Meltdowns

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I've been on this site for many years, but still no diagnosis. I am bipolar and my docs focus on that basically. Yes, the meds treat the depression and mania, but I still have devistating meltdowns since I was a child. When I asked my current doc to diagnose the meltdowns she basically told me I needed DBT therapy for them and the cause is unimportant. Ironically a few years ago when a previous doc referred me to the same therapy those therapists concluded I has AS and wanted to do autism therapy instead but the doc disagreed and insisted on DBT. I wanted to tell my current doc about this but for some reason I didn't. DBT is a therapy mainly used to treat Borderline personality if you are unfamiliar with it. Sigh, even if my current doc thought I had AS would that even make a difference though. Past docs I've brought up autism with have admitted I have traits but "not severe enough for a formal diagnosis". I can't believe I've struggled with this issue for as many years I have. If I wasn't bipolar maybe they would think what as left over was important.

Angnix, I had to present my case to my (primary care) doc and state that I wanted the referral.... presented, stated, but not asked.

For instance, in my case, I started with "my two children were both diagnosed with Asperger's, and there is a strong genetic component to autism spectrum disorders." I added "I think various members of my family of origin have a lot of autistic traits, for instance my father had a doctorate in math and my brother a doctorate in electrical engineering, and both have had various interpersonal difficulties." Then I mentioned a few of my traits, such as touch and sound sensitivities. Finally I stated how I thought having an answer could help me in life, such as planning for my retirement needs as well as getting along better with my adult children.

When you do it that way, they don't really have much basis to say no.

What are your reasons? Are they sound reasons to suspect the ASD diagnosis? Have you taken online tests? Do you seem to meet many of the core diagnostic criteria?

Whether they admit to it or not, these docs are thinking BPD when they talk about getting you into DBT. DBT was originally created by a BPD psychologist for BPD patients. It was later extended to autistic people, but I'm not sure I agree with that. I haven't read enough research.

These doctors might not admit to it because BPD is considered a stigma in the mental health community and "hard to work with." They might not want to brand you with a stigmatizing diagnosis.

Did you know you have the right to see your medical records, including your psychiatric ones? Just request a copy, you will have to sign a release and possibly, pay for some photocopying. This will tell you (a) how they see your case, and (b) how they will describe you to other people in the field, if they are contacted. Both of these could have a positive but perhaps more likely adverse effect on your future experiences. You will be asked on the form to give a reason for the request. You can just say "personal information" or "continuity of care."

If you get ANY pushback about this, they are violating your right as a patient. You should just persist. But hopefully you won't get any pushback. Doctors are sometimes afraid of being sued, or just afraid of being found wrong.

When was the last time you had any talk therapy? I get the feeling you could benefit from that. Obviously, it would be great if the therapist had any special training in autism. But we don't even have a diagnosis for you yet, so just some supportive (i.e., general) therapy could help you through this rough patch you're in.

I suspect I have an ASD because I have social difficulty, in fact so bad that as a child I had social skills therapy, I have meltdowns to an extreme level, I have strong "special interests", i get some sensory issues(mainly overwhelmed in busy environments) the therapists I mentioned earlier gave me the AQ tests and the RAADS tests and both came back positive and "aspie test" comes back positive too, also even a couple of my former psychatrists stated they felt I had "traits" at least, and I've had some complete strangers ask me about it "you remind me so much of Asperger's people I know" I've been told. But I've had one therapist try to argue that I am the opposite, "hyperempathetic" so stuff like that confuses me. But the bipolar is for sure there too and well that is what they have their eyes on.

Some of my traits look like borderline personality too minus the self harm issues. Even on the bipolar meds I have very severe mood swings, problems with self worth and identity, anger issues, etc...

Okay, well, there is enough diagnostic variability in that description that it makes sense for you to seek an evaluation! Some tests and professional opinions that you have ASD or ASD traits. That's the beginning. You will still have to present your case, and you will still have to wait a while for a qualified person to come up.

One thing you don't want to do is go to a generalist psychiatrist for this. That's like asking your general practice doctor to diagnose and treat a rare cancer without any consultation. Also, be aware that the older psychiatrists got their medical training before the higher-functioning or Asperger's entity became well known in the middle 1990s and may not have picked that up in continuing education. So you have to be picky where you get an evaluation.

I'm assuming you guys have Medicaid or similar? Don't let anyone tell you that "adult autism isn't covered." If you make a compelling case, they have to provide this, but they can stall you until you die of natural causes if you let them. Good luck!

I'm just trying to figure out what I am... It's like someone took symptoms of random disorders and put them into one person. I have severe mood disturbances whatever their cause and interpersonal problems that affect my everyday life.

That is rough. I'm sorry you are dealing with this.