Why do professionals get confused between AS - schizophrenia

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ezbzbfcg2
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13 May 2021, 12:19 pm

I'm glad this post appeared when it did.

I saw a doctor recently for a yearly physical and decided to mention I've suspected Asperger's /Autism for some time now. I mentioned interpersonal problems and feeling socially out of step. He dismissed the idea that I could possibly have Asperger's because I have a job, made eye contact with him, and could speak coherently. He said if I had Asperger's, it would have been caught much, much earlier.

I mentioned many people get diagnosed later in life, and many folks cope and mask and are able to appear "normal" on the surface.

He vehemently disagreed, told me I was being paranoid, which in his mind meant adult-onset schizophrenia. I told him I don't have delusions, hallucinations, or hear voices that aren't there. I don't think everyone is out to get me, but I've struggled socially. It didn't matter, he wanted to put me on an antipsychotic which I refused.

Whether I have either or neither, I don't believe these things can be diagnosed after a short 10-minute interaction. And the doctor's knowledge of Autism was severely lacking. HE thought all Autism = CLASSIC autism, and any sort of paranoia or anxiety = Schizophrenia.

This doctor was younger than me, probably not older than 30. So, even in the 2020s, the medical profession can still be quite ignorant of the Autism spectrum. AGAIN, even if it turns out I'm not Autistic, his generalizations about Autism were patently false.

Here's the thread I made about it: viewtopic.php?f=23&t=396880&p=8782931#p8782931



Fnord
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13 May 2021, 12:41 pm

Your mistake was going to a physician for a developmental/perceptive disorder.

I suggest you find another physician (if seeking a referral) or go directly to an appropriately trained and licensed mental-health professional (I found mine at the psych department of a local college).

Look at it this way: Would you consult a podiatrist for a hearing problem?


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ezbzbfcg2
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13 May 2021, 1:11 pm

Fnord wrote:
Your mistake was going to a physician for a developmental/perceptive disorder.

I suggest you find another physician (if seeking a referral) or go directly to an appropriately trained and licensed mental-health professional (I found mine at the psych department of a local college).

Look at it this way: Would you consult a podiatrist for a hearing problem?


On one hand, I agree with you and see where you're coming from.

However, 'you've got to start somewhere.' I assumed he could refer me to someone who might help, rather than make a snap judgement. I wasn't looking for a diagnosis of any sort from him, rather some direction and guidance to a professional who could.

But you're right, I'm going to have to find a new doctor.



Fenn
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13 May 2021, 1:23 pm

When you have a hammer all you see is nails. Also - there is no blood test for Autism OR schizophrenia.

A given professional will tend to see cases where there is some question in terms of what has been successful for HIM in the past. I have often notices that doctors never say "gee I really don't know". They like to do short analysis and then take an action: if writing a script is an action they know how to take then they will take that. If a specific brand of talk therapy is an action they know how to take then they will take that.

The analogy I use is - some cooks can create their own recipes from scratch, others can only make things someone else has come up with the recipes for, but they may be a good cook. Some doctors are like that - they are good implementing medicine but not good at doing original research or problem solving or root cause analysis.

You might do better with a specialist - but you would have to know what kind of specialty you needed before you picked one. You might also do better with a doctor who works at a large teaching hospital - they may have experience with original research and experimentation while other doctors simply are practitioners - they implement the research findings of others.

Right now there is a gap between what we know about the human brain that can be understood with the hard sciences - and what we know about the human brain that can be only understood from a "thinking / feeling" point of view. For example, psychologists can help some people with talk therapy some of the time. Neurologist can make measurements and take pictures of the brain, and even correlate the flow of blood to the activity of certain nerve cells or brain regions. A neurologist can come up with a test where a subject must make a decision and take an action and the number of seconds and fractional seconds can be measured. Equipment can be used to track the movement of the eyes. In some cases medications can be given and this can help - changes in behavior can be seen that are judged to be positive. A spinal tap can be done and specific proteins can be looked for and counted in the fluid - and this fluid also flows up to and around the brain. Genetic samples can be taken and regularities can be spotted and documented. Electronic equipment can be used to measure the electrical activity of the brain to some extent - and even to directly stimulate the brain to come extent. There really is a lot that can be done with the hard sciences that could not be done 50 to 100 years ago. But there is still a gap between the work of the physicist, the chemist, the biochemist and the neurologist and the psychologist and psychologist. There really are a lot of the puzzle pieces still missing. There are gaps between each expert's fields.

When I was a kid watching Star Trek, Doctor McCoy could always solve the problem by the end of the episode. The doctors on Mash would stay up at night worrying about that kid in bed 3. Real life is a bit different.

I work with computers. We have hardware and software. It is all man-made - and sometimes it is more complicated than the best and smartest people can figure out. Sometimes I have trouble understanding code that I wrote. Sometimes there are unexpected hardware failures - a power supply might burn out. At other times it might be a code problem - there might be a bug in the code some place. But the complexity it really trivial when compared to the complexity of the human body, brain and mind.

Humans and Brains are just hard.


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Technic1
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15 May 2021, 3:15 am

Which specialist can tell the difference between Aspergers and schizophrenia?



Technic1
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15 May 2021, 3:42 am

Anyone diagnosed Aspergers and schizophrenic should see a specialist as they were once thought to be the same thing!



shortfatbalduglyman
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15 May 2021, 9:34 am

Autism used to be called "childhood schizophrenia"

Autism defined as developmental disability

Schizophrenia defined as mental illness

They are different kinds of things

Autism and schizophrenia:. Not mutually exclusive