Difficult psychiatrist not accepting aspergers diagnosis

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Which makes it even worse for the people with actual BPD, because it's getting harder and harder for them to get valid help from someone who doesn't write them off as "difficult patient".

What bugs me the most is that after they've made it clear they have no idea what they're talking about (by the nonsense they've just told you) they still insist you pay them their $230 per hour!! !

You are right, psychiatrists don't heal anyone and I think most of them would agree. Healing implies that the illness is totally taken away. Any decent psychiatrist will tell you that they use medications to manage symptoms. Some are pill pushers and medicate for every symptom until the patient is a zombie. However, the majority do NOT medicate for everything. I think your statement of there being no principle involved is BS. I spent 10 years in the medical profession and the psychiatrists I came across were people who care about their patients.

Psychatrists are not in it for the paycheck, they get paid sh***y wages compared with other medical specialists. The reason is because a very high percentage of their patients are disabled and have government insurance. For a 15 minute visit Medicare pays about $30, Medicaid or Medical Assistance payments are even lower in most states.

Yes there are bad psychiatrists out there, just like there are bad people in every job and area of society, but you can't characterize the whole profession based on the few that suck. A person also has to keep in mind that depression and other mental illnesses screw with your thinking and make you think that people are out to get you and hate you and that you'll never get better.

I am on an antidepressant and will be for LIFE. I've had depression since I was a little kid. I've been in deep dark holes so deep there was no light. Every time I went down into a depression it got worse and took longer to get out of. I am now on medication and will never willingly go off because I know what life is like without it. Without it I would be dead. No, I have not been medicated my whole life. The first time I went on medication was when I was 23 and I am now 34.

Therapy is an essential component to medications. For almost three years I did a lot of intense therapy work to learn coping skills and set up boundaries. There are a lot of people who are not willing to put this kind of work into getting better even though they are capable of doing so. In my mind they are just as guilty as the doctor who prescribes the medication that keeps them doped up.

I guess I am just jaded and cynical. It seems to me that once psychiatrists gets into your life, then they NEVER get out of it. They find a problem, your "diagnosis," and they provide a symptom reliever. But, they must monitor it, and so you must keep on coming back... it never ends.

I think you're right about wanting to see another psychiatrist. And yes, some psychiatrists are difficult, and even unprofessional at times. I think it's up to us to judge how good a psychiatrist is treating their patients, we must not forget psychiatrists are merely humans even though they have an MD - and like humans, they will have faults and biases. I don't think the fact a psychiatrist is meant to a 'professional' removes the suspicion of bias in their diagnosis, as I don't really believe their profession makes them see things in a neutral, objective way - a lot of people who haven't actually dealt with the mental health system think of them that way.

Yup, you are jaded and cynical. I went to a psychiatrist because I knew there was a problem and I needed help. The things I was trying on my own were not helping and neither was just talk therapy. The diagnosis doesn't really matter because they are not supposed to treat a diagnosis, they treat the symptoms.

But what does one do if they have severe problems with life (loneliness, etc.), and the psychiatrist is interested in seeing you only as a list of symptoms? That's why psychiatrists should not ever be allowed to give a diagnosis involuntarily, I think that in those cases they do more harm than good. Plus I think it's horrible the way they can label young people, but not be able to tell if they're going through abuse, in which case they need real help like stopping the abuse. I think it's a travesty when the connection between self-injury and abuse is being ignored, and they do it very often.

Last edited by Bun on 09 Feb 2012, 4:00 am, edited 1 time in total.

Any psychiatrist when you present with a "problem," is going to "treat" you. They will have a plan, a program, to assess you, and then come up with a solution. If they give you drugs, then ask them if you will ever be off these pills?

Ahhh.... that's another misconception. The goal for years was to get off medication and I even tried multiple times. However, just like before I ever went on medication, my depression would worsen then get better. As is the typical course for untreated major depression each episode would get worse. With all the therapy I am more stable and will probably be decreasing two of my medications in the spring.

There is a difference between situational depression and major depression. An episode of situational depression may require medication for a short period of time but severe major depression usually gets worse over time, which is why some people will need medication for life. I have had periods of two to three years of depression only on the mild end of the spectrum but then without warning I'd plummet. It's been almost 4 years since my last unmedicated plummet and it took 3 years and the help of medication and therapy to get somewhat functional again. If there were more warning signs and predictability then I'd go off medication and take it only during those episodes. But, I am not willing to risk that. Those deep dark pits are hell.

I don't expect you to fully understand the world of depression or any other mental illness but I would like for there to be some understanding and acceptance that psychiatry is/can been a needed and helpful thing for some people. Broad generalizations are rarely helpful for really understanding something.

A good psychiatrist will have studied psychology intensively, and will know when there are large social, cognitive, and emotional components to the problem that need to be addressed; and they will know when they need to refer to a psychologist or counselor or family therapist. A psychiatrist who tries to keep a patient on meds-only treatment is not taking full advantage of his knowledge. Even in cases where medication is the primary treatment (bipolar disorder for example), counseling can help because it can teach the person how to manage his treatment. Lots of people are diagnosed with something like bipolar and then given meds with little explanation of how they work and how to understand themselves and how the disorder affects them. A counselor can do that, and most of the time they're the best people to do it. Psychiatrists are MDs, and are experts in the physical aspects of psychology. Referring to someone who sees it from the emotional/social/cognitive angle makes a lot of sense for most cases. At the very least, there should be a couple of meetings with a psychologist to help a newly diagnosed person get informed about their diagnosis and create a coherent management plan.

Thanks, Callista. I'm in awe of your knowledge. I think it'll be a helpful read for anyone who has questions regarding treatment.

I'm a psychology major... these things are on the test.

It's no more 'labeling" someone to give a psych dx than it is to give a dx of something like diabetes or epilepsy. You go to a psychiatrist/psychologist for help, they listed to you and make a dx based on their findings. From there they use that dx to treat you. Some dx's are not there for life. For several years my dx was panic disorder and agoraphobia. I was treated for them and I no longer have either. I may have an occasional panic attack, but so do many people and I don't have them often enough to get near "panic disorder". I don't even treat the ones I do get except with distraction and coping techniques which would not work at all when I had panic disorder. I get one maybe four times a year, if that often, and it's been years since I had a full blown one. The agoraphobia is nonexistant now.

Something like a personality disorder may not ever go away completely but it can be managed to the extent that it doesn't interfere with the patient's life any longer and they show no symptoms of it. At that point in time it becomes unimportant and there is no need to inform others of the dx. Something like bipolar or schizophrenia, which must be treated with meds, is going to be a life long "label" dx, and medical personell need to know about it because of the meds that the patient is on.

When I am depressed, my dx is depression. When I am not, that dx does not apply to me, I only have a history of it.

My advice is to get someone else. No doctor; no matter what their opinion or findings may be, has the right to state those opinions and findings as irrefutable fact. Sounds like a typical old-fashioned stick-in-the-mud doctor on a power trip.

A more appropriate doctor might say something like "Asperger's is not something with which I am most familiar, and based on what I have learned from our sessions, I believe you may have BPD and not Asperger's. However, I encourage you to seek another opinion, as that would be the prudent thing to do in a case with a significant diagnosis such as either of these".

All doctors should be open-minded, and always remember that they are not God, and are not supernatural beings who can see facts that the rest of the professional world can only find as opinions.

Charles

I won't trash the field, but this guy has an attitude problem. Actually, I've run into this attitude in regular medical doctors with my IBD. The doctor who said I had Ulcerative colitis refuses to acknowledge my Crohn's symptoms. One GI said I didn't have IBD at all. Doctors can almost be possesive of THEIR initial dx IME.
You will have to find another, sorry.

Sincerely,
Matthew

I can tell you that I have in fact been on medication before, prescribed by a psychiatrist, where the explicit plan from the beginning was that I'd only be on the medication for a short(ish) period of time.

Her role was to manage the medication, so that the other person I was seeing would be more effective working with me. Social anxiety was all I was diagnosed with at the time, but it was known even then that it was secondary to Asperger's, and the point of the medication was to help with the anxiety such that she'd be able to help me more, and then after two and a half years, I was off the medication.

Your descriptions do not match the entire field.