Autism or cPTSD? Which?

Hyper vigilance when out and about, the way I clock certain people or situations and am aware of my escape routes, whats to hand that could be weaponised, making sure my hands are free so as I can fight if attacked.

Time slows down and I can move really fast, I've caught a cup falling from the table, I twist my body to minimise damage when falling down, I've learnt how to roll and how to land. It's hard to explain as these things are instinctive now and whilst I don't get triggered very often now and can deal with memories better, some situations will set me off and I'll be on edge all day.

Autismman said:

following rules and not liking them being broken is most definitely a classic autism trait

Yeah, when I look at the diagnostic criteria and read, "Excessive adherence to rules", I think, how can that ever be excessive? Rules are rules.

If I know that rules are going to be broken, I have to tell myself in advance that this is going to happen, that I shouldn't expect otherwise and that I should remain calm. It could be that someone does not know the rules, or someone does not have the capacity to follow the rules, so it's not necessarily that they are bad people. (I learned that from Marcus Aurelius!)

I think this has a lot to do with the need for events to be predictable. If rules are followed, then events are far more predictable.

The following rules and not liking them being broken is most definitely a classic autism trait. May well just be that your perception of the world is different from others, nothing wrong with that, more people should obey the rules, they are there for a reason. I can understand why this would cause you a great deal of stress. 

Autismman said:

So it’s more of a rules based ideology

OMG, yes! I love a good rule. I get terrifically worked up when I see rules being broken. My current bugbear is people who don't stop their car fully behind the white line at a red traffic light. Come the revolution...

So it’s more of a rules based ideology that you tend to follow and if others are seen to disobey or disregard your view on common sense and safety this causes you worry, concern and ultimately leads to increased stress and anxiety which you are trying to avoid all along? I would compare that to my need to order within my home, I get frustrated and overloaded if things are moved about and not put away tidily, I don’t mind a mess as long as it’s a neat and orderly mess. Things have to be done as soon as possible like washing up and crumbs need to be hoovered before I can relax. As long as I feel there is tasked that have been completed or are on their way to being completed I’m all good. Some people live in clutter and I don’t know how they could ever do that. My mother was a hoarder and would obsessively collect clothes from charity shops which filled up the house along with various ornaments and plastic bags filled with all odd and ends she felt she may one day need.

Thanks for engaging with me here, Autismman. Your gentle probing is helping me to get things a bit straighter in my head.

Autismman said:

So you are trying to avoid further anxiety by completing these self set actions which are influenced by the advise give during Covid and if you are unable to complete these tasks or enough of them to feel safe your anxiety can climb?

Not really. I've long had a "special interest" in microbiology and immunology. I have a good basic knowledge of how these things work. The COVID advice was something that was just basic infection control. If everyone had followed it to the letter, COVID would have disappeared in a few weeks. But everyone didn't follow it and I could see people not following it every time I had to go and buy food. There are always those who go, "I was just...", or "I just have to...", or "It's my human right to...", or whatever and many more people died because of them. So, yeah, standing in a queue when the person behind you is a) standing too close, and b) has their mask positioned UNDER THEIR NOSE, used to stress me right out. I'd be trying to swallow a meltdown until I got out the door. I don't feel I was being irrational; I was educated and I was being observant and I understood the potential consequences. But, I'm also AuDHD and small emotional triggers can cause a huge emotional reaction in my little brain, one that appears disproportionate by NT standards.

I don't feel I am "completing these self set actions". They are not routines I feel compelled to perform, they are simply basic precautions that I take (not always, but often). I touch a handrail on a stairs and I make a mental note to myself not to rub my eyes or nose. I'll either remember (and I suppose remembering takes some effort, so creates some stress), or I won't. If I forget, I get over it. It's more perhaps that I'm paying attention to everything (not just germs) at that same level of microscopic detail that is causing sensory overload and that causes stress and then I start spiralling off into hypervigilance, etc. 

Autismman said:

Are you habits mostly germ focused or more focused on how you think you appear to others?

I don't think I'm "germ focused" in any pathological way. I just think I'm just a bit more hygienic than the average person. It doesn't keep me awake at night. I don't have broken skin on my hands from excessive washing. I've even been known to obey the "10-second rule" and eat things off the floor (dry things, off my own floor).

I had a funny moment recently when I heard someone talking about the "5-second rule" and I thought, "OMG! I've been leaving it 5 seconds too long!" Yet, scientifically, I know that the number of seconds doesn't really matter: food on the floor is going to be contaminated immediately on impact. I make my judgement call and I go for it or I don't.

OTOH, when it comes to how I appear to others, there I probably have something pathological going on (AVPD?). I am cripplingly self-conscious and have been for as long as I can remember—well before starting school. Maybe that's some sort of side-effect of always feeling different from others because I'm Autistic: I always feel I'm in the spotlight and I really don't want to be there. Perhaps, though, it's just because I'm observing everything and overthinking everything, and assuming that everyone else is doing the same.

So you are trying to avoid further anxiety by completing these self set actions which are influenced by the advise give during Covid and if you are unable to complete these tasks or enough of them to feel safe your anxiety can climb? Are you habits mostly germ focused or more focused on how you think you appear to others?

Very informative,  thank you for posting 

I don't think I have OCD. I feel I have more of a learned response to situations where my social and communication differences have been perceived negatively. In other areas, I think I'm just paying a lot of attention to a lot of details, so I probably appear to be a bit "particular".

My "germophobia" is more an awareness and a practice than a fear or a compulsion. For example, I tend not to hold on to the handrail on an escalator, because I feel it is a probably a good place to pick up a virus like the common cold—or a bit of E. coli (ewww). If I do have to hold it (for balance), then I'll probably try to avoid touching my face or touching food until my hands have been washed. These are the sorts of things everyone was supposed to learn and practice during COVID. I was (and still am) a bit more diligent in this regard than the average person. I don't feel like it's controlling my life, or anything, though it is something that might contribute to my general stress level.

My general stress level can become a problem, though. If enough of these little things and others add up, I can become distinctly anxious, hypervigilant, hyperaware, etc. and that can spiral upwards quickly. So, my traits that might seem a little like OCD are not really OCD, but they might not be entirely benign either. On the other hand, I'm very very rarely sick.

Are there any particular things or situations you experience in life that you would say, "Oh, that's my cPTSD!"?

I have both and was diagnoses with cPTSD first, I'm not sure if I could start to unravel where one starts and the other ends.

Usually I’m wishing people around me would leave, not my family but if we have visitors it’s like something is out of place and taking up room where there should be space. Also I can only be social for a very small amount of time before I have to go off and do my own thing. 

Quite a sad hidden world when you think of it like that, how many poor autistic people are suffering in silence batting the world and its traumas 

It’s such a minefield of possibilities and wanted a definite answer is an important thing for me, like having a diagnosis I can accept fully without question. Some of the things you describe like ;

Damojo said:

these bad things will happen

- sounds very OCD also which some with autism also suffer with. I’ve had symptoms of this in my youth and some even today, I would check door handles till they broke, wipe light switches with my sleeve incase I left moisture on it and someone got a shock and even now I sometimes check that I have put the handbrake down on my car because a lot of these things are just using muscle memory so if I haven’t got a conscious memory of it I start to panic a bit. 

Yes, that link Iain kindly provided cites some research that about 60% of Autistics will have PTSD at some time in their life and about 32% will have it now. That compares to about 4% of the general population.

Autismman said:

Are we trying to predict the future to avoid an overload of more raw emotions and trauma because we are already juggling the load we have?

Yes, I think that is a large part of what is going on in my head. I need to "figure this out" and "get this right" or "these bad things will happen ... again."

Autismman said:

I don’t particularly like strangers sitting next to me on the bus or anywhere really, I feel they are way too close

On a bus, I don't feel too bad. It's very much expected that I'll be sitting beside a stranger, so I suppose I'm ready for it—it's factored into my prediction. If they start talking to me (which is rare), I'll get a bit stressed, though. However, if it's somewhere like a waiting room and there are lots of chairs, then it makes me really uncomfortable if someone sits near me when they could have sat somewhere else. Part of that is probably hypervigilance and defensiveness and part might be a bit of germophobia, particularly if the waiting room is at a GP—again, all part of me trying to continuously and very consciously make predictions about what might or might not happen. It's all pretty exhausting.

Thank you for that, Iain. I can see some PTSD things like "avoidance" and "stuck points" and being on "high alert" as being more likely not related to Autism. I probably tick those boxes.

I also notice that I have to be experiencing a high enough base level of stress before this "high alert" thing kicks in and starts to take over and rapidly ramp up my stress/anxiety level. If I can keep my stress level down low enough, I can avoid this stress/anxiety spiral. Recently, I've found noise-cancelling earbuds to be very helpful in this regard, though I never would have associated noise levels with my stress levels before. Less noise now means less stress, and less stress now means I am less likely to go into "high alert" mode and have things spiral out of control and head towards meltdown territory. It also helps that I have become very conscious of this process and I can talk myself through what is happening to me and that helps me stay more calm.

When it comes to things like flashbacks and nightmares, I'm not really sure if my experience is what others with cPTSD experience.

I can replay lots of traumatic experiences in considerable detail at will, but they are only occasionally intrusive (a few times a week, perhaps) and generally don't linger for more than a few minutes. Do they count as "flashbacks" or just memories?

Nightmares that I would relate to trauma are far less frequent, maybe less than once per year. I had a really bad one last year when I was very depressed, it took me hours to get over it. It was in itself traumatic enough that I have replayed it in my mind often since then and wondered how damaged do I have to be to experience something like that 30-40 years after the events that I am sure it related to?