My therapist knew I had Asperger's but didn't tell me

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dougn
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22 Aug 2008, 3:38 pm

I don't know who is qualified to diagnose me or not - but I have a psychiatrist too.

If a social worker can't make a diagnosis and the patient already has a psychiatrist (I was even referred to the psychiatrist by the social worker) the logical thing would seem to be for the social worker to say to the psychiatrist, "I think person X may have X, what do you think," but maybe it does not work like that... Maybe it is a usurpation of the psychiatrist's position.

I have never understand the relationship between the social worker and the psychiatrist to begin with. (Understanding relationships is not exactly my forte....) As far as I know they don't discuss me with each other. The only way one would know what the other is thinking, as far as I know, is if I say so.

So maybe I don't have a diagnosis after all. (I don't even like the word diagnosis, it feels like I have some sort of a disease, which I don't. A diagnosis is what you get for pneumonia. :roll: ) I'm sure I have this and my therapist who knows me better than most other people is sure I have it but who knows what my psychiatrist thinks?

Why does stuff like this have to be so complicated?



adverb
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22 Aug 2008, 4:27 pm

dougn wrote:
Why does stuff like this have to be so complicated?

wish i knew. i gave up on teh formal diagnosis after getting a letter asking me to provide documentation proving i was retarded.

what i would have to do to get diagnosed: see a psychologist. they're the only ones who can officially do it, apparently, and they're different from psychiatrists. see the psychologist several times, for different interviews. they have to observe you over different sessions. i think they give you cognitive function tests like the WAIS iq test (which measures a lot of things. someone i know took it as part of their diagnosis process). they interview your parents about how you were as a child. and they need all of your records from school that might have documented behavior, performance, and especially special needs classes. which were a lot less common for people like us 20 years ago. speech therapy was my only one, and i couldn't find the records and didn't get them from the school after getting that letter (plus not wanting to get my parents involved, which was a requirement).

so yeah, it's a long, hard process.

dougn wrote:
I have never understand the relationship between the social worker and the psychiatrist to begin with. (Understanding relationships is not exactly my forte....) As far as I know they don't discuss me with each other. The only way one would know what the other is thinking, as far as I know, is if I say so.

psychiatrist is a medical doctor. social worker is someone with a bachelors in social work. social worker is there to fill out forms for your services, and connect you to the right services, and make sure you're getting the help you really need. more or less. psychiatrist is there to diagnose you with psychological disorders (depression, schizophrenia - for some reason not autistic spectrum disorders. 'cause there's no medicine for them, maybe?) and give you drugs for them. they won't talk much to each other, maybe not at all depending on what kind of system you're in. you're allowed to tell one what the other is thinking, they'll probably believe you and take it into consideration.

the social worker should be able to refer you to a psychologist who can do the diagnosis, if you want to go through the trouble and expense to make it official. the psychiatrist probably won't, and won't be very interested in it because it's not his field.


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i_Am_andaJoy
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22 Aug 2008, 4:28 pm

dougn wrote:

Why does stuff like this have to be so complicated?


i don't know. :(

i agree with all the posts that point out that this kind of thing is common among psycho-logists and psycho-chiatists, and psycho-therapists... but just because the psychos regularly act psycho and shady, doesn't make it right or acceptable.

all the red-taped bureaucracy is maddening.


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dougn
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22 Aug 2008, 4:48 pm

OK, now I'm confused.

A psychiatrist can't diagnose AS or other autistic spectrum disorders?

If getting officially diagnosed is really like what adverb describes, I'm not bothering. I'm not really sure what I'd get out of it and I'm not going through all that work.

I don't even know what the definition of "officially diagnosed" is... What constitutes an official diagnosis?

My school records... Up until seventh grade or so they look pretty ordinary. I went to school, I didn't harm any other kids, and I got my work done, so nobody was about to put up a fuss even if I was socially weird. (And nobody was really looking for Asperger's in the early to mid 1990s. I'm not sure if anyone is looking for it now for that matter.) They wouldn't find a hell of a lot in my school records until the point where I got so anxious I couldn't attend school... And I don't even know what my records look like after that. I was never "classified" for special education (or whatever it's called, not sure if "classified" is the right word). My school records probably look pretty clean since my parents wanted them to say as little as possible - they didn't want much of a paper trail, so everything was as vague as possible.

Anyway, I really don't think I want to get my parents involved. If I get my parents involved it would be to tell them I have it, not to have them try to find out whether I have it - that would be way too complicated and probably involve far too many weird emotions on their part.



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22 Aug 2008, 5:39 pm

A psychiatrist can diagnose autism. Any doctor can, technically. So can a psychologist or a nurse-practitioner (I think). All of those people are qualified to make medical diagnoses, and autism is technically a medical diagnosis. However, someone who does not specialize in autism would be smart to send you to someone who does. The best person to ask would probably be a neuropsychiatrist who specializes in PDDs, but very few people get that specific. Most are diagnosed by child or clinical psychologists or psychiatrists.

Regarding tapering off an antidepressant:
It's expensive, it causes side effects, and it may take the 'edge' off every mood--not just depression. So getting off it, if you don't need it, is a good idea.

But there's one thing that causes me a bit of concern: You mention multiple episodes of major depression. If you're talking about the sort of depression where you can't think straight, you think you're to blame for everything, and you wish you could get enough energy to kill yourself, then this is a problem.

Long-term antidepressant prescriptions are standard procedure for treating people prone to recurrent depression.

The question here is: Do you need an antidepressant? And if you need one, then is the one you're on right now working for you? That is--are you still having these episodes, despite the antidepressant? Could you get therapy instead, to replace the antidepressant, specifically aimed at teaching you to detect and prevent depression?

There are more options than just staying on the antidepressant or going off it... It just seems that something isn't being done right, if you're on it and still having these problems.


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dougn
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22 Aug 2008, 5:55 pm

I haven't had major depression in around two years or so, and that wasn't just random, it was triggered by something fairly serious.

I've never been suicidal, but at times I have been too depressed to function effectively in everyday life... But when I haven't been able to function it's also partly been from anxiety... It's hard to separate the two, they kind of go together for me. I get anxious, which stops me from functioning, and then I get depressed from the lack of ability to function, which doesn't make me function any better.

But I haven't had anything really serious recently.



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22 Aug 2008, 6:25 pm

Interesting thread, because I had seen the same psychiatrist for 12 years and he never once mentioned that I might have Aspergers, though he did tell me many times I was not "crazy". I didn't have much knowledge about Aspergers until about 3 years ago when I casually ran across some of the literature on the Internet and found that that symptoms and characteristics of the syndrome seemed to fit me to a tee. I brought up the subject in one of our meetings and he said I was Aspergers but that I had a lot of insight into my limitations and was doing well. He never gave me any sort of tests or indicated that any were necessary. He did say that the fact I was Aspergers is why he never referred me to a therapist for any talk therapy, because I couldn't "be talked out of my condition." He joked that people like me drive talk therapists nuts.

I point out that this was a very gifted doctor who practiced for over 30 years, taught psychiatry in a medical college, gave lectures at professional conferences and apparently was very highly regarded by his peers. Unfortunately he passed away suddenly last winter of a heart attack and I am now seeing his partner, who I am not wholly satisfied with.

I can't say I'm upset that he did not bring up Aspergers sooner, though afterwards I did get a lot more clarity about my life. At my age, there isn't much of a need to have a truly "official" diagnosis.



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22 Aug 2008, 6:41 pm

That's a very interesting experience... Very similar to mine in some ways but I gather you are much older than me. (Sorry if I'm wrong.)



nettiespaghetti
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22 Aug 2008, 6:56 pm

My experience isn't the same, but sort of similar. With my son having a heart issue he had several traveling nurses through a program called "Early On" and now that I look back on things they actually said about ME I realize now that in the back of their minds while observing my son they were observing me and seeing signs. I actually feel angry about it because if they had said something it would have helped me make sense of things since I didn't know I had it yet. Just that things they said about me right to my face shows me that they saw something about me was different, yet kept me in the dark along with not really telling me what they really were thinking about my son too. I fired them.


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dougn
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22 Aug 2008, 7:06 pm

What did they say about you?

Did they say anything about your son?



nettiespaghetti
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22 Aug 2008, 10:40 pm

They wanted my son to be talking more, but he seemed to have some delays. One thing that sticks out in my mind is that they said over and over "well you're a very quiet person so I know it's hard" like because I'm quiet so was he, and I'm remembering they also said I was very shy. And then they told me I needed to be more assertive with him (not really an aspie thing per say, but it ticked me off) They also mentioned that they thought he should be walking and they were afraid he had low muscle tone but they could see that I didn't seem to have alot of muscle tone in my upper body because I slouch really bad. (Not word for word what they said but the gist of it). Now that I look back on it I felt like they were always hinting that I wasn't NT. And they were constantly pushing me to take him to special playgroups so that he could get used to interracting with other kids, although the doc had told me he was really glad I wasn't taking him to daycares, etc. because during that time if he got sick because of his heart weakness it could've became critical. So anyways, yeah them saying the things they did every week on top of other things made me feel like they were putting blame and whatnot on me and yet wouldn't actually speak their minds. I got fed up. It's kind of a long story, sorry if I'm not explaining extremely well.


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prillix
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22 Aug 2008, 10:54 pm

coregazer wrote:
year 9. after an incident occured where he was recorded on mobile phones acting inapropriatly then uploaded onto youtube as "spacker 1" and "spacker 2" (none autistic teenagers are the soul meaning of evil, dont you think?) .


Kinda ironic, you're the one promoting the video.



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23 Aug 2008, 1:02 am

nettiespaghetti - I understand your explanation.

I see you have Asperger's - what is your son's diagnosis if any? I gather not Asperger's, if he had a language delay.



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23 Aug 2008, 9:11 am

I had a very similar experience. I got a diagnosis of HFA after 7 years of psychoanalysis and not before. The strange thing is that I was told “You could have Aspergers” only after saying that I would have given up with psychoanalysis. Then I went to a specialist for the correct diagnosis, but I waited till the final diagnosis to tell again that I would have left psychoanalysis, because I didn’t want to alter its precision.

I’m asexual too, but I didn’t need psychoanalysis to understand that.



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23 Aug 2008, 1:47 pm

Sometimes your therapist might throw hints out there too... my therapist I haven't been discussing the possibility of having Asperger's with, to see what he would eventually think. Eventually though, he started saying things like I was being shy like Bill Gates, then I asked him when he showed me his brain keychain, which he said he got at the Asperger's conference and the Asperger's kids liked a lot. So was he trying to make ME mention it on purpose, which I did? I've decided I'm gonna ask him more about this.


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dougn
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23 Aug 2008, 2:09 pm

I probably mentioned this earlier but my therapist did think he threw out a hint when he said that I reminded him of someone he knew who was high-functioning autistic but "not necessarily in that way". To me that made it sound like he didn't think I had Asperger's, though now I obviously realize it's the other way around.

(I have Asperger's, not classical autism, because I certainly didn't have a language delay.)