There’s No Wrong Way to Eat Diseases

Asperger syndrome has been hypothesized as existing on the OCD spectrum? Say whaaaaat, Wikipedia?!

Well, I guess it’s not that far-fetched. I was thinking about how it seems OCD and Tourette’s awareness both have the same color associated with them (teal) and happened to come across this. Maybe I’ll meet someone with autism and we’ll say:

“Hey, you got your autism on my OCD!”
“You got your OCD in my autism!”
“Two great disorders that taste great together.”

There’s no wrong way to be mentally ill/developmentally disabled!

Advertisements

Don’t Hate Me Because I Look Crazy

GunProblem

This could also be titled… “I haven’t posted enough about Adam Lanza yet.”

The above image was going around the internet a while back, and I don’t know who made it. I would like to know so I can slap them. My rant about this is long overdue. Way, way overdue.

It doesn’t matter how you feel about guns; it’s wrong to judge anyone based on how they look. Some crazy people look crazy, yes. But some serial killers (like Ted Bundy and H.H. Holmes [no relation to the retail appliance store, hhgregg… well, hopefully no relation… also no relation to writer Anthony Boucher who used the pen name “H.H. Holmes,” appearing as an endorsement on the back of my John Collier book of short stories, leading my husband to jokingly remark that I only read books approved by serial killers :\]) … anyway some serial killers were known for being handsome and charismatic, allowing them more leeway to get away with their crimes. They were able to manipulate people because they were actually pretty likeable and didn’t look, you know, totally insane and weird.

As I posted previously, my mom had Graves’ disease, which causes (in some cases) bulging eyes. There are also other things to cause bulging eyes (though less common), so there’s currently no telling if Lanza had Graves’. Certainly, I would not be surprised if, after years of having undiagnosed Graves’, a person started to do some crazy stuff. Thyroid storms can cause a racing heart, a feeling of nervousness and being hyper, severe sweating and dehydration, among other things. I can see how maybe theoretically a person with autism could perhaps not be as aware of something being wrong or not good at communicating that to others. And the eye bulging usually happens gradually, so family members tend not to notice it. But this is all just speculation. Way, way up in the clouds, crazy speculation. But not as crazy as killing people.

Anyway, my mom’s eyes had a weird stare, as long as I knew her — and she didn’t kill anyone. Really. I promise.

It’s not good to judge people — but if we’re going to, let’s judge them for things they’ve done, or said — not for how they look.

eWhat?

Eh, I don’t know about this eHow page. It says “How to Distinguish Between Autism and OCD.”

“Understand that both autism and OCD are characterized by obsessions and compulsions.” Really? “Obsessions” which are simply enjoyable, fixated interests are not technically true obsessions. There is also a difference between a compulsion and a self-stimulating behavior.

“Know that autism has been strongly linked to genetic components, while OCD is often a response to life experiences.” Um — as far as I understand, both often have genetic components. If anything, OCD’s genetic link is stronger — especially when you factor in the odds of people with Tourette’s having a relative with OCD. But it is true that some people with OCD develop it after a traumatic experience and it is an anxiety disorder, not a pervasive developmental disorder.

“Realize that most autism patients suffer from internalized obsessions, while OCD patients suffer from external obsessions. For example, an autistic individual might be obsessed with counting or finding synonyms to words, either silently or outloud, while someone with OCD might fear leaving the house, becoming violent or becoming contaminated with germs.” I realize this says “most,” but it should be noted that OCD rituals are capable of being purely internal. Though a person with OCD does have some type of concrete fear at the root of their compulsions (such as leaving the house, becoming violent, or becoming contaminated), compulsions are often mental and done in the person’s head, unbeknownst to any observer.

How to distinguish between good and eHow pages: Understand that both good and bad eHow pages are characterized by good intentions.

Know that bad writing has been strongly linked to genetic components.

Realize that most people who write bad articles thankfully only do so in their heads.

It’s a bird — it’s a plane — it’s autism — no, it’s OCD!

http://www.ocfoundation.org/EO_Aspergers.aspx

This article, entitled “Differentiating Between Asperger’s and Obsessive-Compulsive Disorder,” goes into detail regarding a subject I myself obsessed over once. A few years ago, before I suspected having OCD, I found the Wikipedia article about Asperger’s syndrome and felt I identified with it a lot. Like people with AS, people with OCD find themselves engaging in repetitive activities and have obsessive thoughts and interests. However, AS is more similar to Obsessive-Compulsive Personality Disorder in that people with AS have obsessive thoughts/rituals that are not anxiety-driven, and not considered an annoyance or interference, but rather a preferred way of living.

Apparently, males outnumber females in AS (and probably autism in general), but not OCD. Tourette’s and tic disorders are more frequently seen in men; it’s been hypothesized by some that the genetic predisposition for OCD and TS is a very similar mechanism, and simply manifests differently in men versus women; so in men we tend to see tics more often, in women we tend to see OCD.

From the article: “In summary, individuals with AD or OCD may evidence similar symptoms, including, shifting, incompleteness, anxiety, compulsions, and adherence to rituals. In general, individuals with AD are more socially impaired and demonstrate difficulty forming reciprocal relationships. In AD, individuals may have obsessive thoughts surrounding a restricted area of interest, but these thoughts do not likely cause a marked level of anxiety or distress as they do in OCD. Lastly, compulsive behavior in OCD is completed with the intent to minimize anxiety. In AD, individuals derive pleasure from engaging in these activities.”

Tourettic OCD

Yes, there’s really something called Tourettic OCD.

Apparently in cases of Tourettic OCD, people get the urge to do OCD-like compulsions, but the urge arises from a physical feeling; not a fear or obsessive thought. According to the article:

“TOCD sufferers report discomforting sensory experiences such as physical discomfort in body parts including hands, eyes, stomach, etc., or a diffuse psychological distress or tension, for example, ‘in my head’ or ‘in my mind.'”

What to make of all this? Will there one day be Chronic Obsessive Transient Tourettic Compulsive ADHADD — with a dash of Autism?

Revisiting Alphabet Soup

I realized that a previous post I made inspired me to rant about something. This could be an insignificant detail I’m getting all devilled up about, so if so, please go on about your day.

This article details Jennifer Huettner’s account of what Adam Lanza was like. I linked to it a few posts back as a minor mention but now it’s what I’m going to focus on. She is a high-school Latin teacher. I’ve been interested in Asperger’s for probably several years now, and I originally found out about the article from this thAutcast.com page. Huettner makes the statement: “He had Asperger’s,” which is a pretty clear one, and probably true. But let’s look at some other things she says. For instance: “He was very OCD. He’d clean the desk with Purell.”

I’d like to take a moment and compare this to another popular scapegoat: PMS. People (including women) frequently blame a woman’s behavior on PMS. (It is intrinsically wrong, but not a topic for this blog.) They then begin using the abbreviation in a way that results in incorrect grammar. Like this episode of Doctor Who where people keep saying “ATMOS System” when “ATMOS” stands for “Atmospheric Omission System” and so what they’re really saying is “Atmospheric Omission System System.” People will often say something like: “Oh, that’s just her PMS.” But then somehow it evolves into: “So-and-so is PMSing.” What? PMSing? Pre-Menstrual Syndroming? Similarly, it would be incorrect to say that someone “was very OCD” or, essentially, “was very Obsessive-Compulsive Disorder.” A person cannot be a disorder. Therefore, it doesn’t make sense.

Now, I’d also like to point out that I’m certainly guilty of having used OCD in this way before. As a person with OCD who’s done a lot of research on the disorder, I’m not likely to attribute it to someone who doesn’t actually have it; but I am just as capable as a non-OCD-knowledgeable person in the wonderful world of Ability to Use Bad Grammar. In fact, I’m sure I post tons of things which are technically bad grammar all the time, without realizing it, because I just don’t make it a point to be a complete expert on grammar. I’m not saying Huettner is wrong about everything just because she said something incorrect in this one instance; simply, that we don’t know whether she’s truly insinuating Lanza might have had OCD, or if she’s using OCD in the same scapegoat way that people most frequently use it: to describe someone who is unusually neat, tidy, and orderly.

For example, it would be a lot more clear that Lanza exhibited symptoms of OCD if Huettner had said any one of the following statements:

  • “He was very OCD. He’d clean the desk with Purell over and over again.”
  • “…He’d clean the desk with Purell five times.”
  • “…He’d clean the desk with Purell two times at the beginning and end of class and then he had to count to 10 in his head or something bad would happen.”

or Heck, even:

  • “He was very OCD. He’d clean the desk with Purell only once, but he couldn’t stop worrying that it wasn’t really clean and talked about it repeatedly during class.”

So you see my point. It’s hard to tell whether this is one of those times OCD is just being thrown out there like some common adjective synonymous with “oh, by the way: that guy was not a complete slob.”

This doesn’t mean it would surprise me at all if Lanza did have OCD. I know several people online — and one person in real life — who have a co-morbidity of AS and OCD. I would wager that combination is not uncommon amongst people who have either disorder. I just tend to approach everything I read and hear with healthy skepticism (and hopefully not overly zealous scrupulosity ’cause that would kinda mean I’m using my OCD blog to worsen my OCD problem.) Also, it’s definitely clear that there is no established link between autism and this kind of violence, so he seems to have had other things going on besides just AS. I probably don’t need to mention to readers of this blog that there is no link between OCD and acts of violence, either. There’s no limit on the amount of disorders a person can have, and Lanza may have just had a lot going on.

Someone cleaning a desk, even only once, with Purell before class would be an unusual thing to do; I’m not arguing with that. But someone with Obsessive-Compulsive Personality Disorder, who is preoccupied with more of a general perfectionism rather than with specific obsessions and compulsions, could engage in this behavior every day and as long as they aren’t bothered by doing it, it would not — this activity alone — actually place them under a diagnostic umbrella of Obsessive-Compulsive Disorder. (Someone correct me if I’m wrong, of course, but this is my best understanding.)

When I was in elementary school, I washed my hands every day before lunch. The other kids noticed and made fun of me for this, and would tease and ask me why. I definitely have OCD, and I definitely did have a repetitive hand-washing compulsion; however, this one instance of washing my hands before lunch at school, alone, would not have been indicative of this. It was, however, the only part other kids outwardly noticed (other than the rash on my hands — which did not occur from one simple hand-washing before lunch.) Also of note, I never was a fan of hand sanitizer, and have always disliked using it. I feel that it dries my hands out just as much as hand-washing does. The real peace for me is to resolve not to wash my hands if I know I really don’t need to; however, as a child I had more of a mental block against sanitizer because it wasn’t part of my “ritual” and I wasn’t sure my hands would really be clean. And, it’s kind of true — if you take a pile of dirt, and pour sanitizer over it, it’s not really clean; it’s just sanitized dirt.

Huettner indicates that Lanza had a good mind for grasping the structured language of Latin. We also know that he tended to do things the same way over and over, and wear the same clothes over and over. However, there’s a big difference between whether someone behaves this way out of compulsive need or genuine preference.

“Alphabet Soup Syndrome”

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.