The last time I ran off to see a doctor was about 10 years ago when I got a concussion shortly after graduating college. After that, I have visited optometrists and dentists, but not an MD. I had my own insurance at my first big boy job after school, but I didn't schedule any appointments [early 20s with plenty of other priorities] before I got fired after a couple years and lost employer coverage (ain't nobody got money for COBRA nonsense).

After that, I've been rather chronically underemployed and thus avoided the medical system entirely (with the above exceptions of my eyes & teeth) to avoid being told to go fix expensive problems [and not wanting the monthly drain of premiums].

Anyway, I (for better and worse) had an hours cut that got me eligible for Medicaid. I'd like to know what to say to get a head-to-toe physical (including mental health) with minimal hassle and needing to re-clarify what I want. Mental health-wise, I can state a suspected primary complaint: undiagnosed ADD due to lacking the H as a child as well as seasonal depression [the chronic depression was entirely downstream from the abovementioned ADD].

However, I have no idea what to tell the doctor to look for physically. Probably should get some kind of comprehensive blood screening done. Make sure my hormones, iron, etc… are all within normal bounds. Perhaps I have some conditions that should've spooked me into seeing a doctor five years ago, but I'm still alive and well, so they're no longer causes for alarm [even if they should be].

Every time I find myself in an ADHD related thread on the internets, I feel like I'm seeing my personal struggles being described by others (Anxiety, Depression, executive function issues... the list goes on).

My intermittent attempts to seek out a diagnosis (or rule it out) end quickly with all the utter shite noise in the search results (literally everyone is selling something).

I'm hoping some of you who've been down this road can shed some light. Should I just schedule and appointment with my GP and start a conversation or???

Thanks (hope I got this in the right sub-tilde)

UPDATE: Thank you all so much! I ended up setting an appointment with a nearby adhd clinic that does 2 brain scans, a bunch of bloodwork, several questionnaires, and a couple meetings with a psychiatrist/psychologist (can never remember which is which). 1st scan is on Monday morning, 1st meeting with psych* is in early December. Feeling optimistic.

Reading through all your comments, I feel connected and optimistic in a way I've never felt before when pondering what I can see to be atypical behavior/emotions/response to stimuli but felt powerless to address.

Thanks so much for helping a stranger on the internet, hoping to pay it forward someday.

A little over a week ago, I got an official diagnosis of hypothyroidism from my GP. Fair warning, this post is going to be a little bit of a rambly discussion of my thoughts and feelings surrounding my diagnosis and other circumstances surrounding it.

I'm a US American, but I moved to Germany to do my master's degree in 2018 and have lived here ever since. I've struggled with depression and social anxiety since before I moved to Germany, but my symptoms got notably worse in 2020 (perhaps unsurprisingly). In late summer of 2020 my psychotherapist finally suggested I go on an SSRI, but she wanted me to get a blood test to rule out any physical causes. I went to my then-doctor and got such a blood test. Everything was within the normal range except for my TSH.

For those unfamiliar, TSH is the hormone your pituitary gland sends to tell your thyroid to get a move on. It doesn't directly measure your thyroid function, but it's a pretty good indicator something's up, so doctors use it to screen for thyroid issues. High TSH is a sign of hypothyroidism, and low TSH is a sign of hyperthyroidism. Your average person with a healthy thyroid will probably have TSH between 1.0 and 2.0, but some variation exists. The normal range that doctors use here has 4.2 as its upper limit. In 2020, my TSH value was 4.8. My doctor then said that people with hypothyroidism have higher numbers than that, so I was fine. She wrote my a prescription for a low dose of an SSRI, which did help me to an extent.

I've been fat for a long time, to different degrees. After I first moved to Germany in Fall of 2018, I quickly lost a lot of weight. There were likely a lot of factors -- I wasn't living at home where snacks were constantly stocked, I was buying food on a student's budget, I was eating out and ordering takeout less because of my social anxiety and shitty German skills, and I was walking a lot more. When I came back to the US for family vacation in 2019, I constantly got compliments about having lost weight, which felt weird. I was still overweight according to the BMI, but more of a classic midsize chubby at that time. But it wasn't to last, and I did start gaining the weight back. For a while it, I attributed this to my getting more takeout and walking less. But a year or two ago it felt like it stopped being directly attached to my activity or food consumption. I went on medication that suppressed my appetite as a side-effect, but I continued to gain weight. Since I was already fat and had been gaining weight for a while, I didn't mention anything to my doctors because I was already getting lectures about how I needed to lose weight and exercise more. I don't know for sure what I weigh right now because I've avoided weighing myself for months, because I'm scared I weigh over 100kg and I can't handle seeing that triple digit on a scale.

I've tried and failed to become more active and start an exercise routine several times. I joined a sports course at university with some of my friends, but I quit after a couple sessions because I was hyperventilating before warm-up was over. I've tried to do some basic strength training, but I'd be sore for days after even incredibly beginner-level stuff. More recently, my wife and I tried to take regular walks through the nearby park during last spring and summer. But I'd tire out after an embarrassingly short distance, not even enough to get to where we see the ducks (the highlight of the park for me). As the weather got worse in winter I basically stopped leaving the apartment. It's a struggle to put my shoes on without an extra long shoehorn so I don't have to bend over, and anything that requires me to tie my shoelaces is basically off the table.

I've been struggling with work for the past several months. I can't seem to focus on it, even if I take my ADHD medication. I look at the computer screen and I just can't mentally handle the work. Every day of work is exhausting, even though I work a pretty cushy job as a data scientist and I work from home. I do way less than 40 hours of actual work a week but I'm still too physically and mentally exhausted all the time to do anything but the most trivial household chores. I haven't cooked dinner for myself in months (thank God for my wife).

I switched to a new GP at the beginning of 2024 bc I was having trouble getting timely appointments at my last one. We agree to do one big blood test covering everything, since I have a myriad of small complaints and it's been years since I've had one. That test comes back mostly normal, except my cholesterol is a little high and my TSH is a smidge above 5. My new GP then says we should do a follow-up blood test to look at other thyroid measurements (this would be directly measuring the hormones my thyroid produces) to see if I have hypothyroidism. I mention offhandedly the interaction I had with my old GP in 2020 and she says that's not how you're supposed to do that; high TSH means further testing even if it's not that high. A few weeks and another blood test later and I've now got a new diagnosis and a prescription for artificial thyroid hormone.

It turns out that pretty much everything I've been struggling with for years now? May be because of my underactive thyroid. Your thyroid is apparently pretty damn important and it not working right (in either direction) can result in a truly dizzying amount of things going wrong. Depression, brain fog, fatigue, and weight gain are all pretty classic symptoms, but apparently it can also cause problems with your lungs or even contribute to carpal tunnel syndrome. Everyone with a properly-functioning thyroid, take a moment to thank that lil butterfly-shaped guy in your neck.

I'm so glad to have something that's basically a "feel better" pill now. But I'm left with a sense of deep frustration that I've had so many problems that even I dismissed to myself because I assumed they were just cause I was a stupid out-of-shape Fatty. It turns out it's actually not normal for someone in their mid-20s at my age to struggle to put on their own shoes without assistance, even when they're obese. Being unable to take a short walk without needing to sit down because I'm exhausted and out of breath isn't just because I'm fat and out of shape. I've had no shortage of symptoms heavily impacting my life, but most of them I hadn't even bothered to mention to my doctor because I assumed they were just Me Being Fat and that all I'd get was (yet another) lecture.

This is, of course, coupled with a lot of anger at my old doctor for not even running any follow-up tests. I've only been on levothyroxine for about a week and I already feel like I have a little more energy. I could have been spared years of suffering if that doctor had only done what she was supposed to. Fuck that.

But at the same time, I feel such relief. This all wasn't just me being a bad and lazy person. There was actually something wrong. And, even better, hypothyroidism is pretty easy to treat. I just wish I hadn't gone through over three years of unnecessary suffering when I could have gotten this treatment then.