# Diagnosis Investigation This is an ongoing investigation into conditions, profiles and characteristics that may help explain experiences I've documented throughout my life. **After checking, I found that almost all of these suggestions were made to me online. ADHD was the exception.** **These are not confirmed diagnoses.** Some are stronger possibilities than others, and several may overlap with my existing diagnoses. ## Primary Investigations ### 1. PDA (Pathological Demand Avoidance) **Priority: High | Strongly suspected profile** PDA currently makes the most sense to me out of the possibilities I've investigated. My demand avoidance is not always obvious. Rather than simply refusing instructions, I frequently negotiate, delay, find alternatives or deliberately make an expected task difficult to complete. I've also described: - Becoming resistant to activities I originally wanted to do once they become expectations. - Repeated reminders making me increasingly unwilling to cooperate. - Avoiding demands even when doing so creates consequences for myself. - Using reasoning, negotiation and alternative approaches to preserve independence. - Being able to conceal avoidance or make it obvious depending on the circumstances. - A longstanding sensitivity to having decisions imposed on me. This goes considerably further than occasionally disliking instructions. I recognise a persistent pattern, and I want it properly investigated. However, PDA is a debated profile associated with autism, rather than a universally recognised standalone clinical diagnosis. Strong similarities do not automatically establish that the profile applies to me. ### 2. Alexithymia **Priority: High | Significant reported similarities** I've repeatedly described difficulties recognising, identifying and explaining my own emotions. I can understand the seriousness of an event without knowing precisely what I feel about it. I've experienced delayed emotional recognition, unusual reactions during serious situations and periods when my outward behaviour doesn't match what other people expect. This is one of the more substantial areas of investigation, although some characteristics may overlap with autism, depression or trauma-related difficulties. ### 3. ADHD **Priority: Moderate | Previously suggested** ADHD has been raised as a possibility. Relevant areas include attention regulation, task initiation, switching between activities, intense engagement with certain interests and difficulties managing some expectations. However, these experiences may also be influenced by autism, anxiety or other factors. Further investigation would need to examine childhood patterns and the effects on everyday functioning. ### 4. PTSD / Complex PTSD **Priority: High for professional discussion | Previously raised by others** I've experienced repeated assaults, bullying, significant losses and serious mental health difficulties. PTSD has previously been considered as a possibility, but no formal diagnosis has been established. An investigation would need to examine specific trauma-related symptoms, not simply assume that experiencing traumatic events means I have PTSD or C-PTSD. ## Additional Investigations and Characteristics ### 5. Interoceptive Differences Possible differences in how I notice, interpret and understand internal bodily signals, including sensations associated with emotions and physical needs. ### 6. Prolonged Emotional Numbness I've described becoming completely emotionally numb for hours at a time. This isn't simply hiding emotions or deliberately ignoring them. These periods deserve investigation, including whether they relate to stress, depression, shutdown or dissociative experiences. Emotional numbness itself is a reported experience, not a standalone diagnosis. ### 7. Autistic Masking and Camouflaging Possible extensive masking of communication differences, reactions, avoidance behaviours and emotional responses. This may help explain why other people sometimes notice patterns before I recognise them myself. ### 8. Autistic Burnout or Shutdown Periods of severe exhaustion, reduced functioning and difficulty communicating may warrant investigation in relation to autistic shutdown, burnout and mental health difficulties. These terms should not be used automatically to explain every episode. ### 9. Monotropism and Perseveration I can become intensely focused on questions, investigations and particular interests. I sometimes find unanswered questions considerably harder to abandon than unfinished tasks. This could reflect attention-related characteristics associated with autism rather than another medical condition. ### 10. Speech Fluency and Communication Differences I've experienced delayed speech development and ongoing interruptions in speech, including a stutter I didn't initially recognise. These experiences may warrant further assessment in light of my developmental history, hearing difficulties and dyspraxia. ### 11. Graphomotor Difficulties I experience pain and deterioration in handwriting during extended writing. This may already be explained by dyspraxia and hypermobility, but its impact on education is significant. ### 12. Sensory Processing Differences Strong responses to certain sounds, unwanted physical contact and sensory environments. These characteristics may fall within my established autism diagnosis rather than require a separate diagnosis. ### 13. Feeding and Eating Difficulties A highly restricted range of accepted foods and sensory-related eating difficulties. The important question is whether these experiences are adequately explained by autism-related food selectivity or warrant a specific eating assessment. ### 14. Rumination and Intolerance of Uncertainty A tendency to revisit unanswered questions, investigate details repeatedly and seek explanations for uncertain experiences. This is a characteristic for investigation rather than a diagnosis by itself. ### 15. Orthostatic Intolerance / POTS A previously raised possibility, but one requiring specific physical symptoms and appropriate medical assessment. There is insufficient evidence here to treat this as an established or leading explanation. ## What Is Already Diagnosed My established diagnoses include: - Autism - Dyspraxia (Developmental Coordination Disorder) - Mixed Anxiety and Depressive Disorder (MAAD) etc I also have recognised hypermobility. The purpose of this investigation is not to turn every characteristic into an additional condition. Some possibilities may be incorrect. Others may be overlapping descriptions of the same underlying experiences. **I want explanations that can withstand scrutiny, not simply explanations that sound familiar.** And whilst I do appreciate some of the suggestions people have made, I am very aware that a medical history can quickly turn into a ridiculous number of entries. I'm interested in understanding myself. Not collecting the entire medical dictionary.