what to tell psychiatrist

Post Reply New Topic

Long story short, I'm going to see a psychiatrist in the upcoming months, and I want to present autism/aspergers as a possibility of what I have. What I want to know is what I should present?

I feel like I'll need to go in with a comprehensive list of traits that I have that indicate I might have it, as if I don't I know I will miss some, possibly many. Not missing anything will be doubly important because this person, I believe, will not be diagnosing anything but rather giving an opinion, and could point me in the direction of where I could get a formal diagnosis if I have it. (ie: the psychiatrist might not be armed with the appropriate questions such that I wouldn't miss anything.)

I've got the checklist found here, http://www.help4aspergers.com/pb/wp_a58 ... d4f6a.html I'm at ~75% for it. I figured I'd print off the sheet and bring it in.

But I don't think that's going to be good enough. Only very recently have I been taking an outside perspective on how I socialize. I'm nearly a hermit these days except for my family and a few, close friends, so I don't have a lot of, well, more regular socializing. But as I've been really examining myself and thinking about how I act, there are a couple of moments where I know I've messed up.
Just a week ago, at my singing lessons, my instructor records them and sends them to me and this last one I noticed that I went on about a subject for seemingly too long in one, (which was hardly long at all), and then when I gave him a Christmas gift, I talked over what he was saying. I only noticed this as being bad when I went back to listen to the lesson, and again I probably only noticed it as bad because I've been examining myself for my sociability recently.
The other occasion where I must have flubbed badly, and I knew it but didn't think anything of it as perhaps systemic of a problem of mine, was an interaction I had with a doctor. One of the best one's I've had too, because I went in with a list of concerns and was armed with references to research so that I wouldn't just get 'don't trust the internet', to show I had read proper research papers. In any case it went well and the doctor assuaged my concerns, and I left fairly happy, which is high praise seeing as I despite most of my visits with physicians. The next time I see the doctor I was drugged for a gastroscopy, and when I was coming out of it I distinctly remember the doctor saying that I thought he was stupid, and he was grumbling to me. I remember groggily saying that I didn't say he was stupid and he answered something 'but you were thinking it'. But I wasn't. At no point in any of my conversation had I thought the man was stupid. But it came across that way, I came across as arrogant.

And then there's all these nuances and things that I do that everyone here says are kind of normal aspie traits but, as far as I can tell, aren't part of any diagnostic criteria.
Things like: I ramble a lot when given the chance (eg: all my forum posts, while I still don't feel like they're represenatative of 'special interests'), I find a lot of things boring, I get overwhelmed easily (not the same as liking routine, I find routine incredibly boring and I quite dislike it), I have meltdowns frequently, I tire easily, I seem to have poor impulse control, (these last 3 go hand in hand), I seem to have problems describing my emotions and they can often be delayed until I have time to myself to think about events (so some degree of alexithymia)...I dunno, I can't think of anymore at the moment, but I know there're more. Am I just wrong that these things aren't part of the diagnosis of Asperger's or autism?

Then there's the childhood problem. IF I have aspeger's, then it's entirely likely my entire family does too. I know that as a kid around people I was comfortable with, I was often extroverted, and that is who my parents and family knew me as, a happy, fun-loving, extroverted, take-charge of things kid. And I feel I still could be even now, although that rarely, rarely happen anymore due to feelings of overwhelment of having to do, well, anything. But in the classroom I was quiet and did my work. I had no problem making friends up until grade 4 or so when I suppose didn't fit in with the 'cool' kids and so started ~5 years of awful social experiences until I found my geeky, nerdy friends in highschool. I had a best friend in grade 5 who dumped me as a friend because I was too clingy, but only once do I remember noticing that I was being so, and that was when she got frustrated and yelled at me for following her to do something once. Not until grade 9 did I once again become happy socially as I had found someone to hang out with who was just as happy as I was to have someone who was similar to me. Grade 8 was downright awful, I was picked on by half the class.
The thing is, lots of people I know and talk to weren't ever the popular kid, (basically all the friends I made in highschool) so I've never taken lack of popularity, coolness, non-loserliness, as a sign that anything's different about me.

But of note is that I feel like I can read most people fairly well, most of the time. I've actually been told I'm astute and good at reading people that I know really well.

Ack, once again this is side-tracked. I basically just want to know what I should be telling a psychiatrist. I just want to be as comprehensive as I can and not miss something and I don't want to vaguely answer 'no, this isn't me' due to how a question is asked or worded when in fact, I should be answering 'yes, sometimes'.

Last edited by cavernio on 27 Dec 2013, 11:45 pm, edited 1 time in total.

Just be yourself. If you have AS/ASD, then the psychiatrist is likely to perceive it; but if you try to 'present' as having AS/ASD, then the psychiatrist may come to believe that you are only trying to conceal some other disorder, or that you are faking it and there is actually nothing wrong with you.

Just be yourself.

^^This. You're likely going to be seeing this Psychiatrist for a while, before any diagnosis is made. You can certainly tell them what you suspect, but it's going to be up to the Mental Health Professional to determine what they see as they get to know you. Some doctors are offended by patients who self-diagnose, because they feel someone unqualified is trying to do their job for them.

a doctor who is offended by someone trying to self-diagnose should be fired. the patient is the expert on themselves and patients who take an active role in their treatment tend to have better health than those who passively accept what the doc suggests.

So, should a person just tell the psychiatrist what to diagnose? Should a psychiatrist simply "rubber-stamp" the self-diagnosis of someone who may be faking, delusional, or just plain wrong? Should a potential employer take the word of a self-diagnosed person who is demanding special treatment over the word of a professional who says there is nothing wrong with the person?

Sorry, kid; but there are legal liabilities involved that you seem to have either ignored or failed to comprehend. As an employer, I will always require the written diagnosis of an appropriately-trained, experienced and licensed mental health professional whenever an employee or potential employee claims a diagnosis that requires me to provide reasonable accommodations for their alleged disabilities.

Self-diagnosis be damned!

Just my 2¢s, but I think if you go into a psychiatrist and present as your issue, that you think you are on the autism spectrum, he/she is going to say, "Why? What's the problem? Where does it hurt?" Very few people ever go to a psychiatrist, and say they want confirmation for a self-diagnosis. Parents are the ones who bring their children to a doctor when they suspect autism. But for someone who is 31 there is nothing they psychiatrist can do for you except prescribe drugs of course. Psychiatry used to be about the relationship that got established between the doctor and the patient, and that took a long time to be established enough that it could be analyzed. Nowadays, people present with a problem, and the doctor gives them a prescription for some drug that may relieve that problem.

Well, that's all fine and dandy if some poseur wants to say, "I'm an Aspie; gimme drugs!"; but wouldn't that only serve to reinforce all of the negative stereotypes about Aspies in general?

you don't get drugs for being autistic. Sometimes for co-morbidities. i cannot see someone pretending to be autstic because they want meds for their depression, or meds for their anxiety or meds for their tourettes. they would get the meds for being depressed, anxious or tics, not for being autistic.

I think it's worth bearing in mind that the OP is female, and in her early 30s.

From what I can make out, there are still plenty of pyschiatrists who are unfamiliar with the different ways in which AS can present in women, or who perceive AS as a "male" disorder and are unwilling to diagnose it in women purely due to this bias. Also, at her age she probably has a fair range of coping skills and may appear less "aspie" than she is. (As an adult female myself, these are certainly concerns of mine in deciding whether it's even worth trying to get assessed.)

So I don't think it's unreasonable for the OP to want to be able to clearly explain why she believes she's on the spectrum.

If you are replying to me... that is not what I am saying. I think that the OP should perhaps consider not saying she suspects she is on the spectrum, and instead share what hurts.

You are not going there to get diagnosed with an Autism Spectrum Disorder but to find out what is ailing you be it ASD or something else.

Like everyone has said just be yourself and talk about what you experience. The childhood years are important. If you have school records or childhood records bring them. If you don't have them try and get them. But you continue through other years and talk about now also.

When you get the diagnoses ask the good doctor what factors went into his/her decision. If you don't feel comfortable after that seek a second opinion. And do report back to us. We can't diagnose you but will have a good idea if he/she is incompetent particularly in regards to ASD.

Good Luck

If I go in unprepared and just myself, I will forget over half the things that have made me see the aspie traits I possess. Especially if I should be going into childhood experiences...how good are your guys' memories?? What exactly about my childhood should I tell?? It doesn't help that I think I gloss over and lose memory of many negative events in my life. Plus, as I said before, my whole family shows aspie traits when I think about it, and they're who I spent a lot of my time with as a kid and they raised me, so no I didn't have issues socializing for a huge part of my childhood.

The psychiatrist will be getting a write-up from the intake officer who will direct my file to the psychiatrist, and she alluded that my session with the psychiatrist would probably be similar to what I had with her, which was a bunch of questions and then her asking me what I thought was wrong with me. I felt ill-equipped for most of it, although overall I guess it was probably good as we talked extensively about my actions and emotions, or tried to talk about my emotions.

I am very unlikely to be able to see this psychiatrist more than once. ASD is just one of the things that I think could be an actual explanation as to what's wrong with me. I know I have a serious motivational problem that I strongly feel is separate from depression as I know it, and I get overwhelmed very easily. My quirkiness, interests and social skills don't bother me at all and I've never considered them a problem so long as I ignore the people who make fun of me, talk behind my back, etc, so I've never bothered to look into them as anything abnormal. The fact that I dread doing anything bothers me, that's what I need help with. I need professional help here, and a professional diagnosis of anything could help me immensely financially.

Myself, I feel that the best explanation I have for what I feel I have is ADHD except that I never had any issues focussing or being hyperactive as a kid, and that rules out having ADHD. That only happened when I got seriously depressed and the motivation and focus problems stuck with me even when my depression (ie: not wanting to live) didn't. But being different, yeah, I've always been a different person, happy to be unique, seeing myself as liking different things from a lot of my peers even as a kid, and of course ASD shows lots of executive dysfunction problems, which are all related to motivation and action and that connects it to ADHD...

This is actually a medical doctor I'm seeing and perhaps he'll have some insight into my celiac disease and how it may have messed me up mentally, (although that's doubtful, most doctors I know only know it as a digestive issue and not an autoimmune disease that can damage the nervous system.)

I feel burnt out more than anything, like drugs fried my brain, except there are and were no drugs involved.

I get what you're saying when you just say to be yourself, but myself fails to represent who I am. I can't expect someone, no matter how well-trained, to be able to read my muddled mind for me such that they can understand. Especially if I don't come across as having aspergers just by my socialness and that I might make eye contact casually or something. I mean, I'm not going in there feeling certain of my own ASD symptoms at all, I feel that I'm on the line of having it and not having it, and so if I do have it I feel that I would not get diagnosed with it unless every aspect of where I feel it fits me were to be presented. And yeah, as I mentioned before, what this psychiatrist says, even without a full-blown proper diagnosis of ADHD, ASD or even still depression, could affect my status of being disabled. And this is why it's important that I bring information to the psychiatrist that he might not ask me about.

By saying be yourself I am not saying fail to be prepared. I would tell him you tend to gloss over or forget negative things. For your childhood I would tell him how you got along with, parents, teachers and classmates and why if you remember. Subjects you did poorly with. Any delays in language, did you wet your bed longer then most. I would discuss any serious illness you had, or if you were sick often. Probably you will be asked about these things anyway so it would be good to write it down.

The attitude here is not I have to explain everything in one hour. This is equivalent to an introductory interview he is trying to get a basic overview of you. You are also trying to get a an idea if this is the person you want to help you. If he asks why you are there then that is the time to say I think I might possibly have Aspergers. FYI there is extroverted Aspies, I have met them at support groups.