How to diagnose an adult who doesn't remember being a child.

Hello. I am 36 years old. I have suffered with depression and anxieties almost all my adult life.

I was referred to the Asperger's service on the NHS in 2014 after seeing several counsellors and therapists who recommended an assessment for Asperger's. The first to suggest that I might have Asperger's was a private funded counsellor, paid for by the college I was attending.

The NHS services gave me a few short appointments. The first of which was with a nurse, and involved mainly questions about my childhood which I could not answer. The nurse seemed to have an attitude towards me, and said I didn't have Asperger's because I could not answer the questions - so therefore did not meet their criteria.

I then asked for a further assessment with an actual doctor. I took someone with me to the appointment. The doctor seemed to have an attitude towards me and my companion. Virtually all of his questions seemed to be anchoring around a theme which seemed to be - that he must have thought that I was abused or neglected as a child. Again, not many of these questions could be answered and there were almost no questions relating to the symptoms I experience and how they affect my life.

Now, just now in 2018, they have decided not to give me a diagnosis. The doctor said they will just refer me back to psychiatric services and recommend CBT and further assessments. He believes my symptoms are something to do with my personality. However he said that personality disorders are not diagnosed any more. I think it was a personality clash between myself and the doctor. He probably felt like I was wasting his time because I could not answer his questions. I feel that they have wasted years of my life - as I have been waiting for appointments this whole time.

They have refused to give me a second opinion with another doctor and will not give me any more assessment time.

Many people I know believe that I must have Asperger's. When I told some people that I was being assessed, they said that they thought I had Asperger's but never mentioned it before because they either did not wish to offend me or because they assumed I must already know.

When I first learned what Asperger's and Autism is, I did a lot of research. I became able to identify autism in all of the other students at the college, whom I previously thought just had some learning difficulties such as dyslexia. It became clearly obvious to me if someone has autism or not.

With every other illness in the world, the diagnosis is given based on the symptoms. With most illnesses, the doctor isn't even concerned with the cause. For example, if an alcoholic has depression then they diagnose depression and treat depression. They might recommend for the person to stop drinking, but they don't diagnose alcoholism and ignore the depression.

One thing which is not made clear at all, in websites like this and the information available - is that if a person cannot answer questions about their childhood, no matter what symptoms they have, they will be refused a diagnosis for Asperger's autism. This should either be made abundantly clear, or it should be changed. The assessment criteria for an adult should depend on the symptoms alone and not the cause.

There is no cure for Asperger's, yet they will try to cure me with CBT and give me other assessments which produce negative results.

What am I supposed to do if I cannot answer questions about my childhood?

Parents Reply
  • it is true because of the way they strictly follow a set of criteria for the assessment process.

    I'm not sure what you're saying here. Did the psychiatrist you saw 'strictly follow a set of criteria'? It sounded like they didn't, and were testing against their own personal criteria. Diagnostic methods vary a lot in practice. Here's the NICE guidance: (see 1.2.5 in particular)

    They are happy enough to run on the "say so" of a nurse. Since that is the case, yes any psychiatrist or psychologist can do the assessment.

    A nurse could be trained to carry out an assessment such as ADOS-2 as well as screening. My point, in case it wasn't clear, was that not all psychiatrists and psychologists are 'professionals who are trained and competent' in autism.

    I think it's right that a questionnaire can not be seen as a conclusively negative or positive result. Probably my self-appraisal of my communication skills is higher than reality. So the NICE guideline seems fair.

    I didn't say that they are. I said most people left in computer science have some form of ASD (after the majority of people drop out).

    Sorry for any anti-newbie prejudice. I really don't know how much you know and how much is obvious. I've been reading around the subject for a couple of years and thought could give a perspective.