[romwell]

Thanks for this response!

Re: CPTSD vs ADHD vs ASD, I do run into discussion of differences and overlaps on social media; there is also a correlation (ASD and ADHD traits can lead to adverse treatment by parents and peers, resulting in CPTSD).

I have two cousins (siblings); one has ADHD, and by the looks of it, the way she's treated for her symptoms is going to land her with CPTSD if she's not already there.

FWIW, my treatment started with trauma, and then I realized that it's not all there is to it. I don't feel ADHD contributed to it that much, but in any case, I am getting help with both.

>The fun part with CPTSD is it effects your long term memory formation whenever you have a trigger or flashback so that you can have been going off the walls with anxiety for an entire evening and the next day not even remember what caused it, only that you "had a bad night".

Much fun, can relate; keeping a log helps.

> I can roll down the entire list you posted and pick out one thing after another that might be related to CPTSD ... it can get really hard to differentiate, even with experienced professionals diagnosing people.

I wouldn't put that much trust in experienced professionals, who, until not long ago, thought that ADHD magically evaporates when people grow into adulthood :)

Legit, adult ADHD was not believed to exist until the 1970s. And it's pretty common! Last week, a woman who got her diagnosis in her 40s said that it came as a surprise to her husband, who was a psychology professor (the discussion was in one of the ADHD groups on FB). The said psychology professor, educator, was looking ADHD in the eye for decades and didn't see it. The woman tried ADHD medication for the first time, and was flabbergasted by the positive effect it had on her.

While the overlap is sizable, I feel like differentiation is only hard because the professionals are, well, not that professional.

I would be very curious to know which things you don't relate to, just to get one data point on ADHD vs CPTSD differences.

To my knowledge, the following are traits of ADHD, but not CPTSD:

* Hyperfocus/Hyperfixation: being able, under the right circumstances to develop a seemingly sudden and very intense focus/state of flow, during which you go deep into whatever caught your attention (be it a work project, or an all-night Wikipedia binge to find out all there is to know about three-speed planetary gears). This includes picking up hobbies, getting reasonably good at them very fast (and at the expense of everything else), then dropping them to pick up another hobby. Hyperfocus on an activity comes with not having control over where it goes. Need to fill out taxes? Too bad, need to research the harmony of Girl From Ipanema and the history of that jazz standard in as much detail as is humanly possible!

* Time blindness: not being able to estimate the time it takes to do anything (underestimating usually), not perceiving much difference between events that happened a long time ago and last week, non-chronological organization of events in memory

* Taking 11 years to mail a package: people with ADHD have tons of unfinished projects due to running out of hyperfocus and executive dysfunction. However, these projects are never truly abandoned - and sometimes, they are brought to completion, years later. My favorite example is a gift I meant to mail to a friend for 11 years... and actually did it! The trait here is not abandoning incomplete projects way past the point where most people would.

* Paradoxical reaction to stimulants (in particular, amphetamines, anesthesia, caffeine). In practical terms: coffee can make me sleepy if it's very strong, so does Adderall.

* Feeling calm in emergencies: that's the situations where ADHD people thrive in. Particularly, jobs like EMT seem to be a great fit.

* Speaking faster than other people, and preferring to listening to videos at 1.5x - 2x speed, otherwise it feels "too slow"

* Completing other person's sentences

* Empathizing with other people by immediately bringing up a similar/relatable story from your own past to show that you have a basis on which you can relate (also in ASD)

* Auditory Processing Disorder, aka audio buffering: someone tells you something, you don't hear it and ask them to repeat. Then as they start repeating, what they said finally loads in your brain and you answer their question (before they repeated it). (also in ASD)

* Infodumping: someone brought up a special interest or a recent hyperfixation of yours? Well, well, well. If they didn't want to know the history of the golden age of hydrogen-filled rigid airships, they shouldn't have mentioned Zeppelins, and now they better be prepared to listen up for the next 30 minutes or so. (also in ASD)

* Writing overly long messages and comments compared to most of people (high five here :D )

OK, that should be enough to start. Many other ADHD traits (particularly, executive dysfunction, prioritizing, planning, initiating/switching/completing tasks, memory issues, etc etc) are, to my knowledge, exacerbated by trauma, unlike the above.

As in, trauma is not going to make you speak faster, or fall asleep from a double espresso, or give you a sudden ability to laser-focus on things (often the exciting, challenging things - but not necessarily important ones), and so on.

Thanks again for your comment, would be really curious about your take on the above!

[taurath]

I have about half of those traits - again I’m not saying ADHD isn’t a possible factor to some level :). I have a laser focus, but no time blindness (just memory gaps related to dissociation), I don’t have a ton of in progress projects, I feel calm in emergencies (every emergency is simpler than my catastrophizing mind has already come up with), I have a hypersensitivity to some stimulants and normal w others, I don’t really speak too fast for people nor listen to vids at 1.5/2x, I can infodump but don’t unless I’m damn sure they wanna hear it, I have auditory sensitivity/a bit of a filtering problem in loud places but rarely miss what someone in front of me is saying, I don’t complete others sentences often (it’s usually rude), and I like writing long messages about things I have spent a lot of my life learning about. I also do relate things to myself when empathizing but also sometimes don’t if someone is in obvious distress.

Broadly a lot of those can come from different sources I think. A lot of mental horsepower could explain many of them, in a way?

Otoh, I basically raised myself emotionally - I had absent (emotionally) or commandeering parents and had a very insecure early attachment. I spent most of my time from middle and high school drugged up on medications and spent a ton of time alone - a big factor there was it was I was raised in an extreme religious environment and told I was better than everyone else and that I should act in an extremely specific “godly” way that opened me up for lots of bullying. Pulling apart the pieces of “what happened” has been a lifelong task.

[romwell]

Thank you again for a detailed answer! From what you are saying, I would not be quick to suggest that you have ADHD either.

For one, the traits that you listed are in the overlap with ASD (to my knowledge).

Re-reading your comments, it looks like you don't feel like ASD applies to you however there is even less good information about ASD than about ADHD or PTSD. I never thought it could apply to me until I looked at some recent materials on it.

FWIW, I'm a social butterfly too, and never felt I have trouble reading faces, but growing up with a BPD parent, being able to detect an incoming rage was a vital skill which I developed early on. At the same time, self-assessments (as well as relatable experiences of autistic people with ADHD) indicate at least a likelihood of ASD for me as well.

"Autistics can't read faces" is straight up a myth. I don't know how much you looked into ASD communities on social media, but it's amazing just how many false beliefs persisted in the medical community for ages. FFS, we only stopped zapping autistic kids for being autistic last year.

There are a lot of misconceptions about ASD that have been resolved only in recent years. The traits you said don't apply to you, in fact, are known to not match the experience of many autistic people.

The thing about an autism diagnosis as an adult is that it doesn't really bring much value. There are no meds. You have already figured out all the coping mechanisms and necessary masking to get by in life. And if you are in control of your environment, then it doesn't affect you negatively.

Like, sensory sensitivity is not an issue in your own home, and you can avoid environments that make you uncomfortable. Same goes for people. Hyperfocus is an asset more than anything else.

So for me, finding out that I might be on the spectrum was a curious observation that could explain some of my behavior patterns, but didn't need much attention (unlike the trauma, which I'm only beginning to approach, or ADHD).

I wish I knew more about ASD to ask the right questions, but out of curiosity:

* What is your relationship with planning? Do you tend to plan most of the things that you do? Do you enjoy unplanned activities? How do you react when the plans you made are suddenly changed?

* How easy is it for you to lie? Do you feel comfortable telling a falsehood when answering a question?

* What's your relationship with things? When you buy something (say, a gadget), how long do you use it for? Is it easy for you to throw things away? Can you tell stories associated with most of the things that you own?

* Have you ever had other people confused about your emotions? Like, being perceived as feeling very emotional when you aren't, and vice versa; or otherwise having a mismatch about how others read you, and how you feel.

* The things that you'd be glad to infodump about upon request - how long have you been interested in them, on the average?

* Have you ever felt that you are being clear and direct, but another person took it personally and got offended for no good reason (other than them being unable to hold a coherent argument)? If so, does this happen regularly?

Thank you again for giving such detailed answers, they are very helpful, and help me understand CPTSD, ADHD, and ASD better (as well as myself)!

[taurath]

My relationship with ASD is that I toiled under a misunderstanding of my capabilities tied to an ASD diagnosis early on. ASD being a spectrum, finding even relevant information towards one particular area over another on the spectrum has always been a challenge. I'm of the opinion that, like ADHD, the diagnostic criteria is very open to interpretation and relatively wide. I would prefer if there were specific neurological, gene, or behavioral markers that were more "NT's don't do this, ASD people do do this".

Just as I may have some level of ADHD, I may have some level of ASD. Treatment methodologies I tried in my 20s, and were tried on me in my teens, were grouped around treatment of either or both of those. Ultimately they were not effective at giving me much better quality of life, whereas trauma-informed methodologies have been, especially in aspects like emotional regulation, and giving reasons for say dissociative episodes which had plagued me for a very long time and now are much more manageable, and also predictable.

To your q's...

I plan some of the things I do, but I don't have the need to plan everything. I do well in planned and unplanned environments. I have traveled to foreign countries solo, gotten into plenty of fun sorts of trouble, etc. When I am needing something emotionally like time alone to recharge, or support, a sudden change in environment like a ton of people coming over suddenly can be jarring or upsetting.

I don't like lying. I feel like its not worth it, and then you also have to remain consistent in the lies. If I needed to get past the gestapo in my car with a trunk full of refugee's, I would probably be able to keep a relatively straight face while lying through my teeth and not thinking another thought about the lie later :P

I use a gadget as long as I have need or want of it. I don't attach to objects more than people, if thats sort of the idea. I don't like throwing away things I've spent a bunch of money on, but I don't hoard.

Hard to say but usually I think I'm pretty obvious about my emotional state - for the most part it matches.

This is probably one of my main things to "infodump". I've been having to study psychology, pharmacology, etc from a damn early age because I was raised alongside the idea that there's something wrong with me. I've spent a very long time trying to help my at the time really distressing depression and anxiety and lack of self worth. I tend to get bored of things after a little bit. I played chess for a while, and then found that the endgames weren't terribly interesting. Same via programming, history, social studies/social justice. Idk, I don't have super singular "special interests", I just like to learn and know a lot about a lot.

I am pretty aware of any tone problems. I think it used to happen that I was somewhat blunt, especially in teen years but its hard to differentiate between that as an ASD thing of "not getting" or simply ignoring how words effect other's emotional states, being raised in an incredibly strict and regimented way, and being undersocialized generally. Its funny because I'm aware I'm sort of replying in writing in a sort of matter of fact tone. If you don't mind, I'd not mind some feedback on my writing style and how it strikes you.

[romwell]

Thanks for answering the questions!

The answers you give are not inconsistent with ASD to my knowledge. However, I'm not even sure what's there to treat.

It seems like a lot of "treatment" of ASD traits in children was just making them conform to expectations of an "average" person, which may contribute to trauma and make quality of life worse.

People who mask better look like they're "improving" to outside observers, but might be just behaving in a way more pleasant to others, but also more draining and leading to other issues.

"Attaching to objects more than to people" is, I feel, some nonsense that's made up by people without a clue. I can talk at length about the things that I have, and why I have them; but that would be another long comment :)

Your style strikes me as: direct, precise, detailed, easy to understand, answering the question asked, including information on why you think the way you do (i.e. basis for claims), not taking things personally, having capacity to elaborate on thoughts and ideas in more than one paragraph, and a pleasure to read overall.

From my personal experience, this style seems to be more common with neurodivergent people (ASD specifically). The length of your (...and mine) comments alone seems to be a good enough indicator :)

The "tone problems", I feel, are what other people have because they communicate indirectly, and try looking for signal where there is none. I sometimes have to ask to just listen to the words that I say, and take them at face value, rather than trying to impart another meaning to them based on my tone (which is usually affected by the things that are on my mind to a larger extent than the things I am talking about).

Also, again, sorry to hear that you were receiving treatment that was not helping you. The traits that you describe that may be ASD traits don't look like something that needs to be "treated".

Also, on this:

>I'm of the opinion that, like ADHD, the diagnostic criteria is very open to interpretation and relatively wide. I would prefer if there were specific neurological, gene, or behavioral markers that were more "NT's don't do this, ASD people do do this".

The DSM criteria are little more than guidelines.

The following book does exactly what you described:

I Think I Might Be Autistic: A Guide to Autism Spectrum Disorder Diagnosis and Self-Discovery for Adults[1]

It starts with a categorized "NT's don't do this, ASD people do do this" checklist.

In addition, self-assessments like RAADS-R - over 100 questions[2] and AQ - 50 questions[3] are, essentially, that: yes/no questions where NTs would more likely choose one of the answers, and ASD people the other.

(Do read the information on the page if you decide to take them: these tests have been revised because the researchers were flat out wrong about some of those!)

>Ultimately they were not effective at giving me much better quality of life, whereas trauma-informed methodologies have been

Well, trauma is both very common in non-NT people, and also it's something that can affect people the most and exacerbate other traits that aren't helpful in that situation.

I feel like ASD is not really something to be treated in adults who already live their lives somehow, just something to be aware of because it's useful to know how others differ from you, and what expectations to have about the way your mind works (because we build them on understanding that only applies to some NT people).

The helpful part of learning about ASD for me was learning about masking, and doing less of that. This is not specific to ASD (though there are some who'd want to restrict the usage of that word, but that's a whole another can of worms); and catching myself acting a certain way because that's the expectation of others, and not because I want to do this (or not doing something) helps me spend less energy on things that aren't worth it.

In any case, it seems like trauma is something that should have been helped with first based on my understanding of what you said, and it's very sad to hear that the docs didn't arrive at the same conclusion.

Sorry that you didn't get help right away, glad you eventually did! Thank you so much for writing all of this, and I hope there is something of value in this wall of text too.

-------------------

[1]https://www.amazon.com/Think-Might-Autistic-Diagnosis-Self-D...

[2]https://embrace-autism.com/raads-r/

[3]https://embrace-autism.com/autism-spectrum-quotient/

[eponai]

romwell, I'd just like to say your comments here on this topic are stellar, relatable, and 100% true for me.

>* Paradoxical reaction to stimulants (in particular, amphetamines, anesthesia, caffeine). In practical terms: coffee can make me sleepy if it's very strong, so does Adderall.

:nods: My psychiatrist was waffling between cPTSD and ADHD as a cause of my concentration issues until I told her that one time I tried cocaine and promptly took a nap.

>* Feeling calm in emergencies: that's the situations where ADHD people thrive in. Particularly, jobs like EMT seem to be a great fit.

Oh hey, I've worked in tech support for the past 20 years where high profile clients are freaking out when their servers go down, everything is an emergency, and every day is different. :)

There's one thing that's been left out of this discussion thus far, relating to this comment:

>> I can roll down the entire list you posted and pick out one thing after another that might be related to CPTSD ... it can get really hard to differentiate, even with experienced professionals diagnosing people.

ADHD is caused by a dysfunctioning pre-frontal cortex. [1] cPTSD is caused by ongoing chronic trauma. I had a QEEG done and it was clearly apparent my pre-frontal cortex was low-activity.

I also agree with the theory that cPTSD and ADHD/ASD can go hand in hand, because the ADHD or ASD can cause mal-treatment. I was severely abused as a child precisely because of my (un-diagnosed at the time, because girl) ASD and ADHD.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894421/

[taurath]

One point I’d make is CPTSD is not necessarily ongoing trauma, but unresolved trauma esp in childhood since that’s an inescapable position. It’s a little bit of a chicken or egg problem as trauma can also cause symptomologies similar to ADHD, just as ADHD can exacerbate traumas.

For me I’ve just found it’s helped when finding treatment methodologies for pure ADHD to be able to do a differential diagnosis - ADHD is at least much more commonly diagnosed or thought of as a possibility while CPTSD is a relatively unknown.

[eponai]

What I meant by ongoing is that it is not one specific event like being hit by a car that you can point to...but something that happens over a long period of time. It's why I never pursued EMDR as a therapy. I cannot put one traumatic thing in my mind's eye, rather my entire childhood was trauma.

[taurath]

One of the traits of CPTSD is specifically memory loss/suppression around the traumatic memories. EMDR for me is specifically helpful for surfacing those memories - its not exclusively used for single traumatic events! Also, IFS therapy is another methodology that has helped me make sense of sometimes contradictory emotional needs due to unmet needs in childhood.

[romwell]

Thanks for this comment!

And sorry it took so long to get a diagnosis!