stupid doctor? or stupid me?

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Hi,
i've just got back from an appointment with my doctor and am a bit confused.

When i went in i was VERY anxious, ringing my hands together like i was going to wear the skin off and my hands were shaking pretty badly.

when he started asking me questions, are you in a relationship? no, have you ever been in a relationship? yes but very short and dissasterous, do you have any friends? no, did you have any friends at school? not many, i thought he may be thinking the same thing as me, how wrong could i be?
When i mentioned AS, he baisiclly said that i wasn't aggresive enough and my expression wasn't blank enough!
He then went on to say that i probably think i have it because i read about it and was deluding myself!

After this he put me on 20MG citalopram per day (i know almost nothing about this drug)
and refered me to the counsellor.

this is a bit odd, as another doctor said it was possible that i have AS
and the counsellor said it was very likelly.

Hopefully (if i can keep up the appointments) i can proove him wrong, but for now he has planted a seed of doubt in my brain, which i know i will be thinking about constantlly.

I also wondered if it was financial reasons, shrinks are not cheap after all and the NHS would have to pay for it!

Thanks for reading, i just had to get that off my chest.

I think it's odd. You don't need to be "aggressive" or have a "blank expression" to have AS. He can't say if you have it or not just from 2 criteria.

possibly stupid doctor. If he/she's a gp then would possibly have little to no idea about AS. I'm not aggressive, I'm a diagnosed Aspie.

I have AS - was diagnosed as fitting all 8 of the main criteria from the DSM-IV (sections A & B) - and I'm not aggressive & have learned to use facial expressions quite well (50 years of practice!)

Does your doctor specialize in adults with AS/ASD? If not, you should get a second opinion from a psychologist who has experience working with adults on the spectrum.

Temple Grandin has written about the use of antidepressants in people with autistic spectrum disorders. She says they can be helpful in treating anxiety (she takes an antidepressant herself for that reason), but due to the different nature of the autistic brain, doses should be kept much lower than normal (1/3 to 1/2 the normal dose.)

A blank expression is there in nearly all cases, especially in a professional setting, but if others are there (usually a smile), it's often displayed inappropriately (like always. See: the Joker).

Aggression is one of those things...that is common, but it's not a diagnostic pointer; it's more of something that sends people to the psycho or psychic in the first place, especially boys.

If you were showing or can show appropriate facial expressions for the social and emotional context, you probably don't have AS (it's one of the easiest signs to look for, and that's why professionals who know the bare minimum about AS often look for it).

Do you feel that some of the traits that you had when you were younger have faded? Some of us appear to be able to adapt better to these sort of things, so it's possible that your doctor is looking for telltale signs that are much more prevalent in children. Adults are notoriously more difficult to diagnose. I wouldn't trust your doc's opinion at all unless he/she happens to be an AS specialist who knows something about diagnosing adults.

It's possible you've adapted well enough to escape diagnosis. It's not to say that you are not "spectrum," it just means that you're coping and getting along okay.

Is a non-diagnosis a bad thing? Are you seeking professional help for some area of your life? If you are suffering from depression, anxiety, etc. it's possible that meds may be able to help you. That doesn't mean that your doc needs to understand the core of your personality.

If he is a general psychiatrist, it's not likely he knows much about AS--and his comments indicate that this is so--and he should not have been so dismissive towards you.

Since you haven't provided much background to your account, it's difficult to know what your appointment was for, how many you are to have with him, and whether you wrote down or explained how you might fulfill AS criteria when raising the subject.

Have you filled out the Autism Spectrum Quotient (AQ)? If you score high--at or above 32--you are quite likely to have an autism spectrum condition. Scoring 26 or above indicates an assessment for an autism spectrum condition may be needed. If you explain this in appointments, they can't easily dismiss you. There are few specialists qualified in diagnosing AS, and many areas have none who can assess adults. Local NHS Primary Care Trusts often refuse out of area referrals on flimsy excuses to save money.

Part of why I am in no rush to get diagnosed is because many doctors are idiots.

I want a doctor that knows a lot about AS and that it's symptoms can be varied based on the individual.

Nothing worse than knowing something about yourself but the "expert" says otherwise and imposes his/her preferred diagnosis.

thanks for the support guys!
I'll try to answer as many questions as i can.
when i made this appointment, i was just intending to re-start my antidepressants and so was almost completly unprepared for this, but when he started asking those questions, i must have thought he ment something other than he aqtually did. (this was the first time seeing this doc)
I was planning to bring up the AS thing another time so it could be the only reason to be there.

Somethings about my youth, when i was at primary school, the teachers always told me i was lasy and not paying attention, always in my own little world, all the other kids pens ran out of ink but mine allways dried up once a teacher even slapped me round the head to try to make me pay attention (she must have been pretty frustrated)

At high school i was put into special needs classes to try to help me concentrate and to improve my (very) bad hand writing, but even they gave up on me,
i was predicted very good grades in science and maths (tests) but allways struggled in stuff like english lit, my maths teacher would throw me out of class allmost every lesson because i was not paying attention and being disruptive.
The teachers would often say that i wasn't trying hard enough and was wasting my talent
i went on to flunk all of my exams mostly because of not doing any coursework.

in primary school i was bullied by the deaf kid and was taken to hospital a couple of times for head x-rays after being pushed over in the playground, one time i even had a footprint on my back.

i never really had any friends, just people who convinced me to do stupid stuff that i would get in trouble for.

When i was 14, i met a man who sold secondhand computer games and quickly befriended him, only for him to one day offer me some cider, got me very drunk and had his evil way with me, i was stuck there for more than 2 years untill he died after a routine surgery.

The only real friends i did have i drove away because i didn't know when to leave them alone, hounding them till they got sick of me.

one of my mothers boyfriends used to pick on me calling me "monkey boy" where my brother and sister got none of this, i was also put into fostercare when i was young for a short period of time, and got a hard time there aswell partly because of "soiling issues" i had which lasted untill double figures age wise.
I was also sucking my thumb untill my mid teens which the other kids at high school must have found a little odd.

i'm sure i have picked up some things in my 31 years!

When i got my job as a tyre fitter it suited me very well as i knew almost every size, speed and load rating for most cars on the road, which was great, people actually wanted me to rant at them about the best choice for them, however my mouth has got me into trouble saying things that seem perfectlly reasonable to me, only to have them blow up in my face also i have never been able to keep track of time properly making me constantly late for everything.

About 2 1/2 years ago i had a breakdown on my way to work and lost interest in everything, and have been hiding ever since, made worse by the fact my dad died last month, this is a real scream for help as i don't know if i can do this much longer.
i will try to answer any other questions you may have, thanks

Sounds to me like you got one of those cheapsake doctors who just wants to prescribe you medicene you don't need.

Citalopram is for depression, I don't know why he'd put you on it given the stuff you told him. He just wants your money imo.

actually the last post is something like i would have said, if i was prepared.
he is an NHS doctor (free health service here in the UK, so he doesn't get a penny from me and the drugs are free to me aswell due to unemployment and other things)
as i don't have health insurance and can't afford to go private, the only way to see a Psychiatrist is to get a referal from the doctor.

Next time, if you take along some AS test scores (e.g., the AQ), the doctor might be more amenable. Could you ask the other doctor you saw or the counsellor to write to this one that they suspect AS? They could back you up.

A very AS-like feat.



It's very important if you're going to be accessing services that medical professionals acknowledge you may have AS. This is to ensure the AS is taken into account when prescribing treatments or providing counselling. AS requires a different approach, especially where medication is concerned, because those with AS can react differently to it. Perhaps you could mention this to the doctor as well. This will help ensure you receive appropriate treatment.

Since your doctor is prescribing medication and you are quite likely to have AS, it would be beneficial to print out a copy of the following paper (or refer him to it):

Strategies for Pharmacological Treatment of HFA and AS

I downloaded the PDF version to print out for my doctor even though I am not going to take medication (and it focuses on younger people). He's keen to learn all he can. I hope your one is too and doesn't pressure you into taking medication, especially if he doesn't explain his reasoning for it properly.

oh yes, i almost forgot, i did a couple of online tests.
the long one i got,

your Aspie score: 155/200
your NT score:39/200
you are very likely an Aspie

ADD score: 44/78
you might have ADD
(will post the chart when i can get on the laptop)

i also did thet AQ test 3 times on different days and got: 46, 40 & 44 in that order.
again thanks for the help.


Edit: i just thought i'd say i do have an agressive side but never directed towards people (so far) i have put several holes in doors and (stud) walls out of sheer frustration.

Such is the joy (sic) of getting free medical care.

Sorry for multi posting (and the quality of the pictures) but i thought i had to share just a couple of pages from my huge stack of note books



this one shows some cricket stuff at the top, in the middle are all the results from EURO2008
group stage and at the bottom, a couple of bits about track cycling



and this one shows how i solve sudoku puzzles, the rows/columns/blocks with the least gaps go at the top.



again sorry for the quality

Edit: hey my pics didn't work?!?

ok now it works, but they are MUCH bigger than i thought

Last edited by Justin6378 on 28 May 2009, 3:01 pm, edited 3 times in total.

One of the problems I see is that many adults with AS have learned how to fake being NT. We tend to do things like look at people when we talk to them becuase we have been told to. After a while of wearing the NT mask it can become a habit which we might then do without thinking like driving a car.