Wednesday, July 16, 2008

Invasive questions

Somehow it offends me when an intake form to the dentist office asks me if I have any psychiatric conditions. About the only reason the dentist could care to know is if someone hallucinates during an examination he'll know to keep drilling instead of freak out, call an ambulance, and then have to reschedule the appointment after disturbing everyone in the lobby.

I've been filling out a lot of intake forms recently for different doctors, and they all ask that question or similar ones. Given the amount of prejudice and/or disbelief I can and have invoked by saying the words "Asperger's syndrome" I've mostly fallen into a need to know habit with that particular diagnosis with anyone who knows me personally enough to hurt me. CrouchingOwl is different because my more or less anonymous cyber identity hardly exists without it being associated with the diagnosis, so no reason not to disclose and have one area where I can talk about it as if it were something normal people wouldn't freak out about. Not that I've ever had a medical professional react in those ways, but I've lived and interacted enough in the online "aspies" community to know that one can't guarantee any particular level of professionalism or real knowledge of such a specialized condition from any doctor who doesn't specialize in that area.

So, I continue to agonize on exactly how to honestly fill out such forms. If they ask for psychiatric conditions I have a very easy solution. Asperger's syndrome is psychological, not psychiatric. Psychiatry involves medical health insofar as it can be solved by the dispensing of pharmaceuticals, with a fringe movement where Freud lives on. Asperger's has never been treated successfully with drugs over any broader population than fluke anecdotal accounts. Certain drugs have been used with more or less success to manage the intensity of certain traits such as depressants to lessen obsessive interests, stimulants to do I can't remember what now, and anti depressents for the obscure beneficial side effects they have (which are so broad they are sometimes used as a "brain tune up" drug more than anything) or for, you guessed it, comorbid depression. But those are symptom management, none of them touch the central features of the condition, unlike how anti depressents directly treat depression, anti convulsants directly target seizures, and anti psychotics bulldoze through higher thought processes to leave less room for neurosis. So its not psychiatric.

But some of the forms use the word psychological. For as much as they are planning on looking at the form I could probably leave it blank and nobody would care or notice. Why should I give the doctor a chance to lecture me on what is or is not possible in my volunteered information based on such critical factors such as not walking the right way, having emotions, or being able to make eye contact upon command? Those are all reasons I've known people who have had their primary care giver state as reasons their diagnosis are incorrect.

I'm probably stressing too much about it. What I should probably do is check the box and not write anything in the explanation box and if they ask about it ask in return "Can you tell which condition it is already? No?, then it doesn't matter to what you're doing right now so lets get back on subject."


Anonymous said...


I wouldn't tell a medical practitioner unless it was a psychiatrist or there was a good reason. Unfortunately, most doctors are not at all familiar with Aspergers. They've heard of it, but usually consider it to be like classic Autism.

The dentist may have been wanting to know about psychiatric medications, because one type of antidepressant (MAOI)can react badly with adrenaline in the local anesthetic. But maybe it was just prying or, as you say, just in case someone freaks out.

Rather than just a psychological condition, I'd say it's also a neurological condition. But as you say, it's not a 'psychiatric' condition.

I'm in Sydney, Australia. Unfortunately, it would be very stigmatising to tell anyone I had Aspergers. I've told a few understanding people, as well as psychological professionals. But that's it, sadly.

CrouchingOwl said...

Hello anonymous and welcome to posting on my blog, feel free to do so again. I'm curious how you found it but if you prefer to leave that a mystery thats ok too.

I've never bumped into an assumption it was just like classic autism, but then again you can bump into just about anything so that doesn't really surprise me that you did.