Amyotrophic Lateral Sclerosis (ALS) is a terminal illness of the nervous system, resulting in the degeneration of neurons. When the motor neurons in the lateral spinal cord degenerate, the muscle cannot be stimulated and gradually atrophies. As the disease progresses, the brain cannot initiate and control muscle movement, so voluntary muscle actions, such as reaching for your phone or typing on a keyboard, are lost. Currently there are no treatments or cures to reverse the effects of ALS and the disease process is still widely unknown. Some noteworthy individuals diagnosed with this disease have included Lou Gehrig, Stephen Hawking, Jon Stone, George Yardley, Henry A. Wallace, and Steve Gleason. These are the facts, but I could have never realized what living with ALS was like until I listened to a retired senior, a teacher, and a musician tell me their stories.

The older couple told us of their past year as the husband wrote on an electronic note pad to fill in the gaps of his spouse’s version of their story. They had first noticed his symptoms when he began choking on his food, and they had to adapt as the disease progression got more and more severe. His wife comically said that she doesn’t know where to look when he’s trying to talk to her – “Should I look at his eyes, his mouth, this pad?” Every day, they had to face a new challenge and overcome it together, as a family.

Another patient was a mother, a teacher, now wheelchair bound and with a respirator to help her breathe. Because of her age, none of her physicians expected ALS and thought she was struggling from carpal tunnel syndrome or an ulnar nerve injury. She told us her husband was her biggest caregiver and supporter; her husband joked, “She makes the list and I carry it out.” He talked about his struggles, working full time as well as being a full-time caregiver for his wife and their 3-year-old daughter, as well as still finding time for self-care. Even with all this juggling, he felt guilty. This guilt was expressed by many of the caregivers: some because they didn’t even notice the symptoms and others because they felt like they couldn’t help their spouses. Guilt was felt by the patients too. The mother was upset because her daughter would only remember her in a wheelchair. Despite the difficulties, family was a major support system for each patient.

When asked about how she felt after getting her diagnosis, the musician said, “I felt like a deer in headlights… I never pictured I was going to go out that way… with a terminal illness… Last year I had no trouble walking, singing, cooking, gardening, and this year…” Despite all of this, she said she felt relieved. Her struggle to find a neurologist who respected her was heartbreaking. She had gone to a physician because she felt helpless; she was having trouble playing guitar, she was losing her identity as a musician. However, the physician assumed from her past medical history of anxiety that she was having mental issues with memory, anxiety, and depression. As she continued to receive hostile treatment, she found a second doctor who listened to her. Unfortunately, even though he took her seriously, he didn’t have the courage to diagnose her with ALS, telling her instead that she had a motor neuron disease and referring her to a specialist. When she finally received the diagnosis of ALS, she was relieved. She no longer felt crazy. She was able to be heard. She was able to communicate with someone who wanted to help her. ALS is already a hard disease to diagnose; not having someone on her side only made her situation more difficult. She says now, as each symptom appears, she isn’t afraid anymore, because she knows it’s ALS. This relief of having a concrete diagnosis, of having a diagnosable disease, even one that is untreatable, was reiterated by several of the other panelists.

Although a diagnosis was a relief for many of the patients, they all saw the importance of taking part in clinical trials. They recognized that ALS affects everyone at different times in different ways and hoped that one day they could explain why this illness is so hard to detect and track. Participating in various studies and trials made them feel like they were helping future patients and physicians to be able to better understand why this terminal disease can strike at any time, with no discernable warning signs, affecting each individual uniquely in initial symptoms and progression.

Getting a concrete diagnosis gave these patients the freedom to seize the day and live in the moment. For the musician, as her ability to play guitar diminished chord by chord, and she started slurring her words, preserving her voice and her identity became very important to her. She is using a message banking app to preserve her voice. The software requires her to read thousands of words and sentences. Although she had to accept the things she could no longer do, she realized that she did not have to give up her identity or love of music because of ALS. Overflowing with her love of music, she told us about how when choirs sings together, their hearts become synchronized; and how music lowers blood pressure and stimulates all areas of the brain. As she interwove details about her symptoms with her favorite song, Fire on the Mountain by the Grateful Dead, the two had become part of the same spiritual transformation. Smiling peacefully, she explained, “Maybe nobody else hears it the way I do. I see death as the final healing, finally being released from your body.” She viewed her diagnosis as graduating early and the symptoms that came attached with it as her disappearing slowly, rather than all at once. The unavoidable indignities were just something she had to accept. What mattered most to her was keeping her individual personality in the face of intense daily struggles.

By the end of our discussion, I felt the weight of my white coat as I never had before and recognized that this would be the first of many times that I would have to carry this symbol of patient advocacy. As these patients spilled all their vulnerabilities to a group of 50 students, I realized the most important thing I will learn in medical school is opening my heart without getting crushed under negativity. I learned that, as doctors, we have the tendency to think the ultimate solution is life, when in truth, mortality is the reality. What matters is being present when there is a fire, realizing that “a pail of water” may not be enough to put it out, but continuing to carry that water for your patient.

Long distance runner, what you standin there for?
Get up, get out, get out of the door

There’s a dragon with matches that’s loose on the town
Takes a whole pail of water just to cool him down
-The Grateful Dead

Alzheimer’s disease is “an irreversible, progressive brain disease that slowly destroys memory and thinking skills, eventually even the ability to carry out the simplest tasks” according to the Alzheimer’s Association. Alzheimer’s affects mostly senior citizens, and symptoms first appear in most people between 60 and 70. The first signs of Alzheimer’s, though, can be noticed between the ages of 30 and 65. However, it is very rare for younger people to exhibit symptoms. Most cases of dementia are caused by Alzheimer’s disease [1]. It is known that all Alzheimer’s patients have dementia; however, one cannot say that all dementia patients have Alzheimer’s disease. Alzheimer’s is a deadly disease, finishing predictably in death [2].

Alzheimer’s disease is named after Dr. Alois Alzheimer. In the early twentieth century (1906), Dr. Alzheimer observed alterations in the brain tissue of a woman who had expired of an uncommon mental disease. Her signs involved loss of memory, language difficulties, and erratic conduct. After her death, Dr. Alzheimer inspected her brain and discovered many uncharacteristic clusters (now called amyloid plaques) and scrambled packets of filaments (now called neurofibrillary, or tau, tangles) [1].

Based on his findings, he correctly theorized that these anomalous buildups were accountable for the patient’s loss of memory and other mental complications.

The plaques and tangles in the brain are some of the foremost characteristics of Alzheimer’s disease. Another characteristic is the damage of contacts between nerve cells (neurons) in the brain. Neurons conduct communications between different segments of the brain – for example, they conduct communications from the brain to muscles and organs in the body. Many other multifaceted brain alterations are thought to play a function in Alzheimer’s disease.

In the beginning, this impairment seems to take place in the hippocampus of the brain. The hippocampus is the part of the brain that is indispensable in forming memories. When neurons perish, further parts of the brain are distressed. In the last stage of Alzheimer’s, destruction is extensive, and brain tissue has shortened substantially.

How many Americans have Alzheimer’s disease?

It is estimated   that more than 5 million Americans may have Alzheimer’s disease. If existing population developments continue, the number of people with AD will increase significantly. However, this trend can be stopped if the disease can be effectively treated or prevented.

The reasons people develop Alzheimer’s are still not fully understood. One known reason is aging.   Age is the most significant accepted risk factor for Alzheimer’s disease. In 2010, in the United States, close to 5 million people 65 years and older were living with Alzheimer’s illness. A 2013 report from the Alzheimer’s Association suggests that 1/10^th of all Americans over 65 are suffering from Alzheimer’s. The proportion goes up to about a third of the population for those who are over 85. According to the Alzheimer’s Association, AD incidence is between 60% and 80% of all incidents of dementia [3].

Incidence of Alzheimer’s disease in South Asia

Globally, at least 44 million individuals live with dementia, making the disease a worldwide health catastrophe that must be tackled. In excess of 4 million individuals have some appearance of dementia in India [4].

In the Southern Indian state of Kerala, 1066 qualified members who were cognitively regular at reference, 104 of them acquired dementia (98 of them were found to have AD) over a continuation time of 8.1 years. The occurrence rates per 1000 person-years for AD was 11.67 for persons aged ≥55 years and greater for those aged ≥65 years (15.54). Individuals who were aged ≥65 years, the global age consistent occurrence rate, was 9.19 per 1000 person-years, prevalence rate of AD raised substantially and proportionally with growing age. These are the initial AD occurrence rates to be conveyed from southern India. When compared to reports from rural North India these occurrence rates appear to be much greater. But they are comparable with those reported from China, and slightly lesser than that reported from the western world [5].

Signs of Alzheimer’s disease

Memory difficulties are characteristically one of the first signs of Alzheimer’s; nonetheless, early indications may differ from individual to individual. A decrease in other facets of thinking, for example forgetting words, sight/three-dimensional problems, and diminished thinking or decision making, may additionally indicate the precise initial periods of Alzheimer’s disease. Mild cognitive impairment (MCI) is a disorder that can be an initial mark of Alzheimer’s. However, not everyone with MCI will develop Alzheimer’s.

Patients with Alzheimer’s have difficulty performing routine things like paying bills, driving a car, or cooking food. They repeatedly ask the same questions, go astray without difficulty, misplace things or put them in unusual places, and find even easy things puzzling. As the disease advances, some patients become anxious, wrathful, or furious.

Longevity of a person with Alzheimer’s disease?

At the time of diagnosis, if the person is older than 80, they are only likely to live another three or four years. If the person is younger then 80, they could live for as many as ten years or more.

Currently Alzheimer’s disease is graded as the sixth greatest cause of death in the United States. But fresh evaluations show that the illness may be listed as third, after heart disease and cancer, as a source of death for elderly people.

At the present time, there is no cure for Alzheimer’s. However, treatment can help patients cope with symptoms [1].

In the 21^st century, Alzheimer’s can only be diagnosed with 100 percent precision through a postmortem examination that discloses the occurrence of the distinctive plaques and tangles. However, a complete examination and suitable checkup can afford a dependable diagnosis with better than 90 percent certainty.

Malformed accumulations of particular proteins inside the brain interrupt normal brain performance and produce the reasoning and efficient difficulties characteristically connected with Alzheimer’s Disease. Ultimately, as the sediments expand all over the brain, brain material begins to die. This results in additional intellectual damage. CT scans and MRI scans show the subsequent brain contraction. CT scan shows enlargement of the ventricles in the brain and loss of brain tissue in a patient with Alzheimer’s disease. Recent research is endeavoring to ascertain what produces these accumulations and is watching for techniques to avoid or change them before they cause lasting brain destruction [2].

Alzheimer’s is not curable.
Alzheimer’s is not contagious.
Alzheimer’s is not a natural part of the aging process.
Alzheimer’s is not something you get from using deodorant or cooking in aluminum pans.
Alzheimer’s is not inevitable if you live long enough.

In some families, Alzheimer’s disease is hereditary. But these appearances are very rare, and they account for fewer than five percent of all incidents. If a family member like a mother or a brother has Alzheimer’s disease, it doesn’t inevitably mean that you’re prone to contract it as well.

There is no test that can foretell whether you’ll get Alzheimer’s disease, save tests for the very rare hereditary Alzheimer’s. A blood test can tell whether you have a certain form of cholesterol-carrying protein connected with an elevated occurrence of the disease. This examination can’t convey whether you’ll actually contract the condition; at least 50 percent of people who have an elevated risk factor never get Alzheimer’s.

Taking into consideration medical ethics, healthcare authorities counsel against taking this blood test or undertaking other genetic testing because they want to save their patients from unwarranted fear about something that will perhaps never happen. There are others reasons for which they also advise against testing. If a person has the inherited gene or elevated risk factor, it might negatively affect their ability to acquire health insurance or long-term care.

Causes of AD

All types of dementia are a result of brain cell death. As such, Alzheimer’s Disease is also caused by brain cell death. When there is an ongoing brain cell death occurring over a period of time, then it is called a neurodegenerative disease. When the brain tissue has an increasingly smaller number of nerve cells and connections, then the total brain size shrinks due to Alzheimer’s.

Plaques in the brain are a result of the build-up of a protein called beta-amyloid (also known as “amyloid plaques”). These plaques cannot be seen or tested for in the living brain affected by Alzheimer’s Disease. A postmortem or autopsy will show these plaques and masses. Plaques are found between the dying cells in the brain.

These unusual protein clusters in the brain tissue are always present with Alzheimer’s disease. Scientists are not yet sure if there could be an additional primary activity that is really causing Alzheimer’s Disease. This sort of alteration in brain nerves is also observed in other illnesses. Researchers want to find out how these protein abnormalities progress so that a cure or treatment might be discovered. Researchers have not completely comprehended why the alterations that lead to Alzheimer’s disease befall a patient. It is known that several dissimilar factors are believed to be implicated, aging and a family history of Alzheimer’s, chief among them.

Diagnosis

Alzheimer’s disease is not straightforward to diagnose, as there is no single test for it. The first step physicians take is to rule out other complications before validating whether mental indications and signs are stark enough to be a type of dementia or something else.

Signs and symptoms [6]

Phases of Alzheimer’s Disease:

Aging has effects on memory but not AD.

• Occasionally forgetting things.
• Sometimes items are misplaced.
• Slight temporary memory loss.
• Not recalling precise particulars.

Early phase

• Not recollecting incidences of deprived memory.
• Forgetting names of family or friends.
• Only close friends or relatives may notice the changes.
• Some perplexity in conditions outside the acquainted.

Middle-phase

• Enormous effort recollecting newly acquired knowledge
• Increasing misperception in numerous situations
• Difficulties with slumber or sleep
• Difficulty in recognizing where they are

Late-phase

• Low capability to reason
• Difficulties in talking
• Retelling same dialogues
• Extra rude, nervous, or suspicious

Treatment

For Alzheimer’s there is no recognized treatment. The loss of brain cells cannot be stopped or overturned.

Drug therapy

There are no disease-altering medicines obtainable for Alzheimer’s, but some choices may decrease its symptoms and help recover quality of life. Four drugs are available. They’re called cholinesterase inhibitors. They include Donepezil (brand name Aricept), Rivastigmine (Exelon), and Tacrine (Cognex). Another type of drug, called memantine (Namenda), which is an NMDA receptor antagonist, may also be used. This drug may be used alone or with a cholinesterase inhibitor.

Other therapies

As with other kinds of dementia and neurodegenerative illness, a chief part of therapy for patients with Alzheimer’s comes from the patronage given by healthcare personnel. Quality-of-life care becomes more imperative as needs increase with diminishing freedom [3].

There are other treatments outside the US. In India, Alzheimer’s disease is treated with Ayurveda [7]. Ashwaganda, an ancient Herb used in Ayurveda, is confirmed to be a possible cure for Alzheimer’s [8]. It has also been found that Curcumin (in India it is called Haldi) is more efficient at hindering the formation of the protein fragments than many other potential Alzheimer’s treatments. Optimizing vitamin D and vitamin B12 intake, as well as a nutritious diet rich in folate and coconut oil, have also been tested as to their efficacy at treating Alzheimer’s Disease [9].

Daily mental challenges

Mental stimulation, particularly acquiring something novel, such as learning to play an instrument or a new language, is linked with a reduced risk of Alzheimer’s. Researchers theorize that mental tasks assist in developing the brain, making it less prone to the lesions connected with Alzheimer’s Disease [8].

References

1. What Is Alzheimer’s Disease? National Institute on Aging, U.S. Department of Health and Human Services. https://www.nia.nih.gov/health/what-alzheimers-disease
2. Alzheimer’s for Dummies, Patricia B. Smith, Mary M. Kenan, Mark Edwin Kunik, Leeza Gibbons. October 2003. http://www.dummies.com/health/knowing-what-alzheimers-is-and-is-not/

3. What’s to know about Alzheimer’s disease? Medical News Today. Newsletter. 13 February 2018. https://www.medicalnewstoday.com/articles/159442.php
4. About Alzheimer’s and Dementia. org. India, Alzheimer’s association. https://www.alz.org/in/dementia-alzheimers-en.asp
5. Incidence of Alzheimer’s disease in India: a 10-years follow-up study. Mathuranath PS1, George A, Ranjith N, Justus S, Kumar MS, Menon R, Sarma PS, Verghese J. Neurol India. 2012 Nov-Dec;60(6):625-30 https://www.ncbi.nlm.nih.gov/pubmed/23287326

6. Alzheimer’s disease. From Wikipedia, the free encyclopedia. https://en.wikipedia.org/wiki/Alzheimer%27s_disease
7. Treating Alzheimer’s disease with the help of Ayurveda by Hunila. November 1, 2012 org. http://www.alzheimerindia.org/treating-alzheimers-disease-with-the-help-of-ayurveda/

8. Ashwaganda: Ancient Herb Proven to be a Potential Cure for Alzheimer’s by Dr. Mercola April 07, 2012 https://articles.mercola.com/sites/articles/archive/2012/04/07/ashwaganda-effect-on-alzheimers-disease.aspx

9. Coconut Oil and Alzheimer’s Disease By anh-usa (Alliance for Natural Health) on October 5, 2010. http://www.anh-usa.org/coconut-oil-and-alzheimers-disease/

All health issues are best understood and treated with a combination of biological, psychological, and social factors rather than with purely biological means. This context entails thoughts, emotions, behaviors, social factors, and environment, all of which play significant roles in human functioning and overall health. Therefore, it is important to gather input from all aspects of an individuals’ life to get better insight into depression.

Many people use the word “depression” to explain the feeling of sorrow, but depression is much more than just sadness. Sadness is a normal reaction to life’s struggles, setbacks, and disappointments. However, depressed people don’t feel sad—they may feel lifeless, empty, apathetic, and hopeless. Depression starts with just a feeling and then manifests in physical behaviors. The feeling of helplessness, hopelessness, and worthlessness are intense and unrelenting. An unwanted complication of depression is suicide, which in fact has a higher rate than homicides in the US (1).

Hopelessness is the main indicator leading to suicide, a trapped pattern of thinking where individuals believe things will never get better. The deep despair and hopelessness that accompanies depression can make suicide seem like the only way to escape from the overwhelming circumstances. Therefore, suicidal thoughts must be considered as a cry for help and dealt with accordingly.

Psychosocial context appears to be the commonly associated culprit that may predispose people to depression instead of genetic predisposition and other secondary etiologic factors. Depression in the psychosocial context is related to a person’s perception of daily events. A specific event in a person’s life can trigger the beginning of a vicious cycle. Examples could include: changes in occupation, loss of a loved one, etc.

Modesty

In addition to hopelessness, avarice can lead to depression because it contributes to dissatisfaction, disappointment, and loss of sincerity. Sometimes, the lack of material goods can make a person happier than having them. Jealously chasing material things that others have can lead a person into depression. For example, the ancient philosopher Plato was wise but not wealthy; despite his lack of money he was content with his life. One day, as he was passing by a spring, he noticed a boy drinking water with his hands. The average person, having witnessed this, would give the child a cup, but Plato asked himself if the cup is even needed. If you focus on what you do not have, you will always be disappointed. Actually focusing on what you need in the present time can decrease the damage one incurs from his or her problems. The child was thirsty and he only needed water, so the cup was unnecessary.

If a person is only concerned with his or her own situation and not noticing the condition of those around them, it can turn trivial problems into mountains. By comparing one’s own problems with greater problems of others, the person can get a more accurate perspective. Though a person’s burden may appear unbearable, God has created each person with the ability to handle these burdens. It is recommended to keep hope by exercising patience and concerning yourself with the present condition rather than bringing problems up from the past or worrying about the future. The patience given to human beings is sufficient to all types of difficulties, unless used inappropriately to obsess about what already happened in the past or to worry about distant future.

Never lose hope

As shown in Table Figure 1, The American Psychiatric Association (APA) has established the universal criteria for health professionals to diagnose depression. According to The Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) criteria, physicians diagnose an individual as having depression, which is further classified as minor or major in terms of the severity of the symptoms (2).

Hopelessness deserves special concern because it often triggers the other symptoms which may eventually lead to inertia.

Belief and prayer have found to be extremely helpful in combatting hopelessness by keeping hopes high. This can help to prevent serious depression or even suicide, for even in the most difficult times, belief can allow a person to stand firm with the conviction that even a single leaf would not drop without God’s knowledge. The Qur’an states: “Say (God gives you hope): ‘O My servants who have been wasteful (of their God-given opportunities and faculties) against (the good of) their own souls! Do not despair of God’s Mercy. Surely God forgives all sins. He is indeed the All-Forgiving, the All-Compassionate’” (The Qur’an 39.53).

The Bible echoes a similar tone when it says, “For as high as the heavens are above the earth, so great is his steadfast love toward those who fear him; as far as the east is from the west, so far does he remove our transgressions from us (Psalm 103, 8-12).

What does the literature say about belief?

A survey revealed the fact that 82% of Americans believe that prayer can cure serious illness, 73% believe that praying for others can cure illness, and 64% want their physicians to pray with them. Health professionals – especially doctors and nurses – should be aware of the spiritual needs of their patients, should be familiar with literature on the effectiveness of prayer, and should integrate it into their comprehensive care plans (3).

From the biological perspective, as shown in Figure 2, symptoms and signs of depression shown in Figure 1 occur as a result of the change in the level of neurotransmitters – namely serotonin, norepinephrine, and dopamine. Today, pharmacological interventions to heal depression are mainly provided by drugs. These regulate the levels of the neurotransmitters. There aren’t many scientific studies focusing on depressing and religion, however McCullough’s review of literature clearly states that “People with high levels of general religious involvement, organizational religious involvement, religious salience, and intrinsic religious motivation are at reduced risk for depressive symptoms and depressive disorders” (4).

In conclusion, depression may arise from the lack of staying active. In order to keep away from the negative thoughts which serve as a starting point for depression’s vicious circle, praying and seeking help from the All-Knowing, All-Wise serves as a shelter from the negative feelings of temporary worldly troubles. Praying may provide a protection against negative thoughts that may arise from an external or internal source, eventually leading to a distortion of healthy thinking.

Subjective healing and improvement in health after praying, psychological therapy, and family and social support may stimulate some neurotransmitters, though this needs to be further clarified by comprehensive studies (5). However, even simple words may have an impact on the mood of any individual. Hearing a compliment may cause a smile, or receiving a phone call giving a bad news might cause sadness. How could sincerely pouring one’s heart out to the All-Knowing not reverberate from His eternal source into the body, even if the circumstances appear overwhelming?

Mucteba Muezzinoglu is a freelance currently living in Illinois, US.

Nate Emru is a Mental Health Counselor in Indianapolis, Indiana, US.

References

1. Further information is available at http://www.sprc.org/basics/about-suicide. Reached in April 25.
2. The Diagnostic and Statistical Manual of Mental Disorders (DSM). American Psychiatric Association provides a common language and standard criteria for the classification of mental disorders.
3. Ameling A. 2000. “Prayer: an ancient healing practice becomes new again.” Holist Nurs Pract. Apr;14(3):40-8.
4. McCullough ME, Larson DB. 1999. “Religion and depression: a review of the literature.” Twin Res. Jun;2(2):126-36.
5. National Institute of Mental Health. What medications are used to treat depression? Reached from the website. http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml#pub5

Our hearts are broken today” said the President Obama after the school shooting in Connecticut on December 14, 2012. These words reflected most concisely the emotions all of us felt that tragic day, as our minds and hearts failed to grasp how possibly this could have happened, how come a seemingly human being could go this much lower than the wildest beasts. One of the ideas that was proposed to explain this murky situation was that the gunman had an Asperger’s syndrome, which was immediately refused by experts. “First and foremost, our thoughts go out to the families,” says Lisa Goring, vice president of family services for Autism Speaks. “We are all searching for answers, but it can be so irresponsible to label autism as the cause of this because we endanger totally innocent kids” (1). This article aims to explain what the Asperger’s Syndrome is about in an effort to save especially kids with this syndrome from another stigma that they have to deal with on top of so many other things.

Thirty years ago, only 4 or 5 Autism spectrum disorder (ASD) cases were reported per 10,000 people. Today, however, approximately 1 in 150 children across the U.S. is diagnosed with it; so chances are, you know someone affected either directly or indirectly by these disorders (2). This being the case, the debates, advocacy, and awareness activities are on the rise. Individuals with ASD show abnormal social interactions, language difficulties, repetitive or restrictive behaviors, and special interests. ASD includes Autism, Pervasive Developmental Disorder and Asperger’s Syndrome (3).

Asperger’s syndrome was first recognized by Hans Asperger in 1944 and the term was popularized by English psychiatrist, Lorna Wing, in 1981. The incidence of this syndrome is not well established, but experts in population studies estimate that two out of every 10,000 children have the disorder. It is more common in boys. They are three to four times more likely than girls to have Asperger’s syndrome (ninds.nih.gov). However, the prevalence in females might be lower because of the fundamental lack of awareness of what Asperger’s Syndrome looks like in females. A female with Asperger’s Syndrome might be considered as shy, quiet, perfect at school, tomboyish, moody, overly competitive, aloof, Gothic, depressed, anxious, or a perfectionist (disabled-world.com).

It is always challenging for people with Asperger’s to lead a normal life in spite of it because this disorder makes it hard to develop social and conversational skills. Affected people display socially and emotionally inappropriate behavior, limited facial expressions, body gestures and inability to recognize nonverbal signals. They lack interest in other people; however, they are obsessively interested in unusual and specific subjects. In addition, they prefer to follow repetitive routines or rituals because they cannot cope with unexpected changes.

Children with Asperger’s Syndrome

A child with Asperger’s syndrome may have the listed signs and symptoms (kidshealth.org):

• inappropriate or minimal social interactions
• conversations almost always revolving around self rather than others
• “scripted,” “robotic,” or repetitive speech
• lack of “common sense”
• problems with reading, math, or writing skills
• obsession with complex topics such as patterns or music
• average to below-average nonverbal cognitive abilities, though verbal cognitive abilities are usually average to above-average
• awkward movements
• odd behaviors or mannerisms
• lack of eye contact

Parents usually sense there is something abnormal about a child with Asperger’s by the time of his or her third birthday, and some children may exhibit symptoms as early as infancy. Their early language skills retain but motor development delays (for example, crawling or walking late, clumsiness) are sometimes the first indicator of the disorder (ninds.nih.gov).

Hans Asperger called the children with these behaviors “little professors” because they could talk continuously and in great detail about their favorite subjects. These little professors may have an amazing ability to recall dates, names, and events. One parent laughs about how her ten-year-old knew the scientific name of everyday things—from the sugar in the kitchen to the trees in the backyard. He would keep discussing things using the scientific classification (yourlittleprofessor.com).

Most children with Asperger’s syndrome have difficulty interacting with their peers due to the problems in understanding figurative language and tendency to use language literally. Children with this syndrome do not recognize non-literal language that includes humor, irony, and teasing. They struggle just to understand common social cues so they are mostly loners and may display odd behaviors. A child with Asperger’s, for example, may spend hours each day preoccupied with counting cars passing on the street or watching only the weather channel on television. Children with Asperger’s syndrome are also at risk for other psychiatric problems including depression, attention deficit disorder, schizophrenia, and obsessive-compulsive disorder (aacap.org).

While the more obvious symptoms of autism are usually at their most florid in early childhood, the symptoms of Asperger’s syndrome may only become noticeable with the social and functional demands of adolescence (autism.net.au). Luke Jackson, a thirteen-year-old boy with Asperger’s Syndrome from England, wrote a book named Freaks, Geeks and Asperger’s Syndrome: A User Guide to Adolescence. He wrote this informative, sincere and entertaining book about complicated topics such as bullying, friendships, when and how to tell others about Asperger’s syndrome, school problems, dating, relationships and morality (4).

The idea that every child with Asperger’s syndrome is a potential genius can put excessive pressure on a child with Asperger’s syndrome (yourlittleprofessor.com). Luke Jackson, for example, complains that he is always watching television about high functioning autistic people who can do things like play the piano brilliantly without taking lessons, draw detailed renditions of buildings they had only seen once or add numbers in their heads like Rain Man. “I find these television programs depressing,” he says. “I got all the nerdiness and freakishness but none of the genius.”

Seeing a child struggle socially and emotionally can be particularly heartbreaking for parents. Children who had seemed to be developing in normal and delightful ways suddenly retreat into their own world, excluding their loving moms and dads in the process after being diagnosed with ASDs. Learning more about ASDs can help parents take charge of their child again and find treatments and therapies that work (specialchildren.about.com). In some states, expanded services are available through public school programs. The most valuable service might be “parent in-home training” with a behavior specialist sponsored by the school. Moreover, parent education and skill building groups organized by some hospitals or health centers can be helpful for parents of youth with ASDs.

Speculations about famous people with Asperger’s Syndrome

There are many famous people for whom there is a lot of speculation that they had Asperger’s Syndrome (5 and 6), such as Albert Einstein, Benjamin Franklin, Leonardo da Vinci, William Shakespeare and Ibn al-Haytham. We may never know for sure if all these people have been affected by Asperger’s syndrome. However, most of the listed geniuses focused on something which interested them and their works were not disrupted by the everyday interactions that take up so much time for the rest of us. This might be the key factor behind all their great inventions. Then we can think of their Asperger’s syndrome as a blessing for humanity, because it does give certain strengths and brilliance to these scientists or pioneers that others do not have. In brief, Asperger’s syndrome is not a handicap, but rather a collection of strengths and challenges. If Asperger’s individuals are supported as they explore their capabilities, they can build on their strengths; they can even be the most successful people in history.

References

1. http://shine.yahoo.com/parenting/why-asperger-8217-didnt-cause-sandy-hook-school-164900109.html
2. Delaney T. and Madigan T. 2009. The Sociology of Sports: An Introduction. Jefferson, NC: McFarland.
3. Llaneza DC, DeLuke SV, Batista M, Crawley JN, Christodulu KV, Frye CA. 2010. “Communication, Interventions, and Scientific Advances in Autism: A Commentary.” Physiol Behav. 100, 268-276.
4. Jackson, L. (2002). Freaks, geeks and Asperger syndrome: A user guide to adolescence. Philadelphia, PA: Jessica Kingsley Publishers.
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