Published on 12, July, 2020
Hi everyone, this is my first post and I'm coming from a place of asking for some advice, if possible! I apologise in advance for the tremendous long post.
I'm an AFAB in her 30s, struggled a lot since I'm around 13 and I have been now in therapy for around 7 years.
Around a year ago, despite trying to really work on myself through therapy and really taking it at heart, frustrated by the usual cyclical breakdowns that seem to happen every few months, I started formulating the idea I might be neurodivergent. With research, things started to make a bit more of sense and I, as it happens, started a rabbit hole of research about autism and adhd, done all the online screenings online multiple times, and so one..
The tricky part is that I have been diagnosed bipolar at 18, depression with borderline traits at 22, and finally BPD a few years after. Mind you, thinking back I believe those diagnosis weren't done in a very effective way and definitely not in an a differential manner. And I also believe that I don't really fully fit the criteria anymore of any of those!
My therapist is of the school of thoughts that it doesn't really matter what diagnosis I have and that we can work together in any case, which has been incredibly helpful, especially as I tend to wrap myself into the stigma around them and, well, I have received a few by now... This leaves me in a very tricky place as partially I worry I'm wrapping my head around the autism diagnosis (even though it somehow feels different than the other ones I've received) and I also feel I can't really bring it up in therapy as it might look like a "distraction" from the therapeutic work.
On the other hand, I'm terrified of following this up with GPs as, first, I get really anxious talking to them, second, I am not sure that the assessment offered will actually be differential (given my history with them), third, I am worried of just receiving another one to add to the list that won't make any difference at all. Plus, I'm in the middle of one of my breakdowns right now which is making these kind of anxiety provoking tasks very hard to follow through.
I also have other people in my life that really feel I should prioritise the diagnosis just to get rid of the doubt, so that I can finally prioritise either trauma work or making accommodations and seeking the right kind of help.
Amidst all of this, I'm stuck in a cycle of overthinking and nothing gets decided... I thought of asking here as maybe neurodivergent people might have some insight in what's the best course of action as I don't have anyone irl I can ask an opinion to and also.. Maybe someone can relate?
Thank you very much even just for reading!
MaxL said:it doesn't really matter what diagnosis I have
Maybe for some conditions I guess this would be true, however for neurodiversity you're talking the way people's brains are wired, that is a physical thing. Like any physical system it is important to get the right diagnosis. Heart attack or indigestion...
MaxL said:been now in therapy for around 7 years
That must be hard. Do you feel you are making progress with things? Do you have goals for what you are talking through? Is the person helping you? Does your therapist know anything about autism or neurodiversity? Can you ask them to do some research to support you with this? Most people, even therapists, are happy to learn new things, every day is a school day! And it might help you both figure things out. Give them some homework! Particularly since you say you notice the possibility of autism diagnosis feels different. Trust your instincts.
MaxL said:I'm terrified of following this up with GPs
I get this, it is hard getting in touch with GPs these days, and they need the patient to be an expert in their condition so that they can just refer you to the correct place. When I asked for diagnosis, I told him what research I'd done, what uni had suggested, what happened to me at work, how I felt I fitted the criteria (I wrote it down), and he made the referral. I was lucky I ultimately got sent to an autism charity (via mental health) for diagnosis so picking it up in a 51 years' masking female was no issue to them, where it might have been for the over-stretched community mental health team.
It would also be worth asking how you get those potentially incorrect diagnoses reviewed, I don't know if that's psychology, psychiatry or mental health.... but more is known now about all of those conditions that you mention, than was available when you were diagnosed, so it is reasonable to have them reviewed. For many years I had a diagnosis of one thing, but when I met a new GP and she took a full history she was concerned something was missed and she sent me to genetics who finally diagnosed the physical thing correctly. Sometimes that step of going over all of it to someone new is really helpful.
I think my 'conclusion' is that I have no advice for you, just a few things to help you think about things in a different way.
Hi Fiona, thank you for the reply, very much appreciated :) I'm going to respond now, technical issues seems resolved!
Fiona said:That must be hard. Do you feel you are making progress with things? Do you have goals for what you are talking through? Is the person helping you? Does your therapist know anything about autism or neurodiversity? Can you ask them to do some research to support you with this? Most people, even therapists, are happy to learn new things, every day is a school day! And it might help you both figure things out. Give them some homework! Particularly since you say you notice the possibility of autism diagnosis feels different. Trust your instincts.
My therapy has been overall incredibly helpful, I think especially in terms of some of the things that felt a bit more trauma/bpd related. I used to be quite an impulsive person for certain things, which I am not that much anymore, I can now better realise when I'm idealising or totalising people/things/memories and I can work through it myself. Also, fear of being alone is almost totally gone, I have discovered through the years how much I love solitude and this has been life changing. But it almost feels like this has freed some space for other things to come up, just to mention one, sensory issues, which started being very much "in my face"! Also, notably, I go through these periods where I feel very "levelled" and I start taking on more and more things and then end up crashing after a few months.. So I've started telling my therapist I think these things I'm realising now could be potentially related to neurodivergence, I've tried bringing it up many times with her but she seems to always bring them back to my previous issues. I don't think she's unfortunately that interested in looking it up as I have the impression she might be of a psychoanalytic school which is not that much interested in neurodivergence as I've encountered it through research/podcasts/youtube, so sometimes it feels like I'm hitting a wall. One of the things that I find confusing is, for example, how we talk about overthinking, and how it feels like the only way for me to stop is to be fully engrossed in something - sometimes she tells me I need to put a limit to my thinking and I literally can't even imagine how that would work...
I don't want to just change therapist without proper consideration though, because I am sure that there are some points where we find an agreement and because, with or without autism/adhd, I've piled up a lot of trauma and that's for sure something that we can work on. I'm just not sure if not being able to talk about it with her is helping with the imposter syndrome of it all.
Fiona said:When I asked for diagnosis, I told him what research I'd done, what uni had suggested, what happened to me at work, how I felt I fitted the criteria (I wrote it down), and he made the referral. I was lucky I ultimately got sent to an autism charity (via mental health) for diagnosis so picking it up in a 51 years' masking female
This is very helpful and reassuring, thank you! Maybe one step I could take next is actually writing everything down clearly, instead of just having it all circulating it in my head at all time. But I'm very glad that even with masking there are people out there that will be able to make a proper assessment!
Fiona said:It would also be worth asking how you get those potentially incorrect diagnoses reviewed, I don't know if that's psychology, psychiatry or mental health....
This is something I feel even more afraid to do, just because I have been through the process so many times before, I've been given loads of unhelpful medication in the past, some with very serious consequences, and everytime it has been extremely stressful to re-tell my story, having it labelled, and so on... But I do think maybe at some point it will have to be done.
Thank you so much again, this has been very insightful, and apologies if my reply is once again very lenghty!