It's Obvious! (Well, that's good to know, I suppose)

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So I finally (since waiting since March) had an NHS psychotherapy appointment on Friday. It went complete crap. He basically asserted that I "think" I have an ASD and that because I "think" this, the therapy they want to do with me to help my EDD/BPD won't work because I won't "let it" because I'll just blame my difficulties on the ASD. He said that he didn't really think I had ASD because I'm married, I have a job and am travelling to Costa Rica on my own in January (to visit a friend). This was in spite of him having in front of him the reports of one psychiatrist, one psychologist and one autism specialist all stating that I have an ASD and that it must be taken into account when considering any further diagnoses or therapy.

I went to the cinema to try to distract myself but ended up taking an overdose of my prescription meds while I was there (which I had just picked up from the pharmacy) because clearly the film wasn't distracting enough. I don't remember getting to the hospital (an ambulance was called apparently) and woke up wondering where I was. I spent the weekend in hospital. Yes, this certainly seems like an EDD/BPD behaviour, I admit. I'm not even arguing the diagnosis at this point. Right now, my belief is that I do have an ASD and BPD (or something like BPD... I don't really have the classic traumatic childhood which does makes me wonder, but I do believe there is something other than just ASD going on for me).

On Monday I had an appointment at the local autistic society to arrange support with them - at the meeting was the autism specialist who confirmed my diagnosis, a support worker and the care co-ordinator from the society. I couldn't contribute to the meeting and just cried the whole time because I was still distressed by my experience on Friday. Eventually they managed to get me to talk a little and I blurted out "but what if I don't have an ASD and it's all BPD".

The autism specialist said "Don't question the diagnosis. You'll drive yourself mad. I could send to you to any of the top assessment centres in the country and they would all without hesitation diagnose you as having an ASD. It's obvious."

He also said he knew the therapist and was surprised by his attitude.

So anyway, I have now have an autism support worker (which I'm paying for myself out of DLA) and am meeting her again next Monday. I don't really know what's going to happen with that. I'm not sure how she can help at the moment because the truth is that I really very depressed and not very open to being helped right now ... I just want the ground to open up and swallow me and at my psychiatrist appointment (also on Monday) I surprised myself when I told her I didn't really see myself existing in 2013.

The psychiatrist is arranging for me to have a second opinion from her senior colleague regarding the comorbids to my ASD, and is also arranging for me to see a different therapist in future. Unfortunately that all means .... back on the the never ending NHS waiting list. Will I see 2013? We'll see. Oh I am seeing the psychiatrist again on the 20th. I guess she wants to check I'm still alive ...

I so feel your pain.

I had a failed (including 2nd opinion) NHS diagnosis 3 years ago. It has caused me immense stress because they got it wrong. Their reasoning (which I have done a lot of research on since and found the examples of my ToM ridiculous) was that I appeared socially engaging and displayed sound ToM. A few months ago I had a non-clinical assessment with an AS expert who has a lot of experience in AS, degrees in autism and has an AS consultancy and herself and her son have AS. She found clearly I have it. I had to put in a complaint to PALS (the NHS patient advice liaison service) and I am now waiting for an out of area assessment because the local unit refused to see me again.

I know I have it.

I had an abnormal EEG at age 12 which I recently got a copy of and it displays the same results as many autistic children get (paroxysmal sharp wave activity: http://onlinelibrary.wiley.com/doi/10.1 ... 434.x/full)
I have a sister with schizophrenia and the bone fide research states that a close relative with schizophrenia means you are 300% more likely to have an ASD (http://news.softpedia.com/news/Autism-L ... 9209.shtml)
I have morphological features seen in autistic people
I have two children who are undergoing assessment for ASD (obviously it's genetic) already been told youngest has autistic behaviours by her paediatrician
I have confirmation from a non-clinical expert (who can't legally call it a diagnosis because she isn't a psychiatrist or psychologist)
Even the psychiatrists who saw me 3 years ago admitted in writing "overlap with autism spectrum behaviours"
All the tests I've ever done indicate I have it

...but still they refuse to believe they got it wrong. The arrogance of some clinicians beggars belief. And it makes me so angry that there is still such a lack of research and awareness of the differences in high functioning females on the spectrum.

Like I say...I feel your pain. Don't let it make you go under. Stay strong. The truth will come out in the end.

But that's the thing... My ASD diagnosis isn't in question! I was initially assessed by an NHS psychiatrist (after referral from my GP) who had an interest in ASDs in adults. He found I had it (July 2011).

But my mental health deteriorated and I was referred to psychiatrist because of that. She wanted to confirm the ASD diagnosis, so the NHS paid for me to be assessed the autism consultant at the local autistic society, who indeed confirmed it stating he had never seen anyone who ticked so many boxes and wasn't diagnosed before adulthood (June 2012). The psychiatrist also suspected EDD/BPD and referred me in March for Specialist Psychotherapy (which was the appointment that went so disastrously on Friday).

My mental health continued to deteriorate and I ended up spending two weeks as an inpatient in psychiatric hospital because of repeated serious self harm/suicide attempts and they decided again that they needed to confirm the ASD diagnosis so I was assessed by a psychologist who also confirmed the ASD (November 2012). I also came out of hospital with a diagnosis of depression and the same EDD/BPD suspicion, although my psychiatrist admits to never having met anyone who presents quite like me ... which is why she is now referring me to her colleague for a second opinion to be sure she hasn't missed anything.

I've been diagnosed three times, by the NHS. Most people struggle like you, WhirlingMind, to get diagnosed at all!! But apparently the diagnosis is obvious with me (which surprised me because I though I was brilliant at hiding stuff!).

Yet despite this, the NHS specialist psychotherapist, who is supposed to deal with complex cases such as mine, completely dismissed my ASD diagnosis and refused to acknowledge on how that might impact on my experiences/mental health/treatment.

I am pleased that I have a support worker from the local autistic society (which the NHS is not paying for), but can't see how that is going to make any impact on my mental health which continues to deteriorate rapidly.

I can't understand why the psychotherapist would want to deny something that has already been confirmed by professional colleagues.

This is really annoying too. Because there is no 100% reliable physical test yet for autism, so a diagnosis can be subjective between professionals. Why one professional would want to dismiss the diagnosis of another professional (unless they had a reputation for being a poor clinician) is beyond me.

All they are serving to do is confuse you which is not good when your mental health is suffering.

One thing I would say regarding myself, is that whilst I agree that many adults struggle to get diagnosed, my own situation is pretty unusual and more difficult than most who have such difficulties. The person who did my non-clinical assessment, said usually people go to her before they've had their clinical assessment. She said they subsequently take her report along to the local diagnostic centre that I went to and as far as she knew, they'd all received a clinical diagnosis. Mine has been the "wrong" way round, I tried for a clinical diagnosis first and went to her after. They don't want to admit they made a mistake, they refuse to even acknowledge that the Baron-Cohen tests (AQ, EQ etc.) are a reliable tool for diagnosis and claim that they are used "mainly for research" which I know is untrue. They gave an example of me having sound ToM as an incident of me hiding a dress when I was a child. They didn't ask me why I hid it, or my thought process when I hid it. I did a post on WP asking if diagnosed people had hidden things as a child, and a few replied, who all said they had done so. It was such flimsy reasons. There is clear research on how females can mask and learn behaviours and adopt personas, which is what I've done. They said I was socially engaging as the other reason why I didn't meet the full criteria for an AS diagnosis. If they were aware of the differences in females (which they claim to be) they would know that to maintain such a persona is exhausting and unnatural and a strain. There was no in-depth questioning, no attempt to discuss or analyse the tests I had done which all scored for AS, they just dismissed them. Every example I tried to give, including my sensory issues was dismissed and I came away with a handful of labels, which if you add them all together equal Aspergers!

I know my situation is different from yours, it's just the whole thing where professionals disagree that rears its head.

This psychotherapist seems to have his/her own agenda. Doesn't sound like these sessions are worth bothering with, especially since you have so much support elsewhere.
I'm sorry you are feeling so bad. You sound like you are taking the right measures to help yourself; I hope you start to get some results soon.