Neurodiversity and my diagnoses

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A lot of my diagnoses stem from the brain:
- Asperger's syndrome
- Schizophrenia
- Dyspraxia

But I also have sight problems (which have got worse as I got older) and hearing problems (which were much worse when I was younger). I also have sensory problems too.

My point is: do all these problems come from one source? Is it all to do with my neurodiversity? I was born prematurely and my dad said that from the day I was born, I behaved differently to other babies/children. Or do all these problems arise because of different problems?

Did one of your diagnoses sort of revoke the other? I know schizophrenia spectrum disorders and autism spectrum disorders--when followed according to the diagnostic manuals--are almost mutually exclusive (unless the person has an ASD and very severe schizophrenia, which is the only time the two are supposed to be diagnosed simultaneously).

I was diagnosed with paranoid schizophrenia in a secure unit after I was sectioned by the police - so it was severe at the time. I am more stable nowadays and have insight I experience hallucinations every day and when I am ill I also get delusional, as well as problems with motivation and self-care (which are mild to moderate normally but can get very bad when I am ill - to the point that I don't shower or brush my teeth for weeks and spend the whole of my days wondering aimlessly around the streets). Hallucinations and delusions are not part of AS, so I attain both diagnoses. It is rare to have both, apparently. The two diagnoses are not mutually exclusive though, as AS and schizophrenia can occur together when the AS symptoms were clearly present during the person's whole life and the schizophrenia is very obvious in terms of typical psychotic symptoms.

Not in extreme cases, but generally they are. At least, this is what the dsm-iv tells us. Often times, some schizophrenia spectrum disorders can appear to be an ASD at first, until other schizophrenia signs and symptoms are noticed. I think AS and schizotypal, for instance, are often confused and can be misdiagnosed.

Well, technically all those dxs come from various parts of the brain being wired in a different way, so I would probably say that it's more likely due to neurodiversity. There have been links shown between all three of those dxs, although because I'm more familiar with schizophrenia spectrum and autism spectrum issues, I'll just show an articles about the relationship between schizophrenia and autism:

http://www.psychiatrictimes.com/schizop ... 68/1822823 - particularly interesting because they talk about a case of a patient who was dxed with both schizophrenia and ASD.

There is a caveat in the current DSM which allows for ASD and schizophrenia spectrum disorders to co-exist. To paraphrase, the person generally has to display floridly positive symptoms, like delusions and hallucinations.

I'm another one who has ASD and, in my case, schizoaffective. I get mainly delusions - ideas of reference, thought broadcasting, monitoring, etc. During my last episode, I thought my pdoc was trying to kill me through medication and also was inducing my symptoms, heh. Plus I get auditory hallucinations. Those two symptoms are obviously not part of ASD symptomology. I also get bipolar mood swings and initially I was given the dx of bipolar with psychotic features.

Thanks for the link, I will read it.

I've had mostly persecutory delusions, such as people called "Spies"; when I was ill I believed that they were looking for me in order to steal information stored in my head by the military; these Spies would then kill me in a really horrid way in order to dispose of the evidence. I was sectioned because I walked into a police station trying to report the Spies and then completely lost because the voices said the police officers were Spies and I tried to smash my way out of the police station, so to speak (they wouldn't let me leave because they were concerned about me). My hallucinations are mostly voices that make rude comments about other people and command me to do unwise things, and I now see the Spies in 3D form. But I know these things are not real.

To get to the point......my Asperger's is presented more as socialising problems, obsessional interests, communication problems, inability to read facial expressions, hypersensitive senses etc...... My schizophrenia presents as mainly positive symptoms (hence why I was diagnosed with the 'paranoid' subtype) and some negative symptoms that come and go.

I also have an IQ of 160 (as recorded by an educational psychologist).

My Asperger's also presents similarly, and I've been lucky enough to avoid negative symptoms. I just get positive ones that respond well to medication. Getting the Aspie dx was a struggle because of the overlap of some symptoms between sza and ASD but I am glad I persisted.

I used to think I was talking to God, until "God" started telling me to kill myself. Oh, fun times.

I'm glad that your symptoms are well controlled. I'm on two antipsychotics (olanzapine 20mg, aripiprazole 10mg) which are just about keeping me out of hospital. Although I had three dramatic relapses between Nov 2010 and Jun 2011, all three of which I was sectioned during. I have tried 7 different antipsychotics (including clozapine) which haven't helped 100%, but olanzapine and aripiprazole together appear to be helping, probably due to the fact that olanzapine antagonises serotonin more than dopaimine-2, and aripiprazole is a dopamine partial agonist......

I'm not surprised getting the AS diagnosis was difficult. I'm glad you persisted too.

When you thought you were talking to "God", did you talk out loud? Because strangely enough I rarely talk out loud to the voices I hear, because normally I communicate "telepathically" with them, i.e. by thinking my replies.

That's interesting about your current AP combo. I've tried 5 and the best one for me was ziprasidone, but I got random sedation on it which was quite interfering with my life and I had to come off. I have three AAPs left. I wonder if my pdoc would be open to me combining two AAPs. Personally I've tried Abilify but it didn't touch my symptoms at all, but I don't know how it might work if augmented with another AP.

Currently I just take a mood stabiliser, but I know there's going to be a day when I'm going to have to go back onto some sort of antipsychotic...

I didn't talk to my voices out loud as well - I also spoke to them telepathically. I felt like I had a close bond to God and that he understood me. When I spoke to him, it felt like I had a light within me. It was rather interesting. I also had voices that would comment on my actions, like what I was doing, where I was going, etc.

Yeah - the combination of APs I'm taking is unusual, but my psych and I agree that its a good one. Ziprasidone is efficacious but unfortunately it does cause sedation. If you can't find a monotherapy that works, then perhaps a combination is a good idea. Your location says you live in AU, what does that stand for? I live in London, UK so I get free healthcare and (due to being on income support) free meds, so my psych is happy to put me on anything really, cost doesn't seem to matter. Although aripiprazole is an expensive drug, but then....so are a lot of atypical APs.

What mood stabiliser are you on right now?

That bond sounds interesting indeed, but was it scary at the time? Voices are really irritating to say the least. The only "good" symptom I've had from my illness is a small Guardian Angel, but she hasn't been around for several months.

AU = Australia When I first filled out my profile, I didn't feel like writing out the entire country's name, and I've stuck with the abbreviation ever since.

Australia has a similar healthcare system to the UK, although I've opted to go private because fortunately, I can afford it. However, the government does rebate my doctor's fees, and my therapist has opted to bulkbill me so I don't pay anything to see my therapist up-front. The combination of the rebate and my therapist's willingness to bulkbill me has meant that going private has been affordable.

The medication that my doctor gives me are rebated on the medical system [Pharmaceutical Benefits Scheme], so I find that the maximum amount that I generally pay for medication is around $35/packet. There are some restrictions to the PBS - with some medication, I need to have <x> disorder so that I qualify. Fortunately I qualify for the PBS with all my medication so far, otherwise I would be paying quite a bit to take them off-label.

I'm currently taking sodium valproate as a mood stabiliser. Personally, I would rather try Lamictal because I have more issues with depression than mania, and Lamictal is generally better at raising someone's baseline mood. I've found valproate to be good at squashing manias but it does nothing for my depressions and I've had several bouts of depression since I started the drug back in 2009. I suggested this a few times to my pdoc but I think he is more interested in finding an antipsychotic that would work for me.

Sedation tends to be a problem with me for most of the AAPs that I've tried. I've tried Abilify [akathesia initially, then it failed to work plus I found it sedating], Invega [sedation, Parkinsonian symptoms, anxiety issues, turned me into the cognitive equivalent of a turnip], Ziprasidone [random sedation], Solian [sedation, rear-ended someone driving on the road], Seroquel [made me sleep 17 hours ]. So, I've got Zyprexa, Clozapine and Risperidone to go.

I didn't find the voices scary. To be honest, I spent many years thinking that what I was experiencing was normal and was within the realms of "internal monologue", which occurs with everyone with or without a condition. I seriously believed that everyone else had the same experiences. It wasn't until I was talking to some people on another mental health website where I was made aware that my experiences were atypical, because I was describing voices that I didn't recognise as my own. Talking to my therapist confirmed that view and "auditory hallucinations" was added to my list of symptoms. I was quite surprised when I learnt that.

I don't think I have had any "good" psychotic symptoms either. They've been largely very negative.

I did have some decent experiences while hypomanic. The last time I was really hypomanic, I was very productive, and I had a lot of projects and events happening. It was a whirlwind time and it really felt like I was on some sort of drug. On the downside, I developed a bit of a drinking problem and then when the inevitable crash happened, I was left feeling like utter s**t for a while, heh.

I think the general rule for schizophrenia plus autism is that they must clearly have met criteria for autism prior to the diagnosis of schizophrenia. Often you see this come into effect with an already-diagnosed autistic young adult who suddenly regresses and starts hallucinating and having delusions. (Incidentally, roughly a third of childhood-onset schizophrenics are on the spectrum, though there's some debate about whether they're actually autistic or just resemble autistics.) To complicate things, if someone was clearly NT during childhood and then developed apparent autism in adulthood they may be diagnosed as schizophrenic even if they don't have clear hallucinations or delusions - catatonic schizophrenia commonly works that way as many of them don't communicate their experiences very well.

Regarding the OP's question, prematurity can cause a bunch of those issues, though I've never heard of prematurity being related to schizophrenia. Sight problems in preemies typically take the form of retinopathy of prematurity, which is damage to the retina caused by rapid shifts in blood oxygen levels related to being given extra oxygen to help immature lungs that don't absorb oxygen well. Or they could have a visual processing disorder, such as cortical blindness. Hearing problems in preemies are usually neurologically based, usually some form of central auditory processing disorder. Autism is more common in preemies, as are motor impairments such as dyspraxia or cerebral palsy. And sensory processing issues.

Thanks Ettina. That was helpful.

I was diagnosed with ADHD/hyperkinetic disorder and Tourette's when I was four years old, although ever since I was born everyone knew there was something going on with me. But I no longer fall under the criteria for ADHD or Tourette's.

Looking back on my life, and taking from what my parents said, I doubt I ever had childhood schizophrenia. I didn't fall in the criteria. But AS, yes I did.

I heard my first voices when I was 14, but I believe I started experiencing paranoia at the age of 12.

Just barely missed the cut-off, then. Childhood schizophrenia is defined as onset before age 12.

Yeah, that's true. But I've heard of a child aged 9 (I saw the documentary on YouTube) being diagnosed with paranoid schizophrenia; why wasn't she diagnosed with childhood schizophrenia?