Hi, I was diagnosed with AS at the tender age of 41 (3 years ago).

The DX was made by a clinical psychologist, who works for the NHS, but not  in my local area (different county). I paid privately to see him.

I have been seeing the same psychiatrist for eight years for depression and anxiety. When I was diagnosed with AS, he refused to accept it, and maintains it is not valid, as I paid privately to see the psychologist. I have asked for a second diagnosis on the NHS, but in my county in the UK there are no NHS consultants who diagnose AS in adults.

The conflict is creating a problem with the mental health care I am receiving from the psychiatrist.

What do I do? :-
1. Pay to see another psychologist in another county, or
2. Asked to be referred to see another NHS psychiatrist for my depression/anxiety, or
3. Ignore his comments.

His reasons for his non-acknowledgement of my DX are that:

1. I have had many professional career positions (including management and in the armed services) - he seems to think AS people always have a learning disability as well, and don't work/aren't capable of work.
2. I don't look like (!) or sound like I have AS.
3. He doesn't understand why I paid privately to get a DX in the first place, and what I was trying to achieve by getting a DX.

Any thoughts guys and gals?

I would say you are dissatisfied with the service received, complain (in writing - to the hospital your pyschiatrist is based at) and see what that achieves. I would also include a copy of your AS diagnosis.

If he still refuses to accept it, request to be transferred to another pyschiatrist.

Yeah, I may well do that. Thanks.

I was just wondering, generally, how reliable are AS diagnoses? And how much 'weight' do they really hold?

I am pretty certain that my Dx is correct - I self Dx'd before hand, and my son  also has AS (genetic effect?). In any case, it was another , independent counsellor, who felt that I had AS, that encouraged me to get a private diagnosis.

I think thats almost like asking "how long is a piece of string" lol - as far as I'm aware all UK based individuals capable of officially diagnosing AS must follow a measuring scale that covers the 'triad of impairments'. The Americans use the DSM-IV I think; not sure what we use here.

The diagnosis isn't just what you respond with, but how you behave. The pyschologist who diagnosed me commented that I didn't make eye contact with him once in an hour. He also pointed out that I went into pedantic monologues of my own free will, and that whilst I did make hand gestures, they were repetitive. I also laughed or seemed amused by 'inappropriate' stimuli, and refused any eye contact whatsoever through a monologue.

Basically, if you want your diagnosis, you could talk the talk to get it - anyone can read up on AS and 'mimic' it for that time. But certain behaviours are natural to someone on the spectrum, i.e. little eye contact. It is those little pointers specialists will pick up on. Never just what you say yourself.

Also if your child has AS then I would say you have nothing to doubt.

Thanks for that Ocampo.

It actually says in my Dx that I did not make eye contact during the assessment too. The psychologist asked for my school reports  (primary & secondary). They talk about me 'being aloof' and 'distant' and 'dreamy' and 'refusal to engage socially'. He added these notes to the Dx, but none of this cuts any ice with the psychiatrist, who maintains that I 'was shy', but grew out of it, otherwise I never would have been able to hold down a career.

I think the issue with the psychiatrist stems from two things:

1. As well as dealing with patients with depression and anxiety, he specialises in learning disabled patients, so he must come into contact with autistic individuals who have LD, and feels that I have nothing in common with them.

2. He actually told me he was persuaded by a solicitor to Dx an adult (a client of the solicitor) so that the client could have an excuse for committing a crime (I think it was robbery). So, he feels that adults 'wanting' a AS Dx  do so for shady and nefarious reasons.

I am still amazed that he told me this, and that any legal professional could use a diagnosis of AS to get their client off any crime. I don't see the association between criminals and AS, but perhaps I am just naive about the legal profession!

Hmmm... from what you've just told me there, I personally would switch pyschiatrist. In treating your depression, your doctor must realise that your mind is coloured by Aspergian thinking. Thats where all my counselling has gone wrong over the years - I do believe our thinking is more 'pliable' than some neurotypical thinking (as in, I think pyschotherapies and other 'constructive' therapies are better for Aspies than 'talking' therapy) - and for me sitting, as I saw it, 'moaning about things' didn't help. I wanted someone to give me some constructive advice on what to do. If your doctor cannot accept that, then he is letting you down, and he is also being unprofessional to a certain degree. Especially with regards to being 'bribed' into giving a diagnosis to someone accused of a crime; its not quite that cut and dried in the criminal system here, and I'm suprised that a lawyer would think along those lines. It certainly wouldn't get someone off a crime as I saw plenty of substance abusers and mentally ill people passing through the prison system.

Of course you have been with this pyschiatrist for 8 years, and as we both know it is important to build some kind of rapport. From an outsider's viewpoint, I don't think he is being professional in this respect - would he deny you have a heart problem is a cardiologist diagnosed it elsewhere?

That's amazing; my last therapist felt the opposite.  He thought AS people are generally bright and especially capable in academics; if not, they might have something else instead, like ADHD.  Basically, he seemed to think learning disability and AS are incompatible.

Will the psychiatric community ever have a consistent view of "the AS patient"??  This is getting on my nerves, now...

I know here in the US you can seek a second oppinion.

Thanks Ocampo.

I think your comparison to a cardiologist's report is very valid. I have also had talking therapies and counselling and have also not found them particularly useful. I am now due to have some psychotherapies, but I do not know (yet) if the psychologist (different one) will accept the Dx either.
I think I may well ask to see a different psychiatrist, and have put it off previously for the reasons you mention, but it is now hampering our medical relationship to a harmful degree.
Once again, thanks for your valued input.

This is slightly off topic, but ocampo's reference to cardiologists caught my eye.

Your psychiatrist's problem could be professional jealousy - my (now ex-)cardiologist refused to believe I had any problem with my heart, he said that he had to believe the atrial fibrillation, as it was recorded on a monitor, but wouldn't do anything for my heart pain, as he didn't believe it was in my heart. Fortunately he was going on holiday the day I was sent by my GP to hospital & admitted, and it was his colleague who ordered an angiogram and diagnosed unstable angina; which my ex-cardiologist still refuses to believe!

So, I suggest that you ask for a referral to another psychiatrist. After all, if this one hasn't sorted you in eight years there must be something wrong with his approach!

I'm in the US, but I've had a similar kind of problem.  My psychiatrist even tried to add new diagnoses to the mix, like "Bipolar NOS."  Then she tried to switch my dx to what she called "Asperger's NOS", which she didn't realize wasn't an actual diagnosis until looking it up.  That was one of the major reasons I've decided to switch, even though the new person doesn't accept insurance.

No, not off topic at all - very relevant, and thanks.

I have now written to my GP and asked for another referral to a different psychiatrist, rather than go down the complaint route, which I did also consider.

Thanks for everyone's feedback - most useful.

Good luck