You can't have mood problems because you have ASD?
firemonkey
Citizen
in General ASD
My current pdoc is the best one I've had, but far from perfect.
October 2019: DX changed from schizophrenia to schizoaffective due to further exploration indicating a past history of both low and high mood in the context of concurrent psychotic symptoms.
October 2020. No mention of high mood. **In the context of a dx of autism spectrum disorder **and depression being mild in the past, dx changed back to schizophrenia.
Mild depression = several sets of ECT? On MAOI for a while ?
Comments
ASD has many comormidities,likely most people with ASD have some mood issues
who said this?
You are saying there was no mention of mood was made is the context of the autism spectrum report?
Psychiatrists are very rigid in using their models by design. if it is not in the criteria they don't want to confuse it with something else, so they have exclusion check-lists. It is somewhat arbitrary, but is a sort of standard.
I don't think it is necessarily them saying there is no mood disorders connected to ASD, instead:
a. They treat them as separate things but co-morbid.
b. they are not really committing to saying x is because of y, even if common
c. these are conditions that exist generally in the population.
d. they are working to set criteria, so weren't testing for that, or the test necessitated it be factored out for the test to work.
Taken from letters re my last two psych appointments.
Depression is common in ASD doctors must know that.
I think it's a problematic/weak area for psychiatrists & psychologists.
I suppose this carries on the theme of people with autism being emotionless robots. sigh.
I was treated for depression 20 years before my ASD diagnosis. At the time it was considered to be 'endogenous depression' as the GP couldn't easily identify any other reason. As I look back I can relate it directly to ASD.
It does seem like that. The highs and lows were downgraded to just mild depression . I've never known ECT being given for 'mild' depression. Nor for that matter MAOI. He's better than the other pdocs I've had, in that he took my mention of autism seriously, but he loses a few points over this.
Did he say that you can't have mood problems?
Are this Dx mutually exclusive? Not really understanding. it is is odd than he marks your depression as mild in the past, if it was moderate/severe. I don't know if this is misinterpretation of your history or what.
Why don't don't query him on it?
I know other people who have both dxes,so the combination is possible. I think he's taken the combination of ASD + what he's interpreted as mild depression to arrive at a conclusion that schizoaffective doesn't fit .
It seems to be based on how I'm doing now on regular medication ,which isn't the same as when I was missing a lot of doses( the reason I was switched to depot).
This was how I described my mood state pre regular meds- Most probably mixed- Predominantly dysphoric. Anxiety,irritability,inner tension,busy mind,edgy,depression,contentious,impatient, .
https://www.verywellmind.com/schizophrenia-versus-schizoaffective-disorder-2953129
Hmm...
With all psychiatric conditions diagnosis is an exercise in modelling.
To me this seem more like a problems with the approach to modelling. He is trying to fit schizophrenia with everything else it hasn't worked. He simply got the diagnosis wrong.
You could argue that the distinction between Schizoaffective and Schizophrenia is pretty arbitrary and they should diagnose mood disorder in their own right. Though the onset and pattern might be the reason why they model this way.
Bipolar has it own in some cases psychosis but has a different pattern an frequency, but you can be either just depressive or bipolar with Schizoaffective
This is all about which direction they aprach the diagnostics.
This not a hard science, and I think there is a valid criticism of the modern approach to psychiatry given it is so standardised often without enough efficacy.
Possible motivations:
1. perception and awareness of the disorder for services
2. funding available.
3. rigid thinking about model
4. the models map prevalence and average percentiles. So their is tenancy towards a presentation.
We know that children can be diagnosed with Schizophrenia but it is less typical.
I don;'t think this is about whether ASD excludes the possibility of mood disorder, becuase there is nothing to support that in the diagnostic manual.
It is more that mood disorder are excluded from Schizophrenia necessitating a separate condition called Schizoaffective.
There are so many possibilities as to why they did that, I might be treatment related.
I think the guy is running himself in circle trying to make things fit, which not a good thing. I would simply ask him what is his logic, and if he may be mistaken.
Of the magnitude of reasons why condition are split into multiple conditions when they edit the manuals, the most dubious is simply to make it easier for them to manage and tell thing apart.
I suspect that is part of the reason why.
Schizophrenia has chronic persistent psychotic symptoms. Schizoaffective persistent psychotic symptoms are more episodic.
As bipolar and can have psychotic episodes it blend into that, but it is not necessarily consitient enough to be episodic.
So the major distinction is the chronic part.
The modelling doesn't allow for an in-between.
They would have atypical-Schizophrenia or atypical-Schizoaffective or some third option.
Perhaps a second opinion or mental health advocate to look into this would be a way forward.
Symptoms: Late teens
Hallucinations: Functional,olfactory(rarely),auditory(rarely)
Delusions: Yes
Flat effect pre meds: blunted response sometimes to positive stimuli; heightened response to negative stimuli
Flat effect with meds: Emotionally flat
Episodic according to pdoc (which fits with my history)
In that case you are probably Schizoaffective
(not a diagnosis)