Well, to me your comment also speaks to the increasing degree to which we medicalize personality traits.
I'm sure your diagnosis is legitimate, but also I'm inferring from your comment that you are married and gainfully employed; so it sounds like you're able to build and maintain relationships, as well hold conversations with strangers or non-close acquaintances when necessary.
In years past would any professional have bothered to test someone like you for a disorder?
Being married and gainfully employed and able to build and maintain relationships as well as hold conversations with strangers when necessary can come at an exceptionally high cost for neurodivergent people in the form of masking (like a kind of mental tech debt). Instead of overt social difficulty, this might present itself as anxiety, depression, and suicidality—those conditions are worthy of medicalization IMO.
I agree with what you're saying, but also - everyone has problems. Is anyone truly normal or neurotypical?
Why do some people's problems get the validation of the medical system and others don't?
(These are non-rhetorical questions, I'm really not sure about the answers to them myself)
Why do some people's problems get the validation of the medical system and others don't?
Very roughly, because some people can't function without intervention (for loose definitions of "function"). And some treatment (therapy, drugs, whatever) can help them function.
Autism 1/Aspergers is sometimes kind of borderline - some people can function with it, but it can exact a heavy tool on them as a sibling comment noted. Depress and suicide are relatively more common. Why go through life miserable if it's not necessary?
People without autism or other diagnosable issues are generally more resilient. a bad week, one-off negative occurrence, etc won't send them into a tailspin. That's a very real concern with some neurodivergent individuals.
And you do have to remember, it's all a spectrum. And as observers, we don't know what a person is feeling/thinking internally and not expressing.
I asked this elsewhere but will ask this here - does calling people autistic and medicalising actually prevent misery, depression, and suicide?
This whole thought that autistic people who appear to have no problems are all secretly on the verge of not just burnout, but AUTISTIC burnout and will tailspin into the nether at any moment is a recent idea I have yet to see any actual evidence of other than self-report. The entire idea smacks of non-falsifiability to me.
Non-falsifiability on account of self-report is a pervasive problem in mental health. But just because something isn't falsifiable doesn't mean it isn't true.
If I told you I had to consciously monitor my tone of voice, and mannerisms, and level of eye contact to pass for normal, and had to silently drill these things in my mind before starting or joining a conversation, that I basically had to be like a method actor and get into character before speaking, what would you propose as a way to falsify or verify my claim?
You're right: it's non-falsifiable. And you'd be right to raise an eyebrow about the idea that keeping it up would lead to clinical depression. Doesn't mean it isn't true.
I don’t think anybody has said AUTISTIC burnout is a thing. Certainly, I never did.
And having raised a “high functioning” autistic son, I definitely saw when interventions helped. And I also saw the struggles my son had that his coworkers would have just written off as “quirky”. Sadly, he stopped treatment, was overcome by those struggles, and took his own life, so at least for this sample of one, yes, the interventions help. Right up until they don’t any more.
Yes. I get that your questions appear to be sincere and genuine, but, yes. Relative to the actual, demonstrable, neurological differences in connectivity and so forth in the “neurodivergent” brain, the overwhelming majority of people are “normal”. Relative to the actual lived experience of “neurodivergents”, the overwhelming majority of people are “normal”.
These kinds of questions are asked by people who simply don’t understand the enormity of the difference.
Much like people who don’t have aphantasia speaking to people who do. And so forth.
I'm pretty sure the majority of people on the internet who claim to be "neurodivergent" and/or have a diagnosis for some sort of ASD or ADHD do not show "actual, neurological differences in connectivity" though. For my little brothers it seemed like half the school suddenly had ADHD, mostly the kids who would in the past have been described as lazy, which I find hard to believe to be based on actual neurological differences.
> For my little brothers it seemed like half the school suddenly had ADHD
ADHD is simultaneously overdiagnosed and underdiagnosed; the case of your brothers' school could be the former, or correction of the latter (or both).
> mostly the kids who would in the past have been described as lazy, which I find hard to believe to be based on actual neurological differences
ADHD manifests as laziness to observers making snap judgements, so this actually tracks - turns out, some of the specific symptoms that, in the past, would make someone branded as lazy, are actually a disorder.
The problem with calling people lazy is that it's a moral judgement, which sometimes may be helpful as a form of corrective social pressure, but absolutely does not help when "laziness" is a result of a disorder like ADHD; it only makes them suffer that much more.
Much like people who don’t have aphantasia speaking to people who do. And so forth.
Aphantasia is one that I find extremely hard to wrap my head around. The notion that somebody who’s otherwise normal can’t visualize things is really interesting. I have a friend who has it. The only outward symptom is his dislike of fiction and most TV/movies (and you’d only notice that if you knew him fairly well).
Reading about aphantasia was a trip. I couldn't even understand it at first, so curious if this condition fit me I looked up the test for diagnosing aphantasia which started describe scenes of a beach, now with a sunset, and so on, to which I was hopelessly lost because the responses seemed to suggest I should be "seeing" something. I could "imagine" a beach, and think about how wet sand feels and what waves sound like; but of course I couldn't "see" it, it was just imaginary. I had to read an essay from someone else with this condition discovering that other people do "see" things before I had my little spit-take moment.
I think I _used_ to be able to visualize things. I remember feeling frustrated when I was younger and did a more art because I could never imagine the same thing twice when I wanted to draw it. Every time I tried to think about about it, it would have a different pose or texture or orientation. But even then I think I just had a different "level" of aphantasia. I could never figure out how to use color. I kept to pens and lead pencils for art and couldn't get into painting. Even now, staring at a wall and thinking about repainting it, I cannot visualize it with any other color, much less two or three colors for trim and accents.
One of the advantages, perhaps, is that I don't need to close my eyes to imagine things. There's no point, there's nothing there. I may let my focus drift so I don't get distracted by shiny or moving things. But I can stare at a wall, or go for a hike or a run and just let my mind go wild.
That said, I do enjoy fiction, though I never really get "into" anything in particular. In light of this discovery, perhaps it is because I'm not really able to "visualize" scenes to recreate memorable moments, I can only really enjoy it in the moment and maybe recall a few quotes and descriptions, which are harder to get excited about.
> Why do some people's problems get the validation of the medical system and others don't?
Because there are effective forms of treatment available, but are gated by diagnosis because of $reasons. Validation of the medical system enables one to access those treatments, perhaps most important of which is being able to tell yourself, as well as others, that you're having an actual problem and are not "just lazy" or need to "just get yourself together", etc.
I'm pretty sure that I would get a diagnosis of ADHD, because of my experience (in my youth) with amphetamines. Everyone else would be off their heads and I felt really focused and together (and could sleep!).
> Why do some people's problems get the validation of the medical system and others don't?
I'm going to give a pretty out-there answer for this: because they piss us off.
A problem is medicalized when the people who have that problem can no longer be ignored, either because the effects are so severe that their demands for treatment become loud on a societal level, or because the effects naturally bother other people.
We started treating HIV/AIDS only after years of the affected communities refusing to shut up about it.
We medicalize mental health issues because the people with them cause problems for the people without them. It is notable that many mental health conditions have names describing the experience of being around them rather than the experience of having them. Attention Deficit Hyperactivity Disorder feels like neither, but people around someone with ADHD get annoyed that they don't pay attention and move around a lot.
For another example, we still diagnose some children with "Oppositional Defiant Disorder".
They certainly do. And I don't think we can make meaningful comparisons between individuals in terms of their problems, how they struggle or suffer, etc. For me personally, I don't assume to have it any worse than anyone else, and I always assume that others have deep challenges that I won't ever know about.
> Is anyone truly normal or neurotypical?
Again, these concepts become strained when applied to individuals. It's like the family who has 1.5 children: they don't exist. These are ever-changing labels that we make use of within an extremely nebulous social process. I try to apply them only in well-defined contexts and then throw up my hands in the general case.
> Why do some people's problems get the validation of the medical system and others don't?
I have no idea; in my mind this question is trying to peer closely into the nebula.
Good thing I see no to negative evidence that autistic men actually mask. Autistic women I see more evidence for.
Also, saying "this deserves medicalisation" and throwing a label on people doesn't mean you're actually helping. Lets say somebody was masking - how would medicine help them?
Did you ask autistic men or how did you come to that weird conclusion? They likely mask just as much as women, even if you may not notice from the outside (which is the point of masking).
I agree about medicine not really being the solution, though. If an environment requires masking all meds can do is suppress symptoms, at best.
CAT-Q survey results mostly, a screening tool designed to detect masking, and autistic men report masking a statistically insignificant less than neurotypical men. Autistic women report masking a statistically insignificant more than neurotypical women. But the women did report masking a significant amount more than the men.
Not strong evidence but what exactly is the evidence that autistics are going around masking far more than the average bear? Low social motivation is an old theory for the cause of autistic social behaviours which is a theory which would indicate less masking. I’ve heard all this mask mask mask talk over the last few years, but I haven’t seen any persuasive science.
I should also be clear - I’m not saying autistic men don’t mask, or don’t struggle with masking, I’m saying I can find no convincing evidence that autistic men as a group mask an unusual amount. The diagnostic criteria does not indicate masking as a symptom, just as a potential risk that may confuse diagnosis especially in women by making actual social deficits which actually get you
diagnosed harder to detect but not impossible.
A lot of the stuff I hear people describing as masking is stuff that a few decades ago would have been called professionalism, or manners, or charm, or empathy.
When I'm meeting with representatives of a client, and one of them makes a suggestion that I know won't work, and I refrain from instantly and publicly shooting down their idea and instead I make a show of considering it, then ask them a probing question or two that let them realise the problem with the idea themselves - am I masking? Or am I merely being professional?
When I see something worthy of a compliment and I rehearse it in my mind to make sure it isn't objectifying or creepy, and that it's personalised to them and shows I paid attention to and understood the thing I'm complimenting - am I masking? Or just being charming?
When I'm socialising with people who are talking about their struggles to lose weight, and I in many years going to the gym have struggled to gain weight or visible muscle, but I keep my mouth shut rather than trying to build rapport about our shared inability to reach our target weight because I've tried it and I know it doesn't work - am I masking? Or just showing a normal level of social skills and empathy?
I think maybe you're misunderstanding what masking is. Masking isn't just not being an asshole. I'll give you some examples.
My face is usually flat, and my tone is usually monotone. Most people modulate their face and their tone naturally and don't have to think about it. When I socialize, I have to think about my face and my tone constantly. Yes everyone is doing this at some level, but for autistic people it takes as much effort as the thing the socializing is meant to accomplish, so that part cannot be enjoyed or suffers as a result of the intentional masking.
Another example is I have echolalia, which means sometimes I have an involuntary urge to repeat things that I heard earlier. I also have various tics where I move my body in wild ways that tend to make people uncomfortable or look at me in strange ways if I do them in public. When I'm socializing, I suppress (mask) all of these urges. I'm sure that most people suppress urges to move their body and make noises in public, but not in a way that autistic people suppress these urges -- again it comes down to it being a conscious effort that causes discomfort. I would compare it to having to sneeze for an entire meeting; all you are going to think about is having to sneeze, and the disruption you will cause if you sneeze and everyone will look at you. But it's not a simple sneeze, it's an action that everyone will talk about and gossip about later, something that will ostracize you.
Another thing I do when masking is more like mirroring. I'm constantly monitoring the situation to figure out how to respond, since I can't use the content of people's words I have to use contextual cues to figure out the appropriate way to respond. For instance I can know a joke is being told by the way someone is telling it, but I might not be able to tell you why it's funny based on the content. Still, I can laugh at the joke but I'm not laughing because I found it humorous, I'm laughing because I discerned the appropriate social place to laugh. And yes people laugh at jokes they don't understand all the time, but for me this extends to everything. I don't know when people are being mean to me, or flirting with me, or scamming me in real time. It takes days, sometimes years of reflection for me to figure out the actual social context of a situation I've been in.
I'm sure all this is true for many people, as I can't imagine socializing is easy for anyone. I do see people who can effortlessly talk with anyone and everyone, and I wonder how they do it, and if they face the same kinds of struggles as me when they go home and decompress. Do they stay awake all night replaying every social interaction from the night before? Do they have to spend days recharging before they can go socialize again? I don't know. But for me it's true to a degree where it makes me never want to go outside again. And that's what makes it a disorder instead of just a quirk or something everyone does.
It seems like a no-brainer to me. Women are more expected than men to exhibit emotional intelligence. To be understanding and supportive toward others and so on. A woman exhibiting autistic traits will be judged more negatively than a man, and so may feel more pressure to conceal them.
For instance, a woman who doesn't react in certain ways to someone's cute baby is some kind of child-hating alien monster.
The man who doesn't react in those ways is assumed to be wanting to do that, but actually masking in the other direction so as not to appear effeminate.
This reads kind of like “my parents hit me when I was younger and I turned out fine” though o highly doubt it’s your intention.
Just because things seemingly turned out OK doesn’t mean the treatment was appropriate. In the same way, just because someone manages to “get by” doesn’t mean they don’t need to be diagnosed. It’s just making their life needlessly more difficult whereas they could yave more resources that reduce the burden they have to live with every day.
Just knowing you have a diagnosis, regardless of whether or not you are treated, can be incredibly empowering and helpful. It isn’t a mystery why other people could sit down and study for three hours when I was in college and I couldn’t. I was diagnosed with ADHD, I knew where my blockers were and what they looked like (and continue to!) It gives me a lot more control and ability to manage myself day to day vs. assuming something is wrong with me. The latter feeling can be incredibly demoralizing and even lead to self-destructive tendencies such as a self-medicating with alcohol and drugs. After all: Why bother trying if you’re convinced you’re truly broken? It’s not something that has a name but that other people share this problem with you and manage is, again, incredibly empowering.
The anti-diagnosis attitude is surprising on a site like this. Everyone could do better with a better understanding of their own mind, whether it meets the criteria of a disorder or not. And with any kind of better understanding we need more and better categorizations.
A lot of people who post here meet the diagnostic criteria, and maybe they aren't ready to confront something new and scary about themselves. That's fine, it's something one needs to do when ready. Easier to say "That doesn't apply to me" if you're not ready to do the work; confronting an ASD diagnosis late in life is not an easy task.
It’s like a book where the main character who thought he was a doctor in the asylum finds out he was actually a patient the whole time. A mental health diagnosis forces you to go back and relive every moment with a different perspective.
Many people go through a prolonged period of skill loss/regression. I lost the ability to code for over a year. Took a long time to get to a mental place where that was possible again.
Wow, this is fascinating! What stopped you coding? My assumption is that the reframing would mostly be positive. I can see how it would help to reframe some bad experiences with more understanding for both yourself and the other parties.
My ability to code is predicated on my ability to feel safe mentally and physically. What finding out I'm autistic did was kick out my legs from under me. Every time I sat down to code I couldn't. Like, I felt it was in me, but I couldn't get it out.
I used to code and commit to Github almost every day. My commit log is almost all green since 2018 when I started using Github, but if you look at the last year or so you can see where I just stopped and it goes dark.
Thankfully within the last 4 weeks or so I'm back to my normal self, so it was temporary, but I don't know what I would have done if my job had depended on my ability to code.
> The anti-diagnosis attitude is surprising on a site like this.
Did you know, up until the 1970s, homosexuality was considered a mental disorder [1] by the psychiatric profession?
Can you understand why many homosexuals felt that they were just being themselves, and that them being themselves didn't warrant inclusion in a diagnostic and statistical manual of mental disorders?
With that thought in your mind, can you see how a happy and successful person who wasn't struggling in any way might feel similarly?
The good news is that we eventually decided (mostly) that the solution to that "disorder" was not to try to fix the individual, but to fix the society around them.
Many autistic advocates are, in fact, advocating for improving society such that autism is no longer a major barrier to success. Until we have that, autistic people often require medical care.
It is perhaps important to also note the recent pushback against autism's equivalence of conversion therapy (ABA).
I honestly do not think that’s a fair comparison to someone with something like depression.
LGBT people had been persecuted from so many angles for a long time, the tools used against them are incredibly varied. Just because mental health diagnoses were (and still are) used as a cudgel against them doesn’t mean the entire exercise of diagnosing should be called into question any more than somebody using a knife to stab somebody should call into question all of us keeping cutlery in our home.
I don't really accept the validity of people who are generally more functional and conventionally successful than average being called "disordered" in the first place. It seems like a weird arbitrary insistence of the medical system to simply pathologize anybody who fits into a certain box.
Being in a wheelchair is rarely going to be caused by a disorder, also autism is different insofar that the negatives and positives seem to be linked to eachother and are not merely a matter of random circumstance.
But practically, the disorder definition above basically would lump the above poster in with somebody who was struggling to hold down a part time job or any social relationships as having the same level of disability. All therapies, treatments, accomidations, etc will end up calibrated for the more profoundly disabled person while being offered to the above poster. Generally, peoples first impression of the person will understandably be based on that of the average person with autism spectrum disorder if they're told they're autistic which will cause them to be pretty profoundly misunderstood.
Your lack of knowledge about the range of treatment options and support available for autism/asperges does not make it true that all therapies, treatments, etc are the same. Your "take" seems to be very strongly held based on what appears to be a very limited set of anecdotal data points.
Out of curiosity, given it is a spectrum, what's at the other end of "really" autisitc (if that's even the right word) or does that just go from 0 being "normal" to 1 being that "really"?
It sounds like what you are thinking of is a spectrum more in the sense of a range, where one end is "least" and the other "most". There was an interesting article[0] making the rounds a few years ago arguing that it's more like the color spectrum. While there is an underlying linear value to the color spectrum in the wavelength, you don't really talk about red being "more" of a color than blue just because it has longer wavelength. Instead, we talk about combining, and sometimes mixing, colors. The article author argue that the autism spectrum is like that; it's made up of individual traits that make a whole. As I understand it, diagnosis is in part looking at the number of those traits that a person exhibit. Severity would then be a perpendicular axis to the spectrum of traits.
The problem with this line of labeling is there are multiple possible “spectrums”. I’m not sure what the best visualization would be… Like a starburst, with the center being normal, and all possible disorders going away (except they can be combined, so this isn’t perfect either).
But, if you’re asking about the typical autistic inability to communicate with others, then yeah, 0-1 works as well as any. Just don’t take it as literal or as the only possible set of traits.
Light is a spectrum generated by emitting three colors at varying intensities. Autism might similarly be a spectrum generated by emitting some number of traits at varying intensities.
It’s a spectrum because someone can be incredibly able to understand and relate to people, but completely unable to verbalize and communicate effectively. Conversely someone else can communicate just fine, but has major challenges in ‘modeling’, empathizing, or understanding the behaviors of others.
I have no idea what that comment is talking about, the "opposite" of autism is not schizophrenia -- there's no "opposite" of autism and if there were it wouldn't be schizophrenia, I don't see how that possibly follows.
The were describing connections to the nervous system. Autism was at one end of the quantity of connections and schizophrenia was at the other end. I think it was this thread somewhere.
But would it be worse for the world if we could actually understand and identify things - and find treatments for - executive function failures like extreme laziness or trouble with timekeeping?
Or are the people who fail to hold down a job really just morally bad and of low character?
Was it better for people to just be "weird" or "creepy" or "freaks" instead of somewhere on the autism-spectrum?
The judgement of the behavior predated the diagnostic labels.
> How has autism diagnosis stopped any of this from happening? People are absolutely unapologetic about calling autistic men creepy in particular.
It hasn't stopped it completely but now you've got a LOT more resources available to use to do something about it. And there are many more who will say something like "hey, you should look into this stuff" instead of just simply shunning and shaming than there were 40 years ago. Especially when spotted in early childhood.
There are no magic bullets. The solution to not being called creepy is, in the end, not acting creepy, same as it ever was. But the diagnostic/psych world can help people find a path to get there. Many of us have been following it for a while now. Do I wish my parents and teachers had known what we know today? Abso-fucking-lutely. Could've started to learn to manage a lot earlier.
Recall the context here of the comparison to those "lacking the talents of these gainfully employed autistics". No shortage of bad names to call them either. Many fewer structured and well-studied support systems.
When I talk to autistic men there's often a huffy entitlement that being called creepy is a form of discrimination, since autism itself is seen as "Creepy" independent of any objectively or intentionally creepy behaviour, and spend their time self-victimising instead of thinking about how they could change to avoid creeping out others.
I see them get despondent that they have a disorder which means they can definitionally are socially impaired and always will be.
As for the parents and teachers causing kids to not be creepy, that mostly consists of them saying stuff like "mastrubrate in your room" and "don't tell strangers you want to have sex with them". There's not actually a competent make autistic people not creepy treatment that's in any way mainstream or widespread (Although if one existed I'd be all ears). If I had to suggest anything, it would be intensive immersion in social situations with neurologically typical people, which doesn't really take a diagnosis.
Like I just keep hearing these theories about how we need to diagnose people with autism to get them resources and treatment but I don't know what these things are. Honestly I see men getting into stuff like looksmaxxing stuff because they're convinced of stuff like their perceived "creepiness" being a result of them being ugly (evidence would support that ugly people are seen as more creepy), and at least something like plastic surgery offers them an evidence-based method to reduce perceived creepiness - which is something the medical system DOES NOT COMPETENTLY OFFER despite the medical system also telling them that they have social deficits. I think the neurosis's being caused by labelling and reification are already doing damage.
I think the thing that bothers me most about autism spectrum disorder is it's seen as a sort of life sentence which involves impairments which by definition are lifetime and you can never overcome, and if you fit these boxes, even if you have no significant problems, you're some successful married computer programmer, you are just fucked for life! Yet when I look at the actual research, I see children going from being clinically diagnosable with a disorder to sub-clinical all the time in followup studies. Yet all we really care about is getting MORE people diagnosed with autism spectrum disorder, as in, it should be our goal to have MORE people labelled as being impaired instead of LESS people because we did such a good job resolving their impairments and making them independent that they no longer had any significant difficulties or need for support or a "disorder" label anymore. Being disordered has become a fucking identity where the more people who have the identity the more we are saving people.
Human brains are complicated. Many psychological disorders we have little hard science to understand them with. That doesn’t mean they don’t exist, and much more importantly, that a diagnosis is useful in improving someone’s situation.
>That doesn’t mean they don’t exist, and much more importantly, that a diagnosis is useful in improving someone’s situation.
Show me the actual proof of this. For something so at the core of modern clinical practice, the utility of diagnosis itself is taken for granted rather than actually proven.
I don't think you actually understand modern clinical practice. We are surely better than where we were at in the middle ages with leaches and stuff, but there is still a lot of practice and experimentation to see what works and what doesn't, just evidence without hard proof.
> the utility of diagnosis itself is taken for granted rather than actually proven.
Given the topic of autism, I'm not sure if you are trying to be sarcastic or not.
>We are surely better than where we were at in the middle ages with leaches and stuff, but there is still a lot of practice and experimentation to see what works and what doesn't, just evidence without hard proof.
Here's a question for you. When is the last time mental health outcomes improved in a way which could not simply be the result of reporting differences?
I would say the last time was around the year 2000, when suicide and drug addiction were at all time lows. Every single chance since then, on aggregate, has been useless and the entire field of mental health has completely failed to produce any evidence it has advance an inch this millennium which is absolutely fucking scandalous. I don't know how much oncology improved in the same period of time. Also if you include reported mental health data, people report WORSE mental health now than they did in the past.
Given that, I see pretty much zero reason why the status quo today does a lick to improve people mental health better than the status quo back then. I am just dead stupidly sceptical of diagnosis (at least beyond 2000/DSM-IV levels) as being a source of mental health because not only is it not proven people don't even attempt to prove this.
When the DSM-V was released, the director of the NIMH started the RDOC for research which was nominally supposed to do studies based less on categories like "autism" and more on underlying biological phenomenon, trashed the idea of symptom based diagnosis pointing out it has largely been depreciated elsewhere in medicine, and suggested we might have to get rid of the words schizophrenia and depression because they were confusing things. I think about such things occasionally and wonder if the entire diagnostic nosology we have is basically a fatally flawed system.
So my essential objection is, why medicalise people's identities if there's no evidence it's improving people's outcomes?
> So my essential objection is, why medicalise people's identities if there's no evidence it's improving people's outcomes?
20 years in a time of massive social changes? Would it really happen all so quickly? There are million things that could be making things worse. Heck, it could be case that without these treatments it'd be even worse. I don't know if that's true or not, but I'm saying consider the wider environment in which this is all happening.
It's impossible to really be sure either way. Maybe it's all garbage, maybe not. but make sure you're at least trying to look at the whole picture.
> you're able to build and maintain relationships, as well hold conversations with strangers or non-close acquaintances when necessary
The traits you are describing here and autism don’t exclude each other. Many autists live well. Some Fortune 500 founders and/or CEOs are autistic. I’m tempted to conclude you are projecting a stereotype, but I might be reading too much into your post.
Yes I'm aware that it's understood to be neurological condition.
But it's diagnosed based on behavioral observations, it's not like people get diagnosed with ASD based on brain scans like you would for MS or parkinsons.
I'm sure your diagnosis is legitimate, but also I'm inferring from your comment that you are married and gainfully employed; so it sounds like you're able to build and maintain relationships, as well hold conversations with strangers or non-close acquaintances when necessary.
In years past would any professional have bothered to test someone like you for a disorder?