Should I be concerned?

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I'm going to explain this the best I can. You see, when I'm writing my stories... I always get really anxious when my sentences line up with the other. Like, punctuation wise I mean. It's almost like I just get very OCD about it and try to add words to make sure the end punctuation doesn't line up with a previous sentence. It's not just with writing stories either, but it also occurs when I'm typing in general as well. It's really the only thing that seems to bother me the most when I'm writing.

Could this just be an autism thing, or is it something else I should talk to my psychiatrist or doctor about?

I don't think it is either an autistic thing or something you need to be concerned with.
All writers have stylistic differences and I've never met one who hasn't had some weird aesthetic compulsion like what you have.