On Continuums: ASD, OCD, ADHD, Alzheimers, and Allergies

Since the Aspergers designation was excluded from the DSM V, many people were, and are, outraged that all cases fall under the Autism Spectrum Disorder (ASD) instead of the separate categories of Autism and Aspergers. There is a world of difference between someone who has some mild problems understanding social cues and a strong interest in birding but is highly functioning, and someone who is unable to use spoken language and exhibits almost continuous self-stimulating behaviours.

Then there was a storm of controversy over Stephen Fry's comments about having "OCD eyes" that found it uncomfortable to have a anything appear out of order. For some people, having OCD means feeling discomfort when things are out of place and having an unstoppable need to put them right before the anxiety around it becomes too painful to ignore. In an article in the Guardian, David Adam suggests that OCD is far worse than a dislike of things out of order, as if people who have a mild case don't really have it at all. It's definitely the case that some people have horrid obsessions that affect their ability to function in the world. But it's also true that people can have intrusive thoughts that provoke repetitive actions in a way that don't noticeably affect their function. They're not desires they have, but random thoughts that people can't prevent coming to them. I understand not wanting to abuse the term until it's meaningless, like having an occasional day of high energy isn't the same as having ADHD, but there is no cut and dry line. It's very difficult to determine to what extent thoughts and routines have to disrupt a life in order for it to be considered a true case of OCD.

On Rising Anxiety Rates

A couple weeks ago, CBC ran an article about a high-school guidance counsellor, Boyd Perry, concerned with the increase in anxiety in students, and I've been dwelling on it ever since. This is crazy long as I'm just figuring all the angles here. Perry thinks we need to assess anxiety differently because these kids, some of them in kindergarten, aren't disordered but merely ill-equipped due to the bubble parenting that's become a trend, the swooping in to fix every little thing rather than letting kids feel the pain and learn to cope. According to an annual survey of counselling centres, the most common issue raised by students used to be around relationship concerns. In 1996, anxiety took over as number one spot, and it's stayed there gaining a wider lead ever since.

I agree parenting trends and misdiagnoses are an issue, but I also think it's more complicated than that.

I raised a similar concern a year ago; maybe mid-winter is the season to discuss our discontentment. My students last year were quite sure school is significantly harder than ever before regardless my claims to the contrary backed up with binders of old assignments and exams spanning the decades. I don't think they felt like it's harder just because life has been too easy for them because of overprotective parents, though. At the time I said it's also because of their parent's anxiety over the job market, the demands social media have on their time, and everyone's heightened expectations of themselves and their lives including, but not limited to, the quest for a gratifying career that allows them to work to their potential in a field they find fascinating. Today, I'd add the decrease in face-to-face interactions and feelings of community, the umbilical cord of cellphones that prolongs separation anxiety (with friends as well as parents), unceasing change that keeps us in a state of perpetual turmoil, concern with the state of the world, and even pollution. There are numerous societal, environmental, and personal factors intertwined that are pushing this trend.


WHAT IS ANXIETY

But what does anxiety even mean? A separate issue is that 'anxiety' is a word like 'cancer.' Decades ago I saw an interview with an oncologist (and sometimes comedian and philosopher), Robert Buckman, who insisted that we should use the word 'cancer' the way we use the word 'infection'. Both are very broad terms that could mean someone needs a minor procedure or they're on death's door. You might need a benign mole removed or a blister popped, or you might have pancreatic cancer or AIDS. We don't generally gather family together to tell them "I have an infection" because that's meaningless information. We're more specific about it. We need to apply that specificity to cancer discussions always including the location, the spreading potential, and the stage. The word has become too loaded, typically cueing people to think the worst.