Aspergers and OCD

[FayetheAspie]

Can Aspergers account for OCD traits in the absence of OCD as a separate diagnosis? I'm just curious because OCD has been frequently referrenced in regards to certain traits of mine and yet if I mention the possibility of OCD around professionals, they simply give me this look and never look into it.

 

[Judge]

Can Aspergers account for OCD traits in the absence of OCD as a separate diagnosis?

Such a question would seem to imply that they are interchangeable disorders. But they aren't. Taking into account both similarities and differences between the two.

"Although both OCD and ASD have similar symptoms, they are different conditions. OCD is a mental health disorder, whereas ASD is a developmental condition.

ASD is a condition that a person is born with. OCD can develop during a person’s lifetime.
People with OCD tend to feel compelled to perform repetitive behaviors due to anxiety or distress, whereas autistic people may perform repetitive behaviors for enjoyment or to gain sensory input."

While I have not been formally diagnosed with ASD1, I believe it is a condition I was born with. Yet while being formally diagnosed with OCD, that happened beyond my childhood years. Steeped in some personal tragedies that all spilled out within a single year in my early 20s. A case of "cause and effect".

OCD vs. Autism: Similarities and differences

 

[FayetheAspie]

I know that they are two different conditions. I just did not know if germophobia, perfectionism tendencies, and checking things like doorknobs and light switches multiple times could be explained by Aspergers. If not, I don't understand why they did not seem to want to look into OCD as a possibility. Of course the conversation never made it past the germophobia part as far as I recall.

 

[FayetheAspie]

I believe that I have both. The OCD symptoms I believe developed mostly during my tweens.

 

[Judge]

I know that they are two different conditions. I just did not know if germophobia, perfectionism tendencies, and checking things like doorknobs and light switches multiple times could be explained by Aspergers. If not, I don't understand why they did not seem to want to look into OCD as a possibility. Of course the conversation never made it past the germophobia part as far as I recall.

You have to also consider who "they" are relative to their ability to properly identify one condition from the other. Clearly mistakes can be made:

"Yes, healthcare professionals can misdiagnose OCD as autism, and vice versa, due to an overlap of symptoms. A 2021 studyTrusted Source looked into the childhood diagnoses of adults later diagnosed with ASD. Researchers noted that children with autism might have symptoms mistaken for other conditions, such as OCD.

Additionally, children with both conditions may have had their symptoms attributed to only one condition."

 

[Judge]

I believe that I have both. The OCD symptoms I believe developed mostly during my tweens.

That would be closer to what my situation is. But then I could also understand how the trauma of "family dynamics" may be at the cause of your OCD. The sort of thing best explored with a psychiatrist.

In my own case I was evaluated multiple times by doctors, but at a much earlier era when autism itself was not clearly understood by the medical community at large. So the idea of being formally diagnosed with one but not both conditions doesn't surprise me.

 

[AprilR]

I am not sure about this. I was diagnosed with ocd in my twenties also. For me, ocd has come with intrusive thoughts, compulsions and reassurance seeking. These things did not exist in my childhood.

But since i was a child i had certain obsessions which is different i think.The difference is, not doing certain things when it comes to ocd thoughts makes me so anxious i cannot stand it. I simply cannot control myself from compulsive actions.

Whereas with my autistic obsessions, i just get mildly annoyed but don't get super anxious when i cannot perform the compulsion.

 

[Judge]

But since i was a child i had certain obsessions which is different i think.The difference is, not doing certain things when it comes to ocd thoughts makes me so anxious i cannot stand it. I simply cannot control myself from compulsive actions.

Whereas with my autistic obsessions, i just get mildly annoyed but don't get super anxious when i cannot perform the compulsion.

Points well made when it comes to OCD. That we are compelled to think and do certain things even if we consciously object to it. And that we think of it perpetually making it within the realm of an obsession.

I am guarded about my autism. However when it comes to my OCD, I'm downright secretive about it. Never telling much of anyone outside this online community with a certain degree of anonymity. A series of behaviors in which I know are not in my best interest to explain, let alone admit to.

Her: "Did you notice that was the fourth time you checked the door to be locked?"
Me: "Exactly."

Different dynamics in play besides things like being diligent, detail-oriented, or laser-focused. Things one can be without even having OCD or being neurodiverse.

 

[FayetheAspie]

I often have a certain number of times that I need to try to turn the knob when checking it. If I lose count or get distracted I feel flustered and have to start over. If I can't finish it leaves me stressed (like heart racing) and I often try to find reasons to go back and recheck. I am also this way about hand washing after handling certain types of things. I would think that OCD would explain this better than ASD. That said, I do have ASD stims that are enjoyable and/or calming to me like pacing or rocking.

 

[Judge]

I often have a certain number of times that I need to try to turn the knob when checking it. If I lose count or get distracted I feel flustered and have to start over. If I can't finish it leaves me stressed (like heart racing) and I often try to find reasons to go back and recheck. I am also this way about hand washing after handling certain types of things. I would think that OCD would explain this better than ASD. That said, I do have ASD stims that are enjoyable and/or calming to me like pacing or rocking.

Sure sounds like my brand of OCD. Pacing and rocking are my stims as well.

 

[Neonatal RRT]

Can Aspergers account for OCD traits in the absence of OCD as a separate diagnosis? I'm just curious because OCD has been frequently referrenced in regards to certain traits of mine and yet if I mention the possibility of OCD around professionals, they simply give me this look and never look into it.

Autism, ADHD, and OCD may occur together. The reason for this is that there is an area of the brain called the anterior cingulate cortex (ACC), the "switchboard" that regulates several areas of the brain, and it's this area of the brain that is affected in all three. If you have one of these diagnosis, then you're likely to have, more or less, some symptoms of the other two. Obviously, this is individualized. One diagnosis may stand out as the primary.

The ACC uses serotonin as the primary neurotransmitter and uses the 5-HT2A receptors, which are generally "excitatory". Many autistics will have a lower density of 5-HT2A receptors in the ACC than non-autistics, furthermore, there can be genetic abnormalities in the genes responsible for serotonin binding and transport. The end result is that there can be a significantly lower level of serotonin activity within the ACC than non-autistics.

There are medications called selective serotonin reuptake inhibitors (SSRIs). These work on the 5-HT1A receptors. The 1A receptors are often found in those other areas of the brain controlled by the ACC, and tend to be "inhibitory". SSRIs, as their name implies, blocks the reuptake of serotonin, allowing serotonin to remain present longer. SSRIs may help some folks with their symptoms, but really doesn't address the underlying issue, that is the limited binding and transport of serotonin in the ACC, and as a result, may have limited effect for autistics.

However, within the context of autism, if there is low levels of serotonin activity in the ACC, then the downstream regions of the brain controlled by the ACC are not going to operate normally, and may result in ADHD, OCD, depression, anxiety, and their other common symptoms. Utilize another medication that acts like serotonin and has a higher affinity for the 2A receptors in the ACC (like psilocybin/psilocin), allowing the ACC "switchboard" to operate normally, then those symptoms are likely to be relieved.

Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity? - PMC

The ‘PSILAUT’ protocol: an experimental medicine study of autistic differences in the function of brain serotonin targets of psilocybin - BMC Psychiatry.

 

[FayetheAspie]

I'm not interested in medication; however, those are some interesting neurology facts.

 

[Neonatal RRT]

I'm not interested in medication; however, those are some interesting neurology facts.

Knowledge is key to making informed decisions.