What should I do next?

By Dr. Marie Hartwell-Walker

Q: Between now and my junior year of high school, I have seen a total of five doctors (therapists/psychologists). In 2005, I began treatment for depression which did not work. In 2007, I resumed the same treatment (Lexapro for depression) which seems to have taken the edge off my “dark moments”, I sleep less than 14 hours/day now, and I can concentrate ever so slightly better. Despite all this, time still has a way of slipping by me and I can never seem to complete anything as planned.

My problem is I don’t think that I just have depression. I may be experiencing symptoms of Asperger’s Syndrome (my chief concern) and bipolar disorder. For as long as I can remember, I have never had just one feeling at once and I was known for my rapidly shifting moods. As far as the Asperger’s Syndrome, I first began to suspect this when I was 14. From childhood to now, I convey all the key traits according to the DSM-IV but, despite this, my last doctor was unwilling to pursue a diagnosis. The comment I most often receive from doctors, and others in general, is that I appear to have everything together but I know in my heart that I am a total mess and I fear for myself and my future. In my freshman year of college, I decided that if none of these problems get better I would kill myself by the age of 40.

In addition to seeking help, I have completed an exorbitant amount of research pertaining to my issues. Aside from the symptoms, I have also experienced the characteristic misdiagnoses of female AS patients: potential personality disorder, ADHD, potentially bipolar. I would hate to suffer through the embarassment of a sixth doctor. Also, I’m not sure if I have any psychopathological issues at all. I’m very confused. Should I contact a psychiatrist just to make sure? If so, should I be as direct with them as I am with you? Should I bring my research to the session? One of my fears when talking about my issue is that I’ll sound like I want the disease.

A: I think that the reason you’re not getting to the bottom of this is not that you are seeing too many doctors. It’s that you aren’t sticking with any doctor long enough to get a proper assessment and treatment. By all means, either go back to the doctor you liked best or find a new one. But this time, plan to work with your doctor for at least a year. It sounds like whatever is going on with you is complicated. It will probably take more than a few visits to make a good diagnosis and to try out some treatment options before hitting on the right one. For optimal results you need to forge a partnership with your doctor. Yes, bring your research with you (along with this correspondence). The doctor may also want to have you see a psychologist or some psychological testing to get further data.

I don’t have enough information to offer an opinion about an Aspergers diagnosis. But I can tell you this: Having Aspergers doesn’t have to mean having a life that is a “total mess.” Aspies can be as emotionally healthy as anyone else.

I wish you well,
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 2 Dec 2008

APA Reference
Hartwell-Walker, D. (2008). What should I do next?. Psych Central. Retrieved on September 30, 2014, from http://psychcentral.com/ask-the-therapist/2008/12/02/what-should-i-do-next/