Psychiatrist doesn't think I'm autistic - now what?

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Vole
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20 Aug 2015, 10:51 am

I was trying to come up with something more constructive than "your psychiatrist is an incompetent brassica-brained dinosaur" but I take your point that it would be unethical to deliberately give an incorrect diagnosis. However, what goes in in people's brains doesn't always seem to make much sense and I wonder if the psychiatrist's need to believe he can help (in the context of a service which has help it can offer to social-phobics but not to autistics) could have an involuntary biasing effect on his thought-processes. This is all highly speculative, however, and from what he said about autistic people not being able to go to school because of their obsessions, it's more likely he's just ill-informed on current thinking about ASCs. :lol:

Aspie202
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20 Aug 2015, 10:54 am

What is your psychiatrist trying to help you with? If you can tell us, I bet we can help you here at WP.

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ASPartOfMe
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20 Aug 2015, 5:16 pm

ChloeAnn wrote:

I told him about my sensory issues with sound and food textures, communication problems, trouble with eye contact, my stimming, echolalia, my need for routine and getting upset whenever they're disrupted, for example.

These traits would be easily recognized as autistic ones by anybody with any type of knowledge of autism or has read the DSM 5 criteria for diagnosing Autism Spectrum Disorders

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Aspie202
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20 Aug 2015, 5:38 pm

I guess you'll have to get a new psychiatrist.

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oharris1997
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20 Aug 2015, 5:44 pm

Ask if your psychiatrist has any experience with diagnosing ASD but especially in girls. What you described definitely is accurate of AS as you seem to have the sameish traits as me and I was diagnosed a few month ago. I would suggest going to see a different psychiatrist or a psychologist that has expertise in diagnosing ASD even better if they have expertise in diagnosing females.

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Eloa
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20 Aug 2015, 6:49 pm

ASPartOfMe wrote:

ChloeAnn wrote:

These traits would be easily recognized as autistic ones by anybody with any type of knowledge of autism or has read the DSM 5 criteria for diagnosing Autism Spectrum Disorders

Maybe it depends.
If a person is reporting these traits but not displaying while assessment to a degree.
Was OP echolalic during assessment.
Did Op stim during assessment.
How was eye-contact of OP during assessment.
Were there sensory issues concerning the building and surroundings and sound the assessment was taking place and approach to building and surroundings the assessment was taking place obviuosly displayed.
Was OP distressed from changing routine not being functional during assessment as it is no routine.
In my assessment these were all impairments in place while assessment and reported.
And I think this is maybe off-topic it also applies to online-tests.
In online-tests there is never a theshold of real impairment.

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justkillingtime
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20 Aug 2015, 7:24 pm

The psychiatrist said he was "not convinced". To me, that means he is undecided. He suggested you change your routine; how do you feel about your routine being changed?

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btbnnyr
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20 Aug 2015, 8:16 pm

You could get a second opinion.
I suggest that you make a few item list of concrete impairments if you get assessed again.

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ASPartOfMe
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20 Aug 2015, 10:24 pm

Eloa wrote:

ASPartOfMe wrote:

ChloeAnn wrote:

These traits would be easily recognized as autistic ones by anybody with any type of knowledge of autism or has read the DSM 5 criteria for diagnosing Autism Spectrum Disorders

Hopefully the clinician would interview others who knew this person, look at school records if they exist etc. Autistic symptoms can not be turned on at will, and the inclination to look normal in front of strangers even if the stranger is the last person one should be covering up to can become strongly reflexive, especially for the several hours of observation

12341234
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21 Aug 2015, 12:05 pm

ChloeAnn wrote:

Hey guys, I live in the UK, and I've been seeing my CPN for the past couple of months after I was referred initially for depression and anxiety by my GP - my Mum was worried about me as I've not been in employment or education for 3 years. I brought up the subject of Asperger's as I've been reading about it for some time, and myself and my family are convinced I'm on the spectrum. He agreed, and referred me to a psychiatrist; I've just come back from my assessment, and I'm really not happy.

When I arrived, he asked me if I knew what I was there for, and when I said ASD, he told me my CPN hadn't mentioned it, and that I was there for social anxiety disorder! He asked me how I felt whenever I feel anxious, I told him I get butterflies in my stomach and feel a bit sick, but no panic attacks or anything else associated with an anxiety disorder. He asked me what I do in my spare time - I told him about my obsessions and interests: Disney, attachment to fictional characters, video games, etc. I told him about my sensory issues with sound and food textures, communication problems, trouble with eye contact, my stimming, echolalia, my need for routine and getting upset whenever they're disrupted, for example.

So after all these questions, he said he wasn't convinced I'm autistic because my obsessions aren't 'taking over my life'? He assumed that these intense interests are simply because I don't have anything to occupy my time with, and I told him that I've had them since I was a child - to which he replied that if I was autistic, I wouldn't have gone to school because my obsessions would have been out of control?

He also said that my interests were not narrow or abnormal enough to for me to have Aspergers; I told him that obsessions tend to be less narrow and more 'normal' in females, but he seemed quite dismissive of this. He then told me that I couldn't have Asperger's, as I didn't describe myself as 'odd'?

He concluded by saying he's not convinced I have ASD, referred me back to my CPN, offered to prescribe me medication for anxiety and depression, and recommended that I change my routines! What should I do when I go back to see my CPN? I'm feeling hopeless that I'm going to get the support I need

You ought to complain and ask for a second opinion within the NHS Trust - which county are you in? Lodge a complaint with the General Medical Council questioning his integrity and fitness to practise.

ConceptuallyCurious
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22 Aug 2015, 8:01 am

While I also don't agree with shopping for diagnosis, I do think there are situations in which it is advisable to get further assessments.

In my case, I was assessed (although never a formal assessment) not to have ASD at age 16. Since then my other mental health problems have significantly reduced and it seemed reasonable given the change of circumstances (e.g. The similarities I had with autism could no longer be described through other diagnoses).

I'm waiting for the results of my second opinion (aged 20), but I was referred to a specialist in women with autism who is trained in multiple assessment measures of autism. Though she doesn't always use them - she does it on a case by case measure.

My ADOS was videoed for 2nd marking and the information of the whole assessment is being taken to a supervisory diagnostic formulation.

Even if I am not diagnosed with autism, I will be content that my assessment was thorough, fair and well advised.

In your case, I think being seen by a specialist in autism (rather than a psychiatrist who had no idea he was going to be assessing for autism) would be a wise idea.

I think the issue here is less about whether you do or don't have autism and more about the incompetence of the psychiatrist in this area. (For example, the idea that if you had autism you wouldn't have gone to school.)

Ukguy
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23 Aug 2015, 2:13 am

Vole wrote:

It's also possible that he's diagnosing what he can offer treatment for. My experience in the NHS is that an ASD diagnosis has closed doors for me, and referrals that were made for me to therapy services for the problems i have were turned down once I was given a primary diagnosis of ASD. They were happy to treat the problems I have right up to that point, but the moment that assessment came through, sorry, our service is not a first-line treatment for ASD.

I find it interesting that you say this because I have the exact same experience. I was referred for therapy but while waiting for the referral I sought a private diagnosis for ASD. As soon as the diagnosis came through the referral got cancelled as they decided the service was not suitable. My diagnosis of ASD quite clearly closed doors to help.

Also you are right about they only want to diagnose what they think they can treat. It sounds like OP's doctor has no real expertise about ASD and either isn't capable of making a diagnosis or simply doesn't want to because he can't treat it.

My recent experience of NHS secondary mental health care and psychiatry is very poor. Psychiatrists push dangerous drugs and talking therapies / practical help are impossible to find.

Crazyfool
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23 Aug 2015, 8:14 am

This guy really sounds like a complete moron, I think you should find a new doctor that is willing to listen to you. Personally I feel like when you have Aspergers you'll know it or atleast know something isn't right, then once you read about it, everything kind of clicks.

You're an adult right and you said you have an obsession with Disney movies and animated characters, and he doesn't find that a bit odd? Not a determining factor by any means but most grown adults wouldn't be so into that kind of thing, if at all.

You know you better then anyone, this guys sounds like he just wants to comp out and prescribe you meds and get you out the door.

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