Is it possible I have ADHD?
November 3, 2021 1:01 PM   Subscribe

I live in the U.K, where it is hard to get an ADHD diagnosis as an adult. I have suffered from "depression" and "social anxiety" for over a decade and been on SSRIs for them for a considerable amount of time, I came off them a year ago. I put those terms in quotation marks as I consider them symptoms of a traumatic upbringing and not purely illnesses in their own right; in fact it makes me angry when they are treated that way. Anyway getting back on track, I spoke to my GP they said it's just depression and suggested going back on SSRIs which I don't want to do as I feel they made me extremely lethargic and unmotivated. I don't want a diagnosis but I would appreciate some thoughts around whether you think I might exhibit ADHD symptoms. I am currently too poor to go private, it costs over £1000 to get assessed privately in the U.K unless anyone knows anywhere else I can go cheaper?

The following are what I experience; I am currently unable to distinguish whether it's just because I'm depressed, have some form of CPTSD, simply very anxious or I have ADHD. All of the below points are of course interlinked in many ways. Can anyone relate at all?

- difficulty planning for the future. I struggle to plan ahead beyond what my next meal might be. I recently moved and found it overwhelming to deal with logistically. Whenever I try to think of the future it's like my mind gets filled with a resistant foggy greyness; it feels near impossible to think with any clarity about the next day let alone the next week or year. I should add I did live in an abusive home until I was 28 and was extremely passive, so I never developed adult life skills which is feeding into this I think.

- difficulty organising my day in general. I find myself procrastinating immensely and it's no exaggeration that most of the past decade (I'm 32), has been lost to procrastination; watching stuff on YouTube, repetitively listening to and watching the same things over and over, endlessly researching depression, CPTSD and social anxiety, ruminating about the past and about my failings and low self worth.

- Even in situations where it really matters I find I cannot follow through. At work it gets to the point where I lie about having completed something and then do it at the very last minute. This is my modus operandi, I'm never proactive in any area of my life. I have got fired from a previous job for poor performance. I feel utterly apathetic and like none of it matters. I have not progressed in my career in a decade.

- Extremely painful and near constant repetitive and unproductive rumination every moment of every day about the past. All the things that went wrong and all the big mistakes I have made. Constant mental comparisons with boyfriends' exes. Find myself unable to speak in groups in social situations and burning shame and cruel self analysis after every interaction.

- Getting excited by new hobbies, buying the equipment and then not having the energy or discipline to consistently follow through. I have done this with painting, drawing, knitting, dancing and rollerskating; I also bought a digital piano at 19 and never once touched it.

- Spending addiction. Buying clothes, perfumes, beauty products nearly every day to soothe emotional dysregulation. Have been in my overdraft for a decade and borrowed money to pay off CC debt. Constantly telling myself I'll get on top of it but never have.

- Cluttered room to the point of possibly being a bit of a hoarder.

- Poor impulse control in general. Stuff myself with unhealthy food, know I need to do exercise but never do it; I'm not overweight though by any means. I always have to be forced to do things that are good for me. Always want to go down the easiest, quickest route. Have been accused of being lazy throughout my childhood

- Spaced out during conversations, feel dissociated and disconnected from my body and emotions. When I was younger, it was even worse and my sisters would get annoyed and click their fingers in my face to get my attention when they were talking cos they would see my eyes had glazed over. One sister even started barking like a dog (lol!) and another one would always say "what did I just say?". I got worried to the point I asked them to always ask me to repeat back what they had just said to them.

- Extremely internally focused to the point that I never notice things or people around me. My focus is entirely organised and preoccupied with and around my emotions and feelings. Someone could probably get run over by a car in front of me and I would barely notice sometimes. This has been pointed out to me since I was young when I was labelled the "slow, lazy one", though on the other hand I was praised for being extremely academically able.

- So overwhelmed by own despair and ruminations that I can't process how others are feeling or what they are thinking - poor "mentalisation". Extremely self absorbed. I attend group therapy and feel guilty about how little I care about the others when they are so kind, thoughtful and generous in their attention to me; I find myself unable to repay the favour.

- Academically gifted, effortlessly until 17/18 when the work got harder and I couldn't buckle down and focus and study. Also I got very depressed and terribly socially anxious at this time; hard to parse out what happened during this period and it haunts me (see point above about endless rumination- this period of my life is the biggest wound I pick over). Used to be able to focus and read like 5 books a week but attention span has gone to shit.
posted by Sunflower88 to Health & Fitness (24 answers total) 11 users marked this as a favorite
I’m just writing to say that a UK friend was able to finally get an ADHD diagnosis through the NHS after years of trying, most recently 1.5 years for the official appointment (that then lasted minutes but was very validating.) I’m so sorry that you’re not feeling heard & supported but I believe you and hope you can eventually get more of the support you deserve.
posted by smorgasbord at 1:24 PM on November 3, 2021

I have ADHD and can identify with the overwhelming majority of what you wrote. Right down to the 5 books a week in my youth. That is hyper-focus BTW and is very much an ADHD thing.

I lurked & I see that you are female (me too). Unfortunately many professionals are woefully clueless about women & ADHD. This means you are going to have to fight extra-hard to get a proper diagnosis.

You deserve medical treatment, period. Read as much as you can about ADHD in women in the meantime. Join a Facebook group I like this group and browse

Trust your gut! I believe you and wish you much hope & warrior strength.
posted by i_mean_come_on_now at 1:39 PM on November 3, 2021 [5 favorites]

Here is an adult ADHD self-report screening questionnaire which might be useful, and which you could also show to your GP.
posted by heatherlogan at 1:42 PM on November 3, 2021 [1 favorite]

just depression is a serious illness with a range of symptoms, both physical and psychological. A lot of people are greatly helped by SSRIs and other meds. If the medications weren't worth side effects, other meds can be tried. Many illnesses are treated with low-to medium dose anti-depressants. A health care provider how characterizes you misery and difficulty as just depression is doing you a great disservice.

I have ADHD, diagnosed as an adult, can't take meds. I use coffee as a mild medication with some good effect.

Women tend to get less care, have illness brushed off as just depression, and it's a major problem/ barrier to effective treatment.

Persist, advocate for yourself. Do as much self care as you can; there are good books and websites.
posted by theora55 at 1:48 PM on November 3, 2021 [3 favorites]

What you have described sounds a lot more like standard depression/anxiety or autism spectrum to me.

I have been diagnosed with adult ADHD. For what it's worth, your symptoms don't line up with my expectations of ADHD.

The main ones for me:

1. Executive dysfunction - your mind screaming at yourself to start a project, but you literally can't move your arms to do it.
2. Very distracted by things like thirsty/temperature/comfort/hunger
3. Generally really active in conversations, but bad at sitting through lectures/meetings. Tendency to fiddle with things.
4. Can hyper focus and get into flow states, but it's rare and difficult and usually something you want to do, not something you are avoiding.

With that said, ADHD medication could still help you. I've felt like the thing the medication is closest to being similar to is caffeine. Strong caffeine without the jitters.

I greatly recommend these two blog posts about ADHD medication:
posted by bbqturtle at 1:52 PM on November 3, 2021 [5 favorites]

FWIW there are so, so many ADHD clinics in the UK and you can certainly get an assessment for much less than £1K. This psychiatrist is £350. The wait list is 14 months (so presumably you could pay over time prior to the appointment, maybe?) But there are absolute loads if you go outside of London where yes, it is very expensive.
posted by DarlingBri at 2:03 PM on November 3, 2021

I do not have ADHD; I do have lifelong depression and anxiety, and more recently, PTSD. Most of what you describe lines up fairly closely with my personal experience except for the internal focus and poor mentalisation. Which isn't to say you don't have ADHD! Just to suggest that you may need to do some more reading/research to help pin down a little further e.g. what differentiates depression lack of follow-through from ADHD lack of follow-through, if you want to make a convincing case to your GP and/or other specialists.

I'm sorry you're having trouble getting taken seriously. Even if you do have depression, being blown off with "take meds you already know don't work well for you" is a not-great response when there are other medication and non-medication avenues to pursue. You deserve to be taken seriously and I hope you're able to find a professional who will do that.
posted by Stacey at 2:41 PM on November 3, 2021 [1 favorite]

I was diagnosed on the NHS last year and would suggest going back to your GP and pushing further for referral. You may be able to look at local clinics and discuss with them whether your GP would refer you to them - this may depend on individual commissioning arrangements, but it might help to be clear with your GP that you know what the pathway for referral is. I think it can also help to make it clear to your GP (if that's the case) that these difficulties go back to childhood. The psychiatrist to whom I was referred said that diagnosis in adults depends on evidence of the same problems in childhood (I had to show them school reports). Sorry, I'm not answering your actual question, and I know putting pressure on GPs is hard. You are welcome to MeMail me if you would like to know more about the process of diagnosis as I experienced it.
posted by paduasoy at 2:44 PM on November 3, 2021

A lot of these sound like symptoms of your trauma to me more than ADHD. It sounds like you're dissociating, for example. I suggest reading up on (C)PTSD symptoms and looking for trauma-informed therapy, possibly including EMDR. You will probably have to do some self-advocacy and/or self-pay to get it, unfortunately.
posted by momus_window at 2:50 PM on November 3, 2021 [6 favorites]

Sorry, need to come back and read all the details and provide links, but if in England you can get assessed by ADHD360 under the NHS in a few months for free under Right to Choose legislation/guidelines.
posted by lokta at 3:40 PM on November 3, 2021 [3 favorites]

Recently diagnosed with ADHD myself in the UK (though in Scotland, where there's no Right To Choose legislation). Just wanted to add that a great deal of what you described resonated with me, including the mis-diagnosis of depression. I hope you manage to get this clarified and get the help you need.
posted by Chairboy at 4:52 PM on November 3, 2021 [1 favorite]

When I was diagnosed with ADHD as an adult at 34, it was on the strength of a few clusters of symptoms (a) having been present since childhood and (b) causing a significant negative impact on my life currently.

I don't recall all the symptom clusters now, but these are most of them:

- my papers & closets & appointment calendars are disorganized
- inability to do tasks which cannot be completed in one big whoop i.e. lack of persistence, giving up easily
- time-blindness i.e. inability to estimate how long tasks or commutes will take to accomplish, and an inability to plan my schedule realistically
- inability to break large tasks down into smaller steps, like, I only see the big picture as an unbreakable whole
- excessive daydreaming, doodling, scrolling on my phone, etc. as self-stimulation/dopamine seeking behavior to cope with constant boredom
- excessive sleepiness in the absence of my usual coping mechanisms
- family history of ADHD diagnoses

The specialist who diagnosed me really underlined the importance of the symptoms (a) having been present since childhood and (b) causing a significant negative impact on my life currently. Unless a symptom met both these criteria, it was not used as a basis for the diagnosis.

Some of my other symptoms like task avoidance, feeling like a failure, excessive self-blame, feelings of hopelessness, etc. had other causes (depression, anxiety) and/or they were the direct result of having ADHD (turns out that failing at a bunch of things due to lack of persistence and lack of organization makes a person feel like a failure?). But addressing ADHD did not fix any of *these* issues. I needed therapy and other meds to fix all this.
posted by MiraK at 8:11 PM on November 3, 2021 [8 favorites]

Honestly does sound like your doctor is right. Major depressive disorder and social anxiety (maybe generalized anxiety disorder). With those, future planning is definitely compromised, there’s foggy thinking and a vegetative tendency, as well as intense rumination (which is present in both depression and anxiety). Look up the DSM criteria and see for yourself.

As far as SSRIs, am not in a position to say anything. I took Paxil for MDD and GAD. It helped but came with side effects I hated. Took me a full year to get off it with massive discontinuation effects, I was furious. That said, I no longer ruminate and wasn’t surprised to read one study that found that years after taking Paxil, people were more extroverted, agreeable, etc. The serotonin hypothesis is being challenged lately, although at least some SSRIs are thought to work (for those for whom they do) via different mechanisms. Psych drugs are unfortunately a game of roulette. Something might work. (I think Paxil isn’t prescribed as much these days, for the record.)

Some kind of psych help seems necessary. Also consider moving to another town. Sometimes your crap follows you, sometimes new places and people offer new possibilities for self expression and exploration, because you’re out of feedback loops between expectancies, responses, and behaviour that reinforce beliefs about poor self worth. You get a chance at a new role.

However with intense rumination and little support, that might not work as well… if you can get a referral to a psychiatrist in the NHS for a more careful discussion around meds, and maybe a referral to therapy, that would be good. Even if it takes a while, get the ball rolling.
posted by cotton dress sock at 8:20 PM on November 3, 2021

I hope additional people with trauma expertise can comment, but the fact that you've lived in an abusive situation until quite recently -- 7/8 of your life and 100% of your childhood -- seems huge to me. That will do a real number on you and several of your experiences I've heard from people with CPTSD following abusive upbringing. Which is not to say you can't have executive function stuff, any blend of ADHD and autism, too.

You deserve happiness and better mental health care and I'm sorry we don't all do better by you.
posted by away for regrooving at 10:47 PM on November 3, 2021 [1 favorite]

How untreated ADHD causes and traps you in Depression (one person's experience).
posted by oceano at 12:14 AM on November 4, 2021

The problem you have is that a lot of your symptoms match the symptoms of depression, as well as PTSD and Anxiety. That's not to say that you don't have ADHD, just that GPs are - from personal experience - woefully underqualified to diagnose mental health issues, and if you match depression then they're going to treat you with antidepressants, in part because antidepressants help a whole slew of mental health conditions that present similarly/have similar symptoms to depression.

As others have said, you will need to push for a referral to your community mental health team to arrange a diagnosis from a mental health clinician. If your doctor is not receptive then ask to see a different one, or even change surgeries if necessary. But keep pushing because you WILL get a referral eventually.

I hope you have a friend or a family member who can advocate for you, as this will definitely help. The very symptoms of your illness can make it difficult to explain what's going on, or even summon up the strength to call the doctor in the first place. And then when it feels like they're not listening it can be frustrating and you say things you wish you hadn't and all told you don't end up with an ally for a doctor, you end up feeling like they've brushed you off and you feel even more shit than when you started and why the FUCK should I ever call that surgery again and ohmygod I'm such a screwup and..... [complete crash and burn that just proves what a loser I am]

An advocate will go a long way to stopping that cycle because rightly or wrongly the doctor will listen to the calm not-crazy person more than the patient they're advocating for. GPs are traditionally problem solvers, and they often see patients as problems to solve. But even though listening skills are one of the the best tools to start helping ("solving") a patient, many GPs lack listening skills. People with complex mental health problems are often unable to articulate in rational, logical terms exactly what's wrong, whereas doctors commonly use logic trees to get to a diagnosis. So you're speaking different languages and the end result is unlikely to be optimal.

Try to find someone who can articulate on your behalf what you want and why you want it, and you may find that this gets you further than asking on your own behalf. This is a situation where - sadly - you have to play the ball as it lies, not as we'd like it to lie.

Good luck with this, I really hope you can get a more complete diagnosis.
posted by underclocked at 12:31 AM on November 4, 2021 [1 favorite]

I am in the UK. I was diagnosed (through the NHS) with ADHD-I in my early twenties, after dropping out of university. I have also struggled with depression, and was briefly medicated with SSRIs at around the same time. Many of the things you describe closely match experiences that I had that I now understand were linked to my ADHD:

- difficulty planning for the future

I didn't have any kind of life plan in place at any point - I more or less just followed what I thought everyone else wanted me to do, and when I dropped out of university I felt like I'd gone off the rails and I was completely directionless. I still don't really have a "life plan" but I do feel a lot better about it.

- difficulty organising my day in general

If I'm not in control of the things I have to do and the way I can structure my day, I still badly struggle with procrastination.

- Even in situations where it really matters I find I cannot follow through

For me, I would say this is the same procrastination issue - some kinds of task really set me off like this, and some don't. I've had jobs that I really, really couldn't do, and jobs that I was great at, and I'm now much better than I used to be at telling in advance what will be an issue.

- Getting excited by new hobbies, buying the equipment and then not having the energy or discipline to consistently follow through

Oh boy. Would you like to see my juggling clubs?

- Spending addiction/- Poor impulse control in general

Not to the extent you describe, but I definitely make and have made poor purchasing decisions, and my impulse control is pretty terrible overall.

- Cluttered room to the point of possibly being a bit of a hoarder

When I moved out of my previous house, I discovered a four-year-old cheque from my uncle for a significant amount that I had never deposited, in a pile of papers. I threw basically nothing away in the move, and later had a variety of highly emotional arguments with my partner over dealing with the piles of my stuff in boxes in our new place that I still hadn't unpacked.

- Spaced out during conversations, feel dissociated and disconnected from my body and emotions

I don't run into this often in direct conversation, but I do still space out and have to ask people to repeat themselves occasionally. It happens a lot in meetings, when I'm not being directly engaged with - in order to not completely lose the plot, I have to always be actively taking notes.

- Academically gifted, effortlessly until 17/18 when the work got harder and I couldn't buckle down and focus and study

This is a common story among individuals with ADHD who aren't diagnosed as children - if you're not struggling in exams until later, it's very frequently framed as a personal motivation/attitude issue. I had report after report at school that said "must try harder", but the actual ramifications of those reports only started to become apparent in sixth form, and didn't really negatively affect me until university. As a result of feedback from adults like this in childhood, I internalised a lot of this kind of criticism, and it took me a long time to learn that I'm not really lazy.

All this is to say that although it may not be the only thing going on, I do think it's possible you have ADHD, and it's worth continuing to try to get a diagnosis. Don't be discouraged if you don't feel like you're making progress with your GP. As recently as this weekend I discovered that something I've been worried about and bringing up to my GPs for a few years has a clear, common and easily verified cause that nobody has ever mentioned to me before. Doctors are experts, and they want you to get better, but no GP has enough time and breadth of experience to correctly diagnose and treat any patient in one (or even ten) sessions. You're not being silly; you're not bothering anyone; being diagnosed is worthwhile, and has immeasurably improved my life, even though I still struggle with things. Keep trying, and please feel free to memail me if you want to talk about anything.
posted by spielzebub at 5:51 AM on November 4, 2021 [3 favorites]

I'm chiming in as a woman with diagnosed ADHD, who's talked with friends who thought they have the condition because of what they considered to be focus issues. I'm in agreement with those who suspect that even if you have a comorbidity with ADHD, the other aspects of your trauma seems to be more urgent for treatment than ADHD (which one is more urgent vary individually -- there are those where treating the ADHD creates the positive cascade for the other conditions to improve, but in your case i think it would be the opposite). The dopamine-seeking and motivation-shortage problems can be ADHD, but they're also known symptoms for depression. Considering the description of your trauma, I think it's worth pushing through with exploring alternative meds and therapies to the regime you just left, as priority while you seek more affordable ADHD diagnostics.
posted by cendawanita at 5:57 AM on November 4, 2021

Like others, I don't think it's possible to tell whether you have ADHD, depression or other possible diagnoses from your descriptions of your symptoms. On top of that, you might have more than one thing going on, and then it would be hard for us to be able to suggest which one you should focus on initially.

In general, ADHD is usually a lifelong condition that was present when you were a child. I am currently wondering whether or not I have ADHD and one of the reasons for that is reflecting on difficulties that I have currently (that might relate to ADHD) that are essentially the same as ones that I had as a child.

In your case, I wondered whether it would be helpful for you to speak to a counsellor or therapist. A few people I know have had depression linked to something else (ADHD, ASD,...). Working with a therapist enabled them to have more insight into themselves and get support to pursue diagnoses. In each of those cases, establishing that there was something else going on as well enabled them to get more effective treatment for their depression. Other people I know with mixed anxiety and depression have needed to tackle both at the same time, with a combination of therapy and medication. They have tried several different medication strategies in order to find something effective, and their therapist has been very helpful with that as well as CBT (which is very effective for their particular kind of anxiety).

If you are in employment, you may be able to access short-term counselling anonymously through your employer's EAP. Alternatively, you could ask your GP to put you on an NHS waiting list for therapy, or you could source a private provider (perhaps with sliding scale fees if cost is an issue).
posted by plonkee at 7:59 AM on November 4, 2021

My advice, a stranger on the internet: as a first step/stopgap solution, get a prescription for Bupropion (Wellbutrin) from your GP. You've already got a depression diagnosis, I'm betting it will be much easier to get a 'script for that than the usual ADHD drugs. Wellbutrin works differently than the SSRIs (which were always hot garbage for me, for exactly the reasons you mentioned), and has shown a lot of efficacy in the areas of focus & activation. I find the side effects to be pretty minimal. Takes about a month to kick in. Once you've got that going, you can continue to pursue a formal ADHD dx, if desired. Good luck!
posted by Bron at 8:16 AM on November 4, 2021 [6 favorites]

IANAD, just a woman with an ADHD diagnosis and past depression/anxiety diagnoses chiming in to say that yeah, situational depression/anxiety is commonly comorbid with undiagnosed ADHD in adults for reasons. I was on Bupropion as well for a long time, and it worked pretty well for depression, not so hot for anxiety, won't totally solve the focus and initiation issues but it will make them a bit easier. If your current SSRI is giving you low-energy problems, it's worth switching. Then in a few months (6 or so) you can come back to your GP and say "so the bupropion has improved my mood and depression in x, y, and z ways, but I still feel like I have the same issues with distraction and organization that I've had since childhood, how 'bout that ADHD assessment?" Since the NHS seems to be grindingly slow as a matter of common knowledge, you could even insist that your GP put the request for an ADHD assessment in now, and plan to check in a month beforehand to see if everything has been magically resolved by the new antidepressant, in which case they can just cancel the request.

Having non-neurotypical friends or activity partners who are willing to do a task trade with you will help - I'm the friend who will happily fill out those boring stupid forms for someone if they'll make a scary dentist appointment over the phone for me, or write out a script for starting a hard conversation.
posted by All hands bury the dead at 12:42 PM on November 4, 2021 [1 favorite]

Sorry, I noticed in your question you said you're not on an SSRI, so it wouldn't be a matter of switching, but if your GP is eager to prescribe you something and SSRIs make you lethargic, it should be easy to convince them an NDRI is worth trying.
posted by All hands bury the dead at 12:49 PM on November 4, 2021 [1 favorite]

Best answer: Just a datapoint probably - I'm a mental health professional (not your mental health professional) and if you presented with these symptoms and asked if you had ADHD, I'd be hard pressed to say "definitely not". You know already that you've got some trauma history, which can impact you in all sorts of different ways. I know, though, that it's not uncommon for people with ADHD to develop depressive symptoms as a consequence, and when we're feeling low our brains are oh so good at throwing up "here's one more thing you feel crap about". I'm with All Hands Bury The Dead 's response, hassle your GP so you can get on the waiting list for assessment ASAP, and I'm presuming the specialist will contact you to schedule when your number comes up - if you don't need the appointment you can say so then.

Another datapoint - I was recently diagnosed with ADHD (primarily inattentive) and I resonated with 6 of your 11 points, and recognise another 3 as things that other ADHDers commonly report. None of us can diagnose you over the internet, but I think it's definitely a sensible question to be asking of those who are in a position to help you understand your experience.
posted by Cheese Monster at 11:23 PM on November 4, 2021 [1 favorite]

Response by poster: Thanks all, really appreciate your thoughts. I have asked my GP to refer me for an assessment and will pursue other medications (not SSRIs). If the waiting list is too long or they refuse me I am going to consider saving up and going private. I am currently in group therapy which I am finding useful, I am also exercising regularly and write a to do list every day to attempt to keep me on track.

I understand and appreciate that a lot of my symptoms are likely to be primarily a result of childhood trauma. However, I think I need a quicker fix than 10 years of therapy. I need something which will help me get out of a rut, function more effectively in order to start seriously addressing the childhood trauma.
posted by Sunflower88 at 2:28 AM on November 5, 2021

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