I’ve been internet-diagnosed with autism plenty of times, but the one time I went to get evaluated, they said I didn’t have “it.”
But if it’s a spectrum with different combinations of different traits at different levels of intensity, maybe a diagnosis is irrelevant and what matters is what your constellation of traits actually is, regardless of an official diagnosis (which, let’s face it, is probably highly subjective outside of some constellations–that is to say, with a long enough list of psychologits, I could probably get a dx).
Personally, for me, what this means is I can look to autistic literature to see what resonates with me without worrying about the fact that I don’t share many of the hard markers for autism. For instance, my investment in the truth often conflicts with social niceties even though I can read people’s emotions. I can see myself as an unofficially atypical person in a lot of ways.
I’ll leave my resonsances in the comments below. Feel free to share yours.
Generally, the medical system doesn’t get involved until something “significantly impairs functioning” in one or more different realms. So if someone has all the traits of X, but it doesn’t get in the way of their socializing or working or jerking off, they don’t get a diagnosis. There are some exceptions to this–like hallucinations will probably always land you a schizophrenia diagnosis, but the general idea is that the medica system should not get involved when there isn’t an actual problem.
For “sub-clinical” I just mean any constellation of systems that doesn’t fully meet the official critera. So there’s usually a list of things and people need to have 3 things off one list, at least one of another list, and they can’t have anything on this other list. So sub-clinical would be someone who meets many of the criteria for diagnosis, but not ALL of them.
Funnily enough, you can have hallucinations without schizophrenia. Other than things like dementia and vision loss, narcoleptics (like me) experience hallucinations and apparently much more vividly than schizophrenics typically do, but without the delusion that it’s real.
But I agree with your general point, unfortunately it does also extend to hallucinations not being a big deal to doctors. They genuinely only care if you’re actively dying, a threat to yourself/others, or have something normal like diabetes. If you casually tell them you hallucinate, most of them will just look at you weird and move on.
I’ve never gotten tested for autism, but I imagine many doctors will do the same based on their preconceived notions of autism (e.g., oh you’re physically capable of making eye contact and not visibly stimming without a meltdown? Why are you even here?)
Edit: I just realized this is slightly off-topic from sub-clinical vs clinical. Moreso my experience of doctors using their personal beliefs rather than actual clinical criteria to check off if someone meets the threshold for a diagnosis.
Yes, thank you for clarifying about hallucinations.
I was thinking about schizophrenia in this context because it does seem to be treated completely regardless of whether it significantly impairs a person’s life or not. I’ve heard this from plenty of people with schizophrenia diagnoses who had to fight their way out of the medical cage they were put in.