this post was submitted on 14 Jun 2023
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ADHD

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Long story short, for the last 5 years or so, generally since becoming an adult, I've been feeling foggy, with loose memory (I can't remember a verbal list of more than 3 things for the life of me; grasping for words; etc.), noticed I have a tendency to obsess over new hobbies, inability to do things that need done, general depressive thoughts, etc.

I mentioned to my primary care doctor in a recent visit that I wanted to talk about a possible ADHD diagnosis. The conversation went essentially like this.

"I want to talk about a possible diagnosis of ADHD, or autism, or something of that ilk. I know this isn't really your area of expertise but I don't know where else to go."

"No, it is actually. Did you have trouble at school as a kid?"

"No"

"Are you able to complete your tasks at work?"

"Yes, for the most part"

"Ok, so for adult ADHD I generally recommend just lifestyle changes. Do you drink coffee? Caffeine has been shown to help."

After suggesting I drink coffee she ended the conversation and moved on to review some other unrelated concerns I'd brought.

Does this sound like a reasonable conversation? How did the conversation go with your doctors when you first brought up the possibility of ADHD? I feel like I was completely written off. She never asked about why I was asking about an ADHD diagnosis. I just feel like after gaining the courage to speak with my doctor about something that seems intimate to me, I was just ignored.

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[–] sweetcuppincakes 10 points 1 year ago (1 children)

When I talked to my current psychiatrist about ADHD, she directed me to get neuropsychological testing. Might be worth looking into. I agree that your doc brushed off your concerns too quickly.

[–] [email protected] 4 points 1 year ago

I'll look into that. Thanks for the info!

[–] [email protected] 7 points 1 year ago

You need to ask for a referral to a psychologist that specializes in ADHD and/or neurodivergence. Your doc asked 2 "impacts my life" questions and brushed it off after hearing the impact to your life was low. But she did not cover all the ways your life can be impacted. You need a real professional to help you take this journey. If you are in a country without free access to one then check what your medical aid/insurance does cover.

[–] tubabandit 3 points 1 year ago

They aren’t an expert at all. A proper evaluation involves several questionnaires and interviews that complement/supplement each other to assess the consistency and veracity of your responses, a consideration of other conditions (since ADHD is very commonly paired with other conditions such as depression or anxiety), and may also involve parents or someone from earlier in your life to check for childhood presentations, if possible.

By your GP’s reckoning I’d be fine because I have a good job and several university degrees, but that’s because I’m smart and could compensate. In reality I was drowning at work and home, and unconsciously self-medicating with copious amounts of coffee, all the while unknowingly masking a fairly significant impairment that I wasn’t even aware was there until I entered my 40s.

It might cost a bit of money but get a proper evaluation done with a psychologist. If the GP won’t help you, get a new one or find a nurse practitioner who has some familiarity with ADHD treatment. Medication is not the only fix, there’s lots you can do without it, and lifestyle changes will help you a lot, BUT it works brilliantly for something like 70-80% of cases so it would be folly not to pursue it. There are also non-stimulant treatments that don’t carry the overblown “drug seeking” fears and that may work for those who cannot tolerate stimulants. Based on the evidence provided, your care provider is uninformed or is not acting with your best interests in mind.

[–] [email protected] 2 points 1 year ago* (last edited 1 year ago) (1 children)

Not surprised you were ignored unfortunately. Lots of doctors are concerned about drug-seeking behavior and don’t take you seriously. I’d suggest starting with a therapist who is familiar with ADHD. Have them do an evaluation of you and then have them discuss with your doctor.

And if you haven’t already, get a sleep study done. My symptoms were diagnosed as ADHD several years ago after decades of confusion and frustration. Meds were truly life changing for me. But after a few years on meds, I began to wonder why I had ADHD. I wanted to know what was causing this — why was I the way I was.

I stumbled across a book called Sleep, Interrupted by an ENT named Steven Park. From that book (and from his website) I learned that sleep disruptions due to breathing issues are correlated with ADHD. From there I went down a rabbit hole of medical journal papers on the overlap between disordered breathing and ADHD. The symptoms of ADHD can be very similar to some of the symptoms of UARS, sleep apnea and mouth-breathing, and there is meaningful correlation. Sure enough I have mild sleep apnea and likely UARS. I hyper focused like crazy on improving nasal breathing, I tinkered with my sleep positions, started on OTC heartburn meds, and I totally gave up caffeine (and severely restricted alcohol). My quantitative and qualitative sleep and breathing metrics have improved and my ADHD symptoms have attenuated meaningfully. I don’t use a CPAP and will try to avoid one as long as I can. I still am on meds but at a drastically lower dosage than before.

Best of luck. Don’t give up.

[–] [email protected] 3 points 1 year ago

Yeah, my friends mentioned the drug-seeking aspect as well. It just seems ridiculous to write someone off that quickly though.

I'll check out that book. And the doctor already has me doing a sleep test this month due to daytime sleepiness and increased blood pressure, so maybe we'll find something there!

Thanks for the response.

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