Asperger... or Schizoid?

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I writing this in a state of distress, upset, consternation and confusion regarding diagnosis.

I was diagnosed Asperger syndrome when I was 15, and am now 18. Since then I've gone through a multitude of transformations in terms of character and intense interests, but most of my issues with social interaction (humor etc.) and social anxiety remain. I resisted psychotherapy and was treated with SSRI, SNRI and NaSSA medications, but they have been ineffective and I have been off of venlafaxine and mirtazapine since July 2013 and March 2014, respectively.

My point of anxiety regarding my treatment and self-understanding is that my current psychiatrists have diagnosed me with Schizoid personality disorder. They claims that Asperger syndrome is a "childhood diagnosis" only. I am concerned that, should this be incorrect, I will will receive either ineffective or damaging treatment, considering my history of ineffective to damaging use of psychiatric medications.

While I understand that there is diagnostic overlap between Asperger syndrome and Schizoid personality disorder, from my own non-professional "research" online, I do not believe that I have Schizoid PD for the following reasons:
1. Unlike sufferers of SPD, I can and actually would like to socialize, but can only do so for short periods as I find it extremely exhausting, and afterwards I need a substantial period to recover.
2. When socializing, both in real life (which is rare) as well as online, I still have trouble understanding when an individual uses jokes, idioms or sarcasm, and often take things literally
3. I have significant anxiety regarding eye contact and I'm not sure how much is appropriate or inappropriate and my experiments in this have proved unhelpful in reducing my anxiety
4. Unlike with, SPD I am not callous with my socializing and am extremely sensitive in real-life socializing. I get upset if I make a mistake and say something inappropriate and on specific occasions I get upset when I contemplate the suffering of others.
5. I remain obsessional with my interests and have tremendous energies once I find one that interests me; after exhausting an interest, I move on to the next intense interest and burn that out too, and the cycle continues.
6. I do not have "magical thinking" unless you consider my recent interests in heterodox economic and political systems, as well as my interest in prank religions "magical thinking".

Crucially, I enquire for your perspectives on the following:
1a. Is Asperger syndrome exclusively a "childhood diagnosis"?
1b. If it is a childhood diagnosis, is it true that if it continues into adulthood it must therefore be Schizoid PD?
2. How often do you believe that Asperger syndrome is misdiagnosed as Schizoid PD?
3. Is Schizoid PD the "most current" and "most established" perspective considering the set of symptoms in psychiatry?
4. What are your perspectives on the removal of Asperger syndrome from the DSM-5 and the wider mainstream perspective currently of Asperger syndrome in psychiatry? Does this mean that Asperger syndrome specifically is now a "niche diagnosis" and that autism disorders based on a spectrum is the most accurate model of understanding? Or is the DSM too influenced by the pharmaceutical industry?
5. If psychiatry is an endless series of mere "perspectives", to what extent can it be considered a science? Is deep psychotherapy preferable in cases such as this over medications?

I can say for a fact that since I was dx'ed as a middle-aged man, that it most definitely is NOT "childhood-only."

am no expert but I would say no, at least based on my own experience.

again I only have my own experience to go on, I was initially dx'ed as a child as [depending on the shrink] "schizoid" or "schizotypal." at the same time the school [according to my mother] told my parents that I likely was autistic and that I should be institutionalized [1960s]. in any case, I am one who seems to have many bits of both things.

IMHO a good therapist would consider the DSM to be a often useful guide but NOT akin to a psychiatric "bible" to be slavishly referred-to in all cases. there is too much in the way of politics in the picture, IMHO. no matter what ends up in that reference tome I know what I still am.

can only speak to the 2nd question here, other than it is a bone of contention with at least one shrink, one Dr. Thomas Szasz who long has believed that psychiatry in practice is a bit closer to a pseudoscience. anyways, the meds serve above all, to make one more amenable to other treatment modalities such as talk therapy. only you and your therapist can figure out the particulars here.

The idea that Aspergers is a diagnosis for children only is so wrong that I wonder if you might have misinterpreted what they meant. Is it possible that they meant it was a misdiagnosis based on what could be observed in you as a child but they believe other evidence now points in a different direction?

If they are really making the claim that Aspergers is not a diagnosis of adults or that it always becomes Schizoid Personality Disorder, they are either wrong or duplicitous and in either case you should discontinue all contact with them and perhaps report them for an ethics violation to the relevant employer or governing board.

It is my understanding that psychiatrists give you pills, and psychologists diagnose problems. There are many people on this site who have had an extremely extensive diagnoses from psychologists.

I was diagnosed with Asperger's in my late 40s. I've also had a doctor tell me that ADHD was a CHILDhood disorder; and then, later, I was diagnosed with it, by another doctor. You have to be careful with doctors. I try not to be too critical of them, but the fact IS, they don't know every damn thing!! ! I try to give them a break by saying: "Well, they couldn't possibly know everything about EVERYTHING"; BUT, I hate when they speak so matter-of-factly (to ME, that's narrow-mindedness), and expect you to just "buy" anything they shovel-out, at you. Bottom line: I'd seek the counsel of another doctor!!

I don't have enough knowledge to respond to the rest of your questions.

I can recall discussing my severe allergies with a doctor who was treating me for asthma. I told him that sudafed was effective as an antihistamine, but that it made me feel very drowsy and doped.

"No," he said with absolute certainty, "it's a stimulant. It doesn't have that effect."

"It does when I take it, " I said.

He showed me the relevant passage in the PDR: it's a stimulant for 80% of people but has paradoxical sedative/depressant effects in others...

"I'm one of the 20%," I said.

He was amazed because he had oversimplified what he had learned. This is not uncommon in many areas of medicine.

There is an interesting article I read from someone on this site about the comorbidity of people with aspergers too. For someone to think you have only one issue, may be completely false, and steer them in the wrong direction. Many people with aspergers also have a PD, or other neurological differences. Like avoident personality disorder, ADD, ADHD, CPTSD, PTSD, epilepsy, etc.

I was first diagnosed with an older term of what in the UK is now called learning disability but was called something else in 1968 after I came out of Great Ormond Street Hospital for children in London for Dravet syndrome a severe form of epilepsy where I would have had about 300 seizures a day a diagnosis of 'brain damage' was given of which the medical said lack of awareness and severe 'mental retardation' which using neurodiversity language severe/profound learning disability possible needing residential care during adulthood and with this stripped of neuroprivilege because it was official I was not allistic I was first put into schools within the special educational needs system from about 3 years old in a nursery in 1969 which was for non allistic children most have which had severe forms of developmental disability and few had Down syndrome some had more severe forms of autism etc but were all thought ot have some sort of disability or non allistic or even both as in te case of profound and multiple learning disabilities. I went to what was like a non allistic childs version of infants school which done no academic activity such as learning how to read and write and such things were usually seen as signs of being a bad infuence because you learn to think for yourself. I was still thought of as having a learning disability perhaps a severe or 'low functioning' form of autism becausw it was recommended that I should have been institutionalised in 1968.

It was only in 1977 when I had my IQ tested by Ravens Progressive Matrix as 137 putting me in the mildly mentally accelerated range. And I was this put into mainsteam school and my infanthood diagnosis was not valid and so it was assumed as I was some kind of unknown problem rather than a system which was in the dark ages as far as Asperger syndrome was concerned but the school thought I was about borderline intellectual functioning. I did leave with a few qualifications but nothing that can get a person a job if he has some kind of coordination problem which aspies often do. From 1974 onwards I started to develop temporal lobe epilepsy which resulted in pitch black or closed eye visuals that looked like Shadow spaceships out of Babylon 5 and psychotic like delusions and audible hallucinations which had afftected me and progressed to couple of mild like seizures which the last one was in 2008. This was thought later to be a schizoid personality disorder because the delusions did not persist after the activity which was picked up as a form of epilepsy of which I have taken tablets for as well as supplementing the tablets by smoking marijuana/hash for 16 years for the epilepsy. I now eat spacecakes rather than smoke.

I was diagnosed at Cambridge Lifespan Asperger Syndrome Service on Friday 26th June 2003 at about 2 o clock in the afternoon and I had suspected as such since 1988 but never thought any more of it since I read a book about the autistic spectrum during that time. I was 36 when I was diagnosed as an aspie and the schizoid thing just disappeared then when all I had was Asperger syndrome epilepsy and Post Traumatic Stress Disorder from the consequences of all the progress that my mum had thought was 'marvellous' lead me to having had an abusive childhood. My escape form this abuse was in the learning disability system. When that door was closed there was no escape it was enough to drive someone to drugs. But however all of my time in that system I did feel like I was living under alien occupation and the aliens were allistic people. I don't see AS as a childhood issue. What will happen to the elderly Asperger syndrome person I worry about if I had all these demands put on us then what is that going to be like a we get older?

Sounds like you are definitely more aspergers than schizoid to me.

But I do sometime wonder if people can have both, personality disorders are based in maladapted defence mechanisms due to psychological damage, seems possible to me that people with autism could be more prone to this damage, due to bad experiences their autism led to, and the hypersensitivity. I think technically they tend to treat personality disorders and autism as mutually exclusive, but wouldn't be surprised if that is more or a practical decision to treat the most dominant problem rather than based on an underlying scientific reason that someone couldn't have both (same with schizophrenia, you can be autistic and develop schizophrenia but once you have schizophrenia I don't think you can be diagnosed with autism).

I read a lot about schizoid disorder, it was the first thing I suspected when I started to get to the bottom of my problems. I related a lot to it. The description would fit me very well from an observers point of view, but doesn't match how I actually felt, but an observer would never know that as I would never know that as I put so much effort into pretending I was that way due to choice, that I liked being on my own, aloof, didn't care about criticism because I was uncomfortable with anyone knowing I cared about anything. Wonder if it is like that for people with SPD, somethings I've read indicate they genuinely don't care about social interaction, and other accounts indicate a covert experience that is completely at odds with outward appearance. You read a lot about people with aspergers starting off wanting to be social but withdraw due to bad experiences, to me that seems very similar to the schizoid defence mechanism, I still think I may have a layer of schizoid personality disorder on top of my ASD.

Anyway sorry that was off topic, you can be very confident that if you were diagnosed with aspergers that it is valid for adult life.

Sounds like the kind of conversation I have with doctors.

My husband's original diagnosis was OCD, GAD, SPD and depression.

I called BS on the SPD early on.

SPD can read social cues, they could form attachments to people, they can socialize easily, they do not want to AT ALL.

A SPD parent will not give a rat's ass about his child's/spouse's needs over his/her own. They put very little work into social situations by their own choosing.

My husband misunderstands social cues. If it was easier, he would be around people more. He tries really hard to parent our child.

Originally, he thought SPD was very cool. Oh, I chose NOT to be with people. That is until the ASD specialist called SPD a total BS diagnosis, and picked apart even argument my husband had for being SPD. I have never heard of anyone with SPD having huge issues with executive functioning skills, or TOM. The specialist pointed that out to him.

Your psychiatrist is lazy. The big difference being the two is one is a mental illness (personality disorder) and the other is a developmental disorder. My husband could have gotten booted off of long term disability insurance after 6 months, because allegedly SPD can be controlled with medication (I don't know about cured). With Autism, it started at birth, and can not be cured. Developmental disabilities are covered under the ADA, and the company could not fire him.

They did some other weasely tactics, but he still gets a check.

The only thing that separated him from a HFA diagnosis is lack of speech delay. That's debatable because his mom is also on the spectrum, and isn't very observant.

My husband was diagnosed 4 years ago, by the best ASD specialist in our state.

Absolutely incorrect, it's not a "childhood diagnosis." But some psychiatrists do take that position.



Psychiatrists prefer to use a diagnosis they can prescribe drugs for. It's that simple.

I think the DSM is highly influenced by the pharmaceutical industry, and for many of the disorders listed (if not all of them?), the diagnostic criteria is vague and outdated and needs serious revision.

I think they made a mistake in taking Asperger's Syndrome out, because at least one study has shown that people with AS have brain differences that are distinct to others with autism.

Schizoid and schizotypal are considered to be part of the schizophrenia spectrum. They are seen most often in people who have schizophrenic relatives, and/or in people who have prodromal schizophrenia. Some people who are diagnosed as schizoid (accurate or not) are later diagnosed as schizophrenic (again, accurate or not).

If I were in your shoes, I would seek definitely treatment and/or a second opinion elsewhere.

There are links between AS and schizophrenia, and yes some people with AS are diagnosed with comorbid schizoid personality disorder. But having AS is NOT going to automatically lead to becoming schizoid as an adult. Schizoid is NOT the "adult version" of Asperger's.

There's a school of thought that it is typical for people with autism or ADHD to end up with a comorbid personality disorder (which is part of why some psychiatrists may consider those to be "childhood" diagnoses and may consider a PD to simply be the adult version of it). But I really question that.

Karla Fisher said recently that it is common for people with autism/AS to have PTSD, and the symptoms of PTSD can be mistaken for a personality disorder.

Please check out her Facebook page, you may find some useful information there:
https://www.facebook.com/pages/Karlas-A ... 9821204141

And this is just my personal opinion, or you might call it a hunch, but I think the current understanding of personality disorders is somewhat archaic. I think psychology and neuroscience have a long way to go before those disorders will be thoroughly understood.

Personally I don't put a lot of stock in a PD diagnosis, unless a person really feels that it fits them, because I think it is too easy to misdiagnose someone as having one, who does not. Or vice versa it may be just as easy to misdiagnose someone as not having one.

Psychiatry is big on saying a person is in denial if they disagree with a diagnosis. But I think some people just KNOW they have a personality disorder. I have seen many examples of people giving testimony to that. They figure it out for themselves and embrace it because they know it describes them to a tee. If you don't have that feeling, you should trust your instincts.

As everybody else stated it is not a child diagnosis, I was recently diagnosed and I will be 38 in less than a month. You should talk to a psychiatrist who specializes in this about your concerns and get re-screened.

Although it is known that schizophrenia and autism are closely related. Often parents who are schizophrenic have children who are autistic, I myself am prime example of this. My mother had schizophrenia, she has now passed away.

I am only giving my personal opinion and am not formally qualified to speak about mental issues.

If I had to rename the Autism Spectrum, I would call it a spectrum of dissociation.

In milder cases, we dissociate a physical need from our theory of self, so neglect ourselves.

We dissociate some outward show of emotion from it's intended meaning, so can be socially inept.

We dissociate social context from our way of speaking, so come across as crass, when we may mean to be direct or sincere.

I have spent some time with some schizoid people. Yes, really. My neighbor ran into traffic, when his wife emotionally abused him and left. I brought him potable water, when he could no longer afford it, and got his dog brushed. I befriended one adopted girl, who was abused, in many ways. And, more.

I would associate the sensations they described to me, with religious or mystical experiences -- like psychedelic drug trips, lucid dreaming, or things a trance channeler would say.

In spiritism, there are rules of conduct, but the schizoids in my life didn't consider emotional energies and disincarnate intellegences to have any religious connotations, whatsoever.

I thought it was dissociative in terms of being extra sensory and having no cultural or moral meaning for them.

that just made me have a thought- I wonder if some of us of the aspie brotherhood and sisterhood, have some dissocial personality disorder in us?

I believe so, but I am still able to differentiate between this reality and a daydream.