Advice for a friend - suspected Asperger's

<p>I will start this thread by again offering thanks to those who have helped me in the past. I have followed through on many of your suggestions and have found them to be helpful and enlightening, which is why I’m again appealing for help.</p>

<p>I will begin by stating that I am aware that I am not (yet) a mental health professional, and my limited experiences as a psychology major do not in any way give me the authority to make diagnoses. That being said, it seems very possible that what he’s dealing with could be autism-related. </p>

<p>If the problem ended at simple social awkwardness and did not impair his ability to function, I would probably be more reluctant to address the problem. However, whatever he is dealing with is having significant impact on his life and I really worry for his prospects to be successful in the future. </p>

<p>The first issue here is hygiene. He is incredibly difficult to be around because, to put it simply, he stinks. He refuses to shower for a week or more at a time, and in addition, does not change his clothes. I’m also not convinced that he ever brushes his teeth because they have a pretty solid coating of yellow that makes people cringe. I have spoken to him repeatedly about this issue, and he knows exactly what I’m going to say before I even say it, but says that the showers on campus make him anxious. I suggested that he go the counseling center if he’s having an anxiety issue, but to my knowledge he’s never followed through on that. It’s had enough effect on our social dynamic that we will not engage in physical activity while he is around because we do not want him to sweat. (Which prevents us from playing DDR, which is a favorite among my circle of friends.) It just makes me physically sick to my stomach to be around him, and my boyfriend’s room has to be hosed down with Febreeze after he leaves or else his smell lingers. It’s absolutely disgusting and I don’t know how long I can continue to tolerate it. </p>

<p>Secondly, his behavior is a significant issue outside of our circle of friends. He’s completely socially clueless and has difficulty maintaining conversations outside of his comfort zone, which largely consists of video games and anime. When these topics are not being discussed, he will begin to talk about them inappropriately, or when they are, he will continue on these topics at length and to a level of detail where it would be apparent to most people that those listening were not interested. He has gone so far as to make “choice” types of presentations in college classes on these subjects. </p>

<p>Thirdly, he engages in a number of behaviors that others find very annoying or peculiar. He has a laptop or DS out at pretty much all times during social functions, and he comments out loud about being bored during programs or events that do not focus around his areas of interest, often in earshot of those hosting the programs. He chews absurdly loudly, and also engages in incredibly rapid bouts of sniffing and blinking. </p>

<p>I’m sorry if this description comes off as mean, because I honestly think he is a nice, smart guy with some sort of issue that I highly suspect to be autism-related. I’m trying to paint as much of the picture as possible so that you can get an idea of the problems that he’s exhibiting and the obvious impact that they have on his prospects, both social and future. It should be said that there are times when he is relatively socially normal and engages in a conversation that does not revolve around his interests, but these moments are honestly too few and far between.</p>

<p>He has been diagnosed as having ADHD but I’ve read that Asperger’s is frequently misdiagnosed as this, especially since he was diagnosed at a much younger age. I’m not sure if his family have any suspicions, but I’m reluctant to bring it up to them because I know they have enough on their plate right now with his younger sister currently fighting ovarian cancer. </p>

<p>It’s obvious to me that he’s aware of his oddities, and he frequently puts himself down in front of others. Our group of friends used to reinforce the behavior by attempting to ease his concerns (for instance, he frequently calls himself ugly but he’s not aside from the hygiene issues). However, the group as a whole has long since stopped responding to these ploys because they have become so frequent and he is never satisfied with the answers. </p>

<p>I just don’t know what to do at this point. Currently, he has a place in our group of friends because of my boyfriend’s and my attempts to keep him connected to the group by texting him for meals and other gatherings. However, after my boyfriend leaves I don’t know what I’ll do. My boyfriend has gone so far as to provide him his own chair to sit in, which nobody else touches, but I certainly don’t want him to be sitting in the furniture in my room next year when I return and my boyfriend has graduated. </p>

<p>I feel like this all sounds horribly mean but I can’t help but worry that we’re setting him up for failure by being so tolerant of his behaviors. I feel that any other social circle or place of employment would not have him, given his social skills and hygiene problems. (He called his mother a d0uche when she tried to ask him a question while he was playing his DS, for instance.) The question is: how can I get him help for a condition I’m not by any stretch sure that he has? How can I help someone who has frequently been made aware of his own problems and appears to have no interest (or is perhaps too intimidated) in addressing them? </p>

<p>Thanks for reading if you’ve made it this far. Again I apologize if this comes across as mean, but it is a pretty honest assessment of his general behavior.</p>

<p>Well, I don’ know if I have any suggestions but I just wanted to say that you do not come off as mean. On the contrary, you are clearly a kind and tolerant friend.</p>

<p>Is there an RA or someone in charge of the dorm that could talk to him? Or a professor/other university official who might be able to help? Maybe the “leader” of your group of friends?</p>

<p>If he has Asperger or another form of Autism, he probably is not manipulating. I do think frank honesty might work, though. You may need to give him an ultimatum. The next time you are all gathering in a room, let him know ahead of time that he is welcome to come…if he showers and brushes his teeth first.</p>

<p>Have you considered having the RA talk to him? Would that be horrible?</p>

<p>I don’t know about OP’s school since this kind of thing varies widely, but the RAs at my school would be entirely unprepared for and uninterested in this issue. If it were me, and I am saying this as an aspie myself, I would go to counseling services if you have that at your school and ask them for advice. Someone who knows nothing about autism is not going to have a clue what to tell you (ie almost EVERYBODY on the planet), and while counseling having a clue what they are talking about is not guaranteed, that’s your best shot most of the time. </p>

<p>I don’t have any of the hygiene issues so I am not sure what advice to give you other than that. I suppose I would want my friends to tell me if I was doing something awful, privately, of course-- maybe over email so if I am embarrassed by being called out at least nobody can see-- that goes against most peoples view that everything should be done in person, but I think that’s what would make me personally most comfortable. I would say, though, don’t sweat the small stuff-- there are some things this guy either cannot change or it would be EXTREMELY difficult and take a long time and some help that is beyond what you can offer, and being a good friend to this kid means being able to let those things go when they don’t REALLY matter all that much-- fortunately, bathing is not one of those things and I wouldn’t feel weird about putting your foot down about that if I were you. I, and my friends with asperger’s, personally appreciate gentle, discrete reminders if we are doing something inappropriate in public-- like I have a friend hat tends to drone on and he doesn’t mind if we tell him it’s someone else’s turn to talk as long as we don’t embarrass him in front of others. I don’t know about your friend, but if he does have asperger’s you have to realize that these kinds of things are not as obvious to him as they are to you, so if he would accept some reminders you shouldn’t be afraid to be more blunt than you would normally be with a typical person. It feels inappropriate to say what you’re thinking sometimes but you have to with an aspie.</p>

<p>Thanks to all of you.</p>

<p>He has had a past RA talk to him, but to no avail. He was successful in getting him to do one load of laundry and take a shower, and that was about it. As for the leader of the social group, that’s definitely my boyfriend and he hasn’t wanted to deal with the situation. In fact, they used to be roommates and my boyfriend is a RA now, but he hasn’t wanted to deal with it because he feels like he’s had this conversation with said friend before a dozen times but with no results. He’s not willing to follow through on the idea of excluding him if he doesn’t shower, either. I think because my whole group of friends have largely been outcasts to some extent in the past, there are very few of us who would follow through on this. I’m probably the only one who has/is willing to continually address the issue.</p>

<p>As far as an ultimatum goes, I’ve never actually given one. I sent a text to the general idea of “Hey, could you take a shower before we go to the restaurant? You’re starting to get stinky.” My boyfriend considered that as saying “You can’t come out with us unless you shower” but I don’t think it was necessarily implied. </p>

<p>A friend of mine who is a RA suggested that I send an email to the director of the building about it regarding our suspicions and the situation, but I worry that he won’t be able to address the issue, either due to lack of time or not knowing my friend. I’m not sure if he’s aware of the issue, though I’d be surprised if he wasn’t to some capacity. Last year said friend’s RA made an attempt to address the issue because he was getting complaints from other residents that there was a bad smell coming from his room. </p>

<p>I think I might follow through with emailing the hall director, but I’m not sure how much it will help. My friend has been very unreceptive to help and has little interest in following through, probably because the social ramifications of his actions have been so little.</p>

<p>Emaheevul07: Thanks a bunch for your perspective. I always feel so mean when I point something out to him but maybe that’s what I should consider doing, or at least probe a bit to see if it helps. I realize that change doesn’t happen overnight, and some of the things like the chewing and sniffing are really annoying but certainly tolerable. At least with the conversation, it’s simple enough to change the topic.</p>

<p>From your experience, is there much by way of treatment or therapy for those with Asperger’s, or is it something you just kind of have to live with and learn to adjust to on your own?</p>

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<p>That could be the case, but you might be surprised. If it is autism, these things tend to run a little deeper than that.</p>

<p>I’m not sure that either you or the other friends in the social group have the power to change your friends behavior.</p>

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<p>There is little to nothing out there, particularly for adults. Some people work with therapists and manage to make some improvement, but there is no cure and options are limited. Very few people seem to know anything about the higher functioning end of the spectrum or how to support the adults on it, even medical professionals, so that sort of thing is very hit and miss.</p>

<p>Chewing and sniffing sound more like Tourettes, which is completely unrelated to Aspergers, but he could easily have both.</p>

<p>Is there a way to find out what his specific issue is about showering? Is there a place that he will shower? Is there a private place, where he can shut the door, lock everyone out and have a completely private shower, if that is the issue? If he won’t shower, is he willing to wash his armpits (which are probably the more stinky part) with soap and water daily instead? Can he use a deoderant that also has anti-perspirant, and put that on twice a day? If you use a good enough deoderant, that will go a long ways. He may not be washing his clothes enough.</p>

<p>Look, you are a wonderful friend. Don’t give up on him. You may be all he has and the best friend he has ever had. Don’t just tell him he stinks, help him figure out the problem and find solutions. Tell him you care for him, but this is an issue, so how can we fix it? If he has a serious paranoia about showers, there are ways around it to help him not smell. There are websites and groups all over the place to give advice to people with Aspergers. Believe me, when people start learning about it, they realize that they are not alone and that there are things they can do to help. People would rather put a name to something and try to work with it, than just think there’s something unknowable that is wrong with them.</p>

<p>Just the fact that he notices something wrong and desires to have contact with you and others is a big step, showing he isn’t too far up the spectrum. Be a kind, considerate friend, and keep helping him. But give him solutions. You are a kind and generous girl.</p>

<p>I know you and your friends are college-age, but this problem guy reminds me of a 16 year old. He hears the messages about hygiene, etc., but refuses to react to them. A lot of Asperger’s kids are slow to mature in this way - the thoughts in their heads tend to be kept in isolation. He also may not realize how differently other people think and feel about his issues.
Gentle support and non-negotiable guidelines are the best way to help him. You’ve got the gentle support down pat, and you are being a very good friend. Take the leadership role here - it might be easier for you rather than your boyfriend to insist on standards. Insist that this kid shower before he hangs out with you. No excuses. Give him praise when he makes some progress. Yeah, it’s something like training a dog, but you are doing him a huge favor. Keep your sense of humor, and hope for the best. He will develop eventually.</p>

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<p>Yeah, I realized this statement could come off as being a little callous regarding the complexity of human behavior. I’ve been doing a lot of behavioral coursework in psychology this year so my typical first reaction is to think of the antecedents and consequences of behavior, but I know that even behaviorists admit that this can’t fully explain human behavior. I didn’t mean to imply that it was as simple as “Well my friends don’t react if I don’t use proper hygiene so I shouldn’t bother.” </p>

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<p>Yeah, I kind of worry about that myself, but I certainly don’t want to give up on him as a lost cause. I just want to help him have a fighting chance in the world and without developing more appropriate social skills, I’m not sure what his prospects will be, realistically. </p>

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<p>Not really. We have showers with double curtains, but he feels this is too exposed. We tried to discuss other options with him, but he rapidly shot down anything that we could think of. Also, I don’t believe the armpits are the source of his smell. Basically, it consists of a wet dog kind of smell coming from his hair, and stinky butt. (I know this is the source of the smell because I accidentally put my head down in a booth where he had sat several minutes beforehand… I heaved.) I don’t think that these are smell sources that can be rectified without showering. His hair is very long so it gives off a lot of odor, and he lets it get greasy to the point that it looks damp. </p>

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<p>I think this might be what I have to do, but it’s awful hard to do this on my own without others backing me up, because it makes me feel like a jerk. :frowning: I know it’s in his best interests, though…</p>

<p>Another general question for everyone: Should I discuss my suspicions that he might have Asperger’s with him? I’m really not sure who I should bring it up to (his mother, hall director, RA, etc.). I’m not sure how he’ll react because I don’t think he’s ever considered it. His usual excuse for everything is “I have ADHD,” and I’m not sure if he’d react to my suspicion with understanding or hostility.</p>

<p>He’s not ready to hear about Asperger’s, though it’s obvious that this behavior is not just ADHD. As I wrote before, he doesn’t seem to understand why people perceive his behavior as unacceptable. IME, those with Asperger’s are very resistant to the label. They do generally respond well to direct, firm rules, though, and they do want the approval of others, though sometimes that seems like an impossible goal. I would just frame the requirements as those that your group has established - talk to them beforehand and get some backup for yourself. Also explain how firm and unemotional directives are best, and ask for their help in not letting the situation escalate into frustration and blame.</p>

<p>Julie your friend is lucky to have you as a caring friend.</p>

<p>You might try posting your questions/concerns in the parents forum on Wrong Planet.</p>

<p>[Wrong</a> Planet - Autism Community](<a href=“http://www.wrongplanet.net/]Wrong”>http://www.wrongplanet.net/)</p>

<p>I think you should broach the subject of Aspergers with him. If not you, who will? Gently, kindly, as you are already. Alot of times, people are so relieved to find out, yes, this is the name to the issues that I know I have. And I’m not alone, there are plenty of other people like me, and there are things I can do to help. Instead of just thinking, gosh I know there’s something wrong with me, but I don’t know what! It really helps many people to know what the problem is, and to read about what others do to help themselves. This is a very gentle link, perhaps it would be easier for you to send him an email and ask him what he thinks: </p>

<p>[Asperger</a> Syndrome - Asperger’s Syndrome - Aspergers Syndrome - Symptoms of Asperger Syndrome](<a href=“http://autism.about.com/od/aspergerssyndrome/a/adultsaspergers.htm]Asperger”>Mild Autism in Adults and Children: Symptoms & Support)</p>

<p>He might just say…BINGO! Or maybe he won’t.</p>

<p>As far as the shower, there must be something private. A friend who has an apartment or room with a shower where he can shut and lock the door. A teacher or counselor who can help. A handicapped shower in the gym. There has to be a place on or near campus. Jeez, even if he had to rent a cheap hotel room for a shower every now and then, it would be worth it. Tell him firmly that he needs to find a way to shower, here are the options, and if they are good options, he can’t get out of them. And by the way, here is the soap and shampoo. I care about you and you have to do this so people don’t avoid you. Do it for your friends, please!</p>

<p>It sounds like he might have a bunch of things going on. The blinking and sniffing though sounds like mild Tourettes. He can’t help that.</p>

<p>I like the idea of broaching the idea of Asperger’s with him. </p>

<p>I think busdriver is right there must be an acceptable shower somewhere and it would be worth it to find it.</p>

<p>Tourettes is a possibility, I also wondered if it might be some sort of stim.</p>

<p>Nobody broached the subject of autism with me until I was in college, and I am really glad somebody did. That was what led to me getting diagnosed, which was life-changing in a good way. I knew something was wrong all along but didn’t know what, and nobody could figure it out. But by the time someone approached me about it I was desperate for an answer, any answer. I think I might focus on the symptoms themselves at first, namely the not bathing, and see if you can make some progress on that first. My concern would be that mentioning asperger’s might put him on the defensive if he isn’t open to the idea and make helping him even harder. Might help to try get a breakthrough on the bathing issue first and then bring it up once you actually have his attention, because it doesn’t sound like you have it now. If telling him he smells doesn’t get through to him I don’t think he’ll be very responsive to, “I think you have a disorder.” Just my two cents.</p>

<p>Have you tried explaining to him the importance of personal hygiene? I would make sure that he takes responsibility for that whether he likes it or not and has a creative outlet such as music, art, or a hobby to let loose. People with Asperger’s are usually extremely intelligent, especially in music, art, and technology. I wouldn’t address the probability that he is an Aspie (That is what people with Asperger’s endearingly call themselves. It’s not an insult.) I think that you should address things such as hygiene and manners, but leave his social issues alone. Counseling might help him fight of any issues such as depression too.</p>

<p>I was severely depressed once and I didn’t shower for 2 weeks. It was so bad. I would just spontaneously start crying. I had terrible mood swings and locked myself inside for 2 years, only going outside about 8 times to get the mail or groceries. I was only 14 too. I’m all better now, although I have no idea why.</p>

<p>It sounds like he might be depressed. Believe me when i say that depression SUCKS. You should consider counseling.</p>

<p>It really, really sounds like this kid is an Aspie. Aspies don’t take hints. You probably won’t be able to help him with his social cluelessness-- that’s not easy to remedy-- but you might be able to deal with the hygiene problem. I think you, or your boyfriend, or both of you, should sit him down and say that he probably doesn’t realize it, but his hygiene is an issue for everyone else. Explain that if he doesn’t shower and do his laundry regularly, you regret that it will be impossible to spend time with him. There’s no easy way to do this, he’ll be embarrassed, you’ll be embarrassed, but you’ll be doing him a favor.</p>

<p>Then when he shows up in dirty clothes unshowered, send him back to the showers.</p>

<p>Cardinal Fang is dead right. No hints, be specific and direct. Of course you don’t have to do this in public, or mock him in any way (I know you won’t). It would personally be easier for me to do this if I considered it as a motherly (or sisterly) role, as opposed to a friend’s role. For my friends, I would have a tough time saying anything so personal. As a mother, when my kids were younger, it was easy for me to say—you need to put deoderant on, now. Your shirt smells bad, you need to go change it. You need to shower every day. Your clothes are dirty, they need to be washed. Eventually, all it took was a look from me, and they knew what they needed…and now, of course, they are appropriately trained in hygiene. Making suggestions about using deoderant soap and getting good shampoo (he may be using soap on his hair, or nothing). A strong smell suggests to me that he is not doing his laundry either. Really, your friend may just need to get into the habit of doing these things, and once you get the ball rolling you may not have to remind him. Consider this may be uncomfortable, initially, but if you tell him that he is a good friend and you care about him, so these things need to be taken care of or people will avoid him. It’s consideration for others, particularly women (since we often are very sensitive to smell).</p>

<p>If you are kind and firm, the worst that could happen is that he’d avoid you, but that sounds unlikely if you and your boyfriend are his main friends. You are a problem solver, and you will be proud of yourself for caring enough to do the right thing. I guarantee you that the vast majority of people would just walk away. And the vast majority of parents would say, my daughter shouldn’t have to deal with this kid’s problems! But you are a caring and generous person, willing to step in there, and you have the potential to help your friend so much.</p>