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This is a question My Biggest Disappointment

Often the things we look forward to the most turn out to be a huge let down. As Freddy Woo puts it, "High heels in bed? No fun at all. Porn has a lot to answer for."

Well, Freddy, you are supposed to get someone else to wear them.

What's disappointed you lot?
null points for 'This QOTW'

(, Thu 26 Jun 2008, 14:15)
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Since people are belittling Asperger's below, I thought I'd come out of the shadows and educate you a bit:
This is a repost from my blog, which I wrote some time in September.

So. Yesterday I went to see a psychiatrist for the first time, because I'm trying to get a diagnosis for Asperger's Syndrome or potentially another disorder on the Autistic Spectrum. Since birth I've had some highly unusual difficulties with social interaction, behavioral instincts, spatial awareness, perception of physical interaction, and other things that ordinary people take for granted. Some three months ago I learned of a recently-discovered condition known as hyperlexia: essentially the opposite of dyslexia, i.e. a preternatural ability to read from an early age, to such a degree that it effectively pushes other parts of the mind aside. Those who have hyperlexia are without a doubt on the Autistic Spectrum. Well, I could read at adult fluency - and I mean, I could read a page from a science fiction novel without pausing to think - by my third birthday.

This, plus the other clues in my perceptions and behaviour, lead me to believe that I suffer from Asperger's Syndrome. With close analysis, it's a no-brainer. These elements, when added together, create a pattern of symptoms that can only be interpreted as an ASD by somebody who knows what to look for.

Recent events following my move to Lancaster have convinced me that I need to get this thing diagnosed and find a way to deal with it. My inability to break the ice socially, to present myself without appearing nervous or "creepy", to hold down a job without becoming intensely frustrated; my paranoia and depression resulting from my failed human interactions and the general negative reaction of the public towards my seemingly awkward and intangibly strange body language; all of these things create barriers that I cannot penetrate alone. At least without knowing for sure what they are or what causes them.

Some three months ago I visited my GP with these worries, and received a referral to a psychiatrist. I waited out the twelve weeks or so - which, by the way, is an incredibly long time to wait when one is worried about one's mental health - and finally I made it. I could not sleep a wink the night before, for fear of missing the early morning appointment (incidentally, that's another symptom), so when I arrived I was not at my most alert. I had, however, faith in the system. After all, psychiatrists are qualified professionals, right? They are trained in their field and prepared to ask specific questions in order to diagnose the particular disorders pertinent to the patient in question . . . right?

Apparently not. I decided that I should allow her to take the lead, assuming that the questions she asked would be the right ones based on my goal: to assess whetheror not I have Asperger's Syndrome or another Autistic Spectrum Disorder. The first warning sign was that the doctor - who shall remain unnamed - had never heard of hyperlexia. Okay, this was a little offputting, but hyperlexia is a reasonably new discovery. Old enough that there is already an American Hyperlexic Association, but still, relatively new. Stick with it.

She then continued to ask me a series of questions based purely around my friendships: whether I made friends in pre-school (I didn't go to pre-school, I took one look and told my mother "too many people!" - *ahem* - could this be a clue?), in infant school (one friend at a time, never kept hold of one), all the way up through secondary school (very few friends, treated as an outcast, never understood why, developed a desire to make new friends but never became good at it), and whether or not I have friends now (yep, lots, but breaking the ice is still extremely hard). This fixation took up nine-tenths of the conversation.

Had I realised she was fixating so hard on this, I would have tried to steer the conversation towards other symptoms - lack of spatial awareness, inability to
read facial expressions, ritualised nervous habits, dislike of eye contact, etc. I managed to mention a large number of these other symptoms, but because she kept steering the conversation back to the friendships thing, I barely scratched the surface.

In the end, within a couple of minutes of the end of the session when she wrapped the whole thing up, I learned why. She said, and I paraphrase: "I don't know very much about Autistic Spectrum Disorders, and I don't think anybody else around here does, but they tend to be characterised by a lack of desire to socialise, so I don't think you have one." She then asked me to describe in great detail the depression I suffer as a result of the effects these symptoms have on my life, and prescribed me anti-depressants (and a referral to a psychologist, which I don't hold out much hope for) as a quick fix.

If it weren't the end of the session, and I weren't exhausted from lack of sleep, I might have stuck around to argue with her.

Firstly, she is a practising psychiatrist. It is her duty to keep up with developments in the field of study, such as the diagnosis of hyperlexia as either a separate disorder or a symptom of other ASDs.

Secondly, she knew - almost three months prior to the appointment - that the reason I was seeing her was because I believe I have Asperger's. Would it have been difficult to do a little research into what, exactly, the symptoms of Asperger's Syndrome are? No, it would not. Again, it is a matter of duty. Psychiatric disorders are diagnosed using a checklist of symptoms, assessing the patient against said criteria. If a majority, or a specified number of those criteria, are met, then an initial prognosis can be made and work can begin.

I don't necessarily expect a spot diagnosis; I do, however, expect the psychiatrist who has had three months of preparation time to at least possess a copy of the criteria for assessment! At no point did she ask any questions pertinent to the diagnosis of Asperger's Syndrome, aside from repeated queries regarding whether or not I have any friends. Even my body language and speech patterns during the session should have given something away.

From the website of the Natonal Autistic Society: "Unlike the person with 'classic' autism, who often appears withdrawn and uninterested in the world around them, many people with Asperger syndrome want to be sociable and enjoy human contact . . ."

It took me minutes to find that quote. Minutes.

As for the anti-depressants: I asked immediately about side-effects, and she became quite evasive. She ran her finger down a large paragraph of text in the manual, and mumbled (again, I paraphrase) "possible increased blood pressure and heart rate, nausea, and lightheadedness when you stand up too quickly". I asked her if it could potentially exacerbate the symptoms of depression during the adjustment period, because I know some anti-depressants can do that and it can be dangerous if you're not prepared. She said "oh, yes, that can happen". Clearly she was ready to let me find out about that part for myself.

So I left and begrudgingly took the prescription to the pharmacist, seeing as that's clearly the best I was going to get. The pharmacist mentioned that sertraline takes two weeks to build up effectively in the system, and I'd only been given a fortnight's dose. Fair enough, we're playing it safe. Upon arriving home I check the actual list of side-effects: wow. It includes, but is not limited to: dizziness, vomiting, diarrhoea, tremors, change in sex drive or function (!), effects on the skin and nervous system, and so on.

Okay, most medication lists a lot of side effects. No big deal. I take one - a day's dose - and within half an hour I feel sick and get the shakes. Nice. Time for anti-depression to kick in: a fortnight. Time for side-effects to kick in: half an hour. Brilliant.

Looking up sertraline on the internet, I find the potential is far worse than so far indicated, either by the psychiatrist (no surprise there) or by the packaging. For a start, the actual benefits are highly debateable. In test subjects the inpatients reacted exactly the same way as to the placebo, and only the outpatients received any (actually unspecified in any layman's terms that I could see) positive effects at all. Secondly, an abnormally intense reaction - quite plausible for somebody of my body mass - can cause mania, hallucinations, and, yes, an initial exacerbation of the symptoms of depression, manifested in the form of thoughts of self-harm and/or suicide. Especially, and the packaging itself mentions this, in the 18-29 age group. For those keeping score, I am twenty-six years old.

Here's the good part: withdrawal. Withdrawal symptoms, after a Seratonin Re-uptake Inhibitor such as this, has built up in the system can - and likely will - cause sleep disturbance, violent and vivid dreams, and all kinds of other nasty symptoms including long-term or even permanent sexual dysfunction. The jury is still out as to whether or not this happens in a majority of cases, but the statistics seem to put it at between 40% and 65% of cases (clinical trials don't follow these things up after the test period is over, you see - go, science!).

Think about this. The underlying reason for my depression - which really isn't that bad, I'll have you know - is because of my long-term problems with social interaction, manifested partially but prominently in my inability to initiate romantic relationships. How is losing my ability to perform sexually going to help with that? "Not" is the answer. Here's to short-term solutions, and fighting the symptoms without addressing the causes! Hip-hip . . .

The moral of the story? I don't bloody know, but "go private if you can because the NHS is useless" seems to be a good starting point.

Okay, so the medication thing isn't that big a deal. Irritating, and clearly just a way of getting me out of there and claiming to have done something. I'm not going to take any more of the damn things because it's clearly going to do more harm than good. The part that really offends me is that an hour of my life was wasted with this useless, amateurish attempt at psychotherapy, at the end of which the doctor admitted that she knows nothing about the subject at hand, and then diagnosed me anyway with a patently false assertion!

What was the point in the whole thing? Why did she bother? Could she not have said this at the start? Maybe then I could have presented my symptoms better, rather than letting her take the lead in a dance to which I knew the steps far better than she. That's one hour of my life gone, nothing gained, and my faith in the professionalism of the NHS and the educational system destroyed.

She booked another appointment for me in two months' time. I won't be turning up. I will, however, be complaining heavily and seeking out a psychiatrist who knows what they're doing and can assess me properly and in an informed manner.
(, Mon 30 Jun 2008, 4:06, 13 replies)

(, Mon 30 Jun 2008, 7:53, closed)
@ AB and Gilg
Fuck me. Well, just fuck me. You little fucking shitholes. Here's the guy trying to tell a good story, extremly well written and you two just... words fail. Except that you two really are complete cunts.

Ghost: I'm backing you up completly on this. I'm dyspraxic, which is another part of Asbergers syndrome, and I have the same issues with socialising, spatial awareness etc. The only reason I ever got diagnosed is because of my Java tutor and the universities private psychologist - the tutor spotted I wasn't happy, contacted the psychologist and got all three of us in a meeting and for the first time got me to come out with it. I'd previously tried going (with the aid of my parents) to my GP, the local education psychologist at home and my parents had even tried to get the teachers to tell them what I was like at school. They all gave the same answer: "Oh he's just a slow developer and a bit lazy. he'll grow out of it". Damn right I grew out of it - once I was in sphere of influence of someone who actually gave a damn. No drugs were involved either, just a very good university support group.

The NHS goes some good stuff, and isn't a bad organisation. But for mental health, always go private.
(, Mon 30 Jun 2008, 9:02, closed)
I also suspected a ASD condition for some years now...finally narrowing it down to Aspergers after exhaustive research online.

Good luck with your diagnosis
(, Mon 30 Jun 2008, 10:42, closed)
Get a second opinion!
Sorry to hear about your rubbish experience at the psychiatrist. Definately get a second opinion. Current clinical practice is that it should be avoided giving people antidepressants on a first visit as a proper assessment should be made and the NHS is starting to look at prescribing talking therapies as a option first. Did she actually assess whether you were depressed? If not I wouldn't necessarily try the drugs they can work really well but only if you are biologically depressed.
I don't know a huge amount about aspergers but have you tried contacting a related charity to see if they can reccomend a specialist in your area?
Good luck
(, Mon 30 Jun 2008, 10:48, closed)
I'd never heard of ASD until an acquaintance mentioned it in relation to my (then) 7 yr old son who, within a year of that conversation, was diagnosed with ASD.

After that initial conversation I obsessively read up as much as I could about the subject and realised that this is what I had been suffering with all my life. I'd always been the weird kid at school, only had two friends total in the whole of my secondary school life - always on the fringes looking in, desperately wanting to be included but not knowing how. The pattern continued throughout my adult life, full of failed relationships and social isolation.

After years of total confusion at a mysterious and seemingly unreachable world containing friends and partners which everyone else seemed to find so easy, and to protect myself from further rejection, I have slowly become a recluse. At 44 years old, the only social interaction I have with with my two teenage children, and via the internet. I don't even bother trying to associate with people any more - the inevitable rejection hurts too much. The attitude of the Gilgamesh and AmorousBadger above is unfortunately very typical of the great unwashed masses, who seem to delight in attempting to humiliate and degrade anyone who doesn't fit in.

Am I a sad, depressed, cynical no-life? Oh yes - without a doubt! Had I known about ASD earlier then perhaps things could have been different, perhaps I could have learned how to fit in, but I've got used to my isolation now and prefer it to the alternative.

My advice? Get as much help as you can, push for it, fight for it - and dont take no for an answer. Oh, and find a professional who knows what theyre talking about. There are several ASD websites and messageboards on the net where you can ask for advice or recommendations. Above all - don't end up like me unless you enjoy your own company above everything else.

Good luck!
(, Mon 30 Jun 2008, 11:01, closed)
My nephew has Asperger's
time from raising suspicion to getting a firm diagnosis?

Five years.

He was a sad lonely little boy who couldn't understand why he and the world didn't get on.

Now he's a happier young adult, dealing with the public daily, but it took a long hard fight to get there.

Stay strong and ignore the idiots.
(, Mon 30 Jun 2008, 14:22, closed)
@ Most cunts who have replied


(, Mon 30 Jun 2008, 15:02, closed)
And what about us plebs who can't afford private treatment?

(, Mon 30 Jun 2008, 15:04, closed)
Well done sir. A reasoned and intelligent arguement. Good for you.

Now bugger off and go and play with the rest of the ameobas, there's a good chap.

Yes some people overanalyse and try and pin themselves down to a certain condition because it 'fits' with their behaviour patterns. But not everyone does. And possibly the reason they do this is because the NHS is of no help whatsoever in the first place...
(, Mon 30 Jun 2008, 15:49, closed)
After reading two replies from Rathen
I decided to check his profile.

I'm now quite satisfied that clicking Ignore was justified.

(, Mon 30 Jun 2008, 17:10, closed)
That makes another 3 cocks on my ignore list
Sadly, as you've said, many NHS shrinks have limited knowledge on ASDs. You seem to have landed a particularly clueless fuckwit - she obviously fixated on depression being the route problem, as opposed to being resultant from being somewhere on the autistic spectrum.

I've worked with several children with ASDs - over the last few years it has become my passion to learn all I can about autism and related communication disorders.

There are adequate support systems/agencies for children, but the same is not true for adults. It really depends on whereabouts in the country you live as to what's available.

You have my utmost respect and admiration for writing such a candid post.

*big supportive clicks*

Take care you.


*EDIT* Regarding the three deplorable responses above (which I can no longer see having clicked "ignore").....

If "sympathy" is in the dictionary somewhere between "shit" & "syphilis", then in the Nasty Sorts' dictionary I'm guessing "empathy" must be somewhere between "elephant's cock" and "emphysema."
(, Mon 30 Jun 2008, 21:01, closed)
@ Cuntsocks above.
Wankers. Completely unnecessary. Good story, well told and *clicks*.
(, Mon 30 Jun 2008, 22:12, closed)
well written post
I'm with tourettes ^^^, having worked with children and adults in the UK with ASD, and in the health system for many years, I see where you are coming from, I've heard your story in many guises. There ARE psychiatrists out there who know about this stuff, as there are those who don't. There are teams who have knowledge and resources (usually scarce).Depends where you are.

The best thing you can do for yourself is be informed, link with the Autistic Society and whatever local resources there are that can assist with this diagnosis if this is what you need. There's more to the ASD's than just the social interaction angle, yes its a huge indicator but there is the language side of things, and supposed to be something around compulsive/obsessive patterns also? People are not a list of tickboxes and have unique traits that may or may not even be indicative of ASD, thats probably why its so tricky to diagnose in the first place.

I agree with you on the depression thing, from what you write, it sounds reactive, to a particular event or situation, and as you recognise, its important to deal with the route cause rather than overprescribing. Sometimes doctors prescribe antidepressants to get people over the initial hump and functioning, then deal with the other stuff later. I wonder if it would be worth reconsidering your decision on the 2nd visit, even if you don't hold much value on it. There's nothing to stop you sourcing the 2nd opinion and finding a doctor that is recognised for having some knowledge in the ASD's in the meantime, you'll probably have another wait for this. At least your records will read as you've been playing the game.

People are so ignorant, as we've seen here, some real dicks who can't handle anything slightly outside their narrow perception of how they believe things should be. Its true, if doctors/people in the field are so ill-informed, then Joe Public may well have a bit more difficulty with understanding or just plain acceptance. Hang in there

edited to say, persistence and patience is what gets you places in the system, sad but true, don't be afraid to kick up a fuss, keep everything in writing if you can and don't be afraid to take things higher if you truly believe you have a just cause.
(, Tue 1 Jul 2008, 1:51, closed)

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