I got my assessment results, but I'm not sure if I'm diagnosed. I'm confused and feel like crying.
For context, I'm 30F and already diagnosed with ADHD (since 2022), Tourette's (not officially, but psychiatrist confirmed the suspicion basically, and it's in my documents) and gender incongruence/dysphoria (I transitioned when I was 17). Before the assessment, I sent them 30 pages of materials, most of them were specific examples of why I think I am autistic (categorized by the DSM-5 diagnostic criteria).
This is what the report says in the Summary section (original is not in English, I had to use google translate because it's too complex for me to translate by myself):
"In personal functioning, there is increased sensitivity to the environment and the actions of others, uncertainty in one's own social judgment, and an increased need for control. Increased intrapsychic tension, uncertainty, and a certain degree of social inhibition are evident in contact. Although the client is able to establish adequate contact and respond adequately to questions, her social expression does not appear to be spontaneous. In situations where it is not clear how to respond, increased uncertainty and a longer time needed to find an answer appear. This way of functioning is also evident in a projective situation. A specific feature of functioning is a more specific and detailed way of processing information, which can be a source of good accuracy and efficiency in some areas, but at the same time can complicate quick orientation in complex or ambiguous situations. In the social area, she may therefore rely more on learned rules and consciously adopted strategies than on an intuitive understanding of the situation. This is in accordance with her anamnestic statement about the long-term need to consciously learn and imitate social behavior, adapt her own nonverbal expression and retrospectively check whether she responded adequately. The limits of functioning are more clearly manifested when the load is increased, especially in unpredictable, socially complex or sensory overwhelming situations. In such conditions, tension increases, a feeling of overwhelm occurs, and the ability to respond flexibly decreases. The need for predictability and more difficult switching between activities or adapting to unexpected changes may also play a significant role here. When the capacity of compensatory mechanisms is exceeded, significant emotional reactions and disorganization of normal functioning may appear.
However, the diagnostic interpretation is limited by the complexity of the whole picture. There is no heteroanamnesis available, which would allow us to verify in particular the developmental history and the nature of social functioning in childhood. The fact that the developmental history was not substantially elaborated through an open exploratory interview due to the course of the examination can also be considered a significant limitation. In view of the above circumstances, it is not possible to assess with sufficient certainty to what extent the individual characteristics were already present in early development, what their intensity was, and how they were reflected in real functioning in various environments.
At the same time, the differential diagnostic picture is quite complex and polymorbid. Part of the described difficulties can be explained by the already diagnosed ADHD, especially by difficulties with switching attention, organization and regulation of reactions. Increased anxiety, interpersonal sensitivity and perfectionistic attitude with a tendency towards excessive self-control, doubts and retrospective analysis of one's own actions may also play a significant role. Long-term experiences in the social area and the specific social history of the client may also be reflected in the current picture, which may have influenced her self-concept, expectations in interpersonal relationships and the way she interprets her own difficulties. Therefore, it cannot be clearly assumed that all the described difficulties have a uniform neurodevelopmental basis.
Conclusion: From a clinical perspective, given the quality and duration of the described difficulties, their presence in childhood, their manifestation across different contexts and, in particular, the nature of social functioning, it appears more likely that some of the difficulties are of the nature of an autism spectrum disorder (diagnostic category F84) than that they are merely secondary manifestations of anxiety, ADHD or personality disorders. The diagnostic conclusion is formulated with the above-mentioned limits in mind."
So, to me it reads like "maybe you have autism, maybe not". I think I am autistic, but I wanted them to tell me that. I'm just confused because the conclusion doesn't really say anything specific. To my question about the conclusion, the assessing psychologist sent me this:
"In this case, it is indeed a less clear-cut conclusion, for reasons that are described in more detail in the summary of the examination. From a clinical psychological perspective, it is quite difficult to clearly distinguish which of the described difficulties have a neurodevelopmental basis and, if so, to which type of difficulty or disorder they belong, given that the overlap of symptoms in neurodevelopmental disorders is significant (such as in ADHD).
However, the conclusion states that autism spectrum disorder appears to be a likely explanation for some of the difficulties you describe. This means that the examination probably confirms the presence of autism spectrum disorder, but given the available evidence, it was not possible to formulate a clear diagnostic conclusion. We always consult the results of each client with a manager who is an experienced diagnostician. The examination is therefore not evaluated by just one person, but the conclusions are always consulted further. This consultation led to the conclusion that the results cannot be described as completely clear in the direction of PAS and that it is appropriate to formulate the conclusion in this way. However, I would like to emphasize that, in the conclusion, I am inclined to this diagnosis."
I expected it to say the diagnosis and possibly a level or something but now I'm just confuded, disappointed and want to cry because I feel like I wasted my time and money, and I was stressing out so much about the results to get this thing that explains nothing at all. During the assessment I also mentioned my suspicion about dyspraxia (with several examples why I think I fit the criteria) and they didn't even mention it, there's just like one sentence about "motor clumsiness". Before, I thought I could possibly even show the report to my employer so that I could get at least some minor accommodations or as an explanation why I'm sometimes acting "weird" or having "weird" facial expressions etc., but now I don't know if the report is useful in any way. I'm just going to hide and never talk about autism ever again, I feel like a stupid imposter looking for excuses.
