“It’s probably just anxiety”

[ShiftingSands21]

I got an ADHD diagnosis privately last year from PsychiatryUK. It felt absolutely right to me, like things finally “make sense” after decades of struggle I just couldn’t understand.

Since then I am getting a lot of push back from my GP and 2 NHS psychiatrists (not because I sought a second opinion, just because the first one left). They argue that my symptoms are probably better explained by anxiety. I do experience anxiety, which is a common comorbidity, but I really feel that that underlying core of the issue which has led me repeatedly to psychiatric services over the years since I was a young child, is ADHD. They haven’t listened to our enquired about the ADHD symptoms. I’ve continually tried to bring them up.

I don’t know what to do. I’m finding it so hard to move on with my life with this impasse. I can’t get either the validation or treatment I need.

I can’t quite understand why this is happening. To me it’s so obvious and undeniable that it’s ADHD. But my psychiatrist had said things like “you wouldn’t be able to sit in this chair for the appointment if it was ADHD” (I do have a problem with chairs, it probably became more obvious towards the end of the appointment, but even if not that this is a ridiculous thing to suggest as a single criterion for a socialised adult woman) and also “it would have been picked up when you were little” (but really, would it, in a 5 year old girl in the early 90s who had a complicating comorbidity??).

I am not taking this well. I really need help, but the right help. I can’t stick with the SSRIs they have given me when I know they have it all wrong. I tried but I just can’t do it because it all feels so wrong plus the awful side effects.

Why is this happening. It just feels like a strange sort of sexist bias, combined with lack of expertise on their part. I genuinely seem to know a lot more about ADHD from what I can tell. I can’t make sense of it, I’m angry, I can’t stop thinking about it and I don’t know what to do.

That sounds really shit.

Thank you @BlackeyedSusan

You need to complain to PALS.

I’ve not had any issues my NHS Psych or GP accepting my Psych UK privately paid for ADHD diagnosis.

They’re talking shite and they have to accept the Dx and medicate you for it.

The diagnosis you received from Psychiatry UK is valid and nobody should be arguing against it.

Anxiety is a key symptom in ADHD and the psychiatrist who is arguing about this isn't qualified to assess for ADHD. The GP doesn't know what he's talking about, few of them do.

Were they sent the diagnostic report from Psychiatry UK? Psychiatry UK conduct assessments for the NHS so that's another good reason why NHS staff can't reject the diagnosis.

My son was assessed by a psychiatrist from Psychiatry UK and had to insist very hard to be transferred over to NHS care because I could no longer afford to buy his meds or pay for the scripts and reviews.

Were you prescribed medication by Psychiatry UK?

The NHS absolutely have to accept your diagnosis, it's not negotiable. It's valid and you weren't given it just because you paid for the assessment.

There’s a lot of misunderstanding around, especially how things like adhd and asd can present differently in females. It’s infuriating and upsetting and hopefully, in time, things will improve. If you have the adhd diagnosis, does it matter if the nhs disagree if you yourself know and understand your behaviour?

If you can find out who leads on the ADHD service in yr area. For instance where I am the GP commissions an assessing & prescribing service ( which is based in London, the ADHD clinic is virtual.

If you have the adhd diagnosis, does it matter if the nhs disagree if you yourself know and understand your behaviour?

On the one hand, no.

On the other hand, I can’t afford to pay for prescriptions privately at the moment. I also would like access to occupational therapy or similar for support. So without the NHS acceptance, it’s not easy to access treatment. However they are offering me treatments that aren’t for ADHD and in pushing back against those - or actually sometimes just completely failing to put them into practice because of the ADHD directly - I am becoming a “problem” patient.

Also, maybe it shouldn’t, but just from a psychological point of view, I do find the pushback upsetting. It doesn’t really make me doubt myself or my diagnosis. Just occasionally maybe in a low moment. But it does make me feel unlistened to and feels like they are seeing something else “wrong” with me that isn’t and that’s also a bit weird. I was just beginning to look back at my life and give myself some compassion for a few things that went wrong now that I understand why, and now I feel like I sort of have to put that on hold because they’ve said, hang on, you don’t get to do that!

Frankly, unless they’re trained to diagnose NDs (my NHS Psych isn’t but he 100% agrees with my Dx and, in fact, suggested I look into it after our first appointment!), their opinion means as much as my 2YO nephews does.

Adhd presents somewhat differently in women. You're not a problem patient, they're the problem for being ignorant about what adhd is and how it affects people.

I agree about contacting Pals.

Just remain calm and assertive.

Thank you everyone. I will look into PALS.

I did try to find the background of my current psychiatrist but I actually couldn’t find any kind of a CV or anything online, which is a bit unusual, but he looked very young so maybe quite early in his career.

To answer other questions, P-UK did not prescribe medication at the time of diagnosis due to breastfeeding.

The current NHS psychiatrist said he had read my P-UK diagnostic report and he said it was “contradictory” and “raised questions”. I don’t see how it was in any way contradictory. If it raised questions, he did not seek any clarification with me.

He also talked about how we “all have ADHD traits” which raised alarm bells with me.

The NHS psychiatrist needs to properly explain and justify his views. It's all very well going around having views on things, but he needs to be more objective - something psychiatrists definitely struggle with in my experience.

My ds' private paediatric psychiatrist claimed ds didn't have autism - merely aspergers 'traits' - because he could make eye contact and hold a conversation. Utter bollocks. We had him properly assessed by clinical psychologist using the recognised system they use and, yes, he's definitely autistic.

Keep pushing for answers.

I had to go to PALS for my GP to accept my private adhd diagnosis and for me to get atomoxetine rather SSRIs. I had some really upsetting conversations with professionals doubting the validity of my disagnosis but this hasn’t happened since I wrote to PALS. I even got an apology!

Thanks so much for the encouragement @BarrowInFurnessRailwayStation It just sometimes seems like people have a fixed idea at the very outset which is hard to sway. I’m so glad your DS got the autism diagnosis. It is worrying to think how many people would not be in a position to push through these barriers.

@Busygoingblah that is really helpful to know and I’m so glad you got there.

I went back to the GP and reiterated my points. GP agreed to contact psychiatrist and discuss my perspective. I guess that’s something.

God, you want to see my CMHT psychiatrist. He won't bloody shut up about my recent ADHD diagnosis, and has started putting all my bipolar disorder symptoms down to it.

Seems like we have mirror-image psychiatrist problems

Basically that is the mirror image haha. Honestly though you could look back at so many of my previous symptoms over the years and reclassify them as ADHD rather than depression/GAD/OCD etc that they were ascribed to at the time. I did think at some point maybe I was experiencing bipolar disorder because I was trying to explain suddenly buying all the books about an obscure topic with a grandiose plan only for the whole thing to have totally faded a week later, and also dealing with really up and down emotions. But ADHD does bring that all together really well for me.

I hope you feel like your psychiatrist is helping a bit! As far as I am aware ADHD and bipolar are often comorbid and I can imagine that separating them out isn’t always clear.

On a practical note, if you are looking to access e.g. an ADHD coach for work strategies and support etc, I think you can apply directly for an Access to Work grant for that and arrange it all directly yourself with the coach, I think this is what a colleague of mine is doing.

@LemonViolet Thank you for that! That is helpful information. However I would be reticent about doing that as I don’t feel able to reveal this diagnosis to my employer. I’m not sure if that is
something that is likely to change but I would definitely consider it if I change job.

Been back to the GP who has had a discussion with my psychiatrist. He insists that he is confident I have GAD, that ADHD is relatively unlikely and that my Psychiatry UK report is no good. I was offered a prescription of pregabalin instead of an SSRI since I haven't been getting on with those. My DH came with me and backed me up that we both believe that I have ADHD and that it is the more significant of the problems and that we don't understand why I can't just be assessed again if that's the issue. Actually my DH brought me to tears afterwards when he reminded me all the things he sees in me that he now understands to be ADHD because he completely gets it. I mean, he has to live with me, so this makes sense, and he has read up on presentation in women because he cares... but how can professionals be so unwilling to see what's right in front of them. It's not the GP though. The GP is really good actually and again just committed to relay all my thoughts back to psychiatry, even though she doesn't particularly agree with me. But what now. It's not getting me anywhere. The NHS psychiatrist holds all the cards.

Your dh sounds lovely. As others have suggested, can you contact pals?

Sadly it’s depressingly common -

‘You have a job you can’t have ADHD’

FUCK OFFFFFFF with this shit

My GP also said the psychiatrist told her the report was “contradictory” which is what he told me. Unfortunately he didn’t elaborate on this to her either. I reread the report, which I haven’t for a while, and I can’t even guess what part he might be finding contradictory.

Also I had understood that, regardless of all the doubt, I was still on the NHS waiting list for an ADHD assessment because I’ve been on it since before I met this psychiatrist or the previous one. About 6 months ago I was told I was looking at a 2 year wait. Today, I got the impression I’m not on that list at all. Maybe I was and they took me off it.

I feel like there are no doubt other women having a similar experience and I'm just so enraged on everyone’s behalf.

I have contacted PALS so hopefully I will hear back.

So my GP dutifully reiterated my points to the psychiatrist again. Again he has come back and said that he is confident I don’t have ADHD (after meeting me once and never asking me about ADHD symptoms…) and I will not be referred for assessment. In his letter to the GP he said that one of the reasons was that my level of achievement was inconsistent with ADHD. This has made me livid for a number of reasons. One is that it is very selective. I do have 2 undergraduate degrees. However I also dropped out of both for periods of time, experienced huge challenges completing them and needed various accommodations. I tried to do a masters but couldn’t complete it and dropped out twice and for good. There’s much more to talk about there and I could go on and on but of course the psychiatrist didn’t ask or allow me to talk about any of this. Secondly, I’ve got a male friend who received an NHS diagnosis of ADHD in the last few years in the same local authority. He has a PHD from one of the most renowned institutions in the world. No one told him that this level of achievement was inconsistent with ADHD.

My GP was very sympathetic as I sobbed down the phone to her. But she doesn’t know what else to do.

I’ve requested all my CAMHS, psychology and psychiatry records in the hope it will give me an idea. I think I may go back to PASS to make a full complaint. But I feel so stuck and powerless.

I’m so upset and angry. The psychiatrist doesn’t seem to me to be playing by the rules. The basis on which he has excluded me from assessment don’t seem correct at all.