Legitimate Diagnosis

Post Reply New Topic

So, I had suspected for awhile that I have Asperger's, and yesterday I went to my university's clinic, where it was confirmed by my psychologist/doctor lady. However, she said something interesting that I would like to ask people from here about.

The psychologist said that she was certain that I have Asperger's, but that no Psychologist who was interested in keeping his/her job would "officially diagnose" me, due to the fact that I refused therapy, and because I do not feel that it is a significant "impairment" to me (i.e. although I cannot stand groups of people, social gatherings, etc. with more than 2 or at maximum, 3, other people, I don't feel that it is an impairment because I have no desire to participate in such events, hence my subjective assessment was that it is not an impairment, although others think it is).

She said that to be "officially diagnosed", i.e. I would have to feel that it caused significant unwanted impairment, and there seems to be an interesting intermingling in Psychology between diagnosis and desire for therapy.

However, when I asked her the following question: "Even though refusing therapy leaves me ineligible for official diagnosis, If you had to guess, would you guess that I have Asperger's?"
She replied "Oh, it's not a guess...you fit this."

SOOO, when someone on this site labels themselves as "Diagnosed" or "Undiagnosed", where would my experience leave me? I feel as if I've been diagnosed, but I'm not sure whether or not one has to go through with pandering to the arbitrary bureaucratic structure of official psychological diagnosis, etc. in order to feel that they have been diagnosed.

Either way, yesterday was a very good day, insofar as I now have an explanation for all of the peculiarity, isolation, etc. that I've had throughout my whole life, and just reading forum topics all over this site has made me feel more at home than I have ever felt anywhere. I've been constantly yelling "YES!" at the screen for hours.

Welcome Home!

You can be diagnosed without entering therapy.

"Diagnosis" is when a professional tells you you fit the criteria (or recognizes it without informing you), i.e., '"Oh, it's not a guess...you fit this."' It's her professional duty to put it down in your "folder" after she recognized it.

I've had "Asperger's" in my folder for a year and a bit, I didn't know it was there, but I was diagnosed with it when the professional noted it (my autistic disorder diagnosis supercedes that one however).

So unless you declare yourself willing to cough up a kilobuck or two for therapy, you forfeit an "official" diagnosis? Gah! As usual, money talks the loudest of all.

... Anyway, welcome to Wrong Planet!

It's actually quite common for mental disorders to only be official if they person with the disorder is somehow harmed or impeded by the disorder itself.

For instance if you look up many diagnoses in the DSM you'll see the tag line:

That's from DSM for Asperger's. Look at it for depression:


From ADHD:


Obviously asperger's has not caused significant impairment because you are not impeded. You lack the desire for those particular endeavours... so no problem. That is why you will not be diagnosed. If you, however, desired the ability to interact to a "typical" standard in work settings, social settings and you could not accomplish this yourself, then it would be an impediment, and you would need help to get better... ipso facto you would get a diagnosis.

Distress or impairment is one of the criteria, if you do not feel impaired or distressed by the symptoms, or your condition, AS can not be diagnosed. Similarly, if you'd felt sufficiently distressed to request therapy or counseling, the AS siagnose would have applied. If you'd felt impaired or distressed and still did not want therapy, the diagnose should be applied, I think.

I am not sure if the distress/impairment clause is present in PDD-NOS.

Danielismyname,

How does autism supercede AS? Isn't most AS likely to be diagnosed as something like autism?

JasonWilkes,

RogerB is right. And I struggled with the same problem as you(Lack of impairment leaves us orphans). But, after thinking about it, I cam to the conclusion that it DOES create an impairment. I have just organized my life around it.

I would LOVE to sell, and DO have to sell MYSELF from time to time, but I am too honest and couldn't really bluff even if I wanted to. Do you have ANY idea how hard it is to sell yourself HONESTLY when everyone else LIES? I was once told that I was the ONLY one in a group without all the skillsets. I spent a few weeks with them and they admitted, and showed me, that they did NOT have all the skillsets! In fact, I was the most skilled one there, and had the second highest grade in the class!

I would love to do certain physical things, but really can't. If someone points something out to me, I often seem to be looking at another level. In a class, it is not THAT uncommon that I will look like the dumbest and the smartest person in the class. Luckily I usually express both sides. People are always quick to point out the negatives.

Heck, people even think you are an idiot if you laugh at something nobody else does, or don't laugh at something everyone else does. I've done BOTH.

Autistic disorder supercedes the diagnosis of Asperger's; the cognitive impairment and early onset is what sets them apart, if you have those two, one must be diagnosed with autism over Asperger's.

This is under Asperger's (DSM-IV-TR):

This is bunk. Sounds like the shrink wasn't seeing a chance for profit in you and is bowing out. Transfer your records to someone else. The shrink will have had to note it in your records somewhere that you are AS but refuse therapy so diagnosis is pending.

2ukenkurl is right. Many of us do not live with AS as a significant impairment to us because we organize our lives around it.

I'm going through this with my GP right now.

I want an official diagnosis but don't feel the need to "fix" anything about myself. He feels that since I don't want a "fix" I don't need an official diagnosis. Luckily he knows me well enough that he has started the gears in motion anyway.

In the meantime the 12 year debate regarding whether I need medication to deal with my anxiety and social phobia wages on. Bah. No wonder I don't like Doctors.

This is an interesting discussion to me as I have my initial appointment in less than a week to seek a diagnosis. I do not, have never, and never will, like doctors, and this is a lot of the reason why (besides the necessary invasion of my personal space). If you have a problem they can quickly categorize and leads to further treatment (read $) down the road, they are all over you. If you have a problem they cannot easily categorize and need further visits and tests (read $) they are all over you. If you have something that defies further ($) or does and you refuse to accept further (expenditure of $), they could care less and move on to help the next ($).
This is interesting to me because I am adjusted, pretty much, to the way I am. I don't want any meds. I don't want any therapy. I have a difficult job for me because I am the lead on my team, but my supervisor understands how I am and lets me work around it.
You mentioned not knowing where this leaves you. I am FAR from an expert, as I am just beginning this journey myself, but I think it leaves you where you perceive yourself to be. I don't know that the label--Autie, Aspie, NT--matters so much. You seem to feel you fit in here, as I do. I mentioned in a previous post that I have never felt so at home anywhere in my life as I do on this site so I think I understand how you feel. If you can get help here, great! If you feel like there are answers for you here, great! I think I am what I am, and whatever any doctor chooses to call me has little to do with anything, especially since I will not let them call me a ($).
So, welcome!!

As has been said: I kinda needed my diagnosis of autism, I need the money they give me to eat (it affects my ability to work and study, it's completely disabling in my case).

A diagnosis, verification that you have Asperger's can help if you're having difficulty in study/work, it can allow you to see your deficits and work with your strengths rather than your weaknesses. It also rules out other, perhaps treatable mental disorders that are affecting your life.

Am agree [and with what RogerB has said as well].

AS has a cutoff point in who is diagnoseable with it for a reason as with all specific autism labels [and would think most conditions do have impairment criteria involved to?].
the minimally impaired/mild type of hf ASD [when it can't be diagnosed as AD,PDDNOS or AS] sounds more like BAP [Broader Autism Phenotype].

But refusing therapy should not be something that stops a person from getting a diagnosis on the spectrum.
plenty of SHIers [severe hearing impaired] refuse to have cochlear implants,are they told they are not deaf for doing so? no.

The downside of an official diagnosis is that it might complicate your health insurance, as most insurance companies won't touch autism or "autism related conditions."

An official diagnosis is necessary if you want to try to collect disability income.

There is nothing "illegitimate" about a self-diagnosis. If a self-diagnosised person is in error, they usually figure it out after a few months of hanging out here.

I don't think people with problems want to falsely claim that AS is the cause. I think people with problems want to find the best explaination possible. We all want the best possible diagnosis.

Yeah, but there has to be SOME allowance made, otherwise NOBODY would be diagnosed AS. If you had clinically significant cognitive impairment in something besides social, you would definitely be autistic but not AS. And I don't know what you mean by "early onset". They are both something you are born with, and both might be noticed early.(Although they may appear the same in VERY young children.)

I was at a training session on working with autism on Wednesday and chatted with the guest speaker who paid £600 ($1200) to a private neuro-psychiatrist to be diagnosed AS at the age of 54 (he is now 56). He says it has made no difference whatsoever. I was diagnosed/treated for "hyperactivity" in 1968 and this was never recognised as AS at the time. Only since my son was assessed as autistic 9 years ago did I realise the extent of my AS and, while it explains things it seems to make little difference.

Yours in Peace

Tog