So many possible diagnoses. How to make sense of it all?

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In theory, we are not supposed to try to diagnose ourselves, because we can be led astray by the internet. In practice, we have no choice. It would take a doctor or therapist forever to get to know us well enough to come up with the right diagnosis. Or we would have to see someone who is a specialist in that diagnosis, in which case they might spot it, but then once again we have to do our own research first just to figure out which type of specialist to go to.

This is true for autism, but it's also true for many mental health or some neurological diagnoses.

I believe I'm on the spectrum, and that socially it has had a huge, kind of devastating, impact on my life, so I consider it significant, even though on many other ASD traits I would be mild or even not have the trait at all. I had two (not very thorough) assessments and they both came back as inconclusive, neither a definite yes nor a definite no.

But it has recently been suggested to me (by a friend, not a professional) that I might have Borderline Personality Disorder, and while some traits don't fit, the ones that do are uncanny. When I mentioned it to my therapist, she said that yes some traits do fit. (Which makes me wonder why she hadn't thought of it when I've been seeing her for a year.)

And of course she thinks I have depression and anxiety. (I actually don't think so.) Those seem to be catch-all diagnoses that are automatically applied anytime you are doing very badly emotionally. She also says I might have PTSD.

So, all together, those are an awful lot of diagnoses. I know conditions can be comorbid, but that seems like a lot to combine. How do you sift through this?

Have you seen a psychiatrist? I'm not sure if your therapist is one, but I'm assuming they're a psychologist. If you see a psychiatrist for mental health as opposed to ASD which is neurodevelopmental, they'll screen you with diagnostic tools for MDD, GAD, BPD, and even PTSD. C-PTSD isn't in the DSM as a stand-alone but the psychiatrist can probably determine if you are C-PTSD based on your symptoms and the duration of how any potential trauma occurred.

If you do decide on pursuing a formal ASD dx make sure it's with a neuropsychologist or a psychologist who has the right credentials and psychometry tests to do the job properly.

As for having lots of dx, I have so many it makes my head spin but I think they're all accurate:

I'll try to put them in the reverse order of diagnosis:


- ADHD Combined Type, Inattentive and Hyperactive (2020)

- ASD Autism Spectrum Disorder using DSM5, Level 2 Social Communication and Level 2 RRB (2018)

The ASD test also confirmed:

- Complex Trauma Disorder (I think they just call it PTSD for the above reasons)
It was also diagnosed by a psychiatrist in 2009 after significant trauma, and 2015 after stroke

- MDD or Major Depressive Disorder:
First dx in the late 1990s by psychiatrist, reconfirmed in ASD testing to be 99th+ percentile

- GAD or Generalized Anxiety Disorder:
Also from 1990s psychiatrist, and again in ASD testing at 99th+ percentile

- Panic Disorder

- Agoraphobia

- Alexithymia

- Selective Mutism

- Sensory Integration Disorder (also confirmed by subsequent OT therapist)

- BFRBs

- Synaesthesia, Face Blindness, Audio-Visual learning disabilities

- Acquired Brain Injury (Stroke) 2015
I actually had a second stroke in December 2020 but it didn't do as much damage



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When I had my big stroke in 2015 I had to see a psychiatrist who screened me for Schizophrenia, Borderline, Bipolar, Psychosis, Schizoid, etc. when she was checking my neurological function for recovery. I didn't have any of that but she did identify the CPTSD and she said my Depression / Anxiety were still present from the 90s. She didn't discover my Autism because psychiatrists don't screen for it.


The only thing I haven't been screened for is a psychoeducational profile, but that would be a waste of time and money since I'm not in school or looking for work.

I'd like to be tested for Tourette's but apparently there isn't a test for it? I'm on the meds anyway.

I had a psychiatrist until recently, who was highly recommended by my therapist and who was very nice and sympathetic, and smart, and expensive!, but she provided me absolutely no help. She only prescribed medications that I asked for and did not offer any suggestions of possible medications from her own expertise (except one that I thought was a bad idea). And she did not offer any, or even ever talk about any, diagnosis. I only found out in passing from my therapist that they both assumed I had depression. I have never been helped by a psychiatrist. I think I've seen maybe 5 or 6 over the years.

Sorry to hear that! Psychiatrists where I live aren't allowed to do any therapy at all. They do the intake tests (a bunch of 20 minute verbal questionnaires), and then they prescribe whichever drug the drug companies want them to promote. You have to keep going back but that's only for medication monitoring so you can get your next refill and they can get a commission for prescribing it. I'm not a fan of psychiatrists but they're free here whereas psychologists cost a fortune. That's why I first went to a psychiatrist in the 90s. After my stroke the Neurologist hooked me up with another one to see how my brain was doing. I didn't like her at all. Then I needed a Neuropsychiatrist to be diagnosed ADHD and get ADHD meds prescribed. He wasn't too bad, but again he had zero interest in my emotional needs or follow up therapy beyond pushing big pharma.

Diagnoses at this period of time are basically just theories and labels to explain what's going on with a patient and what treatments might help. If you've got something straightforward, they likely will get it right the first time, but insomnia and depression, as an example, can easily be confused with each other.

For the most part it's the degree to which the treatment improves the patient's life that matters.