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Comment by dave_sullivan | Hacker News Reader

I think in the future we will realize that OCD is actually autism and autism spectrum disorders are disorders with dopamine regulation. I think this because I used to be on the spectrum until I regulated my dopamine levels and now I'm much lower on the spectrum. Anecdotal of course, but the link should be studied more.

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I'd bet that almost all psychological disorders we diagnose today will turn out to have a large variety of underlying conditions that manifest in similar symptoms. We understand extremely little of the brain, we're at best in the "your humors are out of balance" phase of medical science when it comes to diagnosing problems in the brain.

That's a bit reductive as many mental health disorders rarely exist in isolation and are often "symptoms" of other issues. OCD, for example, may certainly have a high correlation with autism, but its manifestation has also been observed in victims of trauma and those with severe, untreated generalized anxiety disorder.

> its manifestation has also been observed in victims of trauma and those with severe, untreated generalized anxiety disorder

Makes sense, OCD rituals are a way to take control for people who feel the world is uncontrollable and scary and might hurt them.

There might be some genetic predisposition but I imagine environment/society is a huge factor. Make people feel safe and loved and they'll realize it doesn't really matter if their faucets drip a little or their books are skew. Conversely, if you live in a crime ridden area, it totally makes sense to worry about whether your door is locked.

Here's a paper which argues that the distinction between ASD, ADHD and OCD is biologically invalid: https://www.nature.com/articles/s41398-019-0631-2

So if that paper is correct (and of course it is only one study, and we should have more studies to explore this question further), that suggests that maybe the distinction between ASD, ADHD and OCD ought to be abolished, and they all ought to be subsumed into one bigger disorder, that then might even be subdivided into a new set of subtypes (based on actual biology) which would have little in common with the existing ASD-ADHD-OCD distinction.

There's a pre-alpha Minecraft mod I read about that divided them into “spoons” (https://en.wikipedia.org/wiki/Spoon_theory), “brain worms” (e.g. depression, obsessive thoughts) and a generalised version of “special interests” (which models both the traditionally-ASD and traditionally-ADHD variants). It takes a very game-mechanical-as-applicable-to-Minecraft view of them, but I thought it was a decent framework. I'll see if I can find a link.

How did you regulate your dopamine levels? Stimulants?

Buproprion

It's life-changing, modern medication. I just came off of a 5-month course. I think it has left me permanently cured of the skipping record. Leads me to believe it is not a problem with dopamine levels, but the brain needed a break from the stimulus that the old neural pathways provided, in order to grow healthier ones.

I've been on it for 17 years. I have been off it twice during my adult life, about 6 months each time. Just to see if maybe I didn't need it. Tendencies I can only describe as autistic returned. For me, it seems to be long term beneficial.

+autism = +dopamine in opfcortex or what

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