I have struggled with self-diagnosed ADHD for my entire life. I am 100% certain of it and score very high on every assessment test I have taken. And I've exhibited most of the symptoms since I was a child, but I did not know about ADHD and how it affects people until about ten years ago. I thought these symptoms were just personality traits rather than a condition that could be treated.
There is a local center that specializes in adult ADHD and I am one appointment away from making it official. But I'm nervous about doing it for two reasons. One is that this will now become part of my permanent medical record. That will make things like life and medical insurance more difficult and/or more expensive. Yes, today health insurers cannot penalize you for a preexisting condition like ADHD but politicians are always trying to repeal the Affordable Care Act and then health insurers will be able to discriminate once again. And life insurance companies can do whatever they want. It feels like an irreversible scarlet letter.
I am also nervous about the medication. I know that most ADHD medications can be habit forming and even though I have never had an addiction I have an addictive personality. I think the reason I have never had an addiction is because I have steered clear of anything that could lead to addiction. I find it ironic that addiction is a common occurrence for people with ADHD yet the main treatments for ADHD are addictive.
I know there are some medications that are not addictive but never understand why those aren't the first line of defense instead of something like Adderall? Do the others not work as well or is it the cost?
On the one hand I have managed to get by without treatment all my life so I can probably just keep struggling along. However, things do seem to be getting worse with age. On the other hand, the thought of a life free from ADHD impairments sounds glorious. Euphoric!!! By many metrics I would be considered a very high achiever but it never translated into professional achievement because of these problems. I wish I knew about ADHD much younger in life and had it treated then, I often fantasize about how different my life might have been from a career perspective.
I feel like my indecision about being diagnosed and getting medication are actually symptoms of the ADHD. I have been obsessing over it for months.
Help!
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laca90007
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I'm not worried that they won't treat it with medication, I'm nearly certain they will. It's the medications that might be addictive that I'm nervous about.
Why do you think they won't treat it with medication? At our age I think behavior modification treatment might not be effective. The bad habits are way too ingrained and hardwired to modify voluntarily. At least for me.
The concern about becoming penalized for having a preexisting condition, if/when the health care laws change, seems valid.
• The fact of the matter is that people with ADHD who are adequately treated should have much better overall health, quality of life, and life expectancy than those who are untreated. (This is my understanding, based on listening to experts in ADHD, such as Dr. Russell Barkley and Dr. Edward Hallowell and others, who cite research data and their professional experience.)
Regarding the fear that ADHD [stimulant] medications can become habit forming, the evidence I've found anecdotes and research data about implies the contrary: that treating ADHD with effective medication reduces the likelihood that a given individual will develop any addiction.
* The only anecdotes I've heard of a doctor for person who has ADHD being concerned about their patient becoming addicted, it was because the patient already had a history of addiction.
* I've heard experts cite studies that the people who are most likely to develop an addiction to stimulant medications are neurotypical people who are misusing/abusing the medication.
Does that mean that there is no risk of the medication becoming habit-forming for someone who has ADHD? No, it's always a risk, based on the type of medication that it is.
But I tried stimulant medication in the beginning of my ADHD treatment (despite some family history of addiction, including a lifelong alcoholic grandfather), because:
1. I trusted my doctor and his experience with treating ADHD, and
2. I desperately wanted help with my ADHD symptoms.
{Adderall XR did help treat my ADHD, but not as well as I hoped. After a few months, I convinced my doctor to try me on non-stimulant ADHD medication Atomoxetine, aka Strattera. For me, it works twice as well as Adderall, and with less side effects. But I know that I did not develop any cravings for Adderall...only an appreciation for the how much it did help me.}
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At the time I began treatment, I was more concerned about the way I would be treated by other people, but my improvement was so significant that I knew some people would ask what was different with me. I actually found my ADHD diagnosis to be a relief because I finally figured out why I had struggled the way I had, I had an explanation other than that I was [lazy, careless, undisciplined].
I embraced by diagnosis... And I've found it to make me more relatable to many people. (You might be surprised how many people you interact with do either are neurodivergent, or have neurodivergent people who are important to them in their life, and thus are very accepting.)
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I didn't even think about the preexisting condition issue regarding insurance. But, my income has gone up noticeably since beginning my ADHD treatment, so I actually have better health coverage and life insurance coverage as a result. (I don't know if I pay more in life insurance that I would if I hadn't disclosed my ADHD...but I am glad that I can now afford more of it, for the sake of my kids, if I should die prematurely.)
One way that people with untreated ADHD deal with their condition is to unconsciously self medicate. I would drink more than 120 oz of diet cola and perhaps a few coffees every day. Nicotine is another drug that can be abused by those with untreated ADHD in an attempt to jump start just a little brain activity. I smoked heavily for a few years back in the early 1980s - four+ packs a day.
After I began using simulant medication, I might have one soda a day or alternatively one coffee. Some days I have none. Someone might have described my past smoking and more recent caffeine use as addictive, but all the desire disappeared once my brain chemistry was normalized.
Most of the evidence suggests that treating ADHD reduces the risks of addiction, although it is still a big stigma among those who are not up to date on ADHD.
Your doctor has to prescribe medications and would quickly see if you were having an addiction problem - asking for earlier refills, seeking larger quantities - it won't be missed.
Sometimes I hear people worry about being addicted, meaning needing to take the medication in perpetuity. I need blood pressure medicines and will take them for the rest of my life, but that is not addiction. It is medical need. I need glasses to see. Until that need goes away with future cataract surgery, I will always need glasses. They are not an addiction, they are a need.
If I had a thyroid deficiency, I would need medicine the rest of my life to bolster the inadequate level of hormones. That wouldn't be addition
Same with ADHD medication. I have a biochemical imbalance, a neurological development defect that produces too little of key neurotransmitters. The inadequacy can be partially corrected by medication, which I will need the rest of my life.
Exactly. There is a big difference between addiction and medical dependence. Many people are medically dependent on medications. This means they are consistent with medication in order to sustain/prolong/improve their life. Taking medication exactly as prescribed is the best defense against addiction.
As for the impact on insurance and medical coverage, I would be extremely surprised if anyone ever increased rates for someone with ADHD who gets treatment.
The risks of auto accidents, health accidents, risky behavior, and other negative consequences are noticeably higher for those with untreated ADHD than for neurotypicals and getting treatment slashes those increased risks.
You will have to content with ignorance about ADHD in the wider community. People, perhaps even close friends or family, my doubt or misunderstand the condition. Still, your life should be better getting diagnosed and treated than if you continue trying to hide it from the world.
The only area I am aware of where an ADHD diagnosis matters is getting a medical certificate to pilot aircraft - there are extra hoops to go through to grant an exception, as the default rule is to deny the certificate if the person were ever diagnosed with ADHD.
I have a relative who has ADHD and when he enlisted in the coast guard they required him to have stopped taking medication for quite a while before he could enter that service. I hope they have come out of the dark ages by now but this may be a second area - ADHD itself isn't an issue but being treated with medications was the issue.
On balance, for me, I am far better off being diagnosed and treated even if it was very late coming. Only you can decide what works for you, but do as much research, look at webinars and read opinions from qualified people in order to make your best decision.
Wow. Thanks so for much for the info about possible addiction. Addiction is listed as a possible side effect on all the stimulant medications. Normally I'm not too concerned about side effects of medication because they are rare. But for some reason I concluded that addiction to ADHD stimulants was less rare. Perhaps something I read or perhaps a bad assumption. I don't know, but somehow that's how I was thinking about it and glad to hear it's unlikely to be something I have to be concerned with. It does sound like over time these medications don't work as well because you can build up a tolerance to them. But I'm not going to let that stop me from going on it. Even if it stops working, it will work for a long time and I will have the benefit. Then I can try something different.
I am certain that treated ADHD is better than untreated ADHD. Getting it treated could be life changing for me. But when it comes to life insurance, undiagnosed ADHD is still superior to treated ADHD. With my current insurance I qualified for Preferred Plus rate and I don't think I would have if I had an ADHD diagnosis.
Health insurance rates are a significant concern for me because I pay out of pocket for my PPO and it is already unreasonably expensive. And I am in perfect health with zero health issues to speak of. I'm worried about how ADHD could affect that in the future.
Thanks to the ACA it's been a good many years since people could be penalized for a preexisting condition like ADHD. But I wonder if anyone here can speak to how their health insurance rates were affected if they got a diagnosis before the ACA?
And does anyone know if this is something that could affect auto insurance rates?
Medication can probably lose some effectiveness over a long period of time. However, a great benefit of medication is it enables you to build good habits. It gives you the boost you need to build coping skills and develop routines and systems that can significantly improve your quality of life. At first, you will be sustained by meds while building good habits. Over time, you’ll be equally sustained by meds and habits and therefore slightly less potency of medication won’t negatively impact you.
There has been a lot of research focused on ADHD medication.
Because of this research, I'm sure that the chance of addiction is very low when taken as prescribed.
It's true that many people build up a tolerance to stimulants. I have repeatedly developed a tolerance to caffeine throughout my adult life, but long ago discovered that if I do a short "caffeine fast" (greatly reducing or abstaining from caffeine for a number of days), then the tolerance subsides and caffeine works for me again. I'm sure that I still have a low grade tolerance, but a severe tolerance to caffeine for me is when it starts making me sleepy.
• I do this "caffeine fast" about once or twice a year. I think only once a year, since I don't crave caffeine and rely on it so much to function, like I did before I started on ADHD meds. (And I take a non-stimulant medication!)
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Many people who take stimulant medication will take "medication holidays", a period of a couple of days (usually weekends off) to several weeks (like summer break from school) without their stimulant medication.
For some, the reason is because they have unpleasant side effects on the medication, and want to live with the side effects for awhile. For others, it's to prolong how long they can use that particular medication, before having to change up another.
It might be possible to switch back and forth between two or more stimulant medications which you and your doctor find are effective for you. I've read somewhere about people with ADHD who use this strategy with their doctor's help... e.g. medication A for two years, then medication B for six months, then back on A again...
A doctor, psychiatrist, or pharmacist would be better able to address these kinds of questions.
hey there, I was prescribed a non stimulant, which is probably the best thing for me. I'm going to start taking straterra which should be less toxic than addreral. Maybe you can ask to get a prescription for a non-stimulant if you're concerned about getting addictive to the drug.
I take methylphenidate xl, it’s a slow release stimulant, 18 months in and no addiction!! I can skip a day or a week if I feel I don’t need it, the only side effect is feeling ridiculously tired which was my permanent state before meds! if you don’t need adhd meds then I imagine they can be more addictive but wen you’re deficient in neurotransmitters, taking stimulants just gives you a ‘normal’ level which is life changing… my anxiety is gone, I can stay awake past 7 pm and I can do things that I was just stare at before thinking I should really go and do that! It doesn’t undo behaviours and coping mechanisms that you’ve built over the years but it makes day to day life so much more manageable
Hi laca90007, I have had a similar (but easier, I will explain why) experience to you, I would say "Yes!! YES the obsessing over and not acting upon your diagnosis IS part of your ADHD". I did this for nearly a decade, never realy investigating or believing I was "different", just lazy, demotivated, depressive, short sighted and ignorant. I mentioned "easier" I am in the UK, being neurodivrgent here is covered by law and the NHS, that makes it easier. Outside of the "insurances" problem, yes Meds can be "habit forming", this is true, but as long as you take as prescribed, are managed well by a team of health professionals that actualy understand ADHD, then this should be down the bottom of the list of your worries. Especially considering the level of improvement meds will make to your sense of self worth, self advocacy, capability and resilience, all of which are the enemy of the "addiction" spiral. I can only reccomend Get a diagnosis, its a rosette, not a badge of shame, you have earned it by being who you are. Get meds if you can and they work for you, you will know very quickly if they are helping or not. Start to claim the life you deserve and CAN achieve, improved wellbeing, understanding, self forgiveness and self tolerance. When you have done this, your "successes" in life will look different, feel different and also they will imcrease as you wont be using a "But the rest of the world can.." yardstick to judge yourself against. I wish you the very best!!
I agree: these worries seem like ADHD worries or depression worries. Neither is reason to stay away from being treated. So what if we're labeled with this condition? So what?! I out myself to people all the time. ADHD is going to be more embarrassing than sti's? Dementia? Depression? Deep anxiety? Weight problems?
If I were to predict the future, it would be that ADHD and mental health issues will get more respect. More people are out than ever before and more scientists and doctors are understanding than ever before. That's a fake worry--that just keeps you paralyzed.
Dependence on meds. I am from a highly addictive family and am addiction prone myself. I never heard of this fear of dependence when I got diagnosed. I have been on Adderall and Ritalin and haven't felt the slightest bit of "dependence"---not sure what that means.
Now if you mean that I don't function as well without consistent meds, well yeah. And I don't function as well without consistent allergy meds. And I'm very dependent on my two joint replacements, very dependent on them. And on my eyeglasses and so on. There is a part of society (often college students) who illegally get ADHD meds and take ridiculously high doses. But concern about addiction to the meds is like problem #54 among doctors and prescribers. Legit meds are at doses that are not all that addictive. And frankly, I can't tell some of the highest legit doses because they interfere with my sleep.
So yes, you have more reason to worry about driving in general or having any alcohol than you do about getting diagnosed for ADHD or treated for ADHD.
And don't forget the risks of untreated ADHD. Increased addictions (self-medicating by all kinds of means), falls, car accidents, dumb decisions, ridiculous decisions, impulsive decisions (my untreated ADHD brother made several of the worst possible life decisions I've seen anymore make), bad social connections, foot in mouth syndrome, failure, failed work reviews, disappointed spouses, hit on esteem, hit on confident, persistent feeling (though sometimes secret) that there is something wrong with us, difficulty connecting with people, inability to do some basic tasks required of adults in our society ... make no mistake untreated ADHD can be devastating.
I am quite similar to you in alot of what you stated. I'm in my early 40s and never understood why I have such a good brain that rarely seems to work on an academic level, unless it was something of real interest. In my late 20s I was diagnosed with OCD, so I put my slow (but accurate) working performance down to OCD. It was only via an occupational health referral due to my slowness at work that ADHD was mentioned. I had to go private, as the NHS wouldn't entertain it and had me pigeonholed as OCD only. With the private diagnosis, the specialist I saw suspects I am also autistic, so it's all been a bit of a nightmare, but it really does explain why I think the way I do. I put so much of it down to OCD, when that is only part of the problem. I've yet to see if the NHS will acknowledge the private diagnosis.
You definitely should go for an assessment, so you know for sure, as it's such a frustrating condition with all the wasted potential and paths not taken. I ruminate alot, especially about past relationships and 'could have beens', especially as my current relationship is so troublesome and wearisome for both of us.
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