To wonder if I actually have ADHD after all?

[FlipsFlops]

I was diagnosed with ADHD last year at a private clinic after getting nowhere with the NHS. I did a fair bit of research and went to a named psychiatrist who specialises in treating ADHD and went in with an open mind not necessarily expecting a diagnosis.

Somewhat to my surprise I was diagnosed very quickly (I'd filled in lots of very lengthy forms before my assessment and off the back of that was told I was a clear cut case), and strongly encouraged to try medication (I haven't yet).

It's taken a bit of courage to tell family and friends - some have been supportive, some a bit sceptical ("but you seem completely normal?" "yeah I've seen all those TikTok videos too").

I still struggle a bit accepting the diagnosis and am prone to beating myself up about it (it's not ADHD, I'm just lazy, don't try hard enough, etc...).

Then I've seen this BBC news report today about the "ADHD private diagnosis scandal" suggesting people are being diagnosed by private clinics who don't actually have ADHD.

ADHD: Private clinics exposed by BBC undercover investigation - BBC News

Have I just been taken in by all the TikTok nonsense (even though I don't use TikTok) and exploited by an industry trying to sell me expensive drugs?

Or do I have a genuine neurological condition that's being called into question by journalists looking to turn everything into a some kind of scandal?

I don't honestly know what to think any more.

Absolutely. The people here saying NHS thresholds are higher than private are affirming the view that private diagnoses aren't as legitimate.

The DSM-V criteria for Adult ADHD is clear and should be the diagnostic threshold for every assessment.

But that doesn't seem to be happening, hence why after years of whistle-blowing and complaints, Panorama have investigated and confirmed that sometimes, corrupt Psychiatrists are enabling 'bought' diagnoses.

@weareallout - she did, yes. Like your dd it all started to go downhill when she started secondary school, (not helped by the pandemic, as she finished yr6 and started yr7 in 2020, amidst all the turmoil). She was always a disorganised, fidgety and easily distracted child, but she loved primary school and found it extremely easy, so basically breezed through it. As soon as the schoolwork stepped up a gear, the wheels started to come off. It was also around this time she started maladaptive daydreaming, which is an adhd trait. She would do it for hours whilst bouncing on her trampoline, almost as if she was in a trance.

@Leftoverssandwich

My follow-up care has been appalling. My GP was able to prescribe under shared-care and I had an review with the Mental Health Trust for 2 years following diagnosis. During my 3rd year I stopped taking the Concerta and contacted the person who diagnosed me but they had moved on. I was given a name to contact but didn't get round to it - then Covid came along - and it was easy to get by unmedicated during those two years. And I have still done nothing about following up as I've been more focused on dealing with perimenopause. I would like to try Amoxetine but I don;t know how to make that happen.

@Soontobe60
Someone with ADHD can often hyperfocus to the point of obsession. I failed all my A level mocks but was so desperate to leave home (uni) I managed to revise solidly for a month.
I missed a 1st my my degree however as I couldn't motivate to do the one module I found boring. In school I never shut up, shouted out, never sat still, was late for lessons, did homework on the bus but excelled at sport.

I really sympathise. I'm in a so-far year long wait just to access an NHS clinic for medication, with no end in sight. Can you try contacting the name you've been given to see whether they can offer any advice?

All I can suggest is check that the private provider follows the same criteria as NHS and that you are referred to NHS first so that the report can be ratified.

We chose a private provider who the NHS outsource work to so knew we’d be ok.

Can’t help but think this documentary is going to be harmful to those with ADHD; either they won’t seek assessment or everyone will start to doubt them when they’ve received a diagnosis and withdraw support.

I’m the one who mentioned the lightbulb moment. What id read on MN was a linked article discussing the under diagnosis of ADHD in women and girls due to how differently the symptoms present ie not jumping off desks and scaling walls. It listed symptoms that I’d experienced my entire life except I was just referred to as ‘class clown’ and ‘overly talkative’ and many other harmful labels.

My parents couldn’t understand why I just seemed unable to do things like my brothers could. I couldn’t either. It really affected me and reading that article made me realise that I wasn’t just a failure.

I think we are probably twins.

Finding out about RSD was my second lightbulb moment.

For adults, it's a postcode lottery. If you live in an area that is covered by an NHS adult ADHD service, typically it's years. It was bad before covid but got worse due to covid as it was a non-essential MH service and shut down to any new assessments and most staff redeployed to other more essential areas.

If you live in an area not covered by an adult ADHD service, you and your GP can apply for exceptional funding to be assessed by the closest service. If you fulfil referral criteria and are accepted for assessment but still, you'll likely wait for years.

ADHD isn't a mental health issue, its a neurodevelopmental disorder. Waiting lists for 'other' MH problems depend on what the problem is

America over-diagnoses virtually everything. They run on a paid for insurance-based health system where healthcare is a business, drugs are advertised on TV etc.

Out of all the psychiatric drugs, stimulant based medications for ADHD are the most researched with higher evidenced efficacy. They can absolutely be a 'magic pill'. But won't suit everyone and come with side effects as all drugs do. Non-stimulant drugs for ADHD would be Atomoxetine which work more like anti-depressants in that you need to take them for weeks to get a benefit but they provide 24/7 coverage whereas stimulants work for hours then tail off. Atomoxetine is often used for people with ASD or learning disabilities for whom the consistentcy of coverage is helpful.

Yeah stimulants can suppress appetite which can be a really undesirable side effect for some, but a desired one for others.

I wouldn't recommend them as slimming aids though as they are not without other effects like increased anxiety, heart rate, blood pressure, insomnia etc especially when abused, and people abusing them to lose weight usually take high doses.

I didn't do well at all. I'm mid 40s and have been a failure all my life. I don't share my diagnosis though. The only people who know about my ADHD are those who live in my house.

@Creamcrackersandricecakes my DD was ok at primary although described as 'high energy'. They don't have to sit still long. Cue Yr7 and couldn't concentrate for more than 15 min unless a practical subject. Described as very bright but not on paper.
ConcertaXL 18mg has transformed her

Low rate then.

@weareallout - I'm hoping the concerta will help my daughter too; still early days on it so 🤞.

I think we are over-medicalising and pathologising ourselves because we seek higher meaning and happiness that is very difficult to find. We used to find our hope in religion and its code of virtues and ethics, but now society is very secular we put the emphasis on science and medicine to explain and remediate our "bad" emotions and behaviours.

From my own experience and those I have loved and taught, I can see that ADHD symptoms can result from trauma like Gabor Maté says. But I think on some deeper level the current trend is about people looking for some explanation for their perceived "difference" from others. This is based on the illusion that others appear to be able to function better in society than them. But in reality, most people (especially those with caring responsibilities and in poverty etc.) find life very difficult. Perhaps the structures and institutions around people (work, family, money etc.) are what need to change.

Its definitely become fashionable to seek diagnosis for things that, to be quite honest, are sometimes personality traits. I would include adult asd diagnosis in that too (sorry, I know half of MN is apparently on the autistic spectrum but it has to be said).
I am NOT saying ADHD doesn't exist. I am saying that fairly average people who are a bit scatty, or suffer from anxiety, or have trouble being tidy, being labelled as ADHD really diminishes the actual, serious difficulties proper ADHD sufferers have. Same with autism. I always understood autism to be an inability to connect with other humans, affecting cognitive processing, and leading to a fairly limited type of life. I have an autistic family member, and he fits the bill for this. You couldn't meet him and not know instantly. He cant make eye contact, he does a job way, way below what he technically could do because he cant really cope with working with people, he has never been in a relationship and never will be.
I met a friend the other day who informed me that her (brilliant, confident, student with a sociable part time job) daughter had been diagnosed as autistic. I have know this girl since she was two. She is really good at maths and very slightly gawky...not even on the same planet as my relative. She can function very well in life and is on track to get a first class degree.
The internet is full of memes about how no two people with a disability are alike, but in my experience that just isn't true.
So, if you are capable of doing well at school, and holding down a decent job, and getting the bills paid (even if a bit late or it stresses you) then even if you DO have ADHD, why does it matter so much?

I was diagnosed with a personality disorder 10 years before I was diagnosed with adhd. I struggled throughout my childhood and teen years but adhd wasn't even considered because I was a girl. I was just given an anxiety disorder in my teens.

I was diagnosed last year at 32 through right to choose because there are no NHS services in my area. The medication I take for adhd has made a huge difference. The antidepressants and antipsychotics I was prescribed in the past never helped and gave me nasty side effects.

I'm worried now that no one will believe I have adhd. I'm worried I don't have it. The BBC should have considered the impact this article and doc might have on people with adhd and the stigma it will create too.

I feel rubbish today, actually.

So, if you are capable of doing well at school, and holding down a decent job, and getting the bills paid (even if a bit late or it stresses you) then even if you DO have ADHD, why does it matter so much?

Because the amount of effort it takes to do these things in the same way someone else would do them normally is exhausting. I only have so many resources to go around and if I'm spending them all just to hit baseline functionality, there's not much left for anything else.

@Hillarious Ifthe psychiatrist who works for the NHS, and also privately, worked purely for the NHS, would the waiting lists come down at a quicker rate? Or am I missing something?
Potentially yes. But as we don't live in a communist state, professionals are not required to sacrifice their earning potential purely for the greater good. It's completely acceptable that a consultant splits their time between private and NHS

I've been quite upset about this today. It almost trivialises ADHD as a diagnosis anybody can get if they pay. My son has combined type ADHD, diagnosed on the NHS last year after a lengthy process. We are still waiting for meds. He already had an autism diagnosis so ADHD wasn't a surprise. Now that I have had to educate myself to help him, I'm certain I too have it. I would like to seek a diagnosis but am worried about doing so. This condition is unpleasant to live with and impacts every area of your life. I don't want reports on unscrupulous practioners to detract from that fact.

It's a shame that youngsters wishing to go into Medicine can too quickly lured by the "earning potential".

@DizzyRascal I’m not a fan of people dismissing potential developmental issues because they think it’s all become a fad.

Had this where multiple family members and friends have been told to have DC assessed and they haven’t done it because “oh everyone has something now”….. Fast forward 10yrs and the DC in question have struggled at school, hating it, every day, extremely limited socialisation and now in minimum wage jobs…. We had our DC who was symptomatic assessed because I wouldn’t tolerate letting them suffer that much. The diagnosis is so important for accessing further support.

As for your friends daughter, girls are incredibly good at masking their symptoms; I also am an autistic woman and have a first class degree, and yet I struggle with managing very basic day to day tasks. You would never know if you met me, because I’m intelligent and excellent at masking.

It's a spectrum, just because someone doesn't meet your expectation of an autistic person doesn't mean their diagnosis is any less.

What a disgusting, ableist attitude.

We have much better understanding of neurodiversity that has allowed more people to be diagnosed and treated. Girls in particular are much better at masking, they may appear to be coping fine but inside it's a constant, exhausting struggle that too often ends with depression, burnout and even suicide because they 'look normal'.

It's not that everyone with an ASD or adhd diagnosis needs medication or a lot of support, it may be a small adjustment and some understanding makes a huge difference but while people still have this awful attitude those people will continue to be marginalised and suffer.

Outwardly you wouldn't think I had any issues, decent career, dh and dc, nice home etc but privately I am a mess. Depressed, shockingly bad executive functioning, almost no emotional regulation, anxiety, panic attacks... the list goes on. That outward presentation comes at a huge emotional and physical cost, we are taught how to act to 'fit in' and keeping that mask up is so damaging.

Educate yourself rather than relying on half arsed, sensationalist headlines.

The internet is full of memes about how no two people with a disability are alike, but in my experience that just isn't true.

Do you have wide experience? Because you mention just two people you know with autism (who are different, but because they are different, you think one of them must not have autism). Autism is known as a spectrum condition because different people have different challenges in different areas (across a spectrum) and present differently.

So, if you are capable of doing well at school, and holding down a decent job, and getting the bills paid (even if a bit late or it stresses you) then even if you DO have ADHD, why does it matter so much?

Because doing those things when you have ADHD can be extremely difficult. Not just 'stressing you'. The cost of them to you can be enormous. I have a 30+ year history of mental health issues, including treatment in specialist centres, which were caused by trying to cope with life with undiagnosed ADHD. I am not unusual.

@RagingWoke Could hug you for this. Great, accurate post, very well articulated. Thank you for sticking up for ND people so well!

You say the diagnostic criteria are clear but they're inherently subjective.

"Often has trouble..." How often is often? What does "has trouble" actually mean? That it's not absolutely effortless, or that it's practically impossible, or somewhere inbetween - if so where inbetween?

"Clear evidence that the symptoms interfere with or reduce he quality of social, school or work functioning" - how much do they need to interfere? how much do they reduce quality of life?

Given most symptoms of ADHD somewhat apply to most people some of the time (are occaionally distracted, make careless mistakes etc) it can't be absolutely black and white