Feel like I am not being heard about possible ADHD symptoms.

[ParkwayDriveFan24]

I had an appointment today to see if I possibly have ADHD. I am experience symptoms that I have read about and they have been there since high school. I explained in depth to the psychiatrist of all the symptoms and examples that I have been going through and it just seemed that they wanted to hear that I had noticeable symptoms before 12 years old. It also seemed that I had needed to have had trouble in school and it be constant but I have read about masking and how if something is said then a child can mask. But according to them that would require too much executive function to possibly achieve at that age. After all that I told them about current symptoms it was also said that I would have to be written up at work constantly and other issues. But I often mask at work and bite my tongue so I don’t blurt something out that I might regret to say. I just don’t feel like I am beating heard and frustrated.

[STEM_Dad]

Hi, and welcome to the forum!

It sounds like the psychiatrist is trying to go by the book, and not really listening to you. The DSM (Diagnostic and Statistical Manual of Mental Disorders) stipulates that ADHD develops in children before the age of 12.

What you've read about masking is right. It's common with ADHD, especially people who didn't get diagnosed as a child because they could "pass" as neurotypical. My struggles were mostly missed in school, because a) I was labeled as "gifted", and b) I hid the fact that I kept forgetting to do my homework but doing it at the last minute with the help of an adrenaline rush (triggered by panic).

Here's what I suggest: find another psychiatrist.

If that's not an option, or you feel the need to give the psych another try, then I suggest that you start the session by expressing that at the previous session you didn't feel like they were listening to you, and that they were just trying to check off items on a list.

Between now and the next appointment, get a notebook and write out all the ADHD-like experiences that you can recall from both your youth and the last few years. You will probably find a pattern of the same types of struggles.

(For me, it was always difficulty maintaining attention, distraction, very limited working memory, time management and organization issues.)

[ParkwayDriveFan24 in reply to STEM_Dad]

I did the exact same thing with homework well for the classes that I didn’t really have an interest in. I would do those the night before or the day of. I would do the same in college too with essays as well. The rush always pushed me through.

I wrote things down in a notebook this time and I found patterns myself but they kept asking about my childhood and specific instances when I couldn't hardly recall every detail of it. I think my best bet is to get a second opinion.

[STEM_Dad in reply to ParkwayDriveFan24]

I think a lot of people don't recall specific instances or events from their childhood, unless it was something particularly good or bad.

At my own ADHD assessment,

For the record, I wasn't diagnosed in a single session. I was already seeing a mental health counselor for treatment of anxiety, and I asked her to evaluate me for ADHD. The sessions were being paid for by my workplace's Employee Assistance Plan (EAP), with provided for 8 sessions of counseling. I received my diagnosis in the 6th session.

• My personal care physician didn't accept the diagnosis blindly. Me had me take a computer questionnaire that took me about 20-30 minutes to fill out. It took him just a few minutes to score...and then that was it, I had a second opinion confirmation. I don't think that the questionnaire focused on current symptoms, and whether they extended more than 6 months.

...So, one evaluation method took a long time, and the other a short time, but both the same result.

I think that many of us don't realize this, but there isn't one standard method to diagnose ADHD.

• When I was in my 20s, I had a job one year as an office assistant for a special education department at a school. My duties included scheduling the ADHD testing (and testing for learning disabilities) with a school psychologist. Those seemed to take 1-3 sessions of 1-2 hours each, and the wait for results (which i wasn't privy to ...I only marked the date received in my records) could take weeks.

~~~~~

Be patient, and be persistent. If you go through the whole process with the psychiatrist and don't get an ADHD diagnosis, then do seek a second opinion. (But expect that to take time, too.)

To try to satisfy the psychiatrist's questions about your childhood, do you have access to your report cards and other school records? They might have comments such as "doesn't use classroom time well". Or, do you recall things your parents would say regularly, like "you'd lose your head if it wasn't attached"?

[ParkwayDriveFan24 in reply to STEM_Dad]

UPDATE. I got a call back for a second diagnosis. The psych department manager ended up taking to me and he is moving forward to an actual interview those of appointment. I’m kind of nervous and stressing a bit over this because I feel like I need to remember more about my childhood. I’ve asked my mom and when I lived with her, she had structure in the household compared to when I lived with my dad and he let me do pretty much whatever without any discipline. I’m second guessing myself as well.

[STEM_Dad in reply to ParkwayDriveFan24]

That sounds promising.

We tend to second guess ourselves, so try shifting your focus like this:

• If you had a family member or close friend who needed an advocate to help them get assessed for ADHD, what would you be willing to do for them?

You've got to have the same conviction to help yourself as you would to help someone that you're close to.

(Many, many people who have ADHD are very empathetic and would readily "go to bat" for someone else when they need us to.)

~~~~~

If you can't think about specific examples, it might be that you struggled so regularly that you became blind to the things that you were struggling with.

My usual response is to try journaling in order to help bring things to mind, but I was reminded by a YouTube video the other day that a lot of people with ADHD do verbal processing. We have to talk things out, and if there isn't someone we can talk to in order to help us recall things, then we have to talk to ourselves. (If you're worried that talking to yourself will make you look crazy, then so it somewhere that you can be by yourself, or do it with your phone out so anyone that sees you thinks you're on a call.)

~~~~~

What were your typical struggles like as a child?

What are your struggles like now?

Start by listing something that's difficult. Ask yourself "why"? If that doesn't seem to get to the root of it, then ask "why is that" to that answer... repeat as many times as you need to, in order to get to an answer that doesn't have a "why"...it just "is". (I've heard that this typically takes 5 or 6 times on average of asking "why" to get to the real reason behind something.)

Expect it to take time. When you hit a roadblock or get frustrated, leave it alone and come back another day.

[Mamamichl]

hello and welcome! Stemdad is on the right path in that there is no single way to diagnose. My daughter was with a series of questionnaires given to her, her parents, and 3 of her teachers. For me, during Covid, I had 3 two hour sessions with a psychiatrist evaluator looking at my symptoms and determining my diagnoses. She was sure I had ptsd and adhd on top of my already diagnosed anxiety. She was on the fence on whether I was autistic as well. I haven’t gone for a second eval yet because that’s already a lot on my plate to try and work on before possibly add asd to the mix.

It sounds like a second opinion is an option. I highly recommend you take that opportunity. My adhd behaviors as a young child consisted of rsd (rejection sensitivity) and I would run away crying regularly. As for the “you did well in school” that is an old belief that is no longer accepted with adhd. I did well on school too, but I would do homework for 5 hours daily to get those grades in high school. I would study for so long to get the grade I got and I would hear peers say they got the same grade I did and didn’t even study. I was actually confused why I had to work so hard for the same grade.

My daughter does a better job of masking than I did too, but by the time she comes home from the day, she’s DONE. We don’t even do homework because talking to her to do anything will set her over the edge. She instantly apologizes for outbursts if she can regulate well enough. When she is fully regulated (usually on the weekend), we discuss how to handle different emotions and levels of frustration. She’s 9 btw. At that age I was only seen as an emotional girl because adhd was a boys issue. We just had a talk with her counselor yesterday on how she masks well for her age and internalizes while me and dad externalize emotions. I sometimes internalize them and blow up at unusual things when the proverbial straw breaks the camels back.

Because adhd is a spectrum like autism, all of us have different skills socially. Personally, I’m surprised you can actually bite your tongue. My blurting before thinking is what my biggest issue in work is. I am unsure if masking is an actual executive function, since many of the adhd videos talk about masking regularly and still having executive function issues.

[STEM_Dad in reply to Mamamichl]

I don't think of masking as an executive functioning skill. I think that it is more basic than that.

I'm not sure, but I think it's related to mirroring (when a person unconsciously imitates the behavior of others). In other words, I think it is a survival instinct, to learn and adapt, and by fitting in with our "tribe".

I found this article that says something similar to what I was thinking:

"Mirroring is a way to gain social acceptance and connect with other people. It’s also how young children learn.

Mirroring can be a type of ADHD masking since it suppresses ADHD behaviors and replaces them with more socially acceptable alternatives."

• psychcentral.com/adhd/adhd-...

~~~~~

For those of us to internalize more than externalize, like me and Mamamichl 's daughter, I think that biting our tongue and bottling things up are just our default. And then, when we can't bottle things up anymore, we might just blow up about something small... because it was the proverbial 'straw'. That wasn't the thing that made us reach the tipping point...there were a lot of things that brought us to the point, teetering on the brink. It was just that one last thing that caused the avalanche.

[ParkwayDriveFan24 in reply to STEM_Dad]

Well the “in-depth” interview was pretty much like the first one. Psychiatrist said the same thing that I would have needed to have been disruptive as a child and have had bad grades. I gave them examples and all but doing well in school seems to be why they won’t diagnose me. I don’t know why Kaiser is so difficult to diagnose ADHD.

[STEM_Dad in reply to ParkwayDriveFan24]

Was that the same person evaluating you, or someone else?

I think that they are behind the times with understanding ADHD.

It is no longer considered to be a requirement that someone who has ADHD did poorly in school. In fact, there are people who have ADHD who now have advanced degrees... Master's degrees, Law degrees, Medical degrees, PhDs.

I didn't do that well, but graduated from highschool with a 3.50 GPA, while taking mostly advanced classes. I even got an acceptance letter to a competitive university. (I couldn't afford it, and based on the rest of my college performance,

I don't like when someone is being too by-the-book to actually focus on patient care. I know that doctors are supposed have professional detachment, but that doesn't mean that they should lack empathy. 😕

[ParkwayDriveFan24 in reply to STEM_Dad]

It was someone else who I was talking to this time. But it was funny to me that it was the same thing that I was told the first time.

That is how my sister-in-law was she did decent in high school but got her masters in college and she was diagnosed with it. Yeah it just seems their requirements to be diagnosed is still basic and a one shoe size fits all type. I’m just gonna probably end up going to a third party that actually specializes in treating ADHD because it is frustrating.

[STEM_Dad in reply to ParkwayDriveFan24]

Well, the common factor between the two is that they both work for Kaiser. I had Kaiser as my healthcare coverage about 20 years ago, and again about 30 years ago, and I wasn't impressed with them.

Does your sister-in-law live in the same area as you? Did she get her diagnosis within recent years? Perhaps you can go to the same doctor who diagnosed her for an evaluation.

[ParkwayDriveFan24 in reply to STEM_Dad]

She lives a few hours north of me and the funny thing is she might have Kaiser herself but when she got diagnosed she was able to do actual hands on testing on a computer and be able to be evaluated that way.

I’m honestly just considering going to a 3rd party outside of Kaiser just to be evaluated at this point. Someone who actually specializes in ADHD.

[cappermcgee]

i know this is older but as an add-on to what everyone else said, ive had the same issues with doctors not hearing me and not taking me fully seriously about how much i am suffering because i am polite, a good listener, and (seem) put-together. before you just dump this psych i really recommend sitting down and writing down everything you want to bring up beforehand and try to unmask best you can while in the room with them, even better if you can do something in the car on the way to the appointment to help you unmask... my parents made me the black sheep behind my golden child older sister, so ive always been able to mask well (almost too well) because they pounded manners into us and i live in a small town so any bad behavior or words would somehow get back to my family. family "reputation" and all the pressure to not cause trouble makes us get lost in the realm of mental health... we look and present "fine" to the world but nobody knows the real torment. (btw feeling like you have to surpress yourself in order to not get in trouble is an adhd trait that you probably developed before 12 and didnt even realize!)

there are probably even more traits you dont know about/havent realized have always been there too, take some time to think and write the points you want to bring up down.. and if you end up going with a different psych altogether then you'll have the list for them, too and be set up even better

[ParkwayDriveFan24 in reply to cappermcgee]

I’m at the point now where I should just go to a ADHD specialist outside of my coverage and get a diagnosis from them. It’s crazy that this second more in depth interview was just the same as my first. I was able to write a lot down before hand and before I was able to finish telling them everything. They stopped me and said ok that’s enough information. So after that I wasn’t expecting much. The same was said and when I asked so me not living in a structured environment when I lived my dad wasn’t an issue, she said no because any kid would do the same if not wanting to do their homework. That was the nail that I was like Kaiser is not going to help me since they are so strict with how they want to diagnose.