Another diagnosis . . . just what we need

Yawwwwwn. That was my reaction when Dr. Whoever, one of the ones in charge of my son when he did a week of day treatment in the psych department of a nearby children's hospital, told me he suspected my son might be somewhere on the autism spectrum. I didn't even go there with him, not really. For one thing, every kid and his dog is getting diagnosed autistic spectrum these days, and for another, it didn't ring true. Finally, I just didn't have the mental space to deal with yet another disorder. Bipolar, ADHD, yada yada, that's enough for now, thanks. I'll let ya know if we ever need any MORE letters.

One thing I know about autism is that it's a communication problem, and my son doesn't, on the surface, seem to have one. He's very verbal, and in the right circumstances, communicates extremely well, is very interested in what others have to say, can reciprocate in conversation, can be genuinely sweet and affectionate. When things are stable and he's in the right environment, he's an awesome kid, and you'd never dream there was anything wrong with him. Of course, if something rocks his boat, watch out. Oh, well, all these brain systems and disorders are related and overlapping, anyway. He has symptoms of just about all of these disorders, and serious enough to cause impairment.

So his psychiatrist, his regular one, tells me today she thinks he's on the autism spectrum, Asperger's. His bizarre thoughts and so forth, she attributes to having too intense an inner world and being unable to successfully navigate between that world and the regular world. She says he doesn't communicate on a deep emotional level with people. Okay, I don't get that part, though the crazily vivid imagination and obsession with certain things -- police and cars -- makes sense. When we get to Kennedy-Krieger in Baltimore, she wants him to be assessed formally for Asperger's. She says the outcome, expectations, etc., are different than those for other disorders. She didn't say he doesn't have Bipolar, exactly, just that there are other things going on, as well.

This is what I know: The SSRI is working, well. His stimulant works. Lithium made him fat and after a while, didn't seem to be doing a damn thing else. Risperdal seems to help some with the aggression, but doesn't make a huge difference in him. Therapy has never, never been able to improve or change his behavior in any way.

Now that the anxiety and behavior problems and aggression, the worst of them, have been helped some by Zoloft (though not eliminated), the weirdo stuff is what remains--the bizarre things he says, the weirdness in his head, the silly-violent, crazy ideas that are still around. The intense and constant need for emotional reassurance, the constant "You don't love me" stuff.
He's been cursing more, talking about body parts more, talking more negatively about himself. But she says he's not psychotic, just needs to learn how to manage his emotions.

I don't know what to think anymore. I'm just really thankful for that little green pill. If we up the Risperdal and the weird ideas don't want to go away, does that mean it's not psycho stuff, but his Asperger's? That's what she says.

Damned if I can sort it all out. Truth is, a while back she thought he had Tourette's. Well, he did have tics, but they were stimulant-caused, and now they're gone. ADHD, Bipolar, Tourette's, ODD. What else can you come up with? Okay, autistic spectrum. Might as well throw that out there, too. Oh, yeah, she also thought he was playing me with SOME of the weirdo talk and stuff, pushing my buttons for attention. Whatever. Sometimes, he's just off his rocker.