Asperger's or Schizotypal?

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I was raised in a small town where people didn't pay attention to psychiatry, writing everyone who wasn't "normal" off as shy, weird, brainy, slow, etc. I was often listed as the first three. However, I've recently come across Asperger's Syndrome and Schizotypal Personality Disorder. At first, nearly everyone I know immediately thought I had AS once they read the symptoms (often recalling how my childhood "shyness" and "weirdness" aligned with it) but now some of them seem to think I have SPD.

I cannot afford a psychiatrist or else I would definitely go to one (as I would very much like to understand if there is anything that could explain why I am the way I am or if I'm just "messed up"), so, I thought I'd come here and see if I can get an opinion. I seem to have many of the symptoms of AS except I don't lack empathy and I'm not a savant (or I don't think I am, I'm almost entirely 'self taught' in most things I know (riding a bike, swimming, etc.) and I do tend to learn at a much faster rate than my peers but I don't have any prodigal abilities-or at least any that I know of). I can keep eye contact, but it is forced and tends to feel very unnatural and uncomfortable to me. I'm quite sarcastic/satirical but I'm also a literal thinker (if others aren't obviously sarcastic or clear, I will presume they are speaking literally), I'm often "in my own little world" (daydreaming, spacing out, etc.) and sometimes I literally have to be isolated from everything and everyone or I'll have a psychological meltdown (apparently that's not normal). Insults don't really bother me (I've just used to them now) but I don't like insulting others and I'm not much for compliments (I feel uncomfortable receiving them and I sometimes feel I have to force myself to give them) even though I truly do think of other people, I just have an extremely difficult time voicing it (this also includes things as "I love you" and occasional apologies). I also honestly, do not care about myself. I mean I want to live, I want to be healthy, and I'd like to eventually have a relationship/family but I don't seem to care if I get sick/hurt (except that it might hurt those I care about). I seem to care more about the well-being of strangers than I do myself (which is also, apparently not normal).

So, it's for those reasons and that I'm "psychotic" (according to a relative) that I'm posting this. I don't completely understand the difference between AS and SPD, as their symptoms seem to overlap, the only noticeable difference I can see is the "psychotic" thing. I am prone to depersonalization and hallucinations, and I've been told I have "magical thinking" but I'm not sure. I've experienced depersonalization for ages and I'm not certain I'd meet the criteria of "psychotic" because I KNOW that I'm hallucinating when it happens and as far as the "magical thinking" I'm a secular (non-religious) atheist and I attempt to find a scientific explanation for everything; I have experienced "ghosts" but I believe that they were hallucinations (perhaps something to do with the magnetic field theory), I've had multiple episodes of "Deja Vu" and "premonitions" but I don't believe there's anything "paranormal" about it and I can often "sense" people coming into a room or hear the tv at a volume others can't but I'm hypersensitive. I am also somewhat paranoid (I often get the feeling that others are talking about/watching me, not like with cameras or anything but when I'm shopping or something) but I mainly think that is more-so a fear/idea that has been ingrained in my mind as a result of abuse I endured as a child/adolescent than anything.

So, I don't really think I fit SPD because I believe my symptoms can be explained scientifically but others aren't agreeing with me and are saying it can't be AS because I'm quite empathetic, have no noticeable/known savant skills and that those with AS don't have any of the rest of the stuff that I do. I'm just quite confused.

What do you think? Does it seem more like AS or SPD?

There is a great overlap between StPD and ASD, but most people with ASD score negative on StPD-tests.
Autistic people tend to get more often psychotic or paranoied in certain situations, but there is usually no "magical thinking" involved. I can also get close to psychotic or fear that's close to paranoia, but those occations are very rare and just under extreme stress.

But the maindifference is the onset.
A person is born with ASD, but StPD starts later in life.
While ASD gets very often "better" over time because you learn to life with it. With StPD it is the other way around.

But in some cases it can get difficult to differentiate, because StPD can also start in childhood.

Last edited by Raziel on 18 Sep 2012, 7:17 pm, edited 1 time in total.

It's not impossible to have traits of both. You could have been born with autistic traits and developed the schizotypal ones as you grew older. You seem to have traits of both.

What is a bit worrying to me is that you're having hallucinations. Now, granted: You know they're hallucinations. But that does mean that there's a glitch in the wiring somewhere, causing you to have sensory experiences that are triggered by your own brain rather than by information coming at you from the outside world; or else the information gets garbled on the way. That's technically psychosis--though not severe psychosis, because you have good insight and seem to be functioning fine. But in your position, I would try to get access to a doctor. If your psychosis did get worse, you might no longer be able to tell when your brain is tricking you; so it really does have to be monitored. At the very least you need to know how to get in touch with a doctor if you have problems.

By the way, I should define "psychosis" for you properly. It just means that you're having hallucination, delusions, or both. It isn't necessarily severe and obvious. It can stay the same all your life--but it can get worse, and if it did, you could lose the ability to seek help, which is why I recommend you keep working on finding a psychiatrist. If you can't ask for help on your own, you're dependent on other people noticing when it has gotten really bad, and you don't want it to get that bad.

Savant syndrome is found in only 10% of the autistic spectrum, and it is my belief that we do not lack empathy at all. What we lack is the ability to understand how someone is feeling by observing their faces and bodies; when we get the information, we tend to care as much as anyone would.

It seems that I've had the symptoms since I was a toddler, but as I stated, I live in a small town so it got written off as just being "shy" and "weird". I don't think they (symptoms) have gotten worse nor do I think they've gotten better, I just think I've learned to "deal with it" in a more "appropriate" manner, so externally I appear to be less "abnormal", internally I'm still the same.



I do worry about that sometimes and I would like to have a psychiatrist (so I WILL continue to look) but I also don't want to be force fed medicine, at least not while I'm still competent. The hallucinations are primarily auditory in nature (I can often times literally hear my thoughts, or I'll hear something that no one else does/isn't there), although I do sometimes experience visual hallucinations as well but I suffered from chronic migraines when I was younger and experienced hallucinations that were quite similar to the ones I have now (except now I don't have pain) and the doctors told me (well my parents) that it was an aura (I believe). So, I don't know if my hallucinations are actually just an aura from a "silent" migraine or if I'm just psychotic (which is all the more reason, I'd like to find a doctor I can afford).

Check this out: McDD (click)
(I'm not saying that you are having it, I was just thinking about it, as a possebility)

According to Wikipedia: "Multiple complex developmental disorder is likely to be caused by a number of different various genetic factors. Each individual with MCDD is unique from one another and displays different symptoms. Various neuropsychological disorders can also be found in family members of people with MCDD." and that's not so in my case. My mother, undoubtedly, is narcissistic but aside from that, I cannot recall anyone within my genetic family that has any psychological disorders (I seem to be the only "abnormal" one). So, while I won't rule this out, I'm still leaning towards my initial inclination of AS.

In any case, this only motivates me more to find a psychiatrist.

I'm pretty sure I have MCDD, when I read about it and read my old reports from when I was a kid. Of course, the diagnosis wasn't around then. But basically, by the time I was 9 (in 1993) I had diagnoses of PDD (mild), ADHD, and conduct disorder. When I was 13 (in 1997), all in the same session with the same psychiatrist, I received diagnoses of Asperger's syndrome (despite a history of speech delays), OCD, and schizotypal PD. In numerous reports from when I was in elementary school, where I was classified as emotionally disturbed and put in special ed, mental health specialists repeatedly mentioned significant mood lability issues for which I was placed on lithium, which was noted to help. I remember frequently having lots of anger and agression. I was also noted to have a flat affect and poor short-term auditory memory. When I attempted to spell unknown words using phonetics rules, I made phonetic errors--meaning I had a tendency to, say, switch phonemes--by, for example, misspelling "build" as "blud," switching the vowel and the consonant 'l'. (I noticed similar issues in learning my second language.) In addition, I was noted in a couple reports (one at 8 and the other at 9) to exhibit evidence of perceptual distortion and cognitive disorganization. They mentioned that without externally imposed structure, my ideations tended to become increasingly detached from reality. They mentioned that I tended to get distracted by both external and internal stimuli, making it difficult for me to keep on task. They mentioned that I had a tendency to go off on tangents in speech, while exhibiting confusion. As for me, I saw nothing wrong with my thinking process at the time, and I kinda experience myself as thinking the same way I did as a kid, though I seemed to have gotten a lot better with these issues, possibly either by their improving or compensating or both.

When I was 13, and moved to a new area where I was mainstreamed, I started having problems with depression and social interaction--far worse than before--and got expelled from my middle school. I was hospitalized for a week after a meltdown that evening. Starting that summer after when I was 14, I started to really confuse fantasy and reality, until they had merged in my head. I had an actual psychotic break, wherein I became increasingly preoccupied with my fantasies and I believed the fantasies and started acting on them in scary and dangerous ways, resulting in a 6-month hospitalization. During hospitalization, my dose of antipsychotics was raised and I seemed to get better. At this point, they taught me about things like "stop, redirect, refocus" (or something like that) and that if I started having weird beliefs again to tell someone. I was released, went to a day school program, followed by a return to mainstreaming where I did much better. Nevertheless, I am still terrified when I ruminate about this period, and somewhat fear falling into it again in the future. (Interestingly, the report during that period also mentioned that my affect often did not seem to match my mood.)

I continued to have weird beliefs, such as believing I was destined to grow up to be the Antichrist when I was 15 or 16--and I would have this recurrently, though it would be in conflict with another part of my mind that knew it was nonsense--, though not wanting to risk being hospitalized again and losing everything I told no-one. I stopped taking my antipsychotics on my own, because they turned me into a zombie, but I actually didn't really have any problems and was eventually taken off of them. I seemed to become much better able to cope with things as I went through high school, and I had a few close friends, with whom I engaged in activities such as playing video games and eating out, though I was still awkward. I went to college and graduated and have been able to hold down a job.

Both my psychiatrist and psychologist today say that I don't seem to exhibit schizotypal PD anymore, but I'm not so sure. For example, in the last couple years, I only have my immediate family for social support. I still have paranoid and suspicious thinking about people's intent toward me and often get the sense that someone's in the room with me, though my psychologist attributes that to Asperger's combined with depression. I also have a tendency to converse with myself when I'm alone, in just about any circumstance and just about anything, and I always imagine myself to be communicating with a person in the room, though with that and the paranoid and suspicious thinking, the reasonable part of my mind knows that's not actually happening. Nevertheless, it creates conflict, as mentioned by my psychologist, because what my reasonable mind is telling me and what I'm experiencing are in conflict with each other. In the last month or so, I seem to have become a lot more anxious and depressed, and have been having a harder time concentrating, so I've been making repeated visits to my psychs, as my parents seem to be getting increasingly tired of me. I've also been engaging in self-harm and suicidal ideations, and I've been having outbursts again (alone in my house), which are a blast from my past, though the Prozac which I just got started on again seems to be helping somewhat.

So I just don't know what's up with that, but MCDD seems to fit with my history fairly well.

EDIT: Though I have insight into my fantasies, I don't seem to have insight into how I was thought disordered. I don't know if I still have it today, or if it's improved or I've compensated for it. Nevertheless, my psychs seem to say nay.

I thought I was an aspie.. the test showed I was scizotypical.

We were both wrong.

I read many TSR books about dungeons and dragons that made the psychiatrics believe that I was scizotypical.

In reality I am scizoid.. Once read the scizoid description I finally figured myself out.. and started taking psyciastry and psycology seriously as a science ... ( a humanitarian science but still a science)

Obviously, no one can diagnose you on a message board. However, some researchers have proposed a new disorder which combines aspects of Autism and schizophrenia. It is called multiple complex developmental disorders (as mentioned by other posters). That proposed disorder is not included in the DSM. Here is an article which discusses the issue:

Autism and Schizophrenia