Getting a diagnosis as an adult

[Jojobump1986]

Hello all,

I'm after a bit of advice. As part of my training in early years development I studied autism/aspergers a little & became familiar with the behavioural traits associated with the spectrum. I noticed a lot of these traits in BIL & shared this with DH. He was reluctant to talk to BIL or PIL about it as we believed BIL was happy as he was, albeit living as a bit of a loner.

We had PIL around today & they told us that BIL has told them he feels he needs help. I was finally able to share my concerns with them & FIL said that my observations confirmed everything they'd noticed.

I don't doubt that, if he were in school today, he'd be diagnosed very quickly. As it is, he's 30 & got very distressed when FIL suggested that he was never going to change, meaning that it wasn't just a phase he would grow out of. He got very upset & said he has to change because he can't carry on like this.

PIL only brought it up a few minutes before they were due to leave - clearly it's a difficult subject for them & I think they wanted an escape route incase they didn't like what we said! In the brief time they gave me after asking for my recommendations I said that the GP would be the first port of call with a view to being referred on to an expert. I'm guessing CBT would be useful for him, I don't really know much about strategies for helping adults. I'm also going to get DH to stress the importance of patience - FIL is very used to being in control of everything & I suspect he'll try to micro-manage BIL & try to force him to go to the GP.

Is there anything else we can suggest that might help? Anyone have experiences of getting a diagnosis/support for an adult? I think it would help him to know what to expect from the process. I'm guessing it'll take a long time & persistence to get support on the NHS. Going private is probably an option. I was going to suggest that MIL offers to sit down with him & write a list of what he sees as his problems to take to the GP just so he can order his thoughts - he tends to get very flustered in stressful situations & I worry that he'll get to the point where he'll be so wrapped up in his own brain that he won't be able to listen to the GP & may get so freaked out thinking he can't even cope with the initial GP visit so won't access any support offered to him. I'm also thinking of suggesting that MIL offers to go with him to the GP so there's someone who will be able to remember anything the GP says, just incase! I shall stress that this should be a casual offer, not done in an escorting him to make sure he goes sort of way!

An added difficulty for us is that we're not supposed to know anything about it so, for now at least, all we can do is support PIL in supporting him!

Any advice gratefully received!

Is your BIL single - I am assuming he is, as I am sure his wife/partner would have noticed something. Sounds like FIL put his foot in it good and proper. What an awful thing to say to someone, that they cannot ever change. No wonder the poor bloke was in pieces.

I wonder if PILs noticed there was something wrong when he was a child as AS and Autism as I'm sure you know show in childhood. You said FIL is used to being in control (assume this means he is a controlling person)and wonder if this has contributed to your BILs difficulties.

Is MIL a sensitive sort of woman who would be able to help her son? Seems like they haven't done much to do so in childhood, teenage and adult years, or is this unfair. I don't honestly think a GP consultation is the best way to go, as diagnosing something like this is quite a specialism especially in an adult.

I wonder if you might be the best person to help this young man. Obviously you would need to clear it with PILs but they did raise it with you after all so obviously wanted your thoughts. I think the best plan might be for your BIL to make an appointment with a clinical psychologist or therapist (BACP website will give registered counsellors and psychologists) and give you details of those in your area and it usually states their specialisms. I don't think anyone should suggest AS or Autism to be honest. Why not just encourage him to see someone in whom he can confide about his emotional difficulties. It is important that he feels safe and comfortable with a therapist and if not, then he needs to find one who he feels ok with. He will have to pay and they tend to charge around £50 per hour dependent on where you live.

Incidentally does your BIL hold down a job, does he have friends, or interests.

No, he's not married & has no close friends.

I think the issue with PIL is more ignorance than anything. FIL is a highly intelligent man who reached the top of his career path & is just used to people doing as he asks. There's no malice there at all, just a very traditional, 1950s style household! They said that autism was something they wondered about when he was very little but they didn't realise that it was a spectrum & because BIL is very intelligent they dismissed it as a phase/him just being a bit socially awkward/just the way he is. They did express concerns about the way he responded to discipline as a child. MIL said he used to 'run all the red lights' i.e. he wouldn't stop misbehaving when given a 'look' like DH would. They sent him to private school as he didn't seem to be flourishing in the state system & they thought he'd benefit from the extra individual support. He still never had any friends round to play that DH remembers & preferred spending time by himself, researching his latest interests.

I have often wondered if FIL has Aspergers too. He doesn't tend to know how to respond to any kind of emotion from others & is very matter-of-fact. He knows am awful lot about almost everything & is very, erm, 'enthusiastic' about sharing what he knows. Put bluntly, he talks over everyone & dominates every conversation. BIL is the same but somehow conversations between the 2 of them sort of flow, but no-one else can get a word in! They once spent about 3 hours straight, including a family mealtime, debating the economic impact of certain social aspects of the Roman society & how they might have done things more effectively. The rest of us just sat there in silence. MIL & DH seemed to accept it as normal behaviour! MIL is also very practical but is less of an authority figure than FIL & has a lot more patience so she would be the safer option out of the 2 of them to discuss it with him! I don't doubt that I would be more able to handle the situation sensitively & with understanding but I really don't think he'd open up to me. It must've been at least a year after we met, if not longer, before BIL would even stay in the same room & make small talk with me if everyone else left!

He does have a job now but this follows a long period after university where he struggled with the intense environment of starting out in his original chosen career (accountancy). He eventually abandoned that I suspect he developed depression at this point & spent a few years living with PIL not seeming to do much. With a great amount of prodding encouragement he eventually gained a few qualifications in computer software & is now living independently & working as an IT tech.

It's the independent living that has brought it to a head. BILs flat is in a terrible state to the point that he's refusing to have anyone visit, gets upset at the suggestion of throwing out a large amount of 'rubbish' & told MIL off when she tidied his kitchen while he was distracted talking to FIL. I don't think they've been allowed back since she did that.

Having done more research I do wonder if it could be OCD & not aspergers, or a combination of the 2. I'm convinced that a lot of the issue with his flat is that it's his safe space that he can control & so it makes him anxious having other people there, especially if they're likely to threaten his control of the space, however well-meaning & 'helpful' they think they're being!

I shall ask DH to remind them that I am not a psychologist & therefore not able to make a diagnosis & they should suggest that he speaks to a professional rather than is bombarded with information about all the things I think are possibilities!

Phew - a lot of interesting information. I dislike attempts to diagnose on the internet but your BIL certainly seems to fit the profile of someone with AS, and yes your FIL may well have it too, given what you say. As you know of course with syndromes it depends where you are on the continuum. I had to smile about the 3 hour conversation on Roman society!!

I think you are absolutely right about the state of the flat being rooted in OCD, and yes it does sound like a combination of the 2. I think you are spot on about the flat being his safe place that he can control and he gets anxious when other people are there. Don't know if you have seen any of the "Hoarders" docs on TV. My partner is a hoarder but not to the extent that we see on these TV programmes but left to his own devices I know he could be edging that way. He hates me to pick up anything belonging to him as he thinks I am going to throw it away. It used to cause arguments, but now he has his own sitting room and bedroom (best arrangement ever) we both use the room with the TV and there is a shelf next to the sofa where he sits and it gets filled with receipts, junk mail, all sorts of stuff (just looking over there now) and then I insist he tidies it and he does but rarely throws anything away.

Sorry you don't want to hear my problems! I wonder if your FIL actually knows that he is on the AS spectrum, and knows that his son is too, and that's why he is telling him that it will never change, and in a way he's right because there is no "cure" or treatment even. At least your BIL manages to hold down a job, and I would have guessed it was IT!

Would it make things better if he moved back in with the PILs - am assuming he didn't get things in a terrible mess when living there. The prognosis for change for a hoarder with OCD is very very poor (which is why I have taken the steps I have re separate rooms) as I don't care so long as I don't have to look at the mess! We are in our early 70s and have been together for over 40 years, and I have long held the belief that we all "get more like we are" as we get older.

From what you've said I think it is highly unlikely that your BIL is going to see any kind of therapist, and a GP consultation I think is out of the question.

Maybe your BIL should be left to live his life the way he wants to, though letting him know that help and support is there if he wants it (re clearing the flat) though I suspect he will not agree to this. The hoarders on the TV programmes had all come to the conclusion that "something had to be done" as they could barely move in the flats, houses. It was incredible to see really. They were all anxious about anything being thrown out as is my partner. He's not so bad if he knows it's going to a charity shop, (though sometimes I go to the tip instead of the charity shop!!)

I'd let sleeping dogs lie!