Kind of vent, kind of looking for advice (psychiatrist, trying to get diagnosed)

[Nleor623]

I type a lot so if you don't care about the rant feel free to skip to the bottom lol.

So I've been upset about my last psych appointment for awhile, both because it was invalidating and hurtful, and because it leaves me feeling like I have no good options. I'd like to vent, and maybe get advice about how to proceed.

I've been diagnosed as depressed/anxious/traumatized or various anxiety disorders since a teenager, although the problems (that I now think are much more ADHD related) have always been there, and started ruining my school career and a lot more by the end of 4th grade. I've since clawed my way through graduating high school and college, but really shouldn't have, and things have gotten so bad I can barely keep up with basic self care and household chores.

I've been seeing a psychiatrist for over a year. As always he disregarded my mention of stimulants being the only medications that have helped, and any other signs of adhd are always somehow depression or anxiety. He did put me on stimulating antidepressants though--welbutrin, which has never done much for me, and venlafaxine (effexor). Effexor was the first antidepressant to actually help, but quickly started losing the stimulant aspect, and at this point it does nothing in that regard. I mentioned it diminishing every meeting.

At the meeting when I maxed out on both meds, I asked for an idea of what we would try next, but he says that's just my anxiety worrying too much about the future, and we had plenty more options to try.

However, last meeting when I told him I was almost back to pre med status (other than some mood improvements that seem to have kept). He asked why I thought that was and I said again that the medicine effects seem to be going away over time.

He didn't believe me. He jumped into some kick-in-the-ass lecture about how the real problem was that I wouldn't even try, and was too scared things wouldn't be perfect, and I was going to be 50 and then 70 and 80 and still exactly where I am now. The kind of things that I already think and will make me spiral (which I did for the first time in awhile after the appointment), but that I'd realized weren't really my fault once I experienced how different life could be on the right meds. He obviously had decided that before I said anything, which is how it usually feels in appointments.

He also wouldn't accept that I can't move off a mostly nighttime schedule, bc my bf works from home on night shift, and has been dealing with chronic pain and mobility issues that he needs help working around. He told my bf in their appointment that he needs more support, but told me I have to stop living life around my boyfriend.

He prescribed me minafodil to help stay awake (technically also a stimulant, but it's usually used for narcolepsy). It doesn't do anything but give me a headache, and I was really hoping it might work a bit to point toward a better stimulant being an option. Now I feel like there's no hope of getting anything that helps.

ACTUAL QUESTION: I recently learned that one of my older brothers just got an ADHD diagnosis, which isn't a shock, but means all 3 of my brothers have a diagnosis of ADHD, autism, or both. I feel like this is a good reason to finally straight up ask him to have me evaluated. But he seemed frustrated during the last meeting even when I was agreeing and apologizing the whole time. I don't know how I'm supposed to advocate for myself, but if he doesn't listen, I'm not sure there's much use in staying with him longer.

Unfortunately he works through the main hospital network in my area, so I'm sure his notes would be seen by whoever else I could try to go to. I also can't leave him without having someone continue my effexor or supervise me off of it, because the withdrawal is awful even after a single missed or lower dose. I feel trapped. Does anyone have any experience or advice? Either on what to say to him, or alternative ways to try and get diagnosed? I also worry that if I got a diagnosis elsewhere, I still wouldn't be prescribed medicine without his agreement.

[Jjflash]

Hello there nleor,I hope you get a better outlook in the very near future.It sounds like you've hit a wall.Im not on meds myself yet but it sounds like they work for a short time before they lose their effectiveness.Is that how you find them.Im sorry I cant suggest an alternative but I hope you find a different solution.Stick with it young lady.

[MagnoliaJones]

Hi Nleor,

I'm so sorry that you are experiencing this!

I don't have much advice to offer other than to say that your psychiatrist is toxic and unprofessional and I would highly advise that you find a new one as soon as you can. I know you said that you worry about his notes being viewed by anyone new, so can you work with your health insurance (assuming you have it) to find another provider that might not be affiliated with the hospital network? I think it's also concerning that a) you and your BF share the same psychiatrist and b) the psychiatrist seems to be more supportive of your BF than you. All the more reason for you to find someone new ASAP. (On another note, where is your BF in all this? Is he supportive of you?)

As far as asking him for an evaluation, you absolutely should. It sucks though that his reactions to you have you doubting whether or not this is appropriate when that's part of his frickin' job. But it really sounds like he doesn't do his job very well in the first place.

One other thing I would suggest is seeing a counselor or therapist alongside the psychiatrist. I don't know all the ins and outs of these things, but it has been my experience that psychiatrists are great for meds and that's it. They're not really built for long-term therapy which it seems like you could benefit from (especially after dealing with him!). Can you find a supplemental counselor/therapist to work with? This could also be helpful if they would like to see you on meds, and can help advocate for what you need. They might also be able to refer you to a psychologist who can do the ADHD evaluation and diagnosis.

Also, are you able to get meds through your primary care provider (assuming you have one)? I was referred by my nurse practitioner to a psychologist who made the ADHD diagnosis, and I get my meds (plus my antidepressant) through the NP. So maybe that's an option?

I really hope you can figure out a way to make this work for you to get what you need. I have to say the more I've been thinking about your post, the angrier I get about how your psychiatrist has been treating you. Hang in there.

[wtfadhd]

well, on the bright side- alot of us on this group have the same experience. ugh! you r being undermined and when you open up about feeling not validated- you are met with the idea that it is just anxiety and need an SSRI vs a straight up stimulant. on this group, we all have ADHD and typically n unfortunately that means we need a stimulant med. the world is just SO uncomfortable with that fact. ugh again. about your bf. check it out, if u said fuck u n deal with your own shit a psychiatrist would say you lack committment and have attachment disorder n roccomend CBT therapy for you. . if you try to co exist with someone and support them then you are charged with poor self care n lack of boundaries!!! us ADHD folks already question ourselves 24/7 and this mixed message jacks us all up.

do whatever you gotta do to be able to afford a provider who understands ADHD. i got dx at age 40. what a nightmare!!! once you get a provider to help you, it will be a game changer. ❤️