Autism and psychosis

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I am really confused. My psychiatrist suggested I needed to go for an autism assessment and that my schizophrenia/schizoaffective diagnosis needs to be reviewed. But all the information I have been looking at, I can see no link between autism and psychosis. Autism does not cause psychosis, so why does the psychiatrist think I do not have schizophrenia?

I had my first psychosis in 2010. I continued taking meds until 2020 with zero psychosis. They tried to put me on antidepressants once they took me off the antipsychotic, and thats what pushed me into having another psychosis. He feels having two psychotic episodes (10 years apart) does not mean I have schizophrenia. It's not what the other docs said but I want to trust this consultant. He's the only one in 38 years of my life who rightfully thought I needed an autism assessment.

It's possible for autistics to develop psychosis. I had a mental breakdown & developed psychotic depression when I was 20 when my first relationship fell apart. My home life kinda s#cked as well. My mom was majorly on my back about me not having a job even thou I was putting in apps for most any job I thought I might could actually do & get to but I was not getting calls about interviews. My ex told me she cheated on me with her ex because he offered her drugs & I started believing things were going on with her that very likely were not. I was paranoid at times, & had some delusions of grandeur at times. The worst moment was when I had a huge fight with my mom & then watched my body slash my upper left arm 9x & went to the ER & got superglue stuff put on. I had been very depressed & unstable for a while before that so I was told they thought I had bipolar depression. When I had my first appointment with a psychiatrist she diagnosed me with Aspergers, Borderline Personality Disorder, & depression. She referred me for autism testing & after I was tested I got told that I had Asperger's Personality due to having Schizoid Personality Disorder & I communicated too well verbally to have anything on the autism spectrum. I also got told that I had Borderline Personality Disorder, depression, & fit all the main features of Schizotypal Personality but did not have Schizotypal.

I've done lots of research & self-analyzing since then as well as trying to work on myself in various ways. I believe I'm autistic & my mom has thought I was autistic since I was a toddler. I think my psychosis, Schizotypal, & BPD symptoms were due to having bad anxiety & lots of panic attacks related in part to autism issues like meltdowns. I think my Schizoid Personality was due to my autism & the depression. The GP type docs I've had since as well as the other psychiatrist I saw for a bit 10 years later say I'm autistic. However the the person who tested me for autism as well as the counselor I briefly saw did not believe I was on the spectrum because I communicated too well verbally & had a high-school diploma even thou I majorly struggled in school & had various accommodations & some of my grades curved to pass due to dyslexia.

My point is that that it is possible for autism related issues & problems to contribute to a few autistics developing psychosis & it is also quite possible for the so-called experts to be wrong about things sometimes. If you think you could be on the spectrum then it might be worth pursuing an assessment. What's really important thou is that you take a proactive role with your health & try to know yourself & what helps & does not help you.

Psychosis occurs more frequently in those who are autistic than in those who are not.

He thinks you may have been misdiagnosed.

There is this idea that if you teach someone how to use a hammer, everything looks like a nail!
That person uses the hammer even when it isn't the best tool for the job.

You may have been diagnosed with something that can be cured with pills.
But, evidence may now show that it was a mistake.

Hi Nick, thank you for your response. Yes I ended up requesting an assessment and I found out a few days ago that I am autistic, and possibly ADHD. Now need to make an appointment with the psychiatrist to let him know of the outcome so he can review my mental health diagnosis.

I kinda expected the outcome but also didn't, so I am a bit surprised and shocked but happy at the same time.

Yes, it was probably a misdiagnosis, but I'm a bit annoyed it was not picked up sooner. I am 38. Been with the mental health services for 13 years, but because of the amount of times I have seen new consultants because they keep leaving, I found out late.

Autism is closely related to schizophrenia on a genetic level and even shares some of the symptoms as per its diagnostic criteria.

It's not unusual to be misdiagnosed with one or the other.

Psychosis is typically a symptom of schizophrenia, rather than autism. But autistic folk can have psychosis too, co-morbid with their autism.

Is that why they ask the questions they do? About hallucinations and hearing voices?

Those can potentially be very danderious so perhaps the psychs are being cautious & trying to make sure their paitents are not a major threat. There are some cases of people who have auditory processing disorder that assume they're hearing voices when their brains are misprocessing some sounds. Some autistics do have auditory processing disorder perhaps that contributes to some autistics & their psychs getting confused.

If somebody (a psychiatrist) is asking you about whether you have hallucinations or if you hear voices, then they are trying to determine whether you have psychosis, regardless of the cause of the psychosis.

I was diagnosed with depression, anxiety and psychosis in the spring of 1998. It wasn't fun. I'm going through a med change right now to help the depression. I thought the front yard was turning into a forest. I thought that I would turn into a quaker if I ate Quaker Corn Bran. I thought my parents house was going to explode and I was going to wake up in India. I also thought that if I used Colgate I was going to Hell and if I used Crest, I was going to Heaven.

It's good to have confirmation that autism and some psychosis symptoms can co-exist here without any other diagnosis.

I did read this in a book a few weeks ago; I've been doing research on AS like it's my job to help me with my marriage to someone with AS. It's good to see this seconded here, especially from folks who have dealt with it.

If you've followed my other thread, you know that my wife is dealing with a phantom pregnancy. I wouldn't say it's really psychosis, but probably close enough for comfort, especially since her father is a conspiracy theorist and she subscribes to some silly ideas that resemble psychosis. (I actually think it's just the way her brain works since she's gullible and grew up having to hear weird ideas).

It's a work in progress getting her away from some of these ideas, but I think it's completely beatable for her if she just is open to looking at more possibilities as to what the issues could be.

Regarding voices...she has chatter in her head but knows it's just her hyperactive imagination making up stories. A lot of them are about her family and their judgment. I think some of this stems from trauma since they are downright nasty to her. Only people who have caused her trouble seem to show up in these thoughts. Getting away from them, as she has been doing, will probably be the antidote.

On the flip side, she's never bored and does plan on taking a creative writing class to harness some of this.

BTW: should add the book I read was one by Tony Attwood. There's a neat section in there about how autism can be misdiagnosed as schizophrenia because of some overlapping symptoms. My wife has delusions sometimes that I 100% believe are from her AS, but doesn't hallucinate. She does have nightmares a lot, but not a hallucination.

Having 2 psychotic episodes doesn't mean you are Schizophrenic. You could have Brief Psychotic Disorder, Schizophreniform disorder, or some other mental disorder than can produce psychotic symptoms-depression and bipolar disorder can do this. With Schizophrenia you are in a psychotic state for long periods of time, often more or less for the rest of your life.

Can't PTSD do this too? I've heard of someone having a psychotic episode or two or three after that, then once they heal from it they're OK.

Autism doesn't however it does travel with things that can look like it. Especially if there's significant trauma that can look suspiciously like paranoia and if you've got weird wiring that can lead to what appears to be hallucinations. My weak visual processing leads to issues with Alice in Wonderland Syndrome, especially when I'm exhausted or stressed. And my auditory processing is so ridiculously overpowered that I wind up with a bunch of complicated tinnitus that appears like hallucinations, but really is just my brain stimming internally.

If it's just two episodes that shouldn't be schizophrenia, but it could potentially be one of the other psychotic disorders, although it could also be the result of significant stress causing the autistic traits to come out oddly.

I wish they'd just admit that the reason why there's so much confusion between the schizophrenia and autistic spectra is because they're part of a broader spectrum. AS and Schizoid Personality Disorder in particular are incredibly hard to separate at this point, and I personally question whether ScPD even exists rather than just being AS with a significant degree of alexithymia for relationships with others. And, I'm not the only one, there's been a long history of the terms being used somewhat interchangeably, most based on the presumption that one is a developmental condition and the other isn't. But, I'm not aware of any real evidence to support that. And at this point ScPD is probably not going to exist in the future, which makes it even more problematic as that means that some autistic folks are going to be pushed further into SPD territory without good reason for doing that.