[flatline]

I have done a rigorous job of self diagnosis. I am autistic. I’ve also had the privilege of being able to pursue meditation, therapy, and other self development practices: I’m not as severely autistic as I was as a young man. I also have childhood trauma that I know contributes to many of my autistic presentations — see the last section on comorbidity. I also have some distinct ADHD symptoms but have never pursued that path because my hyperfocus tends to win out often enough that it’s not a hindrance to productivity. But it still causes problems elsewhere in my life.

For some people these diagnoses will be a very good fit with clear predictive outcomes. But many of us have a grab-bag of traits from several categories and still mostly get along in life, maybe with some assistance particular to one of these diagnosis but no more help overall than anyone else needs otherwise.

The diagnostic models suck. They are too broad here, too narrow there, misunderstood by professionals. I had a psychiatrist (mis)diagnose me as bipolar based on a 45 minute appointment when I was in some sort of crisis in my early 30s and that ended up haunting me years later when applying for a job with a security clearance. I didn’t even know about it at the time. This was one of the top rated doctors in a major metro area. What a sham.

The field is a mess. It has a terrible history of horrific abuse. Some autistic children still receive involuntary-to-them ECT. I think we should be supportive of research into these topics while also being critical of the very obvious problems with them.

[nelox]

Your experience illustrates something that often gets lost in the autism-vs-not-autism debate: many people don’t fall into clean diagnostic categories. You’re describing a profile that mixes autism traits, trauma adaptations, ADHD features, and developmental history, and instead of neatly labeling you, the system failed you outright with a bipolar misdiagnosis. That alone shows how fragile clinical certainty really is.

I think the most important part of what you wrote is that you changed over time. Whether that improvement came from meditation, therapy, maturity, trauma processing, or simply growing into yourself, it challenges the idea that autism is a static essence. Development, coping skills, neurology, and environment interact in ways the current diagnostic boundaries don’t fully capture.

Where I push back slightly is on the conclusion that self-diagnosis can automatically fill the gaps. For some people it’s deeply accurate and validating, for others it may explain one part of their experience but obscure another. As you said, many people carry a “grab-bag” of traits, and a single label can illuminate or compress that complexity depending on how it’s used.

You’re right that the field has a painful history and uneven present. Misdiagnosis is real. Forced treatment is real. Diagnostic tools are blunt instruments for a very diverse human reality. Supporting research while staying critical of the system makes sense, not because autism isn’t real, but because the categories we have are still evolving. Your story is a perfect example of why humility in diagnosis matters, whether it’s done by a psychiatrist or by oneself.

Edit:typo

[cnnlives736]

> The diagnostic models suck

Mental healthcare in-general tends to suck. I went for years to a boutique psych that had suspect people working for them and that would just increase dose until prescribing the max allowed of various meds.

What I’ve noticed is that if a doctor’s or dentist office looks stylish, consider moving to a different one. It’s not worth ruining your life, health, teeth, etc.

[ok_dad]

I was also misdiagnosed as bipolar due to a crisis years ago, which destroyed my career path in the military and post service. Since then I’ve been diagnosed as autistic, but much like you I’m just capable enough to kind of run the rat race but not quite capable enough to thrive.

[dyauspitr]

How though? Isn’t medical data private and you don’t need to share if you don’t want to.

[iambateman]

It’s never occurred to me that someone could become more or less autistic…could you say more about what that has been like for you?

[cromulent]

Not the OP, but after a couple of decades of people pointedly talking about eye contact, small talk, and body language, you learn “coping mechanisms” to deal with neurotypicals and make them more comfortable.

Did your sporting team have success on the weekend? Wonderful, direct eye contact, smile, mirror. Ok, now, to business:

[Aloha]

Commonly called masking - learning the 'rules of the road' for peopling - the hardest thing that young folks with autism or ADHD need to learn is that you must learn how to do this, the world will not (often or always) change to accommodate you - but once you do it, you can appear more or less normal most of the time.

[swatcoder]

There's nothing in the diagnostic models for nearly any mental health concern that presumes a patient would forever earn that diagnosis nor (certainly) that its presentation would be identical through their life even if the diagnosis stood.

There are some clinicians and unfortunately now many patients and caregivers that nonetheless take an essentialist view of diagnosis and come to identify their patient/self/child/peer with what's really just meant to be a guideline for support with ongoing dysfunctions.

In reality, most people face some fluctuating bag of dysfunctions over the course of their life, with fluctuating intensity, with contributing causes too diffuse and numerous to identify. They might be diagnosed squarely by one clinician with one thing thing at one time, then see some other clinician the same day who thinks the diagnosis was overstated or preposterous. Or they might find that a qualifying symptom that seemed very salient at one time of their life hasn't been an issue for them for a long time because of some new learned behavior, some change of circumstance, etc. Likewise, they may even find themselves facing new or greater dysfunctions compared to what they'd experienced or noticed before, precipitated through known or unknown reasons.

For people most intensely disabled by mental health dysfunction, they often can't escape that dysfunction entirely without the discovery and resolution of some kind of radical physiological or environmental issue.

But for the majority of people who just found that they had a hard time with their daily life, but were otherwise independent, and received a diagnosis that helped them see some constellation of related factors and opportunities for accommodation or treatment, things are hardly so static.

For most of early psychology, this marked the distinction between "psychotic" and "neurotic" presentations. The former represented a disruption so severe that escaping disability and achieving independence were largely out of reach, whereas the latter were understood to be real but fluctuating or even ephemeral disturbances.

It's not really until very recently, when so many people started to obsess with "identifying" themselves with this thing or that thing in some kind of permanent way, that this distinction began to fall out of mind.

In the case of those diagnosed with autism as part of generally independent and functional lives, it's not hard to find people who have experienced changes to the symptoms that originally qualified them for the diagnosis -- sometimes positively, sometimes negatively; sometimes during certain times, sometimes permanently. It's also not hard to find people who received such a diagnosis at one time and either felt comfortable fully rejecting that diagnosis at some later time or had a clinician who strongly questioned it or refused to confirm it. None of this stuff is static and much of it is subjective.

[cwillu]

> Some autistic children still receive involuntary-to-them ECT.

Adults too; ask me how I know.

[skrebbel]

How do you know?

[doright]

I strongly believe I was misdiagnosed with autism when in reality the traits were caused by traumatic backlash from those I was supposed to trust towards ADHD traits that would have calmed down after adolescence. The diagnosis was largely a red herring for me and led me down treatment paths that did not address the root of my issues, and I believe I suffered unnecessarily as a result. It is insane to me that people are sooner to blame vaccines and diet than childhood upbringing/environment for causing symptoms construed as autism or ADHD. It makes sense though - no parent wants to be blamed for their child's lifelong disorder, just as mine still don't to this day. Cancer might just be curable, but a parent who refuses to change their mind will never be.

I am doing better these days but I sometimes wonder how I would have turned out if I got help sooner, instead of spending years and years searching for the wrong kind of help. It doesn't help that society is talking more about this and inadvertently leading people to believe that these problems are just the way things are, without considering upbringing and environmental factors.

At the same time, blaming the wrong problem is different then spending all one's time blaming the right problem, which is different than letting go of the past and doing the best one can with one's life. It is nearly insurmountable for me but I try to put forth an effort each day.