Over the years, I have spoken about my experience of psychosis and autism from the perspective of its uniqueness. However, over the last few years, I have come to accept that I am also ADHD, and I feel that addressing the particular intersections at play for AuDHD people experiencing psychosis is something that needs to be done. So, what is different for me as an an AuDHD person with a diagnosis of schizophrenia?
How does my schizophrenia present?
One of the features usually seen in Schizophrenic people is flat affect or lack of emotional response. For me, though, this does not happen. Part of the reason I went 14 years without a schizophrenia diagnosis is because I present as excitable and impulsive. I say absurd things, and quite well embody the description of a “mad scientist” trope.
Despite experiencing typical traits such as paranoid delusions, voice hearing, visual hallucinations, and periods of catatonia, I don’t experience many of what would be called the “negative symptoms”.
My speech is rarely disorganised unless I am deep into psychosis, I can communicate rationally, and even when I am terrified, lonely, and hopeless, I come across as exuberant and in need of constant stimulation. I also demonstrate a lot of insight into my diagnosis because as an AuDHD person, I have spent a long time learning about it in intricate detail.
The insight problem
One of the problems that psychiatrists have had with recognising my psychosis is the aforementioned insight I have. This can be understood as having an awareness that what you are experiencing isn’t real. For me, it was a complicated affair.
I knew a lot about psychotic conditions. I knew diagnostic criteria and contemporary research. I absorbed knowledge from therapists. I knew logically that I met the criteria for a schizophrenia spectrum diagnosis. Despite this, I still didn’t believe I was ill (more on that in a moment). This meant that psychiatrists were faced by a patient who seemed to simultaneously have and not have, insight.
Am I mentally ill?
This is perhaps one of my most controversial opinions, even amongst people who know me well. I do not view myself as having a mental illness, but I do agree that I am Schizophrenic. Much in the same way one can know they are Autistic or ADHD without viewing either of them as illness.
I believe that my schizophrenia is a form of acquired neurodivergence precipitated by a life of traumatic experiences. While I do not believe I am ill, I do take medication. I view this medication in the same way that one might view ADHD meds. They are a tool that makes life more manageable.
How common is schizophrenia in neurodivergent spaces? (Further reading)
Jutla et al (2021) mention that studies have indicated a prevalence of 12% in Autistic populations, with schizophrenia spectrum conditions being three to six times more likely amongst Autistic people.
Gerhand & Saville (2021) found schizophrenia and ADHD co-occurrence rates of up to 38.75%, vastly outpacing the general population.
For more information on my experiences and these intersections, read these articles