To be sure, clinically, thresholds are useful because services, insurance, and research all rely on clear binary classifications, in our current society. But outside that context, it isn’t obvious that everyday language needs to mirror that line. Self-identification can be a way of making sense of one’s life, not an attempt to claim a clinical label.
But at the same time, the spectrum includes people with very high support needs, and there’s understandable concern that broad or casual uses of the term can hide those realities in ways that impact care.
To me, none of this means people are wrong for wondering about autism. And I do not have the experience to advocate for or against "anxiety disorders" being weighted more heavily in clinicians' priors than they currently are (as the OP article heavily implies with its length). I mean only to highlight the mismatch between a binary diagnostic system and a very heterogeneous spectrum, and the need for language that acknowledges self-understanding without flattening anyone’s experience.
For some people these diagnoses will be a very good fit with clear predictive outcomes. But many of us have a grab-bag of traits from several categories and still mostly get along in life, maybe with some assistance particular to one of these diagnosis but no more help overall than anyone else needs otherwise.
The diagnostic models suck. They are too broad here, too narrow there, misunderstood by professionals. I had a psychiatrist (mis)diagnose me as bipolar based on a 45 minute appointment when I was in some sort of crisis in my early 30s and that ended up haunting me years later when applying for a job with a security clearance. I didn’t even know about it at the time. This was one of the top rated doctors in a major metro area. What a sham.
The field is a mess. It has a terrible history of horrific abuse. Some autistic children still receive involuntary-to-them ECT. I think we should be supportive of research into these topics while also being critical of the very obvious problems with them.
But the one thing we know for sure it's that the world is more complex than even this set of 10 pigeonholes. These are more like good insults for people. Haha, a loner, that guy's a schizo! The clinical coldness is almost a perfect mirror for the way we express personal cruelty to others. To reduce them to a factoid, an epithet. It's no wonder people want to reclaim these words as terms of identity, of pride, of nuanced meaning.
Autism and schizo- spectrums have a common base/mechanism: impairment of psychic functions (lack of empathy and non verbal commun, shallow feelings, social distance and similar). Their difference is autism starts at early childhood (maybe birth?), before any intelligence, language, soul and personality has evolved, while schizo/psychosis starts later (after teen age) when all these are fully developed.
The impact of each disorder on behaviour is different due to the different state it finds the rest of the brain. The maturity in schizo, for example, is the cause of its "positive" symptoms like hallucinations/delirium because the brain is full of images and words. On the other side autism heavily blocks social and verbal skills because it kills any "motive" of the brain to develop further from a very early stage.
Autism is a neurodevelopmental disorder which causes and contributes to various psychiatric disorders.
The author is not seeing the forest for the trees, which is incredibly ironic.
"They haven’t seen any cool TikToks about being schizoid. No one’s offering them quizzes about being schizotypal." I'm eagerly awaiting the Great Meme Reset of 2026 when people will stop using memes as their shared knowledge. I even know a pediatrician who does this to support her anti-vax practice so meme culture has reached frightening levels.
Therapy-speak has become weaponized by people who are not well meaning. Please don't go around diagnosing people. If you say someone is bipolar, a lawyer can use this against them in court. I urge people to identify the sources of their (mis)information and humble themselves before offering diagnostics.
This seems to be targeted campaign. I urge people to not be fooled by ill-researched blog posts. Listen to autistic people. Listen to researchers that represent the scientific consensus.
Any diagnosis for autism will first consider whether the symptoms can be explained better by another diagnosis. This is why you fill out a lot of questionnaires and the like when you get your diagnosis. This is the state of art.
Also women are systematically underdiagnosed when it comes to autism, they often get labeled with boderline and the like. The idea that someone is labeling everything as autism is silly.
My niece has a disibility that they haven't really been able to diagnose.
If it is Autism, there is all kinds of free care available.
Usually when you follow the money, you get answers.
So I'm going to flag these posts for now because the goal in the current US climate is pure eugenics. RFK is at his core a eugenicist, as are all high-level anti-vaxxers. Anti-vaxxers seek to blame the diseased for their disease, on such factors as "poor diet", "lack of exercise", or in the case of autism, "having your child vaccinated", against all scientific consensus, and would prefer people suffer and die of horrible and completely preventable diseases like measles and polio since they somehow "deserve it". Governments like the current one have plenty of plans for people they deem unworthy.
[1] https://thehill.com/policy/healthcare/5256614-autism-communi...
[2] https://www.npr.org/2025/05/08/nx-s1-5391310/kennedy-autism-...
[3] https://mjhnyc.org/blog/autism-and-disability-in-nazi-vienna...
Also see specialisms WITHIN Autism that are different to the mainstream Autism
The one I know most about is
PDA: Pathological Demand Avoidance [1]
PDA presents differently and needs very different strategies to mainstream Autism.
Main signs… kids under 12 attend school. However they explode at home or in private. At school the PDAers are masking (pretending to fit in) which is draining. When they get home the pent up frustration is released (explosively). So the family at home see a very different kid to the one that school/extended family witness. If this is an A-Ha! lightbulb moment for you or your child, see the questionnaire at the PDA Society[1]
Don't underestimate TikTok. You can find all sorts of weird fad mental illness there. For a while tourette syndrome was all the rage and the platform was filled with kids faking tics. There are fake epileptics faking seizures too. OCD is another common "cool" self-diagnosis and there are online quizzes to tell you how OCD, or ADHD or bipolar you are. It wouldn't surprise me at all if schizoid or schizotypal caught on.
I think some people are looking for the self-validation that can come with a diagnoses, an explanation for why they are the way the are, feel the way they do, or why they struggle with certain things. Others are just looking for views, attention, or a community to belong to.
While it can be fairly harmless the ability for mass sociogenic illness to spread via social media is interesting and a bit frightening.
At a bare minimum, it will give you a fresh perspective on things you already knew. In my experiences, there will be things you didn't realize about yourself.
They aren't going to tell you what the solution is to all your problems; that's for you and your doctor to figure out. They will give you everything you need to make well-informed decisions, and that's priceless.
Somewhat related, "Health Secretary Wes Streeting is launching an independent review into rising demand for mental health, ADHD and autism services in England." https://www.bbc.co.uk/news/articles/ce8q26q2r75o
Working in IT I've came across lots of extremely smart people with their quirks and eccentricity (not exclusive to smart people of course), I guess there's just a higher proportion of _quirky_ smart people in IT. A lot of the time it just seems to be introversion- it seems lack of interaction with society has to be justified.
“I suck at small talk.”
“I have rigid routines.”
“I hyper-focus on my hobbies.”
“I am always fidgeting.”
“Social interaction exhausts me.”
“I really bad at making friends.”
“I don’t fit in; people find me weird.”
I never considered it althought I'm ticking all the buttons (bad gear ? [0])
Often times it seems like the “soft diagnosis” of a condition can be used to hedge against less-than-desirable personality traits if the person is held in high enough esteem. If they aren’t held in popular regard to some extent or if there’s other factors that can be used to explain their behavior (e.g. the stereotypical “German coldness” or whatever) then they don’t get those benefits. Characteristics like their political views may also negatively affect the likelihood of this “psychiatric hedging”.
At what point do idiosyncrasies become subject to pathology.
Adhd 5-10%, autism 0.5%, cluster b 5%. The rest is quite rare. Adhd has the highest comormobility.
I'm more dubious of clinicians who like to pick random dubious rare disorders that people can't even agree about the basic description of like schizoid out of the DSM like the author of this article.
> Social awkwardness refers to social ineptness without meaningful impairment
Isn't social awkwardness sort of inherently impairing in social relationships?
Which is to say, not really. I say this as someone who has been diagnosed as autistic, and identifies as autistic. All of these diagnoses are presented as clear, well defined constructs that exist in the world, but in reality they’re fictions that that committees have drawn around a vast gradient of human traits.
No individual human truly fits any single diagnosis. For example, I have two family members that depending on how you frame their behaviors could be described as either autistic or narcissistic, yet these are supposedly completely different disorders. Prior to being diagnosed as autistic, I’d been diagnosed with some of the ones suggested in the article as well. Was I misdiagnosed? I don’t think so. None of those constructs are real either. So, they’d not even wrong. For a time, some were useful. Some were harmful. But seeing myself as autistic has been a lot more useful.
What matters to me about identifying as autistic is that it allowed me to find other people who experience the world similarly to me. Until I found other autistic people, I felt like I was a single alien stranded on Earth, alone. Finding other autistic people was like finding out that there were millions of other aliens like me hiding in plain sight.
I hope that someday we can move beyond the 1950s-style nosology of the DSM and have a more rigorous science of mental health, but right now, it’s what we’re stuck with.
I so strongly agree with this and it's not just based on my own experience, but many people I know.
Growing up broke and in sketchy places with sketchy people will induce plenty of anxiety. Then I managed to get out of all that as an adult and starting a career.
The anxiety never fully went away, but it now presents itself the way one would expect instead of "weirdness". Maturing and having a more stable life happened to my friends also and nobody says "I think I'm autistic" anymore like we did in high school and college. Now it's hard to distinguish if we were saying that to ourselves as a slur in self-deprecation, or if we really believed it. Young people are just awkward and too many people get older without letting go of the things they told themselves a long time ago.
Make of that what you will. I know my story is super common, but the only reason I bothered to write this is that it doesn't get said enough.
That feels important
Part of the motivation also seems to be that we've fetishized disorders; having or claiming to have disorder X is a weird way to feel "special" or exceptional. Another part of it is that it functions as a kind of instrument for uptight people to gain a sense of exemption from social norms - real or merely perceived - that they feel burdened by or live in terror of "violating", but who are incapable of or unwilling to ignore them, because what would people say! "Oh, I'm weird, because I have disorder X. Can't help it, sorry! Can't judge me, because then you, not me, are the asshole!"
Needless to say, it's not very rational.
Which is not to say various disordered conditions don't exist.
I think it’s safe to say that if someone appears “weird” to the hive mind of a community, that person is more likely to be correctly diagnosed.
There are people who desire a diagnosis for special treatment, but if the first time you find out about a person’s diagnosis is after knowing them as “weird” the whole time, then they’re not acting weird on purpose, or saying they are X for attention or special treatment.
Disabled people, mentally or otherwise, usually like to keep their business to themselves, unless they absolutely don’t need to. Some mentally disabled people might even forgo getting special treatment via disability services at their colleges, or getting parking permits for disability because they’re not interested in bringing attention to their difficulties or differences, or using these issues as a cause for special treatment. Though, I’d advised that people who need accommodations should get them.
I also saw a comment about disability becoming normalized due to late stage capitalism, which sounds like a thesis out of postmodernist thinking. The fact is that group behavior has always isolated “weird” behaviors and put undue negative attention on them, but it just happened to be the case that that weird behavior was evolutionary helpful, which is why it has persisted for millions of generations of humans across their evolutionary history.
This only applies to high-functioning categories of behaviors. But I’ve found that more often than not, it’s the social reaction of groups that is the problem for high-functioning autists, and less the autism itself. Maybe neurotypical behavior or neurotypical mindedness is the disease because I don’t understand why or how some people find it so hard to think differently. Are they not individuals, are they zombies?
I personally believe that "normal", when it comes to people's behavior, social interactions, and the way their mind works, is a completely broken idea. All of these attributes are completely fluid, depending on the when, where and who with you happen to be.
On that premise, the whole idea of neuro-divergence and the idea that you can classify people in arbitrary categories such as ADHD, Autism, etc ... and that this classification will lead to a way to "fix them" is complete and utter BS.
Someone with Autism can act out and people will be like "That's OK, he has Autism". But when I act out, there is no understanding.
What is missing in the article is there does exist overlap in these condiations, not only symptomatically, but also genetically. As far as genetics, just take a look at the calcium channel gene CACNA1C:
https://pubmed.ncbi.nlm.nih.gov/31805042/
I would probably had an Asperger's diagnosis when I was a kid, but most of my Autism was beaten out of my by my older brother's and kids in school. I mean, I was so deep into astronomy when I was 10 and I would not let go if it even though everyone teased me about it and I talked about it all the time anyway.
I am in my early 60's now, homeless, living in a Minivan, driving around, researching my genetics obsessively to the point where I communicate with some leading specialists in the United States, but still no one cares.
So yeah, do I wish I could say I had clinical Asperger's? Yes. Yes. Only so I can be accepted for my neurodivergence.
I mean, that is kind of how science/medicine work in general. Group the things that look similar, try and find things that work, and use the patterns to generalize the solution.
If you don't generalize you can't apply knowledge from other cases.
Openness (to experience) in the Five Factor Model is quite strongly correlated to IQ, so I'd rather expect that highly intelligent autistic people would score much higher regarding openness.
For a long time ADHD was ignored or dismissed in the UK as an "americanitis", so it's no surprise that there's a backlog of people who weren't diagnosed in childhood.
[0] https://www.england.nhs.uk/long-read/report-of-the-independe...
I tend to invite people to think about how their lives have been impacted. For example, I experience anxiety at late invites to events I'd enjoy. I panic and decline them because I'm experiencing a highly irrational anger fear response to changing schedules. This causes me to miss events I would otherwise enjoy, and then I feel guilty. Having to process all those feelings takes a lot of energy, and it's really draining. That has significant impact on my life.
Compare to a friend of mine who just prefers quiet evenings. She declines things all the time but never gives it a second thought.
Disability vs preference. It's ok if it's either! Neither of us are wrong, we just experience different impacts in our lives.
The HN crowd is surely over-represented in ASD, which makes sense for people enjoying debating nerdy topics and pedantry.
And "I like Lisp" should be an automatic qualifier.
So then I would look at these autism checklists and say, "yep, that's me," but when I actually looked at the strict diagnostic criteria, it wasn't that clear.
Looking at this article, I get it. There are other, more focused criteria that can be more appropriate. But those diagnoses don't trigger the special services, so they don't get used often enough.
What is my takeaway? People often don't conform to a model of average human behavior. Being unusual isn't necessarily a grave character flaw (which is what my mother had me believe) but merely an expression of the great variety of human intellect and behavior. It gives me license, without official diagnosis, to enjoy being who I am without shame or embarrassment.
Also, if someone is mean they are mean: Diagnosis is not a “get out of jail free” card for bad behavior.
I understand that this may be a categorical error, since psychology can be the categorization of symptoms, but a lot of the things I learned "from the outside" really still stick.
Like the wealthier populations getting neat little explanations/excuses whenever convenient. Theres the scholastic benefit of ADHD diagnosis and anxiety diagnosis, which can help a lot in school/academia and to everyone else who cant afford it they get the cheaper label: "being bad at school" or "dumb". And still requires even more effort.
Theres the trauma and therapy cycles for otherwise normal behaviors like separation anxiety from parents, not being popular or highly esteemed, stress from not attaining goals, etc. The cheaper treatment being to suck it up.
What is normal for the poor to carry is a diagnoses and special treatment for those who can afford it.
And this is also reflected within the office as well! The outcome can be better if the professionals empathize with the one seeking treatment (theres a whole class/racial component here).
I agree with your sentiment and I think it's really all down to wealth and/or availability.
Back in the 90s early 00s the internet made us mesh together because each one of us there was a specific person. We had forum signatures and every single post was clearly made by a person, for a person.
Then social media took over and relegated every single person into a tiny unidentifiable avatar next to a non-prominent name, not unlike NPCs in CRPGs.
In turn this has been exploited by the powers that be to ensure the social glue gets even weaker: a society barely held together won't revolt. There's only one thing left to do: productivity, productivity, productivity.
The political opponent is no longer a person. Just a nameless, faceless NPC (personifying everything that's wrong) spawned there to be defeated and collect their social loot tokens.
But I might just be an old fart rambling about the good, old days.
Careful with this. In small amounts it can be good -- recognizing that autistic traits are human traits and we should recognize each others humanity -- but in large amounts it is regularly used to deny autistic people experiences. Like, "it's not so bad. It's not a disability. We're all a little autistic." Etc.
I was involuntarily committed to a psychiatric hospital once and my behavior had them thinking I was Autistic.
It seems very tightly focussed, and more behavioural - and open to behavioural training - than other categories.
Yes, but I think the distinction is explained in the article: "show significant improvement with practice and maturity" and "generally achieve life goals despite awkwardness".
To put it another way, those who are socially awkward can get better, whereas some of the other diagnoses are lifetime impairments with little or no possibility for improvement or cure.
One problem is that the language we've been given is one of defects (ADHD, ASD) and often people are stuck using that label even if they don't see their trait as a defect. So we're stuck saying "ADHD" because psychiatry decided that it's a defect. In reality, nearly every "disorder" has some other context-dependent benefit.
And while there's no "neurodivergence" in nature, there is a divergence from what is considered "normal" by society. "Normal" is an artificial construct, but we all have to live with it, and there are many aspects of my nervous system that clearly function in a way that's outside of two standard deviations from the mean, and this causes me a lot of problems in a society that can't tolerate that. These are very very real, and 95% of the time, I never say a word, and no one else has any idea that I'm suffering. I'm not telling anyone else that they're the asshole. Most neurodivergent people are living like this, despite what you're implying, that we're all just walking around being assholes to everyone we meet. That, is bullshit.
It seems in the DSM 5 the definition was narrowed specifically to focus on two performance deficits: 1) immediate harms either to the inflicted or to those they interact with due to social interactions, 2) catastrophic academic failures due strictly to input/output perception irregularities not otherwise explained by neuro-transmission disorders (things that can be treated with drugs) or low intelligence measures.
That excludes a massive host of social and perception abnormalities that do result in less immediate social rejection and abstract reasoning failures.
IMHO schizophrenia is a breakdown in the barrier between imagination and processing of reality.
Autism and the like is an inability to process social cues like a blind person might have a damaged visual cortex.
And I disagree with that. There is a wide overlap of symptoms in all mood disorders. People with ASD show many traits of the negative symptoms of schizophrenia. This paper might change your mind:
I think the most important part of what you wrote is that you changed over time. Whether that improvement came from meditation, therapy, maturity, trauma processing, or simply growing into yourself, it challenges the idea that autism is a static essence. Development, coping skills, neurology, and environment interact in ways the current diagnostic boundaries don’t fully capture.
Where I push back slightly is on the conclusion that self-diagnosis can automatically fill the gaps. For some people it’s deeply accurate and validating, for others it may explain one part of their experience but obscure another. As you said, many people carry a “grab-bag” of traits, and a single label can illuminate or compress that complexity depending on how it’s used.
You’re right that the field has a painful history and uneven present. Misdiagnosis is real. Forced treatment is real. Diagnostic tools are blunt instruments for a very diverse human reality. Supporting research while staying critical of the system makes sense, not because autism isn’t real, but because the categories we have are still evolving. Your story is a perfect example of why humility in diagnosis matters, whether it’s done by a psychiatrist or by oneself.
Edit:typo
Adults too; ask me how I know.
Yeah, as the old adage goes: with an ADH?D diagnosis you get to try drugs like lisdex or methylphenidate (or the non-stim options if those aren't suitable), but with an Autism/ASD diagnosis you get some pamphlets, coffee morning invites and a reading list.
I don't have a formal diagnosis but my child does and that made me read lots on the subject. Authors like Eliza Fricker, Ellie Middleton, Pete Wharmby amongst others.
It's opened my eyes to many other related aspects, specifically Rejection Sensitivity Dysphoria (RSD) and Pathalogical Demand Avoidance (PDA) and how those play into both ADH?D and ASD. In reading about them I've worked out just how much they apply to my-undiagnosed-self and how understanding the triggers and recognising the early behaviour has allowed me to adapt to minimise their impact.
I think it may have been narrowed in theory, but often not in practice.
Here in Australia, making DSM-5 ASD a shortcut to getting funded by our national disability insurance scheme (NDIS) caused a lot of pressure to broaden the diagnosis in practice - if clinicians have to stretch the diagnosis to get someone the support they need, they feel ethically obliged to engage in that stretching, since it is in the best interests of their client (who are experiencing real challenges, even if those challenges map poorly to the official diagnostic criteria).
And Australia is not unique in providing funding pressures for ASD diagnosis, although NDIS is arguably a global outlier in the scale of that pressure. Apart from funding, growing popular and clinical mindshare of the diagnosis creates independent pressure to broaden its definition.
So a theoretical narrowing coexists with a practical broadening - and the latter is arguably what really counts
I would only add that ASDs do not have "real" negative symptoms of schizophrenia, but what they do have can look a bit similar. The research on anti-correlation was using questionnaires and binned the social questions taking that into account.
There are some clinicians and unfortunately now many patients and caregivers that nonetheless take an essentialist view of diagnosis and come to identify their patient/self/child/peer with what's really just meant to be a guideline for support with ongoing dysfunctions.
In reality, most people face some fluctuating bag of dysfunctions over the course of their life, with fluctuating intensity, with contributing causes too diffuse and numerous to identify. They might be diagnosed squarely by one clinician with one thing thing at one time, then see some other clinician the same day who thinks the diagnosis was overstated or preposterous. Or they might find that a qualifying symptom that seemed very salient at one time of their life hasn't been an issue for them for a long time because of some new learned behavior, some change of circumstance, etc. Likewise, they may even find themselves facing new or greater dysfunctions compared to what they'd experienced or noticed before, precipitated through known or unknown reasons.
For people most intensely disabled by mental health dysfunction, they often can't escape that dysfunction entirely without the discovery and resolution of some kind of radical physiological or environmental issue.
But for the majority of people who just found that they had a hard time with their daily life, but were otherwise independent, and received a diagnosis that helped them see some constellation of related factors and opportunities for accommodation or treatment, things are hardly so static.
For most of early psychology, this marked the distinction between "psychotic" and "neurotic" presentations. The former represented a disruption so severe that escaping disability and achieving independence were largely out of reach, whereas the latter were understood to be real but fluctuating or even ephemeral disturbances.
It's not really until very recently, when so many people started to obsess with "identifying" themselves with this thing or that thing in some kind of permanent way, that this distinction began to fall out of mind.
In the case of those diagnosed with autism as part of generally independent and functional lives, it's not hard to find people who have experienced changes to the symptoms that originally qualified them for the diagnosis -- sometimes positively, sometimes negatively; sometimes during certain times, sometimes permanently. It's also not hard to find people who received such a diagnosis at one time and either felt comfortable fully rejecting that diagnosis at some later time or had a clinician who strongly questioned it or refused to confirm it. None of this stuff is static and much of it is subjective.
Kind of like all those kids in Le Roy, NY who began experiencing involuntary tics. IIRC, it was interesting that it was mostly girls who were affected by the "craze".
https://www.npr.org/2012/03/10/148372536/the-curious-case-of...
In fact the pattern is almost the opposite of what you'd see in the US where it would be hard to get diagnosed with a SpLD and e.g. ADHD was more widely recognised. But the rub lies in the fact that ADHD, ASD and many SpLDs have fairly high rates of comorbidities with one another, to the point where if you've got dyspraxia and no other diagnosable comorbidity, you're actually in the minority of people with it.
In order to cope with this the NHS has spun out much of the ADHD/ASD assessments through the Right To Choose program (well, in England at least, Scotland/Wales/NI are on their own), which means that private companies are being paid by the NHS to make up the shortfall. Ref: https://adhduk.co.uk/right-to-choose/
Some people say some of the private companies are too lenient with their diagnoses. Some people say that the NHS is too strict with their diagnoses. I'm sure the real answer is somewhere in the middle.
As you say, the sharp rise in diagnoses is probably more due to people become more aware, with less stigma attached, and having better access to assessment.
Shit like _Rain Man_ almost 30 years ago or, more recently stuff like _The Good Doctor_ really don't help though, as those just reinforce the negative stereotypes of Autism.
ADHD also has a strong genetic component with heritability around 75% according to various studies. My parents (undiagnosed but one definitely ADD+ASD) have 1/4 children diagnosed (and another 2/4 almost certainly undiagnosed, one neurotypical), and 6/10 grandchildren diagnosed (the other 4 are neurotypical).
Who knows, in 20 years time mainstream schools could have switched from 20% SEND and 80% neurotypical to 80% SEND and 20% neurotypical.
I guess I gamed the problems you are talking about, but as a side effect I am sometimes probably weirder than before (which is a non problem when you live where I live).
I would probably live a sad and boring life if I were to live in any small/medium/big city.
It can really be the difference between struggling with or enjoying a situation
(Paraphrase, I don't recall the words)
If you like Factorio you should be tested for autism because you might be autistic. If you like Pymods (a mod that adds an extreme number of hoops to the game) you should be tested for autism because there's a chance you don't have it.
Very funny and on the nose :)
Also we tend to underestimate our own symptoms. As a ADHD person it took me a long time to understand that many of my struggles were not things everyone experienced. I still find it hard to really grasp that most people don't suffer from executive dysfunction and can just do things, even things they are not interested in.
Honestly if you relate to autistic people chances are high that you have some form of neurodivergence. It might be worth trying to get a diagnosis, even just to be sure.
I studied philosophy during a large extent of my life, and I am a convinced Witgensteinian.
What I find interesting is that now we’re beginning to see more of the “un-wealthy” (i.e., not quite middle class, not quite rich; just covered by health insurance) achieve these diagnoses. Whether or not a child in a single-parent household is diagnosed with “oppositional defiant disorder” likely becomes a question of where that single parent works. While their peers with similar traits are pushed into a classroom in the basement.
> What is normal for the poor to carry is a diagnoses and special treatment for those who can afford it.
With this I’ll defer to our colleague in this thread, jt2190, with two modifications of my own:
> We all have degrees of “diagnosable” traits, it’s only when those traits become problematic [to our position in society] do we [become compelled] to seek help.
Go on Discord. People have usernames, avatars. Discord Profile Bios are just as unique as forum signatures.
I think a really good example of this is self-diagnosing with bipolar disorder (and thus mania). Let's forget for a second that mania must last at least a few days non stop; most people do not notice this part somehow :). If you read the DSM criteria you may think that you actually fit them sometimes: elevated/irritable mood, highly talkative, distractible, flight of ideas, ... . However, you probably don't, and it is mainly a matter of understanding the scale of the problem. Most people do not know just how wide the range of "mood" is in humans, and what does it mean to be on either of the far ends of it.
(percentages are much more illustrative than accurate)
Something being a table is a label we slap on it to abstract certain attributes, that allows us to reason about it without having to think about all of the non-table-attributes it has. What do tables do? What can we do with them? We can put things on, eat off them. We can’t feed them to our pets. We can’t use them as a trampoline. The object being “a table” is just a categorization we make to allow us to think about the object; it isn’t something that the object is.
Similarly, people aren’t “autistic”. They’re just people, who have certain traits, which psychiatrists have decided should be lumped into a category called “autism”, because they’ve noticed a cluster of other people who have similar traits. So, from this standpoint, someone “being autistic” does not tell us anything. We can already see that person’s traits or characteristics. That categorization might be helpful to some people, and it might be harmful to other people; and they should use or avoid using it accordingly. But they can choose to do that, because “autism” isn’t a “thing” - it’s a mental construct.
They're going to be accused of wanting the special and unique stamp in either case, but at least in the second one they can feel somewhat comfortable.
People will, of course, conjure up an unreasonable accommodation (in an attempt to paint all accommodations as unreasonable) in their head to try to justify why this sort of request can't be accommodated, which just increases the fuel for the desire to get the autism diagnosis.
Put another way, if people were a little more accepting, less only-slightly-weird people would be seeking these diagnoses.
I've never managed to understand this when it comes to autism. Autism used to be considered something as extreme as a severe disability (e.g. Rain Man), and latterly with the inclusion of Asperger's into the spectrum, at the very least a collection of undesirable behavioural characteristics. Do people really want to be diagnosed with something wrong with them, or has the perception of autism shifted to at least neutral (if not positive)?
Spend a moderate amount of time with some humans-- e.g., war veterans-- and you'll find that denial of a diagnosis is common enough to trivially disprove this statement.
Anxiety with intrusive and obsessive thoughts is definitely a real phenomena, but nowadays it's just a sign I'm getting fussy and need a break or a nap.
https://www.clinical-partners.co.uk/for-adults/autism-and-as...
"I prefer to do things on my own, rather than with others."
"I prefer doing things the same way - for instance my morning routine or trip to the supermarket"
"I find myself becoming strongly absorbed in something – even obsessional"
These are all questions everybody living in a modern society can relate to.
Of course autism is a real condition, but modern society somewhat requires people to be machine like and that can easily look like someone is on the spectrum.
We know autism affects all sorts of long term outcomes, but if you tried to split it into actual diagnoses, you end up with insurance companies dividing and conquering approvals.
So instead of having several definitions, we put them all behind autism because that has already received appreopiate laws that establish requirements to treat both at school and in healthcare settings.
So basically, once it breached the "we need to address this", rather than every new diagnosis having to struggle to say "look, this problem effects society", it just grows offshoots and spectrum status.
Because it's definitely not a physically identifiable disability. It's all behavioral and that will always have more coincidences.
But the effects of autism are visible outside of social interaction too, with repetitive behaviors, intense focused interests, trouble with adapting to change, rigidity in lifestyle, etc.
Did your sporting team have success on the weekend? Wonderful, direct eye contact, smile, mirror. Ok, now, to business:
(Note, the guy with the blog is a doctor, but he specifically recommends certain medications for this that I don't think anyone else who discusses RSD online would agree with if they knew this.)
Personally, I think it just sounds like a description of anxiety.
Anyway I have it and it's crippling.
Is it due to stimulous overload or anxiety? I think that's the difference.
The point being misdiagnosis ocd as pda is a risk if autism is the only thing people consider. Maybe not a a huge deal since realistically a misdiagnosis often means you get a pamphlet with broadly similar advice and maybe and cbt anyway ... but maybe I'm being overly cycnical.
Also have to ramp off it, which is a problem if you run out or are traveling and can't get a refill.
Regardless of whether the conclusion is "yes you have x" or "no you don't have x" the diagnosis will be accompanied by a detailed analysis of your psychological condition. Whether or not you are diagnosed, that analysis will cover the issues that led you to believe you may have that condition.
>> I never understood why ... americans ... wear their pseudoscientific bullshit diagnoses like medals.
> Borderline Personality Borderline personality disorder involves intense emotional instability, ... and devaluation of others.
>Social Communication Disorder ... knowing how much detail to give, adjusting their speaking style for different situations, understanding implied meanings or hints,
> B5: Antisocial personality disorder (ASPD): People diagnosed with ASPD show a lack of respect toward others. They generally don’t follow socially accepted rules.
> B5: Narcissistic personality disorder (NPD): People diagnosed with NPD have a sense of being better than others... They lack empathy for others
---
> I agree that there is a small fraction of people
What exactly makes you believe the fraction is small?
Western culture is a mental issue beyond repair. It will soon be gone and it will not be missed.
So then you grow up as autistic and/or ADHD person which creates a lot of social friction and conflict in your life, you're called lazy, careless, difficult, overly sensitive, and this is particularly bad if you're undiagnosed. You don't fit in socially so you develop social anxiety (this is par for the course), and after a while that can spiral into depression or even a personality disorder, you might start to self-medicate which can turn into a substance use disorder, and ultimately people afflicted by these disorders are taking their own lives at alarming rates. You should look up statistics for suicidal ideation among children and adults with autism for a reality check.
Most of this can be prevented if those affected were diagnosed and offered support as early in life as possible.
So no, having ADHD and autism, two very closely related neurodiversities, and then developing anxiety as a result of that is not at all unusual.
I don't think it's particularly common. When I went through my dx, I was really hoping for adhd because then I could get meds, but my doc and all my screenings were like, "definitely not adhd, definitely autism".
So, maybe you are seeing rising diagnosis rates and considering that too easy? If encourage you to think about why you feel this way.
The peak ASD diagnostic criterium should be Forth though.
Server admins are just NPCs providing @everyone announcements from time to time, to keep the player engaged (spoiler: the average Joe is just irritated by those). Sometimes you get a quest from them.
Also: 99% won't read profile bios (and you have to pay for actual customization, don't you?) while forum signatures were front-and-center.
I have to say I'm surprised to see Discord mentioned as an opposite to social media instead of... just yet another iteration of the same ploy.
Eczema is a skin condition which happens to some people, it’s not something that happens in most people. But we can see evidence of varying degrees of severity of skin damage due to eczema. This condition can happen for any number of reasons, immunological, endocrinological, or some combination of factors. There are different types of eczema, but for ease for conversation with anyone other than a doctor, you just say you have eczema.
Same for mental conditions, they have their underlying causes, and some representative characteristics we found on average and grouped them as classes for ease of diagnosis and treatment.
I understand the folly of mischaracterizing, so it doesn’t make sense for researchers or medical professionals to not care about the categorical distinctions.
However, as far as the normal public is concerned, someone’s problem is their problem, and they don’t owe you a detailed explanation of their condition, or a doctors note because you’ve been socially offended (I understand maybe that’s not the point in either of your posts, but I thought I should say it now that it occurred to me in the flow of this post).
It may genuinely be that their dog is their emotional support, but it's ultimately a bit of selfishness and wanting to be treated preferentially in a world that feels crowded and rigid.
Real assessments are different. Also, ADHD/ASD folks tend to overestimate how universal their experiences and preferences are.
1) Not being mindful of hierarchy
2) Not being mindful of socially determined rules, that is rules which are not codified in any official language of conduct
3) Not wanting to socialize, or wanting to socialize differently
4) Trouble with emotional regulation, possibly due to social issues
Tell me, which of these points, and there are many more, point to this being an individual’s problem?
For high-functioning autists, the problem is other people.
People need to realize that they’re not great to deal with on average, and if someone chooses to not engage with you, don’t take that as an insult. Maybe you’re all better off not interacting with each other, but that doesn’t imply causing someone financial, emotional or physical harm just because they’re autistic.
Society both explicitly and implicitly punishes high-functioning autism.
It's officially frowned upon, but doctors still use the term "FLK" (for "funny looking kid") to describe babies or children with nonspecific facial deformities, which are pretty reliable indicators of cognitive or learning disability even if the doctor can't put his finger on what the deformity actually is.
> This only applies to high-functioning categories of behaviors. But I’ve found that more often than not, it’s the social reaction of groups that is the problem for high-functioning autists, and less the autism itself. Maybe neurotypical behavior or neurotypical mindedness is the disease because I don’t understand why or how some people find it so hard to think differently. Are they not individuals, are they zombies?
It's the uncanny valley effect. I'm convinced that one of our primal atavistic fears, besides snakes, spiders, and so forth, is "something evil or hostile disguised as one of our own". In the EEA this fear would have protected a community against spies, as well as profoundly sick (e.g. rabies) individuals who risked spreading their disease throughout the whole village. Different cultures give different names to creatures of this sort: vampire, zombie, changeling, skinwalker, bakemono, etc.
Profoundly autistic people are clearly disabled, and so attract nurturing and care; "high functioning" autistic people resemble humans who can function independently, but their behavior is different enough to trigger what I call the Kendrick Lamar response ("they not like us, they not like us") and hence are viewed with fear and suspicion. It's a flaw in the neurotypical mindset born of a trait that helped preserve neurotypical communities against invasion or outbreak, but it's not very specific so others get caught in its dragnet.
That's my idea anyway. Maybe I'm just steelmanning the NT perspective. There has to be a reason why the poor blighters are the way they are...
An interesting fact is that caffeine will often affect the "ADHD mind" differently. It's been reported to have no effect, or have very limited effect, or make people even sleepy, but almost always something non-standard. Once, in high school, without the supervision of my parents, I drank maybe 2 red bulls and 2 cups of coffee, 1 black. I remember feeling disappointed it didn't work, and I didn't feel any rush of energy.
The problem is that no-one can easily understand how their brain works compared to other people. People on both sides don't talk about it enough or openly enough. If you look at the science it quickly descends in to endless confusing/impenetrable psychiatric terminology.
You can study things like anaemia as you can objectively measure the red blood cell count of a patient's blood. You can't objectively measure a patient's "focus" or "motivation". It's really hard to even get a good subjective measure of those things.
For example, it's just one aspect, but prior to diagnosis and taking methylphenidate (Ritalin/Concerta) I thought everyone had hundreds of competing thoughts running through their head all the time. I thought everyone just had better ways of dealing with it than I did. I had no idea that's not the case. I'd got to 50+ years old, got several degrees, married and had a family, had a successful career, not quite FAANG but earning more than 6 figures, all in spite of how my brain works. Surely there can't be anything "wrong" with me.
But when the medication first kicked in I was simply astounded how quiet my brain became and how clearly I could think about just one thing (it may not be the thing I actually wanted to focus on at that time but that's another facet of the fun). How the hell did I manage to get by all this time without this? It's only then in speaking to other people do I find out that, no, most other people don't have hundreds of competing thoughts running through their head all the time snapping at their focus.
> On that premise, the whole idea of neuro-divergence and the idea that you can classify people in arbitrary categories such as ADHD, Autism, etc ... and that this classification will lead to a way to "fix them" is complete and utter BS.
I agree with point about broad classifications, but medicine is far from the exact science that people believe it is. Got these symptoms? Does medication A improve them? Can you live with the side effects of medication A? Does medication B help with the side effects of medication A and not interfere with the improvements given my medication A? etc...
and of course there are extreme cases, like the many non-verbal people (who likely wouldn't be able to live alone, their communication is limited to poking at pictures on a board), and the truly end of the spectrum where nothing sort of institutionalization can provide the environment and care necessary for survival
but of course having our society somehow become so narrow allows for the economic efficiency to even have the surplus that then we give to people with these disorders (in the form or care, attention, medical research, and so on)
I masked for years but recently (possibly linked to some bereavements in the family, who knows what the actual trigger was if there even was one single trigger) the constant effort required just burned me out. Anxiety spiked, depression symptoms loomed, and I just felt exhausted all of the time.
>The key distinctions are that socially awkward individuals understand what they should do socially but find it difficult or uninteresting (versus genuinely not understanding unwritten rules), show significant improvement with practice and maturity, are more comfortable in specific contexts, lack the sensory sensitivities and restricted/repetitive behaviors required for autism diagnosis, and generally achieve life goals despite awkwardness rather than experiencing clinically significant impairment.
It seems to me that this sort of definition would preclude any person having general intelligence such that they are able to learn to mask (or feel like they have to mask less in certain safe areas).
I—-as a non-autistic person—-have lots of default tendencies which were socially discouraged as a child and which are now no longer part of my self concept. I’m not “repressing” a desire to be awkward, I’ve simply learned to be less awkward.
But my understanding of autism, which is I think backed by the article itself, is that autism exists as a fundamental cognitive process and tends to be pretty stable.
Btw the reason I ask is to learn…as a software dev and manager, several of the people I interact with could probably be diagnosed autistic and I’m always curious to try to understand what that’s like better.
[

“I think that these days what we mean by “autism” is basically “weird person disease.””
Sorbie Richner, Rich Girl Rehab
“Accurate diagnosis requires consideration of multiple diagnoses. Sometimes, different diagnoses can overlap with one another and can only be differentiated in subtle and nuanced ways, but particular diagnoses vary considerably in levels of public awareness. As such, an individual may meet the diagnostic criteria for one diagnosis but self-diagnoses with a different diagnosis because it is better known.”
Sam Fellowes, Self-Diagnosis in Psychiatry and the Distribution of Social Resources
Unsurprisingly, these days I meet many people in the psychiatric clinic who are convinced that they have autism, or suspect (with various degrees of confidence) that they have autism, or report being diagnosed with autism at some point in their lives by some clinician. And for a fair number of such individuals, I cannot say with reasonable certitude that they have autism. The reasons they give for considering autism vary widely, but tend to be along the lines of…
“Eye contact makes me very uncomfortable.”
“I suck at small talk.”
“I have rigid routines.”
“I hyper-focus on my hobbies.”
“I am always fidgeting.”
“Social interaction exhausts me.”
“I really bad at making friends.”
“I don’t fit in; people find me weird.”
What’s interesting about many of the items above is that the number one diagnostic possibility in my mind is an anxiety disorder of some sort. I remember seeing a woman who was a classic example of someone with high neuroticism, poor self-esteem, and severe social anxiety, and she had believed for much of her life that she was autistic because some random doctor somewhere at some point (she couldn’t even remember who or what sort of assessment this involved) had told her that she had autism, and she believed it because it fit in with her experience of being awkward-shy-weird.
It is common for me to meet individuals who think they have autism and find myself thinking, “schizoid,” “obsessive compulsive,” “cluster B,” “social anxiety,” “generalized anxiety,” “trauma,” “socially awkward,”… None of these, however, have the mimetic virality of autism.
I don’t want to come across as being skeptical of the reality of autism as a diagnosis or as asserting that most people are misdiagnosed. Autism exists, to the extent that any psychiatric disorder exists. Not everyone is misdiagnosed, perhaps even most people. I am not trying to say, “autism is bullshit.” It’s not. I offer the diagnosis of autism as a clinician perhaps as often as I find myself doubting it.
What intrigues me is that people are drawn to autism as a diagnosis because it seems to offer recognition of something they’ve lived with: they may be deeply awkward, terribly shy, or bad with people, they may struggle with social interactions, they may find other people annoying, other people may find them weird, they may have a hard time connecting to others, they may have been bullied, and they may have directed their loneliness or introversion towards peculiar interests or hobbies. Autism seems to them to capture all that. It seems like an apt and appealing narrative. But autism may also be the only relevant diagnosis they’ve heard of or are familiar with. They haven’t seen any cool TikToks about being schizoid. No one’s offering them quizzes about being schizotypal. A random pediatrician or primary care doc is not going to tell them they have an obsessive-compulsive style of personality. So when some professional doubts that they have “autism,” they see it as a dismissal or rejection of their “lived experience.” Of course, I am weird-anxious-awkward. How can you say otherwise? What they don’t know is that the choice is not between autism or nothing, but rather between autism and about a dozen other diagnostic possibilities.
So for the sake of our collective sanity, let’s consider a few of them…
To be diagnosed with autism spectrum disorder according to DSM-5, a person must have ongoing difficulties in social communication and interaction in all three areas: trouble with back-and-forth social connection, problems with nonverbal communication like eye contact and body language, and difficulty making or keeping friendships. They also must show at least two types of repetitive or restricted behaviors, such as repetitive movements or phrases, needing things to stay the same, having very intense focused interests, or being unusually sensitive (or under-sensitive) to things like sounds, textures, or lights. These patterns must have been present since early childhood (even if they weren’t noticed until later when life got more complicated), lead to substantial impairment in functioning, and can’t simply be explained by intellectual disability (or other psychiatric disorders).
To “have” autism is simply to demonstrate this cluster of characteristics at the requisite level of severity and pervasiveness. It doesn’t mean that the person has a specific type of brain attribute or a specific set of genes that differentiates them from non-autistics. No such internal essence exists for the notion as currently conceptualized.
Autism spectrum is wide enough to have very different prototypes within it. On one end we have profound autism, representing someone with severe autistic traits who is completely dependent on others for care and has substantial intellectual disability or very limited language ability. At the other end, we have successful nerdy individuals with autistic traits and superior intelligence, often seen in science or academia, à la Sheldon Cooper. (Holden Thorp, editor-in-chief of the Science journals and former UNC chancellor, for example, has publicly disclosed his own autism diagnosis.) This wide range is confusing enough on its own, even without considering other conditions that can present with autism-like features.
Autism cannot be identified via medical “tests.” It is identified via clinical information in the form of history, observation, and interaction, and the less information available or the more unreliable the information provided is, the more uncertain we’ll be. To have autism is basically a judgment call that one is a good match to a descriptive prototype. We can get this judgment wrong, and we sometimes do get it wrong. (There is nothing wrong with this fallibility as such, as long as we recognize it. Lives have been built on foundations less sturdy.)
Autism as a category or identity has taken on a life of its own. I am aware that not everyone in the neurodiversity crowd accepts the legitimacy of clinician judgments or clinical criteria as outlined in the diagnostic manuals, such as the DSM and ICD. There are other ways to ground the legitimacy of self-diagnoses, in theoretically virtuous accounts or pragmatic uses, which require distinct considerations of their own; I don’t reject that. But here, I am concerned with autism as a clinical diagnosis and the accuracy of autism understood in terms of alignment with clinical diagnosis. Would competent and knowledgeable clinicians with access to all relevant clinical information concur that the person’s presentation meets diagnostic criteria for autism? If you don’t really care about that, this post is not for you.
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Lascaux Cave
Schizoid personality describes people who have little desire for close relationships and prefer solitary activities. Unlike people who are simply shy or socially anxious, individuals with schizoid personality style genuinely don’t find relationships rewarding or necessary. They typically appear emotionally detached or cold, show restricted emotional expression, seem indifferent to praise or criticism, and have few if any close friends or confidants. They often live quietly on the margins of society, pursuing solitary interests or jobs. They keep their inner worlds (which can be quite rich) private and don’t seek emotional intimacy with others.
In autism, social difficulties stem from genuine challenges with processing social information: difficulty reading facial expressions, understanding implied meanings, picking up on social cues, knowing unwritten social rules, etc. In schizoid personality, the person typically understands social conventions but simply isn’t motivated to engage with them. They withdraw from genuine disinterest. Schizoid personality also lacks the additional features of autism (repetitive or restricted behaviors, various sensory sensitivities).
Schizotypal personality describes people who have odd or eccentric beliefs, unusual perceptual experiences, and difficulties with close relationships. Unlike schizoid personality (which involves simple disinterest in relationships), schizotypal includes strange ways of thinking and perceiving the world. People with schizotypal personality might believe in telepathy, feel they have special powers, think random events have special meaning for them personally, or have unusual perceptual experiences (like feeling a presence in the room or hearing whispers). They typically have few close friends, experience social anxiety that doesn’t improve with familiarity, and may appear paranoid or suspicious of others’ motives. Both schizotypal personality and autism can involve social difficulties and odd or eccentric behavior, but in schizotypal personality, the peculiarity comes from magical thinking, paranoid ideas, and perceptual distortions.
Obsessive-compulsive personality describes people who are preoccupied with orderliness, perfectionism, and control. These individuals are rigid rule-followers who want things to be done “the right way,” have difficulty delegating tasks, and get caught up in details and lists to the point where they lose sight of the main goal. They tend to be workaholics who neglect leisure and friendships, are inflexible about matters of morality or ethics, and are often stubborn and controlling. Both obsessive-compulsive personality and autism can involve rigid adherence to routines, rules, and specific ways of doing things. In obsessive-compulsive personality, the inflexibility comes from anxiety about loss of control. The person is trying to, consciously or unconsciously, manage anxiety through control and perfectionism. In autism, the need for sameness and routine serves different functions. It provides predictability in a world that feels confusing or it helps with sensory regulation rather than anxiety-driven perfectionism.
Severe social anxiety is an intense, persistent fear of social situations where a person might be judged, embarrassed, or humiliated. Social anxiety disorder involves overwhelming fear that interferes with daily life. People with this condition worry excessively about saying something stupid, looking foolish, or being rejected. They often avoid social situations entirely, which can lead to isolation, difficulty maintaining employment, and problems forming relationships. Both social anxiety and autism involve social difficulties and withdrawal. Social anxiety usually improves significantly in comfortable, safe environments (like with close family or friends), while autistic social differences tend to be more consistent across all contexts.
Borderline personality disorder involves intense emotional instability, unstable relationships, fear of abandonment, and a shifting sense of self, with people experiencing rapid mood swings and chaotic relationships that alternate between idealization and devaluation of others. While it can resemble autism through social difficulties, emotional dysregulation, rigid thinking, and feeling different from others, the key distinctions are that borderline centers on intense relationship preoccupations and emotional chaos, whereas autism involves genuine difficulty understanding social cues and communication; borderline features rapidly shifting identity and relationship-triggered mood swings, while autism includes stable self-concept, sensory sensitivities, restricted interests, and literal communication that aren’t present in borderline; and borderline symptoms fluctuate dramatically with relationship stability while autistic traits remain consistent across contexts.
Social communication disorder is a condition in DSM-5 where someone has significant, ongoing difficulty using verbal and nonverbal communication appropriately in social contexts. People with social communication disorder struggle with the “pragmatic” aspects of language, that is, knowing how to use language effectively in social situations. They may have trouble understanding when to take turns in conversation, knowing how much detail to give, adjusting their speaking style for different situations, understanding implied meanings or hints, picking up on nonverbal cues like body language and facial expressions, and knowing how to start, maintain, or end conversations naturally. This makes forming friendships and relationships difficult and affects life functioning. The social communication problems in social communication disorder look nearly identical to the “Criterion A” features of autism. However, unlike autism, people with social communication disorder don’t show repetitive behaviors, restricted interests, sensory sensitivities, or the need for sameness and routine.
Social communication disorder is rarely diagnosed in favor of autism primarily because autism provides access to critical services, insurance coverage, educational support, and legal protections that social communication disorder does not reliably offer, creating strong practical incentives for families and clinicians to prefer the autism diagnosis. Additionally, autism has an established evidence base, validated assessment tools, clear intervention protocols, and a large supportive community with a neurodiversity-affirming culture, while social communication disorder has none of these. It has no community, minimal research, no specific treatments, and little professional awareness since it was only introduced in the DSM in 2013. Service delivery, insurance, and educational systems are built entirely around autism rather than social communication disorder, and since both conditions require similar interventions for social-communication difficulties, there’s little practical incentive to make the diagnostic distinction, especially when the boundary between them (whether restricted/repetitive behaviors are truly absent or just subtle) is often unclear and clinicians are often unsure the distinction really matters.
Trauma-related disorders, particularly from early developmental trauma, severe neglect, or disrupted attachment, can mimic autism through social withdrawal and avoidance of eye contact (defensive protection rather than social processing difficulties), communication delays and difficulties (from lack of language exposure or trauma’s impact on brain development), emotional dysregulation and meltdowns (from emotional dysregulation rather than sensory overload), repetitive self-soothing behaviors (anxiety management rather than stimming), sensory sensitivities (hypervigilance rather than sensory processing differences), and rigid need for routine (anxiety-driven safety-seeking rather than cognitive processing style).
Severe early deprivation can create “quasi-autistic” patterns that can be genuinely difficult to distinguish. The critical distinctions are that trauma-related difficulties typically improve significantly in safe, nurturing environments and with adequate psychological treatment, show more variability across contexts (worse with triggers), are tied to identifiable adverse experiences rather than present from earliest infancy, and lack the restricted interests and genuine social communication processing deficits of autism.
Social awkwardness refers to social ineptness without meaningful impairment that falls within what is considered normal or typical human variation. This can be mistaken for autism because both may involve limited friendships, preference for solitude, conversation difficulties, reduced eye contact, and intense interests, particularly fueled by online self-diagnosis culture and broad autism awareness. The key distinctions are that socially awkward individuals understand what they should do socially but find it difficult or uninteresting (versus genuinely not understanding unwritten rules), show significant improvement with practice and maturity, are more comfortable in specific contexts, lack the sensory sensitivities and restricted/repetitive behaviors required for autism diagnosis, and generally achieve life goals despite awkwardness rather than experiencing clinically significant impairment.
Selective Mutism, Intellectual Disability (without autism), Stereotypic Movement Disorder, Attention-Deficit/Hyperactivity Disorder (ADHD), Schizophrenia Spectrum Disorders, Avoidant Personality Disorder, Attachment Disorders, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, and Rett Syndrome (a characteristic pattern of developmental regression after initial normal development, typically 6-18 months).
Comorbidity is possible and expected. Someone can be autistic and have maladaptive personality patterns, trauma histories, or anxiety disorders that complicate the presentation. Developmental context, response to relationships, and subjective experiences are all very important in looking beyond the surface presentation to understanding the meaning and functions of behaviors.
See also:
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](https://www.psychiatrymargins.com/p/it-is-not-ludicrous-for-mildly-and)
[

](https://www.psychiatrymargins.com/p/the-overdiagnosis-confusion)
It's not just how the "science" is conducted, or limited to a fixed number of sides. Everyone doesn't quite know what anyone else experiences. We all just throw around symbols, hoping someone gets what we mean by what we say, and assuming that we know what others mean by what they say. The meat of what we know and experience never gets transmitted faithfully to anyone.
To be certain, many people do have conditions that, say, I will never have. But that doesn't make me "normal" or those people "abnormal". The definition of a disorder by showing harm to living one's life is a good start, but fraught with the complexity of analyzing things in an implicit social context. If it seems that someone has a problem, I'll consider it a problem, not only if it seems sufficiently and officially abnormal.
Truer words ...
As a matter of fact, calling it science ... quite the stretch when it comes to most medical professionals I've met in my long life.
p.s.: hope you're doing better now.
I think autistic people would have less eye corner wrinkles, because they don’t smile automatically when others smile. A study would be interesting.
Maybe I am biased, but to me NT appear as cognitively lazy. They don’t question norms or standards, unless those norms or standards interfere with their feed-fuck cycles.
I'm simply saying that the way we're classifying people is utter BS, and assigning labels is very hurtful
Everyone is different. The "median man" does not exist. Or if he does there are maybe 3 on the whole planet, not something significant.
Much like your fingerprints, your brain is completely unique, and what chemicals / lifestyle / circumstances affect it in what way is a hugely personal affair. And to make matters even more complicated, it changes very much over time.
If you agree to let any kind of random bozo, with a so-called specialist title and a diploma tell you that you are a "typical neuro-divergent belong to class XYZ", run like hell.
The only way is to experiment with the way your mind works: chemicals, social groups, type of work, meditation, yoga, sports, more or less social interaction, whatever ultimately gets you to where you want to be.
But if you let every other snake oil salesman out there, or the rest of humanity in general, tell you who you are and who you ought to be ... good luck to you.
Once you understand that neurotypicals have special needs and you must play-act to smooth things over, then you play the game.
I think your comment is very insightful. It made me think and reflect. I am not socially awkward, however: but I am autistic. I really think so. My ability to appear less so over time is my own achievement.
When I first started interviewing people, I would have crippling anxiety. On days I had a interview scheduled with a candidate, I would obsess and have anxiety to the point where I wasn't able to focus on anything until the interview was over. It was bad. I'd spend hours rehearsing every line I was going to say. I was an incredibly awkward interviewer.
Fast forward 10 years and hundreds of interviews later, the anxiety is completely gone and an interview doesn't even spike my heart rate anymore.
I absolutely met multiple DSM criteria for anxiety 10 years ago, but not anymore.
I suppose I was cured through "exposure therapy" (or whatever you call doing something repeatedly that gives you massive anxiety).
Interviewing still doesn't come naturally to me. But it's easy now because every interview is basically scripted. I repeat lines that I memorized over the years. I always start interviews with the same ice breaker. I use multiple tactics to put myself and the candidate at ease throughout the call.
Do I still have anxiety even though I've learned how to cope with it? I don't know.
Is someone still autistic if they were able to learn coping tactics that make the symptoms invisible to themselves and others? I don't know.
The brain is neuroplastic, especially when young, but I doubt you can just influence the growth of significantly more dopamine receptors out of pure willpower and habit-forming; especially given that ADHD disrupts those two facilities.
This is in part why dopaminergic drugs such as Adderall work so well, and why dopamine/reward-center disruption due to childhood trauma can have such a negative impact on one's ADHD symptoms.
Again, I don't know how much this applies back to autism, but it has definitely been a bane of my existence constantly explaining to people why I can't just meditate, habit-form or diet or exercise away my symptoms.
These things help, as does directed research and experimentation with what does and doesn't work for me, and because of my ADHD these things are integral to my ability to function as an adult in this insanely complex and stressful world. And it's definitely made a difference in how I manage my symptoms, especially when I look at how my siblings don't manage theirs and lack basic coping mechanisms.
But I frequently run into people who arrogantly assume I've never even heard of meditation, or that I have a bad diet, etc. and offer them up as panaceas. These people often get defensive and more arrogant whenever I try to explain to them that ADHD is not just some "mental block" or collection of bad habits that can be "fixed".
So yea... I also think we need to do way more clinical studies about the effects of teaching coping mechanisms at a young age, but I don't think autism is something that you can grow out of, there are likely specific underlying genetic and neurological factors that affect how much a specific individual can control or cope with their symptoms.
There is a post here about someone who was misdiagnosed and bipolar and that later came up when security clearance was needed for a job.
Because it's not as prevalent in other societies. The fixation of Americans, and especially younger Americans with mental health is not something I've (or clearly, GP) witnessed elsewhere.
I don't think the discussion here is due to a lack of empathy, rather it's curiosity of people looking into this society from the outside (which we're doing all the time because we live in an Americanized world, after all). It seems like the participants in this game of self diagnosis and mental health crusade are very self centered and not very fit to deal with life (which is a complicated matter, I admit to that).
This is not to dismiss the hardships of those people professionally diagnosed with mental conditions, obviously.
If there’s a phrase to describe this wonderful experience of life, it’s “social friction.”
And running them was awful and drove the people who did it insane, mostly because you had to fight spambots.
All praise our VC overlords.
Either deliberately or because that's how all of the other train spotters/board gamers/coders they've ended up hanging out with are.
It does not mean I am bad at it, it means I don't understand the rules. I can copy others people tactics and sometimes it works, but still don't know why.
For what it's worth, exposure therapy is a real term and it's an actual part of cognitive behavioural therapy.
Society is moving in the right direction at least. At one point, the bell curve had 3 sections: normal, genius, retarded. Now we have more gradients and some of them trigger help or maybe longer exam times.
This causes over-diagnosis and resentment. Coping mechanisms grow over time. It’s definitely better if you can appear neurotypical.
I'm sorry you have resentment issues... definitely get that.
The diagnosis is a road to help. I doubt many people travel down that road without there being some merit to their ideas, but even if it is the case that lots of people travel down that road, that doesn't say great things either. That just means we have a giant group of people screaming out for help and they are using one of few outlets to try and get it. I'd rather they get that help through travelling down that road than blocking off the road to anyone isn't 'actually ill', whatever we define that as.
And it’s very expensive to get the diagnosis, it can be up to $20k in California
Nobody will accommodates you.
Suing for ADA violations will cost $20k just for a retainer. And then it's a gamble if you win or not.
And the US government wants to aggregate us into a list for who knows what reason.
I had one good PDoc who helped me, with my genetics, not to diagnose me, but to help me find what helped me and my specific symptoms. Diagnosis is not as helpful as looking at your own symptoms and own history and using that to find what helps you.
If you can't measure a true positive, you can't determine the false positive rate.
It's not about the rising rates, that could be explained in other ways.
Maybe you should join better servers. I'll also add that this was common back in the forum days too. Most admins would just... admin the site.
> Also: 99% won't read profile bios (and you have to pay for actual customization, don't you?) while forum signatures were front-and-center.
Wrong on both counts.
> I have to say I'm surprised to see Discord mentioned as an opposite to social media instead of... just yet another iteration of the same.
I did not present it as an "opposite to social media" - I presented it as a counter to the idea that we've lost the personality GP is talking about
You’re going to keep running into a wall thinking of discord like a forum replacement; It’s designed to be an IRC replacement.
The invitation system intentionally creates some privacy so you can build a sense of enclosed community around them, and so you have some control over who sees what. Not having your conversations on full automatic blast to the public is a feature.
Expending large amounts of cognitive effort to better understand and deal with others can be exhausting. We do it because we have to just to survive. The benefit is we have a lot of uncommitted neural capacity potentially freed up for other things, like experimenting with computers. But it's a stiff price to pay, and in the EEA it's advantageous to be able to participate in a cohesive group without thinking much about it. Our brains are our most energy-hungry organs, and sustenance could get scarce...
Nobody will accommodate me in two years of job searching. They don't deny me outright, they just ghost me if I ask to do a "take home" or any other alternative.
> electric parens
I get you, I was amazed by the litterature around lisps (I always found the beginning of SICP (the wizard-programmer analogy) quite inspiring and fun)
My argument isn't that psychiatric symptoms don't exist or aren't real and there is no real underlying phenomenon. My argument is simply that we've drawn the lines between the units of study too high up and we should be more granular. This level of nosology was chosen in 1952. Do you really think they got it 100% right almost 75 years ago? And what is the mechanism for defining and maintaining these categories? A bunch of committees get together every few years and decide on them, then they tell us all what's "true". Bullshit. What are the odds that a committee will define itself out of existence? Pretty slim. [1]
I have traits that could be considered as autism, ADHD, obsessive compulsive personality disorder, PTSD, bipolar II, social anxiety disorder, and probably a dozen more disorders. But by quantizing the disorder at the current level, by necessity, the other traits are cropped out of view. Relevant information is lost and irrelevant information is blurred together. And the level of overlap between disorders is absurd. They cannot possibly be "real" because the lines between them aren't even distinct.
The useful unit to study is the individual trait, not the cluster of traits that is different in each individual. The traits are more granular and map more closely map to underlying biology anyway. The current model is akin to what the geocentric model was in astronomy. It's outdated, wrong, and holding us back from a more accurate, detailed view.
This kind of presupposes that you have suspicions about autism rather than just something in general. If you think you have autism, you're can target that literature anyway regardless of the diagnosis, while if you have no concrete suspicions, you'll be firing blind, and probably miss a lot more than if you could nail it down to one diagnosis.
By the time I got mine, I didn't need the processes, since I'd figured those out by myself, so the diagnosis is just a nice piece of paper pointing to a road I've already walked.
For ADHD though, that story is very different, since step zero there really should be medication,[1][2] and that is locked behind a diagnosis.
Scheme chads understand that perfection is achieved not when there is nothing left to add but when there is nothing left to take away. They realize functions are nothing special, just another object that can be manipulated and operated on, so why create a separate namespace and binding for them? Why put bindings in the symbol at all, since if you are designing your language correctly bindings will vary with lexical environment? So symbols have been stripped down to just a name that the language recognizes as an identifier for a value, function, special form, or whatever else. And functions are just values that get applied whenever in head position of an eval'd list.
I jest, I jest. Seriously, I love Common Lisp, but I'm with you: Lisp-1s appeal better to my aesthetic sensibilities.
In any case, I see no reason to believe any higher % of people paid any particular attention to forum signatures back in the day.
I agree with this, and your overall post. I’ll just add that if the purpose is treatment, it helps to find root causes, and maybe there’s a common thread in the underlying root causes, likely related to gene expression.
Mental health, like physical health, requires action on your part. If the only thing you're seeking from a diagnosis is accommodations from others, then yeah, you're probably going to be disappointed.
That's truly a shame scripting/glue languages took a different path than lisp, but well, you can always lisp shape anything.