Psychiatrist's manuals like the DSM-V give the impression of a scientific classification, and yet ...
Does this patient have autism, adhd, obsessive compulsive disorder, schizotypal personality(*) disorder? Wait, these could, potentially, all be overlapping names for the same cluster of symptoms.
(*) I'm remembering this one as the personality disorder that can be credible accused of being another name for autism, and don't have the reference books on hand to check.
Schizotypal PD overlaps a *hell* of a lot with autism, but they come apart enough to not be quite synonyms. Schizoid PD is...autism, pretty much. It's only one of the autisms -- many autistic people don't fit schizoid criteria -- but not many people who fit schizoid criteria wouldn't be autistic (whereas schizotypal people are at most a smaller subset of autistic people).
ADHD is an odd category. People kind of see what they want in it. On the population level it's quite clearly distinguishable from autism, in a way that is not true of e.g. the cluster A personality disorders. The problem with "ADHD on the population level" is that it quickly becomes apparent it's not forming a recognizable 'concept' or 'type of guy', in the way autism still does, and personality disorders -- screwed up as *those* concepts tend to be -- still do. You end up with a "the 5% most impulsive people" cluster, which is probably not a thing you want to attach a diagnostic label to, especially not a super-early-onset and lifelong one.
(“Ever? That’s a big question! Well, better think about all the times my legs felt stiff. If I recall correctly, once was the 16th of June, 1994…”
That is totally how I would interpret that question.
Catching up on my backlog, just read this.
Despite the complexity and length of the post your writing remains very engaging throughout, it was a pleasure to read, thanks for writing it :)
Psychiatrist's manuals like the DSM-V give the impression of a scientific classification, and yet ...
Does this patient have autism, adhd, obsessive compulsive disorder, schizotypal personality(*) disorder? Wait, these could, potentially, all be overlapping names for the same cluster of symptoms.
(*) I'm remembering this one as the personality disorder that can be credible accused of being another name for autism, and don't have the reference books on hand to check.
Schizotypal PD overlaps a *hell* of a lot with autism, but they come apart enough to not be quite synonyms. Schizoid PD is...autism, pretty much. It's only one of the autisms -- many autistic people don't fit schizoid criteria -- but not many people who fit schizoid criteria wouldn't be autistic (whereas schizotypal people are at most a smaller subset of autistic people).
ADHD is an odd category. People kind of see what they want in it. On the population level it's quite clearly distinguishable from autism, in a way that is not true of e.g. the cluster A personality disorders. The problem with "ADHD on the population level" is that it quickly becomes apparent it's not forming a recognizable 'concept' or 'type of guy', in the way autism still does, and personality disorders -- screwed up as *those* concepts tend to be -- still do. You end up with a "the 5% most impulsive people" cluster, which is probably not a thing you want to attach a diagnostic label to, especially not a super-early-onset and lifelong one.
My mental model of ADHD is roughly, it's either
A) Actually, autism
B) Nothing wrong with them, but their teacher can't keep control of the class because the class size is too large
C) Nothing wrong with them, and they're trying to score drugs off their psychiatrist
Be careful with the "nothing wrong with" framing - things can be human-normal and still "wrong", in a sense, humans have all sorts of design flaws.
Having average or a bit below average "grit" is costly to a person, even if there's no distinct "ADHD cluster"!
And our society is loading more and more on this trait, both in broken schools and in increasingly abstract work environments
(See Paul McKenna, "Delusions", for the "isn't this one just autism?" hypothesis).