A number of years ago when I was pregnant, I was diagnosed with Anxiety disorder and OCD. Hopefully the fact that I was pregnant at the time was accounted for in the diagnosis, but I guess it’s not that big a deal. I made a lot of progress through cognitive behavioral modifications of various kinds. As we discussed anxiety disorder in abnormal psych last night I wasn’t really sure whether I had more OCD or more GAD (General Anxiety Disorder), if it’s just a case of comorbidity, or if (departing from the diagnostic manual) my symptoms would fall under Broader Autism Phenotype.
But what is interesting is how OCD and Anxiety disorders (and PTSD) are all separate chapters now (plus OC personality disorder). Not just different codeable diagnoses, but new and different chapters in the DSM-V. So much for a move toward spectra and dimensional diagnosis. I get that these disorders, especially the PTSD, have different apparent causes. Another argument is that they also involve different brain structures: the amygdala in the case of anxiety, and the cingulate gyrus in the case of OCD.
It feels like what has happened with Autism is that it’s been shelved as far as etiology goes. Psychiatry is just going to look at symptoms until we can catch up to the neuroscience. My suspicion is that we will eventually find it is a pattern of alternate structures in the anxiety area, the OCD area, and also a social function area (such as the mirror circuits). Lately I’ve been thinking about the nature of the struggles I have in higher level social interaction. Intention is part of it, but so is relevance. One theory I’ve seen is that autistic toddlers have less neural pruning, so it’s like they’re always drinking from a firehose, in sensory terms.
Something I haven’t really written about is my responses to The Rosie Project which I read this summer. A blurb on the cover talks about how everyone wants to fit in. My immediate reaction to that is “everyone wants to belong, not necessarily fit in.” I also wondered about some of his reflections toward the end, about what it means to empathize with someone, and how that relates to the experience of love. The author gave into the idea that people with Asperger’s don’t feel romantic love. In my experience, it’s not that I don’t feel, but that feeling is difficult because I feel too much. It’s the firehose again. Granted I’m a girl, but I think my brother is like this too. It’s not that he doesn’t understand people, it’s that they are painful to be around.