DR MAX PEMBERTON: Why we should stop diagnosing those who say they feel uncomfortable as autistic

Something strange is happening. Autism, a serious neurodevelopmental disease, has gone from relatively rare to ubiquitous. Turn on the television, open a newspaper or browse social media and you will find more and more people talking about having been diagnosed.

What is behind this apparent epidemic? It’s disconcerting, because until a few years ago I could count on one hand the number of patients with autism I had seen in general mental health outpatient clinics. Now I see at least one a week.

Many of these new patients arrive complaining of social awkwardness, perfectionism, obsessive traits, etc. However, having worked in intellectual disability services with profound autism, his complaints are nothing like what true autism is, at least as it used to be called.

Partly fueling this epidemic is that in recent years autism was reclassified as “autism spectrum disorder” (ASD). Autism is a complex condition and the idea of ​​a “spectrum” was believed to better capture the variation in how it can manifest.

But the problem is that in medicine, when something is on a spectrum, there is inevitably “diagnostic creep”: the criteria expand so much that, over time, the diagnosis can become almost meaningless.

In fact, a study published by the universities of Montreal and Copenhagen in 2018 concluded, surprisingly, that if the trend continues, within a decade there will be no separation between someone with this condition and the average person, meaning we will all be classified. as autistic

Another study revealed that between 1998 and 2018, autism diagnoses increased “exponentially” by 787 percent.

In response, Professor Uta Frith, an expert in cognitive development at University College London, warned: “This strongly suggests that the diagnosis of autism has been stretched to breaking point and has outlived its purpose.”

Dr Mike Shooter, a child psychiatrist and former president of the Royal College of Psychiatrists, has said ASD is “grossly and dangerously overdiagnosed”.

Furthermore, there is no doubt that social networks, full of self-assessment questionnaires, are adding fuel to this alarming trend. Thanks to the way the algorithms work, after taking a few tests or searching for autism symptoms, you will be shown a source of similar content, leading you to become more and more convinced that you or your loved one must have the condition.

I see an increasing number of adults who have been diagnosed, many of them after paying a lot of cash for a private evaluation.

It has become a fashionable label to medicalize the simple act of not fitting in or being a little shy and different.

While autism was always considered a male condition (it had been called an “extreme male brain”), the suggestion that women could learn to “mask” the symptoms and have therefore historically been underdiagnosed, has now open the floodgates.

If women can learn to mask the symptoms, maybe some men can too? And so the advance of overdiagnosis continues. In true American style, being autistic has now become an “identity.”

Many of us who have worked with autistic people (or who have family members with the condition) resist this.

It is tremendously offensive that this disease, which imposes serious limitations and difficulties on the daily lives of those who suffer from it, can be hijacked by people who like to code or feel uncomfortable, for example, at a party. This diminishes and belittles the struggles of those with true autism.

Of course, people with autism can lead happy and fulfilling lives, but they (along with their family members and caregivers) need support and resources. The legions now flooding psychiatric clinics demanding to be examined simply take time and resources away from those who desperately need them.

There is no doubt that many of these people who say they have autism have problems. But features of autism, such as social impairment and obsessive behavior, are not unique to the disease. They are present in many psychiatric conditions.

Furthermore, receiving a label removes responsibility and agency from the person. It unnecessarily pathologizes difference, labeling it a psychiatric condition when it is simply a normal part of human variation, part of the richness of life.

Some may like being diagnosed with autism because it makes them feel different and allows them to claim some kind of special circumstances.

People love labels, especially if they believe it means they don’t have to change and can be used as a foil against criticism of their behavior or shortcomings.

The consequence of this overmedicalization of our differences is that the term autistic is losing meaning.

If we don’t fight this, it will be those who need the most help and resources who will ultimately suffer.

My heart sank when I heard that the NHS will be delivering millions of smart watches for health monitoring. God knows how much this trick is going to cost. People don’t want a smart watch, they just want to see a GP.

Strictly bed rest for Amy!

Strict dancer Amy Dowden missed competing in this weekend’s shows after falling ill while filming the previous Saturday. Just hours before collapsing backstage, he admitted that returning to work was “very, very difficult.”

In May 2023, the 34-year-old left was diagnosed with stage 3 breast cancer, and later that year she was diagnosed with “another type of cancer,” forcing her to miss last year’s series. I hope that Amy, who also suffers from Crohn’s disease, gives herself enough time to convalesce.

We put so much faith in modern medicine that we forget that our bodies need time to recover. Skipping this part does us no favors and means we often feel unwell for longer and increases the risk of complications.

How many of us have gone to work with a cold or after an operation when we should have been in bed? I hope Amy doesn’t feel like she has to come back until she’s ready.

I admit to being very cynical about the Government’s new consultation on the NHS. I’m not sure why they need it, given that the problems facing the health service are blatantly obvious.

I also suspect that this public consultation will be used to justify unpopular changes: an attempt to soften us up to covert privatisation, reducing what the NHS offers and introducing covert costs for certain aspects of healthcare.

However, if we don’t tell the Government how we feel about the NHS (good and bad), it sends the message that we are not interested and don’t care. Therefore, I encourage everyone to make their voice heard loud and clear by sending a response to: change.nhs.uk.