Social Anxiety vs. Autism

Discussion in 'Mental Health Disorders' started by RumoursOfMyDemise, Apr 11, 2012.

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  1. RumoursOfMyDemise

    RumoursOfMyDemise Well-Known Member

    Okay, well...I'm not very sure where to head is very cloudy right now and I'm having trouble expressing myself clearly, but here goes...

    I have had severe social anxiety for as far back as I can remember, but being an outcast who was relentlessly bullied in high school only made this even worse. My anxiety only seems to get worse as the years go on, rather than improving at all, even though I have previously put in tremendous amounts of effort to beat it. I'm now at 137 on the Liebowitz Social Anxiety Scale - the worst I have ever been in my life. My anxiety has went through the roof lately - I now even seem to get anxious for no apparent reason, coming close to a panic attack. I have never been anxious for no identifiable reason before, and it's kind of freaking me out. I don't know if this is a side effect of the medication I'm currently on (Sertraline), but I've had this quite a few times since I started taking it in January, and I'm now going to slowly decrease my dosage and come off it since it appears to be doing me far more harm than good. This higher than normal background anxiety might be due to intense stress around uni, but I'm not sure...or it could also be to the high amounts of caffeine I've had lately, I don't know...

    Anyway...what I'm wondering is whether I have just very severe social anxiety, or an ASD such as Asperger's as well. I'd greatly appreciate it if suffers of/ experts on both gave me their opinions and advice on this one.

    I was seen by a specialist on female autism back in December, but the general outcome of the diagnosis was basically that she doesn't know whether I'm autistic or not. This is despite her being an expert in the subject, and after discussing with colleagues. I'm wondering what to do now...I'd much rather someone could just say that I either have it or don't, because this is driving me insane. Although I have both the social and communication difficulties commonly seen in people with Asperger's Syndrome, she can't give me a diagnosis, because I lack the full 'triad of impairments'. In other words, I don't show the repetitive/ stereotyped behaviours typically seen in people on the autistic spectrum. I have no problems understanding body language, sarcasm, jokes, differences in tone or pitch of voice, facial expressions, etc. I also have higher than average empathy, hate routine, and don't have a narrow range of interests. I am, however, very sensitive to both light and sound, which is typical of people on the spectrum. New experiences usually make me anxious. I've always had this feeling of being different to other people in a way that I can't really explain. I've never really felt able to relate to others my age. I make a lot of social 'faux pas', but this is perhaps more due to my social anxiety, and I suppose because of the nature of my anxiety, what is a 'faux pas' socially is more down to my interpretation. My social skills are almost non-existent. The only friends I have are online, and I can't really have a normal conversation with anyone other than my immediate family members.

    My question is: based on the information I've given (I can give more if anyone wants, but don't really feel like going into it right now), what do people who have had experience of both conditions think? And what would be the best way to move forward with my life/ recover? The main problem is that if it is just social anxiety, if I kept facing social situations, my anxiety should, in theory, gradually reduce. I have tried this many times before and only ever seem to make a slight improvement after putting myself through intense discomfort to face my fear, and then just relapse and the anxiety gets worse again, and I become severely depressed. On the other hand, if I AM on the autistic spectrum, facing my fears is only going to cause me intense discomfort, without me ever showing any major signs of improvement, if I am to believe what my psychiatrist has told me. I want to fight this so badly - my anxiety is the worst it has ever been right now, and I'd do ANYTHING to feel even marginally more comfortable around people - but if I have Asperger' there really any point in me fighting it at all? This has been getting me down so much, because I feel like I can't really move on if I don't know which approach I should take.

    Apologies again for the jumbled and somewhat ranting post. Many thanks to anyone who took the time to read everything and to anyone who responds.
  2. Mr Stewart

    Mr Stewart Well-Known Member

    I want to say right off that I'm not an expert and my experiences with autism is limited. I suspect that I may be on the spectrum and am on a psych assessment waiting list to find out, but am sort of in the same boat as you right now, severe social problems and not sure precisely what the clinical reason for them is.

    What you are describing sounds to me as being similar to my niece's situation. She is 15 years old, was initially diagnosed with Generalized Anxiety Disorder, then recently that was changed to pervasive developmental disorder - not otherwise specified (PDD-NOS). PDD-NOS is an autism spectrum diagnosis, but atypical. From what I understand, there certainly is benefit to treatment with ASD's. It's not a lost cause by any means.

    So first off: Sertraline + caffeine. On this I have personal experience. I was on sertraline for 6 weeks (50mg two weeks then 100mg four weeks). It made me a nervous, irritable, angry mess. It caused me to relapse on an old self harming habit. I think this is definitely a good place to start in figuring out what's been triggering you lately. Apparently sertraline can be effective for anxiety but it also has a reputation as being one of the more "nervous" of the SSRI family. Which to me seems like it either helps or it makes things worse without a whole lot of middle ground. I recommend discussing with your doctor about the recent spike in anxiety, maybe see about switching to a new med. My doctor switched me directly to Lexapro (Cipralex) with relatively good results. The irritability went away within a week for me.

    As for diagnosis, might want to look for a second opinion. Pin down a yes or a no. If no, what is it? What's the best way to treat it? Should you try therapy? CBT? etc. etc.
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