When I was diagnosed (by a licensed psychologist) as possibly having ADHD, I was elated. My life as I previously knew it blew wide open.
“When you deal with a neurodivergent brain for nearly 50 years and suddenly have a better understanding of why you do all the weird things you do, your life becomes a much kinder, gentler place. What I didn’t anticipate was the lack of acceptance and understanding I would encounter, especially in the medical field.”
I discovered this after spending two pointless appointments with a psychiatrist.
At my first appointment, I filled out a plethora of forms regarding my mental and physical health then I spent my entire allotted hour answering the doctor’s questions about my mental health. Something he could have retrieved from my psychologist with the permission I gave him to access my files/history. He then had me fill out what I believe was a version of the Adult Self-Report Scale (ASRS). We never addressed my ADHD, which was why I made the appointment.
“We never addressed my ADHD, which was why I made the appointment.”
The second visit can’t even be considered a visit. The doctor asked why I thought I had ADHD and didn’t reference the ASRS filled.
When I tried to explain why I think I have ADHD, he dismissed several of my examples with, “that might be a symptom,” or “well, a lot of people experience some form of that.” The guy then dismissed me after 35 minutes with instructions to come back in a month and to make an appointment with my therapist to further discuss why we think I might have ADHD. Mind you, I tried to explain what I could, but got dismissed. Fruitless.
During another series of events, I moved into an office space that is wide open, has no privacy, is loud and is as bright as the sun is in a desert in summer. Distractions, noise, light smells and people, so damn many people. It’s more than I can stand and I am now, more than ever, seeking new employment.
So I’ve self-diagnosed and here’s what I know. I say I know, because we know ourselves better than most medical doctors ever will know us – particularly if we are capable of being completely honest with ourselves. I’m the person that tells doctors what ails me and what I need. I rarely take them at their word.
As most of with ADHD know, there is currently no formal test or process for diagnosing ADHD, rather the Diagnostic and Statistical Manual of Mental Disorders, 5th edition published by the American Psychiatric Association has criteria for diagnosis.
The criteria include two categories – Inattention and Hyperactivity and Impulsivity. Within those categories are lists of six or more symptoms that must be present for children up to age 16 years, or five or more for adolescents aged 17 years and older and adults. Those symptoms must have been present for at least six months to an extent that is disruptive and inappropriate for the person’s developmental level. Visit the cdc page on ADHD to learn more.
I measured myself against the two categories and the criteria and, based on my results, I likely have a moderate form of ADHD. I fall into both categories but am more hyperactive than I am inattentive. My executive function is pretty okay and my working memory is pretty okay. Full disclosure, my ADHD will override and decimate my executive function and working memory, especially if the tasks ahead of me are not interesting or I don’t like the person asking.
After doing an initial dive into diagnosis (hyperfocus kicked in out of frustration), I found a 2017 study that was eye opening. Study researchers found evidence that further supports the idea that people with ADHD are not the same neurobiologically. According the the author, Dr. Michael Stevens, research revealed that:
“three distinct subgroups may exist within an ADHD diagnosis, and that rather than a single disorder with small variations, findings suggested that the diagnosis encompasses a “constellation” of different ADHD types that function in completely different ways.”
Of 117 adolescents tested:
one group demonstrated impulsive motor responses during fast moving visual tasks (a measure of executive function),
one group preferred immediate reward and,
the third group performed relatively normally on both tasks when compared to 134 non-ADHD adolescents.
Stevens said that the three subgroups were otherwise clinically indistinguishable.
Additionally, Stevens and colleagues used magnetic resonance imaging (fMRI) to try to make connections between behavior and brain function to investigate how the different impulsivity related test profiles related to brain dysfunction. They found that there wasn’t a single fMRI-meausred abnormality found among the three ADHD subgroups. Instead, each subgroup showed dysfunction in different brain regions related to their specific type of behavioral impairment.
This is just one of many studies that continue to uncover the complexities of ADHD diagnoses. The perplexing aspect of all of this, for me, is that a medical professional who supposedly deals with ADHD was so incomprehensibly incompetant.
The M.D. that I want to see doesn’t take insurance and charges $400 an hour (can’t afford). So I am stuck without a diagnosis which means that I can’t access one of the many drugs that might benefit me.
And because of my first unsuccessful attempt to get help, I am completely unwilling to seek another provider covered by my insurance. And let’s not get into insurance in the US. Basically, we pay mob bosses to provide minimum coverage. It’s a scam, really. But I digress.
To date, I’ve successfully diagnosed myself, but remain untreated. My poor underdeveloped brain is completely different from anyone else’s who has ADHD. The good news is that I’ve lived with the thing for so long that I’m used to it. Additionally I am armed with tools and information that allow me to take care of myself the best way I know how.
In the meantime, if you have any spare ritalin, adderall, concerta, focalin, daytrana, metadate or methylin, dexedrine or vyvanse, send it along. I’m looking to self medicate and figure out what works best for me. Kidding. Kinda.
Thanks for listening. As always, feel welcome to contact me via planetnd.marketplace for advocacy work, coaching, interviews, or if you need a friendly ear to listen.
Stacia is a neurodivergent entrepreneur coach and ADHD breakthrough coach. She also has a brand new blog about her life with ADHD!