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

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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

Do you have some kind of proof or example to show your psychiatrist? Could you show him testing results or something like that?

Is there a clinic near where you live that specializes in autism spectrum disorders?

It seems, as per usual, as if these people are "behind the times" when it comes to Autism/Asperger's.

It's a pity, really, that they don't research Tony Attwood or someone of that ilk.

Although I can only offer you dubious advice, I'd say bring up the topic again. It's important that if you are, in fact, autistic, and it's clinically significant, then you should definitely receive support, or at least a diagnosis.

(Also, those sound like special interests to me. They're not actually mandatory in the DSM-5, though, so that shouldn't stop you from getting diagnosed.)

Your experience isn't uncommon. For what it's worth, my advice would be to get a second opinion - you are entitled to this. I've recently been through diagnosis in the UK and had an extremely unpleasant experience with a young psychologist whose attitude was very similar to the one you were sent to, and so I shall be making a formal complaint.

Some parts of the UK, such as where I live, now have units that specialise in adult ASD diagnoses; which is no guarantee that the clinicians there are competent to diagnose adults, as I discovered.

Send me a pm if you'd like to talk.

...Pills , pills , more medicos (Psychs especially ) trying to push pills upon you...


ote="ChloeAnn"]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 [/quote]

This is a tricky situation. I think there are a lot of poor psychologists and doctors out there that are not even remotely qualified to be handing out diagnoses. On the other hand, if someone is continually seeking a diagnosis and everyone is telling them it doesn't fit, then it's probably time to legitimately consider that it might not be right for you.

There is some middle ground there though. I think it's almost always completely warranted to seek a second opinion if your first experience goes poorly. Most people would do the same with pretty much any other medical diagnosis. In my case I ended up seeing a third, since both of my first experiences were poor and gave conflicting answers as well. If you're looking for validation though, there are diminishing returns to seeing more psychologists as well. If 4 people have told you you're not on the spectrum, the 5th is not going make you suddenly feel completely validated. There's going to be some lingering doubt knowing what it took to get to that diagnosis.

So, in summary, definitely seek a 2nd opinion, but beyond that be careful about "chasing a diagnosis" from one Dr/psychologist to the next.

I guess you will have to find a new psychiatrist.

Second opinion?

I mean:
Second opinion!...

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.

At least with a social anxiety diagnosis you will be offered CBT to help you learn strategies, though they might be the wrong ones since they were developed for people without ASD.

A lot of people on this website are reluctant to listen to a psychologist or psychyatrist when they suggest that it isn't ASD. You should ask your psychyatrist what he/she thinks is best and if you can get re-evaluated to see if there's anything that can better explain your symptoms.