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If you feel very strongly about it, and the psychiatrist isn’t open to it, then seek a second opinion. Diagnosing ADHD, especially in adults, has a lot to do with opinion, unfortunately.
Your story is like so many… diagnosed with anxiety or depression. Taken medication for those conditions for years but never helped much… If anti-depressants never really helped much, or never helped you fully, make sure to convey that to the psych. Also, I’d make a list of all the things in your life that you feel have never been addressed or treated by any former diagnosis or medication. Since you’re anxious about the appointment, I’d write down everything beforehand, so you don’t forget things you want to discuss in nervousness.
Some helpful articles as you prepare:
ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism