I Don’t Mind if You Say You Have ‘a Little OCD’
It’s become common for people to use diagnostic terms to describe themselves, saying that they are “sort of autistic” or “a bit bipolar” or “a little OCD.” Some say they are “addicted” to Twitter. Or they casually toss around trauma-therapy terms like being “triggered.”
Many mental health advocates see such comments as trivializing or demeaning, a mockery of those with genuine illnesses. Describing someone as “kind of ADHD” or “addicted to their phone” only evokes negative stereotypes and stigma, these activists contend.
But as a person who is on the autism spectrum and has struggled with heroin addiction, I don’t think such statements are automatically harmful. On the contrary, recognizing that neurodiversity exists among people who don’t meet diagnostic criteria helps humanize those of us who do. After all, if our experiences are completely distinct from the lives of others, doesn’t that make it harder to empathize with us? If our feelings and sensations are totally alien and unlike those of neurotypical people, isn’t that the definition of dehumanization?
Learning that personality traits lie on a spectrum was liberating for me. Being unsettled by change is on a continuum with being so upset by a break in routine that you can’t function. Being sad is an aspect of depression; ordinary stage fright is real anxiety. While having these feelings shouldn’t by themselves qualify people for diagnoses, it can allow them to consider what it would be like if they were magnified, overwhelming and ceaseless — and how hard that would be.
Diagnostic labels can be a double-edged sword, of course. For me, figuring out as an adult that I am autistic was a relief. Previously, I’d seen my compulsivity, over-sensitivity to noise, smells and tastes, total absorption in ideas and difficulty connecting with people as evidence that I was selfish and inconsiderate. The strategies I used to cope with my sensory overload by managing my environment made me seem bossy and rigid; my intensity and the specificity of my interests made it difficult for me to connect with others. Eventually, my loneliness led to self-medication with cocaine and heroin — followed, fortunately, by recovery.
Learning that my seemingly unrelated symptoms are part of the same syndrome and that others share a similarly odd mixture of traits allowed me to manage them better and hate myself less. It turns out I’m not even that unusual in self-medicating autism and developing addiction, though research on this connection is in its infancy.
During my recovery, learning about my autistic traits also helped me recognize that the same characteristics that often made life difficult for me could also be strengths. Applied in the correct context, my obsessiveness, sensitivity and intense interests helped make me successful as a writer.
For some people, however, labels are all stigma and limitations and no help. A young boy who finds out that he is autistic may assume he is doomed to eternal friendlessness rather than viewing socializing as an area where he may have to learn new skills and use extra effort. A woman who learns that she has bipolar disorder may fear that it means she will not be able to live any of her dreams.
Seeing personality traits and diagnoses as fixed and unchangeable — rather than as tendencies or default settings that can often be adjusted — is part of what makes labels harmful. If you view autism as meaning that you are incapable of having friends even as you yearn for them, you probably won’t make an effort to develop social skills and the diagnosis could become a self-fulfilling prophecy. If instead you see it as an explanation for why relationships are especially difficult for you, you can learn from others like you who have made changes and from professionals about strategies that can help.
This is another reason it’s important to recognize a spectrum that spans both typical and extreme behavior is helpful. A spectrum isn’t set in stone: People can often move along it over time, and the line between what is typical and what reflects a diagnosis is a gray one. With the right help and support (which may include medications, therapy and peer connections as well as education), harmful tendencies can be mitigated, while those that lead to flourishing can be cultivated.
As my friend Alissa Quart, the author of an early book on this subject titled “Republic of Outsiders,” told me, when typical people casually identify themselves with those who have disorders, it’s “a sign of how those once viewed as outsiders have affected those at the supposed center, not only transforming what is possible for some, but also what so-called normal means for many.”
To be clear, I am not arguing that severe mental or developmental disorders can’t be profoundly disabling or that people who have them always can or even should learn to be more typical. Extremes can be irremediable in some cases, unaccompanied by benefit.
I just think that our commonalities are greater than our differences. It may not be possible to know how much someone can learn, but assuming that change is impossible can make it so. Finding a balance between seeking growth through challenge and recognizing real limits is critical.
Also important is understanding that not all atypical behavior should change. One of the critical insights of the disability rights movement is that disability is often a product of social context. A built environment without ramps and sidewalk cuts excludes people who use wheelchairs — it’s not their mobility limitations that impede them. Including these accommodations also enables parents with strollers and people using wheeled baggage. It makes the space better for everyone.
For autistic people, accommodations can include things like making public spaces less loud and overwhelming. (I’m not asking this of Times Square, which, like many New Yorkers, I will continue to avoid.) It also means recognizing that self-soothing behaviors — from rocking and hand flapping to using drugs to try to feel better — should not be punished, but understood. If harmful, behaviors should be treated, and if not, left alone.
So, I don’t mind if you say you have a bit of OCD or ADHD — so long as you know what that really means and aren’t just relying on stereotypes. The more we recognize that we all have traits that at the extremes can be disabling, the more compassionate we will be and the more we will be able to benefit from everyone’s talents.
Maia Szalavitz is a contributing Opinion writer and the author, most recently, of “Undoing Drugs: How Harm Reduction Is Changing the Future of Drugs and Addiction.”
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