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Just Diagnosed at 37! Confused, glad but angry. Dr refuses to prescribe medication due to my history of self medication. Help!!

31 Replies

Hi,

My name is Tom. I’m 37 and after years of failed relationships, jobs, friendships and finding myself alone, unemployed and sometimes suicidal I found some money and got an initial psychiatrist assessment. They referred me to a specialist ADHD assessor who quickly diagnosed me with severe ADHD. I initially felt a deep sense of relief. I was always told I was lazy, a procrastinator, not fulfilling my potential, selfish, arrogant and aloof. I believed these things. I became very lonely, isolated and depressed. I slowly removed myself from the world. After the diagnosis I cried for the first time as an adult. I now knew why I was the way I was! This then changed to anger because it had been joked by family, friends and teachers that I was very ‘ADHD’! I felt let down. Doctors had never suggested it. My only relief from the symptoms were illicit drugs. They allowed me to function normally. I was self medicating for a condition I didn’t know I had. The problem now is that my understanding is that medication is by far the best treatment option. And the most effective. But due to a history of substance misuse and self medication they won’t consider this treatment. I now feel lost. And confused. I was so hopeful that finally I can live life to my potential and be happy. Are there other treatments? Has anyone else had similar experiences? Any advice would be welcome. I’m also having trouble explaining my new diagnosis to friends and family. They perceive ADHD as ‘minor’ and not chronic. They seem to think it’s like dyslexia or asthma ( both conditions that are common but deemed not particularly serious: unless you suffer from them then they really are!) . How do I tell them that my past behaviour was driven by ADHD whilst taking responsibility when I’m denied treatment. It’s a mess. I need help please. Thanks Tom

31 Replies
Elfje profile image
Elfje

Hi Tom have he given meds ? Or not

Because adhd is ye not only the behavior it's what it bring too us. Also off course there is different types off adhd

in reply toElfje

No the psychiatrist who diagnosed me said that in her opinion the use of medications that have ‘stimulants’ and are controlled are too risky for her to prescribe. I offered weekly urine testing and offered to work with her to try to get the best balance of treatment that would treat the ADHD whilst minimising the potential for harm. She basically said tough thanks and goodbye. I don’t particularly want ‘stimulant’ ADHD medications but I don’t want them to be entirely ruled out as a future treatment option due to a former co-existing mental health problem I.e substance misuse. I been left hanging and confused. Now what? How do I treat this thing? How do I get help?

Elfje profile image
Elfje in reply to

I advice a therapist

Adhd meds a riks ? Never have problems with it. But ye a coach or therapist can help

Otherwise I don't know

And my diagnosis is ‘severe combined’

Thank you. I intend to explore all possible treatment options and educate myself as much as I can. That is why I’m on this site. I would like first hand experience of living with ADHD and what works for people, what have you tried and not worked as well. Without actually taking medical advice I could just do with a bit of support, first hand information and others experience. Thank you for your reply.

prolang4 profile image
prolang4

if you have a chance to get diagnosed by Prof James Greenbalt, Adhd authority, you will certainly find considerable improvement.

in reply toprolang4

I will find out who this Doctor is and see if it’s an option. Thanks for the reply.

hi tom.

first of all, i’m so sorry for your experience with that practitioner. my very first suggestion to you is to go subscribe and listen to the adhd rewired podcast—especially any of the q&a episodes. the host, eric tivers, not only coaches people with adhd, but he has it as well. he has a facebook group that i’ve heard great things about as well, and there you’ll likely be able to find some additional support as well as some resources.

now that you have an official diagnosis, i would also suggest finding a counselor/therapist who is familiar with adult adhd. psychology today has a clinician search tool on their website. the right counselor will be able to help you navigate your unique experience with adhd, and will likely also be able to help you find a psychiatrist who will be more willing to prescribe medication. it’s possible that the psychiatrist who evaluated you is not actually aware of how the right medication reduces the risk of substance abuse in adhd folks.

another thing a good counselor will be able to do is help you navigate relationships with people who either don’t understand adhd...or don’t care to. unfortunately, some people will never care and you’ll need some help to figure out what to do about that. for now, you can google resources to use to educate others. additude magazine’s website is a great resource.

one last thing: while medication absolutely is the most effective treatment for adhd, please don’t be discouraged in thinking that you absolutely can’t learn to manage without it. it won’t be easy, but again, the right support system changes everything. and for me, once i was diagnosed (and before i went on medication), learning exactly what adhd was like for me helped me begin to make some positive changes including just being able to give myself grace. and hopefully you’ll only have to manage without meds for a short time—just until you’re referred to a more adhd-aware psychiatrist.

good luck to you!

in reply to

Dear Bellydancermama1211,

Thank you so much for your reply. It was really kind of you to take the time and effort to answer some of my questions. I really appreciate that.

At present I live in the UK. For all our love and reverence for the National health service (which is amazing) when it comes to finding help with ADHD it seems a little hard. Not impossible but hard. I think because I’ve literally just been diagnosed I’m going through a natural emotional response of confusion and anxiety.

The medication treatment is by all accounts the best for efficacy and allows talking therapy to be more effective. Even whilst getting my assessment the Psychiatrist had to ‘bring me back’ to what we were doing because I started dismantling the lamp I was sat next to!

I’m going to investigate the information you’ve given me and I intend , for the first time, to be assertive and take charge of my ADHD and health rather than just seeing a clinician and agreeing to what ever they say because my mind has wondered and I can’t wait to leave.

Thanks again your reply has helped. All the best.

needsmusic profile image
needsmusic

Hi Tom,

I am glad you reached out. I am grateful to this site, it helps me not feel alone!

I got "diagnosed" about 15 years ago. It was a relief to understand that I have an atypical brain and the cluster of challenges are not my lack of will power!

The self esteem still remains a struggle at times. I understand ADHD rationally, but I can still get so frustrated that some very simple things for 'most people' are almost impossible for me.

I get a lot of support from book "Attention Deficit Disorder In Adults: A different Way of Thinking" by Lynn Weiss. I go back to this book often. I really recommend you get a copy.

If I could only own 3 books, this would be one of them.

I have also sent links to a couple of TedTalks on ADHD to family members. These have also helped me so much!

Here's one-

youtube.com/watch?v=fWCocjh...

Take care of yourself. I hope these help you.

Pati

in reply toneedsmusic

Hi Pati,

Thanks for the link to the Ted talk I will watch it.

I will also get the book. I have read a lot ( in very short bits) in the last three weeks and what I’m finding is there seems to be two distinct ‘camps’. The books and scientific community who are very much focussed on pathology and medication. The other camp is seems to be more focussed on behaviour, interpersonal relationships and a humanistic context. It can be a little confusing!

I’m also experiencing a distinct ‘hyper focus’ almost obsessional thought process about the diagnosis. I’ve experienced this many times with other interests before - as I call it the ‘door crashes shut’ - and I struggle to regain even a modicum of interest in the subject. So whilst I’m completely untreated and experiencing ‘hyper focus’ on all things ADHD I will get the books, watch the ted talks and continue asking you kind lot all sorts of questions. Thanks for the support. Very helpful. Wishing you a happy summer (if you live in the northern hemisphere) if not then wishing you a great summer in a few months! Cheers .

dgs2018 profile image
dgs2018

Tom, I just read your post and am excited that you found a root cause for your behavior all these years. As a middle-age adult with ADHD, I was treated with Ritalin through elementary school years and since then have not been medicated. As you get older you do learn coping techniques for your unique brain and personality. Sorry that you had to go through so much difficulty before you realized what you had. Yes, self-esteem is a huge issue for people with ADHD for several reasons. Here in the US, we are prone to tie our careers and accomplishments to our sense of self-worth. America is a materialistic society. I imagine the UK is similar in that way. Because the ADHD brain is wired differently, it doesn't respond "normally" or in step with others much of the time. That brings us to conclude that we are somehow incompetent, inadequate or simply a loose-cannon. I recommend that you keep a journal that defines who you are (aside from superficial descriptions), what you value and what you'd like to see happen in your life. Most likely, you are intelligent, creative and think outside the box so think about your passion and what makes you happy. Brainstorm about environments in which you could thrive. Are you an office or nature person; do you like movement or are you okay sitting, etc. There is a place where you can thrive and have a life. Write down your list of strengths and accomplishments somewhere along with Who I Am and review it when you're feeling down. Don't ever think that you are a mistake or somehow less than other people. It's a matter of finding your niche. Remember being true to yourself and happy in your own circumstances beats having material things which don't bring satisfaction. Best of wishes in your life.

in reply todgs2018

I really appreciate your feedback. It’s just the positive and pragmatic advice that I’m looking for.

I couldn’t agree with you enough about the way I have been conditioned through my life to equate ‘materialistic’ success with self-worth. I think that, in a way, the incongruence between my ‘true’ self, creative, uninterested in the rat race and wanting an outlet for my unusual way of thinking has caused me the most internal pain. I would look at my peers and colleagues getting on and seemingly cruising through life and wonder how they did it?

What I’m learning about an initial diagnosis of ADHD is that there is a common pattern. Firstly relief and a sense of catharsis. Now I know! Then a process of regret and introspective hindsight analysis: if only I’d known sooner! Then a feeling of ‘ what do I do now? ‘ Does this mean my life will continue to be a car crash?

But then I read posts such as yours and others with experience and it engenders a feeling of hope. ADHD can be an asset. The negative effects on my life can be mitigated and diluted. The positive attributes of ADHD combined with a life experience that is far from normal can lead to positive outcomes for the rest of my life.

I’m at the ‘education’ part. And your suggestion of a journal is excellent. I will use it to differentiate the truth from the false. With time, help and application I believe that my recent diagnosis will go from confusion and regret to acceptance and perspective. A perspective that envisions finding the true me and how I can contribute to lessening the insidious obsession with materialistic pursuit that leads so many of us with mental health problems to anguish and pain. Thanks again for your insightful and kind post. I really appreciate your take on the condition.

Pediatrician profile image
Pediatrician

Vyvanse is considered to be the medicine of choice for patients in your situation. It needs to be broken down in the body and is considered to not have abuse potential.

in reply toPediatrician

Thanks for this information. I’m meeting with my Doctor this week and will ask about it. Perhaps this could be a good option. Thank you.

Lovinit profile image
Lovinit

I’ll try to tell you the short version of my story. Been taking adderall since 2002, my md diagnosed me. He retired was referred to a different doctor no problem, then about 2years ago I had to find a new doctor because of my insurance change that md said to cover both of our ends I want you to see a psychiatrist because there more trained in that area. The one he sent me to was terrible, she did say I had adhd and would continue to prescribe me my adderall but I had to sign a 10 plus page document saying I will not take drugs (like smoke weed etc.) and they can drug test me at anytime. I didn’t like her. I had smoked weed since I was 16 everyday until about 2years ago. I found a different psychiatrist who I was so comfortable with that on the first visit it told him my entire history all drugs included. He is treating me for my adhd and and also diagnosed me with anxiety and a mood disorder. I take a total of 3 medications and since I haven’t felt the need or interest in smoking just a couple times a month for enjoyment. My life has greatly improved, I’m thankful I found a doctor who is really helping. I really recommend having health insurance, there are all types of plans, one that will fit into your budget. I’ve been seeing my psychiatrist once a month and a therapist who I also like once a week

in reply toLovinit

Thanks Lovinit,

I’m glad to hear that you found a Doctor willing to treat the individual rather than the ‘symptoms’. Unfortunately health insurance isn’t really a thing in the UK. We have it but it’s very expensive and as we have free health care anyway it wouldn’t be an option for me due to the expense.

The use of illicit drugs in my past does seem to be the greatest block to getting appropriate treatment but that fact that you found someone gives me hope that with enough research and pleading my case an appropriate treatment plan can be found. All the best and thank you for the help.

Lovinit profile image
Lovinit in reply to

Or you can lie. What are illicit drugs? Are you currently addicted to drugs?

in reply toLovinit

I’m not addicted to drugs. I have been abstinent for over 3 years. I went into the diagnosis process in a completely open and honest way. The consequences, which I have just found out today, are that my Doctor has reported me to the DVLA ( driving authorities in the uk) and I’m at risk of losing my driving license, I’ve also been made aware that my admission of previous drug use will be reported to social services and thus complicate access to my children, that my travel insurance is now void and that I’m obligated to contact my car insurance company otherwise my insurance is void. So I get diagnosed with ADHD, tell the absolute truth, have conquered my drug addiction for three years through a massive effort and now find that the authorities are now trying all they can to destroy my life! It’s a particularly cruel world at times. Makes me want to put on a back pack and walk into the woods!

Lovinit profile image
Lovinit in reply to

Wow, with our health what we say to our doctor is private unless I say I want to harm myself or someone else it’s supposed to be confidential. I’m also guessing if you knew this is what would happen you would have made a different choice on what you choose to say and not say to your doctor. I’m sorry I’m not very educated I’ve never lived anywhere but my home town in Tucson so I don’t have much of an understanding how things work there for getting mental health treatment. I was never totally honest about everything with all my doctors in the past just my current one and my therapist I have now. I remember growing up my mom telling me don’t tell the doctor you smoke because your health insurance premiums may go up in price cause your a smoker. I guess my parents taught me at a high school age watch what you tell people.

I’m so sorry that all of this is currently happening to you right know. Joking when I say this but for all of the lengthy turmoil there creating for you geez why not just arrest you and throw you in jail. REMINDER I’m making a joke. I don’t mean that intentionally.

I like chatting with you so if you like to share how things are going while this is happening or you need to vent I’m happy to listen

Wendy

in reply toLovinit

Yeah it sucks. We do have patient Doctor confidentiality but much like other countries if you disclose that you are planning on harming yourself or others then the Doctor has to report it. So what subsequently happened in the courts was that by disclosing that you have or had a substance misuse issue then it’s seen as having the potential to ‘harm’ others. So the DVLA (DMV) will instantly suspend your license until you can prove over the course of a year (testing, Doctors testimony etc) that you’re clean. Not all Doctors do this. In fact very few report you. Even whilst taking prescribed medication such as those for ADHD ( which we know make you actually a better driver because you are more attentive) the DMV can require frequent reports from the Doctor that you can drive safely. Once the DMV find out your history the information is sold to the insurance companies so that raises the premium. The access issue to children is complicated and not entirely down to a Doctor breaching confidence it’s more to do with amendments to access contracts that if I fail to disclose that I have ADHD and a history of self medicating then the powers that be will not look favourably on my present arrangements if the mother decided to change access criteria. So as I said I’m clean, doing everything I can to get well and certain barriers get put in the way. A plus point is we have free advocacy services that are great. They literally sort everything out for you but it takes a bit of time.

I hope anyone reading this doesn’t take it as a warning not to be completely honest and open with health professionals. Sometimes you just gotta roll with the punches.

The fact I have these things to overcome after being diagnosed only 3 weeks ago, have had zero treatment and I’m really struggling with my mental health seems to be at the bottom of the list for some medical professionals.

Good news though is that I wrote to Psychiatrist who specialises in the treatment of ADHD and substance misuse ( after it was suggested on here) and he seems really helpful and promising. I have an appointment next week. The only problem being is that I have to pay $1000 for an initial appointment. Expensive business trying to maintain a quality of mental health afforded normal people! No wonder they’re always on nice holidays!! 😂😂

Lovinit profile image
Lovinit in reply to

When I was a teenager and wasn’t on any medication except weed I was outside everyday in nature, I was a trail runner and I rode my horse almost every day I also went to yoga class a lot. I can’t do all of that today because I let myself go, I look back can see how exercising and being outside affecting me. It kept me sane

in reply toLovinit

Couldn’t agree more. I live a 2 minute walk away from one of the best beaches in the uk. I rarely go down there because a couple of times I’ve had bad anxiety attacks being there. And yet when I’ve made the effort to get down there, outside, very early in the morning, I get a fantastic feeling of peace and relaxation sometimes that lasts the day. Exercise and fresh air are vital.

I tell myself that ‘I’ve let myself go’ and it won’t be the same. I’ve got to be careful of that. What I’ve found in the past is that I get back into exercise and , once over the initial shock as to how unfit I’ve become, I become excessive about it. I get injured due to doing too much and then the next time I want to get out, walk, run or whatever, my head will come up with a million of excuses and specifics about how ‘you always get injured’ ‘what’s the point?’.

But as you say when I was exercising regularly my mind was much much better. Sleep was better, apatite, focus just generally better. It’s a no-brainer really and everyone knows how great it is for mental health. I’ve just got to start off small. Just do something. And it’s never too late to take up a new hobby or interest. One of the few times I was actually down the beach I met a 70 year old guy who was learning to kite surf. He was cool. So many ways to treat this stuff without meds ( or at least compliment them). Apart from mediation for me. I’ve done hours and hours and now I’ve realised I’ve got ADHD I’ve come to the conclusion it’s not for me. I found it really really hard!

Lovinit profile image
Lovinit

I didn’t realize at the time but all my years I was smoking weed,

I was self medicating myself. At least I believe I was and my doctor and therapist do too.

Hi,

Everyone I’ve talked to regarding ADHD and drug use seems to have some link or appreciation that it was a form of ‘self medicating’. I used recreationally for a very short time at the start but without knowing it I have to acknowledge that later it was to treat my undiagnosed ADHD. That’s not an excuse but 8 rehabs, thousands of 12 step meetings, hours and hours of counselling and at no point did anyone suggest seeing a professional psychiatrist and seeing if my substance misuse was linked to an underlying mental health condition. I was just another ‘addict’ on the conveyor belt of the recovery and treatment industry. But you live and learn. I now hopefully will live a life clean and sober and calm as opposed to clean and sober and chaotic, anxious and depressed. Much damage has been done but I’m now beginning the process of healing. It’ll take a while but at least I now know the core issue. It’s scary and new but I have no choice but to keep fighting and hopefully have a second chance at a life!

needsmusic profile image
needsmusic in reply to

Hey Tom,

I have read the thread of replies, what an interesting interchange, and one that shows first that you are Not Alone. That helps me vicariously too. I feel so misunderstood, and unknown in many ways. I tend to isolate as I have thin skin (common trait) and I can be so impatient with stupidity.

Socially challenged in some ways, yet I am very friendly, funny and when I am engaged in conversation, people will often tell me very personal things. Its fairly common for people to say that I am easy to talk to, and/or they have never told anyone about "this" (whatever) before.

Reading about your circumstances, and the complications that have come up for you now, even though you are 3 years abstinent of drug use, frustrates me! That society determines that alcohol, nicotine, caffeine, etc. are allowable and legal, but other substances are illegal.

My parents were both drug users. Very unusual childhood. My father was a folk musician- strung out on amphetamines in 1950's and early 60's. Then he started using heroin. He battled that addiction for 15 years....getting clean, then strung out again, etc. He finall got abstinent of all drugs and alcohol, in AA, in 1980. He died with18 years clean and sober. But he acted out with food, money, women, etc. My Mom also used speed in the 50's and 60's. She had prescriptions for diet pills. And she was a daily pot smoker, from the 1960s until she died. But she didn't smoke when she was in one of her several bouts of major clinical depression. It was scary, severe, almost catatonic. I experimented with all drugs, but alcohol is favorite. I got sober and clean at 24 and stayed abstinent for 35 years.

Drug and alcohol use is self medication. Period. It is so frustrating that we are still in the Dark Ages in so many ways when it comes to the variety of brain function and mood issues.

I so love when I hear professionals talking about 'neuro-typicals" (like the normal people LOL) and us neuro-atypical. It's like autism, which now referred to the "autism spectrum" because it has such variation!

I can't wait to hear from you after you listen/watch the TED talk!

BTW, there are several Ted Talks on ADHD, and they have helped me so much.

In closing, I am the eternal optimist. And I hold out the belief that something good is coming to you. Right now must be challenging as hell. Walk off into the woods? Oh hell yea, I get that! I hope that sunlight is peaking out already and your honesty will ultimately be rewarded. Even if it seems like just the opposite right now. Be well. Talk again soon-

Pati

needsmusic profile image
needsmusic

Greetings-

I am on Twitter FYI. @allegradancer

I have connected with many ADHD people and groups.

All of which help me remember that I am not on the wrong planet after all...

be well

DesertAl profile image
DesertAl

I found that the point between being diagnosed and understanding my unique version of the ADHD experience took time. Meds can be very important; I had my first comprehension of what it felt like to make a decision that wasn't catalyzed by compulsiveness. I was diagnosed at 50, I was blessed with many years of being shamed, the standard ADHD derivative impacts.

I think you should press your doctors for a medication path. I take Vyvanse, it can be addictive, my suggestion, you should be in cognitive therapy, EMDR is a modality beinging used to de-energize past traumas, I found it extremely supportive.

I recently began working on relationship issues with my wife, I have a tough time getting out of the house. Two weeks ago I logged into Meetup, the CHADD meetup came up in a search, I joined the group and attended a meetup this weekend. At the end of the meeting, I introduced myself to the organizers, I mentioned, "I was ADHD and the organizer responded, I'm ADHD also, I had never had someone say that to me.

At the meeting, I heard people discussing support services and other resources in the area. On my way home I realized that there was support for me, find a meetup, or another group, knowing that there is companionship and understanding is impactful.

Don't stop explaining what you are experiencing to your support professionals, the impacts of ADHD can be serious, depression, anxiety, self-medicating, self-isolating, all can be the match that ignites self-harming.

Keep the faith.

Jvart11 profile image
Jvart11

They are not the right doctors. They would be more familiar with the Dx and meds. Find a new psychiatrist

Applestoapples profile image
Applestoapples

Hi, I am here to say thank you so much for posting. I too was just diagnosed at 37. I feel all the feelings. I have found this thread to be super helpful for me in my quest to try and do this without meds, (for now), and just learn new coping skills and hopefully pass that all down to my kids as I pass down ADHD.

It's been a year how are you doing?

sophiebrodie profile image
sophiebrodie

Hi Tom!

First of all, great job taking the first step to getting treatment! I know how scary it can be. And great job crying! I know that sounds weird, but crying is actually a sign of strength.

If I had to take a guess, I think the main reason they won't prescribe you anything is because of the addict-ability risk. These meds do have a higher chance of addiction then, say, Lexapro. Don't ask me the science because I don't know. However, this mainly happens in people who don't have ADHD - for example, non-ADHD college students taking Aderall to study. That is why it's a Schedule II drug (Schedule I is the illicit drugs you most likely took).

Even with that, there are plenty of ADHD treatments that don't involve "addictive" substances. There are medications out there that have a low addiction rate, mostly for people like you who self-medicated. If your doctors won't even think about medication, looking at therapy can be a great help. I honestly cannot preach about therapy enough, it's that good lol. Make sure you get one that specializes in ADHD. Certain things I've learned through therapy are how to set things up so I can remember them, focus strategies, and calming techniques. I have inattentive, so you may learn something different.

Don't lose hope! You've got this!

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