#It all comes down to the reasons for the symptoms that differentiate PTSD and Autism

[askaceattorney]

Dear Firegloom,

I actually do have a diagnosis and no I do not have Autism. I have PTSD (Post Traumatic Stress Disorder), so it’s understandable why you’d mistaken the two. However, there is a difference. By the by I am taking some knowledge from the Chief Mod answering this who is diagnosed with Autism Spectrum Disorder and has done research on it and PTSD.

With PTSD, it is a mental illness caused by a traumatic experience. In my case, it was DL-6. Me getting into law books and not making many friends at a young age had nothing to do with any disability whatsoever. That’s because I’m an introvert by nature, meaning I’ve always been one to keep to myself and get tired from too much socializing. There are many people like that without the other symptoms you’ve described.

My trouble with socializing is mostly due to my purposefully distancing myself from family and friends due to my anxiety. Those with Autism have anxieties too, but those with PTSD get them from being overly alert. It’s often triggered by their past traumatic experience. It puts them at a fight or flight scenario in situations where most would never have it. I often overthink what people are thinking, how they look at me and assuming they must hate me. It happens more often than you think. I often panic over Detective Gumshoe being five minutes late for work and will assume the worst, even if it’s unlikely to happen.

Reading other people’s emotions like a math equation is mostly to keep my sanity than anything else. After DL-6, I considered building relationships almost the same as a life or death situation. If I was to love and care for someone, I could  lose them like I lost Father. It was why I avoided ever spending time with Wright and Larry after DL-6 and often secluded myself from the current loved ones. You could say I kept my heart guarded at all times in lock and chains. 

From what the Chief Mod has told me, their experience with Autism has similar symptoms to mine, but for far different reasons. From what they’ve told me, it’s a Developmental Disability that has no connection to past trauma, but having trouble with developing skills that most people would learn faster or naturally such as speech, reading the atmosphere, multitasking and the like. I wouldn’t say I talk formally for that reason. In fact, I’ve never had issues with developing or learning a new skill and I can multitask quite well. 

I’d do more research on the matter, but I hope this answers your question.

- Miles Edgeworth

[mithliya]

Re: the bpd stuff (idk when you posted about it but I saw it recently so), I think my issue with it is that it may be specific but yeah, it is vague - vague in such a way it can be a misdiagnosis. Most commonly I've seen cases of it being a misdiagnosis for bipolar (when symptoms are episodic in context of a mood episode but treated as if a general state), autism (in which emotional dysregulation is common), and trauma disorders (which I think you mentioned?). I think that also contributes to then how the range of presentations of it is SO wide. Someone who is autistic and finding emotions and relationships hard, an undiagnosed bipolar patient who is usually ok but when isn't is very not ok, a woman with a traumatic history who would probably better fit c-ptsd, and someone who actually does have bpd can all end up with this diagnosis. (And I know examples of each of these!) And then they all present differently. Which might be ok ig except they all need different ways of being supported.

i agree with you there and honestly i think there needs to be insistence on certain diagnoses that differentiate these disorders from BPD + it does need to become more specific bc the criteria is SO broad and let’s be honest, many psychs are misogynistic and will slap on the BPD label quite quickly bc they’re lazy.

lots of women with autism are misdiagnosed as BPD, bc of biases with diagnosing autism (viewed as a “male disorder”) and BPD (viewed as a “female disorder”)

bipolar also has mood swings but the mood swings aren’t as rapid as BPD & BPD does not tend to have actual mania but rather something similar. but ofc again… lazy psychs will be quick to slap on the BPD label on women even tho there’s a clear differentiation taught to us between bipolar & borderline

when it comes to trauma tho, most people diagnosed with BPD are also diagnosed with a trauma disorder. they’re highly comorbid for obvious reasons! iirc it’s something like .. 80% of those with BPD that are also diagnosed with PTSD? and BPD also has trauma symptoms within it like dissociation.

but i totally agree that the criteria needs to be narrowed down bc it’s very broad in many ways. so many symptoms listed and u only need a few of them to be diagnosed which is why i was also saying 2 people diagnosed with BPD can actually have 0 shared symptoms and no similarity in their clinical manifestation which clearly is an issue

[shamelesslymkp]

alexithymia WHOMST

so! I did some googling and reading about alexithymia, because mostly what I’d seen on tumblr and in general had boiled down to the following:

alexithymia means it’s hard to identify your own emotions

this can make it harder to identify and understand other people’s emotions

especially based on body language

sometimes people link this to having difficulty understanding body signals like thirst etc

after doing more reading, I’ve come to the conclusion that although the above is not wrong, it’s missing some important additional nuances, to wit:

alexithmyia presents in multiple ways

it can present as difficulty identifying your own emotions, but it can also present as difficulty describing your own emotions

the difficulty in identifying your own emotions is more specifically having difficulty differentiating physiological responses to emotion from just physiological responses in general (or, possibly more simply put: you have trouble linking the physical symptoms you’re having from an emotional response with the more abstract concept of an emotion itself) (possibly that is less simply put, idek)

as such it definitely tends to go hand-in-hand with difficulty identifying body signals, like, in general

studies are actually showing that alexithymia is definitely correlated with low interoception capabilities

studies are showing that in fact the ‘empathy deficit’ people talk about in regards to autism is not actually correlating to being autistic but rather to having alexithymia

this gets disguised by the fact that alexithymia is found in much higher proportions among the autistic demographic

and also because ableism and confirmation bias

additionally! alexithymia is linked to/frequently correlated with the following:

chronic pain/chronic illness

eating disorders

substance-abuse disorders

childhood trauma

PTSD

and (lolcry):

dissociative tendencies

because I am not an expert or even all that good at research, please take a look at the following links below the cut if you’d like more information or to like, check my understanding of the topic! please note that I did not include links to articles arguing against these ones, as they seemed to mainly be critiquing the experiments/results instead of presenting opposing ones, but also because tbh I was not really interested in them and didn’t read them carefully. 

there are reasons I’m not a researcher, okay.

Alexithymia: a general deficit of interoception | by R Brewer - - Royal Society open science, 2016 - royalsocietypublishing.org

Alexithymia is a sub-clinical construct, traditionally characterized by difficulties identifying and describing one's own emotions.

Interoception and emotion | by HD Critchley, SN Garfinkel - Current opinion in psychology, 2017 - Elsevier

Influential theories suggest emotional feeling states arise from physiological changes from within the body. Interoception describes the afferent signalling, central processing, and neural and mental representation of internal bodily signals.

Alexithymia is associated with a multidomain, multidimensional failure of interoception: Evidence from novel tests. | by J Murphy, C Catmur, G Bird - Journal of Experimental Psychology …, 2018 - psycnet.apa.org

Using novel interoceptive tasks, we demonstrate that individuals high in alexithymic traits show a reduced propensity to utilize interoceptive cues to gauge respiratory output (Experiment 1), reduced accuracy on tasks of muscular effort (Experiment 2), and taste sensitivity (Experiment 3), unrelated to any co-occurring autism, depression, or anxiety.

Is alexithymia characterised by impaired interoception? Further evidence, the importance of control variables, and the problems with the Heartbeat Counting … | by J Murphy, R Brewer, H Hobson, C Catmur, G Bird - Biological psychology, 2018 - Elsevier

Interoception, the perception of one's internal state, is commonly quantified using the heartbeat counting task (HCT)–which is thought to be a measure of cardiac interoceptive sensitivity (accuracy). Interoceptive sensitivity has been associated with a number of clinical …

Disrupted integration of exteroceptive and interoceptive signaling in autism spectrum disorder | by JP Noel, M Lytle, C Cascio, MT Wallace - Autism Research, 2018 - Wiley Online Library

In addition to deficits in social communication, individuals diagnosed with Autism Spectrum Disorder (ASD) frequently exhibit changes in sensory and multisensory function … In the current study, we sought to examine both exteroception and interoception in individuals with ASD and a group of typically developing (TD) matched controls, with an emphasis on temporal perception of audiovisual (exteroceptive) and cardiovisual (interoceptive to exteroceptive) cues.

Relationship between interoceptive accuracy, interoceptive sensibility, and alexithymia | by G Zamariola, E Vlemincx, O Corneille… - Personality and Individual …, 2018 - Elsevier

Interoception is the ability to feel one's internal bodily sensations and it is related to emotional experience and the processing of emotional stimuli. Alexithymia is defined by difficulties in identifying and describing one's emotions and externally oriented thinking …

Alexithymia, not autism, is associated with impaired interoception | by P Shah, R Hall, C Catmur, G Bird - Cortex, 2016 - Elsevier

It has been proposed that Autism Spectrum Disorder (ASD) is associated with difficulties perceiving the internal state of one's body (i.e., impaired interoception), causing the socio-emotional deficits which are a diagnostic feature of the condition. However, research indicates that alexithymia – characterized by difficulties in recognizing emotions from internal bodily sensations – is also linked to atypical interoception. 

The relationship between dissociative proneness and alexithymia | by BM Elzinga, B Bermond, R van Dyck - Psychotherapy and …, 2002 - karger.com…

Dissociative tendencies appeared to be especially related to one alexithymic feature: a difficulty in identifying feelings. This relationship was partially mediated by levels of current stress. A history of trauma did not predict dissociation measures. Furthermore, highly dissociative participants were more fantasy prone than low-dissociative participants.

Alexithymia and its relationship to dissociation in patients with panic disorder | by KL Majohr, K Leenen, HJ Grabe… - The Journal of …, 2011 - journals.lww.com

Conditions that impede the regulation of emotional arousal, such as alexithymia and dissociation, may underlie panic attacks ...  Regression analyses revealed a positive correlation between alexithymia and dissociation, even when the Global Severity Index was controlled for. A specific link was observed between "difficulty in identifying feelings" and "depersonalization/derealization."