Did you get diagnosed with...
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ADHD as an adult? (I know there are but I don't know the right thread.)
What kind of doctors did you see? What was the process?
I've got a friend that has asked his doctors a few times but been told to meditate, that it will pass, or that it is just the pandemic. However, the symptoms he describes have been consistent since high school and plagued him his entire adult life. I am not about to armchair diagnose, but it feels wrong to go to a doctor and have them brush off a concern without doing the work.
Any advice I can pass on to him?
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@silverfox TMI PERSONAL INFO TIME I GUESS
I got diagnosed as an adult... in early 2021?
A few years ago (17? 18?) I went to a neuropsychologist, which I had to pay for on my own nickel because my insurance at the time didn't cover it. I spent an exorbitant amount of money and got a diagnosis that was for "neurodevelopmental disorder NOS" abt which I went into kind of a spiral and did nothing for a few years. Ultimately went to a specialist in treating ADHD, got diagnosed with ADHD, ASD and GAD.
My GP was never discouraging particularly but also did not, I think, really believe my self diagnosis. She just kind of ... never wanted to deal with it? Or didn't know how? I don't know, honestly. She was a very helpful doctor in many ways and I think I probably was not communicating with her well around this for a variety of reasons but it is what it is.
I did find that my mental health therapist WHEN I finally got one was very encouraging abt going through the steps to get a diagnosis. Many, many physicians are weirdly resistant to messing with mental health at all unless they are embrace a more holistic "whole person" practice.
Finding a specialist and getting diagnosis is absolutely worth it. My ADHD treating psych also encourages meditation, exercise, diet, etc, but like, ... all of those are all part of treating the underlying issues, which are not resolvable because the neurotype is, as my doctor is firm about, not a disease so much as a different way the brain functions. He likes to say that we ADHD folks would have been super useful to have around if we were hunter-gathering.
Treatment has not solved all or even half my problems. But it had helped me be more aware of what issues there are and helped me to apply structures to deal with those issues. Also when I am on my meds, there are certain super anxious-making thought derails that happened with interruptions in my premedication life that have now simply entirely gone away.
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Not yet, though I am certain I have it based on the fact that a) my kids both have it (it's very common for parents to only realize they have it once their kids are diagnosed), and b) I'm basically the poster child for adult adhd and have been all my life without realizing it.
Having researched getting a diagnosis quite a bit, what I've found is:
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Many doctors, particularly ones of older generations, are not well-versed in adult ADHD. They have stereotypical notions that ADHD is a "kid problem" and people outgrow it. (Some do; most don't.) If your friend wants a proper diagnosis, they'll want to see someone who says "adult ADHD" amongst the symptoms the treat--that's a good sign that they at least are aware that it exists.
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An ADHD diagnosis is subjective, which means different providers may disagree as to the underlying cause of symptoms. What's most important is to have someone who takes the symptoms seriously and is going to work with you to resolve them, whatever the cause.
As for the process itself - a neuropsych eval will be a bunch of questionnaires and observational tests of things like working memory, concentration, stuff like that.
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@silverfox I was diagnosed as an adult. I saw a therapist who was in the same office as a psychiatrist, and while she couldn't diagnose me, she essentially made a list for me to take to him. And he was like, yep. ADHD.
I later had it diagnosed again by an online telemed doctor, because one diagnosis wasn't enough or something? I don't know.
If your friend has a therapist, he should talk to them first. Because they can walk him through meditation in a productive way (which is a pretty standard non-medication treatment for ADHD as part of Cognitive Behavioral Therapy, or CBT), and because they can refer him to a doctor who is likely to take their opinion seriously and diagnose ADHD if it exists plus medicate it if it seems likely he'll respond to medication. Honestly, one of the best ways to deal with ADHD is with both meds and therapy.
Recommended Course of Action:
- Get a therapist.
- Talk to therapist about ADHD and get a referral to a psychiatrist.
- Talk to psychiatrist and get diagnosed.
- Continue to work with both therapist and psychiatrist.
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I spoke to my therapist about it, and explained how it's been affecting me at work. He sent me to a behavioral health doctor, and apparently just sitting and talking about my medical history with her for 15 minutes was enough to convince her. (Hello, stimming)
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@faraday said in Did you get diagnosed with...:
- Many doctors, particularly ones of older generations, are not well-versed in adult ADHD. They have stereotypical notions that ADHD is a "kid problem" and people outgrow it. (Some do; most don't.) If your friend wants a proper diagnosis, they'll want to see someone who says "adult ADHD" amongst the symptoms the treat--that's a good sign that they at least are aware that it exists.
@silverfox used male pronouns to describe their friend, but regardless for anyone else reading who might be going through similar motions, I would like to add that I strongly recommend seeking a female practitioner and/or someone who specialises in "ADHD in women". There's a double whammy stigma not just against ADHD in adults, but specifically female brains as well.
More on this can be found here:
Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women(If you have the patience to read the above study, I would recommend also looking at the references as well, many of which are likewise very insightful.)
tl;dr for the above link: women are severely underdiagnosed due to referral bias, for example in one experiment it was found that found that teachers were much more likely to refer written profiles of students for an ADHD assessment if male names/pronouns were used even when the profiles were otherwise identical. Women & girls with ADHD do tend to present somewhat differently (more internalised symptoms rather than externalised, which is typical across the board for mental health problems in women). Yet despite underdiagnosis and undertreatment, they do not have better life outcomes in terms of academic/professional success or interpersonal relationships if left undiagnosed/untreated. So this matters. A lot. Even if they're more likely to seem OK, on the surface. Research and common medical knowledge is also generally lacking, for example there's been found to be a lot of interplay between female reproductive health & ADHD, but hardly any psychiatrists know or think to ask about endocrine factors when diagnosing and prescribing. Female puberty, menopause, menstrual cycles, contraceptives and endocrine disorders have all been found to impact dopamine levels and the efficacy of ADHD medication.
Additional hurdles exist in the UK where the NHS have only just barely begun wrapping their heads around the existence/validity of ADHD at all. I wish I'd kept a screenshot but it was barely a few months ago that their official medical advice website had stuff about ADHD being linked to low IQs and only being diagnosable in children. They updated that only very recently; apparently there was an explosion of people seeking treatment/diagnosis during the pandemic, forcing them to reexamine their current systems & knowledge base.
For me personally ... I've had to fight tooth & nail for my diagnosis, treatment and medication; it's been a trying journey, but very much worth it in the end. I feel like it's a journey I'm still on, and a lot of people in this community might be able to personally attest to the emotional rollercoaster I've been through this year pursuing it. (Because they were wonderfully supportive and I love them for it.) It's been less than a year since I was diagnosed and it's actually thanks to members of the MU* community that I pursued it at all; a few people in a Discord server I was a member of for a MUD I played were discussing it, shared online tests about it and more than one person seemed to be nudging me with the suspicion I have it. I was pretty resistant to the idea at first but then the more I read about it, the more things started finally clicking into place. I was able to talk to people one-to-one, and even just browsing that ADHD thread here that I'd been ignoring for years helped a lot.
Like @saosmash, I had to pay out of pocket. A lot. I'd estimate for the first year of assessments, appointments and medications it'd amount to something like £5000 in London. It'd be a lot cheaper on the NHS (like just £100 a year), but getting the NHS to believe you have ADHD and need real medication for it is basically impossible without first coughing up for private treatment. (Doubly hard with the aforementioned bias factors.) Hopefully soon I'll be able to make the switch off of private care, with enough important looking letters from the expensive experts I've seen.
I've had to argue with my (unfortunately male) psychiatrist a lot, cite studies (which should've been his job to be informed about). I've honestly cried over this, more than once, both with relief (when getting a prescription) and stress (when having to fight for one). I'd switch practitioner but the waiting lines in the UK during this pandemic are borderline insurmountable, and having to start over with someone new would mean having to pay more again and risk losing the prescription I'm on now until my diagnosis is reconfirmed. Having money to throw at people helps, and still only to a point.
The returns I've seen on this have all been worth it in the end, however; my life is measurably better on medication. My work, relationships, physical health and even academic potential have all improved. (I'm starting a new degree and several new work projects, which I wouldn't have had the confidence to do without this.)
I've had to do a lot of my own research since I've been able to get relatively little help from medical professionals due to both logistical impediments and institutional bias. A combination of Sci-Hub & NCBI have helped enormously. (God bless Alexandra Elbakyan, hero of our times and personal saviour.) I've spent a fuckton of time just searching stuff about the medication I'm on, my symptoms, etc., poring through the available research. It's been time-consuming but kind of fun, if you're a fucking nerd like me. I couldn't muscle answers out of my psychiatrist so I had to hunt them down. Specific individuals in this community who were available to share their personal experiences with me were a big help as well. (Other women especially, and Americans for whom the whole process is much easier & saner sharing their perspective of much more sensible doctors.)
I often think about how life might've turned out differently if I'd been diagnosed in childhood but ... water under the bridge now I guess. Just gotta make the most out of what I have and am capable of now in my upcoming 30s.
