1y ago

Met with a psychiatrist for ADHD diagnosis

I just had my first ever meeting with a psychiatrist to get diagnosed with ADHD.

Long story short, they said that I clearly exhibit ADHD symptoms.

But they're not willing to go forward with a diagnosis because, according to them, I seem to be doing alright in my life, so the symptoms are hardly causing me enough problems to be eligible for a diagnosis. (And also because there's no evidence of me having had such symptoms in childhood.)

And I was just sitting there thinking, do you really think I would be here if I didn't think the symptoms were causing me problems in life?

Based on what they said, they expected me to have experienced things like getting warnings or being fired from jobs, ruining my relationships with people, and such. And they suggested the usual things, exercise, the Pomodoro method, etc. As if I haven't tried them already.

My bad for masking so well, I guess.

Anyway, just wanted to vent a bit. I know it's too common a story. I guess the next thing I need to do is to find a psychiatrist specializing in adult ADHD. Once my (still undiagnosed) ADHD lets me do that.

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Im sorry you didn’t get the diagnosis you wanted or believed you should have.
All I can do I offer my experience.
So, I had lots of markers from childhood, eternally unhappy (doctors many times for depression and anxiety), substance abuse, so many jobs (50+) that I’d left or been fired from etc
So in short ADHD was ruining my life. Post medication is night and day. I’m now a software developer and doing better in every aspect of life.
If you feel you didn’t represent yourself truly to your psychiatrist then perhaps having another session.
I think it really does depend on how negatively it has effected your life and whether medication would help that.
If you’ve presented yourself as doing fine then it’s no surprise they’re hesitant to diagnose.
Also, there are numerous other conditions that can align with ADHD so perhaps exploring those would be an option.
May I ask what you wanted from the diagnosis? If life is going ok and you’re coping well then what can you gain?
Take that question as curiosity and not me being rude (over thinking as always.)
- Thank you for your comment, it's really something to think about. Maybe I didn't really get the important points across to the psychiatrist. I know that lots of people struggle with their symptoms much worse than I ever have. It is true that, in a certain sense, I'm doing fine, outwardly in particular. But it feels like my "doing fine" comes at the cost of a huge mental effort. It's like I have to fight against my brain to be able to do the minimum necessary effort at the things I need to do for work, at home, etc. And all of the things I want to do but don't strictly need to, like hobbies, passions, career aspirations and such, there's simply no mental effort or focus left for most of them most of the time. I constantly feel like I'm not able to focus on anything, I can't perform at my best, always procrastinating, always having to focus all of the little focus I have on simply managing to stay afloat, always drained, always stressed, always overwhelmed with everything. Always feeling guilty for slacking off and being "lazy". Feeling like I'm wasting my life, unable to do things which I really, really want to do but for whatever reason can't bring myself to focus on.
  What could I gain? I could say a lot about that, but I guess it boils down to, I really would like to be able to choose what to focus on and when. Instead of my brain just deciding not to focus on anything, except potentially some ongoing hyperfocus obsession.
  
  It's like I have to fight against my brain to be able to do the minimum necessary effort at the things I *need *to do for work, at home, etc. And all of the things I want to do but don't strictly need to, like hobbies, passions, career aspirations and such, there's simply no mental effort or focus left for most of them most of the time. I constantly feel like I'm not able to focus on anything, I can't perform at my best, always procrastinating, always having to focus all of the little focus I have on simply managing to stay afloat, always drained, always stressed, always overwhelmed with everything. Always feeling guilty for slacking off and being "lazy". Feeling like I'm wasting my life, unable to do things which I really, really want to do but for whatever reason can't bring myself to focus on.
  This is classic ADHD and is obviously taking a toll on you! I relate so much. I was able to kinda keep it together in that same way until I got pregnant a little over 16 years ago, then the hormonal changes and the mental burden of caring for a child absolutely wrecked my ability to mask at all, but I didn't get diagnosed until a few months ago.
  If you felt like you generally had a good rapport with that doctor, it might be worth going back to emphasize these aspects of your struggle and the toll they're taking on your life and health, but if you didn't have a good vibe from the doctor, see someone else.
  I found it very helpful to prepare a list of all the ways I was struggling, including anything I was doing to mask my struggles. I used to be late for everything and forget appointments, but now every event in my calendar has 5 notifications in the lead up so I can't forget (1 week, 1 day, 12 hours, 4 hours, 1 hour). I bet you've developed similar systems that seem excessive to outside observers but totally sensible to your fellow ADHD'ers, and talking to your doctor about the ways your coping strategies cause their own difficulties and burdens might help them realize that you're genuinely doing everything you can but still need help.
  
  Thank you for the encouragement! Looking back, it's obvious that I was dealing with the same issues already in my late teens and early twenties, but it was only during my postgraduate studies that they really started to become an impediment and I started suspecting that I might have ADHD. Now that I have my PhD and am pursuing an academic career, I've really started feeling my web of coping mechanisms start to rip at the seams, and I fear that eventually something will give and everything will come crashing down.
  (And one of the reasons the psychiatrist didn't think I can have ADHD is that I managed to complete a PhD and have a decent academic job. But there are tons of stories out there about people doing exactly that?)
  Making a list of the ways I struggle and what I'm doing to mask them is a very good suggestion. But it also sounds difficult, because many of the coping mechanisms are so ingrained at this point that I don't even realize they're coping mechanisms. And because I need to remember to write things down when I think of them!
  
  Oh yeah, making the list is going to be a pain in the ass! For mine, I started a little note for it in my phone, and every time I came across an ADHD thing while internetting that made me think "omg me too!" I would put it on the list. I also sorta "cheated" to get started by looking at lists of symptoms and problems and coping strategies and copying anything that was relevant to me. I think it helped that I didn't set out to get it all down at once, I just added to it here and there as I thought of things while doing other things, and it grew.
  Here's some of mine, maybe this can help you get the ball rolling?
  Symptoms in Adulthood:
  Head full of constant noise - songs, chatter, repeated phrases - “bees in head” - EEAAO perfect illustration w IRS meeting scene
  Bumping into things, bruises, falling - I used to be a dancer, I have great balance and pretty good coordination, but I'm a real klutz when I'm not focused on movement, get injured often, and am literally constantly sporting at least a couple bruises from just existing in my house - what will happen when I'm elderly and fragile???
  talk too much/overshare, interrupting
  struggle to read anything not totally engrossing, but then dead to the world when engrossed
  Financial instability, overdrafts, credit issues, etc - much better now with autopay etc, but I still occasionally fuck up and pay the "ADHD Tax" at least a couple times a year.
  Auditory processing issues, difficulty with spoken multi-step instructions, have to write things down
  Often blank on direct questions - what do you like, what have you been doing, etc
  Lose track of time
  Can only do one or two things a day, have to devote entire day to social function or anything very taxing
  Have to set reminders and add things to list immediately or they will be forgotten
  Rejection sensitivity
  Completely derailed by strong emotions
  struggle to develop habits (but does make it easier to drop bad ones like smoking, binge drinking)
  Attempts to help self:
  Lists and reminders - I even have lists of lists and reminders of reminders, it is absurd
  Routines, sleep hygiene
  Breaking big tasks into small
  DBT workbook to help with emotional issues
  Meditation - I can't reliably do the sitting still kind, but the walking/doing kind is very helpful
  Exercise (elliptical, pilates, weights, yoga)
  Coffee, energy drinks
  Podcasts and music to try to power through boring tasks
  
  Oh wow, thank you so much for the list! Almost all of the symptoms you've listed apply to me too. Some of them I didn't even think would be related to ADHD, like blanking on direct questions.
  
  🤗 I hope it helps, and even more, I hope you get the care you need. Diagnosis and medication made a huge difference in my life, most importantly in how I think of myself. Doing anything I can do to help anyone else on that road feels really good, because it's as much an act of self-compassion as it is an act of service.

30 comments