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Will a Psychiatrist Help with My Autistic Personality?

From the U.S.: I’ve been diagnosed with GAD. My past includes one episode of Major Depression. I have had anxiety as far back as my memory serves, into early childhood. I’ve also been court ordered , around twenty five years previously , to attend anger management counseling.

There were no labels when I was a kid concerning Asperger or ASD . We were all thrown in to the mix , sink or swim. I had trouble with speech at a minor level and had corrective therapy. Discipline was always an issue. I did have friends but very few . Dating was more like engagement and codependency .

I enjoyed being alone, but the older I’ve become the more I feel I have to be isolated. I have no friends. All my contacts outside of work are family. I don’t like engaging anyone I don’t know for more than a few words. I like my routine and I don’t care for it being changed.

Changes tend to excite my anxiety, sometimes greatly. My wife handles the business ends of our marriage because I can get confused easily with certain things, typically when paperwork is involved. I do not deal well with stressors at all. This has amplified as I’ve gotten older, especially with my job.

Anger was and still is, infrequently now, an issue that sometimes comes from unidentifiable origins and many times without warning. I sometimes spend an entire day angry without knowing why. I’ve taken every test I can online for Aspergers/ASD and I scored positive for every one. I’ve taken some of them numerous times and my scores always are within a few points. My Empathy Quotient is a six .

Is there a good reason to go to a Psychiatric specialist to address this probable ASD label ? I have a job, function somewhat reasonably well, am married and already take Wellbutrin and have Xanax as a backup at work. I’m not sure the medications help enough with the panic feelings I get and I’m afraid to indulge in the Xanax unless I really feel overwhelmed or recognize my anger coming to the surface and can’t remove myself form the situation .

I’m not expecting a cure for the anxiety. In fact, after taking these test and knowing my personality, I’ve felt some relief that I may have Autism. It helps explain a great deal about how my life has been and still is today.

A: You seem to be functioning very well. You are married, have a job and can interact with family and coworkers. None the less, you wrote to us because you understand that your need for routine and your tendency to isolate from others may be excessive. I therefore do think it would be helpful for you to see a psychologist or social worker who specializes in adults on the spectrum. Many people who are diagnosed late in life as being on the autism spectrum experience great relief, for the same reasons you mentioned. It often explains much. A good evaluation can also lead to good suggestions for next steps for becoming more in charge of your feelings and more able to handle things you currently find difficult to manage.

ASD cannot be medicated away. But medication might be helpful for lessening your anxiety. Psychotherapy can help you learn more ways to manage in a world that is sometimes confusing or anxiety provoking for you. For example, the anger you describe may be at least partly because it is hard for you to deal with frustration or change. Therapy may give you more tools for coping with situations where things are unpredictable or when things don’t go as you expected.

You didn’t mention who is prescribing your medications. If the doctor is your PCP, I do think you should see a psychiatrist who has experience with ASD. Your medication probably needs to be re-evaluated in light of the ASD diagnosis.

I also encourage you to look for books on adults with Asperger’s or Autism, especially books that talk about managing a later in life diagnosis. I regularly recommend the books written by John Elder Robison to my patients. I think you would find such books encouraging and helpful.

I wish you well.
Dr. Marie

from Ask the Therapist

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