) these means of escaping an overloading situation are much more likely to experience meltdowns.
It’s easy to take for granted how valuable these kinds of skills and circumstances are in keeping you safe from escalating stress. So let’s take a look at an example.
You’re at the supermarket on a busy Saturday. The store is crowded, people are rude and your shopping cart has a wobbly wheel. One of the fluorescent lights is flickering and the music is terrible, which seems especially annoying because you didn’t get any sleep last night.
You can feel yourself starting to get stressed so you take a deep breath to calm down. You’re concentrating on the shopping list when someone suddenly smashes into your cart. You silently forgive him because you know it was an accident, even though he walked away without apologizing.
The noise and frustration start to make your head pound, so you scan the shelves for your favourite chocolate, the one that you love, the one which makes everything feel better… the one that is sold out. Dammit! You decide to call it quits, grabbing just the most important things on your shopping list before heading home.
Now imagine that you’re three years old. You’re with your dad at the scary food place, the noisy one where the bright lights hurt your eyes. Your heart starts thumping and you get that yucky feeling in your tummy. You really want to make it go away but don’t know how.
Why is everything so loud here? Someone smashes into your cart and you jump. Are other people going to start doing that too? Are they trying to hurt you?
Thank goodness you spot the fridge that has the chocolate milk that you love, the one that you get every time you go to the store, the one that makes everything feel better. Your dad opens the fridge and says “no chocolate milk”. You’re confused and angry. Why aren’t you allowed to have it? It’s your favourite, you always get it, you need it!
You’re confused and scared and just want to leave, but your dad tells you to sit down in the cart. You don’t have the words to tell him any of this so all you can do is cry. There is nothing you can do to escape, and without a release the pain and frustration build towards the inevitable explosion.
The importance of having control
The difference between these two shopping experiences is that the adult:
- Can regulate the extra sensory input
- Recognizes when they’re getting upset
- Can calm themselves
- Understands that people don’t deliberately ram you with shopping carts
- Can communicate their needs and emotions
- Has the freedom to leave when it becomes too much to handle
As the adult has more access and control over escape routes which allow the emotional and cognitive stress to defuse, they’re more able to avoid a meltdown.
Are autistic meltdowns different?
The reason autistic people are particularly vulnerable to meltdowns is because they experience more of the kinds of stressful events that trigger them. They can also find it hard to modulate their response to these events, and can have less avenues for avoiding or escaping the discomfort, so the pressure can build more quickly and result in a bigger explosion.
So autistic people tend to have meltdowns more frequently and intensely, but the underlying mechanisms of how they happen are the same for everybody.
Are meltdowns the same as tantrums?
While they can sometimes look the same on the outside, a tantrum is a voluntary performance and meltdown is an involuntary physiological reaction.
A meltdown is a physical response to being in a situation which is overwhelming. It is not a power struggle or demand for attention. A child having a meltdown will usually try to relieve the tension, or to escape the situation in some way. They can often seem scared, anxious, uncomfortable or in pain, and might find it hard to communicate what it is that they need or why they’re so upset.
Kids throwing a tantrum might also do a lot of these same things, but have much greater control over their behavior. They can stop crying to check if you’re paying attention, they can communicate ultimatums, and it’s easier to understand exactly what they want and why they’re upset about not getting it.
How to help someone who is having a meltdown
Now that we know what meltdowns are, how they happen and why some people are more vulnerable than others, in part two we’ll look at what you can do to be helpful when someone is having a meltdown.
Last updated 25 Nov, 2017 by Bec Oakley