Reply To: Trouble Getting a Diagnosis


Hi Cynthia,

I’m sorry you’re having so much trouble. I relate to much of what you have described as your symptoms and was recently diagnosed as a 38-year-old female. I made straight A’s as a child, was introverted and shy, and generally did not make any trouble. No one knew that I was actually mentally checked out 90% of the time during classes, and I could not manage the overwhelm I experienced during recess activities and PE sports (volleyball, kickball, etc.). I’ve managed to get two bachelor’s degrees, the latest one in engineering. However, I am chronically late, easily overwhelmed by clutter, housework, and all the demands of my job. Sometimes the simplest tasks feel monumental when my brain spins out of control with random thoughts and external distractions. My performance at work is very inconsistent, I forget details, get confused, and sometimes just “drop the ball.” Long meetings or training sessions where I have to stay seated and listen to a presentation or participate in a conversation are incredibly difficult for me, and I typically don’t track very well with them compared to my coworkers. Every single day I would feel like a failure . . . and then I saw a video on youtube, which catapulted me into research, which led me to seek an evaluation for ADHD.

I first called a psychiatrist’s office, which referred me to a psychological testing center for diagnosis before they would consider seeing me. The testing center required me to do a battery of tests, including an IQ test to make sure I simply don’t have low intelligence or a learning disability (even though I have two college degrees!). The psychologist who interviewed me seemed a bit antagonistic toward my complaints and kept saying things like, “But that’s your perception,” and “But you have very high standards for yourself.” She misunderstood several things I told her. For example, in response to her asking me for examples of impairment due to my symptoms, I told her how I missed my turn TWICE on the way to my appointment because my mind was somewhere else and I forgot where I was going. She said, “Oh, but everyone needs a little help with directions sometimes. That’s why we have GPS.” I tried to clarify what I meant – I’ve lived in this area all my life and knew the directions perfectly – but it didn’t seem to register with her. The results for my short-term memory testing, which consisted of memorizing numbers and words and doing mental math WITH NO DISTRACTIONS were above average. Did I mention I’m an engineer? I do math in my head every day, so naturally I’m going to be a little better than most when I’m in a quiet office and covering my eyes to keep from being distracted by the pictures on the wall and the color of the carpet. Based on this and other testing alone, she was ready to tell me I did not have ADHD. And during our interview, she kept asking me for examples of impairment during childhood, which I could not think of at the time (later I thought of the team sports example, but I doubt she would accept this). She ended up giving me a diagnosis of ADHD-NOS (not otherwise specified), which is a diagnosis category from the DSM IV that is used when the patient does not meet the full criteria for ADHD-I or one of the other primary diagnoses. In my case, it was the childhood impairment that was missing. Her explanation for this had something to do with my intelligence helping me compensate, but now that life/work is more complex I can no longer cope. Fine. I’ll accept that, even though newer criteria and understandings of ADHD, especially as it presents in females and in adults, may not meet that older criteria. (The DSM V, as I understand it, does not require impairment for a diagnosis.) The psychologist’s recommendation to me was primarily to “google” coping mechanisms and help for ADHD, which of course I had already done and already tried. She reluctantly said I may want to try medication.

Next, because I had a couple other health concerns, I decided to go to a primary care physician for a good checkup, bloodwork, etc. I told him about my problems with focus, etc., and that I had even seen a psychologist for an evaluation. He stopped me right there and said there really aren’t any good tests available for ADHD in adults. Even for children, but especially for adults. He said the only way to really know for sure, even if you have all these symptoms, is to try medication. If it works, you probably have ADHD. If not, maybe there could be other things going on. (His daughter has ADHD, so he seemed fairly up on the current understanding of the disorder.) Since ADHD has to do with brain function and processes, neurotransmitters, etc., I thought he as a physician saying this made sense. So he gave me a prescription for Vyvanse . . .


I cannot tell you how much that helped. On this medication (and some people do better on different medication), I can direct and maintain my focus on what I choose. I can ignore external distractions. I am less fidgety and restless. When it starts kicking in, the mental cacophony gently subsides, and I begin to feel both mentally and physically calm. I suppose this is what “normal” feels like. I’ve been much more productive at work, I generally arrive on time, and at the end of the day I feel ready to relax and wind down instead of anxious and stressed. My sleep has even been better.

So Cynthia, my advice to you is to find a medical doctor – psychiatrist, family practitioner, neurologist, etc. – who recognizes the current limitations of diagnosis and understands the disorder better so that perhaps they will be open to trying out medication for you. Please don’t misunderstand me – I am NOT disrespecting the field of psychology. My good friend is a psychologist, and she actually echoed what the primary care doc said about medication helping you know for sure. I am actually fascinated by psychology and appreciate its awesome role in mental health. But if you’re frustrated by the diagnosis process, and your insurance won’t pay for the testing (which is not necessarily all that useful per my example above), perhaps consulting a physician will be a more direct way of determining whether you have this disorder.

Good luck!

  • This reply was modified 3 years, 8 months ago by Andrea.