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blueroses
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15 Apr 2012, 11:19 am

My boyfriend, who was 'officially' diagnosed with Asperger's in 2011, recently told me he was previously diagnosed with Schizophrenia in early-2009. He believes very strongly that the resident (it was a new resident, rather than an experienced psychiatrist) who diagnosed him, was incorrect and misinterpreted some of his ASD symptoms, such as speaking with a flat affect, being somewhat socially isolated, having poor executive functioning and organizational skills and being kind of eccentric in general, as Schizophrenia symptoms.

The schizophrenia diagnosis was made when he was 34 years old, roughly 2-3 months after he became a born-again Christian, became obsessive and anxious about his relationship with God and was hospitalized for several days for severe anxiety. (The anxiety was mainly about spiritual issues). We were friends during this time period and I recall being concerned that he was getting OCD-like over religion, but did not think much more about it beyond that. The psychiatrist, however, considered this to be his first schizophrenic episode.

He did not hear voices or experience any other forms of hallucinations, but did believe that God was 'speaking' to him by guiding him to make major changes in his life, like switching career paths and cutting off relationships with non-Christian friends, which he didn't wind up doing anyway. The psychiatrist believed my boyfriend's belief that God had started guiding him and communicating with him to be a type of delusion and made the schizophrenia diagnosis based upon these 'delusions,' his preoccupation with religion and those other symptoms I mentioned above that could also be attributed to his Asperger's diagnosis.

Because he believes he was misdiagnosed, about a year and a half ago he both stopped taking the Abilify he'd been prescribed and also started taking Wellbutrin, an anti-depressant that increases dopamine in the brain. (Apparently, there is a common theory that schizophrenia symptoms are actually caused by increased dopamine levels). He has been perfectly stable and functional since, even with the increased dopamine levels, but we discussed everything that happened and both agree that we would like him to be re-evaluated and get a second opinion. My main concern is that if there is a chance the schizophrenia diagnosis was valid, he may be in remission now, but jeopardizing his health by not staying on the med's long-term. His concern, on the other hand, is getting clarity on his diagnosis, in order to get closure on it and be able to move on.

Either way, we would like him to be re-evaluated. He had an initial session with a therapist who has experience in both in spiritual crisis issues and working with schizophrenic patients, but who does not have experience with ASD's. His uncle, who is a psychiatrist in New York and questions the schizophrenia diagnosis, too, also advised him to have an MMPI test done. (Actually, his uncle's exact words when he was told about it the other day, were that the diagnosis was "total BS," but he also questions the Asperger's diagnosis, so who knows?)

But, the problem is that it seems like some mental health professionals are apprehensive about re-visiting another psychiatrist's diagnosis several years later and the resident who diagnosed him in 2009 completed his residency and moved out of state. Do you have any advice to us as next steps? Also, he in the Philadelphia area and has a good health insurance plan that is accepted by most hospitals/doctors, if that makes any difference.

Thanks for reading through this long-winded post and for any help/guidance you can provide!



faithfilly
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15 Apr 2012, 12:48 pm

blueroses wrote:
My boyfriend believes very strongly that the resident who diagnosed him, was incorrect...

Your boyfriend may know better than anyone else about this.
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...he became a born-again Christian, became obsessive and anxious about his relationship with God... The psychiatrist, considered this to be his first schizophrenic episode.

That's what a typical psychiatrist would think. It can take a lot of time before some Christians settle peacefully into their faith. Spiritual maturity doesn't happen overnight. It's a new way of life that involves learning.
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He has been perfectly stable and functional since...

Be thankful for that.
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His uncle, who is a psychiatrist in New York and questions the schizophrenia diagnosis, too, also advised him to have an MMPI test done. (Actually, his uncle's exact words when he was told about it the other day, were that the diagnosis was "total BS," but he also questions the Asperger's diagnosis, so who knows?)

His uncle probably knows him, so for that uncle to think the diagnosis of schizophrenia is "total BS" he must have a good reason to believe that. As for the Asperger's diagnosis, a lot of professionals struggle with recognizing it.
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Do you have any advice to us as next steps?

I'd say avoid any unnecessary stress, especially worry. Worry is something that doesn't belong in any Christian's life. Worry is what the world does. Christians trust in God's promises as stated in the Bible. Faith is tested by obedience.


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"Has not my hand made all these things, and so they came into being?" declares the LORD. "This is the one I esteem: he who is humble and contrite in spirit, and trembles at my word." – Isaiah 66:2


questor
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15 Apr 2012, 12:59 pm

It does sound like your bf was misdiagnosed. Being religious is not a mental illness in and of itself, but apparently the doc involved believes so, at least when accompanied by OCD. There were no delusions, and your bf is doing well off that med the mistaken doc prescribed. Do go for another assessment, and ask for him to be checked for Asperger's or any other related disorders.


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If a man does not keep pace with his companions, perhaps it is because he hears a different drummer.
Let him step to the music which he hears, however measured, or far away.--Henry David Thoreau


blueroses
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26 Apr 2012, 5:30 pm

It sounds like you guys might be right. Over the last two weeks, he has been evaluated by a therapist and a psychiatrist and both believed the previous diagnosis to have been bogus. The psychiatrist even went so far as to write "Absolutely no signs of schizophrenia present" on a prescription pad and then sign and date it.

So, hopefully, they are both right and we can put this behind us. It's still been a scary experience, though, and I hope I am not always going to have a small "what if?" in the back of my mind.



Bloom
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26 Apr 2012, 8:07 pm

I'm a "mental health professional" :)

Of course, I've discovered on these forums, so are a number of other "Google Elite" :P

Alas, I did not receive my degrees from Google. :P So take what I say as mere experience. :)

And ignore the above snark... :)

*cough* Right! If the individual had a single episode, and was hospitalized for less than a month; question the diagnosis. If the episode lasted less than 6 months; question the diagnosis. If the diagnosis was not based on a constellation of signs or symptoms; question the diagnosis. If the episode did not include consideration of emotional and cognitive dysfunction; question the diagnosis. If the episode did not impair both occupational as well as social functioning for more than 6 months, without regard for his ASD diagnosis; question the diagnosis. If he feels something is off about the diagnosis; question the diagnosis.

You always, always have the right to a second opinion. You always, always have the right to ask for clarification, and justification. You have the right to refuse services, treatment, and medication.

You always have the right to non-disclosure, as well. This sometimes gets marred in the waste of questions at a new site/clinic. If you fear/believe that someone is going to refuse services based on your diagnosis, talk to Patient's Rights (every county has a Patient's Rights office, they're mandated). Whatsmore, you don't actually have to tell anyone you have a diagnosis. You can walk in like a fresh client! The only place this isn't true is many US governmental services. But... that's another topic... :P

Lastly, let me assure you that I've seen a LOT of first-episodes/first breaks, and I've never seen a single break that's lasted less than 6-9 months. There are a limited, LIMITED number of lucky sods that get off lucky with the 6 month time frame. We're typically looking at a year or more before we're able to stabilize someone after their first episode. I tell you this only to reassure you that if this was a "first epi", it was pretty mild, and the worst you'll see. You can keep calm, now, and move on. :)

In all likelihood (and this is where I can get in trouble), it wasn't Schizophrenia, nor a psychotic break, and he was just having an a euphoric, aspie reaction to finding his higher power. Someone should have patted him on the back, not given him wire-cutter to his line with god :P In any event, I'm not saying this was not schizophrenia (DISCLAIMER), I don't know the guy, the situation, or the event/s that followed. I'm just making a WILD guess... :P