Written off by psychiatrist... help!!

[LemonPop]

Hi everyone,

I'm new here, I decided to make an account because I really need your help/advice! Around 6 months ago I finally worked up the courage to ask my doctor for a referral to get assessed for Asperger's, which I've thought I might have for years. My average AQ score is 36 (have taken it a few times over the years for research purposes and for my own interest). I've done a lot of research into autism/Asperger's generally (I'm sure everyone here can relate), and have tons of Aspie traits (which I can go into if anyone's interested). So, I compiled a huge list of all the symptoms and problems I experience, and went through them with the psychiatrist I eventually saw. But it didn't go well at all.

He got really frustrated with my use of terms like "sensory sensitivity" because he wanted me to use less "technical terms" and just describe my difficulties to him (which I did). But I think he was just initially put off by my use of these terms, because he pretty much just disregarded my experiences and argued with me that what I was experiencing was normal. (e.g. I tried to explain how exhausting/confusing social situations are, or how much I can't stand loud and sudden noises/ certain smells/ etc., my obsessions with order, amongst other things, but he just said that everyone feels like that at some point). I'm a neuroscientist and so felt quite confident in my use of these "technical terms" after doing so much research - but he really seemed to dislike my approach immediately (even though I'd just followed the advice I'd found online about clearly identifying symptoms to tell the psychiatrist about in your assessment).

I felt like he totally ignored my experiences and had decided straight away when meeting me that I wasn't autistic at all. I can come across as pretty "normal" to most people because I have learned to adapt over the years, and have developed a lot of coping mechanisms (and, being female, I'm less "classically autistic" anyway). But I thought a professional would be able to understand how I really felt inside and experienced the world. Not so much. He talked with me for around half an hour before dismissing me. I really don't think that's enough time to get to know a person. He made me feel so uncomfortable that I couldn't think properly. He was attacking me with all these challenges and questions, I just couldn't process and collect my thoughts. I prefer to have things written down so I can process properly. He also seemed to sense my dissatisfaction because he said that he was "one of the top psychiatrists in the UK" and if he said I didn't have autism then I didn't. (Felt like this was pretty egotistical posturing to be honest.)

So, I had a really bad experience, and felt like I didn't get to talk about or even mention a lot of the Aspie-type experiences I have that would have been important to bring up. He made me feel like a fake, like I've been making things up. But I also know that so many experiences I've read about from people with autism or Asperger's really resonate with me.

Has anyone else had experiences like this? What did you do? I'm finding it hard to work up the energy to ask for a second opinion at my doctor's, especially as the psychiatrist I saw is apparently so senior. (I'm in the UK, if that makes a difference).

Thanks so much for any advice or help guys!! I really need it.

 

[Keigan]

Next.

One very common observation is that we know more about autism and being autistic than most psychologists or psychiatrists or therapists or doctors or scientists - unless they are also on the spectrum.

 

[xudo]

Welcome

Has anyone else had experiences like this? What did you do? I'm finding it hard to work up the energy to ask for a second opinion at my doctor's, especially as the psychiatrist I saw is apparently so senior. (I'm in the UK, if that makes a difference).

I had a similar experience when trying to get a diagnosis for Tourette's. I'm still trying to get a second opinion (I got a pointless/nonsensical diagnosis from the neurologist I saw.) In terms of your situation, do you know if there's any other person/team you could be referred to? I'm also in the UK (Cardiff) and here, it's the community mental health team who initially see people for ASD assessment. Helpfully, it's also more than one person who sees you and makes the decision on whether to then refer you on to the actual assessment team. I imagine even within the UK, every area deals with things differently. Maybe have a look if there's any information for your area on something like the National Autistic Society website? In Wales, there's a website with all this sort of information on for people to access, so I would hope other areas have something similar.

He also seemed to sense my dissatisfaction because he said that he was "one of the top psychiatrists in the UK" and if he said I didn't have autism then I didn't. (Felt like this was pretty egotistical posturing to be honest.)

Yeah, he sounds like a dick.

 

[Southern Discomfort]

Have you tried asking for a second opinion with your GP? Might be worth a shot.

I haven't had your experience because I was referred to a psychiatrist for mental health reasons and that's when they picked up on it. Having said that thought there are plenty of people out there here and elsewhere with the same experience.

I don't feel very comfortable in telling people if I think they're autistic or not, I don't feel like it's my place to say, after all I'm not a doctor. I can understand why doctors don't like people reading these things and then going to a doctor about them, we can all read things and then get sort of 'freaked out' and think we have it. But I don't think that it should necessarily be rejected because of that, no one really knows you better than you.

If you do go and see another psychiatrist what you must do is go there and talk about your early years, that's probably where you were going wrong. It's your early years where an autism diagnosis can be made with as little misdiagnosis as possible. Autism is a neurodevelopmental condition and is not a reactive, learnt set of behaviours unlike personality disorders so it's the early years where you are the most true to yourself, being a neuroscientist I'm sure I'm telling you things you're quite aware of.

If you've got any school or medical reports detailing your early years try to find them because they will be valuable.

 

[LemonPop]

Welcome



I had a similar experience when trying to get a diagnosis for Tourette's. I'm still trying to get a second opinion (I got a pointless/nonsensical diagnosis from the neurologist I saw.) In terms of your situation, do you know if there's any other person/team you could be referred to? I'm also in the UK (Cardiff) and here, it's the community mental health team who initially see people for ASD assessment. Helpfully, it's also more than one person who sees you and makes the decision on whether to then refer you on to the actual assessment team. I imagine even within the UK, every area deals with things differently. Maybe have a look if there's any information for your area on something like the National Autistic Society website? In Wales, there's a website with all this sort of information on for people to access, so I would hope other areas have something similar.



Yeah, he sounds like a dick.

Thanks for your reply!

Haha yeah, that was my assessment of him as well.

Yes I think I will call the NAS soon, and ask for their advice. I did email them asking about a private assessment at the Lorna Wing centre, but that would cost a lot... The process you describe sounds much better than what I experienced.

 

[LemonPop]

Have you tried asking for a second opinion with your GP? Might be worth a shot.

I haven't had your experience because I was referred to a psychiatrist for mental health reasons and that's when they picked up on it. Having said that thought there are plenty of people out there here and elsewhere with the same experience.

I don't feel very comfortable in telling people if I think they're autistic or not, I don't feel like it's my place to say, after all I'm not a doctor. I can understand why doctors don't like people reading these things and then going to a doctor about them, we can all read things and then get sort of 'freaked out' and think we have it. But I don't think that it should necessarily be rejected because of that, no one really knows you better than you.

If you do go and see another psychiatrist what you must do is go there and talk about your early years, that's probably where you were going wrong. It's your early years where an autism diagnosis can be made with as little misdiagnosis as possible. Autism is a neurodevelopmental condition and is not a reactive, learnt set of behaviours unlike personality disorders so it's the early years where you are the most true to yourself, being a neuroscientist I'm sure I'm telling you things you're quite aware of.

If you've got any school or medical reports detailing your early years try to find them because they will be valuable.

Thanks for your reply. Yes I am considering asking for a second opinion, but I'm trying to get over my defeated feeling and work up the energy to try again.

I actually mentioned my OCD (self-diagnosed, which I'd been getting therapy for) to the psychiatrist when I saw him, and he tried to undermine that as well. I think he just didn't like me.

You make an excellent point about early years experiences. I probably would have told the psyc. about the rage fits I had as a child when confronted with any routine/plan change whatsoever if he had bothered to ask me. But I will certainly make a point of finding out more from my parents and taking any experiences/evidence with me next time, so they form a good foundation for my case. I don't remember much from my younger years as some were quite traumatic, so it would be good to investigate what my behaviour was like more fully.

 

[janie]

I agree with others' observations that the content domain many of us learn before formal diagnosis can shift the usual protocol of sessions in a way that some professionals recoil from.

Likewise, I wonder if his name is Richard...

Finally, many experts see what they know. Endocrinologists palpitate glands and assess hormone levels. Cardiologists hear heart beats and read EKGs. Psychiatrists and psychologists have the DSM V as their primary instrument.

Unfortunately, misdiagnosis and focus on co-morbidity features, instead of underlying core neurology leave many people seeking treatment frustrated and poorly advised, as were you. Richard's bedside manner needs some serious work.

From what you describe, I think it may be possible your appropriate use of technical terms suggested to him some type of somatic or conversion disorder. This is a poor conclusion for accurate language, but it seems Dr. Dick may have concluded you were listing symptoms, not describing your own experience.

This should not have been your experience and I hope it does not convince you to doubt yourself. I was told one of the most consistent things about adults later in life being diagnosed on the spectrum is their own certainty that there is something compelling and different about how they behave and respond across settings and over time to stimulus.

Your experience is valid and deserved Dick's respect and attention.

 

[Amy Susan Rose]

Perhaps the psychiatrist felt threatened by your higher education and did not like the fact that you probably had more knowledge (and experience) regarding being on the spectrum than he could ever have. The fact that he eluded to being one of the top psychiatrist around shows his asinine egotistical mindset. I'm sure he didn't appreciate that you are obviously very intelligent and able to figure things out without his help. As Keigan so rightly stated:
"One very common observation is the we know more about autism and being autistic than most psychologists or psychiatrists or therapists or doctors or scientists - unless they are also on the spectrum."

 

[xudo]

I probably would have told the psyc. about the rage fits I had as a child when confronted with any routine/plan change whatsoever if he had bothered to ask me.

This is the thing, for a lot of people (NT or ND) we forget a whole load of stuff in this sort of situation, You have all this stuff you want/need to tell them and then you inevitably end up leaving something out. I think that's only made far worse when the person you're trying to give the information to is completely dismissive and undermining.

Is there any way you could take someone with you if you were to see someone else for an assessment? I realise that this isn't always a possibility for everyone, as some may no longer have their parents around, or family members may not be accepting of the possibility of a diagnosis being forthcoming. At least if you could take someone with you (even better if they knew you as a child) they could help to fill in some of the things you're not too sure of, and also hopefully make sure that all the relevant information gets across.

 

[LemonPop]

I agree with others' observations that the content domain many of us learn before formal diagnosis can shift the usual protocol of sessions in a way that some professionals recoil from.

Likewise, I wonder if his name is Richard...

Finally, many experts see what they know. Endocrinologists palpitate glands and assess hormone levels. Cardiologists hear heart beats and read EKGs. Psychiatrists and psychologists have the DSM V as their primary instrument.

Unfortunately, misdiagnosis and focus on co-morbidity features, instead of underlying core neurology leave many people seeking treatment frustrated and poorly advised, as were you. Richard's bedside manner needs some serious work.

From what you describe, I think it may be possible your appropriate use of technical terms suggested to him some type of somatic or conversion disorder. This is a poor conclusion for accurate language, but it seems Dr. Dick may have concluded you were listing symptoms, not describing your own experience.

This should not have been your experience and I hope it does not convince you to doubt yourself. I was told one of the most consistent things about adults later in life being diagnosed on the spectrum is their own certainty that there is something compelling and different about how they behave and respond across settings and over time to stimulus.

Your experience is valid and deserved Dick's respect and attention.

Thanks so much for your reply. I'll definitely try to think of examples for each of the symptoms I list that I can fully describe, to really illustrate my experience. I guess I find it hard to get into other people's heads, so that sometimes I just assume others know what I know.

Thanks also for your reassurance, I really need it right now.

 

[LemonPop]

Perhaps the psychiatrist felt threatened by your higher education and did not like the fact that you probably had more knowledge (and experience) regarding being on the spectrum than he could ever have. The fact that he eluded to being one of the top psychiatrist around shows his asinine egotistical mindset. I'm sure he didn't appreciate that you are obviously very intelligent and able to figure things out without his help. As Keigan so rightly stated:
"One very common observation is the we know more about autism and being autistic than most psychologists or psychiatrists or therapists or doctors or scientists - unless they are also on the spectrum."

Thanks for your reply, yes perhaps. I did tell him I was doing a PhD in some areas related to psychiatry (though the central focus is neuroscience and psychology). Maybe he thought I was coming across as being an expert in his own area - I might come across as being rude or very blunt without realising, I do that a lot. Yes, his self-aggrandisement did shock me a bit!

 

[LemonPop]

This is the thing, for a lot of people (NT or ND) we forget a whole load of stuff in this sort of situation, You have all this stuff you want/need to tell them and then you inevitably end up leaving something out. I think that's only made far worse when the person you're trying to give the information to is completely dismissive and undermining.

Is there any way you could take someone with you if you were to see someone else for an assessment? I realise that this isn't always a possibility for everyone, as some may no longer have their parents around, or family members may not be accepting of the possibility of a diagnosis being forthcoming. At least if you could take someone with you (even better if they knew you as a child) they could help to fill in some of the things you're not too sure of, and also hopefully make sure that all the relevant information gets across.

Exactly; I really felt like everything I wanted to say went out of my head, because he dismissed the list I'd made and I couldn't spontaneously recall other things.

I've moved away from my home town to study, and don't really have anyone I could take with me where I lived now unfortunately. But I'll definitely get my mum's input on how I used to be as a child, to take with me as evidence next time (if there is a next time...).

 

[Suzanne]

Seems like he needs a pyschiastist himself with such an unprofessional approached.

The way he spoke to you, was almost like you would imagine a tit for tate game where children are concerned.

I spoke to a woman, in order to see if there was a way I could get a professional diagnosis and she said that it would be very difficult, because aspies know more about it, then "professionals" and who can wonder, when you get obsessed.

How utterly ridiculous to get angry because of your usage of technical terms; almost like he was saying: I am the only one who is allowed to use such terms; you are a mere pitiful creature.

I can imagine how you must be feeling and so, you have chosen a great forum to come to.

 

[Ambi]

Perhaps the psychiatrist felt threatened by your higher education and did not like the fact that you probably had more knowledge (and experience) regarding being on the spectrum than he could ever have. The fact that he eluded to being one of the top psychiatrist around shows his asinine egotistical mindset. I'm sure he didn't appreciate that you are obviously very intelligent and able to figure things out without his help. As Keigan so rightly stated:
"One very common observation is the we know more about autism and being autistic than most psychologists or psychiatrists or therapists or doctors or scientists - unless they are also on the spectrum."

This is exactly what I thought while reading the original post.

 

[Crossbreed]

In my search for a counselor, I have met psychologists that don't want adult autism to be a thing, so they just refuse to give that diagnosis.

Whether you are autistic or not, it is in your best interest to go somewhere where it is, at least, acknowledged.

 

[WereBear]

I am in the US, so I don't know if it is any help, but I searched for a diagnostic center with a lot of experience with adults with Asperger's. I also successfully got a woman psychologist with a PhD, years of experience, and raising a HFA son.

It was worth the effort, the three hour drive, and the two nights of motel and meal bills so I could take the 6 hour diagnostic and still drive safely back and forth.

This doctor also had a telephone interview with my mother about my early years.

Based on my experience, in which my own hunch proved correct: your "professional" didn't have a clue.

 

[WittyAspie]

Welcome to AC! You are welcome here no matter what diagnosis you do or do not have. Many people on here never get a diagnosis, for a variety of reasons. After all, a label is just that, a label. Aspies are all unique individuals who happen to share a lot of the same characteristics. The best thing that can come from a formal diagnosis is better access to resources. If you feel like access to resources would benefit you, then I would suggest seeking a second opinion. If possible, research what psychiatrist you want to see and specifically request that person. I'm in the US, so I am unfamiliar with what options you have. However, the most important thing is that you know yourself, which is sounds like you do.

Aside from that, great job on your education. I am a little jealous that you have gotten to the PhD level at such a young age. I am currently working on my BS and hope to jump right into a Master's program after that. We are glad to have you on the site. I hope we can be an encouragement to you.

 

[LemonPop]

Seems like he needs a pyschiastist himself with such an unprofessional approached.

The way he spoke to you, was almost like you would imagine a tit for tate game where children are concerned.

I spoke to a woman, in order to see if there was a way I could get a professional diagnosis and she said that it would be very difficult, because aspies know more about it, then "professionals" and who can wonder, when you get obsessed.

How utterly ridiculous to get angry because of your usage of technical terms; almost like he was saying: I am the only one who is allowed to use such terms; you are a mere pitiful creature.

I can imagine how you must be feeling and so, you have chosen a great forum to come to.

This is exactly how I felt! Thanks so much for your reply. Yes everyone has been great here, I'm glad I found the forum.

Psychiatry really frustrates me for that reason. These people get qualified and then can obviously only keep up with current developments in specific areas of interest, because the field is too huge to be specialised in everything. It usually seems that professionals learn a limited amount about all disorders, and then think they know everything better than the people actually experiencing them. Being in an academic environment for my work, I know all too well how people can refuse to question their prior knowledge and believe they know all there is to know. This ignores the ever-changing knowledge generated by science.

 

[LemonPop]

In my search for a counselor, I have met psychologists that don't want adult autism to be a thing, so they just refuse to give that diagnosis.

Whether you are autistic or not, it is in your best interest to go somewhere where it is, at least, acknowledged.

Thanks for your reply! Definitely, I have seen that attitude online as well. Because I live in the UK, I get referred to psychiatrists on the NHS and I don't have too much of a say in where I get sent, unfortunately. I could pay privately, but as a student this isn't feasible at the moment. But, next time I visit the GP I will try to ask for someone who actually specialises in adult autism (and preferably, female presentation too).

 

[LemonPop]

I am in the US, so I don't know if it is any help, but I searched for a diagnostic center with a lot of experience with adults with Asperger's. I also successfully got a woman psychologist with a PhD, years of experience, and raising a HFA son.

It was worth the effort, the three hour drive, and the two nights of motel and meal bills so I could take the 6 hour diagnostic and still drive safely back and forth.

This doctor also had a telephone interview with my mother about my early years.

Based on my experience, in which my own hunch proved correct: your "professional" didn't have a clue.

Thanks for your response! Yes the process is a bit different in the UK, but your reply and Crossbreed's have both really made me more determined to ask for a psychiatrist who specialises in adult autism/Asperger's at least. I feel as well that the psyc. I saw really didn't have any idea, to be honest!