Legitimate Diagnosis

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Thanks a bajillion for all the replies, everyone.

The cochlear implant analogy is exactly how I had conceptualized what happened -- the existence of a condition isn't dependent on whether or not I've coughed-up thousands of dollars for therapy that I neither want nor need. The interviewer lady was positive that I had Asperger's (and more importantly, I had been positive that I had Asperger's for some time).

Anyways, thanks again everyone. It's spooky to read through all of the forum threads and realize that there is an entire class of people who make sense to me, whereas I've found few to none in the real world who do.

My psychiatrist diagnosed me with AS. However, "officially," he has only diagnosed me with OCD. That is the way I prefer it.

I got diagnosed without having to enter therapy. She didn't even recommend therapy. She actually said, "You're smart enough that you can probably improve your social skills on your own," and she recommended that I go into a field that emphasizes the good things about AS and does not emphasize social skills, such as scientific research that takes place in a lab.

A psychological syndrome or disorder, by definition, must cause "clinically significant" impairment in one or more areas of a person's life. "Clinically significant" means that it can be easily observed and measured. For example, if someone repeatedly lost jobs due to a lack of expected social behavior, that would be clinically significant.

If it weren't for the clinically significant impairment criteria, everyone would have a list of psych disorders and syndromes. The personality disorders are a good example of this. If you look at them, you could easily diagnose yourself and everyone you know with at least one, but in reality, only people who are struggling at work, school, or home due to the symptoms can qualify for a diagnosis.

Yup. Same thing with OCD. Lots of people have OCD-like things that they do. I myself have a series of rituals associated with page numbers, numbers on the clock, etc., but I don't consider myself to have OCD because my issues do not significantly impact my life. On the other hand, my NLD and my social anxiety disorder *do* have significant, negative effects on my life.

My psychiatrist's view is that almost all aspies have some OCD symptoms, but that they are only clinically significant in about 25% of the cases.

My views might clash with those of a few people, but I don't think an "official" diagnosis really matters. An official label might actually do more harm than good if you feel, at first, you are not significantly impaired. Speaking from personal experience: labels, for me, make me feel impaired. Same goes for therapy...

Edit: especially if people can't stand one another.

Last edited by SilverProteus on 02 Dec 2007, 11:42 am, edited 1 time in total.

Know how that feels. It really bothers me when others tell me to learn how to not be so sincere. Sorry but maybe they should learn to be more sincere instead? Makes no sense.

I've had a thought or two over the course of my life that perhaps I had OCD, ADHD, Schizoid PD, etc, but none of the "diagnoses" seemed to fit well enough for me to actually believe that I had any of them.

It's almost as if I could force each puzzle piece to fit if I pushed really hard, but none fit really naturally, while the AS symptoms explain every facet of my life, which is why this was the first time I chose to actually go and ask a psychologist whether or not this fits me as well as I felt it did.

The interesting question is how to determine whether or not it IS, in fact, a significant impairment. I have organized my life around my personality, which makes it nearly impossible for me to determine whether or not this presents an obstacle in the objective sense. Others would definitely say that my personality traits qualify as an impairment -- I become extremely anxious if I am interacting in a group of more than 2 other people/ I am unable to "blend in" even if I try, I am unable to work in groups without either doing everything myself or doing nothing myself (thus forcing it to mirror working alone), I could continue on and on, but suffice it to say that I have all the generic AS symptoms, although in my subjective assessment of the situation, I do not feel that I am "impaired". But in determining whether or not a significant impairment exists, my subjective assessment is biased, and may not be able to fully capture the situation.

The return to an analogy from earlier: Everyone may feel that a legally blind person is impaired, but if they have tailored their lives around their blindness, they may not feel that they have a significant impairment, although their own subjective assessment of their condition would seem incorrect and perhaps even absurd to most outside observers.

So the question is: If one has tailored one's life around one's personality, how can this person determine whether or not an objective "impairment" exists?

IMHO Aspergers became the domain of psychiatrists because it happens to have manifestations in our behavior. The emerging fact is that this is only a small part of a larger picture. IMHO our behavior is a small part of our condition. Psychiatrists and psychologists are in general ill-equipped to deal with the whole of our condition. The whole of our condition influences our behavior in good and bad ways. And so, a psychiatrist is ill-equipped to help us and is not ideally placed to make the diagnosis or devise the treatment.

Exactly. I am not a label and I don't see myself as significantly impaired. True, I don't have a wide social circle, hyperventilate at the thought of going to a party, and people generally think I'm a weird loner, but there are far worse things.

I know what I am, I don't want 'treatment' and therefore I don't need a diagnosis. Yes, it's been a struggle sometimes to get to this point but I don't know any other way to be and, having arrived here, I don't need the hassle of dealing with medical professionals.

So I am going to wilfully remain an undx-ed, unspecified weirdo. If that makes me a lesser WPer because I don't have an official label (and I suspect it does according to the hierarchy I've seen some people trying to impose) then that's just fine by me.


The degree of impairment is laid out in the DSM and by its very nature it has to be generalised. The problem is trying to fit a set of one-size-fits-all criteria to individuals who are somewhere on a broad neurological spectrum. There are a lot of us out there who had Asperger's before there was any diagnostic criteria - were we impaired when there was no standard by which to measure the impairment?

Everyone, NT or AS, organises their lives to suit their personalities and if the individual is content then there is no determination regarding impairment to be made. Playing devil's advocate, if I'd written the DSM, we'd all be 'normal' and 'unimpaired', and the NTs would be in persistent therapy to free them of their OCD for social contact, material wealth and conspicuous consumption. Who's to say whether my DSM or the DSM as it stands is correct in the great scheme of things?

Diagnosing individuals' places on a broad spectrum is always going to be an imperfect science, and will also depend on the experience of the person doing the diagnosing. If you as an individual don't feel impaired, why should it matter to you if someone else (from their experience) tells you that you are? They're not living your life, in your head, through your eyes.

Got a bit waffley there, sorry

Then you have people like me who cannot function around people at all, I cannot attend classes, nor can I work with people; I cannot actually interact with anyone other than my family and professionals. The thing is, I've been like this my whole life, only the past several months have I realized I have autism and I acquired a label. Unfortunately, most with HFA are like me; many of those with AS are too.

It's a big spectrum.

Over the years, I have had autistic students in some of my online (distance learning) classes. That was before I was diagnosed with AS.

Yeah, that's why I'm studying through correspondence. It hurts far too much sitting in a classroom; it's also a waste of my time as I don't learn anything due to being overwhelmed.

Technology is helpful (I mean, I'm talking to people now, I could never do such out there).

What are you studying?

I think you've got the best of both worlds.
On the one hand, you have a professional opinion that supports what you already felt was true, so you can feel confident sharing your semi-diagnosis with those you choose.
On the other hand, you don't have to worry about being denied health insurance, or other negatives that can accompany an "official" diagnosis.
And if you WANT a diagnosis later on, you can always get one later in life.
It's cool to be you