Can Asperger's be misdiagnosed as OCD?

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SDS185
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20 Jul 2017, 10:16 pm

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.



ASPartOfMe
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21 Jul 2017, 3:42 am

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


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22 Jul 2017, 11:38 am

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.


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22 Jul 2017, 11:42 am

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



Tawaki
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22 Jul 2017, 11:48 am

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.



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22 Jul 2017, 12:02 pm

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.


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22 Jul 2017, 1:27 pm

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.


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22 Jul 2017, 4:06 pm

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.



SDS185
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22 Jul 2017, 8:18 pm

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



I have learned that as someone with Asperger's tries to fit into society, over time they learn to compensate for most of the obvious symptoms of ASD.



SDS185
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22 Jul 2017, 8:34 pm

StampySquiddyFan wrote:
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.


Thank you.

My OCD is nothing like it used to be: I don't have as many checking rituals and when I don't perform a compulsion, I don't dwell on it as much as I used to and just go on with my day.

My intrusive thoughts are on and off but I now know 100% that all guilt, shame, fear, catastrophizing, fixations are not me: Now that I know myself much better, when I have violent and/or perverse thoughts I just brush them off.

Up till about a few months ago, if I did not rigidly stick to my routine, I would have been a LITTLE upset but the times in which I "had" to stick to my routines, I DID think that something "bad" would happen if I did not stick to the routines.

Thing is that I have taken three online tests scoring in the highest ranges for ASD and went over the DSM-5 for Aspegerger's with my therapist of over one decade and she already knew that I have OCD and Tourette's.

The wide range of HFA symptoms I have just do not overlap with OCD alone.

I even have a TON of the more anecdotal symptoms such as horrible handwriting, terrible coordination, accident prone, horrible team player, wet the bed until age twelve, I have Crohn's Colitis, food allergies, bad and rare reactions to most prescription drugs, very large head, flat facial and vocal affect, almost robotic walk, horrible at multi-tasking, don't know when to start or stop talking in most normal conversations, only two friends in my fifty-five years, love women but relationships are not worth the grief, super-sensitive hearing, hate the feeling of tight clothes, wool and other fabrics with a "weird feel," sleep disturbances, I hate confrontation, I had to "study" how people interact with each other and learned from TV and movies how people relate to each other, I like rules IF they make sense, strong sense of justice, love routine (but no longer a slave to it), prefer not to travel very far, take nearly everything literally, always had problems with empathy: I have a big heart and am very sensitive but could never "feel" other's pain-I've listed SOME of the clinically studied and anecdotal symptoms I have.



I'll put it like this: I have known that I have OCD for about five years and in that time, I learned little that gave me perspectives and reasons for my social, physical, self-esteem and depression problems.

When I took the Baron Cohen test online about five months ago and have learned a TON about HFA, I have been able to (with full cause and effect) explain why I had the list of problems I wrote above.

OCD alone can not begin to explain this.



SDS185
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22 Jul 2017, 8:41 pm

Keladry wrote:
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.



I told my new therapist about how the neuro psychologist basically just handed me a copy of my test results, said that I have OCD and not ASD and he did not give me any further areas of research to pursue in addition, the neuro psych doc could NOT explain the dozens of clinically proven and anecdotal symptoms of ASD that I have.

The neuro psychologist told me that I could get another test but I know myself too well and OCD could not begin to explain my social, physical, emotional and perceptual deficits.

Its also possible (as another poster on this thread wrote) that they have not really pursued accurate ways to diagnose older adults with HFA (I'm fifty-five).


My new therapist has a child with ASD and she has year of experience with HFA and EMDR therapy.



SDS185
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22 Jul 2017, 8:47 pm

Tawaki wrote:
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.


It seems like "professional laziness" and this doctor does not have very kind Google reviews.

I just realized something and thanks for making me aware of it: My OCD obsessions and rituals have been really annoying and at times have provoked panic attacks but my compulsions almost NEVER caused me to be late for appointments or work, they were powerful but did not control my entire life.

I had the door, light switch, faucet and stove burner checking rituals but most of them are gone.

I DO fixate and ruminate about things still, but much less now.

Here's an abbreviated list of some of my HFA symptoms. OCD alone could not begin to account for them:
I even have a TON of the more anecdotal symptoms such as horrible handwriting, terrible coordination, accident prone, horrible team player, wet the bed until age twelve, I have Crohn's Colitis, food allergies, bad and rare reactions to most prescription drugs, very large head, flat facial and vocal affect, almost robotic walk, horrible at multi-tasking, don't know when to start or stop talking in most normal conversations, only two friends in my fifty-five years, love women but relationships are not worth the grief, super-sensitive hearing, hate the feeling of tight clothes, wool and other fabrics with a "weird feel," sleep disturbances, I hate confrontation, I had to "study" how people interact with each other and learned from TV and movies how people relate to each other, I like rules IF they make sense, strong sense of justice, love routine (but no longer a slave to it), prefer not to travel very far, take nearly everything literally, always had problems with empathy: I have a big heart and am very sensitive but could never "feel" other's pain-I've listed SOME of the clinically studied and anecdotal symptoms I have.



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22 Jul 2017, 9:05 pm

SDS185 wrote:
StampySquiddyFan wrote:
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.


Thank you.

My OCD is nothing like it used to be: I don't have as many checking rituals and when I don't perform a compulsion, I don't dwell on it as much as I used to and just go on with my day.

My intrusive thoughts are on and off but I now know 100% that all guilt, shame, fear, catastrophizing, fixations are not me: Now that I know myself much better, when I have violent and/or perverse thoughts I just brush them off.

Up till about a few months ago, if I did not rigidly stick to my routine, I would have been a LITTLE upset but the times in which I "had" to stick to my routines, I DID think that something "bad" would happen if I did not stick to the routines.

Thing is that I have taken three online tests scoring in the highest ranges for ASD and went over the DSM-5 for Aspegerger's with my therapist of over one decade and she already knew that I have OCD and Tourette's.

The wide range of HFA symptoms I have just do not overlap with OCD alone.

I even have a TON of the more anecdotal symptoms such as horrible handwriting, terrible coordination, accident prone, horrible team player, wet the bed until age twelve, I have Crohn's Colitis, food allergies, bad and rare reactions to most prescription drugs, very large head, flat facial and vocal affect, almost robotic walk, horrible at multi-tasking, don't know when to start or stop talking in most normal conversations, only two friends in my fifty-five years, love women but relationships are not worth the grief, super-sensitive hearing, hate the feeling of tight clothes, wool and other fabrics with a "weird feel," sleep disturbances, I hate confrontation, I had to "study" how people interact with each other and learned from TV and movies how people relate to each other, I like rules IF they make sense, strong sense of justice, love routine (but no longer a slave to it), prefer not to travel very far, take nearly everything literally, always had problems with empathy: I have a big heart and am very sensitive but could never "feel" other's pain-I've listed SOME of the clinically studied and anecdotal symptoms I have.



I'll put it like this: I have known that I have OCD for about five years and in that time, I learned little that gave me perspectives and reasons for my social, physical, self-esteem and depression problems.

When I took the Baron Cohen test online about five months ago and have learned a TON about HFA, I have been able to (with full cause and effect) explain why I had the list of problems I wrote above.

OCD alone can not begin to explain this.


No problem :D .

I'm glad your OCD has gotten better as well; it can really suck at times.

In neurology, there is often a cluster of four disorders that overlap- OCD, ASD, ADHD, and Tourette's syndrome. I have both ASD and OCD according to my psychologist, but I also have symptoms of ADHD and Tourette's syndrome (part of the ASD). In some cases, the ASD actually causes the other disorders. Since you have two of these disorders, it would be quite likely that you would have a third :D .

Your reasons for believing you have ASD are pretty strong. I would say that you definitely have more than just OCD. I agree that OCD alone doesn't cause the types of symptoms you describe.

I hope you can figure this out :D.


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SDS185
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22 Jul 2017, 9:24 pm

League_Girl wrote:
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.



My rituals used to consist of: Checking the stove burner to make sure its off, running my hand over the faucet after it was turned off, checking the door to make sure its locked and for a short time I would look under a mail box after I deposited a letter to see if it fell through in addition to opening and closing the box several times after putting the letter in but I have almost NONE of that now.

I check the door a little, the stove and the faucet but if I do not check my anxiety is minimal.

I am not a slave to routine and when I have been forced to break up my routine, I do the tasks I could not do at the start of the day throughout the day-In other words, I have understood how illogical all of this is.

Another thing is that my compulsions and rituals have almost never caused me to be late for a job, social appt or anything else-My compulsions did not control my life and my obsessions, although really sick and ugly at times have been managed very well because I have gotten to know myself much, much better and when you clearly recognize perverse, violent, shameful, guilt-ridden, what if and catastrophizing thoughts as not even remotely like you, it makes the anxiety they create greatly diminish.

When I self-diagnosed (with three online tests) for ASD about five months ago, the facts I have learned about HFA have GREATLY improved my view of myself, my world, I literally understand people and life much better because I have a solid frame of reference: Knowing that I had OCD for the last five years changed nothing but reading about ASD and hearing hundreds of videos on it and recognizing myself with a couple of DOZEN clinically studied and anecdotal symptoms has convinced me that I have ASD, with OCD, Tourette's and depression.