Confused and questioning my diagnosis.

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Firstly let me say I'm aware of possible issues with self-observation and denial, and these thoughts don't come from a 'denial-y' place, rather a rational thinking through of the diagnostic process. I have no problem with being diagnosed with Asperger's Syndrome (however meaningless that label will be in 2-3 years!) since it was at my behest that the whole (so far two years) process was initiated.

I took the online tests, I read Tony Atwood's book, I watched countless Youtube videos and read countless forum posts by people with Asperger's (diagnosed). I stuck to my guns despite considering other possibilities; namely Schizoid PD, ADHD-PI, AvPD and Social Anxiety, as well as being told by my psychologist that 'my difficulties were subtle', this latter point I'll return to later.

So it all came down to a 45 minute face-to-face, along with a little information in the form of a questionnaire from my Mum (my parents were unable to attend my assessment), as well as the two-page letter from my psychologist.

I don't know, I've been thinking about this a lot over the past six months and I'm just surprised at how non-rigorous the whole process was. It pretty much relied on my verbal 'testimony', a concern I aired with my psychologist later; no facial recognition tests, executive dysfunction tests i.e.; reaction times, etc, no scans or reading my old school reports (which I did take).

When I say non-rigorous I don't mean to insult the psychologist who assessed me, the procedure is what it is.

It's just when I read about ADHD-PI and Schizoid and they describe me so much better (I get the Aha! moment with descriptions of those far more than with descriptions of AS, indeed I believe that Schizoid IS in its origins almost identical to Asperger's, just not technically on the Autistic spectrum), anyway... the point is also the lack of any kind of differential diagnosis.

So to conclude, has anyone else had similar feelings and doubts at the milder end of the AS spectrum? Have you raised these concerns with a psychologist/iatrist and had any constructive feedback that has confirmed or alleviated these doubts?

I suppose this it part of the problem of an adult diagnosis :s

Let me also say Happy New Year and farewell 2010!

CofB

Well, for a while it was a question of whether I had ADHD or autism. I don't have social anxiety and I can have a conversation pretty well; and I have really strong ADHD traits too. I finally came to the conclusion that I had both, and so did my doctors; I'm currently on Concerta (stimulant for ADHD), which does help somewhat.

It may be that you're in a similar situation--you are autistic with schizoid and ADHD traits. Schizoid PD and ADHD are both closely related to autism, and share a lot of features.

The assessment for Asperger's is still based on subjective measures because the objective measures are no more accurate at detecting it than a trained psychologist. Some Aspies are great at face recognition; some have little or no executive dysfunction issues; some aren't very clumsy. The psychologist, if trained decently (there's always that caveat) was just as capable of detecting autism as any tests he might have given you; probably more so. (The average psychologist can tell autism apart from non-autism with reasonable reliability; telling ASD sub-types apart is generally little better than chance. This is because the sub-types are probably arbitrary rather than reflections of actual symptom groupings...)

In any event, the important thing is you have a label that will let you access the things you need. Autistics get access to social skills stuff, just like schizoid people do; and we get access to executive-functioning, organization, and self-regulation stuff just like people with ADHD do. This label is a tool you can use to get the stuff you need so you can do what you want with your life--learn what you need to know, get the adjustments you need to use your skills, etc. Don't worry too much about exact accurate diagnosis--whether this is right or wrong, it's likely close enough.

Thanks Callista, for the response to my post.

I'm currently on Concerta (stimulant for ADHD), which does help somewhat.

I'm actually considering going to the GP to ask whether this sort of thing might help me, under the Asperger's "umbrella"; I took a Sudafed (the pseudoephedrine kind) before going to a family get-together yesterday and it did help.

It may be that you're in a similar situation--you are autistic with schizoid and ADHD traits. Schizoid PD and ADHD are both closely related to autism, and share a lot of features.

Sounds about right, I'm fascinated by the apparent connection between these three, and SA, I do wonder if SA has Autistic roots...

The psychologist, if trained decently (there's always that caveat) was just as capable of detecting autism as any tests he might have given you; probably more so.

I didn't consider this. I guess I always assumed an objective test would be more flawless than any human interpretation of my situation (also bearing in mind my reservations of the first-person verbal report nature of the assessment). It never occurred to me that the tests themselves might not yet be up to the task... :s Although that's clearly why they are not YET a diagnostic tool.

Again, thank you.

Last edited by CultOfByron on 31 Dec 2010, 6:21 pm, edited 2 times in total.

It's psychiatry, not math. Looking for absolute certainty is likely to result in little more than a headache. You might consider other criteria, such as has the diagnosis provided you with information and other things that have been beneficial to your life.

To: Apple in my Eye; I appreciate that it's not an exact science, hence all my apprehensions subsequent to and prior to my assessment, also I've read Jung (teehee!)

At the moment it's not brought a lot of improvement since I'm looking particularly for something pragmatic, in the sense that I'm okay with being a bitter, cynical 'Outsider' type, but I'm looking for help with the executive functioning and self-esteem side of things; motivation & focus.

Apple, you raise an interesting point though, perhaps I have 'expected' the psychological industry to be a bit more 'scientific' than it really is...?

I think we're taught as kids to imagine that medicine works a certain way that is very idealized. In some areas, like cancer or heart attacks, I suspect doctors are very methodical and logical, but in other areas (things that can't kill you, basically) it seems to get fuzzy pretty fast. I remember hearing of a study where it was found that psychiatrists pretty much decide what condition someone has within the first 10 minutes of seeing them. My experience with CFS & doctors has been similar. It shouldn't be that way, but it seems a common human thing to use imprecise thinking when not being pushed pretty hard to do so. (I remember at certain age realizing that people don't usually think like computers (as I seemed to, especially at the time).)

That's unfortunate that the dx hasn't been too helpful. I'd hope that there's a professional somewhere who appreciates the fuzziness of things and will help you with what you want help for without worrying too much about precise diagnoses. I've had single doctors treating CFS & cognitive stuff as well as mood and anxiety stuff at the same time. (Possibly not ideal, but it worked out well enough at the time.)

Go watch a few episodes of "Mystery Diagnosis" to see just how "fuzzy" diagnosing physical ailments can be.

A trait of Asperger's is a demand for precise levels of accuracy. Welcome to the club.

I'm a big fan of House so I know all about that!

The life coach's two cents:

To me, psychiatry is a lot like sports: If it results in points scored, then that's all that matters and not so much how it happened. This is where the "aha moment" comes in; if you feel much better and you are happy, then the diagnosis is correct, It may be wrong in objective reality, but what does it matter as long as your life is running its course more easily and you feel fulfilled?

If you have your Asperger's diagnosis and you are NOT happy and it does not answer your questions about yourself, then it is wrong, NO one can scan your brain and see how it is work precisely; only YOU know if the diagnosis fits and if it does not, then you need to get with your doctor (or a new doctor) and look at other possibilities.

Before my AS diagnosis, I was diagnosed bipolar, then ADHD, then back to bipolar, then OCD with Anxiety, and finally back to bipolar... It was like a parlor game for the psych docs, but NONE of those disorders seemed anything like me. I was naive enough to take their words for it and I took whatever medications they gave me, but I did not fit the criteria for any of these disorders, the medications either did nothing or made me worse, and most importantly I personally FELT like they were wrong.

Asperger's was first suggested to me by a friend who was studying for his Master's in Psychology. One of his professors was discussing Asperger's syndrome during a lecture and he thought "wow, that is my friend, Steve, exactly." After that class, he took me out to dinner and told me his suspicions. When I got home, I researched Asperger's and wow, yeah! I had the "aha" moment! I found myself for the first time and I cried for three days!

Moral is: If the Asperger's diagnosis seems wrong, then it PROBABLY (not defintely) is wrong. At least it needs to be looked at a little more carefully. Give yourself and a doctor some time to consider other possibilites. The most important thing is the result, Your happiness is what matters.

Last edited by dyingofpoetry on 01 Jan 2011, 6:38 am, edited 1 time in total.

I was diagnosed with ADHD straight out of kindergarden but 35 years later when I went for my Asperger's evaluation as an adult the doctor said he had seen no signs of a learning disability. He said it was so obvious he could not see how they thought I was learning disabled and ended up being special education from first grade to tenth grade.

Thanks so much for all the replies everyone, I had been thinking myself into a tizzy and it was very, very helpful to read all your thoughts on this.

I still feel a degree of uncertainty but I suspect this is something that I must learn to live with.
Mainly it's the childhood aspect that makes me doubt the AS diagnosis, looking back I just don't see a 'typical' aspie child but again I am probably imposing to concrete a definition around the whole thing.

I'll decide whether or not to bring all this up when I see my psychologist next week, even if just to vent some steam.

Thanks again everyone for your insightful replies.

CofB