What is the process for adult ADHD diagnosis?
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.
That's what I did.
"Hey, I've been looking into it and something resonated with me and got me thinking. For weeks I've been considering I may have ADHD. What can I do?"
The GP sent me to some specialist organisation. That org put me through the tests and voila, diagnosis.
From then on I was supposed to try medication, write a journal about that medication for at least the first day or two, measure my heart rate while on them, and report back in to see if everything would be ok. This went back and forth a little bit between me and the psychiatrist until we settled on a type and amount of medication that worked for me without most of the annoying side effects.
Concurrently I had weekly talks with a psychologist specialised in ADHD who essentially put me through CBT (Cognitive Behavioral Therapy) as well as provided me (healthier) methods to cope or deal with certain issues or symptoms.
It was honestly great. It helped me a bunch, got me to learn about myself, and showed me an entire new world that it doesn't always have to be that struggle.
Do note that not all countries or organisations do things the same. My experience could be entirely different from the next, but to answer your question: Yeah, talk to your GP.
Very similar to how it went for me, but I believe we are from the same country.
Though they also involved my parents, which was fun because my parents also took me through some steps when I was much younger (younger than 8, early 90s) but never came from it. When the specialist from the org looked at that report they basically went "Oh, looking at this report if they had the knowledge we have now you would already have been diagnosed".
Which I am adding because some people still talk about ADHD as if it suddenly more people have it while it simply was poorly diagnosed in the past.
Edit:
One thing I would like to add is the specific book used when I had weekly meetings with a therapist to get a handle on things: Mastering Your Adult ADHD: A Cognitive-Behavioral Treatment Program, Client Workbook.
I have mentioned it before on Tildes, ideally you go through it with someone. But it might be beneficial for some folks regardless.
Haha you just asked a bunch of folks with ADHD to tell you their stories, strap in :)
I started with a visit to my trusted GP. Many of our journeys end exactly there, when the GP doesn't trust us and scoff and shoo us off.
My GP gave me the inventory to take home and fill out.
I completed mine and it felt terrible to see all my lifelong struggles laid out on a page. So I printed a copy and made the husband do one too. His scores were hilariously on the far spectrum of "uh-oh".
We both went back, she read them, asked us more questions, discussed medication, and started us on a low dose of concerta.
They don't work for me so I make lifestyle adjustments and be kind to myself, otherwise same. The generic meds don't work for a lot of people, ask for No Substitutes.
Print, fill, and bring the Adult Self Report Scale (of your country) with you. If you get scoffed off, ask to be referred to a specialist. Ask to pay for one if your insurance will cover it. Repeat until you get taken seriously and given a full evaluation.
Good luck! And, remember, you're not crazy, lazy, unmotivated, or stupid. Folks with ADHD are plenty smart and highly motivated (in spurts)
Chipping in here as well, it feels like a lot of US based stories miss a bit of the treatment I got here. Which also involved weekly sessions with a therapist to work through various assignments and other things to be able to more effectively deal with ADHD. I am just dumping the client book that was used here in case it might be useful: Mastering Your Adult ADHD: A Cognitive-Behavioral Treatment Program, Client Workbook.
Yeah I was also very fortunate to hit a home run first try with my doc, but I can't believe the trouble some people have to go through to get a dx—it seems like older physicians especially are just not a fan of ADHD meds, or even acknowledging it's a problem, which is pretty sad, but I would say it's definitely worth struggling through to get some help, totally changed my life.
Thanks so much! After I submitted this post, I mentioned to my wife that I was exploring the possibility of an adhd diagnosis. She got super excited and jumped on the internet and found an adhd clinic that starts the diagnosis w/2 brain scans and extensive bloodwork (followed by a couple inventories and an in person with a psychiatrist). 1st scan is on Monday. 1st meeting with psychiatrist is in early December. Even if its not ADHD I'm hoping they'll be able to point me in the right direction...
That was fast!! Good job Mrs roo1ster!!
My spouse and I both have ADHD (but different types) and we constantly have to cover for each other in ways that seem trivial to one but insurmountable to the other. I'm genuinely very glad for you
I was in your shoes and after literally 5+ years of thinking about it, I finally went to my primary care provider a month ago and told them I've been thinking about getting checked out for ADHD.
They asked me a series of questions and said they don't think it's ADHD but mild anxiety and depression combined with stress that has made it difficult to concentrate and focus on tasks. They did refer me to a psychiatrist to get a second opinion about it though, and the psychiatrist came to a similar conclusion.
Both did recommend I go to therapy however to try and work through my stress and anxiety. I'm lucky the company I work for pays a service to cover 10 free therapy sessions for us per calendar year. Since I'm starting towards the end of the year, I've scheduled my therapy appointments to be once every other week and once the new year begins, I hope to go every 6 weeks or so.
So while my diagnosis for now has confirmed it wasn't ADHD, I don't think it would be too different for them to confirm that you may have ADHD and then seek further help.
In my experience, every single psychiatrist will blame anxiety and depression before they even consider you might possibly have ADHD. It doesn't matter that ADHD symptoms can cause anxiety and depression, you just have to go through the process of trying antidepressants even if they do more harm than good. Not saying this is the case here, but it's worth keeping in mind that many psychiatrists are skeptical or downright hostile towards people who think they have ADHD. You will likely have to advocate for yourself and really analyze your symptoms to get the treatment you need.
I went through a litany of SSRI's in my 20's, none of which helped much. I still harbor a little resentment towards my doctors at the time for never considering anything else might have been causing the anxiety and depression in the first place. Literally 90% of my anxiety, and a good chunk of my depression, resolved within a matter of days(!) once I started an actually-appropriate medication.
I'm totally with you on that one. I know they at least attempt to come at it from a risk reduction point of view, but I don't think SSRIs fit into that model very well. The side effects can be insidious and far longer lasting than just about anything stimulants could cause (barring psychosis or something). I blame the DEA and their ilk for it.
But yeah, it seems so obvious in hindsight! It's hard to not be sarcastic about it, but who would've thought that removing the source of anxiety and depression would help fix things!?
Fwiw, that's because that's part of the DSM definition of ADHD. It's a diagnosis of exclusion. If you have xxx symptoms and they're not better explained by something else, you have ADHD.
There are other disorders that are similar. IBS is probably the most well known.
ADHD is absolutely not a diagnosis of exclusion. Diagnoses of exclusion are diagnoses where you essentially have to rule out every other cause for the symptoms. ADHD has concrete requirements and is frequently accompanied by anxiety and depression. Experts in ADHD actually advise the opposite of what you claim here -- they recommend ruling out ADHD in people with relevant symptoms before trying to treat for depression, as the depression can be almost entirely be caused by the ADHD. Of the two disorders, depression comes closer to meeting the definition of "diagnosis of exclusion" than ADHD does (though that definitely does not entail providers actually doign the work of excluding other causes for depression either).
As for distinguishing ADHD from just depression and anxiety, there are quite a lot of screening tools for all three of these disorders, and they are far from indistinguishable from one another. For ADHD specifically, there are certain key symptoms and signs that any competent, experienced professional will ask about as part of the diagnosis process. While there certainly are a lot of overlapping symptoms (as there also are with other options like OCD and autism), people with ADHD often manifest with a number of symptoms that aren't well-explained by depression or anxiety (though whether these symptoms are prominent varies by person, of course). While it is common for healthcare providers without experience with ADHD diagnosis to dismiss many ADHD symptoms as anxiety or depression, they're usually doing so because of a lack of experience with ADHD diagnosis, not because it's best practice. The DSM requirement you describe is that the symptoms are not better explained by another disorder, not that you need to exclude those disorders entirely (though it may well have been better explained as depression and anxiety for the person who got diagnosed upthread; I'm not their doctor).
In addition, ADHD (unlike depression and anxiety) requires onset of symptoms in childhood (since it's a developmental disorder). Looking at records from childhood like report cards and potentially talking to parents are often part of the diagnostic process for ADHD as a result. The numerous elementary school report cards I got from my mom that said essentially "enthusiastic good student but needs better self-control and attention to detail" were very helpful when I got diagnosed, despite having both comorbid depression and anxiety when I was diagnosed.
I apologize for mispeaking.
Yeah, that's true, and there are many overlapping symptoms that can make it very tricky to narrow down. You just have to be prepared to advocate for yourself, especially if you aren't the stereotypical adhd case (e.g. not a man, not hyperactive, successful, etc)
Yeah I've heard that too. I have some friends who were diagnosed with ADHD and they've mentioned that it takes some fighting to truly confirm if you have ADHD or not. I still want to follow up with my psychiatrist in the future about analyzing my symptoms further. I have definitely struggled to focus on things for much longer than I have been working so it definitely can't just be my stress that's causing my inability to stay focused/concentrate on tasks.
For now though, I think I'm satisfied with just tackling my stress and understanding how to better cope with it and/or use that energy elsewhere.
Hey, in case it is ADHD. I mentioned this book elsewhere as it was part of a program that did help me get a better handle on things: Mastering Your Adult ADHD: A Cognitive-Behavioral Treatment Program, Client Workbook.
Ideally you go over it with a therapist in a weekly setting. But lacking a diagnosis it still might help you get a bit more of a handle on the things that are not anxiety and depression.
Ooh thanks for the book, will definitely take a look! I have another therapy session booked for 2 weeks from now so I'll bring it up with them.
Oh my god a book I can buy on the topic? SOLD. (if I get diagnosed and the meds work, I might be able to read it, along with a long list of other books I bought and never quite got around to reading).
seriously though, thank you so much for the reco, book has been purchased.
Yeah, if you're able to conquer than and improve your situation, that's honestly ideal! ADHD sucks ass, and if you don't have to deal with it, you're better off. :-)
I went to a specialist as an adult about 20 years ago. We spent something like 90 minutes on our consult and I left with a prescription. Along the years I was assessed by multiple "regular" psychiatrists since I have other issues that also require continuous treatment. They confirmed the initial diagnosis. That's about it.
Going to your GP first seems to be the most recommended course of action in North America. I didn't feel comfortable doing that in my country. Most of our GPs knew jack shit about ADHD back then. Our psychiatrists weren't that much better either. I knew they would just refer me to an specialist. So I went to the specialist.
Yeah, GPs here in Germany don't usually even recognize what my stimulant medication is when I write it on the list of things I take, unless I tell them. I only got my ADHD diagnosis out of sheer luck, thanks to my first therapist's decision to have a kid.
I had suspicions but the therapist I was seeing at the time said I couldn't have it because I could sit down and write an essay (even though that only came up because I was explaining that I could only get work like that done by sitting down and doing the whole thing in a flurry of what I'd now clal hyperfocus). We spent years without making much progress because she was treating my feelings of being overwhelmed and not coping with my workload as well as my peers as cognitive distortions caused by depression/anxiety, when they were really a result of my ADHD now that I'd reached a level where my compensation strategies no longer worked and moved internationally away from my support network.
That first therapist got pregnant and referred me to her replacement while she was on maternity leave (which is pretty long here in Germany). Her replacement asked me if I'd considered ADHD as a possibility during our first session. From there we went on to do a screening and then a full two-hour interview, at which point I got my official diagnosis. Took me longer than that to find a psych who could prescribe me meds, but even the diagnosis itself was so freeing, because I finally had an explanation for why I was struggling that wasn't just me being a failure.
follow on question - what has been your experience post diagnosis? What might I expect post diagnosis?
It depends on the provider, but they'll likely need to do tests to make sure you're ok to take stimulants - an EKG most importantly, and blood pressure readings. I know some insurance companies like Kaiser often require drug screening initially and/or regularly. If all that goes well, you'll likely be prescribed a relatively low dosage of some kind of stimulant medication to try.
I say relatively low because each person is different - I'm fairly sensitive to drugs, and the starting dosage of 10mg for me was just too high at the time since I was also at a fairly low body weight. Don't be surprised if there are side effects - pretty much all of them have side effects to some extent, but you need to figure out what's tolerable for you personally. For example, for whatever reason, Ritalin doesn't work well for me at all, but Adderall does. I also tolerate the instant release versions better than the extended release versions, which is the inverse of most people. Adderall still has side effects, but they're a lot more manageable for me, and they often do get more manageable after regular usage. From there, it's basically just seeing whether they work in your life or not, and then working with your psychiatrist to adjust things as needed.
Some things I wish I knew before I started (some of which you might not find on Reddit because the r/adhd mods will ban you for it, seriously):
Good luck! I realize the irony of writing all of this for someone with ADHD, but I hope it helps :-)
Added note, vitamin C is known to break down certain bonds in amphetamines and other drugs, moderately to severely impacting efficacy.*
I use dexamphetamine as the prescribed drug, which means I need to avoid Vitamin C before intake.
*While I'm confident that this happens, I'm not a lab rat so my description why may be off.
In general I've found doctors to be weirdly bad at telling you when you shouldn't take certain drugs at the same time. They'll often know if there's reasons not to take them together at all, but not finer details like taking them at different times. I'm on L-thyroxine (not sure if this is the same name in English; it's artificial thyroid hormone), which you basically need to avoid taking within 30 minutes of anything, and for certain vitamins/minerals you should wait several hours until taking them. My doctor only told me to take it on an empty stomach and I only found out the rest of this online when researching my new diagnosis.
There's so many interactions both known and sometimes unknown that I can't fault them for not always knowing.. but it's also their job to figure it out for you.
Especially in your case where it's rather significant. For me it'll just turn the pill into a dud and that's about it. For you I imagine it's worse if these interactions mess with your thyroid.
Mine also just turn the pill into a dud technically -- it's all because thyroid hormone is pretty tough for the stomach to absorb or something -- but since I'm taking it because my body doesn't produce enough thyroid hormone on its own, it's pretty important to actually absorb it, especially when determining the right dosage.
Yeah, I had overall a great ADHD experience with my doc, but I literally asked "Is there anything I need to know about when to take the meds, what to take it with, all that?" and they said Nope, go for it lol. Turns out protein, citric acid, all that stuff can affect it—maybe just not to a great degree? I haven't done enough experimenting to decide.
Good call, I totally forgot about that one! I believe grapefruit/grapefruit juice has an especially strong effect in that way too.
Grapefruit interacts with so many types of medicine in such odd ways that it's generally advisable to say "Do not use grapefruit in combination with this drug unless specifically told it's fine".
Grapefruit is really weird.
Grapefruit juice interacts weirdly with a ton of medications because of weird enzyme stuff, but iirc the stimulants used to treat ADHD aren't typically among them (though its being a source of vitamin C can potentially still be a factor for the effect described above). At least if you're in the US, the FDA says to check the information sheet that comes with your prescription medication or the drug facts label on OTC drugs, which should list whether you should avoid grapefruit juice while taking that medication.
I’ve reached that overstimulation point with just coffee before. I’m unfocused as if I’m sleepy, but instinctively know more coffee will only upset my stomach. However, it seems to do far more with absorption than with dosage. If I eat the wrong thing for breakfast (cereals), it’s worse than rawdogging the coffee pot on an empty stomach. Likewise, I tolerate espresso-like preparations much easier than French press (drip coffee is a hit-or-miss middle).
Depending on the ratios you're using, espresso-likes can end up having less caffeine in them than something like drip coffee or French press. They have a higher concentration, but you consume way less volume of them. I definitely get more of a caffeine buzz from a pour-over than I do from a doubleshot espresso.
Luckily or unluckily for me, I can take my ADHD meds with coffee to wash them down and still take a nap afterwards sometimes. My body is weirdly good at sleeping.
That would explain my preference for espresso. The high concentration means it acts like an instant-on lightswitch, while the lower total dose means I don't get as easily jittered. French Press and drip are like running the risk of getting way too high because you were impatient with your edibles. Tea, too.
Thank you so much. I'm book marking your post for when I get to the 'dialing in the medication' phase. I'm randomly ahead of the game on a few of those bullet points, mostly because my wife is super into health/nutrition/supplements.
You could chart my life by a boom/bust cycle where I boom shortly after I've successfully re-engaged w/a daily vigorous exercise regimen, and then re-engaged with other good habits once the exercise started paying dividends. Those booms always ended some period of days/weeks after the exercise stopped (as often as not because of physical injury from the exercise). Busts last until some external factor raises my anxiety high enough that it feels like my options are 'take action or die'. I'm hoping that experience with rebuilding my life repeatedly over the years will carry over to being productive once the meds kick in, and the bust side of the cycle will shrink, but I'll start preparing myself for the meds not being a total panacea.
No problem! Your boom/bust cycle sounds exactly like me in the past - it still applies to some extent, since my ADHD seems to be fairly high on the scale, but it's significantly more manageable now. Feel free to reach out if you've got any questions about side effects, or anything really. I didn't get into all the possible side effects or even all the ones I've experienced, (sexual, cold feet, etc) so don't be alarmed if you get any!
I don't know if you mentioned it, but I get the vibe that you'd be considered at least somewhat successful in our society, so I think you've got a great handle on being able to improve yourself and your situation. I think you'll do very well, and good luck with it!
Well, I was diagnosed in 2020, in my mid-40's, six months in to the pandemic. Turns out there is, in fact, a limit to how well I can mask my symptoms, and the stresses of it all had me showing up to a new-to-me doctor to see what was going on.
I did not expect ADHD, as, even though I'm male, I never had the H; I was much more of a lost-in-my-own-mind type, which I've since learned is ADHD-Inattentive type. I have struggled with anxiety, depression, and anhedonia my whole life, but never made the link. On the positives, I am intelligent and well-socialized; people in general like me, and I know how to work with others. It just takes literally everything I have, that's all. (only slightly /s).
My new doctor must have heard something in how I was talking, because she kind of looked at me funny, and asked if I'd ever been tested for ADHD. I said no, she said that it might be a good idea, and I was referred to a psychiatrist for evaluation. It took a few months to get in (couldn't do telehealth for this type of visit, and this was during lockdowns, so that was a whole thing to work around), and, well, we had a conversation. They asked about my life, why I wasn't evaluated earlier (I didn't live in the US as a kid, so I missed a lot steps where it might have been noticed), what I did, how I did what I do, my relationships, all of that. They then wrote me a prescription for Ritalin, and holy shit. My anxiety dropped from a constant 8-9 to about a 3, and literally for the first time in my life, I was able to fall asleep at night without taking a few hours of ruminating to do it. I then spent a long time coming to terms with What Might Have Been.
So I am very grateful for the diagnosis, but it's not all roses. It's been 4 years, now, and the ritalin is no longer nearly as effective as it used to be, even at higher doses. I am in the process of trying to figure out what to do next. The skills I've learned since being treated have helped quite a bit, even with less effective medication, but there is still much to do.
Hope this helps. If you have any follow-on questions, I'm happy to reply.
There are indeed other medications which might provide with the desired effect at a lower dosage. They can be significantly more effective than Ritalin to some patients. Talk to your doctor ;)
That's the plan! Currently on a waiting list to see a psych that knows more about adult ADHD than my current one.
Although if anyone reading this has gone through the same issue with Ritalin, and has found something else that works for them, I'm all ears. It has been surprisingly difficult to sort the wheat from the chaff reading the general internet about such things.
Have you switched from name brand to generic, or from generic to another brand of generic? Generic manufacturers can often use different "filler" ingredients which some people may not tolerate in the same way.
FWIW, sleep/exercise/diet/stress all have a very significant impact on medication efficacy in my experience. If any of those have changed for you, it's very possible that could affect it.
Oh, I've been on the generic/brand treadmill, as well as slow release vs short acting. It's kind of remarkable how different they all feel, considering they're supposed to be the same exact med. If I was testing them blind, I'd never have thought they were the 'same'. Luckily, in my case, the most effective turned out the be the inexpensive IR generics.
I fully agree about S/E/D/S all being critical. A big part of my problem is that the ritalin is losing its effectiveness on how it helps regulate my sleep cycle, which of course has plenty of negative downstream effects. So much balancing, this vs. that. It's tough.
Switching to amphetamine-based stimulants instead of methylphenidate helped a bit for me (though I switched more because methylphenidate wore off too quickly for me). But the biggest help when it comes to the meds getting less effective over time has been the occasional "tolerance week". I'm currently on 30mg Vyvanse and once my psych upped my dosage to 50mg because it wasn't as effective. Coincidentally, I got sick the next week and didn't take anything (since I was supposed to be resting all day anyway), and the next week when I tried the 50mg I had the side effects they tell you to look out for when you're figuring out dosage.
A week off your meds every few months can help a lot. Some psychs (mine included) will try to get you to go off your meds on weekends, but this has never been tenable for me because it just makes me sleep all weekend and never get to have a life outside work. A slightly lower dose on the weekends can sometimes work well though (but ask your doctor before splitting pills or capsules, as whether you can safely split them depends on the med).
Yeah, I always kind of resented the "don't take it on weekends" approach, honestly. As if I'm only deserving of being functional at work. To my doctor's credit, when I told her as much, she seemed surprised by the response, and told me she hadn't thought of it that way before, but appeared to genuinely appreciate the feedback.
You're right, though, tolerance breaks may be a necessity. I may have to pick a slow work week and tough it out for more than a couple of days on, say, a quarter dose to see if it helps any. I'm on IR pills, at least, so cutting them up isn't an issue.
To offer a counterpoint to what you are saying. I personally also do like the feeling of being the slightly less focused but also slightly more relaxed person I am when I am not on methylphenidate. Specifically, I find that I am better able to just relax when not on medication than when I am on medication.
One of the reasons is that, when I have taken my medication, I am also more acutely aware of the times I still do get distracted and that can manifest in being slightly annoyed. At work this is fine as it allows me to get back in focus or do whatever is needed to remove the distraction. In the weekend I don't want to be annoyed by being distracted as most of the things I try to do are unwinding, hobby projects and general fun activities. The sort of stuff where it doesn't matter as much if you get distracted as the activity itself is the goal, not the end-result.
So, generally I make sure that most chores and stuff has been done during the week and that whatever I need to do in the weekend is already prepared. For the latter think shopping lists as we do our bulk shopping in the weekend.
Then in the weekend, I can just truly unwind and just let my brain go do whatever it wants to do.
Of course, when I do have actually important stuff to do I simply do take my medication in the weekend.
edit:
Figured I should also include a few other reasons I don't always take medication in the weekend.
I was about to say I never noticed this when I was on methylphenidate, but then I realized I only ever drank in the evenings after it was already out of my system for the day.
I wish I enjoyed how my unmedicated brain worked more. Unfortunately for me, I don't really get to unwind and relax; my brain gets stuck in THERE IS SO MUCH TO DO OMG YOU MUST BE DOING SOMETHING NOW AAAAAAAHHHH mode very easily, and it's exhausting. I take ritalin so I can actually get to sleep as much as anything.
Part of it is that I've had to be the caretaker for both my parents as they aged, and the cold reality was I had to be 'on' as much as possible, because if I fucked up and missed giving them their meds, getting refills, etc. they could have died. They have since both passed, but it's been a real difficulty coming back down from the edge. (Yes, I do see a therapist about it, which helps.)
Yeah, I can see how that trauma/stress response gives it a different experience. I know I said counterpoint, but I honestly didn't mean it as a “you are wrong” type of thing. More as a different perspective/experience for anyone coming along, reading the threat.
I really do wish you the best in coming back from that edge.
No worries, and thank you. I genuinely enjoy the conversation, and the different viewpoints. :)
Huh, interesting. I have been doing that myself for various reasons but didn't know it was actually recommended by some. I am familiar with the advice of not taking it for a week.
With the methylphenidate variant I am on, it sometimes does make the Monday at times a slight off day because it kicks in differently after not taking it for two days. It is difficult to describe and doesn't always happen, but it does seem to be related to my body adjusting again. For me, it is not that big of a deal, but it might be a dealbreaker for other people.
So going for a tolerance week once in a while could be good advice for people who don't want every Monday to be a slightly off day.
Thank you so much! The prospect of my anxiety, which is pretty much the only effective motivating force in my life dropping to a 3... I might go have a good cry just imagining it. Scratch that - I have no concept of what that might feel like.
I grew up in the US, but my parents didn't/don't believe ADHD is a real diagnosis (cousin was diagnosed in the early 80s and my parents rarely missed an opportunity to make a snide remark about it).
I've got an appointment to start what will be a month long process to initial diagnosis on Monday.
While I also still heavily depend on my medication I also want to attend you to this comment I made
Thank you for the resource/workbook link. I'll check it out; my various doctors haven't used anything like that with me, at least not yet.
Yeah it seems like a lot of the steps people in the US go through are limited to medication. It will be most effective if you can find a therapist who is familiar with the method and who can go through it with you on a weekly basis.
Certainly at the beginning it is the sort of structure you need as you are effectively still learning to apply more structure yourself. But, if that is not a possibility, I feel like it might help to do a "light" version of this with a partner or close friend.
Hello me from a year ago.
This is the route I took, and my GP was very helpful and referred me to a nearby clinic that specializes in performing neurological evaluations. I was able to schedule an appointment within a few weeks and got evaluated. They took a few weeks to analyze it and gave me a positive diagnosis for ADHD.
I circled back to my GP and he prescribed Adderall at a low dose, and gave me a heads up that he was comfortable trying out a few different medications but that if the first 2-3 didn't work for me I would need to consult a psychiatrist for further guidance.
Adderall didn't really work for me, I tried it for about 2 weeks. I was very intensely awake and didn't feel like it was helping even after cutting the dose in half and then in quarters. I tried Straterra for 5 days and stopped, the side effects where intense (headaches, disorientation, acute tinnitus). After this I booked an appointment with a psychiatrist, which was going to take a few months before they had an opening.
I most recently was on Wellbutrin for about 2 months. I actually found it very helpful, after I figured out the dosing regime. The prescription was for twice daily, but I didn't like that it increased my tinnitus (have had it my whole life) so I started only taking one before bed. After about a month I noticed I was consistently waking up with energy, excited to start my day, able to perform all the tasks I wanted to do without getting overwhelmed. That was pretty great.
Last week I had my first appointment with my psychiatrist and after we talked through everything that's been happening, they offered up that in their opinion they don't think I actually have ADHD. It turns out that the symptoms of depression have a lot in common with ADHD (anxiety, executive dysfunction, difficulty focusing). Which is why the Adderall didn't really help much but the Wellbutrin did.
Now they've switched me to Lexapro, and we're going to see how that works.
(Note, I am in the US)
Thank you so much! I've made an appointment with an adhd clinic that will do a couple brain scans and a bunch of bloodwork as part of the diagnosis process. Reading through all these lovely comments I'm admittedly bullish on ADHD, but I honestly don't care if it's adhd or something else entirely, I just want to get some traction...
Lol this is almost the reverse of my experience. Back in undergrad I had an ADHD screening but the psychiatrist prescribed Wellbutrin instead of any stimulants (probably because she assumed I was looking for study drugs). I did not tolerate it well (though I'll give her credit that Wellbutrin is used off-label for ADHD, so she wasn't completely ignoring it).
I was on Lexapro for a little while later on for depression and it was pretty helpful! Though I'm off it now because it turned out that depression had other physical causes in my case. I hope you tolerate it well! Getting the right medication for depression or anxiety is a lot of trial and error, but hopefully you'll find what works for you quickly.
I started with an online doctor service specifically for ADHD. I don’t remember the name, and I am not sure I can really recommend it. It was quite expensive, it gave me a superficial diagnosis that I didn’t feel confident about, and only gave me access to medication. I did it because it is a very ADHD friendly process and was heavily recommended by a friend.
After one month on this service, and my doctor waiting until the day after I would have run out of pills to send a new prescription (the medication I was on should not be skipped), I decided it was a terrible service and went through the “normal” route. I am honestly not sure if I would have made it through that process if I didn’t already have medication.
I had to go to my primary care doctor and obtain a referral for a psychiatrist. This was necessary for insurance reasons. I had to wait quite a while because I changed insurance at the time and had to get a new doctor. Once I had my initial checkup with my doctor, getting the referral was simple. I told him my reasons I thought I had ADHD, he said they seemed reasonable, and gave me the referral.
I had to dig through some insurance BS website to find a list of psychiatrists in my area. Just a fair warning, to prescribe ADHD medication, the psychiatrists need to see you in person at least once. My psychiatrist was a 90 minute drive away from me. That was literally the closest one I could find. I had to take time off to go to the first appointment, but all future appointments were virtual (I actually prefer in person, but I couldn’t find a closer doctor). My insurance website included filters for specific specialities, but I had to just start calling the phone numbers listed and ask in person. Probably 80% of the doctors listed as taking new patients were not in fact able to take new patients.
Anyway, buckle up for bullshit, but it is worth the time investment. Even if you don’t have ADHD, a psychiatrist can give you a differential diagnosis and may identify some other aspect of your mind that you aren’t aware about.
Most importantly, you are not broken. We identify these conditions as “mental illnesses”, and I hate that name. They are classified as this to make insurance simpler, so I won’t be arguing to change it (the US healthcare system already has enough bullshit), but I don’t think it’s a good way to think about our conditions. We are different from normal. Our brains work in a different way. It isn’t bad or good, just different. The world is majority neurotypical, so it is difficult for us to function in it, but that’s just because we are unique. It would be just as difficult for neurotypical people to function in a world of ADHD or ASD people.
Speaking for myself- I know I'm not a bad person. But my ADHD is an illness, and has caused me a great deal of difficulty and pain. I would not wish how my brain works on another person. Others may feel differently, and if they don't feel limited by the diagnosis, I am genuinely happy to hear it. But man, my life has been really hard, despite trying my best, and it rubs me the wrong way to hear the negatives papered over. It certainly hasn't been fun for me, and this isn't because of external, societal factors. And this is not self-loathing speaking, either. I do not, thankfully, suffer from that.
It just genuinely has been hard.
I'm with you on this one. ADHD is a burden on myself, and would still be even if I was the last person on earth. I have trouble doing things I desperately and actively want to do, and even with feeding myself without proper treatment.
Read your comment while eating soup out of a can because I once again forgot to go to the grocery store and get the bread and lunchmeat I've been meaning to since Sunday. Cheers.
I think of it as much like any disability. The dividing line between what's societal and what's inherent is generally blurry. If someone can't walk, that's not something changing society would fix -- but society is the major contributor behind whether they can get a wheelchair and whether buildings are accessible to them. In the same way, there are a lot of things about my ADHD that just suck and can't be changed. It sucks to have to deal with those things. Just like how it presumably it also sucks to be unable to walk. But how easy it is to succeed despite that stuff is hugely dependent on how well society accommodates people with those differences and deficiencies, and often society is just not doing that for us. It's not helpful to think of yourself as broken because you can't do the equivalent of entering a building without a wheelchair ramp.
Hey, I am with you on not wishing it on others. I also can't comment on how you are experiencing it, and certainly don't want to paper over any negatives. What has helped me make a little bit of peace with it all is looking at qualities of my character and personality I really like. For me, this resulted in the realization that there are also lots of qualities I possess as a result of my ADHD that I wouldn't have had otherwise. Qualities I not only appreciate, but others as well.
To give an example, I will always be somewhat of a generalist at most things as my interests shift around. At the same time, this has given me a broad perspective on things. I will never be a project manager because I simply don't have the overview of timelines, but I am the sort of person asking annoying questions the project managers appreciates.
Again, this is not going to be a silver bullet in acceptance and I am not trying to paper over negatives. I am with you on the "it has been hard" part. I am just sharing, as shifting my view a little bit did help me in accepting myself and looking forward a bit more. Although, yeah, it will never not suck at times.
10/10 on positive qualities I possess as a result of my (might be ADHD). I am amazing dealing with crises - so much practice over the years from not taking any action unless its a crisis (and thus manufacturing crisis after crisis after crisis).
So I have always felt like something was off about me; I've taken the online tests for all sorts of things, talked with doctors, everyone has said "well you don't seem depressed," or "you did really well in school, you're not 'hyper,' you can't have ADHD," all that. Also "you are so smart, but ___"—it was never really a positive, more like unlived potential to be ashamed of.
After feeling a lot of similar feelings (I am trapped, circling the drain, why don't I enjoy any of these things, did I ever enjoy them), I took some time off this summer from trying to fix it, and really stopped trying to do much of anything. I played through some video games I had been putting off, and it honestly felt pretty great—and then I was done and couldn't figure out what to do next. Because secretly, even though I had told myself "I am taking this time off to do things I really enjoy," I had just converted playing a game into another task to complete.
So I was telling someone all of this, like "it was great, but I don't know what to do with my hands," Ricky Bobby-style, and they said that their ADHD was secretly pretty great because they always had a new exciting goal with some rando project/hobby they picked up but would never finish. I said, only half-joking, "Ok but what if I can finish things, but I don't want to? Like I just don't care, or enjoy doing anything really, am I depressed?" And they said "That is exactly how I feel when I don't take my ADHD meds."
My brain exploded, I went and looked at the CAARS test again—hey guess what, if you take those assessments with a mindset of "Oh I don't have any problems sitting still, I don't fidget, etc" then yeah you can come up with a score that says you don't have ADHD, but when I was honest about how hard I was having to work to exist in that space without falling apart all the time in order to present the image of having it together, whew. I got like 14/16 indicators: of course I don't have any trouble sitting still, because I have structured everything so I never have to—repeat ad nauseum, all day, for my entire life.
All that to say, man it's so much easier to live when you're not struggling to stay above water all day, just to exist. I keep mentally reaching to pick up things I used to do all the time, like panic or give up on something, and then realizing I don't have to do that. I had an extremely positive experience with my doctor, who just gave me the same test I had already taken online & said "Oh for sure, I clocked you as soon as you sat down" haha—no issues with diagnosis, medication, all that. We did one adjustment upwards because I felt like it was almost working, so far so good afterwards, & I feel fantastic. In the same way that caffeine makes some people sleepy, turns out ADHD can get you real down & stressed; my blood pressure was 20 points better a month into medication. Pulse is not as great because I do not want to live without caffeine lol, so I still have some work to do. And I've learned since that my experience was maybe not typical, as a lot of people have to struggle through multiple medications, dosages, even doctors to get it right. But hang in there because it is the best thing I've ever done for myself.
I had to do a double take - felt like I could have written several portions of your post pretty much verbatim. "Struggling to stay above water all day, just to exist" - fuuuuuuuuuuuuu...
At any given moment I can rattle off lists of things I'd really should be taking action on, but just cannot until the repercussions have become so dire my options are 'take action or be homeless/jobless'. I work in tech, mostly startups (need the excitement to stay engaged), and over 2+ decades every time I've found myself jobless (aka ignored any and all warning signs while there was still time to take reasonable/easy action) there's been an employment gap that didn't end until I was completely out of $$.
My ?proudest? college moment was a logic circuits course where the course grade was based entirely on how many labs you successfully completed (20 total). Lectures were optional. I skipped 90% of the lectures and somehow managed to complete 4 of the labs over the course of the semester. Then late in the afternoon the day before the deadline to finish your labs (8a the next day) I walked into the lab, still having engaged with almost none of the course material and did the other 16 labs, finishing around 5 or 6 in the morning. One of my very few A's at the collegiate level.
It took me 13 years to get my undergrad degree and even that was more luck than intention with a healthy dose of shame driving the result (There are 11 cousins in my generation of my family. All 11 have college degrees, 7 have STEM PhD's. My bs in cs was the last undergrad degree in my generation by a fair bit and I'm 9 years older than the youngest cousin). Since then (20 years), I've started 10s of certifications. I've yet to complete a single one.
good times...
God this is the most relatable shit ever. I'd bet money on your ADHD diagnosis at this point.
yeah I was BA instead of BS but my record was 37 pages in 12 hours lol, and it was good! I was "fortunate" in that my brain kept me doing things without any actual executive functioning, so I did go back to school and get degrees, but when people would say "You must be so proud!" there was just... nothing. I think now that was probably because I wasn't actually having to -do- it lol, I just had to sit down and the ol' system would fire up. Trouble was, that was the part I couldn't turn off—so anyway yeah meds are great lol. I'm taking it for granted that you're going after this, & if you're like me it will 100% change your life, best thing I ever did, however: for the first time now, ever, I have to make myself do things, and it turns out I do not want to do them lol. So there are layers, not a perfect fix, etc. But yeah I have been working down a list of Things To Finish One Day and it's incredible, definitely worth it, talk to your doctor, keep us posted!
sounds very familiar - my best streaks in school were when I was too busy to even think about if I was going to do the 'next' thing, just mindless "what's next. do it."
My experience was to go to a Therapist for a completely different issue, and talk to them for a couple months. Then she turned to me one day and said "Yeah, you have ADHD, I'm going to read the entry from the DSM to explain how I came to this conclusion" and I felt both simultaneously attacked (by the book) and vindicated (for my suspicions that I had it all along).
Go find a therapist and just chat with them. Don't tell them right away, just talk about your symptoms and struggles. Let them come to the conclusion without you tainting their perspectives by hoping for an ADHD diagnosis. If they're worth their salt, they'll come to their conclusion themselves.
I don't trust a GP to make that diagnosis though. The first time I went to a GP about my symptoms, he told me "You're just not getting enough sleep. Here, have some Ambien, call me if you have any issues" and I took it exactly once, hated it and knew that wasn't the solution. The second GP years later said "Hey, you should probably go talk to a therapist, here's a reference. Go talk to them"
Thank you so much. I'm excited about whatever I'm dealing with possibly being adhd, but I'm really just interested in getting some traction regardless of any labels/diagnosis. I'm optimistic about the clinic I booked with yesterday late - diagnosis is based on brain scans, bloodwork and several appointments w/a psychiatrist. If its not ADHD, fingers crossed they'll at least be able to point me in another more likely direction.