Asperger's and Co-morbid Conditions
So...
As some of you might have noticed I am sort of obsessed with figuring out what is wrong with me. You could say it's been the great quest of my life. About 3 years ago my counsellor suggested I had Asperger's and my university's learning centre tested me and confirmed it. It wasn't a proper diagnosis but it made me read about AS, come here etc and I was pretty much convinced I was an aspie. I'm currently waiting to be seen by yet another psychologist for diagnostic testing.
But then I have a lot of other problems that don't seem to be explained by AS at all. Maybe I also have a personality disorder? For a long time, until AS was suggested to me, I thought it was BPD. I know it's a cliche for tortured arty types to claim that but I did do my research, this wasn't the result of dubious online tests, I read books but then there were inconsistencies there. I had the emptiness, the self harm (now free of that for almost 3 years) the dissociation when stressed, the moods, the black and white thinking - but I'm not that impulsive or promiscuous. There's a case to made for that being more a matter of lacking opportuinity than annything else but still...I have eliminated almost all other PDs - some fit if I crowbar them but they're not "me" enough to be the right diagnosis. Then there's Narcissistic Personality Disorder. Everything on the list fits.
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1. has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
4. requires excessive admiration
5. has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
6. is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
7. lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
8. is often envious of others or believes others are envious of him or her
9. shows arrogant, haughty behaviors or attitudes
(sound lovely, don't I?)
But it's not the whole story. It can't be just that.
What I'm wondering is if it's really possible to be an aspie - hardwired in my brain, accounting for my odd way of doing things and seeing the world - and have narcissistic personality disorder (or maybe bpd) - brought on by crappy childhood, accounting for the traits listed above. Because it seems to me that if the personality disorders are based on deviations from the neurotypical norm, they shouldn't apply to autistics. But then what happens when aspies have other troubles - the proverbial "issues"?
I don't know. I was once in a psychiatric hospital where that doctor there offered me a hasty misdiagnosis of BPD; it was a transitional ward and my records weren't ever forwarded to them, and I wasn't sharing anything with that particular doctor, whom I had the misfortune to encounter several times in Iowa. He eventually had my diagnosis, but at the time, he was diagnosing me based on a set of symptoms and the reasons for my admittance, not on my self or function.
I think that relation to such disorders is exactly that: a series of symptoms. While you might meet every criterion for diagnosis, personality dysfunction is treatable (if not curable) in a different manner than neurological differences. While personality dysfunction can be any mix of learned/adaptive behavior and chemical difference, it wouldn't indicate a fundamental difference in neurological structure and pathways.
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