Saturday, November 20, 2010

OK, take a step back... how about what the actual diagnosis is?

I started writing a post based on my reading Tony Attwood's "The Complete Guide To Asperger's Syndrome", and I realized that maybe it would be worthwhile to jump back to chapter 2 before I start writing about where I'm at with chapter 3 (the friends/social interaction thing). Chapter 2 is all about the diagnosis and the criteria used to determine if one has Asperger's Syndrome or not. I know there were a good number of things that were rather fuzzy at first, but one I understood what these things were getting at, it became more clear that this has been more pervasive in my life than I had realized.

OK, so first off... the official criteria (bolded text), and where I think I fit the description (bullet points). The following is from Diagnostic and Statistical Manual of Mental Disorders (aka DSM IV):

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:

(A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction

  • I was completely unaware of these nonverbal behaviors up until around the age of 25. I've always felt awkward about how my posture is, and have been told what is often comfortable for me is sending the wrong signal or might be inappropriate for the situation.
  • I have had numerous occasions where I've been told "hey, that girl was checking you out" and have had no clue what these people were talking about. I've heard that there were women who were interested in me, but I was completely unaware of their feelings.
  • It often felt like I wasn't even there when DJ'ing. I could look out at everyone at the bar, and it often felt like no one was ever looking at me. I can read some very basic things about whether or not people are into the music or not.
  • In general, eye contact is something that is rather uncomfortable for me. it's much easier to look at someone's mouth, and it helps to do so when i might have problems hearing them.

(B) failure to develop peer relationships appropriate to developmental level

  • I've really never have been able to develop lasting friendships. I spent a large amount of time in my childhood alone, especially in school situations (ie lunchroom). Friendships were mostly very platonic and were very scattered, often completely leaving groups of friends at the drop of a hat. Most friendships over adult life have been centered around very specific shared interests (12-step program, music, politics). I often find myself having lots of friends, but not having a whole lot of interaction with them - notably not being asked to join in on very many group activities.
  • Dating has been something I've always felt like my abilities and knowledge are severely behind others in my age range, notably that I'm just now starting to learn how to date in my mid 30's.
  • Having friends in my peer group has been extremely rare. Often friends are much older or much younger.

(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)

  • I rarely have ever been one to share a whole lot about myself and what's going on with me, though this has gotten a bit better with "status updates" on things like MySpace, Facebook, etc. Most sharing of these things is done with whoever I'm dating at the time, if I happen to be dating someone, and even then it might be insufficient.
  • I had a lot of difficulty with sharing and taking turns, often causing my friends (and their parents) to be frustrated.
  • I don't like to DJ with other people, and avoid it if at all possible. I don't share well in that area.
  • I was told that as a child I never shared much with my mother when asked about my day, often just giving yes/no or extremely brief answers to her questions.

(D) lack of social or emotional reciprocity

  • I often feel like I'm just an observer in many social situations, like I either don't have much to give back to a conversation or don't know how to keep a conversation going.
  • I often don't (or am unable to) give very lengthy answers, keeping my answers and statements pretty short, and to the point.
  • I was told by [an ex] that I didn't love her, because how she saw me act wasn't the way that someone who was in love with someone would act. Had problems with this with [another ex], where she couldn't take me not speaking to her for several days to a week at a time (was so depressed and aimless at the time I didn't know what to say).

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

  • Whatever hobbies or interests I take up often end up consuming me as I try to learn everything about what it is that has my attention.
  • I find myself bored easily because I don't do much. I don't have a wide range of activities or places to go. I've often spent much of my time sitting in my room alone because I don't have anyone to do things with or a whole lot of money to do what I want.

(B) apparently inflexible adherence to specific, nonfunctional routines or rituals

  • Finding myself caught like a deer in headlights when presented with an overwhelming problem, and not taking the needed action to address it. Bills/fines often go unpaid, several credit cards have ended up in default, my student loan almost defaulted because I couldn't do anything about them and didn't have the mental capacity to properly deal with them, or know how to ask for help.
  • Refused to stop tight rolling my pants well beyond what was considered fashionable, often causing unwelcome attention. It just felt a lot more comfortable to wear them like that.
  • Morning routines in the past, as far as being strict about showering, grooming, having breakfast etc. it was a running joke how I would never go on a yearly camping trip with a group of friends because of the showering/grooming issue (mostly the lack thereof with no running water or electricity).

(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)

  • I often find myself rubbing the tops of my hands and wrists, sometimes blowing on them. walking around tends to be a nervous habit, especially when i'm on the phone with someone.

(D) persistent preoccupation with parts of objects

  • none that I'm aware of

(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.
  • My best bet for work right now is DJ'ing, but because I've never been able to establish a good sized network of close friends, I'm often not chosen to DJ because I don't have a following - despite being technically sound (or even superior) and or even being able to provide arguably better music.
  • Lack of networking has kept me out of the loop on job opportunities.
  • If there is some truth to related sleep disturbances, then these have caused me to lose a large number of jobs and have difficulties in almost every job I've had. 
  • I have a hard time keeping track of things and organizing my priorities to the point that things often don't get done, either not getting to them in time or completely forgetting about them.

(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)
  • This was confirmed to be the case, that i was bright enough to be ahead of my age group, but socially behind the curve - and people just assumed that because of how smart I was, I would eventually catch up.

(V) There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

  • None that I or my parents are aware of.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.

  • "We" don't think so. ;-)

So that's a big part of "it", what I wrote down how I saw how I fit into those areas (my mother did the same for how she thought I fit, but I don't have a copy to write down everything she wrote). There are a couple other unofficial things of interest in Chapter 2, mainly in regard to adult diagnosis:

Difficulties in understanding social situations and other people's thoughts and feelings.

  • Yeah, definitely. I've run through some serious fields landmines because I wasn't quite in tune with what was going on and that I was getting screwed over by a slew of people. I often couldn't tell when someone was lying to me, or if someone's motives weren't very altruistic.

Tendency to think of issues as being black and white (e.g. in politics or morality), rather than considering multiple perspectives in a flexible way.

  • Gee, ya think? Anyone who's talked politics with me or has seen some of the diatribes on my Facebook page gets this one. Other areas aren't so bad, but this is a tendency.

So there it is, how I fit into this. I need to remind myself of this, and how many areas I fit into this when I have my moments of just wanting to be "normal".

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