The Truth About Autism and BPD: What You Need to Know

hi it's Dr Fox licensed psychologist in state of Texas and in this video we're going to talk about autistic spectrum disorder and BPD now over the years I've gotten a lot of requests for this video and it's a very complex intersection between these two disorders so I've done a lot of research I've done a real deep dive into these two disorders and I think first what we should do is not only break it down but then talk about the distinction and overlap between these two disorders so let's not talk about it anymore let's get into it please like share and subscribe and here we go so first we're going to do is we're going to cut the confusion so we're going to break down both disorders and I think this is going to empower you with knowledge about these two disorders so that you can help not only see the distinction but also recognize the potential overlap now we have to ask ourselves is there overlap and comorbidity and I'm going to talk about some of the most recent research that I was able to find so and then of course at the end like I do with all my videos I want to talk about what you can then do about the knowledge that I'm going to give you so here we go all right so I'll just expecting disorder well let's talk about first what the clinical features of the disorder are autism spectrum disorder presents as persistent deficits in social communication and social interaction across multiple contexts now social and emotional back and forth is usually impaired right so you don't have that social emotional interaction it's impaired non-verbal communication for interpersonal interactions and it's impaired developing maintaining and understanding relationships now with these individuals we usually see that conversations are often one-sided just poor eye contact and understanding of how to use body language to convey meaning but in addition it's also a poor ability to adjust Behavior based upon the environment that they're in now in these individuals we also see restricted patterns of behavior interests and activities we see a lot of stereotyped and repetitive motor movements use of objects or speech as well as an insistence on sameness that's an intense need for routines and ritualized pattern of verbal and non-verbal Behavior now this can include lining up objects parroting what other peoples are saying and they do it repetitively now seemingly purposeless motor movements such as body rocking could be self-biting teeth clenching or even grinding their teeth now in addition they may also have meltdowns when things deviate from the scheduler routine as well as thinking patterns are often fixated and intractable now next we see these restricted patterns of behaviors interests and activities now this goes to an intense focus on objects and fixated interests which I alluded to just a moment ago but it's an intensive high or low sensory input or unique fixation on part of the environment now this can be a fixation on like superheroes particular items like toys or game pieces even video games can be considered a factor here now there tends to be adverse response to sounds or textures which can include disproportionate smelling or tasting of objects or a visual fascination with lights or movement now these symptoms must first arise in early developmental period also known as childhood right now these symptoms may become more noticeable or pronounced when stimuli in the environment are beyond the individual's ability to manage so what that means is is that early in life a lot of times the individual may be able to cope with some of those strategies but then perhaps they get into more of a social setting Pre-K kindergarten Elementary School and those social requirements surpass what that individual is able to adapt to and manage so that's when we first start seeing these symptoms and that's why a lot of times we don't see it until the individual is older they are interacting with other individuals their age or they have more social engagement now these symptoms impair the individual's ability to perform in Social settings at work and or in relationship so again just like we talk about in all my other videos when we talk about sort of what are one of those sort of universal factors or Central factors that distinguish a disorder it is socio-economic dysfunction and that's what this this requires here because this is Autism Spectrum Disorder so in order for it to be a disorder it has to disrupt the individual's ability in Social settings at work or in relationships okay so it's important to realize that now these issues are not better explained so there's some stuff we gotta rule out they're not better explained by an intellectual disability or even a global developmental delay now what does this mean this means for example like when a child takes longer to attain certain developmental Milestones compared to other children their age so they could be slow to walking talking socially engaging playing with toys that are more age-appropriate now this could include walking or talking right fine or gross motor skills when you go from large movements to very small and fine movements like holding a pencil holding a pen this could be learning new things and interacting socially and emotionally with individuals their age now it's important to realize that autism spectrum disorder isn't just a disorder that either it is or it isn't right all disorders are on the Spectrum so let's break down with those three levels of autism spectrum disorder are now that level one without help social deficits are noticeable and impair functioning and the inflexibility leads to significant impairment in one or more contexts and that could be school home during play dates or during various interaction periods now let's talk about Michael Michael is at level one now let me read for you an example Michael greets you when he sees you he says how are you today you look well and engages with you but the conversation feels one-sided and he does not seem to notice the endings of phrases and often says yup while you're mid-sentence he has no friends but his sisters play with him often on his Nintendo switch Michael has a strict routine the last time there was a power outage and he couldn't play his Nintendo he sat on the couch biting his fingernails and repeatedly asked his dad why he can't play and I think that really gives a good example for that flavor of what that level one autistic spectrum disorder is like now let's talk about level two in level two we have even with help social deficits are evident and significantly impaired functioning and there's again this inflexibility of course is still present and it occurs so frequently and to such a degree that it's obvious even to the Casual Observer even to the individual maybe walking by at the street or they may see them at Target and they notice that something is a little out of the ordinary so that's your level too well let's talk about an example let's talk about Julia Julia doesn't look up at you when you say hello she says good to meet you today her voice is flat and she continues to look at her phone playing a game as you try to talk to her she periodically clicks her tongue Julian needs her phone to be on and playing her game while she's awake if her battery runs out she screams and yells and shakes her phone she has little interpersonal or action with her family or strangers she does not initiate any social interactions and this gives us a flavor for level two now does that mean everyone at level two is gonna have this these exact same behaviors and interaction Styles and patterns absolutely not because we know that everybody exhibits these different characteristics of this level or all levels of this disorder and all disorders in a unique fashion that's part of what the challenge is that's why experts who have seen this disorder can really be beneficial in order to accurately identify it just because you see something that looks a little astray or not right doesn't always mean autistic Spectrum Disorder someone who doesn't socially engage doesn't necessarily mean it's autistic Spectrum Disorder just a little aside there let's keep going all right so let's check out level three now this is severe impairment in verbal and non-verbal functioning extreme difficulty coping with change and restrictive or repetitive behaviors significantly interfere with all aspects of functioning so now we're talking about is a greater degree of impairment that influences all aspects of functioning well let me give you an example let's talk about Brian Brian speaks very little and tends to point to what he wants he often uses words instead of phrases saying it or that when pointing to what he wants Brian takes his skateboard with him everywhere he goes he does not write it he often runs his hands over the rough Underside or spins the wheels if change occurs Brian will tightly Embrace his skateboard Rock back and forth and moan now this I think gives us a really good example from Michael June Julia to Brian about the severity of autistic spectrum disorder and as they associate with the different levels now let's talk about BPD now we're going to break down those clinical features of the disorder so let's get into it all right BPD now the following so these criteria must be pervasive across environments with different people it can't just be that you exhibit this at home or with your significant other or with your mom or just your dad or with your sisters so it has to be a variety of different people in your environment now emotional and behavioral instability disrupts relationships and how the person sees himself or herself how he or she emotionally reacts and it drives impulsivity in addition there is an intense effort to avoid actual or perceived abandonment there is a tendency to see others as heroes or zeros that causes relationship disruption and you are uncertain about who you are and what you believe there's also impulsive self-destructive behaviors this can be through money sex drugs and alcohol eating whatever else it may be but that self-destructive component is present now there's recurrent suicidal ideation gestures threats and attempts as well as you see that those emotional fluctuations from sadness to Elation to anxious to irritable and this typically lasts hours not days and that's really critical from ruling BPD out from other types of disorders also the individual tends to feel chronically empty feel like there's an emotional hole inside that cannot be filled it's an intense anger and poor ability to control that anger under high stress you feel like others are out to get you or harm you or even abandon you and reject you now under a high degree of stress also you may feel like you're losing touch with the present and with yourself that dissociative experience right can also occur now these symptoms usually begin in early adulthood approximately 18 years old now during your 30s and 40s the majority of individuals accomplish greater stability in their relationships and Vocational functioning so now some follow-up studies indicate that after about 10 years as many as half of the individuals no longer have a pattern of behavior that meets full criteria for BPD what this shows is that treatment works it's not just a simple aging out of the disorders and behaviors and maladaptive patterns what happens is the individual starts to learn adaptive strategies along the way they start to develop insight into the issues that they're having and start to realize hey wait I need to do things differently these things aren't working in my effort in order to achieve my goals my behaviors thoughts patterns even the images that these individuals hold you start to realize hey wait a minute um it doesn't really match up I need to do it differently so they start to do it differently and therapy is a great aspect for that to help individuals move forward and cause symptom remissions and that's what we're going for now let's talk about Peter Peter is 28 years old was diagnosed with bipolar disorder when he first started college he would say that he always had mood swings and felt emotions intensely but while at College he would have intense crying spells feelings of sadness and then if someone did not follow through on what he said or what Peter thought they said he would get irritated and verbally attack them Peter has a long history of intensive relationships he felt that all of his Partners were his soul mate and that he was destined to be with them forever when the relationships ended he felt destitute lost confused about who he is and his worth and he would make threats of self-harm to keep them close if and when this resulted in perceived abandonment Peter would reach out to his sister his only trusted figure and she would help him seek help inpatient or outpatient now let's just pair this before we we get a little deeper into this let's pair this with with our three levels of examples with individuals along the autistic spectrum disorder do you get a sense for the difference for the contrast between BPD and ASD which autism spectrum disorder let's just think about that for a second I'm not going to pause the video too long you can pause right now and just kind of process those differences let's go a little deeper so let's talk about that comorbidity let's talk about that autism spectrum disorder and comorbidity so we're going to talk about the research first then the clinical perspective so research shows that most samples were of small clinical groups with the majority having a risk of bias that means that these these studies they're not really put together well the samples aren't great they tend to be really small and when you have small samples you can't generalize that really well to the larger population and the pooled prevalence of BPD in autism spectrum disorder was about four percent so that means you have a group of individuals that have BPD right we have a hundred percent of BPD people and in that hundred percent of people with BPD only four percent would actually meet criteria for autistic Spectrum Disorder now those with autism expecting disorder now we have a hundred percent of autism spectrum disorder people or people with autistic Spectrum Disorder you know what I mean and you have about three percent of that group would qualify or show features of borderline personality disorder and this is from those research studies that aren't really put together well that the research methodology is not great so it's not really generalizable so we have to keep that in mind now research does not find a high degree of comorbidity between these two disorders but the clinical perspective can can help us kind of broaden that view okay can help us look at it a little bit more so autistic spectrum disorder is an emotionally restrictive disorder with significant interpersonal impairment that is first evident very early in the childhood portion of the life cycle now BPD is an emotionally expressive and expansive disorder with significant interpersonal impairment that is evident early in the adult portion of the life cycle so we see one that is present here in the childhood life cycle right or we first becomes really evident the childhood well let's just say right that it first becomes evident in childhood whereas your BPD we see that start to become evident later in the adult portion of the life cycle so in early adulthood and we're talking about emotionally restricted as opposed to emotionally expansive disorder autism spectrum disorder fails to grasp the nuances of Social and interpersonal interaction and cultural verbal and non-verbal communication whereas those BPD they may have an impaired ability in Social and interpersonal settings and relationships but this tends to be due to compromised learning or traumatic experiences that created these maladaptive protective mechanisms so we get an idea again of this great difference of not only understanding how our world functions but also how to function within it autism spectrum disorder has little to no desire for emotional closeness whereas those with BPD they have an intense drive for emotional closeness and in some cases they may choose self-isolation due to awareness of avoidance of emotional pain but it's that insight into the pain that could be associated with emotion so it is a willful decision whereas those with autistic Spectrum Disorder aren't often able to discern and say well you know what I'm not really good socially and I don't really get anything from it so I would rather isolate myself that's really complex I mean imagine even Michael who we talked about earlier at level one him making that leap making that step it would be huge for him because he would have to consider all of these different factors not only all of the social factors and interpersonal factors but also the intra personal factors those things that are inside of him recognizing his own emotions so what are some final thoughts well here are my final thoughts I don't think that these two disorders are likely to be comorbid we certainly understand that I think that they are very Divergent I think that they're very different but I think it's important to realize that if you have BPD and you feel a bit like a social misfit so to speak and I'm not being derogatory I'm just using that as an example as as some individual some of my clients who have BPD often say well I think I have autism spectrum disorder because I don't seem to fit in I don't feel like I connect and sometimes for those with BPD it's due to a difficulty of knowing themselves or understanding themselves but also a fear of social engaging but they're able they have that ability to recognize emotions understand emotions to varying degrees whereas those with autistic Spectrum Disorder have an impairment in understanding disorders recognizing disorders now what I will say is a caveat to a lot of this is that some individuals with borderline personality disorder do have what's called Alexa thymium now alexithymia is an impaired ability to recognize emotions perceive emotions and manage emotions so those individuals with BPD that do have alexithymia what I like to do is I like to work on emotional identification identifying emotions and there's all these different things out there right those little faces you know that show Happy mad sad bored shy fearful ecstatic enthused whatever whatever it may be and it's looking at those things and trying to pick up those different emotions in real faces and that can be really challenging for some folks with alexithymia so it is possible for individuals with BPD who have alexithymia to believe that they follow along the autistic Spectrum Disorder so again I I hope you found this valuable please like share and subscribe and please tune in next time for my next video and thanks very much take care and be well and bye bye

Channel: Dr. Daniel Fox

Views: 37,737

Keywords: borderline personality disorder, autism and bpd, autism and borderline personality disorder, mental health, bpd, asd, autism spectrum disorder, autism disorder, dr fox borderline personality disorder, dr fox bpd, dr fox narcissism, dr fox favorite person, dr fox splitting, dr fox core content, dr fox narcissistic parents, truth about autism, truth about bpd, need to know about bpd, truth about autism and bpd, truth about asd and bpd

Id: dfBEoRNcBp4

Length: 21min 5sec (1265 seconds)

Published: Wed Nov 30 2022