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Tyri0n
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28 Jun 2013, 11:25 am

The new Psychiatrist in DC attacked my autism and PTSD and said I just have bipolar type II because, he said, "you don't strike me as autistic."

So prescribed lamictal and letudo. Is there any chance he could be right?



Bitoku
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28 Jun 2013, 11:58 am

I can't say whether he's right or not, but keep this in mind... Bipolar is very over-diagnosed by phychiatrists because it's one of the only conditions that can be treated somewhat reliably by medication, and have that medication covered by insurance. Bipolar also started being diagnosed before most other conditions, and shares a lot of surface traits of other conditions.

Just a question... is this psychiatrist sort of old in age?
I ask this because from my experiences, they may be less likely to notice other conditions because their initial training focused more on bipolar, before the time of understanding a lot of other conditions as well as today. A younger phychiatrist or psychologist can sometimes have a better understanding of conditions simply because psychological study has progressed so far in a relatively short amount of time recently, and the schooling/training for it is quite different than it was 30 or even 20 years ago.

Even Bipolar is a lot better understood these days, and having gone through a psychology degree recently, I can see why older professionals sometimes just aren't equipped with as accurate understanding about it, even though they may have decades of job experience.

But here's something simple that might help... a good way to spot bipolar fairly accurately is basically if the high/low mood swings follow a fairly predicatable time-based pattern, and aren't simply reactive in nature.



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28 Jun 2013, 4:27 pm

Get a second opinion. I don't like people deciding someone has this "mental illness" because they obviously don't have "this." It makes no sense.



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28 Jun 2013, 9:12 pm

Bitoku wrote:
I can't say whether he's right or not, but keep this in mind... Bipolar is very over-diagnosed by phychiatrists because it's one of the only conditions that can be treated somewhat reliably by medication, and have that medication covered by insurance. Bipolar also started being diagnosed before most other conditions, and shares a lot of surface traits of other conditions.

Just a question... is this psychiatrist sort of old in age?
I ask this because from my experiences, they may be less likely to notice other conditions because their initial training focused more on bipolar, before the time of understanding a lot of other conditions as well as today. A younger phychiatrist or psychologist can sometimes have a better understanding of conditions simply because psychological study has progressed so far in a relatively short amount of time recently, and the schooling/training for it is quite different than it was 30 or even 20 years ago.

Even Bipolar is a lot better understood these days, and having gone through a psychology degree recently, I can see why older professionals sometimes just aren't equipped with as accurate understanding about it, even though they may have decades of job experience.

But here's something simple that might help... a good way to spot bipolar fairly accurately is basically if the high/low mood swings follow a fairly predicatable time-based pattern, and aren't simply reactive in nature.


I thought bipolar was underdiagnosed, and misdiagnosed, in favor of depression and schizophrenia, big time?

Perhaps, though, a point could be made that in the ASD population, particularly in the adult population who may on the surface display adequate social skills, bipolar may be overdiagnosed, as what seem to be mood issues are reactions to situations of frustration.



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28 Jun 2013, 11:02 pm

What's letudo?I was once prescribed Lamictal,watch out for any weird skin problems.
My shrink now wants me to be tested,He says I may not be bi- polar.I will do that in late Aug.The remark he made was "you talk a lot like an Autistic person."But did he mean I talk too much,or the mannerism?I wish I asked him.And you can be both.


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28 Jun 2013, 11:37 pm

absolute BS pyschology from that doctor,theres a huge difference between even severe bipolar and any level of autism.
developmental history,age of recognisation/onset,triad of impairments are just several major aspects that blow them apart.

please get a referal to a pysch who is experienced in seeing ASD in adults,am sure if put specifics in on here someone from the same area may be able to recommend someone.

PS.its common on the spectrum to have had [lifelong] difficulties with emotional regulation,this can 'look' like bipolar, am living with someone who is wrongly diagnosed with bipolar; he cycles through 'moods' faster than ultra ultra cycling, the stupid doc had labeled him bipolar and stuck him on a bunch of anti pyschotics when he is a arabic speaker with autism and LD and none of his family can have conversations in english to actualy say what he is like-he was diagnosed on one quick visit, he has emotional regulation difficulties as part of the autism, he tells staff throughout the day that his head is bad because it directs the attention on to him and because he has severe anxiety of transitions which shows in repetition of certain questions or points of his he likes asking over and over and over throughout the day- one of the main ones being to repeat that his head is bad [though it isnt,its just repeating it because of anxiety of going home].
am a fellow resident and saw all this in him,why the hell cant the specialists who train in this stuff spend more time
asessing their clients before labeling them one way or another?

specialists dont realise they are playing with clients lives,to a certain degree.


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Tyri0n
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28 Jun 2013, 11:40 pm

Misslizard wrote:
What's letudo?I was once prescribed Lamictal,watch out for any weird skin problems.
My shrink now wants me to be tested,He says I may not be bi- polar.I will do that in late Aug.The remark he made was "you talk a lot like an Autistic person."But did he mean I talk too much,or the mannerism?I wish I asked him.And you can be both.
]

I'm pretty sure the only reason that I have an Asperger's diagnosis is because Nonverbal Learning Disorder is not officially recognized, and I have that bad enough that they didn't know where else to put me. When I questioned my autism diagnosis and researched NLD last winter, I am pretty impressed at how intuitive and accurate I was. People who know me IRL, caretakers, and basically most professionals all agree with the conclusion I came to.

I'd be willing to accept that I have two main things: NLD and bipolar, and all the other diagnoses are just silly psychobabble or sloppiness. It's quite notable that NLD was also the only other diagnosis that this psychiatrist was willing to accept. He is very well published and apparently quite knowledgeable. Maybe he's onto something, and I like his use of the term "psychobabble" to refer to some of the other stuff (e.g. Schizoid PD, Borderline PD) they tried to label me with.



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29 Jun 2013, 12:03 am

When I was a kid they thought that all Autistics were nonverbal,so I slipped thru the cracks.
I could remember and recite whole songs.People thought I was a bratty kid,I stimmed,still do,and all the other mannerisms,all tags had to be cut out,if you did not get the seams in my socks just so I would scream and roll around,I waved my arms,liked to spin,etc.
My doc says I would have been tested if I was a child today.I guess better late than never,and it helps me to forgive the teachers who were most likely exasperated with me.I had real problems learning to read and write.Then presto,once I could visualize the written word,I became the fastest reader in my class.But I can't do Algebra,the formulas just float out of my head.Even with a tutor I got a F.This was hard on me because most of my classes were advanced,so I felt so stupid about math.


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Tyri0n
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29 Jun 2013, 12:08 am

Misslizard wrote:
When I was a kid they thought that all Autistics were nonverbal,so I slipped thru the cracks.
I could remember and recite whole songs.People thought I was a bratty kid,I stimmed,still do,and all the other mannerisms,all tags had to be cut out,if you did not get the seams in my socks just so I would scream and roll around,I waved my arms,liked to spin,etc.
My doc says I would have been tested if I was a child today.I guess better late than never,and it helps me to forgive the teachers who were most likely exasperated with me.I had real problems learning to read and write.Then presto,once I could visualize the written word,I became the fastest reader in my class.But I can't do Algebra,the formulas just float out of my head.Even with a tutor I got a F.This was hard on me because most of my classes were advanced,so I felt so stupid about math.


I have tons of autistic traits, sensory issues, and rituals. But I don't have an autistic presentation or a ton of impairments in understanding nonverbal communication, supposedly, though I have a history of issues here. I don't get nailed for sexual harassment, and I fit into the workplace pretty well most places. I am a little socially awkward, but in law school, there are a fair number of NT's who are as bad or worse. And it's more like I am physically awkward than purely socially awkward. I am always bumping into things or people. Sometimes it's hard to tell the difference.

I struggle terribly with building personal relationships. That's where my impairments are severe and will not budge. A lot of it seems to be mutual boredom, rather than social skills. But it seems that many aspies do not have this problem, so I dunno.

I have a 44 point gap between my verbal and nonverbal abilities, which is gigantic. That alone explains a lot of my issues. I think if NLD was recognized as its own condition, I would be diagnosed with that, not Autism.



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29 Jun 2013, 1:09 am

Well I don't know if you have Bipolar II, but I remember that you wrote a while ago about Borderline PD and complex-PTSD and you were sure those were right.

Here is a bit more critical view about Bipolar: http://www.psychologytoday.com/blog/mat ... borderline


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Tyri0n
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29 Jun 2013, 9:10 am

Raziel wrote:
Well I don't know if you have Bipolar II, but I remember that you wrote a while ago about Borderline PD and complex-PTSD and you were sure those were right.

Here is a bit more critical view about Bipolar: http://www.psychologytoday.com/blog/mat ... borderline


I am pretty sure Borderline is NOT right after spending some time in a support group. And that psychologist really didn't know what she was talking about under some other circumstances.

My new psychiatrist says the borderline thing is B.S. PTSD? Sure. Maybe. But a lot of the symptoms emerged recently while the events happened in childhood. I have attachment issues, sure, but I'm not sure that's the same as PTSD.

To me, it makes more sense from a developmental point of view that I have had NLD all along, which explains my issues relating to people, along with attachment issues from childhood abuse, and that I developed mild depression/dysthymia as a young adult, and then a combination of the stress of the military and then the first year of law school caused it to develop into full-blown bipolar.



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29 Jun 2013, 12:23 pm

I just noticed that you are trying to find the disorders that you have, read into them and get all exited if you think you are on the right track and start to explain all your symptoms through those disorders you think might fit.

In the past it was more personallity disorders and especially Borderline PD, than complex PTSD after an expert diagnosed you with that and now Bipolar.

That's at least how I noticed it.


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Tyri0n
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29 Jun 2013, 12:32 pm

Raziel wrote:
I just noticed that you are trying to find the disorders that you have, read into them and get all exited if you think you are on the right track and start to explain all your symptoms through those disorders you think might fit.

In the past it was more personallity disorders and especially Borderline PD, than complex PTSD after an expert diagnosed you with that and now Bipolar.

That's at least how I noticed it.


There's often a disconnect between my personal presentation, my inner feelings, and my behavior. I am also somewhat immune to therapy. I also do not connect with people at all but try very hard to make it look like I am, and this includes mental health professionals. This has led to a number of problems with trying to identify and fix my issues. So far, the only diagnosis that has actually helped me identity and fix issues has been Nonverbal Learning Disorder, but I have something else going on too. I don't know what it is. Neither do the professionals, apparently. Until it's identified, it's hard to know what to fix.

It's not my fault that the mental health profession is extremely incompetent. There are objective tests for almost all mental health conditions, including blood tests for some things, but they don't use them because they are stuck in the Stone Age with Freudian pseudoscience.



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29 Jun 2013, 1:03 pm

Tyri0n wrote:
I am also somewhat immune to therapy. I also do not connect with people at all but try very hard to make it look like I am, and this includes mental health professionals.


I can identify with that, I've the same problem.
I don't come along with most psychiatrists and therapists and even developed an anxiety disorder with traumatic symptoms towards older experiences in a psychiatric hospital.
I think they've learned to communicate a certain way with their patients and if you don't fit the profile of the "normal crazy patient" than problems might occour when the psychiatrist can't cope with that and many can't.
I come along with approx. 10-20% of the psychiatrists. That means there are some I can work with, but 80-90% I can't and very often those also missdiagnose me, don't come along with me and so on.

Tyri0n wrote:
This has led to a number of problems with trying to identify and fix my issues. So far, the only diagnosis that has actually helped me identity and fix issues has been Nonverbal Learning Disorder, but I have something else going on too.


It's a very analytical thing to try to fix problems like this. I did it a certain time too. I'm not sure if it helped me or not, but I had the need to understand what is going on. Also many psychiatrists diagnose disorders very fast what I can't take serious. But some are good. I noticed in my case it's not that important how I call things and finding the right lable, but having people I can work with. Therapists who understand me more or less intuitively and that's hard to find and also usually takes it's time. My psychiatrist told me, just the process of getting to know each other takes in a therapy session usually 10 to 15 sessions and that's just the average. So I could imagine that it takes even longer if you have NLD or ASD.


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29 Jun 2013, 11:28 pm

For awhile we had rotating Psychiatrists,every new one would change meds,change diagnosis and you never had time to build trust.Same for the therapists,I'd get one and then after six months or so,I'd get a new one.Things are better now that I use a different clinic.I've had the same ones now for a couple years,I'm just now feeling comfortable being myself around them.


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Tyri0n
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30 Jun 2013, 1:04 am

Misslizard wrote:
For awhile we had rotating Psychiatrists,every new one would change meds,change diagnosis and you never had time to build trust.Same for the therapists,I'd get one and then after six months or so,I'd get a new one.Things are better now that I use a different clinic.I've had the same ones now for a couple years,I'm just now feeling comfortable being myself around them.


Lol...my problem is that I don't connect with people, including therapists and psychiatrists, so I tend to rotate myself. I found an online pamphlet which says that getting frustrated and quitting therapy--and not getting much out of therapy--is a thing for Nonverbal Learning Disorder.

Quote:
Patients with NLD may be late for appointments and often forget what is
discussed. [actually, the only one forgetting what was discussed was a certain psychologist I was seeing]. They may be at increased risk for noncompliance with pharmacotherapy
for comorbid disorders [yes, side effects are horrible] and may require
written instructions, frequent reminders, and reviews of treatment plan. In addition, interactions with clinicians may seem shallow and unsatisfying, despite the clinician’s best efforts to empathize. The pattern of feeling misunderstood likely exists in the patient’s other relationships, including significant others and employers
[yes, yes, and yes]

Quote:
BD treatment may be complicated in patients with comorbid NLD. These patients may underreport adverse effects of medications, including metabolic effects and cognitive dulling, which results in a complicated and frustrating clinical course
[YES]

http://www.currentpsychiatry.com/pdf/10 ... ticle3.pdf

All these things probably apply to other forms of Asperger's also.