Status anxiety

I think I might have a condition that no longer exists

29 December 2012

One of the things we’ll have to say goodbye to in 2013, if the American Psychiatric Association (APA) has its way, is Asperger’s Syndrome. In the forthcoming fifth edition of the APA’s reference work, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), Asperger’s has been ‘declassified’, that is, it’s no longer recognised as a discrete, stand-alone condition. This is a bit of a blow to me because I’ve been gradually working my way up to getting a professional diagnosis. Am I suffering from it or not? Now, it seems, I’ll never know.

For those unfamiliar with this disorder, it’s named after the Austrian paediatrician Hans Asperger who believed that certain high-functioning autistic children can be grouped together in a special category rather than simply labelled ‘autistic’. Among the characteristics exhibited by these children, according to Asperger, are poor social skills, lack of empathy and difficulty in picking up on more subtle forms of communication, such as body language and irony. Typically, a child with Asperger’s will interpret -everything that’s said to him in an over-literal way. For instance, if someone tells him not to lose his head over something he will become agitated because, after all, your head is attached to your body and the concept of momentarily mislaying it doesn’t make sense.

Asperger believed that early diagnoses of this condition was critical because the children suffering from it can go on to have successful, fulfilling lives, provided they’re given the right help. He referred to these children as ‘little professors’ on account of their ability to talk about particular subjects in great detail — bus timetables, for instance. One of his patients became a professor of astronomy, while another went on to win the Nobel Prize for Literature.

I daresay it’s the link between Asperger’s Syndrome and genius levels of intelligence that led to my self-diagnosis. I fantasised about being a member of an elite human sub-species — like one of the X-Men. But there are also other, less flattering reasons for thinking I might be afflicted.


For instance, there’s my failure to grasp the most basic rules of etiquette, a common failing among Aspies. ‘My husband has so little understanding of how to behave in any situation, he makes Homer Simpson look like George Clooney,’ wrote Caroline in an article for the Times four years ago. She gave numerous examples of my behaviour, most of which had never struck me as abnormal.

Take the time we took the children for lunch at Kenwood, an over-priced café on Hampstead Heath. ‘Toby became quite agitated when our five-year-old daughter refused to eat a cheese sandwich that she’d insisted we buy for her,’ wrote Caroline. ‘I told him to ask the manager if he could return it but, after this was turned down, Toby began working his way across the restaurant trying to sell the sandwich at a 25p discount. There were no takers.’

I can honestly say, hand on heart, that I didn’t think there was anything odd about this at the time. But I’m sure Caroline’s right when she says it was ‘weird’ and ‘embarrassing’.

Perhaps it’s no bad thing that my condition is no longer considered a separate mental disorder. Over the years Caroline has taught me quite a lot about how to behave more normally. Had I been emboldened by a clinical diagnosis, I might have proved harder to train, citing my ‘disability’ as an excuse.

As a rule, I’m opposed to the way inappropriate forms of behaviour have been medicalised, seeing it as an unholy alliance between the psychiatric profession and the large pharmaceutical companies. It has led to a decline in personal responsibility, particularly in schools where more and more children are designated as having ‘special educational needs’ and given large doses of Ritalin.

Should the APA be congratulated for declassifying Asperger’s? Unfortunately, for every mental disorder it’s removed from the new edition of the DSM, it’s added five new ones. For instance, if your child has a temper tantrum because he’s not allowed to stay up to watch Doctor Who, he’s not behaving like a spoilt brat. Oh no. He’s suffering from ‘Disruptive Mood Dysregulation Disorder’. Laziness is now classed as ‘Apathy Syndrome’, spending too long surfing the web is an example of ‘Internet Addiction Disorder’ and preferring one parent to another is ‘Parental Alienation Syndrome’. The list goes on.

How do I know all this? Because I’m obsessed with reference books. That’s another symptom of the condition that used to be Asperger’s.

Toby Young is associate editor of The Spectator.

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  • Humphrey Reader

    I have recently been diagnosed with Asperger’s Syndrome (now known as ‘autistic spectrum disorder’ by a reputable psychiatrist. Over and above that I am convinced the symptoms arereal – I do note in myself a tendency to stereotyped phrases, some difficulty picking up social cues and, sometimes, difficulty grasping verbal instructions
    despite being intelligent in other ways. I have also joined a support group in
    Bristol some of whose members show behaviour traits spookily resembling mine. I
    am reminded in fact of the fuss over dyslexia which has been shown to be
    perfectly real in both post-mortem examinations of brains structure and CAT
    scans of dyslexics tackling reading and language tasks. I confess to becoming a
    little impatient with the ‘dahn-to-erf common-sense’ brigade who insist in
    dismissing Asperger’s/ASD, dyslexia, hyperactivity and other mild ‘wiring’ problems as
    euphemisms for persistent naughtiness, idleness, under-achievement and so on. These things are real, and I hope that if any of Toby Young’s intake at his
    free school are diagnosed with Asperger’s/ASD, dyslexia or hyperactivity that
    he and his staff will take the diagnoses seriously, otherwise a great deal of
    unnecessary suffering to his pupils with these very real problems will result.

    I hasten to add of course that, once diagnosed, these conditions can be humanely accommodated, and people whose brains are wired in this way are by NO means incapable of leading normal, independent and productive lives. Some of the world’s best scientists and mathematicians are or were very likely on the high end of the ‘autistic spectrum’. We have a hyperactive young man at work (supermarket) whose exuberance charms the customers and livens-up the workplace considerably, not to mention making him excellent value at staff parties. I’ve spoken with him: he knows he’s like this and he knows people appreciate him as he is – and he knows how to keep his hyper-Tigger tendencies under control! In return, those around him do cut him a little slack when he lets off steam. It’s all a matter of sympathetic, common-sense give-and-take.

    Oh, and PS – I was recommended to go for an Asperger/ASD diagnosis by my brother who’d read ‘The Curious Incident of the Dog in the Night-Time’ by Mark Haddon, and noticed similarities beteween me and that book’s main character. Brother is a thoroughly no-nonsense Catholic priest, and in addition to reading the Haddon book has come across fellow-clerics with my symptoms. I repeat, therefore, that as Toby Young has taken on responsibility for the education of young people he takes this and other diagnoses seriously and not in the flippant and dismissive way implied in this article.

  • Elle

    I think you are missing a couple of key facts.
    1) Maladaptive behaviours and symptoms associated with disorders are on a continuum of severity. Anyone can exhibit a symptom, but if it’s on the less severe end of the spectrum, then it might not reach the severity necessary to be classified as a disorder. Symptoms aren’t an “all or nothing”, but at some point a diagnosis has to be made when daily functioning is clinically impaired.

    2) Yes at first glance it might seem silly to have a disorder such as “disruptive mood dysregulation disorder”, however it’s actually not. If your child throws one tantrum because he can’t stay up late, that’s not a disorder. There’s no way he would be diagnosed with one so don’t given inappropriate examples. What about a child who does that every single time, for every day, no matter what you do, but otherwise has no other issues? As with all disorders in the DSM, the disturbance MUST cause CLINICALLY significant distress or impairment in social, occupational, academic, or other important areas of functioning.

    It’s not enough to be obsessed with something if you aren’t thinking critically about what you are reading. If you are truly interested in understanding the DSM more, take a course at your local university on abnormal psych. Also maybe come to accept the fact that your symptoms may be on the lower end of the “symptom spectrum”, and although they obviously affect your every day life, they are not quite at the cut off level to receive a diagnosis. Don’t feel bad – cases of genius with ASD are not very common.

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