help with communicating with your doctor about adhd

[Hmblue]

How do I help my new doctor understand what I need in terms of adult adhd?

I was diagnosed at 44, (within the last year) though I’ve pretty much guessed that I have had it for a long time. My kids have both been diagnosed and were struggling in school, they are pretty successful now with appropriate supports.

I had to change doctors due to an employment and insurance change, and just had my “new patient visit”. Took a while to get an appointment so now I have about 9 adderall left. (Only take 5 mg because my previous doc was worried about medication tolerance). I’m not married to the idea of meds, but I was a bit disappointed in the doc’s attitude towards my diagnosis.

She basically wants me to go get re-diagnosed. I mean, fine I will jump through the hoops, and probably go through the merry go round of being diagnosed with depression and anxiety, and treating the symptoms rather than the problem. And/or sleep apnea. I don’t think I had that when I was in middle school struggling to turn in homework, probably not in college when I pulled all-nighters to cover up for not being able to break down a project into manageable chunks.

The doctor said that, because I managed to “cope” and get good grades, hold a decent job, etc that I must not really have adhd that needs to be treated.

Apparently, that means it is perfectly healthy to need to have control over every detail of your job and have no surprises so that I reduce the changes of falling flat on my face. It’s also healthy to avoid seeing friends socially in case I might be expected to reciprocate by having people over to my constantly messy, always-under-construction home. It’s healthy to not make any volunteer commitments at my kids’ school because I am afraid I won’t be able to get my part done on time, or afraid I won’t be aware of the unspoken expectations of field trip chaperones or what have you.

I would love to see a counselor or adhd coach “instead” of medication, but guess what? They are like 100% unavailable right now. She also mentioned that adult adhd diagnoses increased significantly in the last couple of years, and her interpretation of that is essentially that perfectly healthy people are just stressed out and think it is adhd; and of course a stimulant medication is going to give anyone a “boost” but that doesn’t mean they “need” it to function. I see the logic, but I would counter that the pandemic finally “broke” a bunch of people that had been hanging on to “normal” by their fingernails, there was finally not enough coping or symptom masking in the world to make up for that extra dollop of stress and expectation and demands on us, and we finally had to recognize the truth.

As with many psychological and neurological conditions, being named a “disorder” or a treatable problem often hinges on an assessment of how much one is able to meet societal norms for behavior and function. This is a very subjective measure; adhd diagnosis may very well be more prevelant in societies like ours simply because we only accept a narrow standard of “being” and functioning in society. But that doesn’t make it any less real; it is still biologically and neurologically based. Furthermore, I may be able to manage to meet society’s expectations, but the other part of that measure is, at what cost? Is denying caring for myself, having normal relationships, or working myself to death to maintain the fallacy that I exist like everyone else, a reasonable cost?

Or, is it reasonable to receive support (medication or otherwise) that helps me to not need all of those coping mechanisms just to maintain normal functioning?

How have any of you been successful in having this conversation with your doctor?

[BlessedLady]

I assume your doctor is your primary care physician. They do not have the extra education and training to diagnose and treat ADHD. Many do, but they do not have the education and training psychiatrists and psychologists do. Have you been diagnosed with ADHD in recent years ? If you have, you can get a copy of your medical records from the doctor that diagnosed you. That might be enough for your current doctor

[wtfadhd]

Everything you said is sooo spot on! your doctor, just like many therapists, doctors, ect- are biased against adhd. if she has already made up her mind that adhd doesnt really exist unless it looks a certain way- then its gonna be fruitless n a waste of time to try to convince her otherwise. omg everything u said is so spot on!

[lemonspeaks in reply to wtfadhd]

agreed!!!

[Meowybeans]

I would change doctors to one who lists ADHD as a specialty. Also there are alternatives to medication have you tried mindfulness or therapy? There are also alternate medications to treat ADHD. You can also investigate looking for a psychologist or a NP as prescriber. You also have the option of paying out of pocket or out of network for psychiatry services

[ongaku666]

RED FLAG!!!!! "The doctor said that, because I managed to “cope” and get good grades, hold a decent job, etc that I must not really have adhd that needs to be treated."

That is the classic issue raised, because you're somewhat functional you don't have ADHD. Because you spent 4 hours on a task you love, you don't have ADHD.

Like all of us spend our whole day and lives doing only that one thing we love! Come on...

Also fyi there's lots of high achievers who have ADHD (some are actual doctors, like Gabor Mate who wrote an excellent book on the subject btw).

I might sound harsh, but a doctor dismissing their patient concerns is one I would stay away from. Why? Because first of all they don't know you from a piece of paper or a couple of stories of your life, and neither do they know you when you tell them you have this sympthom and they tell you it's not that thing you feared... till you prove them wrong. As said by others only trained therapists have learnt enough on ADHD to be able to diagnose, not some doctor who skimmer through the pages of a book.

And you're absolutely right, the argument of ADHD diagnosis exploding during the pandemic is an extremely naive and reductive one. It's essentially like saying that the mental health crisis/boom of the last 5-10 years, is just becuz of a bunch of hypochondriacs who don't know how to deal with life. Like we don't all know we were brought up but very disfunctional parents/families, but noooo, the usual phrase: "I grew up just fine!". Yuk.

I don't know where you live but sadly therapy is not so readily and freely available as it should be all over the world. You might want to invest in your own ADHD-informed therapist, but be clear what you want to achieve with the therapy. If they have to convince you that you have ADHD becuz you doctor said otherwise.... I don't think that's a good way to spend money.

Ultimately only you know how much you have struggled in your life, nobody can even begin to imagine what it was like. But please don't think that medication removes ADHD, it is merely an aid and a means to an end. If it helps you in your daily life, you can choose to take it for many years or not all. In fact you can even take it only on some days, the treatment needs to be tailored entirely to your needs and preferences, please don't forget that! Nobody can make that choice for you and nobody can force you to take medication. Discussing these things with a therapist would be a great way to find out what's the best way to deal with your ADHD, forget that rubbish doctor.

[JLL-71]

I’m not going to disagree with anything you said. I’m going past 60 and managed to “make it” to retirement with ADHD. Most of that time I was undiagnosed, a small part of that time I took medication. Regardless, I had to rely on coping mechanisms to survive.

My only comment/advice to your concern is that it seems like you’re expecting a “solution” to solve all the issues and challenges you’re facing. That’s just not realistic. There’s no holy grail solution that will “fix” things. All the challenges you raised will still be there.

[75ADHDgal]

I suggest you do not deal with your primary MD about your ADHD ! Just because they are physicians does not mean they understand ADHD .And f she wants you to be re- dannosed ask or demand to see a Neuro Psychologist ( as a medical professional myself I know these are best people to do interview testing and diagnosis) then find a Psychiatrist

And just because you seem to manage in life - it is like the cat that is hanginf from a clothes line with hist claws /nails . I was not diagnosed until I was nearly 54 and by that time I had completed Nuring school passed the State board exams, completed my Associate Degree, My Bachelor's Degree ( graduated with Honors) and My Masters from the University of California in San Francisco

I am a Nurse Practitioner - Please tell your primary Care MD you wish to see a Neruo Psychologist for the testing and then need a referral to a Psychiatrist for mediation management and psychologist for therapy (psychiatrist don't do therapy anymore - only mediation management )

[Hmblue]

Thank you everyone, for your great support and advice.

The main reason I discussed with my primary care provider is because I was establishing care, definitely would prefer to see a specialist, so I still need to work on getting that referral.

I appreciate that this doctor is not specially trained in ADHD, and she is doing her due diligence as she sees it. It’s not her I blame, but more the system that keeps it that way.

In any case, I am glad to have this space to air these thoughts with folks that understand and appreciate these experiences. I hope you all have a very Happy New Year!