Asperger’s, Schizotypal, or Neurotypical?

By Dr. Marie Hartwell-Walker

Firstly, I understand that I should not consider any answer to this a diagnosis, however, I do not have health insurance and would otherwise see a psychiatrist directly. I have studied both AS and SPD in depth.

This past November I was diagnosed with Asperger’s Syndrome, PTSD, and Panic with Agoraphobia. In my adolescence I was diagnosed with Major Depressive Disorder (I was suicidally depressed since the age of 12, and at fifteen I ended up in a psychiatric hospital for a week because of attempted suicide), GAD, and Depersonalization Disorder (severe: I have it all of the time–not a hyperbole), all of which developed at 12-years-old.

I had a somewhat emotionally traumatic childhood due to an alcoholic father and several drug-addicted, diagnostically–committed, even!–insane stepmothers/father’s long term girlfriends since I was 7-years-old, and constant bullying throughout my childhood. I don’t like to say my childhood was “bad” because I could not have asked for a better mother whom had full custody of myself and my brother (my parents divorced officially when I was six).

To get to the point of the matter, I don’t remember much before the age of nine or so, so I don’t know exactly how I acted as a young child in social or other situations. My psychiatrist diagnosed me with AS in one session, which always seemed peculiar to me, even though I went because my brother was diagnosed with it only a few months before (this isn’t to brag, but just to give reason as to why we made it until the ages of 21 and 24 without being diagnosed with HFA is because we have both been considered “brilliant” and likely intellectualized our way through emotional and social situations without actually going through the true experience of them) so I felt Asperger’s was a reasonable explanation for my absolute social ineptness, obsessive thoughts, involuntary rudeness, hatred of eye-contact and physical contact with humans, and other symptoms that coincide with AS.

A few months later I stumbled upon the diagnostic criteria of Schizotypal PD, at which point I realized how much better it fit me than Asperger’s (in fact, if I am reading it correctly, I match every one of the criteria on Wikipedia). I studied it for a couple of months before I could find a “free” therapist whom I discussed this scuffle with, and she told me that I did show symptoms of mild psychosis, such visual and auditory illusions/acute hallucinations and olfactory hallucinations and sensitivity to sounds, not to mention jumbled spoken language and neologisms when nervous (such as all of the time). Uncontrollable thoughts, apathy, indifference, social isolation, inability to express emotion, forgetting what I am saying in the middle of a sentence, hostile, occasional lack of understanding language, etc. I am also extremely paranoid, for instance, this past spring at college I had my own apartment and I was friendly with my neighbor (whom I really only forced myself to hang out with because I knew I needed to socialize, not because I wanted to) and I became convinced that he had installed security cameras and it was all because of me. I spent three weeks looking for where the security cameras were hidden.

Because of my paranoia and anxiety of social situations, I only have one close friend and only two my family members I am close with. I trust no one. I am currently unemployed and sometimes when I get cabin fever I think about going for a walk around the block, but I always decide against it because I am afraid of seeing other people walking around the streets, and it makes me really anxious to think of interacting with them or I am convinced they are judging me or thinking of bad things to do to me. I have dozens of phobias–like ladders and bridges! I’ve been known to have panic-induced dissociative trance episodes where I begin to hallucinate terrible things, and then bang my head against a wall until someone stops me or I fall asleep. I also have a lot of odd beliefs I am usually not willing to share with people out of fear they will pin me as crazy. I knock on wood all of the time because I know that if don’t, someone will die or something else bad will happen (it’s happened three times, each time I thought something bad and didn’t knock on wood).

I’ve been pinned as weird or crazy all of my life by other people. I went to college and majored in art, and although almost everyone in art school was eccentric as me, I still never fit in and made few friends. Sometimes I am afraid that people can read my thoughts. However, all of these symptoms have been with me ever since I can remember. I can’t figure out if it’s AS, early-onset SPD, or if I am just a sane, neurotypical person with some issues. I graduated from college with a 3.0, and I’m able to hold down a decent job. There is a history of AS in my family, but not Schizophrenia. And just like another inquirer on a similar subject, I am also afraid that someone will end up seeing this and figuring out who it is, but intellectually, I know that is extremely unlikely and irrational.

The thought of me being sane is more terrifying than the possibility of being insane or autistic. Any thoughts? Thanks.

A: Actually I do have some thoughts, the first being that you are overthinking. The DSM-IV-TR manual is the best the mental health profession’s got for diagnosing mental illness. Its labels are useful in that they do help inform treatment and they provide a way for professionals to communicate with each other. But it’s by no means perfect. Often people don’t fit neatly into one diagnostic label or another.

I suggest you simplify things. Your problem right now isn’t how to find the right diagnosis. Your problem is that you are a brilliant person who can’t function in the world. Your challenge is to both find a way to function better and to find places in the world where your level of functioning works. The fact that you’ve made any friends at all in life and that you have been capable of holding a job at times are solid blocks to build on.

Give yourself a break: Stop studying labels and instead put your considerable intellect to use to find a sympathetic therapist and a free clinic where you can get some psychiatric help. Since you are worried about people recognizing you from your letter, I won’t give you specifics about where to find help. Suffice to say there is a medium sized city near you where there is a major hospital that has mental health clinics throughout your area. Contact them as a place to start looking for low cost or free therapy.

Now: Organize for yourself what the top two issues are that are getting in your way of functioning. From what you told me, I think I’d go after the paranoia and the related social phobia first. But you have a better sense of yourself than I do. The point is that taking on the whole long list of problems all at once is going to overwhelm you and probably defeat treatment. Better to take it a step at a time.

Meanwhile, find a job where you can be you just as you are. As an artist, you may be able to find ways to work from home part or full time especially if you have some computer skills. Magazines and websites need designers, for instance. Use that creative mind of yours to find a way to make enough money to get along but that also limits your contact with people until you are more comfortable.

If you can be patient with yourself and take one step at a time, you’ll find your way.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 7 Sep 2010

APA Reference
Hartwell-Walker, D. (2010). Asperger’s, Schizotypal, or Neurotypical?. Psych Central. Retrieved on September 18, 2014, from http://psychcentral.com/ask-the-therapist/2010/09/07/aspergers-schizotypal-or-neurotypical/