Does a "diagnosis" mean anything?

Post Reply New Topic

I've been meaning to ask this for a while. I've noticed there's a lot of discussion on this forum about "diagnosis". Whether someone has aspergers, whether they are a poser or wannabee who doesn't have a diagnosis, etc.

Here's my experience. (I live in America)

I have few friends, and haven't really made friends since High School. Throughout college I was a loner. Social interaction is often very difficult or uncomfortable for me.

I went to a psychologist in my senior year of college who introduced the term Aspergers to me. He didn't test me or anything, but brought it up right away during the first appointment after talking with me. (I've learned that psychologists and psychiatrists write down a "diagnosis" on insurance forms right after you've even seen them for the first 45 minute session. They do this to get paid by insurance companies or to give you a form to get reimbursed by insurance companies. They always write something, the practice might even be somewhat scamish. Some of them are aware that the practice is cynical and silly. I believe it is imposed on them by insurance companies)

A psychiatrist that treated me around thattime brought up the term "schizoid personality" with me, knowing I had already known about the term Aspergers. I recently asked her for medical records and she sent me a treatment summary that said that my problem was most likely related to high funcitonal autism or aspergers. (Actually, she said my problems with depression and anxiety were secondary to high functioning autism and aspergers) This psychiatrist gave me the MMPI-2 self reporting personality test.

Another psychologist who works with people with Aspergers said she felt I had aspergers, though she described it in therapy as a "mild case" of aspergers. She had given me a few tests (I'm not sure why though, her practice was a bit unorganized and I later learned learned many people who were treated by her were not tested. I took the tests with her before I started regular therapy) One test was on watching social interaction videos and answering questions based on body language, the report she recently gave me said I scored normal. One was an executive functioning test through matching cards (I think the Wisconson card test) The report said many people with Aspergers have trouble on test. I scored above average. I think she gave me two other tests, related to personality and social isolation. Anyway, long story short she diagnosed me with Aspergers after this (she also interviewed my parents)

Another psychiatrist I scheduled an appointment with once wrote schizoid personality but said that the DSM- IV isn't really very helpful for cases like mine when he said it.

Another psychiatrist, when I brought up Schizoid personality as a previous diagnosis, said that Schizoid personality was invented by psychiatrists to get paid by insurance companies and did not write this, instead putting down "general anxiety" on the insurance form.

More recently I've been treated by a psychiatrist (who's maybe a bit out of the box, if not wacky) who wrote severe depression as a diagnosis. One recent psychologists I've been in therapy with put down "Dysthymia" but said she was starting to learn towards Aspergers.

It seems like a diagnosis can vary depending on who you talk to and what their biases are. Does it really mean anything? Do people on this board really take it that seriously? Should they?

Do most people seeking a "diagnosis" in American take a bunch of tests, as opposed to going in for therapy and being handed a diagnosis without testing?

I very deliberately found a Psychiatrist who is familiar with the Autism spectrum and then made a point of not reading anything further about the spectrum so I would be less likely to skew the results one way or the other. I also made a point of paying out of pocket so I can keep my business private. What a diagnosis means to me is that I now know with certainty why I have never fit in well.

I wrote a local autism center asking who to go to for suspected asperger's. And went to her. I dropped off a huge stack of papers ahead of time, she said if I had any tests or whatever to bring them in. So I printed all my online tests, and wrote notes all over them. She asked some questions, and did confirm my self diagnosis, but other wise felt like a waste of money.
She wanted to prescribe stuff. Since there's no medication for asperger's, she started fishing in the dark for something else to label me. She even tried to say I might be schizoid, no I'm not. I've always been very interested in psychology, so it's hard to pull that stuff on me.
I tend to have some randon depression, which I refused treatment for.
I just don't trust random chemical coctails that are new.
(That and I've read Robin Cook's "Acceptable Risk", which will scare you off most new meds.)
And ADD, which I tried treating, but didn't care for the meds. Caffine is just as effective, less side effects, and way cheaper for me.

I have no insurance, and even if I did they usually don't cover mental health stuff.

Most of my childhood was destroyed by wrongful psychiatric labels imposed by many psychiatrists...and yes, it is a requirement by insurance companies so that psychiatrists and hospitals can get paid. I think of psychiatrists as nothing more than "witch doctors" who truly don't know "which' diagnosis to give a patient.

It seems as if the DSM is actually more like a national book of excuses...there is always an "excuse" why one is unable to do anything in life.

I agree with the OP. I am diagnosed but had wrong diagnosis in the past. Can't blame psychiatrists because this was before aspergers was common knowledge but it does seem they really want to put you on drugs. Those drugs are more harmful than good.

I went for a diag. It was an older, experienced Dr. of Psych. He told me straight up that I'm "socially ret*d", explaining part of my brain doesn't work and the label is less important. What he said mattered is knowing what situations I have "no business in" and others where a formalized (perhaps memorized) set of instructions can compensate for a lack of intuition.

My problem seems to be dominated by being almost blind when social intuition is called for. In particular, when responding in a conversation confusing minor details with the major point.

tailfins, sounds like you were lucky to encounter the one Psychiatrist that's worth going to. Brilliant! I agree, the label doesn't matter (unless one is applying for gov't money). What matters is knowing that one is socially handicapped, and which situations are lost causes for us and which are salvageable through memorizing how to act.

A diagnosis may be important to one person, but not another. I don't really care if other people get diagnosed, or believe that it matters. I did get pretty pissed off when I responded to a question that someone had about diagnosis, and someone else asked the cost, and then proceeded with another person to criticize MY decision to spend MY MONEY like it was their f***ing business how I spend my money. Getting a diagnosis is a personal choice that people make for themselves.

It's important if you want services or other things that require verification.

Otherwise, it's up to the person.

I don't like anti-self-dxed prejudice, or the attitude that only a doctor can tell you who you are. I've had a lot of labels and only some of them fit, so...

These are some possible advantages to getting diagnosed:

-You'll find out if your self-diagnosis is correct - you could have something other than AS or you could have nothing at all. This only applies if you go to an ethical, well-informed doctor.

-You can register with your school in case you ever need some kind of accommodation.

-You can inform your employer that you have AS so that you can request a reasonable accommodation and/or protect yourself from discrimination.

-You might become eligible for local ASD programs or services.

-You'll be able to inform doctors of your diagnosis and therefore possibly get better treatment. For example, a doctor might look for conditions common in the ASD population.

These are some possible disadvantages:

-You could be denied insurance in the future or face other forms of discrimination.

-It could be expensive.

-You might not agree with the doctor's opinion.

-It might be an unpleasant experience.

I'm sure there are many more advantages and disadvantages. Those are just some examples.

Don't forget also:

- You could end up diagnosed with something else, and subject to coercion or force to be treated for it, even if it's not an accurate diagnosis, and/or even if you don't want the sort of treatment the psych system has to offer even if you do have the problem.

This has actually happened to a few people I know who sought a diagnosis, and somehow tripped off "warning signs" to certain stereotype-ridden psychiatrists, who decided then that things had to be done against their will "for their own good" etc. And add in families persuaded to believe the same thing... really ugly potential consequences.

(Yes, they don't in most places have the authority to lock a person up without first saying they are a danger to themselves or others, that's the legal phrase you'll hear a lot. What most people don't know though is that in the wrong situation, you can be declared a danger to yourself for something as simple as a chapped lip, which actually happened to me once. Also, when I used to be found after walking around outside when people didn't want me to be, I found that they'd just check off some combination of "danger to self," "danger to others," and "gravely disabled" on the form and that would be it, even if I actually showed no sign of any of these things. And once you're officially crazy, it's your word against respected professionals.)

That danger to myself or others-thingy...

That is exactly what one psychiatrist said to me after a mild meltdown during an appointment!

I was diagnosed with ADD originally. I couldn't understand why my parents had to get me diagnosed and my mother told me because the treatment I was getting wasn't working. I was diagnosed with ADD. dyspraxia, sensory ingretion dysfunction, but it all wasn't good enough. My mother always knew something was wrong but she didn't know what it was and she knew ADD wasn't a correct diagnoses because it still wasn't helping me. In order for me to get the education I needed, I needed a correct label. I'm sure my mother was going to deny the AS diagnoses because she told me my psychiatrist told her to use the diagnoses to get me through school and get me the education I needed.

From what I've found out, a diagnosis seems to carry more weight in the UK than it does in other countries. Conditions such as Schizoid Personality Disorder are usually lumped together under a fairly broad definition of 'Aspergers.'

So how useful a diagnosis will be depends on which country you're living in. The thing that you're diagnosed for will also vary from country to country, and probably from psychologist to psychologist.

Here's the thing though. The way I see it, an "Aspergers" expert is possibly more likely to see your (or mine, who whoever's) problem as Aspergers. A depression expert as depression, etc.

So, I went to an "aspergers" expert and she diagnosed me with "aspergers" or "minor aspergers" or whatever, but that doesn't really prove a thing. A schizoid personality expert might say I have schizoid personality.

And some of these folks will only treat extreme aspergers as aspergers, while some will recognize moderate aspergers, or minor aspergers, or whatever.

It's not like they do brain tests to see what is really going on in your head.

And I totally get that it's useful to get a diagnosis for purposes of accommodations or whatever, but that also means that if someone says you don't have Aspergers, and you feel you need accommodations, you probably want to try to see one or two more psychologists or psychiatrist to see if they will decide you have the label that the law might require, because it increasingly seems to me that psychology and psychiatry is, as well intentioned as practitioners may be, still a pseudo-science.

The whole thing seems more and more like a social construct, and less and less like an objective fact.

A diagnosis is what you make it, whether good or bad, it's your choice.