AUTISM AND COMORBIDITY

Autism, OCD, and ADHD

Can someone have autism, OCD, and ADHD at the same time? Well, the answer is yes, an individual can have autism and other comorbidities such as the above-mentioned and even others like epilepsy and ADD just to mention some. There is a tricky thing to be aware of though, and that is three disorders are different behavioral or mental conditions, but they all have overlapping symptoms that can make diagnosis very difficult because they can easily be misdiagnosed for the other.

Autism can easily be diagnosed as OCD or ADHD and the other way round because of the few similarities they all share. Before we continue, I want us to look at a few similarities found in all three disorders.

Similarities between autism, OCD, and ADHD

1. Repetitive behaviours.

2. Rituals or ritualistic behaviours

3. Obsessive interests

4. Insomnia

5. Tics

6. Impulsivity

7. Inattention

8. Hyperactivity

9. Anxiety

Of all these similarities, some autism shares them with OCD and some with ADHD. From here, I will segregate them for you starting with those that autism shares with the former.

Similarities not shared by autism and OCD

· Inattention

· Hyperactivity

Similarities not shared by autism and ADHD

· Anxiety

Looking at our nine similarities, you can see how easy it is to confuse each of these three mental disorders with the other and how easy it is for them to be mixed up. It’s because they are the same yet different. Therefore, it is very advisable to be able to tell them apart especially when you raise a child with autism.

Another thing to know is how each one functions in the brain and because I often cover autism, in this post we focus mainly on the two disorders. OCD causes OVERACTIVITY in the brain while ADHD causes UNDERACTIVITY. As you can see, they are the same but different. They contrast each other in the brain as I have mentioned that both of them are brain disorders, and I will explain how below.

The contrast between OCD and ADHD

1. OCD enhances activity while ADHD dims or kills it.

2. OCD promotes cautiousness triggered by anxiety while ADHD increases risk encouraged by impulsivity and no sense of fear.

3. OCD compulses or obligates fear that leads to anxiety that ends up in an obsession and results in excessiveness and ADHD erupts in fidgety, impulsiveness, distraction, carelessness, and forgetfulness.

For some years, it was hard for me to identify each. Like I always say, I only got a diagnosis from the doctor. Nothing more, nothing less. I had to learn and teach myself everything by constantly observing my son’s behaviours. Now that we understand the similarities and contrasts between the two, let’s look at each one individually starting with OCD.

What is OCD?

According to Wikipedia, Obsessive Compulsive Disorder (OCD) is a mental and behavioural disorder in which an individual has intrusive thoughts (obsession) and feels the need to perform certain rituals or routines (compulsion) repeatedly to relieve the distress caused by the obsession, to the point where general functioning is impaired (disorder). [Other emphases are mine.]

As you can see from our definition, OCD is a mental and behavioural disorder, and it is also an ANXIETY disorder. Now, the definition of OCD provided by Wikipedia defines it as a general term. Therefore, you might find that you don’t associate any of the behaviours it mentions with autism — I know I don’t. But I want to outline this.

OCD behaviours from an autism perspective

· Tics

· Hoarding

· Peeling and breaking of things

In autism, before an individual can fall into an OCD behaviour, this is what leads them to: do you remember that OCD is an anxiety disorder, right? What this means is that an autistic individual would have to have an anxiety of sorts and to escape that anxiety, they would need to “compulsively” perform certain behaviours long enough to subdue or suppress this anxiety.

These three signs and characteristics are very common in autism, and you probably might have seen at least one if not all of them, but I’ve seen them all and it took me a while to learn that they were OCD behaviours and not autism. Let me share with you when these behaviours are performed.

Why children with autism tic

Let me explain what a tic is: a tic is a regularly repeated twitching movement of a particular muscle, especially one of the faces. (To make a funny face is to tic). That’s an OCD behaviour an autistic child does when they are bored to death. Yes! Autistic children know the feeling of boredom but because they don’t know what to do or how to be so the feeling can go away, this causes them to be anxious, and to eliminate the anxiety they tic. When you see your autistic child tics, know that they are bored.

Why children with autism hoard

When children with autism experience what is called sensory overload, they hoard. They counter the chaos happening in their heads with one they can actually see — to be “in control”. They use physical clutter to declutter their brains. Many parents of children with autism are familiar with what I am talking about but what they don’t know is why their child likes a messy place. My son is one of those. Damn, that child is a hoarder!

The image below is of items of things he “collects”. As you can see, all boxes and containers are empty and belong in the trash bin but not on his watch. What he does is break what he can break, tear what he can tear, crash, and shred what he can. From there on, everything would be scattered all over the place and if you so much as try to even move a single of these an inch, then you must know you are declaring war.

Why they peel and break things

By peeling things, I don’t mean peeling potatoes or apples. Nope! I mean peeling as in vandalizing — as in destroying and terrorizing. If your child does this OCD behaviour, be very worried because what this means is that they are in big distress, they are scared and they are confused. Thus, reacting rather drastically.

During the start of the Coronavirus lockdown. Do you still remember the level-five lockdown? The hectic one? My son was peeling our wall and our floor like nobody’s business. He didn’t understand why he couldn’t go outside. He felt cramped inside the house. He wanted to run around, and the house didn’t give him enough space to do that.

There were plenty of things he wanted to do that were severely disrupted by the lockdown and he hated that with everything. He would tear staff, break things, and finally peel the floor and wall. There were times I am going to be honest when we would let him be for peace’s sake and other times, we had to take the punches because he was hell-bent on peeling the entire house.

That is why there is this myth or tendency that children with autism are violent. Yes, they can be but only because they are scared and confused. Do you see the crack on this image, on the floor and wall? That’s my son’s handiwork thanks to the level-five lockdown.

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition or disorder that affects how a person relates to their environment, that may involve inattention, hyperactivity, and impulsivity. Like OCD, ADHD apart from being a neuro-developmental condition, it is also a behavioural one. Now, let’s look at the three components of ADHD.

Inattention

· Difficulty in maintaining focus on one task.

· Appears as though not listening when spoken to.

· Easily distracted even when there is nothing distractive.

· Often forgets things they have learned previously.

· Forgetful and disorganized.

Hyperactivity

· Struggles to sit still and prefers to run around.

· Excessive fidgeting.

· Frequently climbing on everything and inappropriate places.

· Appear as though not comfortable when they are not in motion.

Impulsivity

· Frequently interrupts and intrudes.

· Lack of forethought and consideration of consequences.

· Tendency to act immediately and recklessly.

The image above is my son doing “yoga” on top of our refrigerator. For starters, he’s way too tall to fit there but does he care? No. Another thing you can notice is that he can easily fall and break his neck or something but all that doesn’t cross his mind. In fact, it doesn’t register at all in his mind. This is an ADHD moment right there and not autism or OCD. You’d probably ask yourself this: really, who does this? And the answer is an ADHDed child, whether they are autistic or not.

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