I think I might have Asperger's. What should I do?

November 22, 2009 11:32 AM

I think I might have Asperger's. In my case, should I even bother being tested? What would a confirmation/disconfirmaton mean?

I'm 22 years old, male, college student, soon-to-be post-bacc medical student.

I've been medicated in the past for anxiety and depression (Lexapro), but I've been drug-free for a year and, I think, coping really well.

My coping methods, however, are optimized for living alone, as I did for a year before my girlfriend moved in with me a few months ago.

When living alone, I can take all the time I need to myself to chill out, calm down, and take myself out of overwhelming situations, generally involving other people. I've been controlling my anxiety and mood swings by avoiding the things that cause them, and now that I live with someone else in a small apartment, I feel like a lot of my "solutions" have just been temporary fixes.

Now, I'd say we just need to work things out and talk to each other, which we're good at doing when we clash, except for the fact that both my girlfriend and my mother think that I have Asperger's.

If it were just me, I wouldn't bother seeing a mental health professional, since I know there's no "cure" for AS and it's just something you deal with. But it isn't just me; I have my relationship with my girlfriend to consider, and I know I can be very difficult to live with (I find myself difficult to live with sometimes too).

My girlfriend says I've become easier to deal with since she's decided I have AS, and my mother says she's wondered for years if I had mild autism. It just seems so late in the game, so to speak, for this to come up.

I'm afraid that if I am determined to have AS, that I'll be considered a faker or excuse-maker since I'm fairly well-adjusted. I'm afraid that if I'm determined NOT to have AS, that I'm dealing with something like a mood disorder instead, and I'm not interested in going back on medication.

I've already sent an email to a local psychiatrist who works with autistic children, asking if she counsels adults or who I should see about it. That's a first step, but how do you think I should proceed?

posted by edguardo to health & fitness (20 comments total)

I think you've done all that you need to do. And nothing in your post indicates that you have Asperger's. But I'm just a random internet-person, so even if you listed your symptoms, what would I know?
posted by pintapicasso at 11:42 AM on November 22, 2009

I sort of think all you really need to do is look at the material available for helping folks with Aspergers develop better coping and social skills and, as they say, take what you like and leave the rest. Some I've run across in a cursory search are Newport's "Your Life is Not a Label," Lovett's "Solutions for Adults with Aspergers," Birch's "Congratulations! It's Aspergers," Aston's "The Other Half of Asperger Syndrome: A guide to an Intimate Relationship with a Partner who has Asperger Syndrome," and Aston's "Aspergers in Love." Does it matter if you have a diagnosis? Or does it matter that you develop some better strategies in relationships?
posted by liketitanic at 11:58 AM on November 22, 2009

You haven't posted enough information for us to even remotely weigh in with guesses as to what, if anything, you're suffering from. Being "difficult to live with" is not indicative of any particular disorder.

Do you have trouble reading non-verbals cues? Do you tend to take thing literally? Do you have profound obsessions? Do little things drive you crazy to the point where you can't function, e.g. annoying sounds, lights that are the wrong level of brightness or crooked pictures on the wall? Do you freak out in crowds? (If I'm leaving the subway and there are two exists, I will ALWAYS choose the one used by fewer people, even if it's the longer way to go.)

There's no cure for AS. On the other hand, there are coping mechanisms, and a therapist (as in "talk therapy") can help you learn them. Also, many people with AS can catch up with "normal" people when it come to learning non-verbal cues. It was a ton of work, but I've learned to be quite good at understanding other people. I haven't been remotely successful with moderating my obsessions (but I don't want to change that aspect of myself, particularly since I've turned my obsessions into careers), and my aversion to "little irritants" actually grows stronger every year. If the TV volume is too loud or too soft, it feels like my head is going to explode. I am continually fiddling with the remote to get the volume just right. Drives my wife crazy.
posted by grumblebee at 12:00 PM on November 22, 2009

The psychiatrist you've contacted is probably already the best source for information on how to proceed. Most of what we as a community can provide to you are data points. But sometimes that's helpful on its own.

I went through the "diagnostic process" myself, about five years ago. At the time I was around 23 years old. It involved some fairly long interviews and testing (this was at a university, though, and I was being interviewed by graduate students, so I think it took longer than it might otherwise). At the end, I was given the diagnosis, and ... nothing changed, really. I thought it be this big, impactful thing, but in the end, the label didn't really bring me anything. It meant more to my mom than it did to me. I found little to identify with in communities of people with AS (who generally had more problems than I did) and it got to the point where I stopped referring to myself with the label entirely. Do I actually "have it"? I don't know. On some diagnostic scale I do, I guess. But I find the label to be meaningless. That said, if the label helps your girlfriend and mother deal with it, then there's no harm in it as long as you personally don't mind. Sometimes it helps people to be able to label sets of traits, because it allows them to see them as something systematic, something normalized, rather than a bundle of idiosyncrasies.

As you recognize, you will probably always have the sensitivities you do. I have sensitivities to certain stimuli: crowds that are too large, noises that are too loud, certain social situations, etc. I deal with them by carefully managing my energy and removing myself from the situation when it becomes unmanageable. The people who are worth having in your life will understand. "Avoidance" is a negatively-charged term, but I don't think that it's necessarily an unhealthy strategy. Your avoidance sounds like mindful avoidance, a conscious recognition of your psychological reality, which is very different from fleeing things because you don't want to deal with them. I think your orienting yourself towards trying to work on these things is a good thing, especially where interpersonal relationships are concerned, but don't put too much pressure on yourself. See what the psychiatrist says and go from there, and remember that you don't have to go on any medication if you don't want to. If you find someone who insists that you go on medication against your wishes, then it's time to switch.

Moving in with someone is a big change, and a few months is not a lot of time to re-tool coping methods that you developed while in a completely different situation. As long as the two of you communicate well, I think you should be okay. It sounds like you already take her feelings into account, which is 90% of the battle right there.
posted by Kosh at 12:02 PM on November 22, 2009 [2 favorites]

You might also consider reading memoirs by high-functioning autistic people. Emergence: Labeled Autistic by Temple Grandin is the gold standard as far as I'm concerned, but you could also look into Born on a Blue Day by Daniel Tammet or even The Curious Incident of the Dog in the Night-Time, which, although fictional, does a good job.

Many of the characteristics of Asperger's are also present in Sensory Processing Disorder, which is like a "milder mild autism." People with sensory processing problems also develop highly detailed coping mechanisms for a world that is to them - at least at times - unbearably overwhelming. A good book on that is Too Loud, Too Bright, Too Fast, Too Tight (Heller).

You're right, there is no "cure" for AS. But the point of seeing a psychiatrist or any mental health professional is not to cure what ails you, but to help you cope with the reality of your internal universe. A psychiatrist - because of their medical degree and training - is more likely than a psychologist or a master of family therapy to suggest drugs.
posted by brittafilter at 12:11 PM on November 22, 2009 [2 favorites]

I'm pretty sure I would have been diagnosed with Asperger's when I was a kid, if they'd been diagnosing anyone back then in the '70's and '80's.

You don't really need an official diagnosis, because as you've noted, there's no cure, and your symptoms are there whether you have it or not.

If you tell people you're an Aspie, it gives people a label they can hang on you so they can, if they choose, decide you're not just being a jerk. It helps them understand some of your weird, anti-social behaviors. They're under no obligation to think better of you, but most people will cut you some slack if you have a problem you were born with than if you simply choose to dress badly, ignore people's feelings, and occasionally hide from social events. They may also decide to be more up front about their feelings, rather than just resenting you for not picking up on their emotions.

Considering yourself an Aspie also helps you notice when you're doing something anti-social. Reading the literature and seeing what other Aspies do that isn't neurotypical behavior will help you realize that maybe you're being a little out there if you don't take a shower as often as other people, or talk too much about stuff you're interested in that they're not, or get in people's personal space.

You can learn to compensate for almost all your Aspie behaviors. You may be short a few mirror neurons, so you may not automatically pick up on people's emotions. But you can train yourself to notice the signs. And you can train yourself to ask questions: "Did I just upset you?"

And you can learn to apologize. A lot.

You can also cut yourself a little slack. I have been known to hide in the bathroom during my own parties when they get too busy and overwhelming. I don't beat myself up about it. That's just my Aspie behavior. People still like my parties.

I don't think it's a question of therapy. I think it's a question of just learning to notice what you don't naturally notice, and to do what you don't normally do that neurotypical people normally do. By the time you're in your forties, it's entirely possible that no one will be able to tell you're an Aspie unless you tell them.
posted by musofire at 12:13 PM on November 22, 2009

What would a confirmation mean?

An actual diagnosis is a requirement to get a 504 plan, which might be useful in reaching your higher education goals.
posted by jamaro at 12:22 PM on November 22, 2009

I know you pretty well and I do not think you have Aspergers. I have known many people "on the spectrum", and you lack several of the salient features. You don't go on the extended monologues (as my handy DSM-IV says "e.g. pursuing a conversational topic regardless of others' reactions") or otherwise socially tone-deaf, you don't have any narrow obsessions I'm aware of, patterns of eye-contact and body language strike me as entirely normal, and I've never noticed any rigid routines or habits.
posted by phrontist at 12:28 PM on November 22, 2009 [1 favorite]

that should read "or otherwise come across as socially tone-deaf"
posted by phrontist at 12:33 PM on November 22, 2009

I'm afraid that if I am determined to have AS, that I'll be considered a faker or excuse-maker since I'm fairly well-adjusted. I'm afraid that if I'm determined NOT to have AS, that I'm dealing with something like a mood disorder instead, and I'm not interested in going back on medication.

Nobody's going to make you take medication against your will. A high-functioning person like you, there isn't a court in the country that would allow it. It's also up to you who you tell about a diagnosis. If you want to keep it between yourself, your girlfriend and your mom — and judging by your description, they won't accuse you of faking anything — then that's your right.

I've been there, and it can be really scary going in for a psychiatric diagnosis, but in your case, if you're curious what a doctor would say, there's no harm in finding out.

FWIW, I was in your position about ten years ago, with a few people convinced that I had AS, and it turned out to be a big fat red herring. I'm a shy geek who likes to be alone but as other folks are pointing out, the autism spectrum doesn't have a monopoly on any of those traits. Reading books about autism and AS helped me realize that the diagnoses didn't apply to me. But those same books also had tidbits of information (about life as an introvert; about making conversation with people who don't share your interests) that did apply, and some of them — I'm thinking of Temple Grandin's in particular — are well-written enough that I'd recommend them to just about anyone. It can be useful to learn and think about how others have made peace with their own brains, whether or not your brain is wired in quite the same way.
posted by nebulawindphone at 1:25 PM on November 22, 2009

Whether or not you have a diagnosis, you and your GF will still need to find ways to adjust to each other -- just like any couple does. If, in the process of getting a diagnosis, you think you might be shown some ways that you're not finding by yourselves, then it could be worthwhile. But since you say she already feels things are improving, it sounds as if you're just fine without one.
posted by TruncatedTiller at 1:49 PM on November 22, 2009 [1 favorite]

I know you pretty well and I do not think you have Aspergers.

Pursuing a conversational topic "regardless of others' reactions" based on our "narrow obsessions" is exactly why we know each other pretty well, wouldn't you say? :)

But that said, I'm glad there's one "no" vote against two "yes," at least.
posted by edguardo at 2:08 PM on November 22, 2009 [1 favorite]

I think the best advice to you would be to go to a psychiatrist and explain your symptoms, what you have done to cope with them, and how it isn't working anymore. Whatever the cause, the doctor will probably be able to determine a good way to cope. Maybe ongoing therapy, maybe drugs, who knows.
posted by gjc at 2:16 PM on November 22, 2009

As a fellow Aspie traveler with a late - but obvious, to all who knew me - diagnosis, I'd recommend, if you can afford it, finding a cognitive behavioral therapist with experience with adult asperger patients. You may be able to learn techniques to help you "fill in the blanks" that the condition has left you with - and enjoy your life a little more. (There's a recent book on the use of CBT in AS, which I haven't read, so I link to this review of it strictly for informational purposes.

If you can't afford to see somebody, after reading some the excellent narrative books above, you might look into a book called "The Feeling Good Handbook," by Dr. David D. Burns. It is a general CBT book, but really, really good in terms of helping you with negative feelings and providing practical advice on dealing with things about yourself that hold you back.

But the best advice is to be OK with it. If you feel as if you're doing fine; if you're loved and supported by honest people then you're doing great - enjoy what AS gives you, and don't sweat too hard what it takes away.
posted by soulbarn at 2:17 PM on November 22, 2009 [1 favorite]

it's a very broad "spectrum" and really a bit of a gray area between people who obviously have some form of autism and those who are just very shy and socially awkward. however a diagnosis may come in handy. I got a psychiatrist to give me a diagnosis when I was in high school, as a result I never had to attend school if I didn't want to. however I never considered myself as suffering from a 'disorder', it was just my personality.
posted by moorooka at 2:33 PM on November 22, 2009

I've recommended Toastmasters many, many times for those with social interaction problems. (I'm a psychologist and very often assess youngsters and adults with Asperger's.) Toastmasters teaches people to give presentations, what others are saying, tell jokes, introduce people appropriately, greet others, etc.

A major problem, of course, is that those who are socially anxious (for whatever reason) have a particularly difficult time joining a public speaking group, even if it is the best thing for them.

But think about going to a Toastmasters meeting. There are probably many excellent groups in your neck of the woods.
posted by Kalepa at 2:43 PM on November 22, 2009

Asperger's is the new OCD, which was the new ADD, which was the new Chronic Fatigue Syndrome. We are so eager to be able to define our problems (and others') that we jump at any label that sounds true. But there could be multiple factors involved that neither you, your mom, nor your ex can fathom, and you owe yourself an actual diagnosis and treatment regimen based on your unique case.
posted by hermitosis at 3:19 PM on November 22, 2009

If you are interested in a diagnostic interview, I would suggest that you look into the clinician's experience with autistic spectrum disorder. Asperger's is a diagnosis not many people are familiar with enough to diagnose effectively. Some people believe that Asp is high functioning autism (autism with high iq) and there are differences.

Why bother getting diagnosed? Some people are happy to have a label that explains who they are, especially if they'd had trouble in situations. Its nice to feel like there are other people out there like you. It may not be a meaningful distinction to you but perhaps for your family it would help. Even if you're not diagnosed, some of the suggestions for social interactions etc. from books can be helpful. Also, it may help your family understand how you may see the world. It may be totally useless.

A good interview and maybe some ratings forms are all you should really need for an Asperger's diagnosis. You'd be better off with somebody who does that sort of assessment on a regular basis because they'll be more likely to give you meaningful recommendations that will be useful for you.
posted by gilsonal at 6:45 PM on November 22, 2009

I am married to someone who registers on the Asperger's or autism scale. At some point, he told me this. Like you he is highly function and very smart and I have no experience with this so I did not figure it out myself. He over-reacts to minor annoyances or normal family life. If I manifested that behavior, it would definitely be a sign of some deep problem in our relationship. So, without knowing that this was a syndrome, I couldn't help but interpret it as important trouble.

Knowing its just the way he is wired allows me to not react or over-react to outbursts so they diffuse quickly rather than escalate. I also sensitive to minimizing the things that upset him in our life. He is a fantastic father, but I have to cut him some slack when it comes to dealing with crying children, for example. Long car rides for vacation are out. Kid's birthday party's - he's useless. Understanding what is going makes the difference between feeling put out by someone who isn't carrying their weight, and dividing parenting responsibilities so he's there where he is strong.

I wish I had known more earlier. If the thing with your girlfriend goes anywhere, I would go to the therapist with her a few times. As people here suggest, there are some coping methods you can learn, but she's got some adjusting to do to make the relationship and family life work. That said, with a little understanding, things go quite well.
posted by alcahofa at 10:09 PM on November 22, 2009

Thanks for all the answers everyone! This has helped me a lot. I'll be going to see a psychiatrist, for better or worse, and I'll try not to worry much about it either way. In any case, I want to do what I can to make this relationship last. :)
posted by edguardo at 7:31 AM on November 23, 2009