Talked to a psychiatrist, misjudged?

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I saw a psychiatrist for the first time today. It was about two things, firstly that I think I have Aspergers, which he agreed and said I "almost definitely have it", and referred me to a psychologist.

This was fine, however he dismissed that I have depression (I've dealt with depression for 7 years). He said I just need goals, which I do to some extent agree with. However, I already have goals, I want to get a job, I want to go to University, I just can't though. Every time I even try I get filled with this immense dread and my suicidal thoughts become much worse. I've thought it may be Bipolar, because once a year or so, for a few weeks or months, I wake up and feel extremely motivated, confident, able and I get up and function normally, and I'm able to work towards my goals, I apply for jobs, look at courses etc. Outside of these rare moments though I feel like complete crap and I simply cannot do pretty much anything. I have very serious suicidal thoughts and I have zero motivation, confidence, and it even takes me hours to get out of bed sometimes, because I know it'll just be another sh***y day.

I was extremely nervous talking to him, it was very gloomy, the seat was right in the middle of the room and he was about 3 meters away, he looked like the most disinterested person I've ever seen. All of this made me unable to explain myself properly, and I think he misjudged me. He said I don't have depression but I'm sure that I do and I really need help because my suicidal thoughts have been much worse lately and I've been considering going through with it. This is really eating at me.

What should I do?

Hi Fraljmir,

I'm sorry to hear about your experience and the fact that you're feeling so awful lately. At least you got a bit of confirmation in regards to AS though, which is good. Did he do thorough testing with you, and do you know if you'll be getting an official diagnosis?

He shouldn't have dismissed your depression like that, especially if you mentioned feeling suicidal. I can imagine why you didn't feel comfortable talking to him. I won't claim to know whether you might have bipolar disorder but try to get an appointment with the psychologist as soon as you can. I hope you'll be able to click with them and find that they're genuinely interested in what you're going through.

In the meantime, try to take care of yourself as much as you can (eat good food and get fresh air). Do you have friends or family you can hang out with or talk to? Try to immerse yourself in your interests and surround yourself with things that make you happy, as hard as that may be for you at the moment. What sorts of activities do you really enjoy doing?

I really like your avatar too, by the way!


But also, don't hesitate to call Lifeline (13 11 14) if you're really feeling bad and wanting to go through with it. Please don't, though!

I'd love to say I'm doing better today, but I'm not. I'm feeling like today might be the day that pushes me over the ledge. At the same time, I don't think I'd ever go through with it, because of my close friends (I have two close friends) and family... They are the things keeping me going every day. I had a drink with a few friends today (I haven't had a drink in about 4 months, but it was a friends birthday). It's a very difficult thing to explain. It's like I'm on a crystal ledge, the slightest movement could push me over, but at the same time, it's a secure ledge that holds me in place always. I really can't explain it. I had a heart to heart with my close friends. One of them doesn't think Aspergers is a real thing, he thinks it's just a thing which anyone can get over (I don't disagree with him, but at the same time I don't agree with him), the other one is supportive and just saying if I need time alone to be alone.

I don't know what to do right now. I hate to be a "drama king", drama is not my thing. I never usually stir things up and I am usually very conservative with my emotions, even online, but jeeze, I just can't hold it back tonight, I just plain and simple don't know what to do. Half of me tells me I should "end it", even though I know I won't, but half of me tells me it's just another day, and to keep trotting along.

And to Myriad, thank you for your response, sorry for not acknowledging it until now. You're right, I do feel good about having some confirmation on AS, which I've thought for the last year or two I've had.

At the same time, I agree with you, he shouldn't have dismissed my depression. However I don't think I explained myself properly, which made it hard for him to "diagnose" me properly, due to atmosphere of the place, and maybe due to my general persona and way of explaining things. I don't think I have Bipolar Disorder if I'm completely honest, but it's definitely a possibility and he basically straight up told me "no" when I brought it up, without letting me explain myself.

I don't know, I just didn't feel comfortable around him. I will try to take care of myself Myriad, I really will, it's tough though. As I said above, I 'hate' to be a "drama king", this is not the usual me. Infact, today, just minutes ago, I was helping someone with a breakup they had with their boyfriend, that's "me". I help people, I like to help people, I also hate to seek help. I can't help that, it's just me. And I'm not trying to brag either, I'm just a little bit tipsy so I'm being honest with my emotions right now...

I do really appreciate your concern Myriad, I will try to keep going, and if I feel like I'm on the edge I'll call someone to seek help, that's as much a promise as I'm capable of doing.

Thanks again.

Psychiatry is not a perfect medical practice there are misdiagnosis all the time. It's not like getting a X-Ray to see a fracture. Or something to see cancer tumor.

No worries Fraljmir, I'm sorry you're still feeling so terrible.

I don't know how much detail you went into when you spoke to your friends, but please make sure you let them know what you're going through in terms of your depression. They might not be able to empathise (especially in regards to Asperger's), but they are your close friends so I'm sure they'd appreciate if you explain what you need from them right now. Same goes for your family. It doesn't have to be much -- it could be as simple as letting them know that you're a bit fragile (if that's the right word ) and need good company at the moment, and also some respect if you need time alone. Something like that.

I get what you mean about not wanting to be a 'drama king', and asking for help certainly isn't easy for a lot of people (including me). I know it's obvious and you've probably heard it before, but there are times when you can't afford to struggle on your own. You're a good person, always trying to help people and putting others before yourself. But there's only so much you can give when you're the one in need. Getting the support you need will actually make you a better helper for others later on, I believe.

If you're really struggling to get your feelings 'out', try writing down your thoughts. It's simple advice but by doing it like that, you're not bottling things up so much and it might help give you insight into your emotions (if that makes any sense). Do you like doing art? If words are too hard you could try drawing, painting or playing music if you're into any of those things. It can be surprisingly cathartic.

If you ever need to, you're welcome to send me a PM if you really need to vent to someone. I won't necessarily know how to help, but I can listen to what you have to say.

As for your appointment with the psychiatrist, that's understandable too. Do you know when you'll be seeing the psychologist? Perhaps bring up that experience with them and make sure you get out what you need to say straight away, so you don't feel like you've missed the opportunity to convey where you're at right now. Writing out notes before you go might help if you find you get stuck for words.

Maybe we can learn from one another, I feel the same way, only I was diagnosed with Schizophrenia 12 years ago. Only I seen a new Dr. and out of no where he says, " Yes, you are Bipolar, but Schizophrenic you are not". I'm left coping. He doesn't even have my file's, or a CAT Scan of my brain. After one meeting he knows me, of couse he can know me, I'm totes doped out on an old school (brain cell eating) med for Schizophrenia. That was sarcasm. I'm now stressing, because I'm not taking it, till he proves his point, or he hears me out. Don't worry, I'm still on my Abilify, so there is that.

I hope I don't come across as uncaring in saying this, but perhaps the psychiatrist was right in a way (although he has not seemed to have expressed himself well).

The symptoms you describe do sound like they may have their origins more in some form of anxiety. You state yourself that your immediate feelings are immense dread and that you were extremely nervous about talking to him. It is possible that prologed anxious states can cause depressive symptoms if left untreated, but if that were the case the priority for treatment should be the anxiety, not your mood, to avoid becoming stuck in a vicious cycle and having to take increasing amounts of ineffective medication. If it really is the anxiety that is triggering your mood, then effective anxiety treatment (likely to be medication plus CBT) should have a corresponding influence on your mood.

Of course I am not qualified to diagnose you and this is only one opinion, but just another possibility to consider.

As he thinks you probably have Aspergers, he was probably having trouble relating to you. A lot of professionals do, with most of their training being for neurotypical people. He expects to feel sad if you are depressed and didn't connect to your emotions so does not think you are depressed.

As difficult as this is, you have to believe your feelings are real even if other people don't respond. Hopefully you can work with someone understanding about what you are going through. I hope you won't torture yourself with the idea you should have communicated better, that's a catch 22 if you think you are on the spectrum as that comes with some trouble communicating. Feel better, it is stressful to feel ignored.

Thanks for the responses. Apologies for the long response time, I was just taking some time to relax and try to enjoy myself, without focusing on anything else. I feel a little more emotionally 'stable' now, but I'm aware any day the instability could come back so I'm just trying to take things slowly. By 'stable' I just mean that the depressive feelings probably won't lead to anything more.

Unfortunately they didn't contact me at all this week (the psychiatrist I saw sent in a referral to the psychologist and said I'd get a call soon), which was a little frustrating. I called the place last night and they said they had no records of it and would send an e-mail to the psychiatrist that I saw to ask about it and they'd call me back soon, so now I'm just waiting for that.

AKAnnieDreaD, I can imagine that would be a shock, especially having had it professionally diagnosed in the past. In my case, I've never been diagnosed, so it's probably a little easier for me to take what the professionals are telling me. I can definitely relate to stressing out until he proves his point or hears you out though, that's exactly how I'm feeling. I hope you're able to find some clarity soon in regards to what your new doctor is telling you.

LittleBlackCat I don't find what you said uncaring, and I've thought about that myself too. It's a possibility, it definitely is. There is definitely a strong element of anxiety there. Based on my own thoughts though, it doesn't seem like the "depression" and "anxiety" elements are fully related. When I described above that once every 12-18 months I wake up and feel extremely motivated, capable, confident in my abilities and what not, and in no way depressed, I do still have the anxiety there, it's slightly less prominent though. I still feel very anxious about social situations, but the "depressive feelings" don't ground me from being able to find a way around it. Normally though, outside of those 2-8 week "up" moments, I feel very anxious about social situations, but the depressive feelings do ground me from being able to find a way around it, so I end up just doing avoiding it entirely. I can't fully explain it, it's too complicated for me to word properly. I've never taken medication though, but it's something I'm open to trying.

Waterfalls, that's probably true. That thought did cross my mind several times during the meeting. For example, he asked me if I "cry a lot", but I've never been someone to cry often so I just said "no", but I think I probably should have explained that I do often feel the need to, but that it isn't my way of coping most of the time (even if I feel the need to cry it just doesn't happen). And yeah, I'm definitely hoping the psychologist will be someone I can open up to more, because with certain people I simply cannot talk about personal things with them properly- words just don't form in my head. As for not torturing myself with the idea that I should have communicated better, well I can't promise that, it's a regular thought of mine haha.

Sometimes I think the way we talk, like talking in a monotone, which a lot of us may do especially when stressed, misleads people into thinking we are not really sad. Don't take that as your fault, it just is. If they take the time to get to know you, they will get it.

Hi again. I saw the psychologist today and I was definitely much more comfortable talking to him than the psychiatrist. The building was inviting, the waiting room was secluded (yay), and the psychologist was nice & helped me to open up. I trust his first opinions more than the psychiatrist's. He agreed that I most likely have Aspergers but didn't want to diagnose me on the first session (of course). He also said that I most likely don't have Major Depressive Disorder or Bipolar, but that it's probably Dysthymia, a mild, chronic form of depression. After he explained it to me and after looking it up when I got home I can definitely relate to most of the symptoms. Serious suicidal thoughts can be present but usually only lead to less severe attempts, if any, and rarely leads to death. So I guess that's a positive? I'm seeing him again in two weeks. Hopefully we can dig a little deeper and perhaps come to a conclusion as to what I have and what treatment is available.

Hi Fraljmir,

I'm glad to hear that you had a better experience this time. Did you get to tell him about your experience with the psychiatrist?

It sounds like you're on the way to getting some answers (and decent treatment), which is definitely a positive! Thanks for keeping us posted and I hope your next appointment goes just as well.

Thanks Myriad,

Yeah I did end up telling him about my experience with the psychiatrist. He was understanding and definitely looked much more patient and interested than the psychiatrist too.

Go with the person you are more comfortable with
and keep away from earlier one because of the bad feeling you got with the first person

At the risk of an unfair characterization... in the US, psychiatrists tend to be pill-pushers while psychologists tend to see the whole person, often in context of their social circumstances. Both specialists can diagnose, but other than knowing a lot about meds, I can't see any advantage of a psychiatrist.

I'm glad (and not surprised) you felt more rapport with the psychologist.

Don't get too hung up on labels, as I can virtually guarantee you that in ten years, the labels of today will be outdated and replaced. In other words, the conditions they describe aren't solid and permanent things, in some ways aren't even real; it's merely a lingo for talking about things that are real.

I hope you will continue to see the psychologist and work on ways to make your life happier and more successful. Best of luck.