Introduction to Why A Holistic Approach is Important in ASD
The Resilience Medicine Approach to the management of ASD with holistic, integrative and cannabinoid medicine.
Introduction
Autism is a lifelong developmental condition that affects how people perceive the world and interact with others. The core features of ASD are:
- Difficulties communicating and interacting with others
- Repetitive behaviours and special interests
- Symptoms that affect quality of life and functioning and key areas such as work and/or school
The difficulties associated with ASD can have a huge impact on your daily life and functioning and it’s common to feel a sense of overwhelm. There is no cure for ASD itself because ASD is not an illness. Instead, it is a difference in the way the brain works. However, people with ASD or neurodiveristy often experience severe distress, secondary mental health conditions and challenges because of the difficulties these brain differences causes everyday life. A holistic approach if you have ASD can dramatically improve your quality of life, help you become more comfortable with yourself and improve your mood. It can help reduce fatigue, anxiety, ‘asd burnout’ and other bothersome symptoms so you feel more at ease in your mind and body and can dramatically improve your ability to function and thrive.
The Resilience Medicine Holistic approach incorporates cannabinoid (cannabis-based) medicines where appropriate, mindbody approaches, diet, prescribed combinations of nutraceuticals & medications where needed, passion and connection and creating a resilience environment using evidence-based and evidence-informed interventions stacked together and personalized to you.
In this article you are going to learn about each of these holistic approaches , how to use them for your healing journey, the latest research & explore a case study to help remove the confusion and help provide a path to feeling better.
What Causes ASD
ASD is thought to have both genetic and environmental factors and everyone’s experience can be slightly different. Genetic influences and certain alleles, environmental factors and immune factors all seem to play a role. Differences in Transcriptomes and in epigenetic dysregulation are also factors at play according to the most recent research. We are still learning more about the multifactorial causes of ASD.
Diagnosis
Diagnosis of Autism Spectrum Disorder in Children and Adults
The process of diagnosing Autism Spectrum Disorder (ASD) in both children and adults comprises a thorough assessment conducted by a team of specialised healthcare professionals. Evaluating an individual’s developmental history, behaviour, and social communication abilities is essential in identifying ASD symptoms.
For children, the diagnostic journey typically begins with a referral from a general practitioner (GP) to a specialist team that may include paediatricians, clinical psychologists, and speech and language therapists.
In the case of adults, the assessment is often carried out by a psychiatrist or clinical psychologist with expertise in ASD. Standardized diagnostic tools, such as the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R), are employed to help determine if an individual meets the criteria for ASD as per the International Classification of Diseases (ICD-10) or the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Timely and accurate diagnosis for both children and adults is crucial for providing appropriate support, interventions, and resources, ensuring improved quality of life and long-term outcomes.
It is often the case in teens that they come to a diagnosis of ASD after seeking help for school difficulties, behavioral issues or anxiety or depression that have often been ‘medication resistant.’ It is then discovered that the mental distress caused by undiagnosed ASD is playing a big role and explains many of the challenges faced. Once diagnosed, ASD friendly strategies and approaches can be initiated.
The Resilience Medicine Toolkit for ASD
The Resilience Medicine holistic approach involves incorporating interventions from 6 main categories: Cannabinoids, Diet + Microbiome, Mindbody, supplements & botanicals, Passion and connection & creating a resilience environment.
In the clinic, we also use functional medicine tests and approaches to further personalise treatment based on biomarkers, gut markers and genomics in some cases, since it has been shown that people with ASD often have a different microbiome and brain-gut factors may be helpful in management once uncovered. We also, where needed, use medications, often with prescribed combinations of nutraceuticals.
These categories were chosen based on Dr Dani’s 15 years of experience using this holistic treatment framework with her patients. Often it is when things from different categories are ‘stacked’ on top of each other to create a unique integrative plan or ‘stack’ that gives the most benefit in ASD, since everyone’s experience is unique.
It’s also worth remembering that even if you have tried some of these things before on your own, it is often getting the right combination of things done at the right time that makes a big difference.
It can be very overwhelming and confusing trying to navigate all of the pieces of a holistic treatment plan on your own. Having expert guidance helps remove this confusion and overwhelm and makes sure you are on the best treatment path for your individual needs.
Medical Cannabis
Medical cannabis is legal in the UK and is available on private prescription from a specialist doctor. Medical cannabis are whole plant medicines which contain over 100 active cannabinoid compounds, which are thought to work together to deliver the medicinal effects although the main cannabinoids used for dosage currently are CBD and THC. The different strains or chemovars, can produce different therapeutic effects, making it a highly personalized medicine.
Medical Cannabis can often help patients those who have failed other approaches, to help improve quality of life, starting a positive ‘cascade’ leaving them more able to engage with other aspects of a holistic ASD management plan.
Most patients see a significant improvement within the first month of
therapy across multiple symptom clusters such as anxiety, mood, fatigue, stress and mental function.
How is Medical Cannabis Different to CBD I can buy in a shop without a doctor?
Hemp CBD oil wellness supplement products available over the counter at health shops are not the same as medical cannabis. Hemp cbd oil non medical products do not contain any measurable THC and are not made as medicines. It is the THC component that is often most helpful in very small controlled doses or ‘microdoses’ usually along with CBD for its beneficial effects.
Medical Cannabis for ASD
Medical cannabis can often help with symptoms that have not responded to medications, including helping with coping and mental function in ASD based on clinical research evidence on the endocannabinoid system and ASD, the neuroinflammatory aspect in ASD and cannabinoids, large real world data sets, observational case series as well as patient experience and expert opinion. This includes high CBD extracts for comorbidities such as anxiety and THC containing extracts helping with behaviors and improved overall functioning. Medical cannabis can also help with the irritability and sleep disturbance many people with ASD experience.
Some adults with ASD find the THC dominant medications are most helpful in small doses and that in the past the CBD they tried made them feel worse. This is quite common in adults with ASD due to a difference in how the neurodiverse brain responds to cannabinoids.
Because it a highly personalised medicine, it is well suited for people with ASD which itself is a very broad diagnosis and can be very different from one person to the next.
It is also generally very well tolerated, more so than other medications used commonly in ASD.
Medical Cannabis works on our endocannabinoid system (ECS) dysregulation, our HPA axis stress response system as well as our serotonin system and also has activity in the gut. All of these mechanisms may be relevant in ASD. Studies have also identified differences in endocannabinoid levels as a possible biomarker for ASD.
Dr Gordon is the most experienced cannabinoid medicine physician in the UK, has trained the first UK psychiatrist physicians in the prescribing of medical cannabis for a variety of mental health indications. She has treated thousands of patients with medical cannabis first in Canada and in the past few years in the UK since it has become legal. She also uses a more holistic individualized approach to cannabinoid therapy due to her background in Integrative & botanical medicine
Therapeutic Diets for ASD
Certain types of diets may influence and improve symptoms of ASD, due to the effects on factors such as the microbiome, affecting neurotransmitter levels and hormone pathways including insulin and stress hormone regulation and even mycotoxin exposure and elimination. It’s often important to tailor the diet based on things like symptom cluster profile, and sometimes gut and/or blood biomarkers and other factors which are assessed as part of the treatment plan.
Following a whole-foods gluten-free low casein diet low in added sugar and greatly limited processed foods as well as eliminating foods with artificial colorants and preservatives is a good place to begin. Some patients may also benefit from doing an elimination and food reintroduction diet to see if certain foods are behavioural triggers.
If the diet is very restricted due to sensory processing issues, approaches such as food chaining and others tailored to each patient may help to slowly expand the diet in both kids and adults.
Mindbody Medicine for ASD
Mindbody practices help to actually change the brain structure and function in multiple ways, turn down the volume on stress, anxiety and pain signals and help our brain’s become more resilient. Utilizing the bi-directional brain-body communication link can be very effective at reducing distress and many symptoms people wit ASD suffer from. One recent study for example (Stockall & Blackwell, 2022) showed that mindfulness training can reduce anxiety in adults with ASD. However, some techniques, such as CBT may need to be adapted for neurodiverse people to get the most out of them and sync with how they process information best. Neuromodulation with biofeedback devices, which can be at home and monitored remotely by a doctor is a new frontier in helping with mindbody regulation in ASD.
Supplements
Supplements including nutraceuticals, botanical extracts, medicinal fungi, adaptogens and and minerals can all be helpful for different aspects of non-core symptoms, such as reducing anxiety, irritability and helping with sleep and cognitive function. Each person will likely have a slightly different ‘stack’ of supplements based on their specific case but could include:
- D-lactate free probiotic
- Lionsmane
- Reishi
- Magnesium Glycinate
- Passionflower
- Hops
- High EPA omega 3s
- EMPowerPlus micronutrient supplement
Medications
Current medication treatments for ASD are limited to helping control behavioural issues, rather than addressing the underlying mechanisms. They have limited efficacy and often significant unwanted side effects. There is a significant amount of current research phase experimental therapeutics including drugs that target the endocannabinoid system. Medical cannabis has been found to be helpful by many patients with ASD in improving function and quality of life. Conventional medications for mental health symptoms are often not well tolerated or effective in neurodiverse people but are sometimes tried. One medication that is sometimes helpful, although it doesn’t work for everyone, is slow release melatonin to help with sleep wake cycle disturbances in ASD.
Resilience Environment
Creating an ASD-Friendly Home Environment
Environmental factors play a significant role in shaping our well-being, with elements such as noise, light pollution, air quality, and exposure to chemicals in food having potential impacts on health. For individuals with Autism Spectrum Disorder (ASD), these environmental influences can interact with genetic factors, making them more susceptible to external stressors. To create an ASD-friendly home environment, it is essential to consider strategies that promote a sense of calm and reduce anxiety.
Incorporating indoor plants into the living space has been demonstrated in multiple studies to decrease anxiety levels and improve mood. Selecting air-purifying plants, such as snake plants, spider plants, and ferns, can contribute to a cleaner indoor atmosphere and provide additional mental health benefits. These plants not only enhance air quality by filtering pollutants but also create a soothing and visually appealing environment.
Establishing a designated calming space within the home can be highly beneficial for individuals with ASD. This area should be a quiet, comfortable corner where they can retreat when feeling stressed or overwhelmed. Encourage the use of this space for relaxation techniques, such as meditation or deep breathing exercises, even if only for five minutes at a time. Consider incorporating sensory-friendly elements, such as soft lighting, weighted blankets, and calming colours, to further enhance the calming effects of this designated area. Soothing lighting using smart bulbs may also decrease sensory overwhelm and help with sleep wake cycle disturbances.
By focusing on these strategies, families and caregivers can help create a supportive and nurturing home environment for individuals with ASD, enabling them to better cope with daily challenges and improve their overall well-being.
Passion & Connection in ASD
Social connection, bonding and having warm close relationships can have a positive impact on physical, immune system and brain health. Spending time with animals has been shown to reduce stress and anxiety levels and can be a great way of connecting for those with ASD.
Many people with autism have special interests, which in adults with asd is associated with increased sense of wellbeing. Special interests in one study were associated with higher subjective well being and satisfaction across specific life domains including social contact and leisure. However, if the focus on special interests becomes highly intense, it can start to negatively impact wellbeing so balance is key.
Functional Medicine Tests for ASD
There is no standard blood test to diagnose ASD, it is a clinical diagnosis.
From stress tolerance and resilience testing to looking at the gut microbiome for biomarkers, circadian rhythm dysfunction, and factors like gene mutations which affect neurotransmitter levels, functional medicine testing can also play a role in the holistic treatment of ASD.
Underlying medical issues or imbalances can often contribute to autistic behaviors and some of these things can be picked up on functional testing including gastrointestinal (GI) overgrowth of Candida and Clostridia, increased intestinal permeability, reduced detoxification pathway capacity and the development of food intolerances and/ or food allergies. These factors all affect central nervous system function.
Case Study
George, Aged 29.
Goal: To be able to feel more at ease and less anxious and overwhelmed at work when having to interact with colleagues and attend meetings.
George had a very high stress job in video gaming and was very good at his role, but because he had to work from the office half of the week, he became increasingly unable to function well due to the overwhelming nature of the office setting and started to have panic attacks. He had tried many medications but they had not been helpful. When he was in Canada on a work trip, he tried medical cannabis and found that it helped him and was keen to learn more.
The Plan: After an initial assessment, we started a low dose of medical cannabis to reduce overwhelm and anxiety and aid focus. We also optimized his diet and started simple at home relaxing brain biofeedback, since other mindbody approaches to reduce anxiety had not worked so far.
The Outcome: 2 months later, he had stopped getting panic attacks and was actually enjoying going to the office more. He was no longer worried about losing his job and felt more relaxed when he got home from work. His energy also improved and he no longer needed his benzodiazepine anxiety pills.
Next Steps
In summary, using a specific holistic approach to managing ASD can dramatically improve quality of life and let you thrive as well as express the unique gifts and skills neurodiverse people have when standard medical treatments such as pills-based approaches have failed to make a difference. To take the next step in your journey, book an initial consultation with our expert physicians.
