Help with Aspergers Diagnosis

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I have a female friend in her 30's who I believe may have Aspergers.

She has never been diagnosed, instead she's been diagnosed with depression/anxiety and has sought treatment for that.
I'm familiar with both depression and anxiety having suffered myself and have tried to help her, but there are things in her behaviour that make no sense to me on this basis, so I started reading up about Aspergers.

She appears to have many of the characteristics:
- socially awkward and while not afraid of approaching people and initiating conversations she admits to not really understanding social cues etc. as a result she lives a very isolated life.
- very good observational skills - notices details others would miss all the time.
- has some very set routines and gets very stressed when she cannot follow them - they appear almost like religious practises to me
- hates change/spontaneity - finds leaving the house extremely stressful and has to try and plan trips in meticulous detail (this always happens apparently)


Some traits I'm not sure whether they fit or not.
- can be very affectionate at times, in fact craves it - hugs/holding hands etc. but dislikes being kissed, but can quickly go into a mood where ANY form of contact is rejected.
- her communication by texts is completely emotionless, yet she notices when I respond back in kind. I think having pointed this out to her, she's learned and now her texts contain emoticons and endearments, although they are sometimes awkwardly written.
- talking on the phone is similar - she dislikes chatting and prefers to keep conversation to just essentials - I sense she finds it stressful to chit-chat.
- has a tendency to sometimes break off mid-conversation and without saying anything just go and do something else. She even just walked out on me after dinner the other week and came back 90 minutes later without realising she'd done anything rude or socially wrong.



Do you think I'm on the right lines suspecting Aspergers?

I know that while she hates the thought of "something being wrong with her", her condition is completely preventing her from living her life, and the treatments for depression/anxiety just don't work on her - I suspect because the underlying cause has never been addressed.

I'd like to suggest to her that she try to get a diagnosis, but I understand that diagnosing adults is problematic in the first place, and diagnosis of women is even less understood.

Thoughts?

Actually, the most important question - how safe am I in suggesting to her she go and try and get formally diagnosed?

Has anyone here has a friend/family member suggest to them in adult life they go for a diagnosis? How did it make you feel? Defensive?? Angry?

When my mother first told me she suspected I had AS when I was seventeen, I was initially hostile and defensive. I couldn't see how I could possibly have a disability. However, after a few more weeks and months of her pointing out my autistic traits as they occurred, I started considering that she might be right, and did some research on my own. The resultant diagnosis and subsequent support has been of tremendous help to me, and I don't think I'd be functioning as well as I am today without it. I'd recommend stating that you read an interesting article on AS or some such, and claiming that a lot of the traits in it remind you of her, then wait and see how she responds. Good luck!

I thought the people who suggested it were lunatics or just totally misunderstood me. I did not want anything to be "wrong" with me. I had spent all my school years defending myself, and once I was an adult with a bit of independence I really didn't want to hear it from anyone. But I do remember what they said when they told me and that came back to me when I finally began to suspect.

I am retroactively grateful to them for trying, although at the time I was not ready to hear it.

Maybe focus on things that you know she sees as issues, and how a diagnosis could help her deal with them better. And help her to not see it as some kind of disability or something "wrong" with her. I'm 32 and seeing a therapist due to anxiety and suspected Asperger's. I guess we'll see if I get a diagnosis, but to me the process is a relief after many years of feeling completely alone as a person and not understanding myself, and not being able to admit I am different. Of course, it's easy for me to say that because I chose to go to therapy after doing my own research on Asperger's, but maybe your friend could feel similarly. I see it as not changing anything about who I am, but finding ways to accept myself and potentially finding a useful label to help do that, so I can be happy.

If you do, start out with the positives of having ASD. Have a book or some legitimate web sites to back up your "observations." Finally, acknowledge that you are simply offering an idea with your opinion. Offer to help her explore more if and when she asks for it.

Sorry I'm late ... traffic was bad, and the trains weren't running on time, either ...

Only appropriately-trained and licensed mental-health professionals can make an official diagnosis of an ASD. We're all amateurs here, and while we are all free to give you our subjective opinions, not one of us is qualified to diagnose you, much less for your friend.

Online tests can not provide an objective ASD diagnosis, either. Most seem skewed to give you a positive result, no matter how you answer each question.

...

(Y'know ... hardly a week goes by without seeing at least one of these "Could I or this other person I know have Asperger's Syndrome?" threads. Do people really believe that we're all qualified mental-health practitioners here?)

Nobody, least of all the OP, is suggesting that a non-diagnostician could or should diagnose. It is a friend asking about how best to suggest to the other friend the idea of possibly, maybe, some day, exploring getting a diagnosis if the other friend chooses to do so. That is all. I wish somebody with the testicular fortitude would have done the same for long before I was 51 years of age. So, I wholly support the OP doing exactly what she hopes to do.

...1

Fnord - You are hilarious!

Hi! I think everyone else has given good advice. I just wanted to bring one thing up.

I'm not sure where your friend lives, but in some places it's hard to get an Asperger's diagnosis for a woman. A regular doctor, psychologist or psychologist may not recognize it, and even if they suspect it they'd probably send her to an autism expert. Often these experts don't accept insurance (not sure if your friend even has insurance). And they often charge huge amounts of money. For instance, I was given a quote of $2,800 USD from one doctor to go through the diagnostic process, and this particular doctor wasn't covered by my particular insurance. Other doctors don't even accept insurance. (This is in Seattle, WA.) So it might not be that easy for her to get the diagnosis, even if she agrees it'd be a good idea to try.

It may be different where you live, however, and she may be covered by insurance if she has it. I just wanted to mention that your friend deciding to get a diagnosis might be only the first step.

This is pretty much the opposite of what happened for me. I'm a girl and (I guess sort of) an adult which in theory is the most "invisible" of the groups. However, every mental health person I've seen so far said I was, no exaggeration, "obviously autistic". So my point is there is hope since because it is the group with the least knowledge about that many professionals will look into it specifically and it is gaining more awareness. I'm still not sure at what I did that was obvious

Many thanks for all the feedback.

We live in the UK, so no problem with insurance. I've no idea how good the NHS is with things like this though.

Her initial reaction was one of anger, but she still took the test - it was positive. I think she's got very mixed feelings about that currently. I hope she'll now take the next step and get a formal diagnosis. I've told her I'll support her. I don't think I can do anything else at this stage.

The NHS can be pretty slow so there may be a lot of waiting. I'm waiting at the moment. A lot of people do go private if they get impatient with the NHS.

This. The diagnostic criteria is designed to diagnose based on the observations of NT people, with no concern for how it feels to be Autistic or any objective physical or genetic markers. Many women and girls who were pressured or forced to try to hide their "weirdness" and "rudeness" are overlooked in diagnosis because they do not behave like young Autistic boys, who have not been subjected to the same societal pressures.

Because women and girls are forced to hide their "weirdness" and "rudeness" as best they can but cannot hide their Autism completely, they are often rejected by NT society. We as the Autistic community do not need to compound this by excluding these women and girls until they have permission from a probably-NT psychiatrist to call themselves autistic. We, as the Autistic community, have the right to define ourselves, and our definition needs to include self-identified girls and women who have been overlooked.

Unless I've been subject to completely out of the ordinary services that are so different to the normal that they're not comparable I wouldn't say that's the case. I live in the UK, like OP, and have been through the NHS. As far as I'm aware I don't behave "like [a] young autistic boy", whatever that means. There wasn't anything out of the ordinary about my birth - I was born on time, at a normal weight, let out of hospital the same day. I reached milestones either on time or earlier than normal. I had no problems academically. I caused no problems at school. The school was surprised that they had to fill in the ASAS - Australian Scale for Asperger's Syndrome (Australian? Yes, in the UK) - because nothing seemed wrong from what they saw in lessons. I was pretty invisible, thought of as "just shy" which covered everything the school saw, really. And yet despite that in a meeting (took them long enough to call us about their decision - they were more than a day late, typical NHS for you) they decided unanimously that I was "obviously autistic" - no joke, that's what they said - and I'm waiting to get an official diagnosis so I can get help. Over the past few months my parents, the school and me have all had to fill out quite a lot of forms, questionnaires, answer questions (especially me, so many questions) and I'm pretty sure the mental health team understand more about my own life than I do myself.

They actually did ask me how I felt and I didn't know. At first they thought I might be trying to hide things from them but now they realize I don't think in terms of feelings. I didn't know that actually. They asked me how I felt so often and I think they've finally got that when I say "I don't know" I genuinely don't know.

I would talk about my opinion on "self diagnosis" but it causes a shitstorm every time it comes up so I'll leave that out I think we've decided to let that topic rest. Things got pretty hostile.

But psychiatrists are no morons. They know what they are doing and have a decade or more of experience even before they start official work on diagnosing. They are very knowledgeable people even on girls and women with autism and while misdiagnosing can and does happen their conclusions are as accurate as is possible. Even before that you need plenty of mental health people to agree (I have seen literally dozens of them, that is no exaggeration. Dozens.) and the decision is not made by one person at each stage, let alone at the final one. It's a very thorough process I can say as someone who has been through the various stages of it other than the very last one.

Sorry for the life story.