What kind of symptoms and things do doctors use to invalidate or disqualify you for an ADHD diagnosis? What was your screening like?

[Nleor623]

I posted a bit ago with an issue with my psychiatrist, but didn't want to bump the old post because I took too long to respond. Thanks to everyone who commented though.

I see my psychiatrist in a week and want to have the guts to ask to be screened for ADHD. I'm not super hopeful at being taken seriously, because while he's nice enough, it seems like a lot of my treatment has been him making decisions before I've said anything (and apparrently disbelieving me if my self evaluation doesn't line up).

Anyway, I have a lot of good reasons to ask to be screened (all 3 of my brothers have it, I fit the dsm inattentive type almost perfectly, school problems started in 4th grade ((when I started advanced classes)), my ability to function is based on caffeine tolerance, etc). I relate to most things others with ADHD talk about, but don't know if specific examples are likely to be met with "thats just anxiety/depression", which is whats usually happened to me.

I've also heard of (especially with inattentive type) doctors saying that if stimulants actually stimulate you as opposed to calm you, that means you don't have it. But at this point I'm deeply fatigued mentally and physically--stimulants make me feel like heavy weights are finally lifted from my back and my brain, lol. Which makes me much more energetic.

Anyway, I'm not trying to find a guide for the "right" things to say, because I want to be honest and be honestly evaluated. But if anyone is willing to talk about their diagnosis and/or evaluation procedures so I know what to expect. Even (especially) if it was bad or not great--what kind of things made them dismissive or disbelieving (that you don't believe are justified). Or even the opposite, what symptoms or traits were probably helpful in your diagnosis and you'd recommend mentioning if other people have them too.

I want to at least kind of plan what things to talk about, but other than being a chronic procrastinator, I'm afraid it'll sound rehearsed and faked.

As always...sorry for the long post.

[jilllewis84]

I was treated for general anxiety disorder for years with little improvement before being diagnosed with ADHD. The thing that was the most helpful for me to communicate in my diagnosis was realizing that my ADHD symptoms occurred *before* anxiety would set in. (The counter argument I get is that anxiety makes it hard to focus, which is why speaking to the sequence goes a long way.) After that, being able to share how adopting practices for ADHD significantly decreased my anxiety and insomnia. When I was finally able to bring these facts to health care providers it became a lot harder for them to try to shove me back into the GAD box (though I do have anxiety, too). I couldn't point to family history at the time -- though that's a really strong indicator, so it's great you have that!

I can totally relate to the stress you're feeling. You're right that, unfortunately, there's no formula to convince a dismissive provider to offer you better care. It's not our fault so many providers don't see ADHD and it's true impacts. I've mostly seen providers who mean well but don't get it, one who seemed delighted to bat me around with a neuropsych exam that "revealed" I couldn't have ADHD and that it must be anxiety and that I must be wrong about my experiences. It can be so demoralizing. But in spite of that, I am diagnosed now, a few months after that really terrible experience. And I have meds and am building community and life is much, much brighter.

Also, don't sweat being over rehearsed -- that's a harder mark to hit than we assume and a provider who jumps to that conclusion is someone who wouldn't have been interested in helping you anyway. Imposter syndrome in ADHD is real and normal, just trust that your calm mind sees what you're going through, knows it's likely ADHD, and prep as much as you need to relate the whole picture of its impairments.

I hope this visit pays off for you but regardless I'm sure you're on the right track. Best of luck!

[Nleor623 in reply to jilllewis84]

I wish I understood more why doctors love shoving people in the anxiety box--like, I guess it's easier to treat, and any comorbid condition is probably going to CAUSE anxiety, honestly. I'd be less annoyed about that being a starting treatment option if they weren't stubborn about reconsidering when it isn't enough. I'm really sorry you had to go through that, did you have to find someone else to get the diagnosis? I worry about even one bad experience because I think I have too much self doubt to try again.I always hear that getting on the right meds after being untreated is such a life changer though, so hopefully worth it to power through like you did

[jilllewis84 in reply to Nleor623]

Yeah, it's a mystery. Maybe it's a combination of how little docs learn about ADHD & how trendy it got to act like ADHD wasn't real? It's true it's hard to be wrong when you claim anxiety, which probably feels good for a practitioner, even if often doesn't get to the root of what's going on.

I did have to find another doctor to diagnose me. The psychologist who did the neuropsych was determined to not listen to me (and in any case couldn't offer treatment after a diagnosis which is not something I knew to ask before). Like you, I was about ready to give up bc finding another provider was so daunting. But I was determined to not stay stuck in the same limiting cycles that being undiagnosed caused. You're right that treatment and meds can be life changing! It's really worth hanging in there.

A perspective that helped, because I totally fell for the shaming around "self-diagnosing" -- I told myself I was looking for someone to diagnose ADHD *or* give me an explanation more convincing than ADHD. That made it so even when that terrible doctor was like, "you don't know you have ADHD, you don't even know up from down" I could remind myself that even if ADHD wasn't the right fit, her dismissiveness was definitely wrong.

Seriously, best of luck! I really do think you're closer to getting the help you need than you realize. Hang tight.

[IamMajyk in reply to Nleor623]

It makes way more money and the drugs are not "addictive" just brain altering that takes Months to come off of... Unlike Amphetamines... It's a fucking racket... To make drug companies rich and keep people from fully living life.

[Gate5 in reply to Nleor623]

Totally derailed me. I finally discovered that Anxiety is worrying about something. You'd think your doctor would tell you that before you diagnosing you with it. They'd always ask "what are you worried about?" My response was always "I don't know." Apparently it was my fault for confusing Stress with Anxiety.

My main problem has always been isolation and avoidance. Which has caused me to be depressed and created low self-esteem. Understanding my isolation is a result of the stress and the amount of energy it takes to self-regulate has been a game changer for me. I've also learned the reason I don't follow through on things is not because I'm anxious but because it will just lead to another unfinished project.

Also just say yes when they ask you all the questions. Like "Do you have trouble keeping appointments?" They mean unassisted by electronic devices. "Are you driven by a motor?" Compared to what? Sleeping? Technically our bodies are a motor. Etc. A good Dr. will help guide you along. A bad Dr. will just use them to derail you.

[ZimmyZimmy]

I am having the same anxiety about talking to the doctors about sounding fake!!!!

So here’s my ADHD suspicion rabbit hole:

About a month ago one of my best friends (who is similar to me) was just diagnosed with it in her early 50s. She brought it up to me because she said I have many of the symptoms! She went over symptoms with me because I thought it was hilarious SHE had ADHD (little boys screaming on sugar…she’s quiet and shy and nerdy just like me).

So I researched everything she sent me. I could have written all of it! It was emotionally shattering for me. I had been on medications galore for severe depression and GAD for about 20 years, even seen the same counselor for 15 of those years! Every time I mentioned over emotional, socially awkward, house is cluttered mess, not depressed but not right, paralyzed…etc, I was told “that’s the depression!”

I scheduled several appointments, one with my current counselor (whom I can no longer see due to insurance), two with my new primary care, and 4 with a new psychologist (insurance covers!). I have filled out several questionnaires. Primary care and my current counselor have both said they are surprised this wasn’t addressed ages ago.

So tomorrow is the “big” day with a brand new psychologist. Intake exam. Like you, I am nervous I will sound rehearsed. I have written 16 pages of notes and situations since childhood that are all similar to everything I’ve read in the last few weeks. Nervous, sad, frustrated…overthinking.

…LOL and I will probably be LATE!!!!

[LeafyGreens in reply to ZimmyZimmy]

Hope the appointment went well (though not sure what “well” is).

I was a shy, quiet girl as child, and smart in school-until high school and university when I was still “smart” but I failed courses, didn’t finish all my assignments, and struggled greatly. I eventually graduated, but overall was under-achieving.

When I stumbled on ADHD info last summer, at age 58, it resonated big time with me. My subsequent reflections on past school, university and work experiences reinforced that I might have ADHD. So I visited family doc for assessment referral.

I was emotional. It was COVID time, I was working from home (loss of structure), and facing huge issues with aged mother who lives alone. Doc said I might have GAD, and offered meds for that. She also told me that my procrastination sounded like her when she was in med school! I don’t think she believed me, but I respected her when she told me she was not expert with ADHD, and since I had learned that so many, women in particular get Mis-diagnosed with GAD and/or depression, I chose to pursue ADHD assessment through a private clinic.

By the time I had my assessment interviews, I had learned a lot about ADHD and had been focussing on and documenting all my difficulties, failures, challenges over the years. So yes, parts did feel rehearsed. At one point I even had fears it was imposter-syndrome kicking in and I was just projecting onto myself the ADHD symptoms I had read about and documented. I am glad I had at least high school and university midterms reports and transcripts to share in the assessment - to inform and corroborate findings. The result: ADHD Primarily inattentive presentation.

A new journey has begun…..

[ZimmyZimmy in reply to LeafyGreens]

I just pulled out a job termination letter the other day from 3 years ago that hits every adhd red flag! I emailed it to the psychologist….

[Nleor623 in reply to ZimmyZimmy]

@zimmy you sound exactly like me, all the way to the late part 😅. I hope the appointment went well!

@leafy, I hear a lot of people mention having transcripts and things from school to support having had problems since a young age--what kind of things would show that? Would poor grades alone say that you struggled in school, or are they looking for notes from teachers that mention symptoms?

Maybe I can find an old school journal and show it's more filled with doodles and completely unrelated writing and notes than with anything actually related to the class....

[IamMajyk]

Find another doctor if this one doesn't listen to you. You have to advocate for yourself. If you need to take someone else with you do that. Don't let the Dr. Intimate you... Especially if you feel like they have been listening to your observations of yourself... You know you better then they ever could.

[Whats-in-a-name in reply to IamMajyk]

Absolutely, try to find a Dr who is NOT dismissive. It’s tough to be your own advocate when you’ve probably had years of being dismissive to yourself. Find someone who specializes in ADHD, if you can. I started by calling the office of someone noted to specialize in children and she pointed me to my current Dr. His first question to me is always, how are you feeling?

[DingoDoug]

Just talk to the doctor honestly and if you have doubts, fears, or anxiety you should share everything, even if you’re sharing that you literally don’t trust the doctor to make your diagnosis appropriately or that you’re worried about having to “prove” your condition