I need a doctor who can help me with my problem, but what exactly IS my problem?
January 24, 2012 8:15 PM   Subscribe

Is it possible that my social and school issues are related to undiagnosed ASD traits? If so, how do I go about finding the right doctor/ psychiatrist/ psychologist to help me sort it all out?

My personal and professional lives have been increasingly stressing me out over the past year. I had a bad breakup about a year ago which ended with my ex harassing me a lot (see previous question). My ability to cope with various things lately seems to be getting worse and worse and though I mostly chalked it up to the post-breakup fallout, now that it's been a year and things aren't necessarily improving I’ve been wondering whether there’s more to it than that. I’ve always been a little on the anxious side but it seems to be getting worse. I’ve also always had various oddball traits and quirks which I never really gave much consideration to, but recently I’ve been wondering if it’s all more related than I originally thought. (I come from a family where problems tend to be ignored and hidden rather than acknowledged and discussed, so it's possible that even if my mom noticed weird things about me, as long as I was getting good grades she wouldn't have been interested in pursuing the matter.)

Anyway, this was all basically precipitated by a recent shitty experience with a psychiatrist who didn’t seem to understand me very well. I didn’t choose her, she’s the one my school pays for, so that’s who I went to because I thought I might benefit from medication to help with my anxiety. Anyway, she prescribed Celexa and I only took it a few times before I started to feel like it was really not the right thing to do. In particular I was bothered by her constantly asking about and referring to my “depression.” I may have a lot of problems, but I honestly do not feel that I am depressed, and I certainly don’t think I have interacted with her enough for her to have diagnosed me as such (I spent, like, 30 minutes talking to her about my ex-boyfriend and that’s about it.) I wouldn’t have a problem being labeled as depressed if I thought that was the case but deep down I just don’t think that’s what’s affecting me. Anxiety has always been the main thing, along with other inexplicable quirky behavioral stuff that’s getting increasingly hard to cope with. In any case, beyond that I felt like she wasn’t really listening to me, she didn’t do a good job of addressing my concerns or answering my questions, etc. After talking to several of my classmates about it, it seems like she pretty much just prescribes Celexa for everybody and sends them on their way. I decided I didn’t feel comfortable with her treating me, so I stopped taking it (after only a few doses, so no withdrawal or anything.) Of course, I do still have problems that need to be addressed. But I need a better psychiatrist. And I think if I had some idea of what exactly my problem was, I could pick someone who’s better suited to help me. That’s the point of this question, so bear with me!

So. I have lots of weird little habits that I’ve noticed (and been made fun of for) for as long as I can remember. In particular, I am really meticulous in my eating and eat super slowly. I frequently count steps when I walk and go up and down stairs. I’ve also always been really picky about what I can touch and what touches me, I hate getting wet, sensitive to light touch, noises, and bright lights, get motion sickness very easily, etc- since the internet, I now know that this is referred to as sensory disintegration, or specifically sensory defensiveness. I also have that sort of need-for-pressure thing- I used to have to sleep with my feet touching the wall; I always have to be wrapped in a blanket or sheet no matter how hot it is, etc. Though I’ve never talked to any professionals about sensory disorders, there’s no doubt in my mind that I definitely have it at least to some extent. I never bothered seeking help for it because I more or less cope pretty well, I mean, I’ve always been this way so it never seemed that abnormal and I didn’t really feel like changing my behavior. I live with it and it’s fine.

In my reading about it, though, it always seems to come up that these types of sensory problems often occur with autism spectrum disorders. I always just dismissed it because I figured if I had any sort of problem like that, I would know, right? So I hadn’t thought much about it in years. But about a month ago I heard David Finch on NPR- he’s basically this guy who was diagnosed with Asperger syndrome as an adult. Anyway, actually hearing him talk and hearing his story was (aside from being really interesting) . . . how do I put this? It hit a little closer to home than I was expecting, like, a lot of the stuff that bothers him bothers me too. I tried to put it out of my mind (again, if I had such a problem I’d know, right?) But it’s been in the back of my mind nagging me for a month now, especially in the context of all the struggles I’ve been having lately in coping with my daily life. I started reading more about it and a lot of the stuff sounds so familiar. But it’s frustrating, because so many of the things that define ASD traits, I feel could either be true of anyone, or you’d have no way of knowing if they applied to you because they have to do with how you perceive things- how could you know it’s not the way everyone else does? Specifically the social stuff. For example, I’ve always felt a little socially awkward, or weird, and sometimes wonder if things I’ve said are inappropriate- but who doesn’t, right? And how would one really ever know that they were reading people’s signals incorrectly if there was no one pointing it out to you? Etc. I will say I have a hard time sort of figuring out how people feel about me and whether they like me (which often leads to me assuming that people don’t like me) but again I figure that’s pretty normal, right?

Other things are more clear-cut, that is, I know I have other traits that are suggestive. I've always been sort of clumsy and walk into shit a lot, but I'm very manually dexterous- I can draw very well and have been drawing since as long as I can remember. Overall I am significantly more comfortable in things that are visual-spatial than anything else. When I try to explain to people how I know how to draw without being taught, it's just the way I think, it's like I just check out of the verbal part of my consciousness and think in images instead and when you do that it's easy. I also derive a lot of enjoyment from just organizing and processing information that interests me in some way- during my last school break, when I was trying to decide what to do with a week of free time I somehow decided that the most fun thing would be to draw a detailed map of the original Legend of Zelda world. (I mean, I wanted to do it so I could beat the game. But I thought it would be more fun to painstakingly construct the perfect map myself, screen by screen including all details and the correct colors, than to use ones that exist on the internet. I was right.) It was definitely kind of an exercise in mental relief, a recharging experience, like the most appealing thing I could possibly think to spend a week doing. But is all this stuff really suggestive of anything or do I just happen to be a klutz and a huge nerd? How the hell do I tell the difference?

So anyway, I normally wouldn’t be so tied up in thinking about this but one thing in particular hit me really hard. Unfortunately I can’t remember where I read it (I tried to find it again, but to no avail.) But it basically said that people with ASD traits can end up in abusive relationships because of their inability to judge people correctly, or understand their motivations, or something. Ever since breaking up with my abusive ex I’ve been sort of torturing myself over it, as in, how did I let that happen? How did I end up in that terrible situation in the first place? How did I not see him for who he was right away, and when I did figure it out, why did I stay with him so long? The older I get (I’m in my late 20’s) and I see more and more of my peers paired off in seemingly functional relationships with perfectly normal people I wonder how I seem to keep missing the mark in my own relationships. Now that I’m single my dating life has been really quite disastrous, which I’ve chalked up to bad luck but when I really look at it I think I also keep picking the wrong guys and making stupid decisions such as sleeping with them on the first date for reasons I can’t really explain. Anyway, whatever my problem is, I want to fix it. Which is why I’ve finally begun considering that perhaps there’s something more going on than me just being an idiot socially. I’m not an idiot in other things- I do extremely well academically. But . . .

That’s the second part of my problem. As long as it’s textbooks, lectures and exams I can really excel. Well, ok, it's not perfect- I do have a tendency to get distracted and procrastinate a lot, but once I force myself to get down to it I do well. But I’m studying in a clinical discipline and as I get further in the program, I am interacting more and more with people than my books- classmates in groups, professionals in my field, my superiors, and patients. This has been . . . much harder for me than I could have anticipated. I just get extremely anxious, kind of like stage fright, to the point of getting that dread feeling in my stomach and not wanting to leave the house when I know I have to do something that day that involves certain types of interaction with people. (I do go, but it’s just really hard and my performance tends to be less than stellar.) Again, this could just be plain old garden-variety anxiety tripping me up. If I knew for sure this was the case I’d probably give medication another try. But I guess I just want to find a psychiatrist who can gently address my concerns about possible ASD traits and confirm or deny them with confidence so I can move forward with some sort of treatment. Like I said, I do not feel comfortable with my school-appointed psychiatrist, so I really want to find another one who has more knowledge about the stuff I’m concerned about.

So basically my main questions are:
1. For those of you who have experience with ASD stuff, does this seem like a reasonable possibility? I know you are not my psychiatrist, but whoever is will probably not be covered under my insurance, so if the unanimous response is “You’re overreacting and it’s all in your head” then I might rethink my need for it,
2. How do I find the right doctor to help me sort through all this? I’m having some trouble. I tried searching around yesterday but it seemed like the vast majority who specialize in ASD are focused on children/ adolescents/ parents. I want someone who can also help me with my other adult* problems. Specific recommendations in the Chicagoland (city and suburbs) area via MeMail would totally be appreciated. For some reason I feel more comfortable talking to male therapists but I’m open to suggestions. Anyone who knows anything about SPD/ sensory defensiveness might be especially helpful but I figure that's a long shot, information about it generally seems to be pretty sparse.

Please feel free to ask any clarification questions or MeMail me about it. I could probably write 20 more paragraphs to this question but it’s already a mile long, so I tried to whittle it down to the essentials (I’ve been mentally composing this question for like a week now, I apologize for its epic length.)

*specifically, my occasional use of various, er, recreational and otherwise self-medicating substances over the past few years. I actually think they've helped me in some ways, so I don't necessarily want to stop. I like the one that helps to take my overanalyzing-thoughts-racing-at-warp-speed state of mind down to a more calm, serene and manageable state. And I like the other one that helps me feel like I can interact socially without feeling awkward, worried, or misunderstood. But I would like to be able to run it past a professional so I can be sure I'm not overdoing it or underestimating its impact on me.
posted by Argyle_Sock_Puppet to Human Relations (8 answers total) 5 users marked this as a favorite
I can't help you with #2, but for what it's worth, for #1 it sounds to me like ASD is at least a possibility.

The more important question, to my mind, is what getting a diagnosis will do for you that you can't do already. You already know you have all of these traits, and there is no medication or whatever that will treat autism spectrum disorders that I know of. It seems to me that what you kind of want out of this is just to be able to think through how having these traits has impacted your life, and come up with coping mechanisms to dealing with them.

The thing is, you can do this regardless of whether you get an "official" diagnosis or not, or even regardless of whether you have a therapist who specialises in that sort of thing or not. All you really need is someone who listens to you, meets you where you are, and works with you to sort out your issues. That doesn't sound like your current therapist, so I fully endorse trying to find a new one -- but I'm not sure there's a lot you would gain by trying to get someone whose specific knowledge is about autism spectrum disorders. Perhaps I'm missing something, though.
posted by forza at 8:28 PM on January 24, 2012

To some degree, getting a diagnosis of ASD won't change anything since . Second, ASD is a spectrum - one end of the spectrum is well within "normal". (In other words, we all have our quirks - some people have a pattern of quirks that look like mild forms of ASD but don't get a qualify for a diagnosis because it doesn't distrupt their life.) So, you may or may not fit the diagnosis (I don't know enough to tell) but even if you don't, it may help a lot to work with someone who is familiar with ASD. Also, since there is no "cure" or "treatment" that will change ASD, even if you do fit the diagnosis, the work would still be around learning to function better in the world. So working with someone who is experienced with ASD clients may give them insight into what might also help you.

I'll try to come back some ideas on where to find help. In the meanwhile, someone who works mostly adolescents and young adults might be able to give you a lot of new ideas. (hopefully, they would be honest about whether they thought they were a good match for what you need.)
posted by metahawk at 8:35 PM on January 24, 2012 [1 favorite]

Forza - working a therapist who only works with neurotypical clients, can be very frustrating since the client may end up feeling like the therapist just can't relate to the way the client experiences the world.
posted by metahawk at 8:37 PM on January 24, 2012

Metahawk: Fair enough, that's a good point. I suppose I was slightly worried about a converse problem, of the OP being pushed into a box she doesn't quite fit perfectly because that's what the therapist is familiar with.

This is why I thought "good therapist" was more important than "therapist experienced with ASD." But YMMV, etc, and I suppose if you can get a good therapist who knows something about ASD then that is the best of both worlds.
posted by forza at 8:42 PM on January 24, 2012

Response by poster: So to clarify, the reason I want to address this with a knowledgeable psychiatrist is because if it is ruled OUT, and they tell me that they are confident that my problem is just regular, generalized anxiety then I would actually probably want to give medication another shot. But my fear was that if my problems did in fact stem from something ASD-related, that being on an SSRI would just be a bunch of side effects and a waste of money without really addressing the root of my issues. So, yeah, knowing one way or another would affect what sort of treatment I end up pursing.
posted by Argyle_Sock_Puppet at 8:45 PM on January 24, 2012 [2 favorites]

A couple of places to start looking for a compatible therapist:
1. Go to Psychology Today Find a Therapist page and search for Autism + Life Coach in Chicago. (I picked "life coach" since that was an adult-type issue, you can experiment with other ones) There are a number of people who work with autism as just one of their areas of expertise.

2. Check out CASPAN, a Chicago area meet-up for aspies and people (adults) on the spectrum. You might meet people there with a lot of helpful experience to share.

3. Most of the resources on this page are for people with much lower level of functioning but it looks like there are one or two that might be useful.

4. Google "adult asd chicago". Don't be discouraged that most of what comes up doesn't fit. Remember this is a spectrum disorder that goes from full, normal functioning (but "quirky" or "different") to those who are not capable of independent living.
posted by metahawk at 8:52 PM on January 24, 2012

On the sensory processing disorder front: Sharon Heller's Too Loud Too Bright Too Fast Too Tight is both a good overview of how sensory processing disorders feel/present in adults, and contains a lot of useful coping mechanisms. It is possible for sensory issues to look like anxiety, or for dealing with them more proactively to reduce anxiety.

If you do want to focus on the sensory processing issues, I believe there are Occupational Therapists (OTs) who work with these issues in adults. Unfortunately, I can't think of any Chicago-area resources, but I'm sure there are some -- look for OTs rather than other specialists.
posted by pie ninja at 3:54 AM on January 25, 2012

When I first read about Aspergers, I thought I might have it, particularly since some family members do. But when I went to a psychologist I was diagnosed with dyspraxia + ADHD instead.

I guess I was a little disappointed, because I feel like my diagnosis is just one of "generally derpy and awkward" and Aspergers seem to have a real community of people who help each other cope that other disorders don't have. I guess what I'm saying, is that you should try not to get too caught up in the idea that you might have Aspergers until you actually see someone who takes you seriously. But either way, you are going to be better off than with your current person because it sounds like you have something more than just depression and a more creative/innovative psychologist or psychiatrist is going to help you find more ways to cope than just pills. There is no cure for any of these things, but physical therapy and learning coping strategies goes a loooong way.
posted by melissam at 3:42 PM on January 26, 2012

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