Do I Have Asperger’s Disorder or Social Anxiety?

Reader’s Question

I’ve always had a lot of problems making and keeping friends. In fact, from grade one to grade 12 I only had one friend. I prefer to be alone most of the time, choosing to retreat into my room, instead of interacting and getting to know those around me. Relationships just come naturally to most people: they need to have them to function, in fact they thrive on it. In my case, a lot of times I am content only having a relationship with myself. I could live with someone my entire life and never develop a relationship with them. I really hate socializing. I find it hard and boring. I don’t like physical contact very much — it makes me very uncomfortable. I have a lot of trouble articulating myself, especially when trying to tell a story. I usually mix up words, use the wrong word or just sound really awkward. It is literally impossible for me to tell you what happened on the TV show House last night. I simply can’t articulate well enough. I didn’t start having actual conversations with people until about three years ago. In terms of restricted interests, for the past couple years I have been obsessed with movies. I’ve usually seen all the new releases at the video store, and almost all of the movies at the theatre at any given time.

For about four months, if you came into my room and moved a pillow too far to the right, or put a crease in one of my magazines, or sat on my bed and flattened the sheet, I’d freak out. Also, when I was in school I’d have to have every line straight on a project, and all the fonts perfect, or else I wouldn’t hand it in. I have never flapped my hands or anything like that, but I pace a lot when I’m trying to think or when I’m nervous. Sometimes I’ll pace for hours at a time. Other times, I whistle or sing the same words repeatedly through out the day.

I have very few spontaneous interactions — almost all interactions are planned, and only said because I’ve realized I haven’t interacted with that person in a long time.

Once I’m interested in something I can’t think of anything else, and it becomes really hard to concentrate on anything. And if something is bugging me or on my mind I’ll think about it non-stop for days, weeks, or months until it’s resolved.

I spend an excessive amount of time on the internet (6-8 hours a night), just switching between my two favorite sites.

Now, I have always been very socially anxious, and always assumed that that was the reason I was experiencing all these problems. Except now, I’m experiencing less and less social anxiety, but still have the same social problems as before. Is it possible for people with Asperger’s Syndrome to have severe social anxiety? Do you think that all my social problems are just caused from my social anxiety or do you think I may have Asperger’s? I have a psychiatrist appointment to get my medication renewed in a few days. Should I mention something? I’m afraid I’m completely wrong, and I’ll just make a fool of myself. Well, thank you for your help. I am really sorry for going on and on, I just really want to get this resolved.

Our Consulting Clinical Psychologist’s Reply

When we consider a clinical diagnosis, the majority of the diagnostic criteria (researched signs and symptoms) must be present before a diagnosis is offered. When we look at Social Anxiety Disorder versus Asperger’s Disorder (AD), your pattern of behaviors, thoughts, and symptoms fit the criteria for Asperger’s Disorder more than Social Anxiety. While both conditions have a level of social anxiety and discomfort, your description of your interests, preoccupation with sameness/orderliness, ability to fixate on one or two topics, preference for being alone, etc. are commonly found in Asperger’s Disorder.

Folks with Asperger’s Disorder can have severe social anxiety, although it is a different type of anxiety. Individuals with Social Anxiety develop severe tension/anxiety as they try to participate in a relationship, wanting to create a relationship but having low social confidence. Individuals with Asperger’s have difficulty with the mechanisms of communication and relationships — having problems with social articulation, emotional expression, understanding verbal and nonverbal cues in conversation, etc. As you mention, you feel you could live with someone and never develop a relationship with them — while the socially anxious individual would have a relationship after the initial social anxiety subsides. It’s like two people wanting to build a house. The anxious person is worried the house might not look right, it might be criticized, or people may not visit. The Asperger’s person doesn’t know how to use a saw, hammer, or drill, or how to mix concrete.

I would recommend bringing this to the attention of your treatment team. They will discuss the symptoms as I have done in my response. The goal is to identify issues that are treatable with medications, those that respond to therapy/counseling, those that improve with understanding and education (doing homework on the subject as you’ve done), and those that can improve with structured training and experience. There are many websites that address Asperger’s in adults, most offering recommendations to improve social skills and relationships.