aspergers and personality disorder

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"suffer from depression and had a challenging upbringing and was diagnosed with personality disorder 3 and half years ago, recently i was assessed by the personality disorder people to say I had aspergers traits although they wont/cant give me a proper diagnosis."

If they can specify a set of traits to which yours belong, then they MUST diagnose for that category. There is no single trait that is, in and of itself, autistic; it is, rather, the collection of traits that co-occurs that gets the descriptor of autistic. When clinicians use the term 'X traits/features/etc', they are essentially committing fraud by trying to identify a diagnosable set of traits without diagnosing them for what they are. If a set of traits can be identified as belonging to a category X, then the category X must be diagnosed.
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"I was told that people with aspergers should not have psychotherapy , in fact it was dangerous."

Whoever told you this was destructively wrong.

Psychotherapy can be aimed at helping to overcome, for example, the tendency to cognitive-behavioural inflexibility we have, without it altering the fact that one is autistic: the therapy provides a work-around, rather than eliminating the tendency to such rigidity of thought and behaviour. There is a massive difference between the two. And, since the tendency to rigidity in thinking is definitely a harmful thing in life (to anybody, not just autistic people), then learning work-arounds is very much a good thing that will help with mental health problems that are based on that way of thinking and behaving.
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"I was bullied for the first 2 and half years of group therapy by 2 women, the staff didnt believe me, even though some of it was going on in front of them.  It was only when these two unpleasant women left that other members of the group spoke out as they were scared of being bullied themselves."

This should never happen. If they were staff, then this should have been a disciplinary matter. If they were group member - then this should have triggered a letter to their referral agent, informing of their inappropriateness for the group.
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David N. Andrews M. Ed., C. P. S. E.
- psychologist (teaching, learning & development)/
- psycho-educational consultant
- autistic adult

I have no advocacy or support on this other than little bits I can cobble together from online forums etc and other autistics.

I initially got told I had complex behavioural disorder when I first asked about ASD, they keep trying to obfuscate it with my time in care (it also affected me greatly but I believe this is a co consideration rather than the consideration) Their rationale was we see autistics every day we solely deal with autistics so you are not autistic.

But with further knowledge I just gleaned within 20 minutes on here and in reference to your paper/journals you posted. I found it usefull to send those along to the "assesors" the meeting I had yesterday was actually meant to discuss why I thought their assessment was flawed previously but turns out they asked me questions liek how sad I was feeling then made a Dx on that. They also asked me if I had anythign else to add I had loads they just never asked me properly or specifically.

We nearly had a huge row over the word memorialised  and stated I get frustrated when I am just using normal words and they are ignorant and try to make me feel stupid becaus ethey do not understand.

If you want to chat about shared experience please reply

off topic and shortened, but: i met someone who met someone whom i also met: who was doing a maths PhD at Cambridge but was repeatedly raped because she didn't know she could say no to someone if she didn't like what they were doing or didn't know them. Which, as far as the disjuncture between IQ and common sense goes, is as extreme as it gets (she was nearly 30). She also got in a car with a man who said, 'do you want to go for a ride?' but she jumped out that time. Person 1 in this story persuaded her to stop being raped is how i know it...

Hi Aspie's Mum,

I am sorry to hear that you and your daughter are going through this difficult time. I hurts me when I look back and can now see how much my mental health problems as a teenager hurt my parents. I wasn't able to understand this at the time. Understanding others emotions doesn't come easily to us on the autistic spectrum but we can learn it. I may not realise I am hurting people at the time, but when I find out I wish I could take it back. Be patient with your daughter. She needs you and loves you.

I am very fustrated at how much the diagnositic label you carry around determines the type of help availible. I belive lables (when they are correct) are helpful, but there are too many assumptions made about which types of help are suitable for a particular diagnosis. For example, I have come up against the 'you have ASD and therefore will not be able to benefit from psychotherapy' issue. I believe I have in the past and could continue to benefit from therapy. I know a lot of people on the autistic spectrum and the variation in their personalities and difficulties is huge.

I agree that most psychitrists do not understand Aspergers and the significance of the Aspergers diagnosis is often underecognised by mental health proffesionals.

I was diagnosed with AS as a child. I recently recieved the diagnosis of Emotionally Unstable Personality Disorder after a period in hospital. The psychiatrist that diagnosed me only met me once and I felt that it was a case of 'you don't neatly fit into any other catorgory so i'll go with personality disorder' I am in the process of contesting this diagnosis

I belive that the 'emotial instability' I experience is primarily a result of Aspergers not PD. When I am in a comfortable situation and not under stress I am very articulate and can display reasonably good social behavoir (i.e i'm not noticably 'autistic') However, when I become stressed, sensorily overloaded, or experience a sudden change in routine/ unexpected social pressure it is af it I suddenly become 'more autistic'. At these times my language ability declines, I have trouble understanding complex information, I resort to repetitive behavoirs to help calm me down and become more 'emotionaly unstable'. Under exteme stress this can lead to a complete meltdown and at these times I may self harm, behave in an unaceptable way or put myself in danger in other ways.

I think it is this contrast between being very 'high functioning' social and emotionally one minute, and then behaving like someone with 'severe autism' the next is the aspect of my difficulties that most people, including myself, find the hardest to understand. I think it is becasue of this that I have picked up the 'emotionally unstable' personality disorder lable. I think the psychiatrist sees these rapid changes in behavoir of being a sign of an underlying mental health issue like PD, but I see it as being a fundemental characteristic of being on the autisic spectrum.

Everyone I know on the autistic spectrum experices increased reaction to stress in this way to some degree. This inconsistancy in my behavoir troubles me greatly. I have been acused by some of 'putting it on' when I am distressed. People can't get their head round it. Do you think your daughter's self harm/episodes of distress are related to her Asperger's issues? What is your take on it?

I personally found speaking with a psychiatrist with a specialism in Autism very helpful (I found it personally helpful, however the other professionals involved dissmissed most of what she said/advised) I don't know whether there is someone like this in your area. If there is, push for an appointment with them.

She didn't say that it was impossible for someone to have both ASD and PD but she said that lots of the PD symptoms could be explained by ASD. She explained that she doesn't tend to use the term 'Aspergers' as she thinks that it can be unhelpful to see people with 'aspergers' as having 'a mild form of autism' as this can undermine the difficulties that people diagnosed with aspergers can have. She explained that she sees all people with ASD as having 'autism' and that people with 'autism' can lie on a spectrum ranging from mild difficulties to severe difficulties and that an individual can move up and down that spectrum depending on their experiences and situations. Some people with autism have a learning disability and some do not. This may sound like pendantics but I think it is a helpful way of looking at it personally. I means that it is possible to be very intellegent but severly autistic and that someone can have have a learning disability with mild autism. Or be somewhere in the middle.

This was helpful to me because I have behavioural and emotional challanges that most professionals feel are 'too autistic/dysfunctional' for someone with an IQ as high as mine. They think that because I have a high IQ I can only be 'at the mild end of the spectrum/aspergers' and therefore my emotinal reactions are too extreme to be because of my ASD .... and therefore it must be a personality disorder. Having a high IQ has also meant I have learnt to mask some of my symptoms and learn social skills by copying other and this can mask the true extent of my difficulties.

I also found it helpful that the ASD psychiatrist explained that it is common for people like me to become 'more autisic' in stressful situations. She also explained that ASD presents differently in females and that most professionals don't get this. Females are better at copying others' social behavoir and tend to be more motivated to 'fit in' than boys with ASD and that this can also mask the difficulties caused by ASD.

The last useful thing I got from my meeting with the specialist ASD psychiatirist was that she explained that ASD is not a purely psychological illess but that people on the spectrum have many neurological and physiological differences too. The brain is wired differently, there are differences in neurotrasmitters, there are changes in the immune system and sensory systems and they are increasingly finding more and more links between ASD and physiology. She exlplaiend that psychiatry tends to view ASD as a purely behavoiral disorder and this means they only have half the picture.

I hope some of this is helpful, please let me know if I can answer any other questions.

Best Wishes

Thank you IntenseWorld. Interesting articles. Clearly the two disorders overlap significantly. I would still appreciate some guidance as to where I should seek help.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416662/ "Finally people with AS/HFA, in clinical practice, could meet criteria also for a personality disorder such as paranoid, schizoid [64] and schizotypical personality disorders [65]. However these conditions are usually first diagnosed in adolescence or adult life and cannot be diagnosed in the context of an ASD disorders."

I have been searching for anyone with the dual diagnosis of emotionally unstable personality disorder and Asperger's, as this is my daughter's situation. She is 17 and began self harm a few years ago, progressing to running off and placing herself in dangerous situations. She was hospitalised under Section 3 of the Mental Health Act last summer and this is when both conditions were diagnosed. She was home for a couple of months towards the end of last year but is now back in hospital. When the ASD was dignosed I hoped it may be the key to helping her, but it seems to have been pretty much ignored so far.

Wheelz - I feel my daughter's unstable behaviour may be the result of her ASD and so I am really interested in your situation and in what the ASD psychiatrist told you.

Can anyone suggest any route I can take to get better help? I am desperate to have my gorgeous, funny, loving daughter back.

I can uderstand your fustration in many ways. I am feeling a little overwhealmed by other people's opionons about the correct diagnosis for me. I also feel that my psychiatrist doesn't understnad Aspergers at all. The fact you were bullied in therapy is appalling. I am sorry that that happened to you. people are always telling me that becasue I have aspergers I don't have empathy/ understand others feelings but I do actually care about other people and I know that would not be a nice thing to happen.

Can I ask what problems you have with your mental health?

I have a diagnosis of Aspergers (diagnosed as a child) and I have stryuggled since childhood with social skills, mangaing my emotions and other behavoiral issues like needing a lot of routines.

I have also had other mental health problems since I was a teenager including depression, self harm and episodes of psychosis. I have recently been diagnosed with emotionaly unstable personality disorder (BPD). I disagree for the following reasons

- My difficulties are not contant. I have times when I get depressed then I develop psychotic symptoms, then I get medication and get better and the depression and psychosis go away. I feel if this was a personality disorder it would be more constnat.

- I feel my problems with relationships and controlling my emotions are explainable by my aspergers and when I have had help with learning about social skills/ emotions ect I have got better

- I was abused as a child and I think this was a cause of the depression. I feel that becasue of my history they are just assuming personality disorder

- I previously saw a specialist ASD psychiatrist and she told me that autistic people are more prone to psychotic like experiences when they are emotionally distrested than other people.

I think it is a strange assumption that therapy can't help people with aspergers as all people with aspergers are different. I feel that the personality disorder diagnosis is like they are saying 'you don't have a real illness, it's just your personality'

thanks, I just feel very alone with it all.  Unfortunately I think the psychiatrist thought the big bang theory comment would be helpful.  I had never watched it and went home and watched an episode, it filled me with dismay. 

I have had quite a disturbed childhood and in my mind I cant see why my past cant affect me just as much as if I didnt have aspergers. I think I may respond differently.

thanks for your replies

I think this example you gave of being bullied in front of the staff in the group therapy is a classic example of how once people know you have Asperger's they automatically assume you can't think normally and they are either blaming you or disbelieving you.  It's shameful.

Hi I really can't help you I wish I could. But I would just like to say that your comment on the idea of Aspergers is Sheldon in The Big Bang Theory. Which I have had from a family member about my own son. Which they find quite funny and don't understand. I hope that someone out there helps you

If you are female, the statistics show that there is a high likelihood of you having been misdiagnosed.  Common misdiagnoses of Asperger's women are BPD, social anxiety, generalised anxiety, OCD, ADHD, schizotypal personality disorder, schizoid personality disorder, etc.

I personally find psychiatrists often arrogant and looking for stereotypical autism symptoms and sadly underexperienced in female presentation.

You could look at my stickied thread about assessment in adults and then approach your GP for a referral for an ASC assessment specifically/second opinion.

It is vital that any clinician does not focus on childhood trauma as a sole reason for behaviours.  Many people on the spectrum suffer childhood trauma because of being on the spectrum.