I want to be a normal zebra not an abnormal horse.

The sentiment that I often hear is that individuals seeking autism evaluations are looking for explanations of social isolation, bullying, exclusion, or social awkwardness outside of themselves.  I want to be a normal zebra not an abnormal horse is a powerful statement made to me by a client years ago.  This urgency is so relatable. If I am autistic, it is not my fault because I am neurodivergent.  If this is a function of the human condition, I am defective.  The first explanation feels affirming.  Other ones feel like personal failure.

Full stop.

Autism frequently co-occurs with other conditions and yes, autistic traits present may not satisfy the criteria for an autism diagnosis.  In some cases, other mental health disorders may in fact better capture the clinical picture.  I know this can be difficult to think about. Mental health disorders do not represent personal failings, and autism is not a benign diagnosis for most.  Both areas may involve experiencing significant limitations in your functioning.

This is a sticky wicket.

The diagnosis of autism has been normalized by the neurodivergent movement. This is not necessarily a bad thing. In the past, autistic individuals were marginalized and discriminated against.  Bringing autism acceptance into the mainstream was and is an important step to helping autistic individuals to access services they need and be accepted socially.

In some ways, this may have created the perception that social challenges are not a function of the self but are outside of the realm of what some consider personal responsibility or failure.  In all cases, this is not true.

Autism is a neurodevelopmental disability that presents in early childhood and can sometimes even be identified in infants.  It is a lifelong condition that is impairing. There are many mental health conditions that share features of autism, like PTSD.  Individuals who have experienced childhood trauma need special consideration. OCD is in that OCD/ADHD/Autism triangle with there being recognized overlap.  Autistic individuals are 4 times more likely to have OCD.  That being said, about half of individuals with OCD have autistic traits but do not meet criteria for an autism diagnosis.  These things are important to tease out and require careful evaluation.  Diagnostic criteria are heterogeneous with a lot of overlap between conditions. Don’t get me started on the DSM.

I want to be clear.  Mental health diagnoses do not represent individual failings.  This is a social and cultural representation of stigma that is both inaccurate and unhelpful.  Additionally, some things we experience are not a function of a mental health disorders at all but are simply on the continuum of the human experience.  There is no abnormal horse about this. We are all zebra’s with our unique life experiences and struggles. Identifying challenges is helpful to creating a treatment plan tailored to your needs.

Whether autism is an explanation for social and behavioral differences or they are a function of something else, your life experiences matter.  They tell the story of what makes you who you are and this matters.  There are no abnormal horses.  We are all zebras, regardless of the source of our challenges.