Can Asperger's be misdiagnosed as OCD?

Post Reply New Topic

I have taken three online ASD tests and have scored in the highest percentiles.
Went over the symptoms of Asperger's with my therapist of thirteen years using the DSM V and she agreed that I have it.

Yet after taking a comprehensive neuro psych test, the doctor stated that all of my problems are from OCD and mild depression and that I do not not have Asperger's.

Could anyone please explain how the symptoms of obsessive compulsive disorder explain my having nearly all clinically proven and anecdotal symptoms of HFA?


I also have complex trauma, Tourette's and depression.

Because knowlege of how autism presents in older adults or that it even exists in older adults is sorely lacking.

On the surface, autistic symptoms like routines/rituals and obsessive interests can look like OCD. I have both ASD and OCD, and I'll try to explain the difference between them.

ASD: I get upset when something changes in the environment. This is because I like to have control and predictability. I also like having certain things in the same place, and I like ordering the same thing at restaurants every time I go. I need to sit in the same chair at lunch each day, and if that changes, I can get very upset. I am also very enthusiastic about my interests, and I can pursue them for hours on end. I carry a toy Squid (from one of my special interests) everywhere I go.

OCD: I'm terrified of every single mental illness on the planet (I don't consider thing like ASD to be mental illnesses). I spend hours checking lists of symptoms, just to make sure I haven't contracted one. I'm constantly looking for reassurance, and I do certain things over and over to "make sure I'm not going insane". I might tap the wall or turn around a specific number of times. I also might keep on doing something until it "feels right". I can convince myself I have every single mental disorder on the planet, so I try to stay clear of lists of symptoms. OCD is a killer- I have spent years of my life looking for reassurance, and when I get scared, it's all I can think about. Thankfully, it's getting better; I used to have a pretty severe case.

I think on the surface OCD and ASD can seem the same, but I engage in OCD rituals "just in case" and I engage in ASD rituals to ensure comfort and sameness.

It can be misdiagnosed as a lot of things or not diagnosed at all, especially if you're female.

My husband's first batch of diagnoses was

Schizoid Personality Disorder
OCD
Major depression.

I've met people with severe OCD and they were nothing like my husband.

Doctors see the rigidity and rituals and automatically think OCD. It's a snap judgement thing.

My GF tried to explain to a Dr my problems and she said the best way she could describe it was it was like "OCD without the OCD". I still haven't been Dx with anything but Anxiety & Depression but there is definitely something else going on.

I have an ASD and a OCD diagnoses. I have had OCD tenancies before like needing to push my mattress up against my bed because it would drive me crazy if I didn't do it. I always thought the mattress was slipping off my bed. But my other routines I had like needing to dress my Barbies dolls for bed was not the same as I was doing for my bed. Both those feelings were different. The bed thing was a compulsion while the Barbie thing was a comfort thing and no I couldn't move on unless I got my dolls ready for bed. Plus I am also a worrier and I used to just worry about anything that was bothering me and do the what ifs in my head. I worried about anything rational which is what makes my OCD so different because I read they have irrational thoughts like they get a thought of of the blue that totally has nothing to do with a situation while I didn't.

For any yeas I thought OCD routines and obsessions were the same as ASD routines and obsessions because mine was called OCD and I was told it was part of AS so see the confusion here? Either my ASD obsessions and routines were mistaken for OCD or they thought they were both the same so they gave me both diagnoses.

I also see a overlap between anxiety and OCD. Both of them are worriers and obsess about it. I also see an overlap with ASD and OCD about when something upsets them, they have a hard time getting over it and moving on. They both like rules and get upset if someone doesn't follow them. They both may need to finish what they are doing before moving on. They both stim. If an aspie is obsessed with cleaning and they like having a clean house, that can be mistaken for OCD. If they both like collecting information on a topic, the difference between OCD and ASD would be the ASD person is doing it for pleasure because they are fascinated by the topic while the OCD person is only doing it because they feel compelled to know everything and thing something bad will happen if they don't know everything and they don't get pleasure out of researching it. They do not get pleasure from it and any comfort. An ASD person stims for comfort and pleasure and because of anxiety due to sensory issues or because they are focusing. An OCD person stims because they feel compelled to and they don't enjoy it and they don't get comfort from it and they just do it over and over until it feels right and they want to stop but can't while the ASD person wouldn't care they are doing it. They may want to stop doing it but only because they have self awareness of how it affects themselves and others around them and because they know it's disruptive so they want to stop that stim and do more of a appropriate stim. That wouldn't be OCD but it ca be mistaken as such if they said they want to stop but they can't so the doctor might assume they have a compulsion. I once told a doctor how I always shower a certain way because I just do and he wrote down compulsions in the computer and when I talked about me cleaning even though there was no intrusive thoughts or any anxiety and no bad thoughts.

I can't add much to the the OCD vs. ASD discussion, but have you considered getting a third opinion, maybe from a psychologist who specializes in diagnosing ASD? I don't think it would be considered "shopping around" as you have one professional who thinks yes, you have it, and another who thinks no. That in itself can be very confusing. The psychologist would probably approach it from a different perspective and administer different assessments than the neuro psychologist, and the combination of all of the above could give you a very thorough and accurate assessment of your strengths and weaknesses.