![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 8 to 32 of 89. Go back in thread:
Posted by jimmygold70 on December 27, 2006, at 17:15:48
In reply to Re: Jimmy and Others Re: Last Night's Post » becksA, posted by Quintal on December 27, 2006, at 12:24:14
Many symptoms of many people do resemble those of Asperger's, and it's very easy to think you have Asperger's when you read the stories - but that's the trick. Some aspect of Asperger'a simply can't be described in those stories. It's something you can only see, it's a matter of severity but very hard to describe. So go and look at a group of Asperger's (I've visited treatment centers several times) to understand that difference. A diagnosis is more than a group of symptoms; it has a deep and complicated essence.
What is frequently described as Asperger's is more frequently some manifestation of a personality disorder - be it schizoid, schizotypal, paranoid, etc... If you can put your hand on some PD diagnosis tool (say MCMI) you'll understand what I'm talking about. I have NPD and NPD is beyond 'malignant self love' (wrong) - lots of anxiety, confusion, hard to verbalize in social settings, mood changes, hard to display one's persona (e.g. smile) - all that shi*t. You will not find those symptoms in the DSM because none of them in particular characterizes NPD: these are peripheral symptoms, but on the other hand, you will see them in many NPDs, especially those with unstable mood (bipolar II and the like).
Look at all the classic NPD symptoms and see how helpful Zyprexa is in that state. I don't say it's a great therapy (have gained 50 pounds in half a year despite diet and exercise!), but it works. Incidentally, it works for the comorbid anxiety symptoms too.
So I find the diagnosis of Narcissistic Personality Disorder (or style), which is VERY prevalent, with comorbid unstable affect, as one of the hardest to treat psychiatric conditions. Let's pick a name for that - "Syndrome Y" (-:
What do you people think?
J
Posted by Phillipa on December 27, 2006, at 18:02:07
In reply to Why not say NPD?, posted by jimmygold70 on December 27, 2006, at 17:15:48
I know one of our babblers had mild Aspergers and was very talented. Love Phillipa
Posted by Quintal on December 27, 2006, at 20:10:56
In reply to Why not say NPD?, posted by jimmygold70 on December 27, 2006, at 17:15:48
According to my last pdoc there is often a biological basis to the personality disorders. Asperger's Syndrome could be described as you say as NPD, jimmygold70 syndrome, or whatever you choose to call it. I bet you also fit the bill for several other personality disorders? That's the reason my pdoc doesn't use those diagnoses. It can be equally easy to think you have any other personality disorder and be mistaken.
Narcissists don't often have trouble putting themselves first and displaying their persona - that's the hallmark of narcissism. If most of your problems are of that nature then the diagnosis of NPD seems dubious. There seems to be a tendency among some people (including psychologists) to say that shyness is narcissism - that shy people hold themselves aloof out of a belief that they are superior to other people, when in fact the opposite is usually true - they feel inferior and fear bullying and judgement, 'negative evaluation'.
>What is frequently described as Asperger's is more frequently some manifestation of a personality disorder - be it schizoid, schizotypal, paranoid, etc...
How do you know the opposite isn't true - what is commonly described as a personality disorder is not Asperger's Syndrome? It's often arbitrary.
>I have NPD and NPD is beyond 'malignant self love' (wrong) - lots of anxiety, confusion, hard to verbalize in social settings, mood changes, hard to display one's persona (e.g. smile) - all that shi*t.
For *myself* the anxiety, confusion, poor verbalisation, blank facial expression etc. are primary symptoms that have troubled me all my life and were a frequent cause for concern among my teachers, parents and relatives. They are not self-diagnosed.
>You will not find those symptoms in the DSM because none of them in particular characterizes NPD: these are peripheral symptoms, but on the other hand, you will see them in many NPDs, especially those with unstable mood (bipolar II and the like).
Someone with those tendencies is more likely to fit the diagnosis of Borderline Personality Disorder - one which fits me quite well with the instability and tendency to rage but not for the poor verbalization and obsessive interest in specific subjects and overall social avoidance.
This is such a grey area where there's much confusion and everything overlaps. For instance where does Asperger's Syndrome end and garden variety geekiness take over? Where do ADHD and dyslexia end and plain stupidity and dim wittedness take over? That seems to be arbitrary - dependent largely on the personal opinion of the diagnoser.
There are a few biological and neurological problems that set autistic spectrum disorders apart. Epilepsy is more common in autistic populations as are immune system deficiencies and metabolic disorders as well as learning disabilities. My guess is that someone who strongly identifies with Asperger's Syndrome and also has some of those problems is a strong contender. Perhaps one of the hallmarks of Asperger's is the tendency to obsess over a specific (and often obscure) subject and become a 'walking encyclopedia'. That's not common with other psychiatric disorders.
Yes, I do have many of those problems. I had childhood epilepsy, I have an abnormally weak immune system and I'm frequently admonished for reciting facts and figures from my current subject of interest. According to my grandmother I was even taken to the doctor by my worried parents and was suspected of being autistic for a while, but that was dismissed as I was quick to read and write and did not fit the profile of classical autism. Asperger's Syndrome was not a diagnosis not used by GPs in the UK at that time and I often wonder what would have been the outcome if it had.
You're right - I should have put a disclaimer in my previous post, but I was eager to show that a talent for the piano was not a disqualifier for Asperger's Syndrome. Being very talented in athletics might be though ;-)
Q
Posted by Phillipa on December 27, 2006, at 21:15:11
In reply to Re: Why not say NPD? » jimmygold70, posted by Quintal on December 27, 2006, at 20:10:56
Quintal what if your immune system is overactive like mine? Love Phillipa
Posted by Quintal on December 27, 2006, at 21:41:21
In reply to Re: Why not say NPD? » Quintal, posted by Phillipa on December 27, 2006, at 21:15:11
>Quintal what if your immune system is overactive like mine? Love Phillipa
I'm not sure about that. I get the impression that people on the autistic spectrum have more problems with immune system deficiencies, though autoimmune disease is also common. Why do you ask?
Q
Posted by Phillipa on December 27, 2006, at 23:13:44
In reply to Re: Why not say NPD? » Quintal, posted by Phillipa on December 27, 2006, at 21:15:11
Because mine is overactive. Hence the hasimotos thyroiditis and I'm obsessed with the nursing I did. My only interest is medical. Love Phillipa
Posted by Declan on December 28, 2006, at 14:21:25
In reply to Re: Jimmy and Others Re: Last Night's Post » becksA, posted by Quintal on December 27, 2006, at 12:24:14
Eager to please?
Some time back people here were throwing around interesting labels like 'executive dysfunction' requiring treatment with amphetamine.
Yesterday someone said 'Hello' to me and I said 'Bye' before I knew it. Like being trapped in a reasonable but painful comedy.
Posted by Quintal on December 28, 2006, at 14:51:34
In reply to Re: Jimmy and Others Re: Last Night's Post » Quintal, posted by Declan on December 28, 2006, at 14:21:25
>Eager to please?
Yes, mostly I like approval - I don't like being told off, but I usually end up provoking that reaction.
>Some time back people here were throwing around interesting labels like 'executive dysfunction' requiring treatment with amphetamine.
I remember that, but I never understood exactly what it was supposed to mean.
>Yesterday someone said 'Hello' to me and I said 'Bye' before I knew it. Like being trapped in a reasonable but painful comedy.
I think it's called Malapropism and my dad does it a lot. I've had similar moments myself. Often get confused about the appropriate words to say in greeting so say nothing at all, or more often just "sorry" apologising for my confusion which ends up confusing and alarming people even more. Even worse, I sometimes turn my back on people in greeting or look away - that's one of the things that first caught my attention about Asperger's Syndrome. That's what I like about computers - you have time to think and plan out the most appropriate response which I can't do very well in real life.
Q
Posted by Declan on December 28, 2006, at 15:36:04
In reply to Re: Jimmy and Others Re: Last Night's Post » Declan, posted by Quintal on December 28, 2006, at 14:51:34
I wish I could stop the world, just freeze it, for maybe 10 years, while I got up to speed on what it's all about (including all the economic things).
Then I would restart it again and know what to do.
Posted by Phillipa on December 28, 2006, at 17:51:33
In reply to Time to Think and Plan » Quintal, posted by Declan on December 28, 2006, at 15:36:04
Declan how bout being 20years younger knowing what we now know? Love Phillipa
Posted by Declan on December 28, 2006, at 18:12:20
In reply to Re: Time to Think and Plan » Declan, posted by Phillipa on December 28, 2006, at 17:51:33
Hey PJ, that would be even better. The way I had it I'd be 10 years older.
Posted by Phillipa on December 28, 2006, at 20:05:51
In reply to Re: Time to Think and Plan » Declan, posted by Phillipa on December 28, 2006, at 17:51:33
Declan think how young and sexy we'd be!!!!!Love PJ
Posted by Declan on December 28, 2006, at 23:04:33
In reply to Re: Time to Think and Plan » Phillipa, posted by Phillipa on December 28, 2006, at 20:05:51
Yeah, and not so many silly ideas either.
Posted by Phillipa on December 28, 2006, at 23:08:50
In reply to Re: Time to Think and Plan » Phillipa, posted by Declan on December 28, 2006, at 23:04:33
Declan why's it silly I think it would be fun. Love Phillipa
Posted by Declan on December 28, 2006, at 23:25:57
In reply to Re: Time to Think and Plan » Declan, posted by Phillipa on December 28, 2006, at 23:08:50
I didn't mean your idea was silly, PJ.
What I meant was..... if I was young again I would not waste my God given youth worrying about the sorts of things I worried about.
(Am I good enough? Do people like me? etc etc)
And I would know how to think for myself.love, Declan
Posted by jimmygold70 on December 29, 2006, at 9:30:48
In reply to Re: Why not say NPD? » jimmygold70, posted by Quintal on December 27, 2006, at 20:10:56
> According to my last pdoc there is often a biological basis to the personality disorders. Asperger's Syndrome could be described as you say as NPD, jimmygold70 syndrome, or whatever you choose to call it. I bet you also fit the bill for several other personality disorders? That's the reason my pdoc doesn't use those diagnoses. It can be equally easy to think you have any other personality disorder and be mistaken.
That's true, I don't hold an Aristotelian view anymore - I favor treatment of symptom particulars over classifications (-:
> Narcissists don't often have trouble putting themselves first and displaying their persona - that's the hallmark of narcissism. If most of your problems are of that nature then the diagnosis of NPD seems dubious. There seems to be a tendency among some people (including psychologists) to say that shyness is narcissism - that shy people hold themselves aloof out of a belief that they are superior to other people, when in fact the opposite is usually true - they feel inferior and fear bullying and judgement, 'negative evaluation'.
NPD was just an example, you can see shyness in social phobia but then if it is something more pervasive and longstanding you might like to look at other features - Avoidant, Schizoid, Schizotypal.
> >What is frequently described as Asperger's is more frequently some manifestation of a personality disorder - be it schizoid, schizotypal, paranoid, etc...
>
> How do you know the opposite isn't true - what is commonly described as a personality disorder is not Asperger's Syndrome? It's often arbitrary.> >I have NPD and NPD is beyond 'malignant self love' (wrong) - lots of anxiety, confusion, hard to verbalize in social settings, mood changes, hard to display one's persona (e.g. smile) - all that shi*t.
>
> For *myself* the anxiety, confusion, poor verbalisation, blank facial expression etc. are primary symptoms that have troubled me all my life and were a frequent cause for concern among my teachers, parents and relatives. They are not self-diagnosed.I have a similar life story, so I can realte very easily. And I even used to have a diffculty smiling.
> >You will not find those symptoms in the DSM because none of them in particular characterizes NPD: these are peripheral symptoms, but on the other hand, you will see them in many NPDs, especially those with unstable mood (bipolar II and the like).
>
> Someone with those tendencies is more likely to fit the diagnosis of Borderline Personality Disorder - one which fits me quite well with the instability and tendency to rage but not for the poor verbalization and obsessive interest in specific subjects and overall social avoidance.Ye, it's just that BPD is a bad diagnostic group. If you see Theodore Millons' treatment of BPD, and he is THE personologist, he gets to so many different subtypes which make you wonder: Dr. Millon, please - take this diagnosis off (-:
> This is such a grey area where there's much confusion and everything overlaps. For instance where does Asperger's Syndrome end and garden variety geekiness take over? Where do ADHD and dyslexia end and plain stupidity and dim wittedness take over? That seems to be arbitrary - dependent largely on the personal opinion of the diagnoser.That's right. That's where statistical thechniques get in, and a good system such as Millon's or just the refined five factor model (the 30 subfactors) makes much more sense than "Asperger's".
> There are a few biological and neurological problems that set autistic spectrum disorders apart. Epilepsy is more common in autistic populations as are immune system deficiencies and metabolic disorders as well as learning disabilities. My guess is that someone who strongly identifies with Asperger's Syndrome and also has some of those problems is a strong contender. Perhaps one of the hallmarks of Asperger's is the tendency to obsess over a specific (and often obscure) subject and become a 'walking encyclopedia'. That's not common with other psychiatric disorders.
I have this obsession. My father has it too. Would that fit in the PDD group? I don't think so. Sure, people with Asperger's do have it. It's like saying that because people with some kinds of cancer have headaches and people with migraines have headaches, so they must be of the same spectrum.
> Yes, I do have many of those problems. I had childhood epilepsy, I have an abnormally weak immune system and I'm frequently admonished for reciting facts and figures from my current subject of interest. According to my grandmother I was even taken to the doctor by my worried parents and was suspected of being autistic for a while, but that was dismissed as I was quick to read and write and did not fit the profile of classical autism. Asperger's Syndrome was not a diagnosis not used by GPs in the UK at that time and I often wonder what would have been the outcome if it had.Again pal, you're commiting the naturalistic fallacy. Go and take a look at a real group of Aspergers and you'll get my very point. But this really doesn't matter. I have 95% of the symptoms you describe except chilhood ADHD instead of childhood epilepsy. I know I have a narcissistic style, I know I have unstable affact and some idiosyncracies. And I used to be schizoid as a kid.
By the way, what is a 'weak immune system'?
J
Posted by Quintal on December 29, 2006, at 15:54:34
In reply to A naturalistic fallacy? » Quintal, posted by jimmygold70 on December 29, 2006, at 9:30:48
>That's true, I don't hold an Aristotelian view anymore - I favor treatment of symptom particulars over classifications (-:
Is that so?
>NPD was just an example, you can see shyness in social phobia but then if it is something more pervasive and longstanding you might like to look at other features - Avoidant, Schizoid, Schizotypal.
I examined those categories five years ago and found parts of myself described in all of them but none described me as a whole very accurately. The pdoc at that time dismissed avoidant - I'd attempted too many things in life for that; schizoids aren't troubled enough by their problems to seek treatment, and he'd never seen schizotypal actually used in 30 years of practice. There was no question of antisocial, narcissistic, histrionic, obsessive compulsive, dependant - they just don't describe me very well at all. Borderline was a possibility considering I had an episode of self-harm, but overall opinion is that my problems lie elsewhere. It is a quagmire of a diagnosis as you point out and few seem enthusiastic about using it in the UK in any case.
Having to depend on the UK NHS means that they're not very proactive or interested in finding out where my problems do lie. My GP was intrigued by the possibility of Asperger's Syndrome but still re-prescribed Parnate (which I'm reluctant to take without a benzo) at my last appointment for anxiety and depression as that's the most she could do for me at that point. We'll see what comes of it when I see her next.
>I have this obsession. My father has it too.Would that fit in the PDD group? I don't think so.
Nobody has suggested that *you* are on the autistic spectrum jimmygold70. You seem to have taken it upon yourself to disprove some perceived accusation. Obsessions alone obviously do not make the diagnosis of Asperger's Syndrome, that often comes from the wider picture of the person's life and history of social functioning and where the obsessions figure in that; but yes - some people who have obsessions will fit in the PDD group.
>Again pal, you're commiting the naturalistic fallacy.
Don't call me 'pal'. I am no more committing the naturalistic fallacy by considering the possibility of Asperger's Syndrome than you are in suggesting the personality disorders. It's equally possible to imagine you suffer from NPD or any other personality disorder or psychiatric diagnosis and be mistaken - the naturalistic fallacy. As is widely acknowledged, the boundaries between the personality disorders are arbitrary - as are the boundaries between 'normal' and pathological behaviour. They are rarely helpful diagnoses in any case and offer a poor prognosis as well as stigma and negative connotations in the medical community and the general public. Since there is a possibility that in labelling a person with 'X' personality disorder we may actually be describing the same phenomena as Asperger's Syndrome I prefer the diagnosis of Asperger's Syndrome wherever it is plausible.
>Go and take a look at a real group of Aspergers and you'll get my very point.
What exactly is your very point and what am I supposed to observe among these people that will dissuade me from that diagnosis? Since you have never met me in person how do you know I do not possess those very characteristics? Also, how do you suggest I gain access to an Asperger's Syndrome treatment facility? Bedlam lunatic asylum closed it's doors on gawpers centuries ago along with similar institutions. How did you, a person apparently diagnosed with a type B personality disorder, get inside an institution for vulnerable people to perform this examination? Would you please share your findings? I have lurked among Asperger's Syndrome support groups and feel much more at home there than I do here. I am on the same 'wavelength' as the people who post there.
>By the way, what is a 'weak immune system'?
'Weak immune system' is the layman's term I used to describe my deficiency in white blood cells and unusual vulnerability to recurring infections. Hypogammaglobulinemia to be technically precise.
There are many reasons why I relate strongly to Asperger's Syndrome more than the personality disorders. I will make a separate post detailing them another day if you wish but here are just three examples that stand out glaringly why I find greater resonance with Asperger's and not NPD or other personality disorders:
__________________________________________________
The unwritten rules of social behaviour that mystify so many with AS have been termed the "hidden curriculum".[13] People with AS must learn these social skills intellectually rather than intuitively.[14A person with AS may have trouble understanding the emotions of other people: the messages that are conveyed by facial expression, eye contact and body language are often missed. They also might have trouble showing empathy with other people. *****Thus, people with AS might be seen as egotistical, selfish or uncaring. In most cases, these are unfair labels because affected people are neurologically unable to understand other people's emotional states. They are usually shocked, upset and remorseful when told that their actions are hurtful or inappropriate.***** It is clear that people with AS do not lack emotions.
Unlike Asperger's Syndrome, SPD does not involve an impairment in nonverbal communication (e.g., lack of eye-contact or unusual prosody) or a pattern of restricted interests or repetitive behaviours (e.g., a strict adherence to routines or rituals, or an unusually intense interest in a single topic). Instead people with SPD are typically more indifferent with regard to their activities. SPD does not affect the ability to express oneself or communicate effectively with others, and is not believed to be related to any form of autism.
__________________________________________________Q
Posted by Phillipa on December 29, 2006, at 19:04:59
In reply to Re: Why not say NPD? » jimmygold70, posted by Quintal on December 29, 2006, at 15:54:34
There was recently a poster here with a diagnosis of Aspergers. He was increibly intelligent but also played in a band. How can that be? Love Phillipa
Posted by Phillipa on December 29, 2006, at 19:07:43
In reply to Re: Time to Think and Plan » Phillipa, posted by Declan on December 28, 2006, at 23:25:57
Declan you're right we like each other that's enough right? See I'm already looking for approval. Love PJ by the way PJ was a name given to me by a poster. At first I thought it pajamas then realized it was a combo of Phillipa and Jan my real name. Duh to me
Posted by Quintal on December 29, 2006, at 19:41:02
In reply to Re: Why not say NPD?, posted by Phillipa on December 29, 2006, at 19:04:59
>There was recently a poster here with a diagnosis of Aspergers. He was increibly intelligent but also played in a band. How can that be? Love Phillipa
Phillipa, are you referring to Michael aka Ame Sans Vie?
For some Aspie's music is their obsession and they are very good at it. I was in the school band myself when I was younger but was an atrocious trumpet player. I could understand the theory perfectly but I'm just too clumsy and nervous to play an instrument properly.
Q
Posted by Phillipa on December 29, 2006, at 21:05:56
In reply to Asperger's Syndrome? » Phillipa, posted by Quintal on December 29, 2006, at 19:41:02
Quintal yes. Love Phillipa
Posted by Quintal on December 29, 2006, at 21:54:49
In reply to Re: Asperger's Syndrome? » Quintal, posted by Phillipa on December 29, 2006, at 21:05:56
I had him down on my list of suspects. Him and Elizabeth, with one other who still posts occasionally - I won't mention his name publicly. He seemed to have that distinct Asperger's look about him on the website photo too. I just checked the archives and here is Michael saying how much hope the new diagnosis gave him back in August:
http://www.dr-bob.org/babble/20060802/msgs/675063.html
This confirms my suspicions. Now I just need to find a neurologist or some other specialist who deals with Asperger's in the UK. Has anyone here been diagnosed in the UK?
Q
Posted by jimmygold70 on December 30, 2006, at 4:38:28
In reply to Re: Why not say NPD? » jimmygold70, posted by Quintal on December 29, 2006, at 15:54:34
Well Quintal, I think you made your case. If Asperger's diagnosis seems more clinically useful for you - go for it.
BTW:
1. What medications helped you?
2. Do you find it hard to interpret others' facial expressions?
Posted by elanor roosevelt on December 30, 2006, at 10:53:46
In reply to Re: Time to Think and Plan » Phillipa, posted by Declan on December 28, 2006, at 23:04:33
> Yeah, and not so many silly ideas either.
you are confusing foolish and silly
foolish thing we tend to regret
silly is good
very good
Posted by Quintal on December 30, 2006, at 11:05:04
In reply to Re: Why not say NPD? » Quintal, posted by jimmygold70 on December 30, 2006, at 4:38:28
Most medications helped my depression and anxiety at least for a while but there was still something wrong with me even when I was doing well. I assumed the medications were ineffective because of this and requested others hoping they'd be better - that pattern continued for years hence my long and complicated treatment history. Klonopin was the most effective for anxiety and opiates for depression.
Obviously I know when people are smiling, frowning etc., it's the meaning of more subtle body language I struggle with. At times I have failed to understand what seem to be glaringly obvious cues with hindsight; e.g. I was once violently sick into the hand basin at my friend's university lodgings after a night of heavy drinking. I must have left it there and gone back to bed because in the morning my friend's flatmate cornered me on the stairs to tell me how she'd had to pick the sediment out with her bare hands when she needed to brush her teeth after breakfast. She left the conversation hanging with a wide grimace that lasted for about 10 seconds in which I stared back at her blankly wondering what was going on. It only occurred to me when ruminating over it a few days later that that pause had been her way of giving me the opportunity to apologise. That solved the mystery of why she'd suddenly started acting so coldly toward me - so I guess rumination does serve a useful purpose at times.............
I've committed many other more subtle social solecisms over the years due to misinterpreted facial expressions and gestures.
Q
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.