on pursuing autism diagnosis

Who do I see first to get my diagnosis? My general med doctor will not agree to start testing, but will send me to any specialized doctor I ask about. Psychiatrist? Psychologist? Therapist?

realsocialskills said:

If you have the option, you should go to a neuropsychologist, preferably one who has experience evaluating adults for autism and other cognitive and neurological conditions. 

The person who is testing you should be familiar with neurodevelopmental disorders, learning disabilities, and cognitive issues. If you have options, it’s better not to go to someone whose primary area of expertise is mental illness. (Which can often be the case for general psychiatrists, except for psychiatrists who specialize in things like treating ADHD.)  

Going to someone whose primary expertise is in mental illness can cause diagnostic problems because symptoms of autism and other neurological and cognitive disabilities can often look similar to symptoms of mental illness.  (Eg: self-care problems can look like depression; difficulty speaking can look like anxiety; needing to stim to self-regulate can look like OCD.) 

If you also think you might have a mental illness, that’s also worth investigating, but mental health evaluation that isn’t neurology-focused might not by itself give you good information about neurological and cognitive issues. (Eg: knowing that you have depression or psychosis will not tell you whether or not you are autistic, and it won’t make the possibility that you have a developmental or neurological condition any less important.)

That said, if a psychiatrist is the only realistic option you have for pursing autism evaluation, it’s something that *can* and often does work out ok. It’s just riskier, and worth avoiding if you have better options. But a lot of autistic people are in fact diagnosed by general psychiatrists, so I don’t want to overstate the extent to which it’s better to avoid that. It’s just that it’s worth knowing that if you have a choice of how to pursue evaluation, a neuropsychologist is likely to be a better option than a general psychiatrist.

tl;dr If you’re looking for autism evaluation and you have a choice of where to go for it: It’s better not to go to someone whose primary area of expertise is treating mental illness. Someone who has experience with evaluating adults for learning disabilities, autism, and other neurological/developmental/cognitive disorders is likely to give you much more useful autism evaluation.