Is this typical of a diagnosis?

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I'm new here, but I've been lurking for a while. I'm pretty convinced that I'm an aspie. So convinced in fact, that I decided to put it to the test. My experience was kind of trying, and I'm having difficulty letting it go, so I thought that I would seek some comfort knowing that others have dealt with similar issues.

Anyways, I talked to my physician about it and we scheduled a sit down in the mental health department to do an evaluation. After a long wait (about 4 weeks), I ended up meeting with a psychiatrist. I told him right away that I thought I had aspergers or some form of ASD. I explained some of the things that I had been diagnosed with as a teen (Post Traumatic Stress Disorder, Depression, Borderline Personality Disorder and Social Anxiety Disorder), and told him that I didn't believe that I had any of those because I thought aspergers described me much more accurately.

We talked a lot about my family life growing up, which was terrible. We talked about my work history, also pretty dismal. We covered my school career, which was a disaster. I told him that I never quite fit in with my coworkers or peers. I always ended up working by myself. I am completely incapable of 'small talk'. I was teased relentlessly throughout my school years and totally lacked the instincts to protect myself from it. When I would get in trouble as a child, my parents would ground me to the outside in order to keep me away from my books that I would obsess over. I have ridiculous special interests (myrmecology and cryptography), which I have an incredible and obviously abnormal amount of knowledge about.

As the interview progressed, he went through my prior diagnoses and ruled them out one by one. He agreed that none of those fit. He proceeded to rule out several other possibilities that he just rattled off. He asked if I had considered obsessive compulsive disorder about the obsessive interests. I responded that I was absolutely sure that I don't have OCD. He then said I was 'quite a challenge'. This whole time, he just absolutely refused to talk about autism. He told me that "this 'not fitting in' is all in your head", which shocked me so much it basically rendered me speechless.

At the end of the interview, he looked at the paperwork that summarises his recommendation and said, "Hrm, I think I'll go ahead and say you have Avoidant Personality Disorder". He scheduled a return visit for me to sit down with him and he said that he was going to have me sit down in the near future with a psychologist for a neurological assessment (? I think thats what he said).

So I got rid of 4 diagnoses, and gained a completely new one!

I don't quite understand what happened in there, so any thoughts you guys might have to share would be wonderful.

It occurred to me as I was writing this that perhaps he wasn't qualified to diagnose an ASD, and just wanted to rule everything out before passing me along? I don't know. Help?

Meow.

So, if I understand well ; you met a psychiatrist because you thought you have Aspergers. He said you don't have PTSD etc... and he said that you have an APD, is it right ?

In which country do you live ? Usually, I don't think that psychiatrist are able to diagnose Aspergers... Maybe is it some Center specialised on Autism in your country... it's very probable. There they know certainly more things about autism than the psychiatrist. In medicine and psychology, everyone is qualified for something, so going to a Center is better.

Last edited by sMeow on 06 Nov 2011, 6:24 am, edited 2 times in total.

Good questions. I'm in the midwest area of the United States. I'm in my late twenties.

Sorry, I don't want to get too specific for privacy reasons.

You've done a pretty good job summing up the situation. I'd like to know specifically if a 'neurological assessment' is used to diagnose autism?

I don't know if there are any autism centers nearby, but I will definitely look into that possibility. Thanks!

For me my mom thought I was going thru a teen phase when I told her. I visited a psychiatrist and he told her I was aspie in 45 minutes, no tests just talk. Both of that weird huh? Plus the fact he said at first: maybe/on the spectrum/ aspergerish...it was when I went in again that he told me yes.

He diagnosed you in a single session? That's something of a warning flag.

Ye, it's a bit strange. :>

sMeow.

Yes that's weird, but why??

It sounds to me that he was prepared to give you a dx of Avoidant Personality because it was a "purely" psychiatric assessment and he felt qualified to do it in a short time. It sounds like he would have been prepared to dx you with OCD, too, if you had gone with that idea.

ASDs are neurological in nature and they take much longer to diagnose. My take on this is he wants to sit down and do a fuller assessment which will, among other things, determine whether you are on the spectrum. My dd did the 15 tests of the WISC-IV, a couple of school-related achievement tests and four or five specific ASD tests. I consider that a thorough assessment... and we are still doing other assessments at school. If this is what he means by a neurological assessment, then that's a good thing. OTOH, he seems to be biased against the dx of ASD, by dismissing your feelings rather than investigating them. (Our psychologist told us after all this that he was initially surprised when he met with her individually for a play therapy session, because in every other way she didn't present as most AS kids do: she was poised, self-aware, etc... but he did all the assessments to have a bigger picture of her. You couldn't do that in an hour.)

I agree that he doesn't sound like he is highly experienced or knowledgeable in the area of ASD. Not all people in any one field (neurologist, psychiatrist, psychologist, educational psychologist, pediatrician) are, but some of the people in any one of these professions can be.

Autism Centres or suggestions from support groups, etc. can be helpful in determining whether you should continue to have him assess you or find someone else.

J.

Atleast he is following it up with you meeting another specialist.

The lady shrink I went to for years hadnt even heard of Aspergers when my family and I brought it up as a possible dx.

She then read up on it, and then declared I had it.

A couple years ago I finnaly got the real deal- the real diagnosisi takes a battery of tests, and interviews with not only you, but with people who knew you when ( parents, siblings, friends, etc).

Maybe this second guy arrange for you to get the real diagnosis.