Stress is the body and minds natural preparation response to perceived demands, threats, or challenging situation. If stress rises high enough, the peak can trigger the Freeze, Fawn, Flight, Fight Emergency Protocol, which can strongly affect cognition (thinking), mood and behaviour. We can refer to this peak as a Crisis, Meltdown, Anxiety Attack or a Panic Attack. It can also be the point of Self-Harm or Suicidal Ideation. Short-term stress can be helpful in motivating actions, however, chronic or overwhelming stress can be problematic. Stress Mountain is a visual metaphor for tracking the process of overwhelming stress – from the Trigger Event changing your Baseline, through the Rumble Warning phase for Early Intervention, to the Distressed phase which indicates Late Intervention ending in Harm Minimisation if the peak Crisis / Meltdown phase can’t be averted, and then the Recovery phase, which is vulnerable to being Re-Triggered. Being able to visualise the phases and responses of Stress Mountain enables you to better determine what you can do for each phase to either return you to your Baseline quickest, or at the least minimise the harm.

At the end of this we have a brief rundown on the Wellness and Safety Plan, which can be used in conjunction with Stress Mountain.

What is a Meltdown?

“Meltdown” is the common term used to describe the Freeze, Fawn, Flight and or Fight response neurodivergent people, such as Autistic, Intellectually Disabled or ADHD people have to a situation where neurotypical people would feel at most discomfort. Internally, it can feel like an anxiety attack, panic attack, freeze (physical and or verbal), fawning behaviours (people pleasing) or a time of disassociation and blank memory. Meltdown more refers to the external observer, noting what it looks like for someone who is going through this Stress Mountain peak, and generally applied only to people who are neurodivergent to minimise their distress and frequently reframe it to naughty behaviour – people don’t choose to have a Meltdown.

Behind the Meltdown are background factors that are generally misunderstood and thus not factored in to the overall stress and ability of the neurodivergent person. A common factor that many neurodivergent people experience is insufficient energy (Spoons) to maintain a positive present experience and preferred behaviours in complex scenarios (such as socialising) – We cover this in more detail below Understanding Neurodivergent Energy. The early warning that you are about to have an “out of spoon error” (the Meltdown) is called a Rumble Warning. Meltdown’s don’t just happen – they are the result of the environment energy demands exceeding the resources of the person. The Meltdown is the result of not managing that difference in supply versus demand early enough and thus your brain switches to Survival Mode, generally via the Freeze, Fawn, Flight, Fight Emergency Protocols.

Meltdowns Causes

Factors that can influence this balance of energy are insufficient body functions to manage the current unchanged situational demands, or an increase in energy demands due to a change in the current situation, or both.

Internal reasons why your energy may now be insufficient to an unchanging situational demand include:

• Meds – did not take medication
• Hunger – not eating recently enough (often the last 4 hours)
• Hormones – menstrual and or adrenaline etc
• Fatigue – poor sleep, or recent over exertion

Situational change is about how you perceive consciously, or subconsciously, the cost of the

Reasons why a situation can change to be more demanding include:

• Derailed: when needing to switch from one task to another, but the time given is insufficient
• More tasks: someone or something asks more of us, tipping the energy demand over what is in supply
• Incompatible method: someone asks you to do a thing that is not compatible with your efficient for you method, thus it costs more, beyond what you have available

Understanding Neurodivergent Energy

A common factor for Neurodivergent neurology is insufficient resources, aka Spoons. Spoon Theory helps us to understand how all tasks require the use of resources (internal energy, finances, time, friends, knowledge etc), and if we don’t have those resources, we are out of Spoons, and thus can’t do the thing (demand for the resource exceed the supply). Knowing that different tasks cost different Spoons for different people and circumstances helps us better understand why other’s may find your task easier or harder to do than you and sometimes you can do a thing, sometimes you can’t do a thing, and what you might do to change that.

While neurodivergent often means Autistic, it can also be many other neurodiverse cohorts. Most Neurodivergent people have co-morbidities (cooccurring) diagnoses with other neurological, psychiatric and or biological conditions (eg ADHD [Attention Deficit Hyperactivity Disorder]) or Chronic Pain. It is fairly rare to have these co-occurring condition recognised and diagnosed, leading to many Neurodivergent people not having useful medication, supports and or strategies in place. A common experience in ADHD, for example, is fatigue, simply because your Dopaminergic System is struggling. ADHD medications typical support this, however if you have not been diagnosed, your medication is inadequate, or you have another confounding condition, it won’t address that fatigue even if you look energetic. That is, you may have a diagnosis of Autism, which helps explain certain chunks of your life experience, but if the diagnostician missed (or wasn’t qualified to notice) your ADHD, you are probably struggling just because of inadequate medication. My my experience as a therapist, almost all people diagnosed with Autism benefit from a diagnosis of ADHD and the ADHD medication that helps the dopaminergic system. Low amounts of neuronal Dopamine, Noradrenaline and Adrenaline lead to increased difficulties thinking, feeling and acting, which leads to exhaustion and chronic low Spoons.

Neurotypical life strategies work well for neurologically typical people doing typical things in this society that is evolved for Neurotypical people. Unfortunately, there is a fair chance that most of these strategies are more difficult for a Neurodivergent (neurologically divergent) person to use, that is it costs more Spoons (internal resources) to enact. Developing improved strategies takes time to personalise, and a safe environment to develop those improved strategies. Neurodivergent people can often find themselves in a-typical situations, which mean that those neurotypical strategies are even more expensive to try to use with often neutral to negative results, leading to even greater loss of available Spoons.

What this amounts to is, if you are a Neurodivergent Person, you are probably confused, tired, and out of Spoons. A standard solution to this is to start substituting Adrenaline via Stress to compensate for that fatigue. When Adrenaline levels get high enough, people stitch to Survival Mode. There are two major presentations for this: the Anger series, and the Fear Survival Series.

Stress Mountain

Stress Mountain is the very human process of struggling in adversity, failing to accommodate, and having a Meltdown of Normal Functions aka freezing, anxiety attack, panic attack, aggressive behaviours, self harm, suicide attempt or some other stress response. Stress Moundatin has a number of phases, most we can act on if we identify them correctly and avoid the Meltdown and return to the Baseline.

Summary of Stress Mountain

Stress Mountain has 5 distinct phases.

• Baseline: Where we mostly live
• Rumble Warnings: The early warnings that we are not coping
• Distressed: The late warnings that we are not coping
• Crisis / Meltdown: The temporary time we are unable to function, often with behaviours that are not desirable
• Recovery: the post peak return to the baseline state
  • There is a high risk of re-triggering another Crisis / Meltdown while recovering

The Baseline is our basic normal functioning level. It can be elevated by a pre-existing stress that often results in us getting less Rumble Warnings before we go into the Distressed Phase.

While in the Baseline phase (most of our experience), we can do some things to ensure our best odds of remaining in a good functional state. We will cover that few times as it is a common theme. Our first warning of running out of resources is the Rumble Warnings Phase. This allows us to enact Early Intervention Strategies to return to the Base State quickly. If we miss these warning signs and don’t enact the strategies, or they fail, we will next move to the Distressed Phase, where we have the opportunity to enact our stronger re-stabilisation actions, escalating in strength as we near the Crisis / Meltdown Phase.

The goal of the early and late interventions is to avoid having to go up the mountain and end up in the Crisis / Meltdown Phase.

If we can see that we are headed to the Crisis / Meltdown Phase and no intervention is working, then we must enact Harm Minimisation to do what the label says – minimise harm. It is a good idea to have a Crisis Plan or Safety Plan to help you or others know what to do at this point. People are not very good at thinking well when either in this state, or helping someone in this state, so it helps to have this pre-prepared and easily available.

Following the Crisis / Meltdown Phase, we will need to self-care and return to our Base State. This can be done with just Natural Recovery, or we can get better and faster results with an Improved Recovery Routine. It is important to assess how our Recovery Routine works, as it is impossible to accidentally do actions that hinder our recovery, mistaking them as things that help.

After a Crisis / Meltdown, we are vulnerable to being easily Re-Triggered, returning us to an elevated earlier stage of Stress Mountain, making it harder to avoid another Crisis / Meltdown.

For full details of every Phase, read below. At the end is a full version of Stress Mountain with additional information.

Phase 1 – The Baseline

Our Baseline is our general capable well functioning self. That is, we can mostly do what we want to do, and we are able to use the behaviours we like to use. Some people may find that this is a rare state to be in, and that indicates that something is wrong in either your environment and or your medication – poor medication may indicate an erroneous or missing diagnosis.

Our cognition is at its good normal ability when we are in our baseline and not compromised in any noticeable way. Our feelings are generally mild and suitable to the situation. People with a mood disorder may feel some anxiety or anger, but this is usually at a controllable level.

In our Baseline state, we are free to make any choices we want to, given the situation and our wants.

Pre-Stree Line

Pre-Emptive Actions

I was talking to a psychiatrist about 30 years ago about what can be done to minimise the effects of mental illness. He pointed me to the Bio-Psycho-Social model, pointing out that all 3 of these fields affect our ability to function (I’m saying this far more concisely than he did), and that if we look after those fields ‘health’, then at least those aren’t making our symptoms worse. I’ve expanded on the model (in the link).

In my experience, often what triggers people to have experiences like Stress Mountain in the absence of a specific external trigger is not managing the biological aspect of their body. That is, not taking medication (as prescribed), or medications that aren’t actually treating the cause of the problem; not eating regularly or well, and or not knowing the foods that we react poorly to; hormones; and fatigue. There is huge benefit to being fit over being sedentary.

External stressors increase the likelihood of an external trigger sendings us up Stress Mountain. When we manage our social circles well, then we are generally around positive and supportive people who inspire us to better growth. We can rely on our friends and family (when we have good family) to give us support – we don’t have to do all of this alone.

Having some level of financial safety is also important. It is hard to feel safe and able when we don’t have any financial resources to put towards problems. Financial stress easily pushes our stress levels up so that we are on the Pre-stress Baseline instead, increasing our reactivity and increasing the odds of having a Metldown.

Having no goals in life can indicate that we are in a general default Survival Mode. It is hard to Thrive without a future goal, or having reasons behind what we are doing now.

With these things being maintained, you will find the number of times that you travel up Stress Mountain decreases.

Trigger Event

A Trigger Event is the point at which you have switched from normal responses to your environment in the Baseline Phase to starting the Rumble Warning Phase.

An event can be an Internal or an External Event.

Internal Event

Internal can be a biological shift or an internal thought or memory. Psychological experiments have demonstrated how choosing to think specific kinds of thoughts can change our level of emotional arousal up or down. This is the essence of how calming exercises such as mindfulness work – we deliberately bring to mind the kinds of thoughts that brings our emotional arousal state down. The reverse can be applied to hype ourselves up.

We can often accidentally think certain kinds of thoughts which have a physiological response, either rousing us up, or down. If we are in a higher Baseline state due to a Pre-Stress situation, then we are more prone to get stuck in these thoughts or to have a stronger reaction to them.

The most common kind of internal thought or memory that can affect us is Negative Self Talk. This is where we say to ourselves, either in our own voice, someone else’s voice, or just a feeling that reflects, a very negative impression of ourselves or the situation. Self talk is natural. It helps us to highlight to our conscious brain what is going on. What isn’t helpful is if that is biased and worse, uselessly repetitive. For that, it is important to consciously change the internal dialogue narrative via mindful counter messages, challenging the essence of the negative self talk.

An Internal Biological Shift can be due to

• Forgot to take medications or took a substance that isn’t helpful:
  • Meds: Take your meds if safe to do so.
  • Substance misuse: Depending on the situation, either wait for the substance to stop affecting you – while you do nothing! – or go to the Emergency Department of your local hospital to get help.
• Didn’t eat food in the last 4 hours, or you ate an allergen / food you’re intolerant to:
  • Forgot to eat: Eat safe Crisis / Meltdown prevention foods.
    • If you have an Eating Disorder that has affected this, take the specific steps needed to manage that.
  • Allergen / Intolerance: Either wait for the effects of the bad food to pass (while doing very little), or go to the ER if needed.
• Hormones such as menstruation, an adrenaline surge, cortisol or thyroid problem:
  • Menstrual: if you have active ovaries, check out our PMDD page for lots of discussion on this.
  • Adrenaline: if you have had an adrenaline surge, we have discussed most of that above in Understanding Neurodivergent Energy, and that section has links for further reading.
  • Cortisol and Thyroid: talk to your GP.
• Fatigue from poor sleep and or having completed a hard task (for you):
  • Poor sleep: go to sleep if you can. If you have sleep problems, check out Beating Insomnia and Beating Pre-Sleep Anxiety.
• Sensory trigger, such as:
  • The environment has become too loud,
  • Touch irritants (surfaces that you need to touch feel bad),
  • Hay fever style ongoing allergens,
  • Bad smells,
  • Changing lights,
  • etc
    • Most of these can be managed if you have identified what the irritant is.

External Event

In our attempt to balance our current internal resources and situational demands, a change in the situational demand can trigger Stress Mountain.

• Threat:
  • The external change may be due to a Clear and Present Danger:
    • Clear and Present means that you can both see it and it is obvious. Threats are not generally subtle, and if it is subtle, then usually a subtle solution is warranted.
    • Danger means inaction will lead to you, or someone else, being physically hurt.
  • Moderate risk:
    • This means that a fair chance of physical, cognitive or emotional harm is likely to occur.
• Additional task requirements:
  • If we are at our resource limits, then we may not be able to cope with additional demands on our resources. This could be:
    • Additional sensory stimuli (music, people talking, lights, smells etc).
    • People.
    • New task parameters (which leads to the next category about derailment)
• Derailment due to change / switching tasks:
  • Derailment is to do with how we have optimised our resources to deal with this situation, not the new one, and the struggle to switch tasks. We discuss it in more detail here.

Phase 2 – Rumble Warnings

That struggle will look different for different people. These warning signs are called the Rumble Stage. Stereotypical Autistic cues for the Rumble are:

• Direct observable behaviour cues:
  • Pacing.
  • Rocking.
  • A significant fidget increase.
  • Sudden stillness.
  • Withdrawing from.
  • Clearing through or echolalia.
  • Verbal and non-verbal expressions of discomfort.
• Internal Cues:
  • Feelings shift significantly (dysregulation).
  • Hunger or Medication wears off:
    • Anxiety increase.
    • Aggression increase.
    • Feeling disturbance.
  • Noting an unexpected action behaviour change.
  • Finding yourself avoidant of new tasks or continuing the current activity.
• Cognitive Cues:
  • Struggling to comprehend things you normally would.
  • Forgetting things faster than normal.
  • Mood behaviour shift.
  • Making 3 minor errors in quick succession.
  • Finding it hard to make choices.

Early Interventions

It is important to note when the circumstances has changed drastically and we have struggles coping in that situation. We may not have realised how low we were on our internal resources, or the demands just generally exceeded our abilities.

If you have done all of these checks and are still struggling, it is time to have some quiet time and do some calming exercises.

Phase 3 – Distressed

We enter the Distressed Phase if we either did not notice the Rumble Warnings, or the Early Interventions Strategies did not work.

Late Intervention

Common themes to consider are:

• Who you can call for support.
• Clear markers to indicate which particular plan you may need to use, for example:
  • If aggressive, calming medications.
  • If looping, Beta Blocker.
  • If migraine, sleep.
  • Note: These are just samples, not what you should have.
• PRN Medication:
  • PRN medication prescribed by your GP or psychiatrist.
    • PRN stands for Pro Rata Nata, which means “as you need it”.
  • This should be something that addresses distress, is safe to use, unlikely to be misused.
• Minimising harm in case you cannot head of the Crisis / Meltdown (see the following sections).
• Do you need to go to hospital?

Harm Minimisation

Phase 4 – Crisis / Meltdown, The Trauma Coaster

Crisis Neurology and Survival Mode

In the middle of our brain is our Amygdala. It is part of the limbic system, which includes the thalamus and the hypothalamus, which contain the template for being able to tell if this situation is “safe” or “not safe”. The Amygdala is closely connected to our cerebellum, which is what all of our sensory system reports to. The Amygdala compares our sensory perception to our memories and works out if it matches “safe” or “not safe”. If we are “safe”, we feel comfort, happy, content or other helpful feelings, and suggests that we either “rest”, “recover”, “repair”, or “prepare”. If we are “not safe”, we feel fear (a Clear and Present Danger; triggers the Survival Fear Series), anger (something needs attention or it likely will get worse; triggers the Anger Series), or disgust (something will make you sickened; triggers repulsion or hate) if it can, or just anxiety or aggression if it can’t. The Amygdala doesn’t tell your Prefrontal Cortex what is wrong, just what it feels like, and your Prefrontal Cortex uses that clue to find out what it is itself. This system is very fast, but not creative.

When we are switched to Survival Mode, resources are diverted from our slow Prefrontal Cortex to our fast Amygdala, because we are more likely to survive then. That means our responses are faster to actual threats, and likely to keep us alive. They are awful when we don’t know what the problem is.

Dopamine and other necessary neurotransmitters are no longer enabling the prefrontal cortex to be able to solve what to do and take intelligent actions. When you talk to someone in this state, they often can’t give you answers, or the answers are very simple.

Some actions are seeking to trigger additional emergency neurotransmitters to shock the system back into some form of balance. This can lead to self-harmful / suicidal behaviours.

Shutdown

Both the Anger Series and Survival Fear Series have shut-down modes: either Passive (watching) or Freeze (non-action, often with non-thought).

Flight / Run aka Anxiety / Panic Attack

Both the Anger Series and Survival Fear Series have avoidant modes: either Run (Anger – “I can’t win this battle”) or Flight (“It can’t hurt me if I’m not here” / “I’ve got to get out of here”).

Internal experience:

Fight aka Aggressive Behaviours

Both the Anger Series and Survival Fear Series have agressive modes: Fight

The Fight aggression can be verbal or physical, to the self, objects or to another person.

The Trauma Coaster

Having a Meltdown is hugely disempowering. While here, you have not real choices. To make a choice, you need to have the awareness of the choices you can choose and the resources and skills to enact that choice. When we are in Crisis, we don’t have much if any cognitive ability. Our brain has surrendered to our Survival reflex. Without cognitive ability, we don’t have skill or cognitive awareness, so choices are gone. We are just reacting however our Survival Brain thinks we keep us alive.

We have lost the power of choice.

Many of us have been put into situations where our choices were taken from us by abusive people. Having a Crisis of circumstances push us into Survival Mode feels very similar to when we were abused. That similarly to a prior trauma situation can be traumatising all over again. Worse, carers and staff often try to make us feel bad for having a Meltdown and any of the actions we took when we were in Survival Mode. Too little attention is traditionally spent on looking at why we had a Meltdown and thus prevention, and focusing on what we did when we had no choice. That adds salt to that re-opened wound. A standard tactic of abusive people is to blame the victim for what the abuser did, that is, blaming the victim for what was out of their control.

After a Crisis, especially when we have had a Meltdown, what we need is comfort and support. Later, when we are more stable, we need to analyse what went wrong and how to prevent that and was our Safety Plan and Harm Minimisation Strategies adequate.

Phase 6 – Recovery, or …

Natural Recovery

We will have a default system in place to return to Baseline which we will refer to as Natural Recovery. Unfortunately, some of us have developed bad habits that lead to Hindered Recovery. If we are thoughtful, ahead of time, we can systematically work out what gives us Improved Recovery.

For most people, Natural Recovery is having some quiet time to rest, contemplate and recuperate. This should be done in a quiet environment with only supportive safe people around.

Improved Recovery Routine

Improving on the default can get us to the Baseline faster and better.

Step 1: Get Safe

We entered Survival Mode because we felt unsafe. If you feel unsafe after you have exited the Meltdown, then it is important to change for safety. That can include asking people to move away, or moving yourself to a safe location. It should be somewhere that you feel safe. Often that includes more enclosed, darker and quieter, but your personal needs may be different. Move away from likely triggers and or dangers.

Step 2: Recuperate Resources

We rose up Stress Mountain because our internal resources didn’t match the actual or perceived demands of the situation, prompting us to switch to Survival Mode to get through the actual or perceived Crisis. Survival Mode actions likely burned up even more resources.

Hindered Recovery Routine

Mistake 1: Not resting

As outlined above in Improved Recovery, we climbed Stress Mountain because we didn’t have enough resources, and then we expended even more in the Meltdown. We need to rest to recover, and not letting ourselves rest is anathema to recovery. If you feel the need to not rest, here are two questions that are worth considering:

1. Who is pushing us to go straight back to being “functional”.
   • If it is someone else, they are either
     • misinformed about what is needed (educate them later), or
     • abusive (they won’t listen to the education – check out the Toxic People Mind Toolset and keep in mind Grey’s Law)
   • If it is yourself, why are you being mean to yourself?
2. Who will need emergency hospital care if you rest?
   • If you can identify someone, then yes, this sacrifice may be worthwhile.
     • Should you call the emergency number for Fire, Police and Ambulance? If not, then this may not be an actual emergency.
   • If no, then you are being mean to yourself, or someone else is (see above).

Mistake 2: Staying in a stressful location

Our Amygdala does its best to work out if we are “safe” or “not safe”. If you have an anxiety disorder, then it already struggles to figure this out. What doesn’t help is staying around people who are stressful, or an environment that is triggering to you. Triggering environments can be due to lighting, sound, reminders of tasks, or bad memories.

Mistake 3: Not eating, or eating poorly

We’ve covered food a few times. We need to eat something to help us recover some biological resources. See above for what to try to eat.

What we should avoid are things that are not compatible with us. For example, I personally react poorly to chocolate and gluten. For many years, my recovery food included chocolate. I didn’t know at the time that I respond poorly to chocolate, so it took a while to figure out that this food should be avoided, especially after I am trying to recover from a Meltdown.

A large proportion of Neurodivergent people have a food allergy or intolerance (estimates are around 30%). If you experience intestinal pain, IBS, or strange moods / energy levels that begin up to an hour after you ate, then you likely have something you should investigate.

Phase 7 – Re-trigger

• Internal
  • Ruminating on thoughts and memories
    • See Controlling Thoughts in Recover Calm above.
  • Hunger
    • See Recuperate Resources above
  • Medication has reached the end of its effect
    • Can you take your next dose? Or is this the end of the day for that medication for you? Talk to your script writer if this is a frequent problem, or therapist for strategies if you cannot modify your medication to address this.
• External
  • Unexpected noise
  • Actual or perceived demand beyond your current ability to manage
  • Actual or perceived stressful person

Wellness and Safety Plan

If we frequently struggle to manage our mood and behaviours, then it is a great idea to have a developed Safety Plan that can help us maintain our Wellness and guide us through recognising the various stages of Stress Mountain. For that, we have a Wellness and Safety Plan. While we have aimed to make the use of it fairly intuitive, in my opinion it becomes intuitive once you understand how it is supposed to be used.

In short, the top row is how you can tell that you are currently at Baseline, aka Well. Signs that you are doing well are important for you to know that these signs mean I am well. Often my clients don’t know how to tell, and figuring these signals out for you helps your enteroception (ability to look within and know your inner state). On the left is what you can do to maintain this (pre-emptive steps) and on the right is what is likely to decrease your wellness, aka avoid.

The second line is your Rumble Warnings. What warns you that things have got to this stage. On the left is how to get back to being Well, aka Early Intervention Strategies. On the right are the things to avoid so that you do not become worse.

The third line is your Distressed phase. List what are the indicators for you and or someone else that you are now needing help, but we aren’t at Crisis yet. On the left are the things you can do to improve, aka Late Intervention Strategies. On the right are the things you should definitely avoid, aka the opposite of Harm Minimisation.

Last of all is the plan for when you are in Crisis / Meltdown and who you should contact if you can’t keep yourself safe.

On the reverse side are your contacts, including who is good for what kind of support, and who you shouldn’t contact when you are in this state. Additionally, instructions for current medication in case you need to get someone else’s support, need to go to hospital, or you are struggling to know what to do. Allergens are listed so that other people can avoid those too.

All of this is covered in detail on the Wellness and Safety Plan page. Below is the front and back of the Wellness and Safety Plan.