#diagnostic criteria doesn’t mean I HAVE IT

[dorianbrightmusic]

Earlier on, I saw a pretty bad take on whether autism is a disability. Since said take was part of a post that had been derailed some time earlier, I’m posting this separately. Thank you to @neurodivergent-willowfor a concise and excellent response to the bad take earlier on.

Ok - let’s make something clear: Autism is a lifelong neurodevelopmental disability. (The ‘developmental’ bit, by the way, means lifelong.)

Since the take I saw used nonverbal people as an example of ‘why autism can be disabling for some people’, I wanna quickly say: Many autistic people are nonverbal and require support accordingly. Nonverbal autistic people typically have higher support needs. Being nonverbal is both disabling in and of itself, and usually associated with a greater level of baseline disability. But even when autistic people are not nonverbal, they are still disabled. If your view is that autism is only disabling because of being nonverbal, you are misunderstanding autism as a whole.

Autism, by definition, involves a combined disability of social communication, restrictive/repetitive behaviours, and usually (but not always) sensory issues.

Re social communicative issues, we struggle with social reciprocity (criterion A1) - oftentimes a pragmatic language deficit - and with nonverbal communication (criterion A2). These result in difficulties maintaining relationships (criterion A3).

I’ve seen people attempt to explain these via the social model of disability (usually bastardising the social model to ‘neurotypicals don’t understand us’). But even if society were accommodating, or if double empathy explained everything (which it doesn’t - and it doesn’t account well for nonverbal autistics), the social communicative issues would still be there. And the diagnostic criteria do not specify the nature of the social communicative disabilities. A1 may be struggling with speech altogether for some autistic people, while for others may involve turn-taking, for others tone, and so on. A2 might be an eye contact alone for some people, while it might be a total inability to discern nonverbal cues altogether for others. Criterion A is defined by there being a disability in social communication. Autism is heterogenous in part because the nature of that disability does not matter - the important bit is that there is a disability.

Criterion B requires at least two of the following: intense but restricted interests, difficulty with change and transition, repetitive and restrictive behaviours, and sensory processing issues. All of these are inherently disabling. Yes, you can derive strengths from the mindset that accompanies them - sure, special interests can be great - but they also heavily limit what we can do in life. (I’ve seen special interests used qs an example of a non-disability - but the thing is, having difficulty engaging with other material is inherently going to limit what you do and think about in life. Which is pretty disabling.) Again, the nature of these disabilities does not matter, so long as they are present and not explained by another condition.

I have relatively mild autism, and I need relatively little support for it. But even when I use my accommodations, I’m still goddamn disabled. My social communicative issues, even if they’re part of my personality, still impair me considerably. I have been taken advantage of due to them, and I have also been horrible to other people due to my literal-mindedness and inability to ‘read the room’. Even though I’m trying not to hurt people, I will always be running up against invisible social walls. My repetitive behaviours and sensory issues are worse again. I get so frustrated without a schedule that I’m liable to slip into depression in the holidays. I get so frightened by loud noises that I scream when someone knocks on the door gently. My pain processing - which is, by the way, the most common area of sensory processing dysfunction in autism - is screwed up badly enough that I find normal light touch painful, and my muscles randomly hurt all the time. The medication I take for this has been correlated with a higher risk of dementia in future. My repetitive/restrictive behaviours have become BFRBs - for about a decade, I’ve picked my skin for an about an hour a day, if not longer. This has resulted in countless infections, as well as one wound deep enough that I had to go to urgent care, as I had destroyed every single skin layer and possibly the fascia below. Given that I always have open wounds, I’m not sure I’ll ever be able to go swimming.

Here in Australia, my autism is considered mild enough that I’m not eligible for the NDIS (our main government disability support service). But it is still a disability that affects every area of my life.

I’ve seen people on social media try to say that neurodivergences aren’t disabilities, but just differences, and then apply this argument to autism. This is bad logic, as not all neurodivergences are the same. And this is also terrible logic, because the neurodivergence movement is fundamentally a disability rights movement. It’s never been about ‘we’re different, not disabled’ – rather, the foundation of neurodivergence is that ‘disabilities of the nervous system, neural development, and mental health are all part of the natural variation of human life’. That’s it. It’s literally an extension of the disability rights precept that disability is part of the natural variation of human life.

If your understanding of disability states that autism can’t be a disability because it has good bits, you are disregarding much of the disability rights movement as a whole. Disability is a neutral concept. Disability is when your health means you can’t do certain things. That’s it. It’s not inherently bad, although people who resent their disabilities are in their right to do so. Consider how the Deaf community talk about Deaf gains, for example – advantages and perks associated with their disability. Also consider Deaf culture as an example of the complexity and richness of disability as a concept. If physical disabilities can be neutral, and if physical disabilities can be things that many people wouldn’t change about themselves, the same goes for mental and neurodevelopmental disabilities. So you can absolutely appreciate the good parts of autism and still say that it is a disability.

Also: I wanna point out that a huge number of autistic people are disabled by other things as well. From memory, about 30-40% of autistic people have intellectual disability. That’s a lot of autistic people. As well as that, consider the association between autism and apraxia of speech, specific learning disabilities, motor issues, connective tissue disorders, agenesis of the corpus callosum, etc. Consider how many of us develop mental illness – consider the association, in particular, with schizophrenia spectrum disorders and eating disorders. Also consider the fact that about 25% of autism is syndromic – that is, it appears in concert with another condition. These syndromic autism condition include: Down syndrome, Fragile X syndrome, neurofibromatosis, Rett syndrome, Tuberous sclerosis, callosal disorders, and so many others.

Autism is a disability. Even if it weren’t, it’s usually accompanied by other disabilities. Even if you don’t feel disabled by your own autism, the condition itself is still a disability.

[heir-of-the-chair]

You know, when they said “you never stop learning things about yourself” I don’t think they meant five consecutive years of having a new identity crisis.

[seraphasia]

the problem with self-diagnosis that most concerns me is the risk of people, teenagers especially, pathologizing normative behavior

[bli-o]

I’m most definitely autistic but I’m not sure if I want to pursue a professional diagnosis because…

-many professionally diagnosed people regret getting a diagnosis because it as jeopardized their rights or harmed them in other ways

-many professionals and autistic people have shown the diagnostic criteria in my area is inaccurate

-I theoretically have access to a diagnosis, but I feel my psychiatrist really doesn’t take me seriously

edit: this doesnt include a “it’s none of my business” option because that is mostly assumed; you probably shouldn’t go around harassing people or claiming they’re faking disorders. This is mostly about if you think it has an adverse affect on the person self diagnosing or the community of the thing they’re diagnosing as.

[five-thousand-loaves-of-bread]

not all autistic act same + you can’t always tell someone autistic by just look or interact, but. i find when late/self/no diagnosed invisibly autistic people (who often lower support needs but not always) say “autism don’t have a look” really annoying because

you talking about us who visibly autistic who strangers can tell a mile away or immediate when interact with us. we the “autism look.” we exist just because you not one of us don’t mean we don’t exist.

yes need fight against “all autistic act same and i can always tell” but say opposite also doesn’t help it harms

autism stereotypes not true for all autistic (except like. diagnostic criteria) but need remember many autism stereotypes exist because it true for some of us remember us in your advocacy

[interstellar-cluster]

Almost-friendly sysmed reminder

Firstly, anti-endos be respectful. This post isn’t to bash you or disordered systems. It is meant to educate people on the DID/OSDD criteria and how the DSM-5 and ICD-11 both essentially prove the existence of non-disordered systems.

Please also note that we’re endogenic. We don’t have any diagnoses and we’re taking the information in the DSM-5 and ICD-11 at face-value.

Another note: This post is also not meant to say that people’s experiences are invalid or not true. Once again, we’re taking this information of the diagnostic criteria for DID at face value, and this doesn’t account for personal experiences. This is purely the diagnostic criteria for DID/OSDD. We also don’t have a lot of information on UDD so we won’t be talking about that here.

Every system is valid.

The rest of this will be under the cut because it is LONG and I don’t want to clog up my page.

So we’ll get right to the point. Trauma is not part of the diagnostic criteria for DID/OSDD, nor is the disorder developing in early childhood part of the disorder. Trauma is very commonly associated with trauma in early childhood but this doesn’t mean that the disorder requires trauma to develop.

Regarding the Structural Dissociation Theory, this is only a theory. It might be proved, disproved, changed or they may not fit every experience. Theories aren’t concrete, and the human brain is so incredibly complex that it’s almost impossible at this time and age to prove anything.

Criterion 3 in the DSM-5 and criterion 6 in the ICD-11 state that the plurality or symptoms of such must be distressing for the plural with the disorder. If the plurality is not distressing or, in the ICD-11, causing significant impairment in important areas of functioning (personal, social, educational, etc), then it is not a disorder.

These criteria are explicitly stated to exclude plurals who do NOT find that their plurality causes impairment to their functioning. This inherently means that plurality CAN exist without causing distress or impairment.

Another criterion that explicitly excludes non-traumagenic systems from the DID criteria is that the plurality must not be part of normal cultural or religious practices. This includes tulpamancy and is, once again, stated to exclude these types of plurality from being diagnosed with DID because they are recognised to be non-traumagenic and that they exist.

So, TLDR; trauma isn’t necessary for plurality; you need to be distressed about the symptoms of your plurality to be disordered which, by extension, means that non-disordered plurality exists; and cultural and religious practices are excluded from the criteria of DID which means that doctors acknowledge that plurality can exist without being disordered.

(This entire post also occurs to OSDD because it generally follows the same criteria as DID with either DID criterion A or B or both not occurring in OSDD patients.)

Thanks for coming to our Ted Talk. We’re not looking to discuss this, sysmeds/anti-endos can look but do not interact. We will freely block anyone who reposts this just to argue for the sake of ridiculing endo systems.

- 🕸️🎧

[prettyboykatsuki]

how surprising ur response doesn’t address the issue at all!!!! i would love for u to go off on me because it’s easy for me to win a disagreement when i know i’m right lmao and also i KNOW 100% for a fact that countless people would agree w me but it’s not reaching the correct audience w a sane mindset cuz all ur followers are 🌽 addicts too thinking the same shit as u and pitying and comforting ur ass in ur replies🤦‍♀️🤦‍♀️🤦‍♀️shits cringe to watch but anyway every normal person knows it’s weird and that’s all the matters i suppose cuz post that shit literally anywhere else and your ass WILL get dragged

maybe let’s try a one month no 🌽 challenge and try again! maybe ur mind will detox and you’ll realize ur fucking weird

i didn't respond to your ask with any dignity because the original premise of your ask was not worthy of being dignified with time nor attention.

ive gotten tens of asks of people who also want to hold moral superiority over me by regurgitating opinions they've adopted from their online internet circles without any real nuance and thus i have no reason to take it seriously. you are not the first person to try to peddle this to me and there is nothing about your ask that warrants any of my thoughtful consideration.

i normally wouldn't bother with correcting this one either, but because im already in a deeply irritable mood - sure, i will give you the response you are asking for, starting with the post you are criticizing.

firstly, you're incorrectly reading my post. you intentionally misrepresent my post with your wording and also the sort of joke i was making by implying "memed about waiting for the age of consent" so i can indulge my porn addiction."

im going to disregard your application of harmful real world rhetoric to what is essentially fiction and go along with the idea that fictional characters are in anyway effected by my posting.

the main issue is fundamentally that you are misreading it. i know you are because i am the original poster and the author of this post - which means i can directly tell you that the point of this post is ironic.

it is poking fun at the people who have accused me of pedophilia for aging up a fictional character for years because he is now, in canon, an adult.

the irony of that is that i was doing what horikoshi was when writing my fics. the people who treated my aging up as invalid simply because horikoshi is the author are no longer able to wield it against me. the author has no confirmed his adulthood, which makes that argument moot.

your argument is that i was in some way making a joking about having waited for izuku to reach adulthood in order to sexualize him. this is blantantly incorrect and a misreading of the post in general. that is not something you can counter because if you've spent any time on my blog at all - it would be very clear i was already aging up and sexualizing characters on my own whims.

both posts for better viewing.

the other thing you spout off about is porn addiction. this is the main reason i didn't find any reason to take your points seriously. if you knew, researched, or understood any of the points you've borrowed from your peers on tiktok - you would know why porn addiction is not a term you can apply to erotica.

in the first place, there is no universally understood diagnostic criteria for porn addiction. there are other forms of research related to how porn interferes with cis-heterosexual partnerships and the quality of sex life and some affiliation with watching porn as a compulsive behavior - but neither of these things qualify as addiction.

pornography is a highly politicized topic because our society is structured upon old school protestant christian beliefs and puritanism. but pornography and sexually explicit materal is a difficult thing to quantify in usage. it is culturally ubiquitous and has several nuances in relation to its use. it is near impossibly to quantify sexual behavior because it is a normal, human urge like hunger or thirst whether or not you choose to believe that.

here are three articles making points about the claims around porn addiction from reliable sources that you're welcome to point out.

one | two | three

as i keep repeating - addiction is a specific line of behavior and being frank, it's rather insulting you think i suffer from a porn addiction given i used to do actual drugs and suffered from real life addictions lmao.

but if you want to use other addiction diagnostic critera in this argument. my posting on silly erotica tumblr does not

interfere with my daily life or relationships

negatively affect my performance in school or at work

cause me to withdraw from social situations

lose interest in my other hobbies and activies that improve quality of life.

none of the above applies to me. but im guessing you don't have any actual concern.

it's very clear to me and everyone else that your peddling of this term has nothing to do with whether or not i actually have the addiction - and everything to do with you attempting to moralize my behavior to an audience and boost up your own points.

if i really did have a porn addiction, implying i had an addiction - you are implying that this is something i should be ashamed of just as you are implying my fellow porn addicts should also be ashamed.

you see addiction as a point of shame and not a disease and don't show any actual empathy which makes you a morally bankrupt human being in my subjective view. you don't have any actual arguments about how this might effect my behavior or character. only that addiction (a thing people can't control) is bad, that i am bad for watching porn and being addicted to it.

neither of these are provable as you do not know me.

instead your attempt to find fault is to arm yourself with puritan talking points and internet tiktok buzzword language and make your clauses have some kind of ground or validity. it is trite and frankly embarrassing watching you come into my inbox with such confidence that you would be able to argue with me critically and meaningfully.

the last thing i will address is your point about this not being a popular opinion.

you are under the impression im not aware of this and that this is not a choice i've made deliberately so i will be kindly blunt.

i, unlike you, have formed these opinions with my own critical understanding of culture, sociology, psychology, and politics by researching and reading from people who study these things with more expertise than me.

these opinions are formed by my own discretion and worldview. they are unpopular opinions.

unlike you, my peers are not decided by my moral parading. rather, im frank and upfront with those world views and have formed a circle that agrees with them.

i do not need your validation nor the validation of people online to confirm whether or not im a good person. the reason people agree with me is not pity, but because they too have formed their own opinions and ours happen to allign.

you think this is pitying behavior because the people you choose to align with would cast you out for showing even a breadth of disagreement or critique. you have not fostered a space for intelligent conversation because you can't see disagreement without accusing someone of this or that.

you are all the same and you are all equally confident in your hivemind opinions. i applaud your audacity and admire your confidence in your own ability to argue something you've barely formed your own conscious thought about.

i dont need to detox anything and i dont care about being weird. i also, really don't care about you or your opinions.

you are unoriginal and boring, a pest of the highest pedigree and i don't find you intimidating. your inability to receive validation from your own moral character will doom you to shame and guilt for as long as you allow and thats much more punishment than i could ever dole out to you

have a good day pookie 🫂🫂

[aspd-culture]

Heya, idk if this is a valid question or is really dumb, but like, does the age at which ASPD behavior starts to show have to be strictly 15?

I have been wondering whether I should get officially diagnosed, since the media and general societal representation of it doesn’t seem as reflecting of me (with exception of a few) but I do relate extremely closely to most of the diagnosing criteria. Although??? The physical aggression thing?? Like I have those impulses and plenty of them, but I just don’t follow through with most because of convenience. That sort of thing is one of the main things that makes me doubt whether I do actually have it. (Same with impulsive behaviors etc)

But my main point/ask is the age thing. As a very young child I was pretty sweet? Ig? Like I wasn’t an aggressive child, rather pretty passive. As far as I recall, my symptoms started when I was about 15-16, when I was starting to process that mine was a traumatic situation? and earlier than that I was just an edgy teen, I guess? I sure had some of the symptons way earlier, but the main ones/ the ones that I feel are more prominent in me didn’t show up until a bit later? I’m not sure. So my question is, does it mean it can’t be ASPD?

Also your page is lifesaving. Thanks man.

Note: due to the way copy and pasting criteria works on tumblr, this post will be written exclusively in plain text, as copying and pasting it all over again would take forever, but I want this post to be accessible still.

I haaaate the way the DSM phrases criteria. Absolutely no worries, it is confusing as heck and you wouldn't be the first person at all to ask about this.

So, the symptoms of Conduct Disorder or Oppositional Defiant Disorder (DSM criteria below) need to show by or before the age of 15. (I do not know if Intermittent Explosive Disorder satisfies this criteria, but it very well may.) That means they may start when you're a toddler, or they may start when you're 14.5. Anywhere in there, you have to qualify for one of those two disorders, but you also do not have to have been diagnosed with them.

Also, having had been an "edgy teen" definitely could have been those symptoms showing themselves. The reason ASPD can't be diagnosed before 18 is because teenage edginess could either be symptoms or be normal, and the only real way to tell is if it continues past teenage and into adulthood.

The diagnostic criteria of Oppostional Defiant Disorder is as follows, quoted from the DSM-V TR:

A. A pattern of angry/iritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.

Angry/lrritable Mood

1. Often loses temper

2. Is often touchy or easily annoyed

3. Is often angry and resentful.

Argumentative/Defiant Behavior

4. Often argues with authority figures or, for children and adolescents, with adults.

5. Often actively defies or refuses to comply with requests from authority figures or with rules

6. Often deliberately annoys others

7. Often blames others for his or her mistakes or misbehavior.

Vindictiveness

8. Has been spiteful or vindictive at least twice within the past 6 months

Note: The persistence and frequency of these behaviors should be used to distinguish a behavior that is within normal limits from a behavior that is symptomatic. For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months unless otherwise noted (Criterion A8). For individuals 5 years or older, the behavior should occur at least once per week for at least 6 months, unless otherwise noted (Criterion A8). While these frequency criteria provide guidance on a minimal level of frequency to define symptoms, other factors should also be considered, such as whether the frequency and intensity of the behaviors are outside a range that is normative for the individual's developmental level, gender, and culture.

B. The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning

C. The behaviors do not occur exclusively during the course of a psychotic substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.

[End quote]

Conduct disorder's criteria more clearly shows the lead-in to ASPD.

The diagnostic criteria for Conduct Disorder is as follows, quoted from the DSM-V TR:

A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:

Aggression to People and Animals

1. Often bullies, threatens, or intimidates others.

2. Often initiates physical fights.

3. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)

4. Has been physically cruel to people

5. Has been physically cruel to animals

6. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)

7. Has forced someone into sexual activity

Destruction of Property

8. Has deliberately engaged in fire setting with the intention of causing serious damage.

9. Has deliberately destroyed others' property (other than by fire setting).

Deceitfulness or Theft

10. Has broken into someone else's house, building, or car.

11. Often lies to obtain goods or favors or to avoid obligations (i.e., "cons' others).

12. Has stolen items of nontrivial value without confronting a victim (e.g. shoplifting, but without breaking and entering; forgery)

Serious Violations of Rules

13. Often stays out at night despite parental prohibitions, beginning before age 13 years.

14. Has run away from home overnight at least twice while living in the parental or parental surrogate home, or once without returning for a lengthy period

15. Is often truant from school, beginning before age 13 years

B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning

C. If the individual is age 18 years or older, criteria are not met for antisocial personality disorder.

[Skipping a bit of the quote which specifies codes for the various ages CD can present. It is worth noting that these are *not* criteria, they are specifications to be noted in the file of the person being diagnosed with conduct disorder to accurately describe their experience. As you'll see, these specifications are flags as to whether a child/teen with conduct disorder should be evaluated for ASPD upon reaching adulthood.]

Specify if:

With limited prosocial emotions: To qualify for this specifier, an individual must have displayed at least two of the following characteristics persistently over at least 12 months and in multiple relationships and settings. These characteristics reflect the individual's typical pattern of interpersonal and emotional functioning over this period and not just occasional occurrences in some situations. Thus, to assess the criteria for the specifier, multiple information sources are necessary. In addition to the individual's self-report, it is necessary to consider reports by others who have known the individual for extended periods of time (e.g., parents, teachers, co-workers, extended family members, peers).

Lack of remorse or guilt: Does not feel bad or guilty when he or she does something wrong (exclude remorse when expressed only when caught and/or facing punishment). The individual shows a general lack of concern about the negative consequences of his or her actions. For example, the individual is not remorseful after hurting someone or does not care about the consequences of breaking rules.

Callous-lack of empathy: Disregards and is unconcerned about the feelings of others. The individual is described as cold and uncaring. The individual appears more concerned about the effects of his or her actions on himself or herself, rather than their effects on others, even when they result in substantial harm to others.

Unconcerned about performance: Does not show concern about poor/problematic performance at school, at work, or in other important activities. The individual does not put forth the effort necessary to perform well, even when expectations are clear, and typically blames others for his or her poor performance.

Shallow or deficient affect: Does not express feelings or show emotions to others, except in ways that seem shallow, insincere, or superficial (e.g. actions contradict the emotion displayed; can turn emotions "on" or "off" quickly) or when emotional expressions are used for gain (e.g., emotions displayed to manipulate or intimidate others).

Specify current severity:

Mild: Few if any conduct problems in excess of those required to make the diagnosis are present, and conduct problems cause relatively minor harm to others (e.g., lying, truancy, staying out after dark without permission, other rule breaking)

Moderate: The number of conduct problems and the effect on others are intermediate between those specified in "mild" and those in "severe" (e.g. stealing without confronting a victim, vandalism)

Severe: Many conduct problems in excess of those required to make the diagnosis are present, or conduct problems cause considerable harm to others (e.g., forced sex, physical cruelty, use of a weapon, stealing while confronting a victim, breaking and entering).

[End of Quote]

As you can see, the criteria required before age 15 is not as intense as many professionals describe it. Remember that you are only required to have shown 3 out of the total 15 criteria in there. There is even a whole specifier for Conduct Disorder that is mild and only includes things like lying, basic rule-breaking, and/or staying out past curfew.

Acts of physical aggression are not actually required for ASPD at all, it's just that many prosocials see that being one of the possible symptoms and fixate on it, thus pushing everyone with ASPD into the box of physical aggresion. You absolutely can have ASPD and never act on any violent thoughts or urges.

I was also a very sweet and passive child, developing most of my externalized ASPD symptoms (rule breaking, disrespectful behavior/actions, challenging authority, etc) around age 13. However, the internal symptoms were there for me much younger - easily bored with poor handling of boredom, lack of empathetic reactions, difficulty apologizing/showing remorse due to not really feeling it, becoming very angry but not showing it, resulting for me in self destructive behaviors like cheek biting or controlled destructive behaviors like breaking something that wouldn't be missed (pencils and pens mostly for me).

Regardless of what symptoms were shown when, symptoms are still symptoms, and if you had enough for Conduct Disorder or Oppositional Defiant Disorder before your 16th birthday, you are well within possibility of having ASPD. Keep in mind that the lying, manipulation, etc that can qualify for Conduct Disorder doesn't have to be grandiose or destructive except where it is explicitly stated in the criteria that it does (such as fire setting only counting for the destruction of property criteria if you meant to damage something with said fire).

It's so easy to count yourself out of ASPD because you don't fit the stereotypes or public perception of ASPD, but I assure you that there are many, many ways something as complex as a personality disorder can show itself.

It is absolutely a great thing, however, that you are covering your bases and making sure to do the research to see if this is what you have. That is the basis of an informed self-dx, should you come to the conclusion that you have ASPD.

Now, as for actually getting diagnosed, your mileage may vary with professionals. Many have bias against pwASPD ingrained into their practice, and won't diagnose you with it even though you have it if you aren't/weren't violent, law-breaking, or if they just think you "seem far too kind to have ASPD" (a real quote a former professional said to me a few months before I was diagnosed by my long-time psychiatrist). This doesn't mean you don't have ASPD. If they can't give you other explanations that make sense, and if their reasons for denying you that diagnosis are based in stigma or anything other than actual criteria, then you are well within your rights to continue being self-dx.

A professional should be able to explain, using criteria, why you don't have a disorder you think you may have. If they're doing their job, they should be willing to explain to you what their reasons are and point you in the direction they think may be causing the symptoms. And no, "just acting like a teenager" isn't good enough if enough symptoms have persisted into adulthood for you to meet the criteria for ASPD.

I hope this helps, apologies for it being so long.

[scarlet97531]

⭕️❗️can we please talk about how horrifyingly essentialist some ppl are when talking about mental health diagnoses??? Like some ppl will be acting like once you’re diagnosed with something that’s just what you are forever?? But like mental health diagnoses are ((usually)) entirely based on symptoms, and symptoms change all the fucking time. It’s not either you have DID or you don’t, if you stop meeting the criteria of the diagnosis you don’t have DID anymore??? You might just have OSDD or some kind of non disordered plurality. You aren’t permanently bound to every mental health diagnosis you’ve ever met the criteria for in your life.

It makes me so mad when ppl say shit like if one alter meets the criteria for a disorder then the whole system has it or the alter is just faking it or something?? Like NO????? DIAGNOSES ARE NOT BOUND TO YOUR BODY AND SOUL. THEY ARE CATAGORIES. THEY ARE SYMPTOMS. YOU CAN HAVE ONE ALTER WITH ONE DISORDER THAT NOT EVERYONE HAS 😭

This honestly drives me so insane because like essentialism can be so bad in so many ways. Sure there are some disorders with genetic or physical components, or that affect your whole brain all the time or something, but like?? NOT ALL OF THEM???

Like I just know that anyone who thinks alters can’t have different disorders actually just believe that alters are all fundamentally the same person just like. In different moods or something. Which I HATE. Like yeah maybe some systems are like that but definitely not all of them????

Like in my system some of us have different eating disorders, some of us have depression or anxiety and some of us don’t, honestly lately I’ve been suspecting that some of us don’t even meet the diagnostic criteria for adhd

Cause we’re all really different and we all have different symptoms

Dust has really bad catatonia but for most of the rest of us it’s just not a problem?? Like idk are you gonna say that the rest of us secretly do have really bad catatonia too? Or that Dust doesn’t have real catatonia or some shit?? like what does that even mean 😭

If some of us meet the criteria for a diagnosis and some of us don’t than what’s the point of saying all of us have it??? There is no reason for us to say all of us have a thing when only one or two of us actually had the symptoms???? WHATS THE FUCKING POINT BRUV LITERALLY WHAT

Sometimes things effect everyone in a system and sometimes it doesn’t mkay? People can decide for themselves if it’s more useful for them to say it’s just a specific alter or just some of them or all of them mkay? They know themselves and each other best mkay? YOU DONT GET TO TELL OTHER PEOPLE WHAT DISORDERS THEY DO AND DONT HAVE MKAY?????????????

[fierceawakening]

@ante--meridiem you’re making sense to me.

I often will use the term “shitty person” over “bad person” (“Wooooow, Mitch McConnell is a shitty person. I knew he was right wing but wow, he really did go above and beyond to not work with Obama and then fold to Trump.”) for the reason you give. I don’t know why it is, but “bad person” sounds more like it might mean “born evil,” where “shitty person” for some reason has more of a connotation that you could’ve been something else and you Just Kept Going.

I just feel like tabooing “bad person” can and sometimes does have the side effect of shaming traumatized people for expressing justified anger without caveats. (When, at least from my own experience, we’re *often* scrupulosity spiraling about whether or not they knew better, as one very common coping mechanism for us is to decide that our abusers must be correct that what they do IS really our fault. If we rely on them for housing and food, it’s a lot easier to think to ourselves “I must’ve set them off. I can do better next time and then they’ll feed me” than to acknowledge “They’re capricious. I might not get fed, just because that’s how they are.”)

So to me, we need at least to be forgiving of that phrasing, because someone may be just beginning to try out the idea that they didn’t deserve what happened at all. In my experience what helps someone in that particular circumstance is to be told by their support system “no, you don’t need to take that back. You’re not angry because you’re ungrateful or judgmental. You’re anger because that was, full stop no question about it, straight up trufax just wrong.”

Or they might even be me, who is used enough to the idea that I’m angry and it’s okay to fucking CALL MYSELF FIERCE AWAKENING, but who still falls into patterns of “I’m so judgy! I deserve to have bad things happen to me because I can’t stop judging other people!” and therefore really wishes people would choose a different hill to die on.

The other thing is… I don’t know if it’s right to say we Disagree on judging yourself. Like, yeah, thinking “I am a bad person” is destructive, and is usually repetition of something someone who traumatized you told you.

But there’s a different thing, where you look at yourself and ask “am I living in accordance with my values? When faced with hard decisions, do I choose the thing that reflects the character I want to cultivate, even if I’m scared?”

Which I think is broadly what you mean when you say “don’t think of yourself as a good person, as you might forget there are things you still need to fix.”

Like I’m pretty sure that if I told myself straight up I’m not a good person, my brain would take that to mean I should commit suicide, as that sounds weirdly unfixable.

But “do my choices reflect my aspirations? Do I have work to do?” Doesn’t do the same thing.

And that’s I think why I get so frustrated with tumblr’s way of talking sometimes. Like there seem to me to be a lot of people who say things like “I’m a narcissist; what were you expecting from me? You shouldn’t think I’ll give you that weird empathy thing. But if you reject me because I didn’t, that’s ableism.”

And I’m just “dude, you can’t have it both ways!

“If you’re telling me the way you act is fixed because of your neurotype, then I’m justified in telling you I and others need to keep our distance because your pattern of behavior is highly likely to stay the same.

“If you’re telling me I can’t assume because of your label that you act the way the diagnostic criteria say someone with the label acts, then you don’t get to tell me I’m being ableist and demanding the impossible when I ask you to show empathy through your actions.”

[tobeabatman]

if you are in BED recovery and are making being fat a part of your identity then sorry you’re gonna fail unless you change your mindset. same as anorexics and bulimics making superskinny their personality. you are just enabling yourself and giving yourself an out for the failure you are setting yourself up for. fat activism will not care when you die like how proana doesnt care when anorexics die as long as they have ways to continue their selfdestructive behavior while others with the same issues cheer them on.

TW: Eating disorder talk. Mainly BED, but anorexia and bulimia as well.

You don’t know anything about binge eating disorder, bulimia, or being fat then.

With anorexia, disorted body image is literally a part of their diagnostic criteria. This is not the case with BED, aka binge eating disorder.

BED has no weight or appearance based diagnostic criteria. You can be at any weight and have BED. BED’s diagnostic criteria also doesn’t include anything stating that people with BED want to get very fat, like seriously…

BED is not a condition opposite of anorexia where we are obsessed with putting on weight. BED is the most common eating disorder (about 50% of all ED cases), so if that was true, we’d most likely have multiple fear-mongering documentaries and news stories made out of us already, and everyone would know about BED (at the moment they don’t).

The fact that you’re even seperating BED and bulimia as if our ED’s were absolutely different, is stupid. Both us people with BED and people with bulimia experience binging. The difference is that people with bulimia purge.

And the fact that people with BED don’t purge doesn’t mean that people with bulimia want to be super skinny and people with BED want to be super fat… Many people with bulimia are fat and many people with BED are skinny, news flash. Purging doesn’t automatically make you skinny, and neither does binging automatically make you fat. Someone’s BED can turn into bulimia and vice versa.

Now, I wanna clear up why fat activism is actually good for my BED:

People with BED often feel like they lack control. This is what commonly drives binging, according to many mental health professionals. We are out of control with our eating, and our bodies.

The feeling of lack of control is amplified in a fatphobic society. A lot of models actually get BED, not anorexia, because they feel out of control with their bodies (which leads to binging).

Telling myself that it’s okay if I get fatter when binging, actually helps me with my binging. I don’t feel as much shame afterwards (disgust, depression or guilt after binging is a diagnostic criteria for BED), when I feel like my body changing doesn’t matter.

This means that I’m less likely to experience binging as soon as I would otherwise, if I did feel more shame. (And this is actually how BED commonly works: shame triggers more binges. I doubt that you knew that).

And my binges getting further in between and my shame lessening, means that I have a better chance of recovery.

I mean, what do you think my dietitian and psychologist would encourage me to do? Feel deep shame with my body after binging, so that I would recover from a guilt-based eating disorder?

I would encourage fat activism to people with anorexia as well. It’s harder to hate your body for its size, when you realize all the lies there are surrounding fat bodies. And being angry at fatphobia helps with feeling out of control.

Although I understand that recovery and mindset change doesn’t happen overnight. I still have internalized fatphobia, and I’m still in BED recovery. I get it.

Anyway, I feel like this person watched a little bit too much of My 600lb Life, realized that those participants most likely had BED, and then went off to make this whole weird twisted story in their head about how BED works…

Watch my XL-sized body die tonight✌️ /s.

Tl;dr:

BED is not anorexia but opposite. Bulimia is pretty close to BED. Fat people with BED feel shame about their bodies, which triggers more binging. Fat activism helps me reduce feelings of shame and guilt, which helps me prevent more binging. Stuff like My 600-lb Life does not give its viewers an accurate representation of how BED works, because the show is not even focused on BED. It’s reality TV: the whole purpose is to show some people in absurd light so that you can feel better about yourself (whether those people are hoarders or very fat people, etc.).

There is no weight-based criteria for BED: people with BED can be skinny. A lot of models experience BED instead of anorexia, because a lack of control in their bodies can lead to binging (without purging). I’m not going to die from BED because I’m a fat activist: BED isn’t even as deadly as anorexia.

[all-pacas]

DIAGNOSTIC OLYMPICS, SEASON 2, EPISODES 1-9

S1: part one, part two, part three

Hi! I was curious about who on House (besides House) gets the most diagnoses right. Other folks have already run a tally (it's Chase), but I was curious how other factors would influence the tally — whose ideas get run with, who manages treatment, who screws up… So I thought I'd keep score.

1 point for getting the answer. This is almost always going to be House.

.5 points for Valuable Contribution — stuff that isn't the final answer, but either is thought to be the final answer or is valuable to the solving of the case. Stuff like "noticing something on the MRI" doesn't count; things like "figuring out how to treat" does.

-.5 to -1 for Mistakes — stuff that delays or prevents diagnoses, injuring or killing patients, etc.

ACCEPTANCE DIAGNOSES: Adrenaline tumor

+1 House: The only one who cares about the case, and the only one to do anything to solve it. -.5 Foreman: The patient crashes and he… stands there watching. “We don’t know what’s wrong with him, it’ll just buy him a few hours!” We’re not here to discuss the ethics of treating murderers (that’s for S6); that’s just bad doctoring. -1 Cameron: I can justify delaying telling her patient the cancer diagnoses (although it’s still not great), but the point that Cameron had it 100% confirmed and was shown just chatting and laughing with her new best friend instead of telling her? That’s negligence. By withholding information, Cameron is delaying treatment. She also refuses to help treat the main patient.

AUTOPSY DIAGNOSES: Blood clot

+1 House: While he doesn’t entirely get the diagnostic credit, he very much gets the credit for figuring out how to find and treat the clot. +.5 Team: Everyone kind of lands on “clot” at the same time. +.5 Cameron: Is able to hear the patient has an extra flap in her heart. This impresses House, and gets her the point. +.5 Foreman: Spots the clot when no one else does. +100 CHASE STOP IT: Went back and forth a lot about Chase kissing the patient, and decided finally he doesn’t get a demerit, because the criteria is actions that affect the case and diagnoses and medicine. Being manipulated by a 9 year old is a bad look, but it ended up having no effect on anything but Chase’s spine and conscience. Compared to Cameron’s demerit last episode: her having a fit about Death Row Guy wasn’t a problem (Foreman and Chase did too), it was her refusal to do anything for him that was. Foreman being mean about Rabies Lady last season was an issue not because it wasn’t nice, but because it led to him dismissing her symptoms and affected her treatment. Luckily for Chase’s points if not his ethics, kissing the 9-year-old after she manipulated him because he has a spine made of jello didn’t harm her.

HUMPTY DUMPTY DIAGNOSES: Chicken Disease

+.5 House: Another episode where I would argue his methods fail him. If he had followed up when he heard the brothers arguing about the patient’s job, or revealed he understood Spanish sooner, or interacted with the patients at all, then things might have been solved quicker. He still got there in the end, but his refusal to engage meant it took longer. +0 Cuddy: Her guilty insistence that this was all her fault was sympathetic, but did slow things down. Luckily, it had no real effect on the case: the patient had a reaction to meds she put him on, but it’s not clear House wouldn’t have done that anyway. +5 SHIP TEASE: This episode really seems to launch the House/Cuddy ship, between everyone’s insistence that they must have slept together in the past (something not established until much later), and House actually being sincere and nice to her in the end of the episode.

TB OR NOT TB DIAGNOSES: Pancreas Tumor (and TB)

+1 HOUSE: As usual, he figures it out. +.5 CAMERON: Goes against House’s orders and tests for TB, which the patient is unsurprisingly positive for. She doesn’t get points for that per se, but rather for smartly pointing out they have to rule out which of his symptoms are from the TB and which aren’t, which House agrees with. +.5 CHASE: Notices a small issue with his heart, which forms the main diagnoses theory most of the episode.

DADDY’S BOY DIAGNOSES: Radiation poisoning leading to tumors

+1 HOUSE: Another episode where they have no strong leads and are just chasing symptoms until the last second. +50 for Wilson’s terrible handwriting

SPIN DIAGNOSES: Pure Red Cell Aplasia

+1 HOUSE: Technically, Wilson first discovers the PRCA, but everyone assumes it’s a symptom, not the cause. +0 CAMERON: Spends the episode whining and complaining about the patient being an immoral cheater, but doesn’t let it interfere with her job. She’s learning! CHASE DID IT: First time the assumption for a patient worsening is “Chase messed up,” and it will not be the last!

HUNTING DIAGNOSES: Fox Parasites

+1 HOUSE: We’re really moving away from episodes that are strictly puzzles, which means House gets the win without much else to say. +1 ROWAN CHASE: He co-authored a paper on berylliosis that Chase read and connects to the case. House likes the theory, even if it doesn’t pan out. Roundabout, this is yet another example of Chase being weirdly up-to-date on old fashioned tech and illnesses. Does his dad just write a lot of papers? +0 CAMERON AND CHASE: I mean, we’re not judging on morals, just medicine, but stealing drugs and jumping a coworker/getting jumped by a high coworker and just going with it are definitely losing them both points somewhere. +50 RAT POINTS for Steve McQueen!

THE MISTAKE DIAGNOSES: Like eighteen things spiraling out of missed ulcers.

+0 TEAM: No real diagnosing in this episode; it’s all about Chase’s, well, mistake. -1 CHASE: Sorry, buddy. He had understandable reasons, his dad sucks, but he still killed a patient. On the plus side (or maybe making him feel worse), he genuinely had good rapport with her and her family and did a lot to help and support them. On the other hand: he killed a patient! No coming back from that!

DECEPTION DIAGNOSES: Munchausen’s, but also a bacterial infection.

+1 CAMERON: First correctly “diagnoses” Cushing’s, which the patient had faked the year before, so she wasn’t wrong exactly. Then realizes it’s munchausen’s and proves it handily. Good job Cameron! +.5 HOUSE: Giving him a few demerits this episode. On the one hand: He alone believes the patient is actually sick, and does whatever he can to prove it. On the other hand, he dismisses symptoms and the munchausen’s diagnosis even after it’s fairly obvious, doesn’t take a real history or do the tests asked of him… yes, he’s being an ass intentionally because he doesn’t like Foreman in charge, but he’s still fucking around with patient care. +0 FOREMAN: Once again hates the poor, and decides based on no evidence that the patient is an alcoholic. Even once they think she has a tumor on her pancreas. His second shot at running a case, and it’s still iffy: he’s enjoying being boss and not really thinking about medicine. NICE TOUCH: When House decides to make the patient sick for real, he uses colchicine — the gout medicine that was poisoning the kid all the way back in s1e3

RUNNING TALLY:

HOUSE: 23.5 TEAM: 4.5 FOREMAN: 1 CHASE: 2 CAMERON: 3

Cameron is, surprisingly, pulling ahead! Even with her demerits, she keeps having consistently solid ideas and has now twice come up with a diagnoses: in S1 putting the pieces together a moment before House, and in S2 realizing and proving munchausen's, even if it wasn't the "real" problem.

[sophieinwonderland]

Imitated DID is essentially people parroting what they believe DID to be. It doesn’t necessarily mean they are faking, but that they are misinformed, likely experience a high degree of suggestibility and also likely are prone to fantasy and cognitive distortions. DID is not what the media portrays. If the dissociative symptoms are not causing a disruption to living, then it is not a dissociative disorder. Thinking you have alters is not a dissociative disorder.

Seeing yourself as being composed of many parts is fine and normal. People are not one-toned but multidimensional beings. Every person is a complex person. Everyone is free to choose how they wish to view and identify with themselves. Fitting the criteria for a dissociative disorder, however, is not a choice a person can make.

The issue with so-called Imitated DID is that it often DOES meet the diagnostic criteria.

I fully agree that simply being plural is not a disorder. Every disorder has a requirement of clinically significant distress or impairment and it's super important that this remains and is respected.

If you look at many of the cases of Imitated DID though, they seem like they do likely cause some level of distress or impairment and would need treatment, regardless of if the patient is ashamed of their alters or not.

Half of the paper that started the Imitated DID myth was dedicated to a Borderline/ASPD group.

And as I discussed before, they seemed biased against many of these patients. Their first case study, they seemed to doubt simply because she has a history of prostitution and an older boyfriend. And the above implies that drug and alcohol use somehow makes people more likely to be experiencing imitated DID.

There's also a level of ableism at play, suggesting people with these personality disorders are faking their DID symptoms because of these personality disorders.

Remember too that this is the title of that paper:

It is not subtle that the goal of inventing Imitated DID was creating a legal defense for doctors who are sued by patients for alleged misdiagnosis.

And that they're trying to paint the patients who sued their doctors as part of this "hard to detect" group made up of liars, druggies, and prostitutes who can't be trusted.

The underlying point is clearly that these patients can't be trusted in court.

By publishing this, any expert witness could cite this in court when a doctor is sued for malpractice by a patient with DID.

That's the real goal. That's the reason this whole theory was invented.

The concept of Imitated DID was malicious and ableist from the start!

[actuallyadhd]

hiie!

i'm 18 and i've been trying to self-diagnose. i'm curious about adhd and abuse. i relate to the adhd experience of executive dysfunction, depression, rsd, time blindness, sensory issues, emotional dysregulation etc. but growing up in a super strict and abusive household i've never even had hobbies let alone hyperfixations. so is it possible? to mask so severely that you have no hyperfixations??

i've heard from diagnosed folk that have had an abusive childhood but they all say that it made them hyperfixate more as an escape mechanism. but then i went in the opposite direction, so maybe i don't have adhd? i might have had some hyperfixations ig but it never lasts as long as peope with diagnosed adhd say it does. so ig they are not hyperfixaions but just things i like a lot.

i also don't "stim", i feel like i've forever been understimulated as my mother would remove anything stimulating books/games/TV/music etc. any "stimming" actions were condemned and ridiculed (leg shaking, finger-tapping or even simple vocal stims), this has been enforced in my brain as socially rude and uncultured so uhh ig it could be that i've been masking. that could explain why i did so well in school because there was either math or no stimulation at all. but maybe i'm just having a bad time from all the other things and not adhd?

idk i am like 70% sure i have adhd but i have no access to a clinical diagnosis, so i'm doing extensive research and i want to be thorough before i can make any claims.

Sent April 12, 2024

It can be really hard to know whether some things are due to trauma or ADHD or something else. I have a friend who grew up in an abusive home and got assessed for autism but the clinician couldn’t give a diagnosis because the amount of trauma was making it hard to tease out what was causing which things.

I do think that a lot of ADHDers have trauma because of how we get treated due to our differences. That doesn’t mean ADHD is actually a trauma response; it means that sometimes, trauma happens because we are different due to ADHD. I can recommend Crappy Childhood Fairy on YouTube if you are interested in learning more about trauma and some ways you might be able to deal with it.

Hyperfixations/special interests and stimming are really common ADHD things, but they are not part of the diagnostic criteria. Have a look at our self-diagnosis post to find out more about how to figure this out.

Regardless of whether you have ADHD, you are welcome here. You may find some of the printables at the web site useful, so do consider checking them out.

Followers, what do you think about ADHD and trauma?

-J

[thecorvidforest]

loving reminder for young/chronically online systems that pretty much no matter what trait is seen as “the default” in your online system spaces, i can pretty much guarantee that there are systems who don’t experience/identify with that trait. you not experiencing it doesn’t make you a faker.

being fictive-heavy is normalized in your spaces? there are many systems who have few-to-zero fictives, and systems who have few-to-zero introjects overall. we’re one of them, and we know several others.

most systems in your spaces identify as queer and/or have queer alters? i guarantee there are cishetallo systems with no queer-identifying alters.

becoming a system because of trauma from abusive parents is seen as the default? there are tons of systems with amazing parents who became systems because of things like medical trauma, school bullying, poverty, etc.

you’ve never met or seen a single other system who seems to have formed from the same kind of trauma you did? i can nearly guarantee there are other systems who did. and even if there aren’t, that doesn’t mean it wasn’t “bad enough.” trauma is trauma. our brains don’t care what caused it, only that it was traumatizing.

being physically disabled or having XYZ other disorder is seen as the norm? there are plenty of systems who aren’t physically disabled in any way, and plenty of systems who don’t have XYZ disorder.

most of the systems you see seem to have lots of 3-dimensional, self-aware alters with lots of elements that differ between them? this isn’t the case for many many systems (and contrary to popular belief, identity disruption is only part of the diagnostic criteria for DID, not OSDD/UDD).

what i’m saying is, there are quite literally no traits that will not vary between systems, and that includes the medical ones. there are a lot of traits (or lack thereof) that don’t get much representation online, but that doesn’t mean they don’t exist or that they mean you’re somehow secretly faking.

[krak3n23]

Diagnosing Andrew Minyard

An hour long research adventure ft akums razor 

A serious note before we begin. I did this fun, I have no medical background besides also having been on a cocktail of medications for similar symptoms. If a medication is causing you to get worse instead of better: tell your doctor, don't quit cold turkey you might get brain damage, and medications are not a cure all. Thank you and lets begin.

Originally I went into this thinking that Andrew being on an antipsychotic was simply an oversight, or an under researched plot point. However, thinking about the fact that Nora has had this series in her mind for over ten years by the time of publication, I have decided to actually look into the idea. 

I have narrowed down Andrews diagnostic history and medications to two primary options. Either Andrew is on a fictional representation of real life antipsychotic medications or Neil is an unreliable narrator. (or of course… this is an oversight, but I’m not pursuing english to not give authors a benefit of the doubt.) 

There are a few antipsychotics that Andrew’s may be based on, one is ARIPIPRAZOLE. This medication, (like some other generation 2, or atypical antipsychotics), has the adverse side effect of causing an increase in irritation, being overly excited, and having a decrease in risk assessment. Aka, drug induced mania. It can also cause an inability to sleep, a symptom that Andrew experiences. 

The poor research, I think, comes in with another symptom: tardive dyskinesia. This condition is not uncommon in the list of side effects for antipsychotics and is the uncontrolled movement of muscles, like Andrew’s smile, however that is an uncommon form of the symptom. This side effect would also explain why Wymack is okay with Andrew not being on his medications for games. 

Personally I think if Andrew is on an antipsychotic, it would be this one. 

This medication implies Andrew having the diagnosis of Bipolar 1. This is due to Andrew not fitting the criteria of Schizophrenia. These are the two main disorders treated by antipsychotics, which means he likely has one of the two, if he is in fact on antipsychotics. Andrew, to our knowledge doesn’t experience hallucinations off of his medications, therefore he does not have Schizophrenia. 

Now for the second theory, Neil is an unreliable narrator, or the media was just villainizing Andrew further after the incident. There are cases of other medications causing mania, the only set that would make sense for Andrew to be on is antidepressants to treat either OCD, or PTSD. 

Andrew does have PTSD, and it would make sense for him to have become violent when triggered, as he is literally a metaphor for the fight response. Antidepressants are often used to treat the depression and anxiety of PTSD, therefore if this scenario is the correct one, the psychiatrist on Andrew’s case believed the incident to be a fight response due to his PTSD. 

Antidepressants however, rarely cause mania for anyone who doesn’t already have that symptom. This is part of the reason why people with Bipolar disorder often get their diagnosis after going through several combinations of drugs, their brains can have “unpredictable” responses to medications that treat depressive symptoms, and anxiety symptoms, of their disorder. This is why I think Andrew, at the start of the series, has undiagnosed Bipolar disorder. If he had been given a cocktail of medication I would argue he had it diagnosed, however we only hear of one medication. 

Andrew does mention hallucinations due to his medications, not in great detail, but he does seem to believe that during his time on them he had them, and delusions as well. These are both symptoms of severe mania episodes, and are why I think Andrew specifically has Bipolar 1. Drug induced mania is itself a classification under Bipolar, however I think Andrew had that already and the medication simply triggered prolonged manic episodes. Bipolar 2 I would like to rule out because Andrew lacks defining symptoms of Major Depressive disorder, while yes he is depressed, it appears more like Persistent depressive disorder, which according to the DSM-5 is less debilitating and is part of Bipolar 1. In addition to this, Bipolar 2 causes hypomania, which is less severe manic episodes, and quite frankly I think Andrew does have full on manic episodes even off of his medications, such as the incident that got him on the medication in the first place.

Either way, Andrew was not on a good medication for his brain chemistry. Especially since he would miss days and the external manic symptoms would go away, I do actually think he was on an antipsychotic. Some generation 2 antipsychotics do cause manic symptoms, but this is typically noticed during early usage. Andrew’s frequent misuse of the drug, smoking, drinking and usage of a stimulant while medicated, could have prolonged this side effect. Generation 2 antipsychotics are also, as their name suggests, relatively new, especially for when the series is set. All of the side effects may not have been fully understood at this time, and honestly the court probably wanted the situation to go away as soon as possible and therefore didn’t do the routine check-ins with due diligence. If a patient experiences those symptoms for a prolonged time they are supposed to switch over to a new medication. 

So Andrew’s diagnosis, he has PTSD and Bipolar 1 disorder in either scenario and I do think he was on a generation 2 antipsychotic.