Newly diagnosed adult with ADHD...I think.
December 12, 2019 12:15 PM Subscribe
After consulting with my PCP and therapist, I was recently screened by a LICSW who specialized in adult ADHD. I found the screening interview confusing in a few ways and find myself wondering what to do now. Can you folks who have been through this process help me understand some of the things I was told during the screening?
My PCP, therapist, and the social worker who did the ADHD screening all agree that it sounds like I am an adult with ADHD symptoms. I've suspected for a few years and done a lot of reading and tried to learned skills to help cope but they just haven't helped, so I finally found it in me to get screened.
However, during my screening process the social worker used a lot of black and white statements about people with ADHD and said she couldn't give me a specific diagnosis because I didn't seem to fit the profile of having childhood ADHD. I understand that the DSM requires symptoms to show up prior to the age of 12 and also understand how serious the diagnosis is and how careful she needs to be, especially considering the use of stimulants in treatment.
I also will say assessing my childhood was difficult for her because I had some trauma occur around 6–10. She (rightly, I think) decided against interviewing my mom about my childhood because my mom was struggling with addiction (and still is) during that time and was often absent. My dad is dead and my brother is out of my life so she didn't have another perspective to go on. I also experience anxiety and I know that can present as ADHD, though I've done a lot of work on the anxiety and didn't feel like the things I think might be ADHD improved.
One of the reasons she said I didn't fit the profile in childhood was because I talked about struggling to learn to read longer than my peers, I eventually ended up really enjoying reading and liked to lose myself in a book. Her statement on that was straight up: "people with ADHD don't like to read and can't do so for longer periods" I pushed back on this and asked about hyperfocus and she simply restated it.
We talked about my grades in school, I said that while I often got in trouble with teachers and didn't understand why, but found I could do pretty well in school without much effort through middle school except in math and science. Her statement regarding that: "People with ADHD don't get good grades unless they have a parent compensating for them or really enjoy learning."
I said I got okay grades in high school (I failed a few math and science classes) because my mom excused me for 30-60 absences when I was struggling and then my junior/senior year I was able to take 3 art classes that were self-directed (several at the local college) and pick other classes I was really interested. She said it was unheard of to get that many good grades (I was like a B- average) and had only had one patient with ADHD who got good grades in school because she went to a Montessori school. I asked if it was possible that the unchallenging and unremarkable rural school I went to just wasn't challenging but she didn't think that explained my grades.
After I graduated I went to art college and thrived despite procrastination but she said that did make sense since I was interested in it and had a lot of flexibility.
After I described my childhood she said she didn't see signs I had ADHD before the age of 12 and that's when the statements she made above were made. I felt like I somehow blew my chance to describe my childhood accurately. I was kind of struggling to organize my thoughts or interpret her questions and told her that but she said I didn't need to give her more information than I already had.
Another statement she made was when she asked me about caffeine usage and whether I could sleep after I drank caffeine. I said I could when I was younger but now avoid too much during the day. She stated "people with ADHD drink coffee to fall asleep." I was befuddled by what she meant and when I looked it up later I read that some people with ADHD might find caffeine relaxing instead of stimulating. However, she very clearly said "people with ADHD" and not "some people" which made me feel like she was implying "people who have ADHD, who aren't you."
She told me she would call my therapist to discuss before making a diagnosis because she wanted to talk to someone who knew me well in the present, though my therapist has only known my 6 months. After that conversation she called and left me a message saying she was going to diagnose me with ADHD Not Otherwise Specified but really struggled because she didn't think it was present in my childhood.
I'm left feeling frustrated, like maybe I don't deserve to say I have ADHD. Her voicemail told me I could see if my doctor would prescribe medication and encouraged me to join a group therapy session and to learn coping skills. I'm open to group therapy, but I have been learning coping skills for years and have read a lot of strategies that don't seem to help. I meditate, I do yoga regularly, I use the pomodoro method during work, etc.
I'm still feeling unsure of what to do next and I don't see my therapist for a few weeks and am not sure what to say to my PCP about medication. I'm scared to ask and be denied because the social worker told me her notes to my doctor would say she couldn't diagnose ADHD during childhood.
Thanks for reading this far. I'd like to hear whether the black and white statements make sense to others, if it's possible I don't have ADHD because, well, I fucking love reading and didn't fail out of school, and...can I ask my doctor for medication without looking like I'm drug seeking? Should I get another opinion from another ADHD specialist? (Not sure if I can afford to do so for awhile.)
My PCP, therapist, and the social worker who did the ADHD screening all agree that it sounds like I am an adult with ADHD symptoms. I've suspected for a few years and done a lot of reading and tried to learned skills to help cope but they just haven't helped, so I finally found it in me to get screened.
However, during my screening process the social worker used a lot of black and white statements about people with ADHD and said she couldn't give me a specific diagnosis because I didn't seem to fit the profile of having childhood ADHD. I understand that the DSM requires symptoms to show up prior to the age of 12 and also understand how serious the diagnosis is and how careful she needs to be, especially considering the use of stimulants in treatment.
I also will say assessing my childhood was difficult for her because I had some trauma occur around 6–10. She (rightly, I think) decided against interviewing my mom about my childhood because my mom was struggling with addiction (and still is) during that time and was often absent. My dad is dead and my brother is out of my life so she didn't have another perspective to go on. I also experience anxiety and I know that can present as ADHD, though I've done a lot of work on the anxiety and didn't feel like the things I think might be ADHD improved.
One of the reasons she said I didn't fit the profile in childhood was because I talked about struggling to learn to read longer than my peers, I eventually ended up really enjoying reading and liked to lose myself in a book. Her statement on that was straight up: "people with ADHD don't like to read and can't do so for longer periods" I pushed back on this and asked about hyperfocus and she simply restated it.
We talked about my grades in school, I said that while I often got in trouble with teachers and didn't understand why, but found I could do pretty well in school without much effort through middle school except in math and science. Her statement regarding that: "People with ADHD don't get good grades unless they have a parent compensating for them or really enjoy learning."
I said I got okay grades in high school (I failed a few math and science classes) because my mom excused me for 30-60 absences when I was struggling and then my junior/senior year I was able to take 3 art classes that were self-directed (several at the local college) and pick other classes I was really interested. She said it was unheard of to get that many good grades (I was like a B- average) and had only had one patient with ADHD who got good grades in school because she went to a Montessori school. I asked if it was possible that the unchallenging and unremarkable rural school I went to just wasn't challenging but she didn't think that explained my grades.
After I graduated I went to art college and thrived despite procrastination but she said that did make sense since I was interested in it and had a lot of flexibility.
After I described my childhood she said she didn't see signs I had ADHD before the age of 12 and that's when the statements she made above were made. I felt like I somehow blew my chance to describe my childhood accurately. I was kind of struggling to organize my thoughts or interpret her questions and told her that but she said I didn't need to give her more information than I already had.
Another statement she made was when she asked me about caffeine usage and whether I could sleep after I drank caffeine. I said I could when I was younger but now avoid too much during the day. She stated "people with ADHD drink coffee to fall asleep." I was befuddled by what she meant and when I looked it up later I read that some people with ADHD might find caffeine relaxing instead of stimulating. However, she very clearly said "people with ADHD" and not "some people" which made me feel like she was implying "people who have ADHD, who aren't you."
She told me she would call my therapist to discuss before making a diagnosis because she wanted to talk to someone who knew me well in the present, though my therapist has only known my 6 months. After that conversation she called and left me a message saying she was going to diagnose me with ADHD Not Otherwise Specified but really struggled because she didn't think it was present in my childhood.
I'm left feeling frustrated, like maybe I don't deserve to say I have ADHD. Her voicemail told me I could see if my doctor would prescribe medication and encouraged me to join a group therapy session and to learn coping skills. I'm open to group therapy, but I have been learning coping skills for years and have read a lot of strategies that don't seem to help. I meditate, I do yoga regularly, I use the pomodoro method during work, etc.
I'm still feeling unsure of what to do next and I don't see my therapist for a few weeks and am not sure what to say to my PCP about medication. I'm scared to ask and be denied because the social worker told me her notes to my doctor would say she couldn't diagnose ADHD during childhood.
Thanks for reading this far. I'd like to hear whether the black and white statements make sense to others, if it's possible I don't have ADHD because, well, I fucking love reading and didn't fail out of school, and...can I ask my doctor for medication without looking like I'm drug seeking? Should I get another opinion from another ADHD specialist? (Not sure if I can afford to do so for awhile.)
Best answer: And yes, I wouldn’t get second opinions in the first instance - try the pills, And if you like get lots of user reports beforehand.
posted by The Last Sockpuppet at 12:33 PM on December 12, 2019
posted by The Last Sockpuppet at 12:33 PM on December 12, 2019
Best answer: Her statement on that was straight up: "people with ADHD don't like to read and can't do so for longer periods" I pushed back on this and asked about hyperfocus and she simply restated it.
This is nonsense.
Anyway, you've got enough of a diagnosis for a start. My suggested script for speaking with your PCP would be: I've been working with LCSW and therapist on my problems with [effects ADHD may be having on your life]. I've spent a lot of time working on coping skills and plan to continue to do so, but I've been thinking about trying medication. How would that work?
You're not going to get a prescription that lasts more than thirty days for any of the stimulants; it's not a lifetime decision here, and being clear about what problems you hope to ameliorate by trying medication should help your physician feel comfortable with a trial prescription.
posted by asperity at 12:34 PM on December 12, 2019 [4 favorites]
This is nonsense.
Anyway, you've got enough of a diagnosis for a start. My suggested script for speaking with your PCP would be: I've been working with LCSW and therapist on my problems with [effects ADHD may be having on your life]. I've spent a lot of time working on coping skills and plan to continue to do so, but I've been thinking about trying medication. How would that work?
You're not going to get a prescription that lasts more than thirty days for any of the stimulants; it's not a lifetime decision here, and being clear about what problems you hope to ameliorate by trying medication should help your physician feel comfortable with a trial prescription.
posted by asperity at 12:34 PM on December 12, 2019 [4 favorites]
Best answer: Her statements do sound contradictory and ill-informed to me. If ADHD were this easy to diagnose with straight up yes/no questions it wouldn't be as hard to get a diagnosis as it is. I'm not a pro but I've done a lot of reading. I don't think you should let this lady make you feel bad about wanting help or thinking you don't deserve help because to me your story makes perfect sense. It's just hard for anyone to get any kind of care these days. Same thing happened to me when I went looking for help for anxiety. It's good that you will get a prescription to start with. Just keep on keeping on.
posted by bleep at 12:43 PM on December 12, 2019 [1 favorite]
posted by bleep at 12:43 PM on December 12, 2019 [1 favorite]
Best answer: MeMailed you, but just to say a few of my points publicly for others: all of those statements are incorrect. People with ADHD can get good grades, may love to read, and can experience sleep disturbance from caffeine. People who conduct psychological assessments are fallible in many ways, and training on ADHD assessment is just not that good unless it's your specialty. Also, ADHD-NOS is ADHD, you count as having ADHD.
posted by brook horse at 12:57 PM on December 12, 2019 [20 favorites]
posted by brook horse at 12:57 PM on December 12, 2019 [20 favorites]
Best answer: I got diagnosed with ADHD in my 20s. When it was first brought up, I immediately said I couldn’t have it because I didn’t have the symptoms as a kid. I did well in school and wasn’t a ‘problem kid’ at all... but I was forgetting how, as a kid, I was constantly loosing everything, couldn’t keep papers organized (except sometimes, when they were obsessively organized!), had no sense of direction, and would struggle to get my homework or projects done until the very last minute. But they would always get done, often late at night, and I became a perfectionist.
If you look for descriptions of adult women who didn’t get diagnosed until adulthood, there is a lot of variation around school, etc. That caffeine statement is ridiculous. If it comes down to finding signs in your childhood, one of the things to look for, however, is how social pressure obscured your symptoms. Did you always worry about what your teachers were going to think and it gave you enough adrenaline to finish things and hand them in at the last minute? How did your parents/family life provide pressure for you to hide/push through your difficulties? (Personally, I think “I often got in trouble with teachers and didn't understand why” is loud and clear confirmation of some symptoms being present when you were young.)
How are you with crowds, loud noises, loud music? (Either love or hate are both common). Did you have trouble not interrupting people? Keeping track of time? Remembering how long it’s been since something has happened, remembering dates, numbers, names? Look back for anything that could have been a result of wanting either more or less stimulation (mental, physical, auditory, lights). Love or hate repetitive tasks? Did you have anything in particular you did when you were overwhelmed? (I had a habit or either giving up and lying on the floor our of exhaustion or hiding in the bathroom— often with a book!) Did you ever have problem where something wasn’t the way you needed to be and waves of emotion or overwhelm just broke out of you? On the other hand, in a dysfunctional family, maybe you became very strong and good at controlling that kind of thing. My fight or flight reflex enabled me to hide a lot, and I buried the knowledge of how hard everything was in order to keep up the ‘good kid’ facade and survive. Trauma can create immense ability to hide and ‘pass.’
Don’t let the social worker’s black and white statements make you feel you don’t deserve to say you have this issue if you think you have it. (If you message me I will happily provide moral support or a sounding board or links to read. Feel free. Really.)
posted by delezzo at 12:58 PM on December 12, 2019 [8 favorites]
If you look for descriptions of adult women who didn’t get diagnosed until adulthood, there is a lot of variation around school, etc. That caffeine statement is ridiculous. If it comes down to finding signs in your childhood, one of the things to look for, however, is how social pressure obscured your symptoms. Did you always worry about what your teachers were going to think and it gave you enough adrenaline to finish things and hand them in at the last minute? How did your parents/family life provide pressure for you to hide/push through your difficulties? (Personally, I think “I often got in trouble with teachers and didn't understand why” is loud and clear confirmation of some symptoms being present when you were young.)
How are you with crowds, loud noises, loud music? (Either love or hate are both common). Did you have trouble not interrupting people? Keeping track of time? Remembering how long it’s been since something has happened, remembering dates, numbers, names? Look back for anything that could have been a result of wanting either more or less stimulation (mental, physical, auditory, lights). Love or hate repetitive tasks? Did you have anything in particular you did when you were overwhelmed? (I had a habit or either giving up and lying on the floor our of exhaustion or hiding in the bathroom— often with a book!) Did you ever have problem where something wasn’t the way you needed to be and waves of emotion or overwhelm just broke out of you? On the other hand, in a dysfunctional family, maybe you became very strong and good at controlling that kind of thing. My fight or flight reflex enabled me to hide a lot, and I buried the knowledge of how hard everything was in order to keep up the ‘good kid’ facade and survive. Trauma can create immense ability to hide and ‘pass.’
Don’t let the social worker’s black and white statements make you feel you don’t deserve to say you have this issue if you think you have it. (If you message me I will happily provide moral support or a sounding board or links to read. Feel free. Really.)
posted by delezzo at 12:58 PM on December 12, 2019 [8 favorites]
Best answer:
I'd like to hear whether the black and white statements make sense to others, if it's possible I don't have ADHD because, well, I fucking love reading and didn't fail out of school
If the social worker said what she said, in the way you describe, then it sounds far too strident, and very black-and-white indeed. I'm not aware of any evidence that backs up such a strident attitude. If anything, the category of twice exceptional, which emerged in the 90s, recognizes that some folks have a highly contradictory set of strengths and weaknesses in academic/intellectual functioning. It's not at all unheard of for some students to have terrible organizational/academic skills and habits, but still do okay-to-great due to compensating with their strengths. At some point, the demands of the academic environment might exceed the ability to compensate--that can happen any time between late elementary up through college--and that's when such folks start considering the possibility of ADHD and/or a learning disorder. It happens that some people who would merit such diagnoses do not fail out of school, and even enjoy intellectual/academic activities.
can I ask my doctor for medication without looking like I'm drug seeking?
You can, because you're in on-going therapy and have gotten an evaluation (even if it's not one you feel great about) - this requires quite a commitment already, and would strongly suggest that you're not just in it to score some uppers quick-like.
I'm going to turn this around a bit, though, and suggest that an equally big concern would be a PCP who prescribes ADHD medication too loosely. With the exception of one or two kinds, these meds are all in the stimulant class (Adderall, in fact, is just straight-up amphetamine, i.e., speed), which means they are quite strong, and can produce serious side effects. For example, you mention having a history of anxiety - because these are stimulants, they are known to exacerbate anxiety/irritability/agitation, sometimes quite acutely. Going on such meds would ideally have you monitored through regular follow-ups with a qualified psychiatrist (i.e., not a pill-pusher but someone who takes an interest in you holistically). Finding such a psychiatrist is something you could ask your therapist to help you with - it is typically within the scope of practice for therapists to do this kind of referral/case-management work with their therapy clients, so maybe consider bringing this up as a request?
Should I get another opinion from another ADHD specialist?
I think this would be ideal, especially if you could undergo a psychological testing battery to get a clearer picture, seeing as all the other people who could report about your past are some combination of unavailable, unreliable, or (probably) uncooperative. ADHD is at least partially a rule-out diagnosis - because there are so many other diagnoses which produce overlapping symptoms, it is important to to gauge how all of that history (such as the trauma you allude to) fits together to produce your current patterns.
But I am mindful of your affordability constraints, and these assessments are not cheap when administered by a licensed psychologist; unfortunately, insurance (in the US) also doesn't tend to cover these, especially if you are not currently an enrolled student in some sort of program. However, depending on your location, you might be able to find a training clinic where you could be tested by a psychologist-in-training (who are all supervised by licensed psychologists), at far more affordable rates.
(My source for all the above is my own training and work as a clinical psychologist who sometimes does testing for ADHD and learning disorders).
It sucks to have to go through this, especially when you already know how much effort you've put into being well. I'm happy to answer any additional questions by MeMail. I wish you the best of luck going forward.
posted by obliterati at 1:08 PM on December 12, 2019 [3 favorites]
I'd like to hear whether the black and white statements make sense to others, if it's possible I don't have ADHD because, well, I fucking love reading and didn't fail out of school
If the social worker said what she said, in the way you describe, then it sounds far too strident, and very black-and-white indeed. I'm not aware of any evidence that backs up such a strident attitude. If anything, the category of twice exceptional, which emerged in the 90s, recognizes that some folks have a highly contradictory set of strengths and weaknesses in academic/intellectual functioning. It's not at all unheard of for some students to have terrible organizational/academic skills and habits, but still do okay-to-great due to compensating with their strengths. At some point, the demands of the academic environment might exceed the ability to compensate--that can happen any time between late elementary up through college--and that's when such folks start considering the possibility of ADHD and/or a learning disorder. It happens that some people who would merit such diagnoses do not fail out of school, and even enjoy intellectual/academic activities.
can I ask my doctor for medication without looking like I'm drug seeking?
You can, because you're in on-going therapy and have gotten an evaluation (even if it's not one you feel great about) - this requires quite a commitment already, and would strongly suggest that you're not just in it to score some uppers quick-like.
I'm going to turn this around a bit, though, and suggest that an equally big concern would be a PCP who prescribes ADHD medication too loosely. With the exception of one or two kinds, these meds are all in the stimulant class (Adderall, in fact, is just straight-up amphetamine, i.e., speed), which means they are quite strong, and can produce serious side effects. For example, you mention having a history of anxiety - because these are stimulants, they are known to exacerbate anxiety/irritability/agitation, sometimes quite acutely. Going on such meds would ideally have you monitored through regular follow-ups with a qualified psychiatrist (i.e., not a pill-pusher but someone who takes an interest in you holistically). Finding such a psychiatrist is something you could ask your therapist to help you with - it is typically within the scope of practice for therapists to do this kind of referral/case-management work with their therapy clients, so maybe consider bringing this up as a request?
Should I get another opinion from another ADHD specialist?
I think this would be ideal, especially if you could undergo a psychological testing battery to get a clearer picture, seeing as all the other people who could report about your past are some combination of unavailable, unreliable, or (probably) uncooperative. ADHD is at least partially a rule-out diagnosis - because there are so many other diagnoses which produce overlapping symptoms, it is important to to gauge how all of that history (such as the trauma you allude to) fits together to produce your current patterns.
But I am mindful of your affordability constraints, and these assessments are not cheap when administered by a licensed psychologist; unfortunately, insurance (in the US) also doesn't tend to cover these, especially if you are not currently an enrolled student in some sort of program. However, depending on your location, you might be able to find a training clinic where you could be tested by a psychologist-in-training (who are all supervised by licensed psychologists), at far more affordable rates.
(My source for all the above is my own training and work as a clinical psychologist who sometimes does testing for ADHD and learning disorders).
It sucks to have to go through this, especially when you already know how much effort you've put into being well. I'm happy to answer any additional questions by MeMail. I wish you the best of luck going forward.
posted by obliterati at 1:08 PM on December 12, 2019 [3 favorites]
I have been diagnosed with ADHD. I took the meds (Vyvanse) and they made me super tired, coffee makes me tired, etc. I kinda understand how my brain works a bit better now. I'm excited. I don't feel like a bad person for my inability to focus and my chewed up cuticles. For me, I just know that I'm a good person and can rest my busy mind in helping others. I hope that you find a place and or way to do the same. If you aren't getting the support that you want or need from ANYONE providing ANY healthcare to you, work with your community and find another option if possible. If not possible, speak frankly and candidly about how you feel. We are here if you need to talk again!!!
posted by lextex at 1:09 PM on December 12, 2019
posted by lextex at 1:09 PM on December 12, 2019
Best answer: I don't have new information to add, but I'll join the chorus of people who are frustrated with the blanket statements you were given.
I am a woman who received an adult diagnosis of ADHD, which fits my experiences and symptoms extremely well. I am also someone who has always loved to read, got good grades, and finds caffeine usually more stimulating than relaxing--and I have definitely benefitted from ADHD medication.
(Also, regarding hyperfocus: it is certainly something I have experienced and used well, but I can't control it, really. I heard someone say that the attention deficit in the name should be replaced with disregulation, i.e. the inability to control one's attention well, and that seems absolutely right to me. I pay intense attention to things, but they're often the wrong ones, according to society's dictates and my plans and intentions).
posted by Edna Million at 1:28 PM on December 12, 2019 [6 favorites]
I am a woman who received an adult diagnosis of ADHD, which fits my experiences and symptoms extremely well. I am also someone who has always loved to read, got good grades, and finds caffeine usually more stimulating than relaxing--and I have definitely benefitted from ADHD medication.
(Also, regarding hyperfocus: it is certainly something I have experienced and used well, but I can't control it, really. I heard someone say that the attention deficit in the name should be replaced with disregulation, i.e. the inability to control one's attention well, and that seems absolutely right to me. I pay intense attention to things, but they're often the wrong ones, according to society's dictates and my plans and intentions).
posted by Edna Million at 1:28 PM on December 12, 2019 [6 favorites]
Best answer: "People with ADHD don't get good grades unless they have a parent compensating for them or really enjoy learning."
Or they're pretty bright and skate through based on being able to remember things. I was diagnosed as an adult with ADD (probably inattentive or combination). I read a lot as a kid and got good grades. I think this appears differently in girls.
posted by bluedaisy at 1:55 PM on December 12, 2019 [11 favorites]
Or they're pretty bright and skate through based on being able to remember things. I was diagnosed as an adult with ADD (probably inattentive or combination). I read a lot as a kid and got good grades. I think this appears differently in girls.
posted by bluedaisy at 1:55 PM on December 12, 2019 [11 favorites]
Best answer: Hey roses, I went through something similar last year, and I really feel ya. In my case, my therapist diagnosed me with ADHD first. When I visited a psychiatrist, the person doing the initial interview was really dismissive because I was seeking help while I was in graduate school, and he assumed that I was confusing difficulty with graduate school with ADHD (despite the fact that I've struggled with attention and deadlines my whole life). I was shocked. In the end, they didn't diagnose me with ADHD. It felt to me like I could have "passed their test" if I had been "complained more" about my symptoms, and if my symptoms weren't masked by my achievements. It was hard to answer their questions well because I've spent my whole life trying to act like I'm fine! I felt like if instead of making me fill out a multiple-choice questionnaire, they had asked me to describe every time I've crashed and burned because I forgot basic things or couldn't meet a deadline, they would have judged differently. I was philosophical about it, but my therapist was actually pretty frustrated, and when I told her some of the things they had told me, she thought it wasn't backed up by the research.
I don't have advice about how to talk to your PCP, but I just want to encourage you - not all professionals agree. Some adopt a black-and-white mentality because of a system that is built to make a hard determination about who does or doesn't deserve medication, but it doesn't necessarily reflect reality. It definitely sounds like your social worker was blind to your actual symptoms due to stereotypes not backed up by science. Please don't let her statements make you feel undeserving of help and medication.
posted by a huckleberry at 1:58 PM on December 12, 2019 [1 favorite]
I don't have advice about how to talk to your PCP, but I just want to encourage you - not all professionals agree. Some adopt a black-and-white mentality because of a system that is built to make a hard determination about who does or doesn't deserve medication, but it doesn't necessarily reflect reality. It definitely sounds like your social worker was blind to your actual symptoms due to stereotypes not backed up by science. Please don't let her statements make you feel undeserving of help and medication.
posted by a huckleberry at 1:58 PM on December 12, 2019 [1 favorite]
Best answer: This social worker has a very poor understanding of ADHD and seems to have an even worse understanding of how to conduct an assessment! For the record, I am a formerly-licensed MSW who has diagnosed children with ADHD as well as worked with children with ADHD as a teacher and child care provider. There are very few absolutes with ADHD, just as there are very few absolutes with every cognitive difference/mental health condition. Diagnosis is based on meeting X of Y criteria, generally. I encourage you to look up the ADHD DSM criteria on your own—grades aren’t on there *anywhere*. I’m so sorry you had this experience.
posted by epj at 2:08 PM on December 12, 2019 [2 favorites]
posted by epj at 2:08 PM on December 12, 2019 [2 favorites]
I had the same experience, especially where "you did fine in school" turns into, on exploration--well, you always did your homework late the night before, and never EVER did any of the reading, and often spaced out in class, but just tended to absorb information like a sponge and were able to regurgitate it even without paying attention.
My son is now having the same experience and I have to look into how to get him help for how to learn these things when the whole system is set up to help kids whose behaviors are causing problems for others. He will zone out in class; given 20 minutes to work, he'll do the whole worksheet in the last five minutes, and what he produces is fine, he clearly learned the material, but he's not learning to put in effort, to revise, to think things further through. In middle school he'll need those skills, and I'm no use at all.
So yeah, that person was pretty much just wrong. I will say, I've been pursuing non-med treatment/support without the official diagnosis. I have executive function problems and anxiety that goes with it; if I don't want meds (and the ones I've tried make me feel CAFFIENATED in a bad way), I have decided I don't need the official label, since it won't change the treatment. I may change my mind in the future.
posted by gideonfrog at 2:46 PM on December 12, 2019 [5 favorites]
My son is now having the same experience and I have to look into how to get him help for how to learn these things when the whole system is set up to help kids whose behaviors are causing problems for others. He will zone out in class; given 20 minutes to work, he'll do the whole worksheet in the last five minutes, and what he produces is fine, he clearly learned the material, but he's not learning to put in effort, to revise, to think things further through. In middle school he'll need those skills, and I'm no use at all.
So yeah, that person was pretty much just wrong. I will say, I've been pursuing non-med treatment/support without the official diagnosis. I have executive function problems and anxiety that goes with it; if I don't want meds (and the ones I've tried make me feel CAFFIENATED in a bad way), I have decided I don't need the official label, since it won't change the treatment. I may change my mind in the future.
posted by gideonfrog at 2:46 PM on December 12, 2019 [5 favorites]
Best answer: I’m a textbook ADHDer (hyperactive type) who was diagnosed very young - and I am absolutely horrified that your health care provider thinks *reading for fun* is a valid diagnostic criteria. I have heard about other ADHD people coming across other providers with this ridiculous idea. I do not know where they are getting this extremely bad information from, but it is sadly not unheard of.
I was an absolutely voracious and early reader, the type that plowed through multiple books a day from preschool onwards, and no health care provider (and I’ve seen lots) has ever, ever questioned my ADHD diagnosis. I also got great grades in subjects I cared about.
This health care provider absolutely sucks, does not appear to know what they are talking about, and you should go elsewhere if humanly possible.
posted by faineg at 3:21 PM on December 12, 2019 [1 favorite]
I was an absolutely voracious and early reader, the type that plowed through multiple books a day from preschool onwards, and no health care provider (and I’ve seen lots) has ever, ever questioned my ADHD diagnosis. I also got great grades in subjects I cared about.
This health care provider absolutely sucks, does not appear to know what they are talking about, and you should go elsewhere if humanly possible.
posted by faineg at 3:21 PM on December 12, 2019 [1 favorite]
Best answer: The Tumblr suggestion for discussing symptoms and diagnoses: Always use your worst days as your baseline for answering questions. Describe how you feel/think/operate when you're barely able to cope, not how things work on the days when you've managed to pass for fully healthy.
posted by ErisLordFreedom at 4:31 PM on December 12, 2019 [3 favorites]
posted by ErisLordFreedom at 4:31 PM on December 12, 2019 [3 favorites]
Best answer: Nthing the complete disagreement with the LICSW's black/white statements about what ADHD people are and are not capable of doing. I also fucking love reading and didn't fail out of school, plus I had childhood trauma in the 6-10 age range. But... I only graduated high school with a 1.7 cumulative GPA (I just didn't bother doing the work in classes that didn't interest me, and excelled in the classes that did interest me -- classic hyperfocus), and for most of my adult life I was barely holding my shit together -- TERRIBLE with financial issues because I could never remember to pay my bills on time, always fucking things up at my job, apartment was always a mess, et cetera et cetera. Diagnosed as an adult (about 8 years ago, while working an extremely demanding job that did not utilize any of my natural skills and destroyed what was left of my self-esteem), tried some meds, eventually changed jobs to a role that suits my brain's natural functionality much much better, learned some life management skills that help me cope without meds (I don't like the physical side effects), really took my time and got my shit together in a holistic way, and decided I was finally ready to try college in my late 30's (on track to graduate cum laude in spring 2020, a powerful self-esteem booster after that 1.7 high school GPA). Took a course last year called The Creative Advantage, meant to teach creative problem-solving, and surprise surprise, many of the creative thinking concepts and processes taught in that class mimic the way my big ol' ADHD brain works naturally. The ping-ponging that my thoughts do naturally is apparently an incredibly valuable idea-generating and problem-solving tool. NO WONDER so many of us ADHD folks go undiagnosed for so long, if the diagnostic model your social worker is using is one that still gets a lot of traction in the field. People underestimate us.
I agree with whoever said upthread that you can ask your PCP about meds without worrying that you'll be perceived as drug-seeking, and with whoever said that not all professionals agree. I would definitely recommend talking to your PCP and your therapist about what some second-opinion options would look like and how that would work with your insurance coverage, at the very least so that you know what your current options are and can make informed choices.
posted by palomar at 5:45 PM on December 12, 2019
I agree with whoever said upthread that you can ask your PCP about meds without worrying that you'll be perceived as drug-seeking, and with whoever said that not all professionals agree. I would definitely recommend talking to your PCP and your therapist about what some second-opinion options would look like and how that would work with your insurance coverage, at the very least so that you know what your current options are and can make informed choices.
posted by palomar at 5:45 PM on December 12, 2019
Best answer: Her statements are weird, and do not match up with my experience at all. (I was given the ADHD-Primarily Inattentive Type diagnosis in my 40s. While I've never had a cup of coffee, caffeinated tea or soda too late in the day gives me trouble at bedtime. At the age of 12, I was a voracious reader and my grammar school's valedictorian. I was an honor-roll student more often than not in later years, in some fairly competitive programs and schools.)
This social worker has picked the wrong specialty. Please speak with your doctor about trialing meds.
posted by Iris Gambol at 6:08 PM on December 12, 2019 [1 favorite]
This social worker has picked the wrong specialty. Please speak with your doctor about trialing meds.
posted by Iris Gambol at 6:08 PM on December 12, 2019 [1 favorite]
Best answer: They fed you a fuckton of nonsense and I'm really mad about it. GOD. I always advise people here to only see a neurologist for an adult ADD/ADHD diagnosis for exactly this reason.
group therapy? for adult adhd? aaaaaaaaaa
posted by poffin boffin at 7:44 PM on December 12, 2019 [3 favorites]
group therapy? for adult adhd? aaaaaaaaaa
posted by poffin boffin at 7:44 PM on December 12, 2019 [3 favorites]
Response by poster: I can’t even articulate what a wonderful bunch of people you are to have given me reassuring, informative, and compassionate answers here. Best of the web indeed <3
I scheduled an appointment next week with my PCP to start a conversation about possibly doing a trial of meds to see if they help and will ask my therapist for some recommendations for someone qualified to help me manage those meds if I go that route.
Again, thank you to everyone. I feel a lot less frustrated and confused, but also, now I feel like it’s okay to admit that I’m also really pissed off. This process is hard and expensive enough without a shitty provider.
posted by the thorn bushes have roses at 8:37 PM on December 12, 2019 [5 favorites]
I scheduled an appointment next week with my PCP to start a conversation about possibly doing a trial of meds to see if they help and will ask my therapist for some recommendations for someone qualified to help me manage those meds if I go that route.
Again, thank you to everyone. I feel a lot less frustrated and confused, but also, now I feel like it’s okay to admit that I’m also really pissed off. This process is hard and expensive enough without a shitty provider.
posted by the thorn bushes have roses at 8:37 PM on December 12, 2019 [5 favorites]
Best answer: Her statement on that was straight up: "people with ADHD don't like to read and can't do so for longer periods" I pushed back on this and asked about hyperfocus and she simply restated it.
Bullshit. I got diagnosed at 41; I was a good student, a passionate reader (still am) and your social worker (I’m one of those too) doesn’t know what she’s talking about.
It’s quite possible to pass as “normal” for a long time and then reach a point when your ability to cope gets exceeded as an adult.
Medication may or may not help you, but it is worth trying. Just know that even with medication that is effective there are new strategies and approaches that need to be learned.
Best of luck.
posted by nubs at 9:33 PM on December 12, 2019 [2 favorites]
Bullshit. I got diagnosed at 41; I was a good student, a passionate reader (still am) and your social worker (I’m one of those too) doesn’t know what she’s talking about.
It’s quite possible to pass as “normal” for a long time and then reach a point when your ability to cope gets exceeded as an adult.
Medication may or may not help you, but it is worth trying. Just know that even with medication that is effective there are new strategies and approaches that need to be learned.
Best of luck.
posted by nubs at 9:33 PM on December 12, 2019 [2 favorites]
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