Should I get a second opinion or am I just not accepting DX?

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So on Wednesday I went to see a psychiatrist who is an ADHD and Autism specialist privately on the recommendation of a local ADHD support group. The psychiatrist said I have ADHD and insisted that I also have Asperger Syndrome. I was expecting to be told I have ADHD, but after 40 mins of rather strange questioning and some short tests he was adamant that I am on the autism spectrum as well as having ADHD. On Thursday I went to see my regular psychologist and she is questioning his diagnosis. In her words "you can make eye contact and it seems like we have a relationship." and "You aren't like the children I've worked with in schools.".

I've been made to see various psychologists and psychiatrists since I was 12 years old because I used to have temper tantrums and throw my chair and things across the classroom, so I am surprised no one picked it that I may have AS before.

I'm questioning what I should do now? Should I seek further clarification or a second opinion? I'm starting to feel like I've been deceived by someone again and parted with a lot of money, I'm very easily tricked, my girlfriend has described me as an "easy mark" several times.

I'm really confused as to what I should do?

EDIT: I'll add that the specialist also had a detailed report from my psychologist.

That's really difficult and I can only offer my own experience. I was referred to a psychiatrist as I suspected I had Apergers. After a few consultations he put my apparent problems down to a mental problem and referred me for CBT with the psychologist. At my first session with the psychologist I expected to start the therapy but instead he told me he thought I had Aspergers. At first I was relieved by this but in the weeks that followed I got upset by it as I felt I couldn't progress until I was actually sure of my diagnosis. I have now seen them both again and they now both agree it's Aspergers.

In conclusion it seems professionals may disagree and, for the person seeking help, that's an awful experience.

From your post I'm concerned that so much is based on work in schools and your ability to make eye contact. Some ASD traits can, I understand, be overcome by learning behaviours that don't come naturally. Your profile says you're 32 so I suspect that's likely. Secondly I would contend that there is a big difference between diagnosing a child and an adult.

You should be within your rights to ask for a second opinion.

Based on what has been posted many times here many experts do miss diagnosis autism in females.

Everybody has a right to a second opinion

The non expert said things that a non expert might say another words wrong things. Adult Autistics often do not present as Autism Children due to maturing and learning. Thus because a person can make eye contact does not mean they are not autistic.


But you should ask the expert psych why he or she is adament. That is your right as a client and information you need.

This right here is a HUGE red flag that this psychologist has no idea what she is talking about. And she doesn't even know that she doesn't know what she is talking about.

It makes a lot of sense to me that you would want to get input on this kind of diagnosis from someone who has met you for more than one afternoon. Its too big of a diagnosis to simply guess at. But the therapist you spoke of is not the right person for this job.

Its a repetitive theme that women on the spectrum get called out for not having autism because they are able to look someone in the eye and have decent verbal communication skills. This is because females on the spectrum are better at these things. Even in girls who are significantly challenged by autism, have lowered IQs and limited pragmatic speech, have a different profile than boys. These girls do tend to talk more, have more eye contact, and be more desirous of having friends. But they also have significantly more behavior problems and more sensory problems.

There are lots of resources on the internet for women on the spectrum. I suggest that you spend some time educating yourself. Only you can know if you need to ditch this therapist, or if its possible for you to go back to her with more information and help educate her on the issue. You might even decide that autism doesn't describe you, but that therapist still has no idea what she is talking about.

She isn't a bad psychologist, she isn't a specialist in ADHD and ASD, so she probably doesn't know what she is talking about. She has helped me a lot with anxiety issues and emotional regulation.

The psychiatrist who gave me the diagnosis of ADHD and Aspergers is an expert on ADHD and ASD. I just thought it would take longer than 40 minutes. I expected it to be a more scientific process, but maybe he has so much experience he can diagnose people easily. I certainly have traits of Aspergers, but they could be just ADHD too:

• Miss subtle social cues. The games other people play constantly trying to "figure me out" make me quite stressed. (social politics, someone flirting with me, can't easily tell if someone dislikes me).
• Told I am naive and tactless.
• Stimming/Fidgeting. Pacing, rocking, spinning and foot stamping/hand flapping when stressed.
• Often blind to sarcasm (I don't have issues with metaphors though).
• Often very slow to get jokes.
• Don't understand teasing.
• Taking things literally a lot.
• Auditory problems - I can't filter background noise and sometimes get very stressed with sudden loud noises or certain noisy environments. Voices can sound like a bad radio sometimes.
• Visual problems (LED lighting/Florescent light will stress me out). A bright camera flash will make me jump or blind me for a few seconds.
• High pain threshold.
• Weird response to heat, I can hold objects up to 85'C (yes I measured it). It freaks people out.
• Bad meltdowns/temper tantrums, I get tunnel vision and get into a rage oblivious to my surroundings. I've got arrested and also hurt myself before
• Need to wear sunglasses almost all the time. Sometimes even indoors.

I don't have trouble sleeping. I can socialise in small groups in familiar places.

I was diagnosed with ADHD when I was a child, it was largely uncontrolled and I received minimal help with it. I managed to get myself through school without getting expelled and get a degree in an area I was interested in. The whole point of going to see this specialist was so I could get ADHD meds (SNRI) as an adult as I've been struggling a lot at work.

Regarding the eye contact thing, I've been told I had problems with this as a child, teacher reported it to parents. I'll admit I make a conscious effort at it and did work on improving it when I was in my early 20's.

It doesn't matter to me if I am on the spectrum or not, I suspect I probably am, I just thought diagnosis would be more thorough and scientific than a verbal battery of questions I found odd.

^ somanyspoons. I agree.

OP, that sounds a lot like me - I've been hiding my AS, without even knowing what it was for decades.
I'm perfectly capable of making eye contact - it's a automatic response by now ("look at me when I am talking to you" is printed on the inside of my head, since childhood).

As others have written, do educate yourself about autism/asperger as the first thing. Read some blogs, for example https://everydayaspergers.com/ and https://visualvox.wordpress.com/
And also take a deep look at the questions in AQ and RAADS-R - don't just take the tests, but think long (days) about the questions before you answer them, in writing, to yourself.

Then question your psychologists and psychiatrists about their opinion.

I agree too, and best wishes to the op

Thanks everyone for your suggestions. My girlfriend and some close friends think the expert psychiatrist is correct, I am just surprised that he came to that conclusion so fast. Maybe I will get a second opinion.

I think if the expert was unreliable he would have milked a lot more time and testing out of you. The other shrink just shows why you were correct to see an expert. I can't relly imagine expert b refuting expert a.

A 40-minute session with someone who, perhaps, gave you a couple of online tests, should not produce a definite diagnosis.

The other therapist seems like he/she has an outdated notion of autism, the typical pre-DSM IV version of it. The one where Classic Autism was the Only Autism.

I would try to obtain a diagnostician who specializes in adult autism.

Forty minutes seems like rather a short time; most diagnostic sessions I've heard of including my own would be several hours at least, and several hours-long sessions over days or weeks at most, depending on how many tests are conducted and how full a diagnosis embracing the testing for and eliminating of other conditions.

However, despite the short time, the second clinician sounds like he knows more about Aspergers and autism than the first one, your regular psychologist.

I agree with everyone else, she has an outdated, narrow and steretypical knowledge of autism and Asperger's.

Her comments are the same kind of mistaken remarks made by lay-people, the general public, and they are things that ordinary friends and family often say to people with Aspergers or high functioning ASD.

She may be a good psychologist in general, but this is something she's as clueless about as the average Jane on the street.

Eye contact is often learned through the years by older people on the spectrum; adults do not "present" the same way as children, and especially female adults do not present the same way even as male adults.

If I were you, I would be inclined to reject your psychologist's limited and mistaken take on it, accept your diagnostician's conclusion, but also seek a second opinion from another clinician just to confirm, undergo possibly more or different testing methods, and find out for sure.

There are some good opinions/suggestions here. I just want to offer the idea that the specialist who diagnosed you with an autism spectrum disorder may be experienced enough that, by history (what you experienced as a child and more recently) as well as by clinical impression, it was not felt a battery of tests was necessary.

How do you feel about the idea that you might be autistic? Is that helpful to you, or upsetting? Where do you think you'll go with this information?

That's a good point, Bea -- another thing that's sometimes said around here is that when the process was over, the clinician told the person "I knew you had Asperger's in the first ten minutes" but they couldn't just make it a ten minute deal, lol!

This actually happened to me too; mine was hours and hours but I was told later that the first ten, fifteen minutes made it clear, the rest was due diligence.

It may very well be that forty minutes was all this diagnostician needed to feel conclusive in his verdict.

As it is often stated as a hidden ""Syndrome"" People/professionals that spend more time observing the outside forget about the inner.. It is often the inner self that isnt expressed through body language that i think might get some people confused.. unless you are a specialist that can see the minute subtleties other professionals wouldnt.. I myself seem to have done pretty well at this of late.. after all the reading i have thus far done i often seem to pick out the subtle traits of those that i think maybe on the spectrum where all others wouldn't pick up.. and after conversation aspergers comes up and find out very quickly they are on the spectrum.. Maybe its the reading, maybe its seeing the similar traits in myself that i had maybe perceived as been ""Normal"" and wide spread only to find they are rather unique to a few..So now being aware of these subtleties i am often able to detect them in others.. Like a flick of the switch, so to speak, a couple of years ago i wouldn't of had a clue who may or may not be on the spectrum, unless very obvious.. But now being made aware and researching i seem to have a bit of a radar for it so again to speak ... But this also stems down to a passion, a passion to understand.. So in many ways the person that mentioned they had been around other people on the spectrum, may not be fully focused in that area and are only connecting a few visual cues, whereas those that do seem to know alot about the spectrum tend to be very deeply involved in this area and with time have also managed to pick up subtleties that others would miss... Also, like myself its very common for aspies, to learn a behavior, for instance i used to HATE looking into peoples eyes, and still do now to some extent, up until maybe 8 years ago i would always look at the mouth /forehead or off to one side, but in the last few years i have managed to hold eye contact alot more, and alike i can also get into conversations with people, but other times i cant.. Also it seems many of the specialists on the spectrum, seem to fully understand the false stigmas and even bring them up before myself.. But the ones that to me seem to have very little clue are those that govern all decisions based on what a certain book says and misses the other cues because they were to busy concentrating on what they ""THINK"" they should be looking for as opposed to what they ""SHOULD"" be looking for... For those on the spectrum, especially us maturer apies we can often pass off rather well, but the inner workings that arent seen can be masking... As when i was younger i was much more verbal in many aspects... but again overtime it became more internal to the point i may seem a little stoic, but rest assured im firing on all cylinders internally... It also seems right now the spectrum is gaining more momentum in the understanding of this area and specialist's are now flooding out data that contradicts what was previously thought adding to a very wide/broad and different knowledge base out there... Those that are keeping up with new knowledge are those that you can tell are keen to understand.. but then you have some that follow a book like you are part of some ikea instructions manual and wander why some of the pieces dont fit or are missing in their arguments... Its knowones fault parse , however certain organisations etc have not helped at all in informing the ""REAL"" truths of those on the spectrum, so in many cases at the moment it can be hit and miss with specialists unless they have quit a focus to learn about those on the spectrum and keep up with modern scientific understanding rather than is in some way still a rather draconian thought process in their evaluations... I hope that made some sense!

It certainly explains some things. I just kind of thought I might be imagining them. I'm not sure, maybe I'm just surprised and having a hard time accepting it or upset that it wasn't picked up sooner and I might have done better in school. I really don't know how I feel about it.

A few friends I've disclosed to say it doesn't change the me they know. At least it explains why I don't "pick up" on things like other people seem to do. I do have some very nerdy hobbies and collect things others might consider odd.

The questions the diagnostician asked were really weird and rapid, almost like so fast he was trying to confuse me.

I'm also wondering how to talk to my parents about this.