Has there ever been a point in your life when you’ve felt so overrun you wanted to shut down completely? Many people have had this experience, though it is more common for autistic children, adolescents, and adults. Meltdowns are frequently misunderstood and are often described as panic attacks or tantrums. In children, meltdowns can look like tantrums (either age-appropriate or in a way that seems immature for their age) from the outside, and they are often mistaken for anxiety and panic in adolescents and adults. While they are often associated with anxiety, meltdowns are different from panic attacks, and understanding what is happening can help with both management and prevention. To start, it is important to know the differences between tantrums, panic attacks, and meltdowns.

Tantrums: Most common in young children, tantrums are uncontrolled anger and frustration, usually in response to not getting something they want. As children mature and learn to deal with independence and frustration, they learn self-regulation (how to calm themselves down) and effective communication skills. Most children have fewer tantrums after about age 3, and there is not usually a need for specialized treatment to address them.

Panic attacks: Triggered by anxiety or nervousness and caused by adrenaline (the fight or flight response), panic attacks can often be identified by shortness of breath or tunnel vision. At the moment, strategies for panic attacks include grounding techniques (noticing the things around you to help stabilize you) and relaxation techniques. They are sometimes treated with daily or as-needed medication, and therapy can often help individuals better learn to manage panic.

Meltdowns: Caused by overstimulation (too much sensory input) or an unexpected change in routine, meltdowns may look like uncontrolled emotions (crying, screaming, etc.) or total withdrawal. Meltdowns can occur in both children and adults (though they can be harder to recognize in children if their communication skills are limited).

What can you do to help when a meltdown is happening?

The best course of action with a meltdown is not to stop it but to ensure everyone’s safety. Meltdowns cannot be stopped until they’ve run their course. If you are witnessing a meltdown from the outside, it can be hard to understand that this person is not in control of their body or behavior. Discipline or trying to discuss logic or consequences are not helpful strategies in the midst of a meltdown. Instead, parents or teachers can help children experience meltdowns by removing others from the room, picking up things on the floor that can be easily tripped over, and keeping as calm and neutral as possible. It can be helpful to use phrases such as, “You might feel better if you…” and other ways to suggest directions rather than demanding them. Physical intervention should be avoided unless there is an issue of imminent danger.

If you are the one who experiences meltdowns, it can be helpful to let loved ones know how they could react supportively when you are melting down. If possible, try to find a safe space if you anticipate a meltdown—the bathroom or your parked car would offer some privacy and would allow you to experience the meltdown and let it pass. It is probably not helpful to try to stop a meltdown, but rather to adjust your environment to be as comfortable as possible.

Recovering from a meltdown

Once a meltdown is over, the person needs time to recover. If you are on the outside, providing comfort or reassurance, or something tangible, like a snack and a drink, could be helpful.  After a meltdown, recovery can be slow because that person’s reserves have been depleted. Do not expect too much or push too hard—respect their boundaries and give them space and choice.  If you have just experienced a meltdown, be kind to yourself. Recognize that it will be some time until you are able to “jump right back into things” again, and focus on small, concrete things that you can do to build back your endurance.

Preventing Meltdowns in the Future

If you can become familiar with warning signs for a meltdown, you can often actively prevent them. Look for symptoms of anxiety rising or increased feelings of being overwhelmed. Some ways to manage stress are:

  • Reducing uncertainty by thinking ahead/planning and researching new events
  • Allowing plenty of time for task completion
  • Minimizing rules where you can
  • Enabling choice and control for the individual
  • Understanding/Explaining the reasoning behind a task
  • Avoiding or finding accommodations for settings that agitate hypersensitivities
  • Accepting that some things can’t be done, especially for those with PDA

Warning signs that a meltdown is about to occur are personalized to every individual. Still, two common symptoms are withdrawing from conversation and hiding. It is also important to note that Meltdowns can look different than just outwardly explosive behaviors. They can also be less intense, such as curling up in a ball and rocking back and forth. The hiding could be the meltdown already occurring. The most important thing to remember is that, like everything in life, there is a learning curve to meltdowns. Not preventing one doesn’t mean you’ve failed the individual. Instead, look at it as a learning opportunity on how to help better next time.

PDA Meltdowns

PDA, Pathological Demand Avoidance, is a subtype of Autism and has specific triggers for meltdowns.  Increasing demands typically trigger PDA Meltdowns. Sometimes, presenting a task to a person with PDA is met with anxiety and avoidance. When this task is pushed further in a demanding way, the individual can then reach the breakdown point. The escalation to meltdown in this situation can happen very rapidly. Some early warning signs include distraction, excuses, and procrastination. After that, the person may experience withdrawal, reducing meaningful conversation, and even physical incapacitation. Sometimes the person may take complete control and get the job done (but don’t feel too relieved, a meltdown might follow shortly). A full meltdown may look like agitation/shut down that can escalate to self-harm and running away. The best way to avoid a PDA meltdown is to approach tasks and chores in a suggestive manner rather than an obligation. If you are interested in learning more about PDA, check out this blog post

link: https://helpandhealingcenter.com/blog/all-about-pathological-demand-avoidance/

Dr. Jessica Myszak has had over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she is able to work with families who reside in Arizona, Colorado, Delaware, Florida, Georgia, Illinois, Missouri, Nebraska, New Hampshire, Nevada, Oklahoma, Tennessee, Texas, Utah, Pennsylvania, Virginia, and North Carolina, Washington DC, Wisconsin, and soon, Alabama and Kentucky! If you are interested in learning more about potentially working with her, you can visit her website here or email her here to get the process started.