Letter from my therapist

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My therapist told me verbally that I have 2 diagnoses of Dysthymia and General anxiety disorder in addition to the Asperger's syndrome that I was diagnosed with as a child. I have been asking her to give me a letter stating my diagnoses for my records for over 2 months. Yesterday she had promised to give me the letter, but she forgot and told me she would screen shot me a copy today I'd I reminded her via text. When she sent me the letter, it didn't say anything about dysthymia or general anxiety disorder. It only showed the psychological codes for phobia anxiety and autism. I asked her why it didn't say my diagnoses and she said that those are under those codes. When I looked up the Autism code it says specifically that type 1 does not include Asperger's syndrome. Also, the anxiety code is not general anxiety disorder. It only covers certain phobias and fear of choking. I do hae phobias, but I'm also anxious about other things too which I've told him. Neither of the codes include anything about Dysthymia. Dysthymia has it's own code. Also, the letter has some minor typos and doesn't go into any detail (It's only like 1/3 of a page). In addition, I tried raising the point to her that to the average person, those codes don't mean anything because most people don't know what the codes mean. When I first saw the letter, F40.298 and F84.0 didn't mean anything to me.

This bothers me a little bit because I have been telling people about my dysthymia and general anxiety disorder when asked or appropriate. Now it leaves me wondering if I even really have them. I was hoping that in the 2 months she had, my therapist wound have written a nice, formal, professional letter stating my diagnoses and how they affect me mentally sometimes. Her excuse this time was that her mother was injured and had to go to the ER last week. I feel bad about that, but at the same time, she has a new excuse seemingly every week for something. Any insight on this matter would be appreciated.

It seems to me like some psychs don't like offically diagnosing paitents or telling them what those diagnosis are. They'll put things down for insurace purposes but not for paitents own records. That's how it's been for my girlfriend. They've told her she had a few things but lots of other things are up in the air & she's done lots of research & kinda self-diagnosed to help figure things out & explain things to others. Medical docs for non mental issues don't like telling her things either but luckily she can access those charts online. Some of her medical things they never told her about have treatment options avilable but that's never been discussed with her. I don't know why some psychs & docs are like that.
If you feel like your therapist keeps making excuses, I would consider trying to find a new therapist.

I just had my appointment via zoom this afternoon. My therapist told me that she didn't put a code for dysthymia because sometimes those symptoms appear within the anxiety phobias. I then said that no, the code for phobias doesn't cover dysthymia and that dysthymia has its own separate diagnostic code. She replied by saying that I don't really have dysthymia. I was shocked! I asked her why she told me I had a long time ago and she said it was because she needed to submit a reason for treatment to my insurance company. So then I asked her to confirm it was all a lie for insurance purposes and she said that at that time, she didn't know me well and she thought that's what I had. But now, after getting to know me better, she doesn't see it in me anymore. She said that diagnoses can change all the time and that sometimes you have one thing and other times you have something else. My therapist also told me that I try to focus too much on creating things that aren't there. She also disputed my Asperger's syndrome, saying that only children and teens have that and because I'm an adult now, I just have ASD. This was sort of upsetting to me because now I don't know what I have. We both agreed that it would be best for me to call the office on Monday to make an appointment for a full psych aval to get some real data that she can analyze, instead of her just guessing week to week. It's a little bit awkward for me too because I've already told a few people about my dysthymia where appropriate and I felt it was necessary. I almost feel robbed of a part of my identity if that makes sense.

Isn't it a good thing to not have mental illnesses

Yes and no. It is a good thing to not be mentally I'll, but it's not a good thing to be told you have a mental illness and then find out that your therapist just told you that because they had to submit something a reason for treatment for insurance purposes. It's really upsetting to be lied to like that. She never should have blurted out a diagnoses for me if she wasn't absolutely sure I had it. She could have even said "I'm leaning towards dysthymia, but I'm still not 100% sure. Let's schedule some tests to investigate further" and that would have been better. Plus I still don't have an explanation for my severe mental breakdown that I had in January. I thought the dysthymia was the explanation why I sometimes have crazy thoughts and why I tried to kill myself at the beginning of the year. Now I'm more confused about it than I was before I started therapy again. Also, I already wrote a letter to someone saying that I have been recently diagnosed with dysthymia, so now my therapist is making a liar out of me. It's just very unsettling.

Yeah and it's sad that you tried to kill yourself as well.

The even weirder thing is that I haven't had any suicidal thoughts in just over a month. I don't get them nearly as often anymore. This makes me wonder if I should go forward getting a psych eval or if it would just be a waste of time. I have a consultation in November because that was the soonest I could get. Considering I tried to kill myself in January and I've been completely clean since April, would it be too late by then to get an accurate diagnosis?

I don't think it's never a waste of time talk to someone even if you do seem to be going through a bit of an easier time at the moment.

If you don't understand the reason you tried to kill yourself (and it wasn't that long ago) then it's still worth discussing.

Well I know the reasons I wanted to kill myself. What I don't know is why I react so strongly to emotionally painful events. Is getting too attached to people purely an Autism thing?

I don't know if getting attached to people a purely autism thing. It might be just a thing that happens to certain people more than others.

I got several diagnosis in my life… some came, some left and with the time I did my own research.

I was dx with major depressive disorder, recurrent. This might’ve been true years ago, but since years I’ve dysthymia. I did. I didn’t dx with it though.

I never got dx with tics, I have tics though, but very mild so they get easily overlooked.

So the best is simply to start your own research. I needed years and years and reading many books and studies to diagnose myself as best as possible. It’s also a good idea to go to an expert in a certain area when you think you have something.

That's what I plan on doing. I am going to get a formal evaluation in November.