Horrible day at psych yesterday.

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Yesterday, I had a long-awaited appointment with the psychiatrist at the local mental health clinic here. It was another step, so I'd been told, on the way towards getting an evaluation for ASD. She had to evaluate me, and decide whether I needed a DIFFERENT evaluation, one that would point me towards ASD. It was horrible, and I've written a letter about it that I intend to give to my therapist...but I want to post it here today, just because I need to share, vent, and not feel so alone about this. (I'll be removing names, places, that sort of thing, first.)




I approached [clinic] because I wanted to be evaluated for Asperger's Disorder, or Autism Spectrum Disorder. I have been treated as though I was irrational, as though I was making things up, as though I was stupid for wondering.

I feel that I went into this expecting to be listened to, to be trusted to relate my own experiences in life, and, instead, I was not believed. I feel that I have been treated like a liar.

I walked into my appointment with Dr. A today, and told her that I had worried that I would not know what to say at the appointment, and had written up a couple of pages of what I felt I needed the most help with; with what described what I am living with in the best way, and that that might be an easier way for me to get out my full story. She showed no interest.

Dr. A took one look at me and how distressed I was, and, in retrospect, it seems she immediately decided that I was depressed. The only questions she asked me were obvious depression screening questions, or standard background questions, going over information from a previous visit when I was a traumatized 17 year old girl. No matter how much I tried to explain to her that I was having a terrible day, but that this is not how I feel every day; that I am not hopeless or helpless; that I have good self-esteem, she shut me out. Every time I told her that I was not depressed, that I'd been depressed in my life, but knew that I was not currently, she just kept repeating that she felt that I met many of the diagnostic criteria for depression. Any time I tried to relate a part of myself that didn't happen to fit into the diagnostic criteria for depression, she either outright ignored me, or implied that I'd already made up a diagnosis for myself, and was just fitting things in my life to fit into that diagnosis.

When I tried to emphasize issues that I have dealt with since childhood, she asked me why, if I'd always had these issues, was I only bringing them up now? When I explained that, for many things, I had thought that EVERYONE dealt with them and that, for others, I had avoided the stigma that had followed the behaviors of my brother, who was diagnosed Autistic, she asked me, "If he was diagnosed, why were you missed?" as though I was supposed to be able to answer that question.

She asked if I was applying for disability, and, in the context, I believe that she meant, "Are you doing this so that you can apply for disability?" For the record, I work, although I hate it, and am not applying for disability. I don't need it.

When I explained to her that I had entered into service at [clinic] because I was curious if my life's struggles could be due to being on the Autism spectrum, she asked me, "If you had Asperger's, how could you be caring for your children?" I was flabbergasted, and insulted. When I stated that there are many women in the world who are on the spectrum who lead good lives, are married, have children, and that since the moment I became pregnant with my first daughter, I have thrown myself into learning absolutely everything that I could about parenting so that I could be successful, she asked, "Then, what are you here for?" When I repeated, "To learn more about myself, to see if I can learn skills to better my life, so that I can be an even better person for my family," she ignored me again.

I tried to explain to her that how I was coming across is NOT how I am in every day life. That, if she had seen me three hours prior, I would have been a totally different person. Yes, a person with some issues still, but not on the edge of overwhelm and tears.

She went to the point where she told me that she could see tears in my eyes (which were there both from being suddenly told that my husband was going to inpatient rehab for 60 days, out of the blue, and tears of frustration for her not listening to me when I told her that I was not depressed!) and asked me, if I was not depressed, why did I have tears in my eyes? I told her, "...well, because of what I'm going through today," and she asked me, "Why? Why would you cry? Lots of women have their husbands go to inpatient treatment." I tried to explain over and over again, that it was an overwhelming change, that I'd just found out about this, that I'd have to rearrange my life, my children's lives, everything. And she just looked at me so deadpan, like none of that mattered, and like it was no rational reason for having to hold back tears. She seemed to be asking me, "....and?" as though she was waiting for a valid reason for my distress. I had no words. I should never have had to argue and rationalize with a medical professional about whether I had the right to feel distressed about a horrible, horrible day.

She told me, "Patients often come in here with depression, but are so RIGID in what they are thinking that they refuse to see anything but what they are set on," when I tried to explain to her that I had dealt with depression in the past, as a teenager, and knew my own mind well enough to know that I was not struggling with it in the present day.

She recommended, over and over again, that I read pamphlets on the symptoms of depression. When I stressed to her that I HAD read pamphlets, and articles, and books, about many aspects of depression, she ignored me, and repeated that I should read some pamphlets.

In the end, she insisted that I have depression and anxiety. (anxiety, yes, depression, NO!!), refused to even entertain the fact that it could be ANYTHING other than depression, and essentially told me that unless I agreed to give up breastfeeding my 6 month old baby and start taking anti depressants, there was nothing she was willing to help me with. Without truly listening to me, she encouraged me to stop my breastfeeding relationship with my infant to start medication for a depression that I do not have. Even when I told her that what I was interested in was learning about lifestyle changes, and things that I could do to feel healthier, she shut me out and pushed antidepressants.

She didn't seem to believe that seeking answers and guidance on how to live better sans medication was a valid reason for seeking help.

All that I wanted was an open minded, listening ear. For someone familiar with ASD in adult women, who could tell me one way or the other. If the answer was, "We've listened to you fully, and are very, very familiar with how this manifests in adult women, and we still feel as though you are not on the spectrum," I could absolutely have respected that. But, even that was not how I was treated. I've been told that Autism "isn't a thing for adults." It's been implied that if I were Autistic, I never would have succeeded in school, and would have had to have been in special education. (both of these by a prior provider) As I've tried to explain my world and my experience, I have felt totally steamrolled over with diagnoses that were place on me, seemly in one look at me.

I don't know how to go forward with this. I entered into this full of hope that I could find ways to function better in my life. Now I'm here, in limbo, feeling crushed, discouraged, and, yes, angry.

"Patients often come in here with depression, but are so RIGID in what they are thinking that they refuse to see anything but what they are set on,"

The same can be said for doctors. I have met enough to know they come in all degrees of competence and this one is not listening to you or examining all the possiblities in this diagnosis. Whatever it takes I suggest you get a new doctor. A good doctor would address your concerns (and not be so rigid in their own) which would include screening tests for autism.

I think you did a A++ job in addressing your concerns and presenting your case. Its just a case of it happening to be wasted on a poor professional. I've known of doctors so much better than that. Keep at it till you find one you respect and trust.

Depression and anxiety are 2 of the 3 most misdiagnosed things in women with AS. Often because they are co-morbids, but also symptoms of the deeper underlying issue. Even if you don't have depression, your behaviour on the day due to both other issues and her, coupled with some of our symptoms can certainly look like it to an outsider unfamiliar with AS. Also - the first thing my GP did was screen for depression and schizophrenia (which I didn't have, but they always screen for first), then diagnose anxiety, and refer me to an autism specialist for assessment.

I'm very sorry you went through this.
Many women I have spoken to have been treated this way by mental health professionals who do not specialize in AS.
The process is hard enough without adding people like this into the equation.
*big hugs*

The best thing I can suggest is that you find a clinic that specifically specialises in Autism.

It's like someone being accused of being a communist in the 1950s. And the very fact that the person says, "No, I am not a communist" is somehow taken as evidence that the person is a communist afterall.

And so bizarrely, from her perspective, the fact that you say, No, I am not depressed, is somehow taken as evidence that you're depressed afterall. And even after you say, you've had depression before, you're very familiar, have read a lot, she still pushes the crapola pamphlets. Being very charitable, she got stuck.

And she doesn't know jack about autism. This doctor is an idiot.

And I'm so sorry about the part where she directly recommends antidepressants, recommends you discontinue breastfeeding, even though you have an established breastfeeding relationship with your child---when you do not have depression. This part rises to the level of physician malpractice.

But good luck getting the system to listen. They literally cannot acknowledge this bad a result, that their vaulted system of physician training, etc, produced this poor a result. If you make the complaint yourself, they will attempt to marginalize and discredit you. That's just the way systems work. Your therapist theoretically might be able to make the complaint for you, but I don't think they work that way. Another possible advocate might be your g.p. But doctors don't like to take on other doctors.

She's a slam-dunker. Maybe one out of ten people who actually does have depression actually needs to be pushed to take antidepressants. But what about the other nine out of ten? Even if someone does have depression, I still think this bully approach does more harm than good.

This doctor is also a lazy bum. You bring in a couple of pages which you have written, and even though she's read hundreds and hundreds of pages in college on all kinds of topics, and all through medical school, the hell with it, she doesn't want to read it.

Last edited by AardvarkGoodSwimmer on 31 Jul 2013, 11:10 am, edited 1 time in total.

So true.

Sounds extremely frustrating, I've had my fair share of these kind of "mental health" professionals in my life who do everything but make you feel mentally healthy by dismissing your feelings.

They diagnose you by how your are in that very moment they see you and for some reason seem to think you are like that all the time even if you tell them you are not. They seem to think that they know more about you than you yourself in a brief discussion, possibly denying you the kind of treatment you want and might benefit from.

I have hard time trusting that majority of psychiatrists even understand human behavior even though they are supposed to be experts in it, be happy if you have the freedom to avoid the kind of psychiatrists you don't want to deal with.

I also would suggest you to find another Doctor, it's your life, you know best how you are like and what you are truly feeling and what are your difficulties. You deserve to get the kind of help you want for the kind of problems you are experiencing.

Last edited by Nanoscale on 31 Jul 2013, 1:03 pm, edited 2 times in total.

What a horrible, horrible experience--and what a jerk of a psychiatrist. But don't give up--there are some smart psychiatrists out there. See if you can arrange to see someone with some experience with people on the spectrum. Such a person would have caught on right away, instead of going in for the immediate, easy diagnosis.
Hang in there.

Thank you, everyone, for the support and advice. I think that, for right now, I'm going to continue therapy. I love my therapist, and she has also worked with kids on the spectrum at some point in her career, so she's been much more hopeful and helpful. I'm glad to know that this doctor is WRONG, and that the way I was treated wasn't right. Thank you all so much for the validation! I'm still shaken from the whole thing, but no longer so shaken that I'm questioning going back to the same building ever again, to see my therapist. I know that I can be tough, and work through this, without this doctor, until the day that I can get myself in to someone more professional.

Again, thank you, everyone. I really needed to hear all of this.

You were treated heinously and good on you for writing that letter. You deserve better treatment and I'm sorry you had to endure that. Really just wanted to post to offer my support. IMO, those in your situation need empowerment.

Hmm....do you know of AWR (Autistic Women's Radio)? A good Wrong Planet friend of mine was a founder of this radio station featuring loads of successful autistic women. It's based in Australia, but broadcast throughout the world including America. I think you can still access it via Autism Hangout with Craig Evans. You know, these might be good resources for you right now. Anyway, all the best in dumping that doctor. The Lab Pet's alter ego is the Therapist Slayer. Sort-of like Buffy the Vampire Slayer but scarier.

I will have to look into that radio station! It sounds like it would be an empowering thing to listen to.
I do have a favorite blog that I follow, that I remember any time I hear, "People with ASD DON'T/CAN'T do [thing]" It helps!

You probably are already thinking about this, but just in case:

Get in touch with local social services, and investigate applying for all the programs available for folks in a situation like yours. I am guessing there will be a change of income level and that is what they are there for. Plus having the young children may make additional options available. Things such as Food Stamps and Welfare and also WIC (Women, Infants, Children) and LIHEAP (HEating and cooling assistance). We have used the last two at different points. There may be others. There is an online calculator to see if you qualify and some may allow online application. Be sure you are on government site and not phishing fake site. Wish you the best of luck with it.

put a complaint in about the doctor,it might help with moving on from the experience,and whoevers her boss needs to be let know she is obviously in need of retraining in certain areas.

I'm so sorry about your experience, OP. I dealt with basically the same thing a few years ago. (It was when I was 23, just like you, actually). I wound up getting a second opinion from a qualified professional who gave me an accurate diagnosis and I hope you're able to do the same.

From what I have heard from other women with AS, if you are female and on the higher functioning side or at least present that way, then this whole experience is almost like a right of passage. Not that it makes it okay, but, if it makes you feel better at all, you are definitely not the only one. And, this experience does not mean you are crazy or a hypochondriac or that this person you spoke with for an hour or less knows you better than you know yourself.

Good for you for writing a letter, too. I wonder if there might be value to including a resource list with your letter with good books or documentaries that would be educational for her. I'm guessing she wouldn't actually look into any of those resources, due to ego issues, but it would be great if something constructive came out of this.