We actually don’t have the same emotional expressions. The early studies on “universal” emotional expressions (joy, disgust etc) were extremely biased. The researches paid western actors to make facial expressions, took pictures of those expressions, then showed those pictures to various uncontacted / low contact tribes. However, the researches tended to ask the tribes what expression they saw repeatedly until they gave the answer the researches expected.

Even smiling isn’t universal. Think about cultural differences between smiling even in modern day Russia. There’s evidence that smiling might have been an expression of joy but was deemed socially inappropriate in Ancient Rome.

Emotional expressions in the brain differ between individuals and even differ within the same individual on separate occasions of the “same” emotion. Lisa Barrett has an excellent book on this topic: How Emotions are Made.

It’s no so much stacking that’s a notable symptom, it’s collecting, arranging, sorting and displaying, often without playing with the toys as intended. Instead the focus is more on neatly sorting by color / shape / size etc. and sometimes preferring to keep them in that configuration over playing with them.

This is similar to the tendency for some autistics to focus on the part of a toy, like spinning the wheels on a toy truck, instead of playing with the truck doing truck things.

While these are commonly associated with autism, these two examples are neither necessary or sufficient symptoms to diagnose autism. Meaning that you can see this symptom in an allistic (not autistic) person and it does not mean they have autism and you can have autism and not have these symptoms.

One thing common to many autistic people is ground up processing. Their minds do incredibly well with details (the spinning truck wheel, the defining characteristics of the toys they sort) but sometimes don’t see “the big picture” as easily. It can be an incredible strength in many ways, especially when embraced and harnessed instead of shamed and “corrected.”

Hey, You’re in a tough spot and I know how hard it can be. I’m sure people have recommended everything under the sun to you and sometimes doing the work to accommodate ADHD feels like more work than just suffering the consequences. Especially as an adult. I love the Spoon Theory and I’m glad you have that as an analogy. I’m going to recommend a few things here, assuming that you don’t have a lot of clinical knowledge about ADHD.

Sleep and exercise are a must. Exercise can (temporarily) improve processing speed which is relatively low in many people with ADHD. You don’t have to be a mega athlete, but a routine of exercise that gets your heart rate up each day can and usually does help. Outside of stimulant medications, exercise and sleep are the two biggest things you can do for ADHD. Read / Audiobook

Why We Sleep by Matthew Walker

The meds you listed do not help with ADHD directly, but maybe some of the downstream emotional effects. Ask directly about stimulants, they can be a game changer for some, but you will need to be careful with sleep and appetite.

The recommendation to avoid food dyes and additives was huge in the 80s, recent research suggests only 1/3 of people with ADHD benefit from disarray changes. Read / Audiobook: Getting Ahead of ADHD: What Next Generation Science…” by Joel Nigg ^ Can be a bit dull but clearly explains research and evidence as well as examining what treatments are supported by science and to what extent. Use more as a reference than cover to cover.

For the love of all that is distracted, learn about ADHD for real from good sources! I’d start with ADHD 2.0, an update from Hallowell and Ratey, two psychiatrists who have ADHD and are big names in ADHD research. Some interesting suggestions about cerebellum involvement in ADHD and movement / balance therapies still under study.

As a personal tip, try not to get angry or down on yourself with the ADHD instances as much as possible. Forget your wallet in the house? You have to go back anyway, you can go back chuckling at yourself or furious, but you still have to go back. I’f you are angry or otherwise activated then you’re taking up mental resources, making it more likely that you’ll grab your wallet, but leave your sunglasses on the table.

Also look up Rejection Sensitive Dysphoria. Essentially a culmination of micro frustrations by peers and authority figures over the course of your childhood results in something like 20000 instances before age 12. That can lead to social sensitivity, overreacting to social stress, and a sense that people might be about to leave you / social self-doubt.

Also, if you have access and the money for it, go to a qualified psychologist and get a good psychological evaluation. Knowing your cognitive profile (relative strengths and weaknesses in cognitive functioning) as well as your memory abilities (visual often weaker in ADHD) can really help you assess how difficult various tasks will be for you and you can cope accordingly.

I hope this helps.

I used to keep fish. I loved learning about the nitrogen cycle, setting up the co2 diffuser, balancing tank parameters, designing the filtration system, researching, purchasing, and acclimating exotic fish. Fascinating, colorful and compelling. But once the set up was done and I had a mature tank I was bored and dreaded basic maintenance. The fish didn’t deserve a subpar home so I did my best, but when we moved and sold the set up, I never went back.

I agree that sensory sensitivities are also more common in ASD, but ADHD, especially in more severe cases, can also have sensory sensitivities as can OCD and other conditions.

OP I think there’s enough here to justify an evaluation by a psychologist if you can afford it / it’s available where you are. If not, reading about ADHD and applying some of those strategies will not hurt you. I’d recommend ADHD 2.0 as a starting point.

ADHD and anxiety are also comorbid, and some of your symptoms may be more about anxiety and might respond well to anxiety related interventions. ACT (acceptance and commitment therapy) has several good workbooks about anxiety which could be helpful.

It’s frustrating that an assessment is so expensive. And the psychologist will probably only get reimbursed for 4hrs of testing so your report will be short and cursory anyway… I’ll avoid going on a long angry insurance rant here.

Do you have any Universities near you? See if they have graduate psychology programs. Those students need people to practice giving assessments to and are supervised well. They usually give assessments for very cheap because it’s a training program.

It takes about 5 half lives to clear 95% of a substance from your system. A quick google says the half life varies from 5-21hrs, so even if you’re on the slower end, a week should do it.

If you’ve been on it for a very long time then your CNS may need more time to get back to baseline, but you probably don’t need a perfectly clean slate to assess if a new medication works for you. Plus, switching from a nonstim to a stimulant is a totally different class of drug and you should feel the effects of a stimulant fairly quickly.

Just make sure you time and dose correctly to avoid messing up your sleep.

If a professional is required by law to make these reports, and makes you aware of these duties at the start of your care, then there is no valid ethics complaint and no violation of trust. The therapist must tell you in their informed consent about these limits to confidentiality and should have done so before any personal information was disclosed to them.

While there is a potential of some harm due to this disclosure, therapists are not in a position to investigate and determine if abuse / credible threats of violence occurred and are explicitly not supposed to do so. They are supposed to make a report and allow other state agencies to investigate. If OPs family ended up hurting someone and the therapist was drawn into legal proceedings, they could equally be sued for having this information and not following their duty to warn.

OP, these issues do belong in therapy and you should be able to get support for them.

I appreciate your point about personal responsibility for AI output and viewing it as a tool. However, I’m not sure how other things being bad for the environment too negates AI being bad for the environment. How does the level of outrage around an issue correlate to the factual severity of it? Also, AI is bad for the environment and it’s pretty clear

Unlike AI, Bitcoin wasn’t being so rabidly adopted and the (US) government wasn’t issuing EOs to prevent regulation.

There’s a lot of research suggesting cis women with ADHD have symptoms (and metabolism of stimulant medications) fluctuate with hormone cycles. It’s not talked about enough that HRT would cause similar issues for trans fem folks. There isn’t great research on just how those effects would show up for trans people, but it’s reasonable to assume they would.

Conversely, estrogen and the like can mitigate psychotic symptoms so maybe that’s a side bonus?

It’s really great that you’re seeking help and talking openly about this! Encopresis is too often shameful and kids suffer when parents don’t speak up.

There’s lots of conflicting advice out there and I strongly recommend you find pediatric autism specialist if as all possible. A generalist MD or therapist is not likely to be knowledgable about this topic.

This website, despite the sales pitch, has good information and a detailed manual. It might be worth reading. https://www.encopresis.com/encopresis-manual/

Editing to add that interoception may be part of the issue. People with ASD often have more distant perceptions of internal bodily sensations than allistics, so your son may only perceive his need to defecate at a 1/10 where another kid might feel it at a 7/10. Teaching body check ins and mindfulness can be helpful, but is tricky with young kids.

This was a very brief explanation of many studies looking into this exact problem. The conclusion is from their research, not mine. You’re also making my point, that expressions of joy, happiness etc vary between cultures. This article talks about some of the research but I recommend reading the original studies or Barrett’s book.

Article

You could consider getting a psychological assessment that will give you an idea of your cognitive strengths and weaknesses. They can also administer instruments like the Strong Interest Inventory if you’re still looking for help deciding on a career.

Don’t forget to include base rates in your calculations. Autism estimates can be as high as ~1 in 20 or 30 (for AMAB) depending on how you measure it and Psycopathy is far lower even accounting for measurement challenges. Also, the HARE, even the updated one, is more than 40 years old. I would be very suspicious of people using that measure clinically.

Anecdotally, autistic people can be prone to overly concrete / dichotomous answers on some measures, which leads some to endorse actions or thoughts they have had, but occur extremely rarely, when the measure is asking about a prominent and repeated symptom.

It is possible to be both, but there are many things that distinguish the conditions. Also, if a person is autistic and has not had that understand or proper accommodations, then “antisocial” habits that develop out of self-protection may be misconstrued as pathological personality traits.

This is a deep and nuanced conversation and it would be worth deconstructing your answers on the HARE with a therapist or someone who knows you well to see if your perceptions of your symptoms match with other’s perceptions.

I can’t sit down and read anymore either, but I found that audiobooks work well. I can take a walk, do the dishes, clean, laundry, commute, etc. while also being more entertained. I also listen to books with a sleep timer when I go to bed. That lets me distract my mind while I fall asleep and has been a huge help for falling asleep faster.

If you manage to find a way to make reading tolerable, start with ADHD 2.0. It’s worth it.

Ouch! Well, if you’re up, may as well read:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195638/

Yes, which is the point. Face valid, self-report measures for rare psychiatric disorders are extremely problematic and subject to misinterpretation. Lie to doctors for fun all you want, but if you actually want an answer to this question you’ll need to be clear about your symptoms and you will need a qualified professional to walk you through the diagnostic process.

OCD doesn’t have to have rituals necessarily but that’s what most people think of as a hallmark of OCD. A differential dx like this is important, but hard to do without a professional who can help you not just list your symptoms, but assess the qualitative nature of them.

Regardless, it does sound like this impacts your functioning and happiness, I’m glad you’re reaching out and getting some support.

I’ve had plenty of men tell me they refuse a vasectomy because it would impact their testosterone production… which is just not true, not how the body works, and has been proven over and over. So despite the procedure being the better choice for their family planning etc, they make choices that are less safe, less effective, or offload the family planning to their partners because they’re unscientifically afraid their masculinity will be affected.

While autistic people do have some struggles with perspective taking, the “theory of mind” concept is still hotly debated. Is it still a theory of mind issue if an autistic person does not engage in perspective taking automatically, but can do so with intentional attention and / or coaching? That symptom is neither necessary or sufficient for an autism dx.

And for your other comment, lying happens for so many reasons it’s not a useful symptom either. Neurodiverse people lie all the time to get neurotypical off their back or avoid explains why, for example, trying to converse over the rattle of the fridge motor makes them want to punch things.

I don’t think this will answer your question directly, but Misdiagnosis Mondays has a good series on differential diagnoses and is generally good information.

https://neurodivergentinsights.com/misdiagnosis-monday/?srsltid=AfmBOoq306GEP_3YnMoTEwI--5eAwjVxqTfYpcHV3xicFTS9yrIAV85X