Fetal Alcohol Syndrome In Adults

When a pregnant woman drinks alcohol, the drug can cross the placenta and affect the developing fetus. After birth, the baby may show signs of fetal alcohol spectrum disorder (FASD). The most severe type of FASD is fetal alcohol syndrome (FAS).

Many symptoms of FAS last into adulthood. Most adults with FAS experience two types of fetal alcohol effects (FAE): primary effects and secondary effects.

Fortunately, with proper support, adults with FAS can lead fulfilling lives.

Primary Effects

FAS damages the central nervous system (CNS). This damage has both physical and psychological effects.

Physical Effects

The most common physical effects for an adult with FAS include:

• short height
• small head circumference
• abnormal facial features, including a small jaw, flat cheekbones, thin upper lip, flat philtrum (groove in the upper lip), upturned nose, flat nose bridge, and wide-set, narrow eyes
• vision or hearing problems
• heart, kidney, or bone problems
• poor coordination or balance

Psychological Effects

The most common psychological effects for an adult with FAS include:

• intellectual disabilities
• memory problems
• poor judgment 
• impulsivity 
• mood swings
• poor social skills

FAS can also cause attention problems and hyperactivity. In fact, some health care providers misdiagnose FAS as attention-deficit/hyperactivity disorder (ADHD).

Secondary Effects

While most primary effects occur from birth or early childhood, secondary effects (also called secondary conditions or secondary disabilities) appear later in life. 

The most common secondary effects for adults with FAS include:

Trouble With The Law

According to the Centers for Disease Control and Prevention (CDC), 60% of adolescents and adults with FAS experience trouble with the law, including arrest and imprisonment. 

That’s because the disease causes developmental abnormalities that can make it difficult to understand and follow laws.

For example, due to intellectual disabilities, some people with FAS can’t understand the concept of ownership. They may then steal or trespass without realizing it’s wrong. 

FAS can also make a person more likely to commit sex crimes. About 52% of adults with FAS and other fetal alcohol spectrum disorders have engaged in inappropriate sexual behaviors, such as unwanted touching. 

In addition, some people with FAS have trouble controlling their emotions, which may lead to aggression or violence. Others can be easily manipulated into committing crimes or being victims of crimes. 

Trouble Finding Employment & Housing

Because FAS causes problems with judgment, attention, and memory, many people with the condition have trouble maintaining a job. In fact, about 70% of people with FAS are unemployed. 

Unemployment makes a person with FAS more likely to experience homelessness. In addition, even if a person with FAS has a job, they may struggle with money management, which can also lead to homelessness.

Mental Health Problems

Adults with FAS face a high risk of mental health problems, including:

• substance use disorder, which affects 60% of adults with FAS
• depression, which affects 44% of adults with FAS
• psychosis, which affects 40% of adults with FA
• anxiety, which affects 20% of adults with FAS
• bipolar disorder, which affects 20% of adults with FAS

In most cases, these issues stem from both genetic and environmental causes. 

For instance, while a person with FAS may have a genetic predisposition to depression, unpleasant circumstances (such as the legal troubles or unemployment described above) could make their depressive symptoms worse. 

How Do Adults Manage FAS?

FAS has no cure. However, a person with the condition can take steps to manage their symptoms and live a happy life. Depending on the person’s needs, these steps may include:

Therapy

In therapy, a person with FAS can learn to manage certain symptoms, such as impulsivity and mood swings. The therapist can also provide treatment for any co-occurring mental health disorders the person has.

Psychiatry

Psychiatrists can prescribe medications to help treat certain primary and secondary effects of FAS. The most common medications prescribed for people with FAS include:

• stimulants to treat hyperactivity, impulsivity, and trouble concentrating 
• antidepressants to treat depression
• anti-anxiety medications to treat anxiety

In most cases, a parent or caregiver should monitor the person’s use of medications to prevent substance abuse and other problems. 

Workplace Accommodations

As mentioned above, many people with FAS struggle at work. In many cases, these individuals could have succeeded if they had received proper accommodations. Accommodations are adjustments that make it possible for a person with a disability to perform a certain job. 

The Americans With Disabilities Act (ADA) requires employers to provide reasonable accommodations for all people with disabilities, including FAS. The most common accommodations for people with FAS include:

• a more flexible work schedule
• more frequent breaks
• an on-site mentor who can provide training and encouragement

The only way to prevent FAS is to avoid alcohol consumption while pregnant. If you feel unable to stop drinking alcohol, please contact an Ark Behavioral Health specialist. We offer medical detox, mental health counseling, and other evidence-based treatments for alcohol use disorder.