PTSD

TMS for Aspergers: Understanding Social Cues One Step at a Time

October 1, 2020

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Encountering social awkwardness is normal in everyday life. Stumbling across awkward situations and getting embarrassed now and again is something that people learn from a young age, but for individuals with Asperger’s disorder, this can be a real challenge. Sometimes people can generalize and combine both Asperger’s syndrome and social anxiety together, but this is not the case. While the two are vastly different, someone with Asperger’s can find it difficult to understand social and emotional cues. 


For someone with Asperger’s they can long to be able to fit into a crowd, but social awkwardness can take over their wants to fit in. With a new study of transcranial magnetic stimulation (TMS) and how it affects patients with Asperger’s disorder, it can be an incredible, life-changing experience with improving their judgement of social and emotional cues, and how to respond to them.


Continue reading to learn about:

  • An in depth look into Asperger’s Syndrome
  • What is TMS?
  • Revolutionary Results for TMS on Asperger’s
  • What Does the Future Look Like For TMS Procedures on Patients with Asperger’s?

An In Depth Look into Asperger’s Syndrome

How to Distinguish Asperger’s From Social Anxiety Disorder or Autism

So you may be wondering, what exactly is Asperger’s Syndrome? Well, many people ask this because it can be easy to get it mixed up with either social anxiety disorder (SAD), or even autism spectrum disorder (ASD). Doctors now have actually grouped Asperger’s and autism together, saying that it is a mild form of autism.


Someone with Asperger’s experiences problems with social skills. They can be just as smart as the person they're standing next to, but it can be a challenge when meeting new people, or dealing with large groups of people. People with Asperger’s can miss social cues that can be obvious to someone that doesn’t have the disorder, like understanding what body language is, or even understanding facial expressions. People diagnosed with Asperger’s can also come off as emotionless, meaning that they don’t smile, or it’s hard to show empathy for other people.

Asperger Syndome Symptoms
There are many signs of Asperger’s Syndrome and it is important to know how to distinguish it  from social anxiety disorder and autism. Image courtesy of Verywell Health. 


Comparing Asperger’s to social anxiety, someone’s anxiety is the driving force behind their problems with interacting with new people they meet, or even going out in public because they fear public humiliation. They are capable of forming and maintaining relationships, but they can experience issues with being overly sensitive to body language and even misreading it, can speak too softly, or even stand too far away from people out of fear of embarrassment. 


The main difference between autism and Asperger’s syndrome is cognitive ability. It can be described as a form of “high-functioning autism”, meaning that someone with Asperger’s can be very intelligent, but just not able to understand different social cues and can find themselves to be socially awkward when it comes to being out in public. With autism spectrum disorder, it can be difficult for an individual to communicate, show problems with social interaction, causes effects to the five senses, can have difficulty in a change of routine, and they can even have intense emotional reactions to many different kinds of situations. 

Background of Asperger’s Syndrome


Now that you know a little bit about Asperger’s syndrome and how to properly distinguish it between social anxiety disorder and autism, you should know when it was first discovered and researched on. In the 1940s, Vietnamese pediatrician Hans Asperger was observing young boys that were on the autism spectrum that had normal intelligence, but were quiet and lacked social skills. 


Asperger first referred to this disorder as “autistic psychopathy,” but described the children that he was observing as “little professors”, because they showed an intense focus on an interest that they had. Because of their intense interest in something, this resulted in them having a difficult time to reciprocate normal conversations. His extensive work resolved in the founding and understanding of Asperger’s and what it is known as today.

Hans Asperger studied Asperger's
Hans Asperger observed young boys that were on the autism spectrum, and distinguished what we know of today as Asperger’s Syndrome, the mildest form of autism. Image courtesy of ABC. 


Many years later in 1994, Asperger’s Syndrome was included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as being completely separate from autism. It is a controversial subject because many researchers believe that it is the mildest form of autism, but many others believe that it is its own separate disorder that shouldn’t be grouped into the spectrum. It was ultimately grouped into the DSM-5 in 2013, along with other developmental disorders, as part of the autism spectrum disorder. 

What is TMS?

Moving onto transcranial magnetic stimulation, otherwise known as TMS, it is a safe and FDA-approved treatment that can be used on many different kinds of brain health issues, mainly depression. This is a non-invasive treatment option for individuals where medication, or even talk therapy doesn’t seem to work.

 

effects of depression on brain before and after tms
TMS can help activate parts of someone’s brain that have been closed off before due to depression and it results in a significant mood boost and decreasing depression. Image courtesy of AltaPointe Health. 


TMS involves an electromagnetic coil that is pressed up against someone’s scalp near their forehead, where electromagnet is sent to the brain delivering a magnetic pulse. This is a painless procedure known to combat depression and activate parts of the brain where there has been decreased activity that could be due to depression, or other brain related disorders. TMS ultimately helps to decrease depression and boost someone’s mood. It is even said that seven out of ten people have shown to respond to the procedure and fifty percent of people experience long-lasting results from TMS.


Are There Side Effects to TMS?

If you were wondering, yes, there are side effects to TMS, but they aren’t as bad as they seem. Some common side effects include headaches, discomfort on the scalp at the site of the stimulation, tingling, or even twitching of face muscles, and lightheadedness. While these are the most common and minor types of side effects that TMS can have on someone, there are some uncommon side effects as well. These can include seizures, maina, which is more common in bipolar disorder patients, and even hearing loss if you’re not using the proper ear protection equipment during the procedure.

tms procedure
TMS can help for many people suffering from depression, but there are some common and less severe side effects, such as headaches and lightheadedness. Image courtesy of Medical Product Outsourcing. 


To make sure that TMS is a good option for you, it is essential to undergo a simple physical exam, and even get a psychiatric evaluation to make sure that you are qualified for it. If you’re considering TMS, you have to make sure that it is the right procedure for you, and with proper testing and medical evaluations, it can determine if it’s worth the very minimal risks that it has for you and your health.

Revolutionary Results for TMS and Asperger’s

For many people suffering from Asperger’s, there has been new evidence showing how effective TMS can actually be on the human brain to help overcome the disorder. Asperger’s is known for not having a lot of treatment options, not even medication. Besides therapy, TMS is another helpful way to be able to fight the disorder that many people suffer with to maintain relationships and even learn to understand empathy, and learn social and emotional cues. 

tms remisson rates
Seven out of ten people that undergo TMS have shown to respond to the procedure, while fifty percent of people go through remission and experience long-lasting results. Image courtesy of TMS. 


TMS has been proven to minimize the symptoms of Asperger’s by being able to pick up on social cues more naturally, make eye contact more naturally, and even helping to make friends easier than ever before. Beginning to understand feelings like never before as well can be something that comes out of TMS. For many Asperger’s patients, this can be very scary at first, because for once in their life they are starting to understand social and emotional cues from their family, peers, or even strangers they meet. 


The electromagnetic pulses that are transmitted to the patient’s brain can open up someone's mind to make them think things that they have never thought before with using their emotions to do so, which is something that can be quite difficult for someone with Asperger’s. The brain is such a complex thing to be able to understand, but TMS has shown to have a positively significant effect on people with Asperger’s Syndrome. 

Is There Evidence From Someone With Asperger’s That Underwent TMS?

Yes, actually a man named John Elder Robison underwent TMS to help his Asperger’s when he was 50 years old. He was first diagnosed with Asperger’s when he was 40 back in 1990, and many doctors believed that he was on the autistic spectrum because he lacked many emotions, and it was just generally believed that people on the autistic spectrum lacked emotion. For Robison, he struggled to show emotion, read emotion, even give empathy to people close to him.  He felt disconnected to reality throughout his childhood and early adult life due to his Asperger’s Syndrome.


In 2008 when he turned 50, he decided to participate in a three-year research experiment using TMS to hopefully improve his Asperger’s. Researchers would study his brain functions before and after TMS to see if there was any significant improvement. This study’s goal was to “re-tune” the brain cells in Robison’s brain and how they communicate together to make it easier to show his emotions and how to better connect with the world around him.

John Elder Robison
John Elder Robison underwent TMS on his Asperger’s Syndrome, which successfully worked and helped him to understand his emotions, along with the emotions of  people around him. Image courtesy of Doctors Book Club. 


Although this sounds like it significantly helped Robison, he faced many different challenges afterwards. Robison felt crippled by the weight of the emotions that he was previously never used to experiencing and even by other people’s feelings as well. He even recalls describing his newfound emotions by someone skinning their knee. A common reaction to falling and skinning your knee would be wincing at the pain that comes with it. Before, Robison would feel emotionless after the act, pushing himself to get up and continue on, not even reacting to the pain in his knee. Before, he never would’ve experienced the common reaction to wince at pain, but now he can feel empathy for people and their pain.


For the first time in Robison’s life, he has been able to experience emotions, both his and others, but he also feels that his Asperger’s has shielded him from the horrible effects that the world can have on someone. He would feel bad for people that would express how expensive college was, how they couldn’t afford to get their car fixed, or even how they wish they were financially better off, and before he wouldn’t feel any kind of sympathy towards them. He now feels that he has learned how challenging it really is to live in the world we know of, and this is something that has been very overwhelming to him.

functions of the brain
There are many different parts of the brain that TMS can be used on for an Asperger’s patient that can significantly help them to understand emotions better. Image courtesy of Psych Scene Hub. 


Overall, even with the challenges that Robison faced after his TMS procedure, it has improved his sense for picking up social and emotional cues when meeting, or talking to people, and it has helped him to gain insight into his emotions, along with other people’s as well. TMS is a revolutionary procedure that worked wonders on Robison’s Asperger’s Syndrome to help him live a better life, even if it has been eye opening in some negative aspects of the world as well.

What Does the Future Look Like For TMS Procedures on Patients with Asperger’s?

As of now, the Food and Drug Administration (FDA) has only approved TMS for depression, so for many patients with Asperger’s, they may have to wait a while before it is approved by the FDA to undergo this procedure. Many researchers believe that TMS would work wonders on patients on the autism spectrum, including Asperger’s, but first there has to be more research to deem it safe, and more successful stories on it, like John Elder Robison’s. 


As of now, it seems that like depression, TMS is able to open up certain parts of someone’s brain that has Asperger’s and is able to let them experience emotions, and understand social and emotional cues. With more research on this topic, we hope that in the near future we will be able to see the FDA approve TMS on patients with Asperger’s to give them a whole new life of being able to understand what feelings and emotions are like never before.


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