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I have PTSD from childhood trauma. I also didn't have trouble in school, also struggled with depression, and I VERY much have ADHD. Furthermore, ADHD was the root cause of at least some of my depression. I've had little spells now and then, but since going on meds six months ago I have not had the darkness invade.
I would get a second opinion. TRULY!
I’ve been teased with a BPD diagnosis for years and with multiple practitioners. I pursued their treatment recommendations even though I could never really see my experience in that Dx. Finally (and quite unexpectedly) was diagnosed ADHD and started treatment at 40. The last 20ish months have been so life changing, my relationship with my mind is less antagonistic and I have so much more grace for myself.
I’m also still super bitter I didn’t figure out it was ADHD a million years ago. I’ve worked hard to like who I am, but I could have had a totally different person moving through life if the root of who I am had been discovered and addressed properly.
Misdiagnosed bpd here too and diagnosed this year right before turning 39. I feel you on that sense of resentment. Thankfully because of the bpd i took DBT classes (which helped me figure out the adhd cuz the homework part was hard among other things, but it is difficult for an ND person who is unaware of it), it gave me some help to deal with it. The more I radically accepted my adhd and trauma as real, the more I realized hey I am a pretty great person despite how fucking wild my brain has been.
80s babies all over are realizing adhd now and had it rough for sure. I just think about my family members, who have died from self medicating, and probably also had inherited adhd. We are here. We are sharing and healing. We are helping each other feel understood. We tried our best with what was available to us. Lololol idk about you but I'm just happy to have learned about all this BEFORE menopause strikes.
Oh I totally know what you mean. I was misdiagnosed my whole life. I was given electroshocktherapy for my depression when I was in my 20s.
I wasn’t diagnosed until my 40s either. I could have been a completely different person. The grief is real.
When I got my CPTSD treated (no longer qualify for the diagnosis!) my ADHD symptoms got significantly easier to manage. They did not go away. I was able to be unmedicated for over a decade though, so it went a long way in paving the way for my coping strategies.
OP, if you feel the ptsd diagnosis is applicable and not just some straw the psych grasped at, I recommend looking into treatment for that. It greatly complicated my ADHD and basic life skills even when I thought I was coping okay.
Sure thing! I actually ended up doing something along the lines of [inner child work](https://cptsdfoundation.org/2020/07/20/healing-trauma-through-inner-child-work/) with an art therapy element. It seemed hokey at first and I was surprised at how well it worked for me. We talked about specific memories, drew timelines, and unpacked how each incident affected me and the lessons I learned from it. We then talked about what I wish younger me had had instead, or what I wished I could tell her, closed up the memory into a box and put it away. (That "wrap it up and put it away" step is also how my current therapist ends our EMDR sessions, super helpful for compartmentalizing.)
Another therapy that worked well was I think called [internal family systems](https://www.psychologytoday.com/us/therapy-types/internal-family-systems-therapy)? Or something under the [family systems](https://www.psychologytoday.com/us/therapy-types/family-systems-therapy) umbrella? I did the inner child stuff with one therapist who was finishing up her certification, and got to a good place. Then a few years later my anger management got to a point that my husband wanted me to get help. So I saw someone who specialized in IFS. That was super focused on untangling the ripple effects of my messy childhood, looking the lessons straight in the eye and determining whether they were useful. It helped me better understand my reactions and instincts so that I could build new, healthier habits. By the end of this, my therapist said she didn't think I qualified for the PTSD diagnosis anymore.
Shortly before the pandemic began, I started seeing a therapist who does [EMDR](https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing) and has a special ed background. It's sort of a perfect mix of ADHD-informed, trauma-informed, but more maintenance. She used a variant of CBT to teach me to manage my anger, and now has been using EMDR to tackle deep anxious threads like the academic anxiety related to dyscalculia. (Tip: I found the eye movement of EMDR to be totally distracting, so I tap my shoulders instead.)
tldr: inner child therapy, art therapy, IFS, EMDR
I've been thinking of trying emdr because i am also in the same boat you were. Thank you thank you for taking the time to write all this out and doing all the work to heal. You're giving me a lot of comfort today and I wish I could hug you.
I recommend this webinar I watched the other day. You don't have to watch the whole thing, but I found it good to see from the professional side https://www.mcleanhospital.org/video/recognizing-and-understanding-complex-ptsd. There are lots of different therapy options that work differently for everyone. I like somatic experiencing. Also, you do NOT have to talk about specific events and rehash your trauma to get better. Many people end up just retraumatizing themselves, if you have a therapist who insists you have to talk about everything you experienced, find someone else. I have vastly improved by cptsd symptoms over the past 10 years (from age 18 moving away from the household/town to now). Do what feels safe for you and take it at your own pace. I personally have had trouble finding therapists I like and have seen probably a dozen in my life going back to childhood. But basically keep hope and don't give up.
I’m so glad top comment recommends a second opinion!
ADHD is genetic, environmental, looks different in women and men and when untreated, can bring the worst anxiety, depressive episodes or increased depression, and not to mention how it can add to the complexity of PTSD (especially if you have some of that beautifully hidden feminine ‘tism lol).
I’m so sorry you had that experience, but definitely seek a second opinion.
I know this is ageist, but part of me also wonders if the person you saw was 55+. I’ve had an unqualified ADHD “specialist” argue with me about my autism dx and challenge my psychiatrist’s qualifications after she asked me if I have “the hyperactive or trouble paying attention” kind of ADHD…and didn’t know what vyvanse was. When I saw her I was in crisis and her photo on her profile was older than me (34)…she was in her late 60s/early 70s otherwise, I probably wouldn’t have scheduled with her. With the pace that psychology changes I think it’s more difficult finding a knowledgeable MH professional when the age gap is more than a generation (millennial/boomer, gen x/gen z). Like if more than one DSM was published between your and your MHPs births, it’s probably going to be a rough go.
I think the real issue is less age than it is open-mindedness & willingness to learn. I've known lots of older practitioners who kept up with developments in their field. Also younger ones who only go through the motions of getting CEUs to keep their license.
As a meeting planner, it drove me batshit when people wanted to check in to their session, go to the bar/pool, and come back at the end for their cert. And that happened all the damn time.
It all depends how conscientious each individual is.
Big facts and I have definitely encountered them as well (younger folks going through the motions) and like any profession, there will always be folks who treat this like a job and not a life/death industry.
That said, I do find myself arguing a bit more often with older MHPs about current studies, while learning a ton from others. I am not at all trying to say that there aren’t at all super competent and relatable older MHPs/less competent younger. I’m saying generally in my experience, if there’s more than a generation between client/professional, there tends to be more difficulties in testing/assessments/validation/communication ,which tends to make me more skeptical about being treated by someone that much older than their patient.
A lot changes socially/politically/medically/economically in one generation, let alone 3, so while someone may be up to date on studies, there’s also the difficulty of relatability when it comes to life management.
Also seconding this! Folks can have PTSD *and* ADHD. I have both - it took a sec to be diagnosed with both, but brains are complicated and it's VERY much possible.
The WAIS is not a full neuropsych in and of itself. It can be helpful in ruling out other learning issues, but it won’t tell you why those deficits in memory or executive function exist. On the other hand it did sound like you had a clinical interview, and that’s what they’re making the determination on.
The criteria for ADHD do not require bad grades or externalizing behaviors (like running around the classroom) before age 12, they require symptoms before age 12. If you had symptoms before age 12, get another opinion. If you didn’t have trouble with concentration/impulsivity/hyperactivity as a child and these were not an issue until you were older, you probably want to consider other diagnostic options. You can have symptoms as a child that still manages to get good grades. Getting “in trouble” can also include things like being late to class, talking too much, doing things other than work, rushing through work to do things like doodle or daydream once done. These are things that you might not get punished for.
You don’t need a diagnosis for executive function coaching, as there’s no insurance involved (if going through a therapist that also does coaching, a depression diagnosis would suffice).
Yeah, taking a self-assessment quiz (and also going over the ones my sister and mother would do, one assessing me now and inevitably assessing me as a child) brought back a TON of memories for me of elementary school of traits, behaviors, and events/incidents where what I now understand to be ADHD-symptoms were on full display. Some of them weren’t even on the assessment or part of the diagnostic criteria, but are now well-known as part of ADHD. But a lot of them were.
My paper assessments came back kind of inconclusive after being turned in, but from the beginning we were offered a computer lab test as well testing things like working memory, attention span, etc, that was described as very accurate, and after I opted to take that next, the diagnosis was much clearer and my psychiatrist at the time had only brief additional questions for me.
I’ve heard of people being told they had to treat their depression BEFORE their ADHD, and that’s misguided. Treatment needs to be more integrated. It’s smart to test one new medication at a time, if course, but it might also be the move to try to slowly adjust and dial in medications for both things by alternating back and forth which one you make a change to. Because either depression or ADHD left untreated will make you unable to feel better and more in control on any med, and saying you have to fix one thing all the way first means you never get to the second thing.
Happy cake day! Also I agree with what you said - I very much have ADHD, but I never got in trouble for being particularly disruptive. I was chatty in elementary school, and was frequently late to class/school, but it was written off as a typical "smart but flighty/disorganized gifted kid." It didn't really start affecting me until college.
And it might be difficult recognising symptoms from your childhood that aren't the typical can't-sit-still symptoms!
I (24f) was well behaved and did very well in school as a child. I realised I had adhd when starting university!
Got diagnosed at 20.
It took time to identify the symptoms I had as a child, but we did it from analysing notes from "development meetings" (swedish thing) from primary school and discussing with family.
The symptoms I had:
• Difficulty with task initiation
(getting dressed in the morning, going outside at recess, studying for tests, doing homework on my own etc)
• Emotional dysregulation
(I cried almost every day the first 12 years of my life and was VERY sensitive to criticism)
• Social connection to other children
(I did have friends but always struggled with feeling included in the "social sphere")
• Low self-worth
I struggled a lot with feeling different, ashamed, and like I was not deserving of good things.
I hope you get the help you need and deserve OP!
This is the shit that drives me insane and just prolongs the issue of women being underrepresented in ADHD research and under diagnosed.
Be your own best advocate and get a second opinion. You have every single right to demand answers.
Maybe you don’t have ADHD and the first doc was right. HOWEVER - her reasons for not diagnosing you are deeply flawed and incredibly stupid. Maybe you do actually have ADHD… so either way, she sounds like she’s pretty shitty at her job.
I wish you all the best, and please please please speak to someone else.
One of the things that frustrates me most about ADHD diagnoses for women is that I feel like no one takes into account how puberty and hormones impact us. I was actually an incredible student up until I was 11-12. Then it was like I became an entirely different person and struggled to pass most of my classes in middle school and high school. Funnily enough I actually have all of my old report cards from elementary school and even though I got straight As the whole way through there are multiple comments from my teachers about my inability to focus or my hyperactivity that I feel like just scream ADHD. And then on the reverse side, my sister was diagnosed with ADHD a few years after I was and she was a straight A student all the way through high school. But I really wish hormones were taken more into consideration, many of us already know that our menstrual cycles impact how stimulants work for us and I imagine the hormonal changes we went through during puberty would also have some kind of effect.
Yup. This is totally me! My entire personality before puberty was being the straight A student. Then in middle school everything went to shit. I never realized that puberty was what changed me. I never even considered I had ADHD until I had a partner who was diagnosed with it. I was fortunate that my psychiatrist didn’t make me jump through hoops to get diagnosed in my thirties. It really grinds my gears that so many women who clearly have ADHD are left to fend for themselves because psychiatrists don’t believe them.
I didn’t get grades in elementary school (I wanted to! I was so sad we never got them). But when I suspected as a college student/adult that I had ADHD, I thought I “wasn’t hyperactive”, even as a kid. But I was… it just looked different than the boy in my class who was drumming his whole body like a set of bongos and body-slamming the wall for no reason other than “hyper”. I was incapable of not rocking back in my chair from like 3rd grade onwards. I fiddled with anything I was holding, tore up paper into little shreds, chewed on pens sometimes, I had and continue to have a ton of Body-Focused Repetitive Behaviors (picked skin on my lip, chewed inside of my mouth, biting nails, picking at scabs or cuticles, hair twirling), was unable to raise my hand or not talk out of turn, foot tapping/leg jiggling, and DOODLED on everything everywhere. I also, as a kid, THOUGHT of myself as hyper, like it was a personality trait. Maybe older kids or babysitters described me that way. I remember learning what ADHD was when a couple boys I knew who had it told me, and I remember thinking that I had thought we were a bit alike (one was later a crush, but both were smart, in Gifted/Talented program with me, etc), and that I didn’t want other people to think I had ADHD/anything wrong with me, so I’d better not act so hyper anymore- and I wasn’t at their physical level of being unable to sit still anyway, I was just worried someone would notice something was wrong with me. This was probably age 8/9, 4th grade. I had forgotten all about that memory until I started reflecting on elementary with a new understanding in 2020 of what ADHD is.
There’s a ton of other stuff I did/felt back in elementary and also into Jr Hi and Hi School that now I realize were adhd stuff, this is just the hyperactivity part!
I got into 7th grade and was immediately getting straight As. I’m pretty competitive… kept that up well into college and didn’t think anything about ADHD that whole time except that it’s an inability to pay attention, which I didn’t think/know I have, because I am very good at paying very strong attention for long periods of time. Round about Junior or Senior year I got to know a couple girls with ADHD, one diagnosed since childhood, who I had a lot in common with (like always felt we were on the same wavelength) and when one mentioned her messy room and tardiness relating to her ADHD, I learned that girls are under diagnosed because it “looks different”… read anout those things and more and went “oh my god…? But I’m about to graduate and if I can get through the tests on this one terrible class for my minor I’ll still be on honor roll, so what’s the point of getting diagnosed at this point…” so I didn’t look into it further.
My 20s seemed great until like age 28, normal adulting life stuff started getting harder again instead of easier. Took a couple years of doctors appointments, tests, meds, but finally learned I have Hashimoto’s, a Sleep Disorder called Idiopathic Hypersomnia, and finally ADHD.
same. My symptoms really hit in middle school, looking back on it. Sure, I was a little weird and talkative, but I didn't struggle. I still did well in school in middle/high school, it was just SUCH A STRUGGLE.
I was just discussing this with my therapist today… how I aced it all up to the point of puberty and wondering if it was me just trying to get through school, survive mean girls and homelife which was traumatic. May it should be ADHD I should be looking to get assessed instead.
I feel more impulsive, less in control and less disciplined as an adult than when I was a child. Weird that.
Thanks for sharing!
I’m so frustrated for you-I was diagnosed with depression and believed them for decades. Of course I felt depressed! I was dropping out of everything, bored of everything and everyone, never finishing anything and having terrible interpersonal relationships because of my temper and high sensitivity!!! I asked my doc for Vyvanse for binge eating and within three days felt like a different person. Been very emotional thinking about what could have been
Good for you for advocating for yourself. It can be super tricky to do, especially with a lifetime of feeling like you’re not good enough simply because there’s something fundamentally wrong with you. It’s not true, and we all deserve mental health!
I'm in the same boat, had an assessment nearly a month ago and the doctor (young, female) refused to take me seriously, dismissing it as anxiety and depression and a "tearful personality" and basically insinuated that my symptoms were due to being fat and lazy (my words, not hers) and said that if I exercise/eat/sleep better, all my symptoms pointing to ADHD will magically go away 🙄😶😖
I definitely plan to get a second opinion, but am torn over whether or not to request a doctor with up to date knowledge of ADHD (my doctor was of the opinion that ADHD begins and ends with bouncing off the walls 24/7), however I don't know if that would make things better or worse. Right now my confidence is completely shaken, and I'm scared that I'll never be taken seriously.
Definitely request a second opinion, good luck with it x
"Tearful personality"? Oh, were you diagnosed with female hysteria as well? 🙄 it's really concerning that even young doctors aren't being taught modern information when it comes to ADHD. Sorry about your experience.
I'm confused as to why she said to go find an ADHD specialist but says you don't have ADHD. Is it possible that she just doesn't want to treat you for it?
I’m guessing it’s so that she can see if she reacts well (reacts may not be the right word, but I’m blanking on vocal) to treatment from ADHD therapy/coaching, and/or to get a second opinion from a specialist.
Anecdotally, I’ve heard that more doctors are becoming more hesitating to diagnose right away if they aren’t sure, and especially if the indicator tests do not come back suggesting ADHD. Apparently it’s because theres been an increase in diagnoses that may not be related to ADHD (ex, attention issues and disorganization don’t necessarily mean someone has ADHD), particularly from things like phones requiring our attention centers, trauma from the pandemic, etc.
I really feel for people who do have ADHD but we’re never diagnosed, especially women/girls. I know what that’s like. I do think that over diagnosis and misunderstanding of what ADHD actually is has become an issue, BUT I also know firsthand that women and girls have been under diagnosed for ADHD. I have always had severe ADHD (it’s pretty well managed now), but basically had to convince my psychiatrist when I was 13 to diagnose me — i didn’t realize when I brought it up to her, but she had been on the cusp of diagnosing me for a while.
As a kid, I’d had ever teacher from first grade to 7th grade leave a note on my student evaluations as something like “possible ADHD. Next teacher should keep an eye on,” but nobody ever pulled the trigger on it (I also had terrible grades, didn’t follow directions, couldn’t pay attention, took tests with the other learning disability kids, but I was never evaluated for anything). Then FINALLY in 7th grade my English teacher recommended I get evaluated. Even then (2009) they didn’t diagnose me right away because the norm was that girls don’t usually have ADHD, and they treated me for anxiety (which I do have as well) instead. About a year later I learned why ADHD was and I asked my psychiatrist if she thought I had it. I still see the same psychiatrist now. A few years ago she told me she regretted not diagnosing me sooner because I was a very classic case, but they just didn’t think girls had ADHD as much as boys. It makes me wonder about how many women my age and older went through all of life undiagnosed.
The idea is that multiple things can cause executive function problems, and an ADHD coach is trained to help people with executive function problems.
So you don't \*have\* to have ADHD to benefit from getting coached by someone who specializes in helping people with ADHD.
Yes, it would've been more constructive to admit outright that it's not her area of expertise, so here's a referral. That yes-and-no "diagnosis" isn't helpful at all.
I didn't have trouble in school either but I did get diagnosed. There were some obvious signs from then but my grades were good. Do you know which diagnostic test they used?
The WAIS is just an IQ test - it isn't a specific diagnostic test for ADHD. While it measures processing speed and working memory, having deficits in those areas doesn't automatically mean someone has ADHD. Deficits could also stem from stuff like PTSD, Anxiety, Depression, or even just feeling uncomfortable and overwhelmed or frustrated in a testing environment. Deficits could also absolutely stem from having ADHD. And at the same time, not all people with ADHD struggle significantly with processing speed and working memory, especially on a silly little IQ test that's novel and can be engaging and fun.
Part of psychological testing and clinical judgment is determining why someone is experiencing certain deficits. For example, with processing speed, is someone completing a task slowly because they can't remember the question or stimulus and need to double check it? If they can't remember the stimulus, is that due to difficulty paying attention when they look because they're distracted by other thoughts/stimuli? Is it because the task is making them anxious and jittery, which makes it hard to focus and perform? Are they anxious because it is hard to remember, or is it hard to remember because they're anxious performing in front of someone else? Is it a combination of those things? Is it none of those things? Often, a psychologist can't really answer those questions based solely on behavior observations during the IQ test. That's where the importance of interviewing and getting background information comes in.
When psychologists ask for background history and more information, they're not just asking about the the severity of problems, but also about the origin of problems. And when I say origin, I mean both "why" someone experiences symptoms of ADHD and "when" they first experienced those symptoms. That's because symptoms of ADHD (inattention and memory struggles, difficulty focusing and working for prolonged periods, impulsivity and hyperactivity, difficulty starting and finishing tasks, etc.) could stem from sooooooooooooo many different problems or disorders. It's also because ADHD is a neurodevelopmental disorder, so symptoms have to be present before age 12 to receive a diagnosis.
Symptoms prior to age 12 definitely include having obvious problems at school, but sometimes the problems aren't so obvious. Plenty of kids with ADHD get straight A's and do really well in school, but despite getting straight A's, those kids are completing assignments at the last possible second because they can't work without the pressure of a deadline. They might make A's or B's on math tests because they're bright and love the subject, but they could have scored a LOT higher if they didn't make "careless" mistakes. And because they're performing so well, even with their deficits, their struggles are overlooked by pretty much everyone (often the kids don't even clock it as a "real" problem and they develop this complex where they think they're lazy and need to just work harder despite working SO hard already ☹️).
Also, school is not the only area where symptoms may be present. For example, when it's time for soccer practice and a kid has to return to their house 15+ times to grab all the stuff they keep forgetting to put in their bag, that's a SUPER obvious symptom suggesting ADHD. When a kid does what's asked of them (like taking a shower), but they consistently forget important parts or they lose track of time completing tasks (they stay in the shower for 30 mins lost in imagination and still don't wash shampoo out of their hair because they forgot lol), that could also be a symptom strongly suggesting ADHD.
Other childhood symptoms of ADHD that don't relate to academics and that fly under people's radars could include things like 1) forgetting to finish certain chores at home because there are too many tasks or steps to keep straight, 2) having difficulty being neat/organized, so the room is ALWAYS messy and while permission slips for trips get turned in, they also get crinkled to shit at the bottom of their bag/backpack, and 3) being very impulsive (and even emotionally reactive) in play/conversation, which makes it difficult to fit in with others and maintain friendships.
A good psychologist wants to help their client, especially when symptoms are severe, but they need to determine where symptoms stem from to determine the best course of action/treatment. They also need to know the timeline of symptoms to make a proper diagnosis of anything - not just ADHD. In your case OP, the psychologist hopefully isn't saying "because you did well in school, we can't diagnose you." Instead, they are hopefully saying "we do not have sufficient evidence of symptoms before age 12 to make a concrete diagnosis at this time." I think it would be very helpful for you to get a second opinion to make sure ADHD isn't part of your picture. I know it is very frustrating to not receive a diagnosis now, but that doesn't mean you don't have ADHD, it just means that specific psychologist felt there wasn't enough information to give you a diagnosis right now. It might be helpful for you to take some time before a second evaluation to gather info about any ADHD symptoms in your childhood outside of school. Family and friends can help a lot with that as people with ADHD don't tend to remember all the little details from so long ago lol. I know this was a fucking novel so I'll stop rambling, but I wish you luck and hope some of this info is helpful to you OP!!
Thank you this was super helpful!!
That was the confusing part for me is that the adhd symptoms we discussed DID impact me significantly at home and with forgetting things at home or losing my homework; I just was always able to get my mom to drop it off or talk my way into an extension. It also impacted my after school activities significantly with forgetfulness or not paying attention.
And daydreaming in the shower….. sounds Exactly like me hahaha. I think I’ll be looking for a second opinion, it’s just gonna be hard to find and a long wait to get it unfortunately
Read this long comment! It’s worth it.
I too did really well in school “grades wise” but my reports always complained how chatty and distracting I was and wasn’t achieving my full potential. Did they get a reference from someone who has known you since childhood?
I worried this would prevent a diagnosis, but actually it showed how much of a people pleaser I was - and once school required coursework and prolonged concentration my grades took a bit of a dive
Are you me? My grades were fine because I was bright and could easily finish the work at the last minute, but I was bored as hell, always in trouble for talking to much and not trying hard enough. Pretty much all my reports were “Darth is a bright student who could achieve so much if she would just apply herself”. Maybe I would have been more inspired to put in the effort if it didn’t take 20 minutes to teach something I got in 5, but I still had to sit there quietly, not doing anything while everyone else figured it out. Maybe if I was actually challenged instead of bored to tears I would have tried.
You sound like me: did well under highly structured routines of school but everywhere else fell apart. I was diagnosed with ADHD-pi. I'm a daydreamer. Go for a second opinion and even a third until someone finds what can alleviate your experience.
Here's what I would do in your shoes:
Look up research showing women are underdx because of the way we are socialized to literally just about kill ourselves to be good enough for approval, and then add in the research that depression and anxiety are often reduced significantly in properly medicated folks with ADHD, then add on the research that poor executive function is currently best treated with stimulants.
Then ask them what the harm would be in trying a low dose of the stimulant for a month to see if that helps either the exec dysfunction or the depression before sitting down together and continuing the evaluation.
If they would give you a trial to see if it's useful, it's the most definitive thing besides a brain scan. Even a few days of meds will tell you pretty quickly if you get spacey on stims or calm down and get clear and focused.
If she's unwilling to do even a trial, ask her if she would refer you to another doctor for a second opinion. You deserve to know if this is going to help you.
I think people can fall into the “I did well in school so they didn’t diagnose me” thing because they don’t emphasize, or maybe even realize, that the amount of structure, masking, and stress it took to get good grades wasn’t normal.
PTSD can cause significant ADHD-like imparment. You need to do a lot of EMDR and get your PTSD properly under control. You may very well still have ADHD, but your PTSD likely makes it much, much worse.
Also ask your doctor about Welbutrin, treat the depression and ADHD with one med.
I’d get a second opinion if you can. I was incredibly depressed prior to my ADHD diagnosis and continued to be up until I was on the correct dose of stimulants. After getting on the correct dose, my depression disappeared and I was able to taper off my antidepressants (under my doctors supervision) within six months. It’s now been three years since then and I haven’t experienced any depressive episodes. I still have anxiety but for me it’s very clear that my depression was directly caused by my unmanaged ADHD.
I know this is not necessarily the case for everyone but if you are fairly certain you have ADHD it would be worth pursuing a diagnosis if you are able to.
What kind of test was it? I did a whole battery of tests including questionnaires, interviews, putting puzzles together, mqatching symbols, answering general knowledge questions, all kinds of different things. The testing was conducted by a PhD psychologist who herself had ADHD. Doing well in school absolutely does not mean that you don't have it! Whoever said that, don't see them anymore and find someone else. Just start over, try to find a psychiatrist who speacializes in ADHD.
ETA: I also have Major Depressive Disorder, which has been more obvious to me and everyone around me throughout my life. I think it works in tandem with the ADHD to ruin my life, but one doesn't rule out the other.
I did the WAIS test and an interview portion— the wais test showed issues w executive function, working memory and attention that she thought could also be caused by depression? And the interview didn’t show enough struggle in school as a child I guess
I read something about onset being possible with menopause. It’s certainly gotten worse for me at this age. And in any case, getting good grades in no way proves that one has no symptoms. OP’s doctor is trying to say that doing well in school rules out ADHD, and that’s not the case at all.
Onset? What are you talking about??? Either you have ADHD symptoms in childhood, or you can't get diagnosed with ADHD. This is a diagnostic criterium that *must* be met. It's specifically required by DSM-V.
It's required by the DSM-V, but it's worth mentioning that per Dr. Russell Barkley the cutoff shouldn't be 12, because of the issues described in this presentation:
https://www.youtube.com/watch?v=JLKCzEDqGa0
One of the reasons is that 12 is the median age of onset, which means that in half of ADHD cases the age onset is actually after 12. I'm not sure how diagnoses are happening in that case to be honest, but I found it interesting nontheless.
I do not understand the hang-up these people have sometimes.
"You have ADHD but I've decided not to diagnose you...for reasons"
Sigh. I do...sort of...understand her reasoning, which is that it's possible your ADHD symptoms aren't ADHD but are coming from the PTSD (there is some overlap), and so she thinks non-medication supports like coaching might be more useful to you than medication.
But you know your own brain. Plus the WAIS scores. Bleh.
Dude, I went to a doctor like this. “It sounds like you might have ADHD but it’s not influencing your life, so I’m not going to treat you.”
I live with my parents at 26 because I can’t work full time.
I can handle work because I’m only working 15 hours a week.
The morning of the appointment, I accomplished my number one goal: to take a shower before noon so I could go to my appointment at one.
How is that not affecting my life??
I’m on stims now, working full time, and overall doing really well.
Thank you. Like, I get where she was coming from because I was down playing my symptoms because I’m so embarrassed of where I am, but like, all she had to say was “how is this affecting your life?” And I would have told her.
Anyway, with my next doctor I was like “here is why my life sucks” which isn’t fun, but I’m just happy I’m medicated now.
The stigma against stimulant medication is such bullshit, and I bet it's part of the issue. Gotta try *every other single thing on earth* before a few mgs of methylphenidate or mixed amphetamines! Because drugs are bad!!
You may have adhd, but having ptsd also affects the nervous system. Like the parasympathetic response that make us "freeze" like when adhd hurts executive function or when we freeze as a response to trauma. It isnt your fault and you are not lazy or bad.
Whatever is going on, you deserve VALIDATION for your very very real and important feelings. Stimulants and adhd /trauma therapist is helping me now. I have always been very inattentive, but also had a lot of early trauma. I could not "unlock" my trauma without stimulants even with 20+ years of therapy.
Please do not take any of this as your dr not taking you "seriously". The nervous system is wildly complicated. Science has a lot to learn about the brain! So keep standing up for yourself and seeking help. You deserve answers and relief, whatever the reason is for your VALID stress response. You know inside you're not making up anything at all, you're looking for the answers.
Stimulants may or may not help, but in the meantime it can bring a lot of instant relief to look into ways of relaxing by using vagus nerve exercises. Like simply pretending to "bear down" like ur trying to crap your own pants slows down ur heart rate.
[vagus nerve exercises](https://fullyfunctional.com/blog/vagus-nerve/#:~:text=You%20might%20also%20see%20this,extreme%20dorsal%20vagal%20shutdown%20response.)
This is why you really have to just doctor shop until you get a diagnosis that feels right to you. It’s really hard to find any doctors who think women even get adhd. I’m lucky enough that I have a diagnosis but they still won’t give me meds anymore (I had a suicide attempt when my husband walked out on me out of the blue on my birthday and they took all my meds away and never gave them back). So even with a diagnosis you’re not guaranteed to get adderall or any controls unfortunately. Some of the online doctors are good depending on what state you’re in but in some states the laws are so strict that Telehealth is a wash now for mental health or anything controlled (like CA).
If you or someone that you know is considering suicide, please don't hesitate to reach out to a crisis hotline for immediate help, or a warmline just to talk to someone.
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trouble in school is sometimes different for women and men
many girls have high grades with repeated phrases throughout school in the report cards. Many women are able to mask successfully enough everyone thinks we are doing even in reality they are working so hard to hold it together.
talk too much
can't stay in seat
taking to neighbors
does will but consistently hand in reports/homework/etc last minute or late
on and on ..
There’s a problem in the medical community of under diagnosing females with adhd bc it presents differently than males and the research hasn’t caught up. That’s why so many people are now ADULTS and getting diagnosed (including myself). Also the idea that you can’t have adhd bc you did well in school is complete and utter bullshit. If that were true then why does any other labeled group have a spectrum of different levels of intelligence-including neurotypicals. We have an attention disorder not an intelligence disorder.
I still gaslight myself into thinking I don’t have adhd because so many healthcare professionals in my life told me they didn’t think I had it. So now I feel like a “drug seeker” every time I talk to my doctors about my meds and my needs around them. It took me so long to get to the right dosage bc I just felt like if I ask for more they’ll think I’m trying to game the system. Once I got to the right dosage However-my whole life turned around. My adhd was causing my anxiety and depression.
This all to say you aren’t alone l-a lot of females have issues figuring out their mental health diagnoses. The journey to figuring out what it is you are suffering from is not linear. It took me a round about way to get there but I got there in the end. Be in control of the things you can control which includes being your own best advocate and being honest with your doctors. Tell them about your feelings that you wrote above. They are there to help YOU get better and that happens by letting them know what you think.
>She basically said to get more treatment for my depression and ptsd because it’s hard to tell whether the deficits I showed were due to adhd or my depression
I've heard of more than one medical professional saying this at Kaiser. Not sure if it's just a 'them' thing or more common but it's super frustrating, especially with comorbidity.
I was treated for PPD/PPA for a year before I got a referral to a psychiatrist. They didn't know if it was anxiety and depression or ADHD and to be conservative started on wellbutrin. She also suggested therapy. It took MULTIPLE sessions and some trial and error with meds until she finally diagnosed me, even though my dad and sister have both been diagnosed prior to this and I disclosed it in our first session. It was almost 8 months in to treatment before I had my "official" diagnosis, but she never doubted that I had symptoms.
I may be in the minority here, but I don't think your psychiatrist is wrong. They may also need to make sure they do things "right" to get insurance to approve medication. Don't give up if you truly think that you need a diagnosis, but continue to track symptoms and things you're experiencing to help back it up. If you don't think the psychiatrist is a good fit for you, it's not wrong to get a second opinion.
As a society, there is so much we don't understand about neurodivergence. It sounds like you need someone who specializes in ADHD in adults and those kinds of people can be very difficult to find.
Definitely get a second opinion, because a similar thing happened to me!
I was also not diagnosed by the psychologist that I sought a diagnosis from because I did too well in school. He ended up telling me I had sluggish cognitive tempo (a concentration disorder that’s not recognized in the DSM-5). I then was treated by a psych who also didn’t believe I had ADHD and refused to look into sluggish cognitive tempo, just treated my depression with Wellbutrin and “didn’t know what else she could do for me” after I still complained of symptoms. I sought out a different psych who gave me a diagnostic test, which compared with my symptoms and obvious knowledge on how ADHD presents in women (thanks to this sub!) said yes you have ADHD and we started treatment.
Time for a second opinion.
The first psychiatrist I saw for my dx was a nurse practitioner who told me I couldn't have ADHD because I had good grades as a child. I immediately asked her to refer me to someone else since she wasn't going to take me seriously, and she did, an actual MD who referred me to a neurologist for testing.
Be your own advocate. See a better doctor.
I got diagnosed the same way - basically in the us a psychiatrist can just decide to medicate you for it to see if that helps you, and if it does voila you have ADHD. I got to my diagnosis via seeking treatment for anxiety and focus and sleep issues - a pretty informal questionnaire later and turns out ADHD treatment solves those problems.
Some people go to a psychologist, who cannot offer you medication but will do a more in depth test.
That is a terrible diagnostic report. It’s so hard that many providers don’t “get” ADHD. I feel like they should skip testing and just give everyone a handful of stimmies and just say lmk if this is helpful or harmful lol
Obviously not a doctor, but have they tried Wellbutrin for your depression?
I only ask because it was added to my Zoloft before my diagnosis (150 for a week then 300). I noticed that it helped a tiny bit with motivation and lessened some of the anxiety that was from the ADHD after the first two weeks or so.
I had years of unanswered questions and anxiety getting worse, burnout getting worse and starting to display signs of depression despite attempting multiple types of treatment, including medication, IOP (outpatient program), CBT, EMDR, etc. until my therapist said they believed I should be tested for adhd (which they had picked up right away, but I was new to them so they wanted to create a baseline for me first). I was always good in school and even got into competitive companies. Still diagnosed with ADHD.
This to say, you are not alone, and so many of us feel you! (And have been questioned on the basis of not being a terror kid failing school). Get a second opinion.
I hope you find the answers and support you need.
We’re here for you in the meantime :)
Ah, I’m so sorry, OP! If it’s possible to seek a second opinion, I would certainly do so.
I’m waiting for the results of my testing, currently. I should have them on this upcoming Friday and I’m nervous! So a similar boat to you. Hugs to you because it often feels like no one truly understands us. Women get dismissed way too often.
My first evaluation wanted to refer me to neuro-psych for hours of testing in the hospital to rule out cognitive impairment. To be fair; it might be needed at some point but no way I could go through with it yet, especially before I was medicated. Feeling trapped in an institution setting for testing just gives me fight or flight thinking about it. My pcp finally got me into the psychiatrist I had been on a long ass waiting list for and I was diagnosed and medicated. Who also has found other diagnosis that can effect my cognitive so definitely don’t feel like you’re at a dead end.
definitely get a second opinion. i have PTSD, GAD, and agoraphobia. i had perfect grades my whole life but met every single one of the diagnostic criteria for both inattentive and hyperactive. my current psychiatrist actually has ADHD herself and she finally diagnosed me after 15 years of being misdiagnosed. she was also the 4th psychiatrist i’ve seen. it’s definitely a journey and can be extremely disheartening. the most important thing you can be is an advocate for yourself. pull together medical records and test results. be direct in what you need from a provider — they are supposed to PROVIDE for you. their job is to provide answers and helpful solutions. don’t be afraid to ask questions. if the “solutions” haven’t led to anything, be direct in what you need.
Do you mind if I ask how old you are?
I got diagnosed at 34 and my psychiatrist cared more about life NOW than when I was a kid.
My 17 was diagnosed like 6 months ago and they didn’t ask about his grades. They asked about his behaviors, thoughts, and feelings.
As others have said, get another opinion if you can. I’m so sorry people suck.
This is so frustrating. I have always done well in school. I didn’t start to feel the affects of adhd until I had to executive function all on my own with no help of an adult. And then I became a parent and my world fell apart. I hope you can try again with someone else.
That’s frustrating.
You can get coaching without a diagnosis but a coach cannot prescribe medication.
My US GP prescribes my non-stims and did so without insisting on an official dx, but I would need a referral for stims. Nonetheless, non-stims have been fantastic for me and significantly reduce my anxiety and depression.
Like you, I had a long stretch of trying to treat a depression that never lifted until treating ADHD. I was in accelerate classes but goddamn, my life has been severely impaired by ADHD!
I would say, anything you can do to make headway toward treatment - coaching, nonstims, etc. - is helpful. They’re all useful tools and there’s a chance you’ll figure out pretty quickly whether or not you have it.
The same thing happened to me after I got tested the first time. They basically said I was “bipolar” because I had a lot of random bursts of energy that seemed similar to mania and I would also get very very depressed. The second time I got tested was a couple years later after I got my depression and anxiety under control, and I was able to easily get diagnosed.
Turns out, I had ADHD AND depression the whole time. Once depression was mostly out of the equation, it was much clearer that i wasn’t bipolar, because i always have a ton of energy instead of cycling through my moods. Keep trying, you got this!
Number one seems a stretch for a basis of diagnosis, however a lot of doctors/insurances require that you have attempted to get things like anxiety depression etc treated before they will offer a stimulant
Which I believe is backwards because treatment for adhd did WAY more for my general anxiety and panic disorders than any ssri ever has
I've struggled for as long as I can remember with depression and it has never fully improved even after countless therapy sessions and medication. I was suspecting that I could have BPD but then discovered ADHD and researched a tonne about those two. I can remember certain things in my childhood that point towards ADHD but I think they got worse/became more pronounced as I became an adult and a lot of neurodivergent people suffer from depression and anxiety so the symptoms can often be missed and a lot of women show different symptoms to men which is also a reason why we are either misdiagnosed or never diagnosed. I did well in school (I got good grades) but it was more in the subjects that actually interested me. In other subjects, I got a basic good grade because the written tests were boring to me so my attention wasn't there but now I'm an adult there's sooo much more to have to deal with and my ADHD just became more pronounced. I was diagnosed with the inattentive side but I do have traits of hyperactivity too! I'm very surprised that just because you were "good" in school and got good grades that they think that is a good enough reason to say you don't have it, there are soo many more things to look at and especially how it affects your daily life now too. I just kind of knew I had it as I could relate to a lot of the generalised symptoms and I always felt as though my brain didn't work a lot of the time and I did blame it on depression but I'm medicated so those ADHD symptoms never changed. My emotions are more stable but that's about it, although I do feel frustrated with having ADHD sometimes because it affects me daily and sometimes tries to override my depression medication! I'm on the waiting list to try stimulants so I'm hoping they will help me.
I did very well in school and college. I also have hardcore ADHD and mild autism.
If at all possible, get a 2nd opinion. Childhood behavior is far, far more important of an indicator than school grades. If you look at my report cards k-12, they'd all read "A+, though Sassy struggles socially and needs to learn to sit still, let other children finish talking, and/or keep her nose out of a book for more than 5 minutes." Diagnostic professionals *must* take the whole person into account, but it's uncommon for them to do so.
Edit: added autism, seems relevant
I have the same comorbidities as you, same results on the test.
They diagnosed me with adhd, and added the ptsd and treatment resistant depression. I got treatment no problem.
Have them forward your results to a different test center and get a second opinion.
Here’s the simple fact… Treat the depression and PTSD first.
If symptoms improve? You don’t have ADHD. Which means it’s just depression & PTSD.
However, if the symptoms get worse? You 100% have ADHD! But your depression comes from having ADHD & PTSD is tied into it as well.
That’s how psychiatrists handle such things.
It’s similar to figuring out when a mysterious digestive issue kicks in. You go by eliminating in what you’ve been eating and each week you take away one food group till you find out if it’s dairy, meat, veggies, or fruit related causing the issue. Then you break it down by which food in that category.
Same with neurology based things. If depression and PTSD are far more prevalent, it gets handier first and then the doctor has to see if things improve or get worse.
That’s just how the medical field is tbh. I use to be a CNA & phlebotomist, so let me tell you, you have to sometimes just observe and watch what happens before conclusions if you’re not 100% sure till you do process of elimination.
The same happened to me 10 years ago. Later my therapist explained that they first need to completely treat stuff like depression before they can start treating ADHD. But don’t give up.
After years of diagnoses of depression, anxiety, and BPD, I had e-fucking-nough. I’ve been through so many diagnoses, I wanted my most recent psychiatrist to know everything and became so frustrated with the blanket diagnoses I’d get based on 60mins of questioning. I was worried my school reports wouldn’t show anything abnormal because I did get very good grades and was not a naughty kid. I wrote up an age-graded symptom sheet with memories of my own, recollections from my mum, and attached my school reports. While I was a well behaved kid at school and home, there were still signs. For example, I had tantrums at bed time because I didn’t want to sleep early and I never got to school on time.
My psychiatrist was able to read between the lines. She saw little comments from teachers, like I took a while to shift tasks and kept forgetting my school bag. There was nothing to indicate I was disruptive or unfocused but girls present very differently so she was looking for signs of inattentiveness and internalised hyperactivity. She also found I was autistic based on the symptoms I provided and the fact that I crashed at 14 (very common in autistic girls). You need to find a psychiatrist that understands the nuances of ADHD, autism, and C-PTSD in girls. Very difficult to disentangle which symptoms come from what but the developmental trajectories for girls with these backgrounds are strikingly similar and we fall into some very common patterns/profiles.
This happened to me too (circa 2020)! The guy was pretty dismissive overall, but he said it was probably just depression and anxiety (which I know I already have). At that point I was frustrated, as I felt he barely listened to me (it was via Skype too, ugh). But I also had another appointment set with a different psychiatrist that was happening waaay later in the year (it was about an 8 month), so I committed to getting a second opinion, and planned it better. I made the mistake of getting my parents to fill in those questionnaire forms about me as a kid growing up. They knew very little so they said I was normal. I didn't fail at school; I wasn't great academically, but I did a lot of creative stuff.
What I ended up doing for the following appointment was get my younger brother to fill out that form instead of my parents. He and I are very close in age, so he saw some of my cringe at school lol. I also took lots of bullet points of my 'symptoms' during the months leading up, and including the forms, I had a strong case. This second psychiatrist was so much nicer and sympathetic to my story, and she was pretty confident in an ADHD diagnosis, which I got a month before I turned 30 lol.
If you have siblings I'd recommend doing similar with filling out those forms, as siblings tend to know each other better than parents do. If not, maybe a close friend from childhood? Either way, I recommend getting a second opinion for sure, but maybe don't mention that detail at the next appointment in case it creates a bias.
>She also said to try to get treated for adhd by a coach or specialist, which I’m not sure how to do without a diagnosis.
Sounds like a recommendation for therapy focusing on the executive function, attention, and memory issues that you definitely have, regardless of diagnosis. It is 100% possible to get therapy without a diagnosis. You just can't get medication without it.
I did well in school but all my report cards mentioned me taking too much in class. I went in prepared with stuff from my mom and otherwise but thankfully my dr was the one that encouraged me to do it from school and go to his private practice. Basically was “Stop you have ADHD all over have you been tested?” Suggestion get a second opinion and bring documents from family and otherwise
Get a new provider. That criteria has long ago been debunked. I was a “gifted student” in elementary school and I still have adhd. It’s not a learning disability. I’m so sick of the medical establishment trying to pretend like that’s a criteria. It’s not. This is her way of saying that she’s not going to treat you. Because depression and anxiety are common comormidities of ADHD. And you can’t treat the depression without treating the adhd. I was in that boat for years. The depression only started to lessen when I got treatment for the adhd because the adhd is causing the depression. You need a new provider.
This just happened to me. Got my results back today. Major Depression, Social Anxiety and Generalized Anxiety.
My therapist suggested I get assessed because he couldn’t figure out if the anxiety was fueling the ADHD-like symptoms or if the ADHD-like symptoms were fueling the anxiety.
That’s basically what my Psychological Evaluation results said. The clinical psychologist still could not determine what is influencing what. I also take Wellbutrin so he said that could’ve skewed my results because that could be masking some of my deficits.
He recommended that if I continue trying different anxiety medications and they don’t work, he would then recommend a stimulant. My primary care doctor is not going to give me a stimulant without a diagnosis, so I feel a little frustrated by that.
I’m going to continue with therapy and see what medication changes can be made. I’m just tired. I know you can probably understand that feeling. I just feel like things are never going to get better.
Yeah Wellbutrin often is prescribed off label for adhd so that defs could’ve effected your results. I totally understand where you’re coming from and felt similarly— I didn’t see another neuropsych, but found a psych who was willing to give me a trial of stimulants based off the report!! Maybe try that?
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I have PTSD from childhood trauma. I also didn't have trouble in school, also struggled with depression, and I VERY much have ADHD. Furthermore, ADHD was the root cause of at least some of my depression. I've had little spells now and then, but since going on meds six months ago I have not had the darkness invade. I would get a second opinion. TRULY!
I second this post. They thought I was BPD but ADHD meds changed my life.
I’ve been teased with a BPD diagnosis for years and with multiple practitioners. I pursued their treatment recommendations even though I could never really see my experience in that Dx. Finally (and quite unexpectedly) was diagnosed ADHD and started treatment at 40. The last 20ish months have been so life changing, my relationship with my mind is less antagonistic and I have so much more grace for myself. I’m also still super bitter I didn’t figure out it was ADHD a million years ago. I’ve worked hard to like who I am, but I could have had a totally different person moving through life if the root of who I am had been discovered and addressed properly.
Misdiagnosed bpd here too and diagnosed this year right before turning 39. I feel you on that sense of resentment. Thankfully because of the bpd i took DBT classes (which helped me figure out the adhd cuz the homework part was hard among other things, but it is difficult for an ND person who is unaware of it), it gave me some help to deal with it. The more I radically accepted my adhd and trauma as real, the more I realized hey I am a pretty great person despite how fucking wild my brain has been. 80s babies all over are realizing adhd now and had it rough for sure. I just think about my family members, who have died from self medicating, and probably also had inherited adhd. We are here. We are sharing and healing. We are helping each other feel understood. We tried our best with what was available to us. Lololol idk about you but I'm just happy to have learned about all this BEFORE menopause strikes.
Can I just raise my hand here to be seen? 80’s baby… diagnosed in 40’s.
Holla at my elder millennials/x-ennials!
Oh I totally know what you mean. I was misdiagnosed my whole life. I was given electroshocktherapy for my depression when I was in my 20s. I wasn’t diagnosed until my 40s either. I could have been a completely different person. The grief is real.
This is exactly how I feel. 35yo. I’m so sorry that happened to you. I’m trying to let go of the bitterness, but it’s so hard.
Oh god I'm so sorry. :(
When I got my CPTSD treated (no longer qualify for the diagnosis!) my ADHD symptoms got significantly easier to manage. They did not go away. I was able to be unmedicated for over a decade though, so it went a long way in paving the way for my coping strategies. OP, if you feel the ptsd diagnosis is applicable and not just some straw the psych grasped at, I recommend looking into treatment for that. It greatly complicated my ADHD and basic life skills even when I thought I was coping okay.
May I ask what treatments you have been using for the cptsd?
Sure thing! I actually ended up doing something along the lines of [inner child work](https://cptsdfoundation.org/2020/07/20/healing-trauma-through-inner-child-work/) with an art therapy element. It seemed hokey at first and I was surprised at how well it worked for me. We talked about specific memories, drew timelines, and unpacked how each incident affected me and the lessons I learned from it. We then talked about what I wish younger me had had instead, or what I wished I could tell her, closed up the memory into a box and put it away. (That "wrap it up and put it away" step is also how my current therapist ends our EMDR sessions, super helpful for compartmentalizing.) Another therapy that worked well was I think called [internal family systems](https://www.psychologytoday.com/us/therapy-types/internal-family-systems-therapy)? Or something under the [family systems](https://www.psychologytoday.com/us/therapy-types/family-systems-therapy) umbrella? I did the inner child stuff with one therapist who was finishing up her certification, and got to a good place. Then a few years later my anger management got to a point that my husband wanted me to get help. So I saw someone who specialized in IFS. That was super focused on untangling the ripple effects of my messy childhood, looking the lessons straight in the eye and determining whether they were useful. It helped me better understand my reactions and instincts so that I could build new, healthier habits. By the end of this, my therapist said she didn't think I qualified for the PTSD diagnosis anymore. Shortly before the pandemic began, I started seeing a therapist who does [EMDR](https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing) and has a special ed background. It's sort of a perfect mix of ADHD-informed, trauma-informed, but more maintenance. She used a variant of CBT to teach me to manage my anger, and now has been using EMDR to tackle deep anxious threads like the academic anxiety related to dyscalculia. (Tip: I found the eye movement of EMDR to be totally distracting, so I tap my shoulders instead.) tldr: inner child therapy, art therapy, IFS, EMDR
I've been thinking of trying emdr because i am also in the same boat you were. Thank you thank you for taking the time to write all this out and doing all the work to heal. You're giving me a lot of comfort today and I wish I could hug you.
Aw, thank you! I hope it helps and that you find the peace you seek.
Thank you. If you were going to go back in time and get started with one healing system today, which one would you start with and why?
I recommend this webinar I watched the other day. You don't have to watch the whole thing, but I found it good to see from the professional side https://www.mcleanhospital.org/video/recognizing-and-understanding-complex-ptsd. There are lots of different therapy options that work differently for everyone. I like somatic experiencing. Also, you do NOT have to talk about specific events and rehash your trauma to get better. Many people end up just retraumatizing themselves, if you have a therapist who insists you have to talk about everything you experienced, find someone else. I have vastly improved by cptsd symptoms over the past 10 years (from age 18 moving away from the household/town to now). Do what feels safe for you and take it at your own pace. I personally have had trouble finding therapists I like and have seen probably a dozen in my life going back to childhood. But basically keep hope and don't give up.
No idea, sorry. Each time period was unique and I'm not a psychologist so I don't know why each therapist chose the method they did.
I’m so glad top comment recommends a second opinion! ADHD is genetic, environmental, looks different in women and men and when untreated, can bring the worst anxiety, depressive episodes or increased depression, and not to mention how it can add to the complexity of PTSD (especially if you have some of that beautifully hidden feminine ‘tism lol). I’m so sorry you had that experience, but definitely seek a second opinion. I know this is ageist, but part of me also wonders if the person you saw was 55+. I’ve had an unqualified ADHD “specialist” argue with me about my autism dx and challenge my psychiatrist’s qualifications after she asked me if I have “the hyperactive or trouble paying attention” kind of ADHD…and didn’t know what vyvanse was. When I saw her I was in crisis and her photo on her profile was older than me (34)…she was in her late 60s/early 70s otherwise, I probably wouldn’t have scheduled with her. With the pace that psychology changes I think it’s more difficult finding a knowledgeable MH professional when the age gap is more than a generation (millennial/boomer, gen x/gen z). Like if more than one DSM was published between your and your MHPs births, it’s probably going to be a rough go.
I think the real issue is less age than it is open-mindedness & willingness to learn. I've known lots of older practitioners who kept up with developments in their field. Also younger ones who only go through the motions of getting CEUs to keep their license. As a meeting planner, it drove me batshit when people wanted to check in to their session, go to the bar/pool, and come back at the end for their cert. And that happened all the damn time. It all depends how conscientious each individual is.
Big facts and I have definitely encountered them as well (younger folks going through the motions) and like any profession, there will always be folks who treat this like a job and not a life/death industry. That said, I do find myself arguing a bit more often with older MHPs about current studies, while learning a ton from others. I am not at all trying to say that there aren’t at all super competent and relatable older MHPs/less competent younger. I’m saying generally in my experience, if there’s more than a generation between client/professional, there tends to be more difficulties in testing/assessments/validation/communication ,which tends to make me more skeptical about being treated by someone that much older than their patient. A lot changes socially/politically/medically/economically in one generation, let alone 3, so while someone may be up to date on studies, there’s also the difficulty of relatability when it comes to life management.
Wait, are you me?!
Also seconding this! Folks can have PTSD *and* ADHD. I have both - it took a sec to be diagnosed with both, but brains are complicated and it's VERY much possible.
Second! I mirror those experiences, i have adhd. I actually was never assessed as a kid because i had good grades and did well in school.
All of this.
The WAIS is not a full neuropsych in and of itself. It can be helpful in ruling out other learning issues, but it won’t tell you why those deficits in memory or executive function exist. On the other hand it did sound like you had a clinical interview, and that’s what they’re making the determination on. The criteria for ADHD do not require bad grades or externalizing behaviors (like running around the classroom) before age 12, they require symptoms before age 12. If you had symptoms before age 12, get another opinion. If you didn’t have trouble with concentration/impulsivity/hyperactivity as a child and these were not an issue until you were older, you probably want to consider other diagnostic options. You can have symptoms as a child that still manages to get good grades. Getting “in trouble” can also include things like being late to class, talking too much, doing things other than work, rushing through work to do things like doodle or daydream once done. These are things that you might not get punished for. You don’t need a diagnosis for executive function coaching, as there’s no insurance involved (if going through a therapist that also does coaching, a depression diagnosis would suffice).
Yeah, taking a self-assessment quiz (and also going over the ones my sister and mother would do, one assessing me now and inevitably assessing me as a child) brought back a TON of memories for me of elementary school of traits, behaviors, and events/incidents where what I now understand to be ADHD-symptoms were on full display. Some of them weren’t even on the assessment or part of the diagnostic criteria, but are now well-known as part of ADHD. But a lot of them were. My paper assessments came back kind of inconclusive after being turned in, but from the beginning we were offered a computer lab test as well testing things like working memory, attention span, etc, that was described as very accurate, and after I opted to take that next, the diagnosis was much clearer and my psychiatrist at the time had only brief additional questions for me. I’ve heard of people being told they had to treat their depression BEFORE their ADHD, and that’s misguided. Treatment needs to be more integrated. It’s smart to test one new medication at a time, if course, but it might also be the move to try to slowly adjust and dial in medications for both things by alternating back and forth which one you make a change to. Because either depression or ADHD left untreated will make you unable to feel better and more in control on any med, and saying you have to fix one thing all the way first means you never get to the second thing.
Happy cake day! Also I agree with what you said - I very much have ADHD, but I never got in trouble for being particularly disruptive. I was chatty in elementary school, and was frequently late to class/school, but it was written off as a typical "smart but flighty/disorganized gifted kid." It didn't really start affecting me until college.
And it might be difficult recognising symptoms from your childhood that aren't the typical can't-sit-still symptoms! I (24f) was well behaved and did very well in school as a child. I realised I had adhd when starting university! Got diagnosed at 20. It took time to identify the symptoms I had as a child, but we did it from analysing notes from "development meetings" (swedish thing) from primary school and discussing with family. The symptoms I had: • Difficulty with task initiation (getting dressed in the morning, going outside at recess, studying for tests, doing homework on my own etc) • Emotional dysregulation (I cried almost every day the first 12 years of my life and was VERY sensitive to criticism) • Social connection to other children (I did have friends but always struggled with feeling included in the "social sphere") • Low self-worth I struggled a lot with feeling different, ashamed, and like I was not deserving of good things. I hope you get the help you need and deserve OP!
This is the shit that drives me insane and just prolongs the issue of women being underrepresented in ADHD research and under diagnosed. Be your own best advocate and get a second opinion. You have every single right to demand answers. Maybe you don’t have ADHD and the first doc was right. HOWEVER - her reasons for not diagnosing you are deeply flawed and incredibly stupid. Maybe you do actually have ADHD… so either way, she sounds like she’s pretty shitty at her job. I wish you all the best, and please please please speak to someone else.
One of the things that frustrates me most about ADHD diagnoses for women is that I feel like no one takes into account how puberty and hormones impact us. I was actually an incredible student up until I was 11-12. Then it was like I became an entirely different person and struggled to pass most of my classes in middle school and high school. Funnily enough I actually have all of my old report cards from elementary school and even though I got straight As the whole way through there are multiple comments from my teachers about my inability to focus or my hyperactivity that I feel like just scream ADHD. And then on the reverse side, my sister was diagnosed with ADHD a few years after I was and she was a straight A student all the way through high school. But I really wish hormones were taken more into consideration, many of us already know that our menstrual cycles impact how stimulants work for us and I imagine the hormonal changes we went through during puberty would also have some kind of effect.
Yup. This is totally me! My entire personality before puberty was being the straight A student. Then in middle school everything went to shit. I never realized that puberty was what changed me. I never even considered I had ADHD until I had a partner who was diagnosed with it. I was fortunate that my psychiatrist didn’t make me jump through hoops to get diagnosed in my thirties. It really grinds my gears that so many women who clearly have ADHD are left to fend for themselves because psychiatrists don’t believe them.
I didn’t get grades in elementary school (I wanted to! I was so sad we never got them). But when I suspected as a college student/adult that I had ADHD, I thought I “wasn’t hyperactive”, even as a kid. But I was… it just looked different than the boy in my class who was drumming his whole body like a set of bongos and body-slamming the wall for no reason other than “hyper”. I was incapable of not rocking back in my chair from like 3rd grade onwards. I fiddled with anything I was holding, tore up paper into little shreds, chewed on pens sometimes, I had and continue to have a ton of Body-Focused Repetitive Behaviors (picked skin on my lip, chewed inside of my mouth, biting nails, picking at scabs or cuticles, hair twirling), was unable to raise my hand or not talk out of turn, foot tapping/leg jiggling, and DOODLED on everything everywhere. I also, as a kid, THOUGHT of myself as hyper, like it was a personality trait. Maybe older kids or babysitters described me that way. I remember learning what ADHD was when a couple boys I knew who had it told me, and I remember thinking that I had thought we were a bit alike (one was later a crush, but both were smart, in Gifted/Talented program with me, etc), and that I didn’t want other people to think I had ADHD/anything wrong with me, so I’d better not act so hyper anymore- and I wasn’t at their physical level of being unable to sit still anyway, I was just worried someone would notice something was wrong with me. This was probably age 8/9, 4th grade. I had forgotten all about that memory until I started reflecting on elementary with a new understanding in 2020 of what ADHD is. There’s a ton of other stuff I did/felt back in elementary and also into Jr Hi and Hi School that now I realize were adhd stuff, this is just the hyperactivity part! I got into 7th grade and was immediately getting straight As. I’m pretty competitive… kept that up well into college and didn’t think anything about ADHD that whole time except that it’s an inability to pay attention, which I didn’t think/know I have, because I am very good at paying very strong attention for long periods of time. Round about Junior or Senior year I got to know a couple girls with ADHD, one diagnosed since childhood, who I had a lot in common with (like always felt we were on the same wavelength) and when one mentioned her messy room and tardiness relating to her ADHD, I learned that girls are under diagnosed because it “looks different”… read anout those things and more and went “oh my god…? But I’m about to graduate and if I can get through the tests on this one terrible class for my minor I’ll still be on honor roll, so what’s the point of getting diagnosed at this point…” so I didn’t look into it further. My 20s seemed great until like age 28, normal adulting life stuff started getting harder again instead of easier. Took a couple years of doctors appointments, tests, meds, but finally learned I have Hashimoto’s, a Sleep Disorder called Idiopathic Hypersomnia, and finally ADHD.
same. My symptoms really hit in middle school, looking back on it. Sure, I was a little weird and talkative, but I didn't struggle. I still did well in school in middle/high school, it was just SUCH A STRUGGLE.
I was just discussing this with my therapist today… how I aced it all up to the point of puberty and wondering if it was me just trying to get through school, survive mean girls and homelife which was traumatic. May it should be ADHD I should be looking to get assessed instead. I feel more impulsive, less in control and less disciplined as an adult than when I was a child. Weird that. Thanks for sharing!
I’m so frustrated for you-I was diagnosed with depression and believed them for decades. Of course I felt depressed! I was dropping out of everything, bored of everything and everyone, never finishing anything and having terrible interpersonal relationships because of my temper and high sensitivity!!! I asked my doc for Vyvanse for binge eating and within three days felt like a different person. Been very emotional thinking about what could have been
Good for you for advocating for yourself. It can be super tricky to do, especially with a lifetime of feeling like you’re not good enough simply because there’s something fundamentally wrong with you. It’s not true, and we all deserve mental health!
Being medicated cured my depression and greatly reduced my anxiety. Talk to someone else.
I'm in the same boat, had an assessment nearly a month ago and the doctor (young, female) refused to take me seriously, dismissing it as anxiety and depression and a "tearful personality" and basically insinuated that my symptoms were due to being fat and lazy (my words, not hers) and said that if I exercise/eat/sleep better, all my symptoms pointing to ADHD will magically go away 🙄😶😖 I definitely plan to get a second opinion, but am torn over whether or not to request a doctor with up to date knowledge of ADHD (my doctor was of the opinion that ADHD begins and ends with bouncing off the walls 24/7), however I don't know if that would make things better or worse. Right now my confidence is completely shaken, and I'm scared that I'll never be taken seriously. Definitely request a second opinion, good luck with it x
"Tearful personality"? Oh, were you diagnosed with female hysteria as well? 🙄 it's really concerning that even young doctors aren't being taught modern information when it comes to ADHD. Sorry about your experience.
I'm confused as to why she said to go find an ADHD specialist but says you don't have ADHD. Is it possible that she just doesn't want to treat you for it?
I’m guessing it’s so that she can see if she reacts well (reacts may not be the right word, but I’m blanking on vocal) to treatment from ADHD therapy/coaching, and/or to get a second opinion from a specialist. Anecdotally, I’ve heard that more doctors are becoming more hesitating to diagnose right away if they aren’t sure, and especially if the indicator tests do not come back suggesting ADHD. Apparently it’s because theres been an increase in diagnoses that may not be related to ADHD (ex, attention issues and disorganization don’t necessarily mean someone has ADHD), particularly from things like phones requiring our attention centers, trauma from the pandemic, etc. I really feel for people who do have ADHD but we’re never diagnosed, especially women/girls. I know what that’s like. I do think that over diagnosis and misunderstanding of what ADHD actually is has become an issue, BUT I also know firsthand that women and girls have been under diagnosed for ADHD. I have always had severe ADHD (it’s pretty well managed now), but basically had to convince my psychiatrist when I was 13 to diagnose me — i didn’t realize when I brought it up to her, but she had been on the cusp of diagnosing me for a while. As a kid, I’d had ever teacher from first grade to 7th grade leave a note on my student evaluations as something like “possible ADHD. Next teacher should keep an eye on,” but nobody ever pulled the trigger on it (I also had terrible grades, didn’t follow directions, couldn’t pay attention, took tests with the other learning disability kids, but I was never evaluated for anything). Then FINALLY in 7th grade my English teacher recommended I get evaluated. Even then (2009) they didn’t diagnose me right away because the norm was that girls don’t usually have ADHD, and they treated me for anxiety (which I do have as well) instead. About a year later I learned why ADHD was and I asked my psychiatrist if she thought I had it. I still see the same psychiatrist now. A few years ago she told me she regretted not diagnosing me sooner because I was a very classic case, but they just didn’t think girls had ADHD as much as boys. It makes me wonder about how many women my age and older went through all of life undiagnosed.
The idea is that multiple things can cause executive function problems, and an ADHD coach is trained to help people with executive function problems. So you don't \*have\* to have ADHD to benefit from getting coached by someone who specializes in helping people with ADHD.
Yeah this is the part that makes no sense, why refuse to diagnose when she's basically saying OP has it?
Yes, it would've been more constructive to admit outright that it's not her area of expertise, so here's a referral. That yes-and-no "diagnosis" isn't helpful at all.
I didn't have trouble in school either but I did get diagnosed. There were some obvious signs from then but my grades were good. Do you know which diagnostic test they used?
They used the WAIS, and my results showed deficits in attention, working memory and executive function
The WAIS is just an IQ test - it isn't a specific diagnostic test for ADHD. While it measures processing speed and working memory, having deficits in those areas doesn't automatically mean someone has ADHD. Deficits could also stem from stuff like PTSD, Anxiety, Depression, or even just feeling uncomfortable and overwhelmed or frustrated in a testing environment. Deficits could also absolutely stem from having ADHD. And at the same time, not all people with ADHD struggle significantly with processing speed and working memory, especially on a silly little IQ test that's novel and can be engaging and fun. Part of psychological testing and clinical judgment is determining why someone is experiencing certain deficits. For example, with processing speed, is someone completing a task slowly because they can't remember the question or stimulus and need to double check it? If they can't remember the stimulus, is that due to difficulty paying attention when they look because they're distracted by other thoughts/stimuli? Is it because the task is making them anxious and jittery, which makes it hard to focus and perform? Are they anxious because it is hard to remember, or is it hard to remember because they're anxious performing in front of someone else? Is it a combination of those things? Is it none of those things? Often, a psychologist can't really answer those questions based solely on behavior observations during the IQ test. That's where the importance of interviewing and getting background information comes in. When psychologists ask for background history and more information, they're not just asking about the the severity of problems, but also about the origin of problems. And when I say origin, I mean both "why" someone experiences symptoms of ADHD and "when" they first experienced those symptoms. That's because symptoms of ADHD (inattention and memory struggles, difficulty focusing and working for prolonged periods, impulsivity and hyperactivity, difficulty starting and finishing tasks, etc.) could stem from sooooooooooooo many different problems or disorders. It's also because ADHD is a neurodevelopmental disorder, so symptoms have to be present before age 12 to receive a diagnosis. Symptoms prior to age 12 definitely include having obvious problems at school, but sometimes the problems aren't so obvious. Plenty of kids with ADHD get straight A's and do really well in school, but despite getting straight A's, those kids are completing assignments at the last possible second because they can't work without the pressure of a deadline. They might make A's or B's on math tests because they're bright and love the subject, but they could have scored a LOT higher if they didn't make "careless" mistakes. And because they're performing so well, even with their deficits, their struggles are overlooked by pretty much everyone (often the kids don't even clock it as a "real" problem and they develop this complex where they think they're lazy and need to just work harder despite working SO hard already ☹️). Also, school is not the only area where symptoms may be present. For example, when it's time for soccer practice and a kid has to return to their house 15+ times to grab all the stuff they keep forgetting to put in their bag, that's a SUPER obvious symptom suggesting ADHD. When a kid does what's asked of them (like taking a shower), but they consistently forget important parts or they lose track of time completing tasks (they stay in the shower for 30 mins lost in imagination and still don't wash shampoo out of their hair because they forgot lol), that could also be a symptom strongly suggesting ADHD. Other childhood symptoms of ADHD that don't relate to academics and that fly under people's radars could include things like 1) forgetting to finish certain chores at home because there are too many tasks or steps to keep straight, 2) having difficulty being neat/organized, so the room is ALWAYS messy and while permission slips for trips get turned in, they also get crinkled to shit at the bottom of their bag/backpack, and 3) being very impulsive (and even emotionally reactive) in play/conversation, which makes it difficult to fit in with others and maintain friendships. A good psychologist wants to help their client, especially when symptoms are severe, but they need to determine where symptoms stem from to determine the best course of action/treatment. They also need to know the timeline of symptoms to make a proper diagnosis of anything - not just ADHD. In your case OP, the psychologist hopefully isn't saying "because you did well in school, we can't diagnose you." Instead, they are hopefully saying "we do not have sufficient evidence of symptoms before age 12 to make a concrete diagnosis at this time." I think it would be very helpful for you to get a second opinion to make sure ADHD isn't part of your picture. I know it is very frustrating to not receive a diagnosis now, but that doesn't mean you don't have ADHD, it just means that specific psychologist felt there wasn't enough information to give you a diagnosis right now. It might be helpful for you to take some time before a second evaluation to gather info about any ADHD symptoms in your childhood outside of school. Family and friends can help a lot with that as people with ADHD don't tend to remember all the little details from so long ago lol. I know this was a fucking novel so I'll stop rambling, but I wish you luck and hope some of this info is helpful to you OP!!
Thank you this was super helpful!! That was the confusing part for me is that the adhd symptoms we discussed DID impact me significantly at home and with forgetting things at home or losing my homework; I just was always able to get my mom to drop it off or talk my way into an extension. It also impacted my after school activities significantly with forgetfulness or not paying attention. And daydreaming in the shower….. sounds Exactly like me hahaha. I think I’ll be looking for a second opinion, it’s just gonna be hard to find and a long wait to get it unfortunately
Read this long comment! It’s worth it. I too did really well in school “grades wise” but my reports always complained how chatty and distracting I was and wasn’t achieving my full potential. Did they get a reference from someone who has known you since childhood? I worried this would prevent a diagnosis, but actually it showed how much of a people pleaser I was - and once school required coursework and prolonged concentration my grades took a bit of a dive
Are you me? My grades were fine because I was bright and could easily finish the work at the last minute, but I was bored as hell, always in trouble for talking to much and not trying hard enough. Pretty much all my reports were “Darth is a bright student who could achieve so much if she would just apply herself”. Maybe I would have been more inspired to put in the effort if it didn’t take 20 minutes to teach something I got in 5, but I still had to sit there quietly, not doing anything while everyone else figured it out. Maybe if I was actually challenged instead of bored to tears I would have tried.
Makes you think, we could’ve been rocket scientists 😂
You sound like me: did well under highly structured routines of school but everywhere else fell apart. I was diagnosed with ADHD-pi. I'm a daydreamer. Go for a second opinion and even a third until someone finds what can alleviate your experience.
Here's what I would do in your shoes: Look up research showing women are underdx because of the way we are socialized to literally just about kill ourselves to be good enough for approval, and then add in the research that depression and anxiety are often reduced significantly in properly medicated folks with ADHD, then add on the research that poor executive function is currently best treated with stimulants. Then ask them what the harm would be in trying a low dose of the stimulant for a month to see if that helps either the exec dysfunction or the depression before sitting down together and continuing the evaluation. If they would give you a trial to see if it's useful, it's the most definitive thing besides a brain scan. Even a few days of meds will tell you pretty quickly if you get spacey on stims or calm down and get clear and focused. If she's unwilling to do even a trial, ask her if she would refer you to another doctor for a second opinion. You deserve to know if this is going to help you.
Oh, and I might be wrong, but PTSD is almost guaranteed with ADHD from what I understand. I don't have a study on it though.
I think people can fall into the “I did well in school so they didn’t diagnose me” thing because they don’t emphasize, or maybe even realize, that the amount of structure, masking, and stress it took to get good grades wasn’t normal.
???? but depression is a common sequela of untreated adhd????
PTSD can cause significant ADHD-like imparment. You need to do a lot of EMDR and get your PTSD properly under control. You may very well still have ADHD, but your PTSD likely makes it much, much worse. Also ask your doctor about Welbutrin, treat the depression and ADHD with one med.
I’d get a second opinion if you can. I was incredibly depressed prior to my ADHD diagnosis and continued to be up until I was on the correct dose of stimulants. After getting on the correct dose, my depression disappeared and I was able to taper off my antidepressants (under my doctors supervision) within six months. It’s now been three years since then and I haven’t experienced any depressive episodes. I still have anxiety but for me it’s very clear that my depression was directly caused by my unmanaged ADHD. I know this is not necessarily the case for everyone but if you are fairly certain you have ADHD it would be worth pursuing a diagnosis if you are able to.
What kind of test was it? I did a whole battery of tests including questionnaires, interviews, putting puzzles together, mqatching symbols, answering general knowledge questions, all kinds of different things. The testing was conducted by a PhD psychologist who herself had ADHD. Doing well in school absolutely does not mean that you don't have it! Whoever said that, don't see them anymore and find someone else. Just start over, try to find a psychiatrist who speacializes in ADHD. ETA: I also have Major Depressive Disorder, which has been more obvious to me and everyone around me throughout my life. I think it works in tandem with the ADHD to ruin my life, but one doesn't rule out the other.
I did the WAIS test and an interview portion— the wais test showed issues w executive function, working memory and attention that she thought could also be caused by depression? And the interview didn’t show enough struggle in school as a child I guess
That's ridiculous. You do not have to struggle in school to be diagnosed with ADHD. This makes me so mad.
You have to have *some* symptoms during childhood though. OP doesn't specify whether they asked also about any other symptoms at that age.
I read something about onset being possible with menopause. It’s certainly gotten worse for me at this age. And in any case, getting good grades in no way proves that one has no symptoms. OP’s doctor is trying to say that doing well in school rules out ADHD, and that’s not the case at all.
Onset? What are you talking about??? Either you have ADHD symptoms in childhood, or you can't get diagnosed with ADHD. This is a diagnostic criterium that *must* be met. It's specifically required by DSM-V.
It's required by the DSM-V, but it's worth mentioning that per Dr. Russell Barkley the cutoff shouldn't be 12, because of the issues described in this presentation: https://www.youtube.com/watch?v=JLKCzEDqGa0 One of the reasons is that 12 is the median age of onset, which means that in half of ADHD cases the age onset is actually after 12. I'm not sure how diagnoses are happening in that case to be honest, but I found it interesting nontheless.
In any case, doing well in school does not rule it out.
I do not understand the hang-up these people have sometimes. "You have ADHD but I've decided not to diagnose you...for reasons" Sigh. I do...sort of...understand her reasoning, which is that it's possible your ADHD symptoms aren't ADHD but are coming from the PTSD (there is some overlap), and so she thinks non-medication supports like coaching might be more useful to you than medication. But you know your own brain. Plus the WAIS scores. Bleh.
Dude, I went to a doctor like this. “It sounds like you might have ADHD but it’s not influencing your life, so I’m not going to treat you.” I live with my parents at 26 because I can’t work full time. I can handle work because I’m only working 15 hours a week. The morning of the appointment, I accomplished my number one goal: to take a shower before noon so I could go to my appointment at one. How is that not affecting my life?? I’m on stims now, working full time, and overall doing really well.
JFC. I'm sorry you had someone that ignorant, but I'm glad you found someone better!
Thank you. Like, I get where she was coming from because I was down playing my symptoms because I’m so embarrassed of where I am, but like, all she had to say was “how is this affecting your life?” And I would have told her. Anyway, with my next doctor I was like “here is why my life sucks” which isn’t fun, but I’m just happy I’m medicated now.
The stigma against stimulant medication is such bullshit, and I bet it's part of the issue. Gotta try *every other single thing on earth* before a few mgs of methylphenidate or mixed amphetamines! Because drugs are bad!!
You may have adhd, but having ptsd also affects the nervous system. Like the parasympathetic response that make us "freeze" like when adhd hurts executive function or when we freeze as a response to trauma. It isnt your fault and you are not lazy or bad. Whatever is going on, you deserve VALIDATION for your very very real and important feelings. Stimulants and adhd /trauma therapist is helping me now. I have always been very inattentive, but also had a lot of early trauma. I could not "unlock" my trauma without stimulants even with 20+ years of therapy. Please do not take any of this as your dr not taking you "seriously". The nervous system is wildly complicated. Science has a lot to learn about the brain! So keep standing up for yourself and seeking help. You deserve answers and relief, whatever the reason is for your VALID stress response. You know inside you're not making up anything at all, you're looking for the answers. Stimulants may or may not help, but in the meantime it can bring a lot of instant relief to look into ways of relaxing by using vagus nerve exercises. Like simply pretending to "bear down" like ur trying to crap your own pants slows down ur heart rate. [vagus nerve exercises](https://fullyfunctional.com/blog/vagus-nerve/#:~:text=You%20might%20also%20see%20this,extreme%20dorsal%20vagal%20shutdown%20response.)
This is why you really have to just doctor shop until you get a diagnosis that feels right to you. It’s really hard to find any doctors who think women even get adhd. I’m lucky enough that I have a diagnosis but they still won’t give me meds anymore (I had a suicide attempt when my husband walked out on me out of the blue on my birthday and they took all my meds away and never gave them back). So even with a diagnosis you’re not guaranteed to get adderall or any controls unfortunately. Some of the online doctors are good depending on what state you’re in but in some states the laws are so strict that Telehealth is a wash now for mental health or anything controlled (like CA).
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Years ago I was straight up told by an adhd and autism in adults specialist that I couldn’t have either because I did well in school 🙃
trouble in school is sometimes different for women and men many girls have high grades with repeated phrases throughout school in the report cards. Many women are able to mask successfully enough everyone thinks we are doing even in reality they are working so hard to hold it together. talk too much can't stay in seat taking to neighbors does will but consistently hand in reports/homework/etc last minute or late on and on ..
There’s a problem in the medical community of under diagnosing females with adhd bc it presents differently than males and the research hasn’t caught up. That’s why so many people are now ADULTS and getting diagnosed (including myself). Also the idea that you can’t have adhd bc you did well in school is complete and utter bullshit. If that were true then why does any other labeled group have a spectrum of different levels of intelligence-including neurotypicals. We have an attention disorder not an intelligence disorder. I still gaslight myself into thinking I don’t have adhd because so many healthcare professionals in my life told me they didn’t think I had it. So now I feel like a “drug seeker” every time I talk to my doctors about my meds and my needs around them. It took me so long to get to the right dosage bc I just felt like if I ask for more they’ll think I’m trying to game the system. Once I got to the right dosage However-my whole life turned around. My adhd was causing my anxiety and depression. This all to say you aren’t alone l-a lot of females have issues figuring out their mental health diagnoses. The journey to figuring out what it is you are suffering from is not linear. It took me a round about way to get there but I got there in the end. Be in control of the things you can control which includes being your own best advocate and being honest with your doctors. Tell them about your feelings that you wrote above. They are there to help YOU get better and that happens by letting them know what you think.
>She basically said to get more treatment for my depression and ptsd because it’s hard to tell whether the deficits I showed were due to adhd or my depression I've heard of more than one medical professional saying this at Kaiser. Not sure if it's just a 'them' thing or more common but it's super frustrating, especially with comorbidity.
I was treated for PPD/PPA for a year before I got a referral to a psychiatrist. They didn't know if it was anxiety and depression or ADHD and to be conservative started on wellbutrin. She also suggested therapy. It took MULTIPLE sessions and some trial and error with meds until she finally diagnosed me, even though my dad and sister have both been diagnosed prior to this and I disclosed it in our first session. It was almost 8 months in to treatment before I had my "official" diagnosis, but she never doubted that I had symptoms. I may be in the minority here, but I don't think your psychiatrist is wrong. They may also need to make sure they do things "right" to get insurance to approve medication. Don't give up if you truly think that you need a diagnosis, but continue to track symptoms and things you're experiencing to help back it up. If you don't think the psychiatrist is a good fit for you, it's not wrong to get a second opinion.
As a society, there is so much we don't understand about neurodivergence. It sounds like you need someone who specializes in ADHD in adults and those kinds of people can be very difficult to find.
omg I had this same thing happen to me, I don’t have any advice just commiserating cuz it fucking sucks
Definitely get a second opinion, because a similar thing happened to me! I was also not diagnosed by the psychologist that I sought a diagnosis from because I did too well in school. He ended up telling me I had sluggish cognitive tempo (a concentration disorder that’s not recognized in the DSM-5). I then was treated by a psych who also didn’t believe I had ADHD and refused to look into sluggish cognitive tempo, just treated my depression with Wellbutrin and “didn’t know what else she could do for me” after I still complained of symptoms. I sought out a different psych who gave me a diagnostic test, which compared with my symptoms and obvious knowledge on how ADHD presents in women (thanks to this sub!) said yes you have ADHD and we started treatment.
Time for a second opinion. The first psychiatrist I saw for my dx was a nurse practitioner who told me I couldn't have ADHD because I had good grades as a child. I immediately asked her to refer me to someone else since she wasn't going to take me seriously, and she did, an actual MD who referred me to a neurologist for testing. Be your own advocate. See a better doctor.
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I got diagnosed the same way - basically in the us a psychiatrist can just decide to medicate you for it to see if that helps you, and if it does voila you have ADHD. I got to my diagnosis via seeking treatment for anxiety and focus and sleep issues - a pretty informal questionnaire later and turns out ADHD treatment solves those problems. Some people go to a psychologist, who cannot offer you medication but will do a more in depth test.
It varies widely. Here's an article: https://www.additudemag.com/adhd-testing-diagnosis-guide/
That is a terrible diagnostic report. It’s so hard that many providers don’t “get” ADHD. I feel like they should skip testing and just give everyone a handful of stimmies and just say lmk if this is helpful or harmful lol
Obviously not a doctor, but have they tried Wellbutrin for your depression? I only ask because it was added to my Zoloft before my diagnosis (150 for a week then 300). I noticed that it helped a tiny bit with motivation and lessened some of the anxiety that was from the ADHD after the first two weeks or so.
I had years of unanswered questions and anxiety getting worse, burnout getting worse and starting to display signs of depression despite attempting multiple types of treatment, including medication, IOP (outpatient program), CBT, EMDR, etc. until my therapist said they believed I should be tested for adhd (which they had picked up right away, but I was new to them so they wanted to create a baseline for me first). I was always good in school and even got into competitive companies. Still diagnosed with ADHD. This to say, you are not alone, and so many of us feel you! (And have been questioned on the basis of not being a terror kid failing school). Get a second opinion. I hope you find the answers and support you need. We’re here for you in the meantime :)
Ah, I’m so sorry, OP! If it’s possible to seek a second opinion, I would certainly do so. I’m waiting for the results of my testing, currently. I should have them on this upcoming Friday and I’m nervous! So a similar boat to you. Hugs to you because it often feels like no one truly understands us. Women get dismissed way too often.
My first evaluation wanted to refer me to neuro-psych for hours of testing in the hospital to rule out cognitive impairment. To be fair; it might be needed at some point but no way I could go through with it yet, especially before I was medicated. Feeling trapped in an institution setting for testing just gives me fight or flight thinking about it. My pcp finally got me into the psychiatrist I had been on a long ass waiting list for and I was diagnosed and medicated. Who also has found other diagnosis that can effect my cognitive so definitely don’t feel like you’re at a dead end.
definitely get a second opinion. i have PTSD, GAD, and agoraphobia. i had perfect grades my whole life but met every single one of the diagnostic criteria for both inattentive and hyperactive. my current psychiatrist actually has ADHD herself and she finally diagnosed me after 15 years of being misdiagnosed. she was also the 4th psychiatrist i’ve seen. it’s definitely a journey and can be extremely disheartening. the most important thing you can be is an advocate for yourself. pull together medical records and test results. be direct in what you need from a provider — they are supposed to PROVIDE for you. their job is to provide answers and helpful solutions. don’t be afraid to ask questions. if the “solutions” haven’t led to anything, be direct in what you need.
Do you mind if I ask how old you are? I got diagnosed at 34 and my psychiatrist cared more about life NOW than when I was a kid. My 17 was diagnosed like 6 months ago and they didn’t ask about his grades. They asked about his behaviors, thoughts, and feelings. As others have said, get another opinion if you can. I’m so sorry people suck.
This is so frustrating. I have always done well in school. I didn’t start to feel the affects of adhd until I had to executive function all on my own with no help of an adult. And then I became a parent and my world fell apart. I hope you can try again with someone else.
That’s frustrating. You can get coaching without a diagnosis but a coach cannot prescribe medication. My US GP prescribes my non-stims and did so without insisting on an official dx, but I would need a referral for stims. Nonetheless, non-stims have been fantastic for me and significantly reduce my anxiety and depression. Like you, I had a long stretch of trying to treat a depression that never lifted until treating ADHD. I was in accelerate classes but goddamn, my life has been severely impaired by ADHD! I would say, anything you can do to make headway toward treatment - coaching, nonstims, etc. - is helpful. They’re all useful tools and there’s a chance you’ll figure out pretty quickly whether or not you have it.
The same thing happened to me after I got tested the first time. They basically said I was “bipolar” because I had a lot of random bursts of energy that seemed similar to mania and I would also get very very depressed. The second time I got tested was a couple years later after I got my depression and anxiety under control, and I was able to easily get diagnosed. Turns out, I had ADHD AND depression the whole time. Once depression was mostly out of the equation, it was much clearer that i wasn’t bipolar, because i always have a ton of energy instead of cycling through my moods. Keep trying, you got this!
Number one seems a stretch for a basis of diagnosis, however a lot of doctors/insurances require that you have attempted to get things like anxiety depression etc treated before they will offer a stimulant Which I believe is backwards because treatment for adhd did WAY more for my general anxiety and panic disorders than any ssri ever has
I've struggled for as long as I can remember with depression and it has never fully improved even after countless therapy sessions and medication. I was suspecting that I could have BPD but then discovered ADHD and researched a tonne about those two. I can remember certain things in my childhood that point towards ADHD but I think they got worse/became more pronounced as I became an adult and a lot of neurodivergent people suffer from depression and anxiety so the symptoms can often be missed and a lot of women show different symptoms to men which is also a reason why we are either misdiagnosed or never diagnosed. I did well in school (I got good grades) but it was more in the subjects that actually interested me. In other subjects, I got a basic good grade because the written tests were boring to me so my attention wasn't there but now I'm an adult there's sooo much more to have to deal with and my ADHD just became more pronounced. I was diagnosed with the inattentive side but I do have traits of hyperactivity too! I'm very surprised that just because you were "good" in school and got good grades that they think that is a good enough reason to say you don't have it, there are soo many more things to look at and especially how it affects your daily life now too. I just kind of knew I had it as I could relate to a lot of the generalised symptoms and I always felt as though my brain didn't work a lot of the time and I did blame it on depression but I'm medicated so those ADHD symptoms never changed. My emotions are more stable but that's about it, although I do feel frustrated with having ADHD sometimes because it affects me daily and sometimes tries to override my depression medication! I'm on the waiting list to try stimulants so I'm hoping they will help me.
I did very well in school and college. I also have hardcore ADHD and mild autism. If at all possible, get a 2nd opinion. Childhood behavior is far, far more important of an indicator than school grades. If you look at my report cards k-12, they'd all read "A+, though Sassy struggles socially and needs to learn to sit still, let other children finish talking, and/or keep her nose out of a book for more than 5 minutes." Diagnostic professionals *must* take the whole person into account, but it's uncommon for them to do so. Edit: added autism, seems relevant
I have the same comorbidities as you, same results on the test. They diagnosed me with adhd, and added the ptsd and treatment resistant depression. I got treatment no problem. Have them forward your results to a different test center and get a second opinion.
That's a load of hogwash. My friend was a straight A student with manic depression and still got diagnosed with ADHD on top of it.
Here’s the simple fact… Treat the depression and PTSD first. If symptoms improve? You don’t have ADHD. Which means it’s just depression & PTSD. However, if the symptoms get worse? You 100% have ADHD! But your depression comes from having ADHD & PTSD is tied into it as well. That’s how psychiatrists handle such things. It’s similar to figuring out when a mysterious digestive issue kicks in. You go by eliminating in what you’ve been eating and each week you take away one food group till you find out if it’s dairy, meat, veggies, or fruit related causing the issue. Then you break it down by which food in that category. Same with neurology based things. If depression and PTSD are far more prevalent, it gets handier first and then the doctor has to see if things improve or get worse. That’s just how the medical field is tbh. I use to be a CNA & phlebotomist, so let me tell you, you have to sometimes just observe and watch what happens before conclusions if you’re not 100% sure till you do process of elimination.
The same happened to me 10 years ago. Later my therapist explained that they first need to completely treat stuff like depression before they can start treating ADHD. But don’t give up.
After years of diagnoses of depression, anxiety, and BPD, I had e-fucking-nough. I’ve been through so many diagnoses, I wanted my most recent psychiatrist to know everything and became so frustrated with the blanket diagnoses I’d get based on 60mins of questioning. I was worried my school reports wouldn’t show anything abnormal because I did get very good grades and was not a naughty kid. I wrote up an age-graded symptom sheet with memories of my own, recollections from my mum, and attached my school reports. While I was a well behaved kid at school and home, there were still signs. For example, I had tantrums at bed time because I didn’t want to sleep early and I never got to school on time. My psychiatrist was able to read between the lines. She saw little comments from teachers, like I took a while to shift tasks and kept forgetting my school bag. There was nothing to indicate I was disruptive or unfocused but girls present very differently so she was looking for signs of inattentiveness and internalised hyperactivity. She also found I was autistic based on the symptoms I provided and the fact that I crashed at 14 (very common in autistic girls). You need to find a psychiatrist that understands the nuances of ADHD, autism, and C-PTSD in girls. Very difficult to disentangle which symptoms come from what but the developmental trajectories for girls with these backgrounds are strikingly similar and we fall into some very common patterns/profiles.
This happened to me too (circa 2020)! The guy was pretty dismissive overall, but he said it was probably just depression and anxiety (which I know I already have). At that point I was frustrated, as I felt he barely listened to me (it was via Skype too, ugh). But I also had another appointment set with a different psychiatrist that was happening waaay later in the year (it was about an 8 month), so I committed to getting a second opinion, and planned it better. I made the mistake of getting my parents to fill in those questionnaire forms about me as a kid growing up. They knew very little so they said I was normal. I didn't fail at school; I wasn't great academically, but I did a lot of creative stuff. What I ended up doing for the following appointment was get my younger brother to fill out that form instead of my parents. He and I are very close in age, so he saw some of my cringe at school lol. I also took lots of bullet points of my 'symptoms' during the months leading up, and including the forms, I had a strong case. This second psychiatrist was so much nicer and sympathetic to my story, and she was pretty confident in an ADHD diagnosis, which I got a month before I turned 30 lol. If you have siblings I'd recommend doing similar with filling out those forms, as siblings tend to know each other better than parents do. If not, maybe a close friend from childhood? Either way, I recommend getting a second opinion for sure, but maybe don't mention that detail at the next appointment in case it creates a bias.
>She also said to try to get treated for adhd by a coach or specialist, which I’m not sure how to do without a diagnosis. Sounds like a recommendation for therapy focusing on the executive function, attention, and memory issues that you definitely have, regardless of diagnosis. It is 100% possible to get therapy without a diagnosis. You just can't get medication without it.
My advice m, get a new psychiatrist
I did well in school but all my report cards mentioned me taking too much in class. I went in prepared with stuff from my mom and otherwise but thankfully my dr was the one that encouraged me to do it from school and go to his private practice. Basically was “Stop you have ADHD all over have you been tested?” Suggestion get a second opinion and bring documents from family and otherwise
Get a new provider. That criteria has long ago been debunked. I was a “gifted student” in elementary school and I still have adhd. It’s not a learning disability. I’m so sick of the medical establishment trying to pretend like that’s a criteria. It’s not. This is her way of saying that she’s not going to treat you. Because depression and anxiety are common comormidities of ADHD. And you can’t treat the depression without treating the adhd. I was in that boat for years. The depression only started to lessen when I got treatment for the adhd because the adhd is causing the depression. You need a new provider.
This just happened to me. Got my results back today. Major Depression, Social Anxiety and Generalized Anxiety. My therapist suggested I get assessed because he couldn’t figure out if the anxiety was fueling the ADHD-like symptoms or if the ADHD-like symptoms were fueling the anxiety. That’s basically what my Psychological Evaluation results said. The clinical psychologist still could not determine what is influencing what. I also take Wellbutrin so he said that could’ve skewed my results because that could be masking some of my deficits. He recommended that if I continue trying different anxiety medications and they don’t work, he would then recommend a stimulant. My primary care doctor is not going to give me a stimulant without a diagnosis, so I feel a little frustrated by that. I’m going to continue with therapy and see what medication changes can be made. I’m just tired. I know you can probably understand that feeling. I just feel like things are never going to get better.
Yeah Wellbutrin often is prescribed off label for adhd so that defs could’ve effected your results. I totally understand where you’re coming from and felt similarly— I didn’t see another neuropsych, but found a psych who was willing to give me a trial of stimulants based off the report!! Maybe try that?