Feeling frustrated and confused after dangling ADD diagnosis.
posted by anonymous to health & fitness (9 answers total) 4 users marked this as a favorite
Early twenties, male. Increasingly in the past few years, it has become more and more obvious to me that I have some sort of attention problem. The primary impetuses (impeti?) for finally seeking treatment were the loss of a plum job half a year ago, and my coming entry into graduate school this fall. After a false start (my original appointment four months ago was cancelled at the last minute because they had mistakenly let me schedule during an office holiday - !) I was extremely excited to finally have my evaluation this past week. I traveled from my home to the state I grew up in, because I am independently too poor for health insurance and thus have insurance through one of my parents, but which is only valid for non-emergency care in that state (thanks, US health system!). Before going to my appointment, I read the book "Delivered From Distraction" and was on the verge of tears from recognizing myself so strongly and also from reading something that actually seemed to UNDERSTAND. My family is very supportive of me in general, but tend to be cagey and denialistic about the idea of me having any sort of psychiatric issue, because I am supposed to be the 'not messed up one'; we have a lot of genuinely serious mental illness amongst our relatives. I am outwardly high-functioning-- I graduated from a great school with honors, and I'm headed to another great school with a scholarship-- but people don't really see how much I struggle behind the scenes with basic things and how hollow my successes sometimes feel to me (it feels like I achieved them by coasting and that I could have done so much more of substance if I were more normal). I'm functional on a macro level but so, so dysfunctional on a micro level. Everything major gets done eventually, SOMEHOW, but the amount of struggle, anxiety, inaction, and messed-up steps it takes along the way is just horrible.
Anyway, I went to the psychiatrist's office with high hopes. She sat at a computer and typed down the answers to the vague life questions she asked me. Honestly, I felt like I was at the DMV. A lot of the things she asked me I wanted to go into more detail on, but time seemed a bit short. I felt very uncomfortable with the fact that she went into a lot of personal and troubling things, just as data points-- without addressing them or empathizing with me in any way. For example, she had me go into minor detail about the circumstances of a close relative's suicide; this is something I've never had a serious conversation about with anyone, and to have a stranger ask me to casually mention it and then move on to, I don't know, whether or not I have heart murmurs was really distressing for me. This combined with my revealing of other mental health histories of close relatives made me feel kind of...I don't know, cheap and used? I know that seems like a stupid way to phrase it, but that's really exactly what it felt like -- the same sense of humiliating, unwarranted intimacy as an unwanted sexual encounter. Does this mean I need therapy or something? It had never occurred to me that I needed to talk these things through so much, but it was really apparent that I wanted to work through them, which was well beyond this woman's apparent ability or role. This was my first encounter ever with any sort of psychiatrist or therapist...I guess I thought they had similar approaches. Anyway, after about 35 minutes, she informed me that I had ADD as well as hypomania. This made a lot of sense to me. She also thought I should be trying meds, which, YES, but here's the catch. I'm going back to my current city tomorrow. I'll be back staying with my parents in a week or so, for a week. Then I'll be working abroad for two months. Then I'll be moving to a whole other state for graduate school. Complicated, right? The doctor said she didn't feel comfortable trying out any meds without being able to monitor me (concerns about a stimulant aggravating the hypomania), and recommended I seek help again in my new state in August, bolstered by her already-done diagnosis of ADD. I basically deferred to her, but this is so, so frustrating for me -- to have someone say that I'm not imagining this, I do have a problem, but I'm just going to have to sit on it for a few months. I want to start school off on a good foot. I don't think the doctor understood how hard it was for me to even get it together to make this appointment happen, much less a whole other one while I'm concurrently already moving across the country and juggling seven hundred related balls. I can't even jot a few lines of a fucking email to a friend I've been meaning to contact for months!! As I was leaving my appointment, the next patient was standing in the waiting room, ready to come in. My appointment was exactly 50 minutes. I get that doctors need to see multiple patients, but it was apparent that if I had needed extra scrutiny or to give additional information, there wasn't the time.
I feel really kind of helpless and paralyzed. I felt really let down by having received more understanding and empathy from a book than from a live psychiatric professional. I understand the doctor's concerns, and I don't a priori disagree with her conclusions, but I don't really know what to do with them. Waiting months to get any help feels crushing. Is this how psychiatry is in general, or did I just end up with someone whose style doesn't jibe with mine? It didn't really seem like she gleaned any information from me I couldn't have sent more easily in an email. I don't think the deferred medication trial would bother me if I felt like my problems were being addressed in some, ANY, other way. I'm not just fishing for drugs; in fact, my deep ambivalence about psych meds is partly what made me take so damn long to seek help in the first place. But it's reached the point where the lack of any ability to do anything about my situation is making me want to scream. I feel like I'm trapped in this ADD mind, knowing there's something better and more productive out there.
This came out really rambly, but I guess the TLDR version is: should/(how)can I seek a second opinion in the two weeks left before I leave the country*? And, is this just how psychiatry is? Should I be seeking some alternative form of help?
Thanks for your help, useful advice and compassion.
*NB: I did not plan at any point to take whatever meds while I'm abroad; I just wanted to start the trial before I leave to begin, I don't know, doing SOMETHING, and to not just enter August without having tried anything at all.