Reply To: Diagnosis Says I Don’t Have ADHD… Now what?

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Hi. Another ex lurker coming out to see if I can help.

Since I’m functionally mild or perhaps even subclinical and with no comorbidities right now, I have been managing without meds and only an informal rediagnosis (originally diagnosed at 13) from my (ADHD and dyslexic) clinical psychologist who helps my OCD-without-the-C husband manage what his Prozac can’t handle. I don’t find exercise and meditation to work alone either, and medication alone (at least the type and dose I was on) didn’t do enough starting 3rd year of grad school (age 24) so I quit that (and barely finished grad school).

What I have found to really help since rediscovering ADHD through this website is that a cognitive-behavioral approach, with the behavioral leading and inspiring the cognitive, is what works best for managing without going back on meds. (My psychologist only rarely uses them himself and so is in no rush to write me a referral to an M.D., but will do so if I feel I need meds.)

I started with making designated bins and bags for keys and other things I lost a lot, checklists for multi-step tasks in which I often forgot steps, calendar and alarm use for meeting reminders, and a system of using stress toys as an alternative to yelling and screaming under acute stress and a record of how many acute freakouts I had with or without successful containment. I check in regularly with the psychologist to report how the techniques are working and ideas I have for other behavioral or cognitive interventions.

A key cognitive intervention is to remind myself not to stop once it’s been a while since the last crisis (usually an RSD episode triggered by work setbacks), because ADHD is a risk factor for just about everything, and because my “time blindness” is especially strong with respect to the past. Anything that happened more than 2 months ago is water under the bridge for me. It has its perks, but I now realize it’s probably why my vision of the future tends to be crude and pessimistic, and I therefore tend to avoid abject failure more than pursue thriving. Without feeling happy memories from the past as relevant, I have trouble seeing opportunities in the future.

If you have money for a book, Russell Barkley’s “Taking Charge of Adult ADHD” has helped me better understand why behavioral interventions work best for me (“point of performance”), and, through a concept of “time blindness” beyond nonpunctuality (which I mostly avoid with anxiety) that deals with working memory and the use of the past to predict the future, why it took figuring out that I had not grown out of or been misdiagnosed with ADHD to stick to treatment.

So if you still go to a mental health professional regularly, talk to him or her about setting up a cognitive-behavioral approach to problem symptoms that led you to consider ADHD as a likely cause, with emphasis on “in the tough moment, point of performance” techniques. And make sure you sleep well too – that has a huge effect on my symptoms. Good luck!