schizotypal or ASD?

I have been meaning to write about this one for a long time. Since as far back as when I first started this blog. It’s a topic I find rather complex and at the same time somewhat near to my heart since I now identify rather strongly both with ASD and schizotypal disorder. My original intention was to include as much actual research as I could. But I’ve had to admit that the whole research angle just isn’t going to happen with me. So it’s just going to be little old me speculating on the topic as best I can. There’s a good chance this is going to be a bit long and a little rambly, but I hope I’ll still be able to get something relatively useful out on the page.

Schizotypal disorder and autism spectrum disorders both cause social awkwardness and can in some cases seem very similar. I’ve encountered at least one other person with schizotypal disorder who was assessed for autism spectrum disorders before landing on schizotypal disorder. I was too. Although it needs to be said that it is entirely possible to have schizotypal disorder or schizophrenia without having any of the “autistic traits”. I’ll elaborate on what these traits might look like later in the post.

Before I was diagnosed with schizotypal disorder, I was assessed for autism spectrum disorders. After the assessment I was told that I did in fact cover the criteria for an ASD diagnosis. This was quite a revelation to me.

I’d never thought of myself as possibly autistic. Sure, I’ve always been socially awkward, keeping to my closest friends as much as possible and acting much the shy wallflower any time I found myself without my friends. But the problems I was having didn’t really feel like the problems an autistic person might deal with. They were “me” problems.  I was unfortunately influenced by the misconceptions about ASD and simply couldn’t connect my own experiences with what little I’ve seen of autistic people in movies and tv.

People with Asperger’s were “weird” – that’s to say, not my brand of weird. As a kid, I played just fine with other kids my age. Sure, I was a mostly solitary child, who preferred to sit inside and draw rather than play outside with the other kids. But that’s because I’m introverted. I have no problem keeping eye contact, I just sometimes find faces distracting when I’m talking or thinking. I can’t seem to follow schedules and find routine boring. I hate math, love metaphors and have an excellent sense of humor, thank you very much. And I don’t have what one could consider “a special interest”. In fact, I tend to skim over many different topics and enjoy many different hobbies without fully immersing into a single one. I thought for a long time that “a special interest” in a topic automatically made you an expert, knowing every possible little thing, able to recite facts as if you’ve memorized every last detail. Just goes to show how little I knew.

I’ve later learned that all these things were misconceptions perpetuated by media that simply didn’t understand autism at all. I, like many others, had almost all my knowledge from movies and tv shows. The autistic character is usually either the completely non-communicative child who sits there, rocking back and forth fixated on spinning wheels and throwing epic tantrums when disturbed, or it’s the savant who’s autism is more like a superpower. So, basically either Rainman or the kid in that one Bruce Willis movie I forgot the name of. And the rest are more or less variations of the same two tropes.

In truth, those are only two flawed examples of a whole spectrum. The vast majority are relatively “normal”. Their brains simply function a little differently from the norm. It’s natural they would have some difficulties. A bit like a left-handed person living in a world made for right-handed people. And just like left-handed people, there isn’t really just one type of autistic person. They’re all different with their own thoughts and feelings and personal interests.

Furthermore, there were other autistic traits I never knew existed, such as sensitivity to certain stimuli like textures, sounds, smells, visual stimuli such as strobing lights – which who in their right mind even enjoys all that obnoxious flashing anyway?! As it turns out, I do have some sensitivity to some stimuli. I’ve always had a strong preference for soft fabrics over course and scratchy. I detest the smell of cigarette smoke and I find both visual and auditory “noise” exhausting. But I’ve always considered these things as normal – and they generally are. We all have things we like and dislike. They don’t have to be indicative of a disorder or disability.

Special interests are often the hallmark of an autistic person. But to say they work like a kind of superpower, giving them superhuman awareness and mastery of a topic they take a special interest in, is plain ridiculous. It’s true savants exist, but they’re incredibly rare. Special interests are more of a thing that brings joy and relaxation to the autistic person – even facilitates human connection, giving a sort of framework through which one can communicate with others, much like a hobby. But unlike a mere hobby, it can also arrest one’s attention to the exclusion of everything else including bodily functions such as the need to eat and sleep, and can make it difficult to focus on anything else.

Being passionate about a topic doesn’t necessarily mean you know every little thing about it. Sometimes a special interest can even be an annoyance rather than a passion, a niggling detail that you just can’t help but focus on until it grows on you and you realize that it’s become a part of you and this is just your life now. Someone caught up in their special interest genuinely can’t keep themselves from thinking and talking about it, even when it bores the people around them to death, or when they need to focus on homework instead. And as long as it’s bringing joy and meaning to their lives, why would they want to focus on anything else? I don’t believe I have any special interests like that. More often than not, I’m not particularly interested in talking about my hobbies all that much. Unless someone gets me going on a topic I’m particularly passionate about, I’m happiest simply quietly engaging in my hobbies by myself. I do tend to focus a lot on one thing at a time until I get bored of it and start looking for something else to focus on. But I can put those things away when I need to. I use them mostly to fill the silence, so my head doesn’t start filling it with things I don’t want.

Another big feature of ASD is the meltdowns. I’m sure most of us have seen at least one video of a kid having a screaming, crying meltdown somewhere on the internet. It can look like an epic temper tantrum, or a big emotional breakdown. But it’s not. It’s not something they can fully control. It’s a bodily reaction to stress and/or over-stimulation. The specifics and severity can vary quite a bit and can sometimes depend on the situation. I don’t think I’ve ever had a meltdown like that. Although I’ve had situations where I felt overwhelmed and my mind would just shut down on me and I’d either disappear into my favorite books for days or do nothing but play solitaire for hours until I’m able to face the world again.

The last autistic well-known autistic trait I want to mention here is “stimming”. This can be rocking, fidgeting, rubbing your arms or legs, or other forms of movement with a repetitive nature. People stim for many reasons, typically during strong emotion, such as to get rid of excess energy when excited or to self-soothe when anxious. I’ve sometimes had periods where I’d do something like this. I’d bounce my leg when excited or anxious, at one point I had a little “delicious food dance” where I’d rock from side to side, sometimes I’ll tap my foot. When I was little I’d have this bedtime ritual were I had to rub a corner of my comforter all over my body before I went to sleep.

So, as it turns out, I was never aware of just how many autistic traits I actually do have. Besides the aforementioned examples, I learned at the age of 27 that I can’t actually take a hint. So many things just fly straight over my head and I never really noticed before. Later I asked my mom if she knew and she said: “Oh, yeah.” Like it was the most natural thing in the world! It apparently never occurred to her in all those years to, y’know, mention that to me. It would have been nice to know sometime during my teen years, when I felt like I was somehow stuck behind a glass wall that I couldn’t figure out how to get past, or later when I started wondering if maybe words didn’t mean the same thing to others as they did to me. Knowing my mother, she simply acknowledged this fact about me and quietly adjusted her own behavior to accommodate my ‘quirk’ without thinking too much about it. Unconditional love and acceptance can apparently have its downsides too.

Anyway, as I was saying, the social awkwardness of schizotypal disorder is very reminiscent of that of ASD’s. At least on the surface. It made me think that perhaps the two are somehow related. I’m certainly not the only one who’s noticed the similarities. I’m half-convinced that I was born with ASD which somehow evolved into schizotypal disorder as I grew older. Perhaps my aspie brain couldn’t cope with the strain of trying to live life as if I was normal, and the stress of it developed into a mental disorder? Although on the other hand, I don’t think people with ASD are necessarily more likely to develop STPD than anyone else. Both do have a genetic element, making each more likely to surface in some families, but I don’t think the actual genes involved are the same.

I’ve heard some people mention the possibility of autism and whatever causes schizophrenia and schizophrenia-like disorders belonging to the same broad spectrum, simply residing on opposite ends of the bell-curve. Sort of like this:

Human Spectrum Bell-Curve

Although in reality the colors would probably blur together a lot more.

So, the reason those who suggest the two reside on opposite ends of a spectrum give for the theory is that while both are characterized by social awkwardness, the underlying reason for the awkwardness appears to differ. Where those with ASD, roughly speaking, tend to be more oblivious whereas those with schizotypal disorder and paranoid thinking, in particular, tend to be more hyperaware of other people’s intentions to the point they over-interpret and basically assume the worst. In this regard, perhaps my brain works more like that of ASD than the schizotypal, so I don’t know that this is necessarily true. The truth is probably rather more complicated than what a neat, little model can fully explain.

While looking up the possible relationship between ASD and schizotypal disorder/schizophrenia, I found a research article that startled me quite badly. It was about how schizophrenics with autistic traits had a bleaker prognosis than those without autistic traits. I wish I’d saved the article as I never got to read the whole of it, nor can I remember where I found it. I was too busy going “oh, crap. I’m so screwed!” And have been a little leery of seeking out more articles like it.

Despite my initial scare, the interesting thing for me here is that autistic traits + schizotypal traits makes for a slightly more complicated progression compared to only having one or the other. This suggests to me that the two are different, but can sometimes overlap. Thankfully, it’s not as bad as I initially thought when I first saw that one article. At least in my own case.

In practice, rather than looking at it as an “either-or” situation, I consider myself as having both ASD and schizotypal disorder and try to make concessions in my life to accommodate both. I know for a fact that I struggle with social relations, that my hobbies sometimes take up a little too much time, and that stress causes my mental state to deteriorate. So, it’s basically about knowing my own vices and weaknesses and taking steps to compensate for them so I can live as normal and comfortable a life as possible. It’s not so much about putting myself in one box or the other. It’s taking the elements of each that match my own life and try to learn from them.

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