Friday, July 10, 2009

An Apple a Day

While a person might be described as passionate, somber, or as a worry-wort, it isn't until those people become manic, depressed, or paranoid that those in the medical profession may ethically intervene. The debate is when a person has gone far enough outside the bounds of "normality" to necessitate medical intervention and who gets to decide that an individual has gone too far.

What is the goal of the medical profession's treatment, anyway? Is it to bring people into the range of normality or to completely eliminate the deviation? Should a person be left just a little bit cancerous? Just a little manic? Just a little depressed? Individuals with bipolar disorder are said to be more realistic and to have a better perspective on their emotions, to be more creative, better at setting goals and have greater motivation than the average person. Some of the world's finest artists are considered bipolar. There are streams of thought that doctors should only treat the depression side of bipolar disorder, should only treat the mania if the person is in physical danger from it, or should only treat the mania enough to bring it down to the hypomanic state and not to eliminate it. This is influenced by the requests of those in manic states who refuse to take their medicine and say they feel great and don't want to be brought back down. What is a doctor's obligation in this situation?

Derek Paravicini's blindness is said to be one of the contributing factors in his auditory abilities that make him a musical savant.

Stephen Wiltshire's memory for details that aid in his being an artistic savant might be partially explained by his autism.

If Derek's blindness and Stephen's autism were taken away, would their quality of life be benefited or harmed? If they would be harmed, would it be ethical to treat them for these conditions? Who decides?

With the proliferation of depression medication in the USA, people aren't feeling happier. Are the treatments helping? Is it ethical for doctors to prescribe a treatment that might work, even though it might exacerbate the problem and they don't really understand what's going on with the problem or how the treatment works to address it?

In the deaf community, no treatment was available and an identity of being deaf emerged. One had to accept that this was one's reality and would remain so. In combination with being unjustly connected with insanity or mental deficiencies, those who were deaf could not function within the larger community because the larger community rejected them. It was only through schools like Gaullaudet University that deaf students were empowered to become fully functioning members of society. There, they learned deaf culture among their other studies to learn to be proud of who they were and the great people through history who were deaf, who helped shape a community they could belong to with pride, and their own language--American Sign Language.

With the advent of cochlear implants, controversy arose. Was deafness something needing to be fixed? Was a parent denying a child his heritage if the child was removed from the deaf community by becoming a hearing person? Were those with cochlear implants traitors? Some high schools and colleges began removing ASL from their approved foreign language credits. In some circles, the treatment for deafness led to the deaf community being expected to fully integrate and not maintain a separate culture. Many (most?) in the deaf community did not and rejected any calls that expected them to do so. They said they didn't need or want to be fixed--there was nothing wrong with being deaf.

Following on its heels, autism diagnoses are on the rise. What is widely established as an incurable syndrome that must be accepted as one's reality is now being challenged with people like Jenny McCarthy claiming to have cured her son of autism through intensive therapy.

Did her son have autism? Was it caused by vaccines as she believes? Should she have tried to cure him of it? Are some or all forms of autism curable? Numerous treatment models, adaptations, diets, modified vaccination schedules, and other ways of trying to treat autism have arisen, but enough information isn't available yet for any consensus.

In the void, an autistic identity has developed for some in which they identify as being autistic, see it as a source of pride, identify with famous people in history who might have been autistic, and do not want to be treated for something they don't see as wrong. Which brings us back to the question of when a person has gone far enough outside the bounds of "normality" to necessitate medical intervention and who gets to decide that an individual has gone too far. When it comes to Asperger's and autism, what do you think?


  1. Your comments were off, but now seem to be on...

    This is a touchy subject. What is "normal" anyway. Do we categorize autism and Asperger's as disabilities? Particularly with Aspies who live independently? Or should they be medicated to be more mainstream?

    My husband doesn't take any medication for his Asperger's. Sometimes we wonder what affect it would have on him. I don't know much about them, but I think meds prescribed for Aspies are more along the lines of helping them relax in social situations and maybe deal with some of the paranoia issues, and possibly depression.

    Does your husband take anything?

  2. How strange. I haven't changed any settings. I'll chalk it up to one of those mysteries of the internet.

    No, my husband does not take medication. I imagine he would be quite reticent to do so if it were ever offered, as well. While he does have general social anxieties, he doesn't recognize it as anxiety and feels comfortable with the workarounds he puts in place, like allowing me to speak for him. It makes other people think I don't let him speak for himself, unfortunately. I wonder if women with AS whose husbands speak for them have people thinking the husbands are abusive and controlling or if it is more accepted. He's so disconnected from his feelings that he wouldn't see a need to medicate for emotions, even if there were compelling reasons, which I wouldn't say there are. I wonder if he will suffer more from anxiety if he effectively addresses some of his alexithymia. I suppose if he ever suffered greatly from it that I would strongly lobby for medication.

    I haven't thought of it in the realm of a disability. I can see why some might. I see it more as this isn't getting us where we want to be so we need to do what we can with what we have to move us in the right direction. Since we've exhausted our own limited knowledge, we're learning from counseling, from reading, from the internet... I'm not comparing him to the mainstream. I'm comparing him to my lowest common denominator needs, which he was able to fulfill at one time and so in my perpetually optimistic mind should be able to be met again with the right supports in place.

  3. I sometimes end up speaking for my husband too, and worry about the image that projects. I encourage him to speak for himself because of that, and he's getting better, but a lot of the time, especially with his family, he won't speak up and they in turn step all over him.

    When he was "officially" diagnosed, the therapist asked if he wanted a written proof-of-Asperger's thing or some such to use in the case of the American's with disabilities act. We were just, "uh.... no thanks".