For some people, disorders occur in clusters: such as ADHD + OCD + Tourette’s or Asperger’s + OCD + TS or + AS + OCD + ADHD + TS. I’ve also heard there can be a financial incentive for schools to diagnose kids with disorders, particularly ADHD, but that’s a whole other discussion, and a topic on which I need to do much more research. Regardless of that, it can be easy for us to get stuck on labels, and worrying about what is “wrong” with us — but sometimes those labels have a place. Sometimes they help to explain things about our lives which otherwise simply wouldn’t make sense. They can also help others to understand us and once they know the reasons for our “weird” behavior, it doesn’t seem quite so “weird” anymore. Sure, I have tics, but place me in a room with a bunch of people with TS who shout a lot and I’m probably going to be distracted and irritated at first. But if I know it’s a tic, I can get used to it and relax.
However, if our unusual ways aren’t interfering with our lives, placing a bunch of labels on someone unnecessarily just creates confusion, and may sow the seeds for problems that otherwise wouldn’t have been there — especially when over-medicating is involved. Recently I talked to a Mom whose child has the AS + OCD + TS + ADHD combination, and she was describing to me how he’s on a new medicine which makes his tics better, but his ADHD worse.
Why do these disorders occur together? And really, in the scheme of things, how common is it? I can’t find my copy of Brain Lock right now, but I seem to remember that the rate of OCD in the general population is about 1 in 200. OCD amongst people with TS however, I remember to be about 1 in 40.
And that makes sense. There is strong evidence of a genetic link, specifically between these two disorders — in other words, they may actually be related to one another. But there is also evidence that in some people with TS, it is linked to ADHD — and I believe it is particularly things like coprolalia that are more often linked with ADHD. This means that basically, we may have two different kinds of TS — one that clusters with OCD, and another that clusters with ADHD. But what about the people with all three?
With AS, it’s interesting because AS and OCD are often misdiagnosed for each other. They both involve stereotyped, repetitive, compulsive behaviors — but the motivations for these behaviors vary, and that’s where the difference lies. But it is possible for a person to have AS and OCD, as was theoretically the case with Adam Lanza. Although I want to be perfectly clear that for all we heard in the media about Lanza and his AS, we still do not have a confirmed diagnosis. Just what is probably a pretty reliable opinion from one of his teachers.
So, maybe our alphabet should be ASOCDADHDTSADDOCPDCTDTTD. Or, ASOCDHTP.