Depression / Asperger's / therapy - seeking advice

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Hi
Thanks first of all for a great and entertaining site.

I'm currently in a bit of a quandary. First the background:

I am mid-30s, male, self-employed programmer. One of five children. One sister is severely autistic- a rare case where we have received "expert medical opinion" to the effect that her autism was induced by an allergic reaction to immunisation. I had an allergic reaction to the same substance - my first asthma attack from which I am told I nearly died. As I was only 6 months old I can't recall this! WIthin the family history (previous two generations) we have a number of cases of severe depression, one of which ended in suicide. Another who suffered from depression was put in an asylum, as they called them back in the 1920s, at the age of 15. He remained there for life. From what we can gleam from family records, letters, etc. his symptoms could easily have fit with Asperger's and were even heading towards Savantism, but he also suffered from extreme bipolar instability. Child abuse is also rife in the family history, sexual, violent and emotional.

Throughout childhood I was tested and treated for a row of conditions, none of which ended up with a firm diagnosis. I always outperformed most at school. About 8 years ago I was diagnosed with fibromyalgia, but 12 months ago I was re-diagnosed as having recovered fully if I had ever had it at all.

Severe depressive episodes have always been present but they have been much more frequent since the fibromyalgic symptoms faded (around 18 months ago).

I have recently begun psychotherapy to attempt to help me deal with the depression and with my own experiences of abuse as a child and teenager. My therapist has referred me to a psychiatrist for a confirmation of her diagnosis of my depression and for the prescription of some serotonin-based medication. However, when I look at the descriptions of Asperger's it fits SO well in so many areas I am becoming a little confused. I began looking at Asperger's because one of my closest friends has been diagnosed with it.

So my questions:
To what extent can Asperger's and depression (major bipolar) coexist? Is it a good idea to mention to my therapist that I have looked at Asperger's and even done some self-assessment tests /online tests where I score quite highly as a likely Asperger's candidate? Or does the fact that I am also a very good fit for bipolar depression suggest this is more likely to be the situation? I of course want to continue the therapy to deal with issues from childhood trauma, but I am concerned about undergoing medical treatment for depression if in fact Asperger's is the underlying issue - and equally concerned about not taking medical treatment because of a self-diagnosis of Asperger's. Is there a pattern of either correlation or mutual exclusivity between the two conditions? What are the typical reactions of therapists to the suggestion of Aspergers? (It may be relevant to the last question that I am currently living in Germany).

My next appointment for therapy is less than a day away...

Thanks for any feedback / comments here. I am interested both in expert opinion and accounts of own experiences that may relate.

I am by no means an expert, just a parent of two children on the spectrum.

In my reading, though, I have read much about Asperger's and depression coexisting -- it just seems to go hand in hand sometimes, ESPECIALLY with people who are older and on the spectrum, where there was a lack of understanding about the syndrome.

I would tell your therapist that you suspect that you might have Asperger's. At that point, I would leave it at that, and see what your therapist says about it. They may have been thinking the same thing, and waiting to bring it up themselves. OR, if they seem to NOT agree with this assessment, then you might ask "why" they don't think you have Asperger's. If they can explain themselves intelligently, then maybe you do not have it. But if they seem to not have a good answer, as if they don't know much about the condition, then you may want a different therapist.

Please keep us notified as to how things go with the therapist.

Kris

I'm not a medical professional, so all I can do is describe my own relevant experiences.

I was abused by my family. I had the symptoms of AS from the very beginning but because I was intelligent and did well academically, it was assumed that my difficulties were merely the result of me not trying hard enough.

I was diagnosed with generalised anxiety disorder in my late teens, and a couple of years later, depression. I had a breakdown at 18 and also suffered with ME / CFS and took 2 years to recover.

I had some counselling and psychotherapy which helped a little as it was good to talk about the abuse. The problem is that all the therapists I saw were Freud-worshippers, so when I tried to explain the AS type symptoms I had (although at the time I didn't even know that AS existed) they just said that it was because of issues from my past and that there must be something I wasn't telling them. And they seemed to think that just because I'd told them about my past, I should suddenly just be cured....

Eventially, via some local mental health charities and support group, it became apparent that I had AS and I was able to convince my Doctor to refer me to a psychiatrist who diagnosed me. I am still waiting to see a specialist.

I found it helpful to talk about the abuse, but other than this, I actually found the therapy damaging as they kept making me try to fit things that didn't actually apply to me. I have also found that all the aspies and auties at the support group that I attend have had the same problem with counselling.

So it might be worth considering getting an AS diagnosis first and then looking for appropriate counselling or psychotherapy with someone who has a good understanding of AS and experience of working with people who are on the spectrum.

As for bringing up the subject of AS, it is probably worth thinking of examples of how you fit the diagnostic criteria, and try to find examples from various points in your life, including when you were very young as AS is something you're born with (well, putting aside the immunisation issue for the moment). It might be a good idea to have a relative come with you who can confirm that you showed symptoms of AS from a very early age.

It is possible to have depression and / or bipolar as well as AS, but there is also some overlap in symptoms, particularly with bipolar, so it is difficult to answer your question as to what a correct diagnosis would be. I suppose one important question is which came first? In which order did these issues occur?

Well, this is just my experience and opinion. I'm not a medically qualified person, so this is all I can offer. I hope it is of help.

I wish you well.

Pretty much everybody with AS seems to suffer depsression. If you think you fit the profile for someone with it then you really should try to find a professional who specialises in it to get confirmation.

I'd be really careful about taking SSRI's - I assume that's what you mean by seratonin based medication. Doctors love handing this stuff out like candy but the side effects are often worse than any relief they provide and they can be a nightmare to get off. I'm pretty sure they were never tested on people with AS anyway.

Thanks for your comments here. Yesterday was therapy session number 3, very intense and I think very helpful. I waited until the end of the session to bring up AS as I didn't want it to dominate the discussion. I had been feeling far too murderous for that

@KRIS:
The therapist initially said something along the lines of not knowing anything about the condition, but then slowly remembered what it was as she has apparently dealt with various "autistic cases" over the years. She was absolutely certain AS does not apply to me and thinks I am just reading myself into the condition; her single reason being that if I were to have AS or be anywhere on the spectrum I could not possibly be sitting in her room by free choice, talking so openly about my feelings. My response - that is to say, my inner response, I just smiled politely - is: after 2 nervous breakdowns, 4 suicide attempts, years of debilitating psychosomatic illness leaving me a cripple, a failed marriage and a broken engagement, it is just possible a person on the spectrum might reach the point of freely seeking help to deal with the past! She did, however, say she is not well enough informed and she will do her homework this week by reading up on AS, promising to bring me a list of reasons why it does not fit. I am actually looking forward to that, as it is a chance to argue it out based on logic. That should work - I have all the background knowledge of my own life and she doesn't, nyah nyah nyah

@SOUNDED:
Therapist has concluded that I appear to be able to get through this without SSRIs and/or the dreaded tricyclics. Just as well - I have been on both in the past as attempted treatments for fibromyalgia and the side-effects were almost fatal from the SSRI. So I was kind of skeptical anyway. A bit of St. John's wort is all I am taking. If my therapist really doesn't agree on As then it's her problem. I'm convinced. And I will go elsewhere if and when I feel the need for an official diagnosis. So far she is helping a lot and not doing any damage.

@GIRL7000:
You're quite probably right that it would be better to have the AS diagnosis first, but at this stage I have reached a point where if I don't have some therapy I'm going to do some harm somewhere. I've already done enough. And although the therapist's initial reaction was negative, she is aware of pretty much all the symptoms I identify with, just sees the "talking about the emotions" as outweighing them all I think. And she is most definitely a long long way from Freud-oriented. We are primarily looking at ways to deal with the rage/need for revenge feeling, with some self-worth issues, and behvaioural patterns to stop the depressive episodes hitting with full strength. But thank you for what you said. It actually was very helpful and is percolating through me still - the best therapy is always the encounter with someone who knows from within. Bless you as you have blessed!

I'm going back into my shell for a day or so I think. Thank you all.