Reader’s Question

I have been diagnosed with many things over the years, but none of the diagnoses has seemed to explain the various difficulties I have had since childhood. These diagnoses I have been given include Borderline Personality Disorder, Bipolar Disorder, OCD, Social Anxiety and Clinical Depression.

I will admit I definitely have some borderline traits, but I have become increasingly sure I have an autistic spectrum disorder (ASD) like Asperger’s since I began researching it when it seemed someone I knew might have it. As I read more about it, I was stunned to find so much that fit me, especially the sensory issues, obsessions and difficulties in communicating emotions. Since I was a child I have thrown tantrums if things of mine were moved or lost, and I hated loud noises, struggled to interact successfully with my peers, had obsessions lasting up to 4 years (with some even longer to the point that they kept me from focusing on my degree and were all I could think of and talk about), collected various things, been reluctant to change the clothes I wear, shown a lack of response to pain (when I fell as a child, I did not cry and just stood back up), and found it incredibly difficult to understand the emotions of others and of myself (I find it unbelievably hard to offer comfort when people get upset). I was also clumsy and always knocking things over and spilling things, tended to love escaping to my room and into my music, and used to love memorizing facts and reading encyclopaedias and bird species books.

The borderline traits make things very complex. They appeared after sexual abuse and living with a very controlling and obsessive mother. Although I can easily survive long periods of total isolation, I do get depressed as a result, and when I’m in a relationship, I become very untrusting, scared and confused, wanting time alone but at the same time not trusting the other person to be loyal when apart from me. Is it possible I have Asperger’s or some such but it was missed as a child back in the 70s/80s?

Our Clinical Psychologist’s Reply

Although it was in the 1940′s that a Viennese child psychologist by the name of Hans Asperger first noted the phenomenon, diagnoses of Asperger’s Disorder were rare until the late 1980′s, when all of the autistic spectrum disorders began receiving much more attention. Even today, however, there is some debate within the professional community about the criteria used to make the diagnosis.

Most professionals regard Asperger’s Syndrome as a less severe and extensive case of pervasive developmental delay or autism. Whereas autistic children have profound developmental delays in a wide variety of social, educational, and language areas, the main characteristics of Asperger’s Disorder center around:

Social Interaction Deficits

Asperger’s children have difficulty remaining engaged with others, interacting with sustained focus, and developing emotionally-integrated social interaction skills.

Odd, eccentric, and often repetitive behaviors and movements

Asperger’s children tend to engage in unusual, repetitive behaviors such as hand-wringing, finger-twisting, etc.

Unusual preoccupations or rituals

Asperger’s children tend to want to engage in certain behaviors repetitively and experience frustration when they are stymied from doing so.

Communication oddities and difficulty

In contrast to autistic children with marked language delays, Asperger’s children tend to be rather concrete in their understanding of things communicated to them, tend to have difficulty maintaining eye contact and adequately engaging with others when conversing, and tend to focus on their own idiosyncratic interests.

Limited range of interests

Asperger’s children tend to have an almost obsessional focus on things of interest to them but have difficulty broadening their range of interests.

Unique high skill areas

Asperger’s children tend to have a savant-like talent in certain areas while lagging somewhat behind their peers in other skills.

Some coordination difficulties

Some Asperger’s children have mild coordination problems.

These days we recognize that developmental delays exist along a continuum or “spectrum” and that there is a wide variety of spectrum disorders, not all of which are easily defined, categorized, or diagnosed.

Mental health professionals also recognize that it serves neither the science nor their clients well to attempt to strictly pigeon-hole individuals into distinct, singular diagnoses. Most people are complex individuals possessing a variety of distinguishing traits and characteristics. So, it’s quite possible for someone to have various aspects of several syndromes. It would be best to work closely with a team of professionals to get an adequate assessment of your situation and devise the best plan of intervention and support.