Thinking in Pictures: My Life With Autism

The biological nature of autism and subsequent treatments guide the focus of Chapter 6. Grandin reports her experience with anxiety, the contribution of biochemistry, and the role of medication. Grandin also includes emphasis on potential concerns, and tips surrounding medication and other biological treatments.

Anxiety and panic attacks play a role throughout Grandin’s life, a theme present in others with autism. The hypervigilance of the nervous system is a significant contributor to anxiety. Physiological changes of puberty launch Grandin into extreme anxiety and resulting health problems, such as colitis. Initially, Grandin looks to the medical field for explanations for her physical health problems, but without solid information, she eventually reads journal articles exploring the symptoms of anxiety and the role of biology.

Hesitant to take medication, a severe response following surgery motivates Grandin to finally try medication, and she experiences both immediate and gradual improvements. “Taking the medication is like adjusting the idle adjustment screw on an old-fashioned automobile engine. […] Now my nervous system is running at 55 mph instead of 200 mph, as it used to” (127). Other benefits of the medication include a change in behavior—a more fluid public speaking style.

Multiple types of medication are available for helping reduce problems associated with autism, but Grandin warns about inappropriate prescription practices and potential side effects. An individual’s whole health knowledge and personal reaction to a medication warrants monitoring and evaluation on an ongoing basis. Possible drug categories include antidepressants, SSRIs, beta-blockers, blood pressure medications, and tranquilizers. Some medications can exacerbate symptoms rather than help, prompting caution. 

Other physiological and psychological issues may contribute to the symptoms of autism, or co-occur with autism. Epilepsy, for instance, may produce symptoms that appear to be autism. Special attention to those without verbal skills, co-occurring ADHD, and self-injury is also important. These, and other physiological and psychological issues, can change the picture of autism and how best to treat the individual.

Grandin addresses multiple concerns regarding medication, including the prescription of medications without comprehensive knowledge. This also includes the best dosage, which is typically lower than the standard amount of a medication. A high dosage can produce undesirable effects. Special concern also exists for the effects of tranquilizers, neuroleptics, and atypical antipsychotics. Treatment with medication, therefore, needs to include attention to all of the potential risks and benefits.

Extensive knowledge surrounding biochemistry and treatment options for autism allows Grandin to make multiple suggestions concerning the treatment decision process. She refers to non-medication options that parents report as effective, including a gluten- and casein-free diet, or dairy- and wheat-free, respectively. Grandin also notes magnesium, B6, melatonin, and exercise as other potential options for treating symptoms related to autism. “My message for parents is simple, and it’s advice that a good doctor gave my mother over forty years ago: trust your instincts about doctors, about medications, about yourself, and most important, about your child” (142). 

Maneuvering the social world can present challenges to those with autism, in both romantic and non-romantic contexts. “As a child, I was like an animal that had no instincts to guide me; I just had to learn by trial and error. I was always observing, trying to work out the best way to behave, but I never fit in” (153). A lack of social intuition, as well as differences between her interests and those of her peers, affected Grandin’s ability to interact with others.

Rather than attraction, such as physical attraction that brings people together in a romantic relationship, Grandin describes the importance of common interests. This sharing of interests is also the basis of friendship. “Friendship always revolved around what I did rather than who I was” (153). Other differences related to social relationships include difficulties with interpreting the emotional cues of others and struggles with shifting attention during interactions. Not everyone with autism faces the same difficulties, so variations and the severity of autism result in different social struggles.

For Grandin, continual referral to—and an update of—her visual library helps in learning how to act socially. Social skills require explicit teaching, like that of math, language, and other learned skills. Through observation, seeking of knowledge, and practice, Grandin maintains appropriate social contact through her work:

Sometimes parents and professionals worry too much about the social life of an adult with autism. I make social contacts via my work. If a person develops her talents, she will have contacts with people who share her interests (160).

Grandin again references a lack of emotional attachment to people, instead feeling connected more to places. From her perspective, this is not a deficit, but a difference.