Trouble Getting a Diagnosis

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This topic contains 7 replies, has 7 voices, and was last updated by  sss 6 months, 1 week ago.

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  • #72267

    cynzav.79
    Participant

    Hi,
    My name is Cynthia and I’m 25 years old.
    I just wanted to ask about what everyone’s experiences were in getting an ADHD diagnosis as an adult because so far my journey has been incredibly frustrating.
    I’ve had issues with attention/focus/motivation my whole life. In a nutshell, I wrote off a lot of symptoms as personality quirks and decided I was lazy, unmotivated, lacked discipline, had a short attention span, was distracted easily and forgetful, and that it was normal for everyone to have 100 thoughts going at once at 100 mph at all times.
    I stumbled across an article about ADHD in adult women and realized that I related to a lot of what the article was saying and started researching ADHD on my own.
    Since that first article, I’ve researched extensively and the more I learn, the more sure I am that I have ADHD and need medication. (I realized a lot of the therapies recommended for ADHD are things I’ve done my whole life and they’re no longer enough to keep my life in order.) What I feel I need is medication so that I can combine it with the focus therapies I’ve used my whole life to get back on track and prevent myself from screwing things up more than I already have.
    (Even before I thought I had ADHD I realized that there is too much going on in my life and I’m not handling it as well as I should because they’re just regular things that every adult has to deal with and this is starting me on a path where things are slowly starting to become too out of control for me and could potentially lead me to screwing up major things at work, school, and at home.)
    The first psychologist I saw told me that he didn’t know what was wrong with me and it would be like searching for a needle in a haystack. He also added that he believed me to be an overachiever and have too much going on in my life and am probably just burnt out (because I’m working on my Master’s degree and working a full time job) and that I was too successful to have anything wrong with me.
    The second psychologist has used the method of going through symptom checklists and decided that I exhibit a lot of depression and generalized anxiety symptoms AND that it appears that I also have symptoms of a combined inattentive/hyperactive ADHD. However, she refuses to make a diagnosis for ADHD without psychological testing as she believes it would be unethical to refer me for medication without testing to “prove” I have ADHD. (my insurance won’t approve psych testing though)
    The problem I’m having with her is that she keeps bringing up depression. I have been depressed but it was circumstantial and very much so attributed to my external environment so I know what depression feels like and I can say with 1,000% confidence that I am not depressed. I’ve told her this yet she keeps mentioning things like “depression meds can actually be great for treating anxiety” and even gave me an exercise to do where I write down what I’m doing during every hour of my waking life for a week, write down on a scale of 1-10 how much pleasure I get from it, and rate on a scale of 1-10 how productive I feel I’m being.
    My problem is not how I feel about things, how I do or don’t do things. I’m lazy and unmotivated and I justify it just enough to get by at work, school, and home.
    I tried telling her this and she told me that I’ve done a great job of “googling” ADHD.
    I am ridiculously offended because every time she says I did a “good job of googling” I’m describing things I actually do in life and it feels as if she believes that I’m repeating stories I’ve read on the internet about how ADHD people do things but I’m NOT. I’m telling her my actual experiences with focus and other symptoms related to ADHD and she keeps trying to push a depression agenda on me.
    I think if anyone knows how I’m feeling, it’s me and I am not sad in any way, shape, or form. I know what depression is and I’m not depressed. I have some anxiety but it doesn’t hinder me or my daily activities. I’m very confident that the main source of my problems is ADHD but she won’t listen to me. This is causing me a lot of stress and frustration.
    Any advice on how to handle this?

  • #72374

    ADHDmomma
    Keymaster

    All you can do is keep trying new clinicians or get the evaluation done for an official diagnosis. You might have better luck seeing a psychiatrist than a psychologist — they may be more willing to make the diagnosis without extensive testing since they are more educated/experienced.

    You do have the classic experience of a woman with ADHD — falling through the cracks, being told you’re too “high functioning,” and being diagnosed with depression.

    “I Was a 45-Year-Old Woman! I Had My Own Business! I Could Not Have ADHD.”

    Depression can be caused by undiagnosed ADHD, or it can be its own stand-alone condition:

    Is It ADHD, Depression, or Both?

    Penny
    ADDitude Community Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism

  • #72465

    MattColo
    Participant

    Hi Cynthia. Sorry to hear this. I wish I had some good advice for you. All I can think of is find someone that specializes in adult ADHD. I realize this might not work with your insurance.

    Anyway, this problem is exactly why I’m hesitant to start this process without knowing whether the doctor has enough experience. Kind of ironic that a fear of failure, which it seems a lot of ADHD people have, is preventing me from moving forward.

  • #72974

    Ellings4
    Participant

    Hi Cynthia,
    I wrote you a long reply and I think it disappeared…
    The summary is probably better than the long ramble.
    Basically, you say you’re a masters student.
    Your college/university should have a disability resource center (sometimes called different names – disabled student services etc…)
    If you are an enrolled student they should be able to provide you with guidance through this process of getting diagnosed and trying medication and other support tools. They may even have a support group for students on campus for accountability and learning study and life strategies.
    Sometimes they pay for diagnosis and/or testing or do it in-house. Even if they can’t help you on campus, they are usually connected to folks in the community who work with students with ADHD and who their students have had good experiences with.
    I missed out on this because I figured this out right after graduating, but I still was given recommendations of what psychologists and psychiatrists in town were good and really well educated on ADHD – not just that stereotype version.
    In addition to getting accommodations to help you with your master’s program, these offices are usually a very good place to get started on the diagnosis process. Of course, how good they are varies by university and by the person you actually talk to, but they are generally a really good resource and place to start.

  • #73316

    Andrea
    Participant

    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 . . .

    Wow.

    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!
    Andrea

    • This reply was modified 6 months, 1 week ago by  Andrea.
  • #73382

    sss
    Participant

    I had some lengthy testing done by a neuro-psychologist and the conclusion was that I don’t have indicators for ADHD. The Dr. said it’s anxiety. (I’ve had anxiety all my life, lessening over time because I’ve learned what self-care is and improve in that over time). So my thought was “oh great, I’ve been working on the anxiety for many years and I’ve still got these problems. What’s wrong with me that I can’t work out this anxiety enough to live a functional life”. (my ADHD is the inattentive kind). There goes my hope of finding answers and solutions.”

    I’ve played over and over in my mind… OCD? Autism maybe? But not thinking ADHD, until Jessica McCabe’s TEDX Talk appeared on my Facebook newsfeed. When I listened to that, and each video she has made, pieces starting falling together and I could see how I could change my space and lifestyle to help me function better.

    I don’t know why the test didn’t detect it, except that I’m sure I was in hyperfocus during the test– so maybe that’s why it didn’t pick up on it (????) Just my theory.

    • This reply was modified 6 months, 1 week ago by  sss.
  • #73427

    allisonkoster
    Participant

    Hi, I”d like to chime in here on usually the “Gold standard” for diagnosing ADHD. Forgive me if someone has already repeated this but I am at work and don’t have much time right now to read through all the posts. I am a LCSW and have a particular interest in ADHD. As an adult the most stringent guidelines for being diagnosed would include you going to see a therapist (an LCPC, LCSW, or psychologist). When you call to make an appointment ask to be matched with a therapist that knows about ADHD and is comfortable diagnosing. The therapist would take a history of your symptoms. Would use the DSM-5 to talk with you about diagnostic criteria and discuss symptoms that you may have in detail. Ideally they would also be able to get historical information on you from either a parent or a mentor you have had for awhile (although this is not necessary it is very helpful…if you were a child the therapist would send specific forms to teachers and your parents and then one to you to fill out and would do an interview with your parents). Then you would be referred to a psychologist for psychological testing. This would include an IQ test, an Achievement test, and a Continuous Processing Test (CPT) which would make use of a computer program. CPT is great because there is no way for someone to fake symptoms so if it comes back that you have slow reaction time, impulsivity, etc. no one can argue that! The only downfall with CPT is some really smart people or people with mild ADD may score in the normal range. CPTs are usually half an hour. The older version, TOVA, is an hour long and usually can help diagnose high iq and low symptom ADHDers.

    Now that is the most stringent way to diagnose. A lesser version is you see a therapist, go through the symptom criteria and also see a psychiatrist. If there is any Bipolar in your family history you should really get psychological testing to help provide more proof that you do have ADHD. Dormant Bipolar can often be “Triggered” by starting on a stimulant. IE someone who has had depression in the past and has undiagnosed Bipolar because they have never had a manic episode…well if they start on a stimulant this could cause their first manic episode. There are non stimulants on the market that can help.

    I hope this helps! ADHD is real, it affects women, and people with ADHD are HIGHLY likely to have a comorbid disorder, such as depression or anxiety…especially if the ADHD has not been treated in childhood and there have been stress and self esteem strains as a result.

  • #73452

    sss
    Participant

    Thanks allisonkoster. This is really helpful. Also thanks for the acknowledgement of ADHD being real (in your last sentence). Because my testing didn’t come out as me showing ADHD tendencies, sometimes I have wondered if I’m just trying to pin a label on myself– like, making it up to justify my limitations and feelings of deficiency.

    This thread is a godsend to me– to know that I’m not the rare bird whose behavior defies diagnosi
    s. And glad that I now have a direction to pursue if I really want to go out and try to get the diagnosis. cynzav.79, thanks for initiating this discussion topic.

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