Should I get a second opinion?

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Hi,
I am in my late twenties and currently trying to figure out if I am on the autism spectrum (level 1). I have been researching and doing online tests for some time now, with most of the tests leaning towards me being on the spectrum. I see most of the common symptoms in myself in some way, except for "understanding on body language/facial expressions", which I feel like I can do without many problems.
I have been talking to my psychotherapist about my suspicion, and they said that it is unlikely that I am on the spectrum, because I can read language/facial expressions of others and I get emotional if I see other people which are e.g., sad. They also said that my problems with making friends/talking to people are likely related to Complex PTSD from bullying during school instead.
While I think that could also be an explanation, I wanted to hear some opinions from other people which are on the spectrum, if you had similar experiences, and see if it maybe makes sense to get a second opinion.

Thanks in advance!

Hey! Welcome to WP.

Autism is, of course, a spectrum. Symptoms vary a lot. Just because one autistic person isn’t able to do something, doesn’t mean every autistic person shares that inability.

My dad is on the autism spectrum and i notice he can’t read facial expressions. He seems to have difficulty figuring out what emotions someone might be feeling, based on both speech and actions. However, I, also autistic, can read facial expressions somewhat well. I can read emotion from expressions and sometimes speech

Emotional expression in autistic people vary. I see it range from being
Very monotonous person with little to no facial expressions
——————
loud, very outgoing person with extreme expressions.

Difficulty making friends is a problem i share, and have not yet figured it out. I am an introvert with social anxiety. If someone compliments me, i can’t tell if they’re trying to be my friend, or just being nice.

Welcome to wrong planet.

Everybody has a right to a second opinion.

What many people even proffessionals do not understand is that disability does not neccaserily mean inability. As said above it varies a lot but Autistic people generaly have some ability to read body language, to have empathy but less ability then typical.

It is somewhat common to be Autistic and have PTSD. It is very possible your poor ability to make friends is a result of PTSD caused by bullying. The question is why were you a target? Were you targeted because you always had a poor ability to make friends due to Autism or some other reasons?


Reasons people obtain proffesional diagnosis fall into two general catagories.

To get disability benifits and accomidations.

To get proffessional validation for their suspicions. Some people need proffesional validation, and some people don't.

FYI - Compared to the general population a much higher percentage of Autistic people are non binary.

Welcome!
I think people assume you are not autistic if you can read body/facial expressions because that is the most well-known symptom of autism, when in fact there are many symptoms and which ones you have varies a lot from person to person.
I have a moderate ability to read facial expressions. Some autistic people can do this better than I can; some struggle more. If you have a lot of other autistic traits it is likely you are on the spectrum.
In addition, I think many of us are seen as having less empathy than we actually do because it is more difficult for us to act on it. If I see someone who is sad, that will make me sad. Trying to help that person feel better is another matter.
All of this is based on my personal experience and may or may not apply to autistic people in general. If I'm wrong about anything, I apologize.

It doesn't sound like your psychotherapist gave a thorough assessment, just their thoughts - so it sounds like if you went for an assessment, it would be a first opinion rather than a second opinion. My assessment when I was young took several sessions with different professionals (a psychiatrist, a psychologist, an occupational therapist, and a speech and language therapist), with many activities, which resulted in a thorough report, so I don't see how one psychotherapists "I think [X]..." can replace that kind of process.

Also being bullied at school is a common experience for autistic people.

If it's available to you, go forward with an assessment that is thorough, and keep an open mind (that you may be autistic but also keep an open mind that you may NOT be autistic - if it's a thorough assessment, accept the result and be open to any possibility - you may go in for an autism assessment and come out with another diagnosis you had never even thought of).

welcome! lots of good input from experienced ND members here. I spent about 3 years studying autism, reading articles, taking self tests, etc before I decided I must be autistic. Its perfectly OK to ask for 2nd opinions. the problem most adults have when seeking diagnosis is that many doctors today do not have enough experience with older autistic adults, or autism in general, nor have they updated the information about science's current understanding of autism. It is the devil to find an autism specialist who has experience with adults in order to get proper diagnosis. Although most neurologists and scientists may have had a chapter in a book in their education, the majority of those who are general practitioners will only have run across autism in about 2 to 3 percent of their client/ patients (2 to 3 percent is a generally accepted statistic to how many autistic individuals exist in the entire population). So for the most part we do not have access to experienced or up to date professionals to do our testing and assessments.
Make sure the doctor you choose has had plenty of experience diagnosing adult autism. You can ask before you make an appointment, how many actual autism diagnoses in adults this particular doctor has made.

First attempt at diagnosis for me turned out to be ( I asked the person making the appointments who told me he did hundreds) that although the doctor did 300 or more psychological/neurological profiles a year, he told me during my summary appointment he had never diagnosed a single person with autism in a 40 year history of practice!! ! He did not know or understand about autism today. Instead he gave me about 5 co diagnoses which explained to him my test results.

I took that assessment report to the next doctor (my 2nd opinion) who worked only with autistic people and especially adults all his career, and he showed me on that profile that it actually reflected my autism completely, with some areas being super high performance but most being really poor. He explained that Autism is the result of uneven neurological development and that spiky profile in neurological assessments is a dead give away!

If you go for a second opinion, please look for somebody who has a lot of actual experience with autism and works regularly with adults. ( it will be very hard to find such a gem, but it is worth the hunt! )

There is no reason you cant have both ASD and PTSD. the two conditions are not mutually exclusive. The only way to be sure is to get an official assessment.

Welcome to WP!

Regarding your question:

1. Does your psychotherapist routinely work with Autism? Or is it just something they are vaguely aware of? My understanding is it takes some specialized knowledge to do an assessment.

2. If you've met one autistic then you've met one autistic. We're all different.

3. Some people fit the "Broad Autism Phenotype (BAP)." They have some Autism traits but not enough so to qualify for an Autism diagnosis.

4. Some people fit into other diagnoses that happen to share some characteristics with Autism.

Which all gets us back to #1. Does your psychotherapist routinely work with Autism?

Wow I am amazed and thankful that so many people responded! I am thankful for you all and I'll try to respond as much as I can.

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Thank you, that helps me. The way my psychotherapist phrased it, it sounded to me like not being being able to read emotions at all is like the biggest criteria for autism diagnosis, but maybe things aren't that simple.

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To be honest, I have very few memories from back then so cannot accurately say why I was targeted. The events I remember were mostly me being "socially awkward", not talking much and being "shy". It could be related to autism but it is hard for me to tell.

For me personally, it is primary as validation and knowing why I am the way I am (and having an easier time understanding that I am not "wrong").


Oh, interesting! I heard that there is apparently some correlation between being transgender and autism, but haven't read up on that much.


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Thats interesting and kind of describes how I feel! I tend to feel similar emotions to what I feel other people feel like at the moment, but never seem to have any way to "act" on those feelings? Like, what I am supposed to do if someone else close to me is sad.


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Good points. From what I understand, my current psychotherapist is not specialized into this, and it was less of a full diagnosis as non-autistic and more of a general vibe as "unlikely to be autistic". I probably should have elaborated on that in the initial post - my bad. From my knowledge the official way to get a diagnosis as adult where I live has a wait period of over a year, which is kind of why I made this post (to see if would be worth to take on that effort/investment). I am trying my best to be open towards either result that such an assessment could deliver.

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Thanks! I will try to figure which doctors and similar in my area have experience with this. I am still trying to connect to local autism-related support groups, maybe those have some tips.



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From what they said, they don't. Like the other people here said, I guess i will have to look around to see which people are experienced with this near me.

I will read up on those, thank you!

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Again, thanks to all of you. It feels really good to talk about this with people who had similar experiences!