Which illness(es) may have caused this?

[user9366]

Hello.

I’m a 21 year old male. Recently, I was told by my doctor I have ASD (high functioning), ADHD and OCD, which I felt was an important step because of how debilitating the last months have been.

Still, I find myself having problems that are intriguing and which cause me significant stress and pain. Since I’m a kid, it’s common for me to get stuck in inner debates for weeks or months over trivial matters, where I seem to be in denial and just fighting my conscience/intuition, causing me to feel great despair, sadness, and impairment.

Let me give you an example:

There’s a movie I and my parents loved to watch when I was a child. In fact, it was my favorite movie as a kid and I still love it. Many years later, I choose to rewatch it and have great fun, but realize critics rate that movie way lower than I thought, and that common beliefs about the movie differ greatly from my opinion, as I regarded it as one of the greatest animated movies of all time. I start reading their opinions and they start making sense to me, but at the same time I feel sad the movie I loved may not be as good.

Most people at this point would simply move on with their lives and do something productive or something that will make them happy. After all, why get stuck? Instead, I may well spend my next weeks scrolling down on my phone about this, trying to convince myself my previous opinion is true, though I seem to deep down believe the contrary. Maybe the movie really isn’t that good, I could just admit it, but I’ll always fight back, and to my detriment, because it never works. Sure, I may not need to take this new impression very seriously since I’m very sensible to arguments and can quickly run out of ideas to defend my point, and having a knot in my stomach when I say the movie is great doesn’t prove it to be objectively not great, since some people may believe it is great without feeling remorse. Anyway, I should just move on at this stage, because, as I’ve said earlier, trying to “fight back” only makes it worse. And after a lot of despair, I may just want to stop thinking about the issue at all.

Yet i can’t. I’m always pulled back, either by feeling tempted to “win the argument” or because thoughts about it come at me. I’d tend to think I’m just being prideful or stubborn, but this has been so natural in my life that I doubt such is the case. This was just an example. I could point many others.

It’s hard to tell how debilitating this is. What concerns me most is that I can’t “blame” this on any health condition because it doesn’t feel much alike any diagnosis of mine, though I may be wrong (I hope I am).

I’ve wondered if this could be due to being autistic and having ADHD, which makes people fixated on some topics. However, I’ve been told that “hyperfixations” are usually pleasing experiences. These inner debates are anything but that. On the contrary, they cause withdrawal, pain, physical discomfort and despair. I’ve wondered if this could be OCD, since thoughts are recurrent, but I usually ruminate not out of “fear” coming from a spontaneous thought, I do so because I engage in debates about issues. Granted, my “themes” aren’t the most common, yet this hardly sounds like obsessive-compulsive disorder. I’ve wondered if a combination of these or other illnesses could generate this unpleasant scenario in my head.

I’d really appreciate any feedback. It’s not nice to live with this burden, especially because speaking about this is so difficult due to the nature of the issue.

[CaringBee]

Dear @user9366

Thank you for reaching out in an effort to make sense and better manage what you are experiencing. What you shared sounds taxing and it makes sense that you’d feel scared and weighed down by it. I’m glad you were able to put it into words clearly, especially when the thing itself feels confusing and painful. It shows your ability to reflect and identify the issues you are facing, a great first step.

From what you describe, it’s typical of your diagnoses. The problem isn’t that your topics are “weird” or trivial (like a movie’s quality). I believe your brain locks onto uncertainty and won’t let go until it finds a perfectly convincing answer. That’s very typical of OCD-style rumination: you get a doubt, feel a spike of distress, then try to argue, research and “finally settle it.” Autism can add a strong need for things to be logically consistent and “right,” and ADHD can make your attention keep snapping back to the very thing that hurts you. Put together, it can absolutely create the kind of long, painful inner debates you’re living with. Please know that you are not prideful or stubborn, your brain is genuinely stuck in a loop.

You’re also right that most people would just shrug and move on. The fact that you can’t suggests this could be a mental health pattern. The knot in your stomach when you try to “just accept” things doesn’t mean your opinion is wrong. I think it suggests your brain dislikes uncertainty and seeks more reassurance.

There are ways to work with this. Therapies for OCD and rumination often focus on gently stepping out of the debate instead of trying to win it: noticing “oh, this is that loop again,” resisting the urge to keep researching or arguing in your head, and learning to live with some uncertainty while you choose to do something that matters to you in the real world. I acknowledge it’s hard to do alone, though, especially when this has been your pattern since childhood.

Thus, I encourage you to talk about this very specifically with the doctor who diagnosed you (and with your assigned therapist, if you have one). You could even read or show them what you wrote here, or use the movie example as your story. You might say something like: “I get stuck in long, painful inner debates about things like this, for weeks or months. I feel like I have to resolve them, but I never can, and it really affects my life. Could this be part of my OCD/ASD/ADHD, and what can we do about it?” They can help you figure out whether this is mainly OCD rumination, how your autism and ADHD contribute, and what specific treatment might help.

Please know that the way your brain works is understandable given your diagnoses, and it’s something that can be worked on step by step, and with support. Please speak to your doctor and therapist soon and reach out here whenever needed, too.

[user9366]

Thank you very much for your words. I’m glad you’ve explained this thouroughly. Curiously, this “topic” I’ve shared is fairly recent. Since August I had had problems with a deep existential thought that gave room to pejorative conclusions. For months I’d ruminate on it constantly or shake and tap parts of my body as a reaction to those thoughts. I remember thinking I wouldn’t mind if something else came in its stead and that it couldn’t get worse. Well, turns out it’s just as annoying when the topic is a kid’s movie and not a deep philosophy question :-).

I’m hoping to start CBT soon, I feel it could be life changing.

Thank you again for your reply.