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Adult ADHD Advice
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Hi Billin, welcome!
I am just quoting a couple of posts here for simplicity, hopefully some of it is relevant to you. In relation to GP, it is his responsibility to send you to a specialist. It is that specialist's responsibility to assess whether you have a particular condition. Firm but persistent
and if no joy, then a new GP.
Many people on this thread have been diagnosed by Dr Michael Fitzgerald, see discussion in last few posts, regarding pros and cons. I used to Recommend Dr David Carey, but he's no longer with us. He used to do a very thorough assessment.
Dr Stephanie Bourke in Blackrock Clinic also assesses, ~4 month waiting list.
Dr Romanos/Dr Murtagh team in John of Gods ~12 month waiting list.
ST Pats not taking any ADHD assessments at the moment, though there may be some flexibility where other conditions prominent (anxiety depression etc)
PLease do ask any other specific questions if you have them!
Quote:[/QUOTE]Hi all,
I'm sure I'm not asking anything that hasn't been asked before but I've been through about five pages on this thread and getting a bit overwhelmed but not found the info I'm looking for.
I'm 26 and have suspected for a while now that I have add/ADHD. I was a bright "problem child" growing up, and my childhood issues (that I went to therapy for) morphed into depression and anxiety as a teenager (that I've only been in treatment for for a couple of years). However, while the anti anxiety meds I take help a bit, the antidepressants I try only ever seem to make me spiral into a worse state.
Everything I've ever read about add/ADHD rings bells for me and after years of being too embarrassed to get help, I'd like to seek a diagnosis to maybe finally get some peace of mind.
My main question is: HOW.
I've struggled with the HSE mental health services for the last two years and absolutely refuse to go down that route. So how do I go about seeing someone privately? I'm keen to see someone who will spend some time with me to work out a diagnosis, rather than just tick some boxes to get paid.
No amount of searching online has helped me figure this out. My GP is always reluctant to refer me anywhere and I'm also reluctant to share my suspicions with her as she sees me as a bit of hypochondriac (although I don't hold that against her as it's not really wrong, but in this case I'm 100% certain I'm right).
Is there any way to get a referral without going through my GP, and if not, how should I go about asking my GP for a private referral without having her dismiss me as a crazy person?
Hi PPn, welcome!
I am just quoting a couple of posts here for simplicity, hopefully some of it is relevant to you. and will post again belowOriginally Posted by cannex
hey Messyhead, hope you had a good xmas. I recently replied to the same question so I'm gonna copy and paste it here for you too.
I'm female too and we generally are more often diagnosed inattentive.
Prof Michael Fitzgerald: here is his no. 018211796, you can only ring the secretary in the morning I think.
I would strongly recommend that you let your GP in on the whole process. Discuss it with GP and tell them why you made an appointment to see a specialist. If you just arrive at you drs appointment with a prescription and a report out of nowhere you might have a harder time with presribing meds and the dr being on board with your treatment. (or change Dr)
As far as the appointment went with Fitzgerald - I went there with 2 questionnaires filled out. I got it from a Canadian website. It was a good few pages long and it was checking for all kinds of disorders. I filled in blue the things that affected me as an adult and I marked red that effected me as a child. - So I brought that.....
I had spent weeks writing down, when I got the chance, examples throughout my life that included extremely impulsive behaviours and all other behaviours I thought could relate to why I thought I had adhd. By the time my appointment came around I had both sides of 5 foolscap pages written out describing my life and behaviours. (aged 35 at the time)
I also asked my mum to come with me as it is recommended that you bring someone to the appointment who knows you well, preferably from childhood and she was able to tell him about my behaviour as a child. But, it can also be a partner, sibling etc. Just someone who knows you well.
So, if you go ready with all the info he needs the appointment will give you the best chance of coming out with the right diagnosis.
The HSE will need a more detailed report but they just dont have the resources. If only these things were treated with the same urgency as something physical.
If you have the co-operation of your GP, and go on the waiting list to see the mental health team in your area, its a long pointless wait but it means you will probably be doing what you dr considers good protocl - find out, discuss.
Have a read of the posts, lots of info and others who are trying to figure our way through getting treatment in Ireland. It feels good to have aha moments and relate to the same stories and nod in agreement and not fel like its just you.Quote:
Originally Posted by Feu
A psychiatrist may diagnose you in the one visit, depending who it is. This is a relatively painless process ( ) just asking questions about your history and behaviour. Again it is worth having a think about this before you go along (although attending unprepared could be seen as symptomatic in itself ]), like what are the functional difficulties you are having, what impacts your day to day life. While many adults will not have "documentation" from when they were at school, it is actually worth bringing along a school report or something if you have one, they are often illuminating! Frequent comments along the lines of "X won't stay in their seat" or "X daydreams through class" can speak to history of these difficulties. If a clinical psychologist does the diagnosing, you will still need to see a psychiatrist or GP before medication is prescribed. Liz i think you said you were going to a psychiatrist, but if being diagnosed by a clinical psychologist, this can take up to 3-4 visits depending on the psychologist. You shouldn't have too many appointments if being diagnosed by a psychiatrist, but there will be follow up if medication is commenced.
If you have not already had your appointment, it is worth thinking ahead of time about whether you want to try medication or not, and discussing any concerns re: medication with the psychiatrist when you meet them. There's lots of research out there on the efficacy, side effects, long term outcomes of medication, mostly on children (i.e. started when kids, followed through to their late 20s/30's). Laurence Greenhill is one of the experts on this, he actually spoke here a couple of years ago, and he really knows his stuff: https://www.ncbi.nlm.nih.gov/pubmed/18573923.
This is also a nice article on the European situation for adult treatment, although 6 years old: https://bmcpsychiatry.biomedcentral....471-244X-10-67 That article states that stimulant medication is effective for about 70% of people with ADHD.
Most people say that stimulant medication is very effective in increasing focus, and decreasing distractability. Therefore doing what they want it to do. Some people express side effects such as reduced appetite (and when prescribed to children and adults they will monitor their weight), weight loss, nausea, sleep difficulties, and one of the reasons some people dislike it is a feeling of "not myself", which could be described as being less emotional, feeling "robotic", or even devoid of emotion. There is lots about this online, obviously. Cost really varies, I've seen from €65 a month to over €100, so definitely shop around.
There are lots of behavioural and environmental modifications that you can make apart from or in conjunction with medication. I have a lot to say about this, depending on the difficulties you are having, so maybe I'll hold off unless people are interested
In a nutshell, routine routine routine! Routine will help prevent/improve some of the functional difficulties associated with add/adhd e.g. losing things as mentioned by numerous posters above. I think it was also Cannex that mentioned having a little chest of drawers for like bills and things like that, that can so easily be lost or misplaced, and leaves people with ADHD tearing their hair out. Having a set place for things, and then developing the habit of always putting things there, can really work over time. Some people i work with have a literal checklist for when they come in the door, and for when they are leaving the house, to reduce stress and anxiety.
I think as well for people with a recent diagnosis of ADD/ADHD, considering seeing a counsellor, with experience/knowledge of the difficulties associated with ADHD would be beneficial. There is a high incidence of other difficulties correlated with ADD/ADHD particularly depression, anxiety, substance abuse and sleep disturbances. Some people are interested in ADHD coaches which is more of a thing in america
You could also consider seeing a life coach or OT on a regular basis, who may focus on the more practical side of things then therapy, like helping you set and achieve goals to reach a particular milestone in your life
Disclosing to your workplace can be a really good idea depending on the setting. Sometimes employers can be really supportive, and really open to modifying your role etc, and sometimes it is hard for them to understand the condition. Their attitude can depend on how much "this will affect the business", i.e. if it is quite easy to move you to a slightly different role, that's handy. Having a good idea of how things could be improved for you is helpful when thinking about having this discussion i.e. if i could change x and y, I will be able to work mostly independently, that kind of thing.Quote:
Poolshapedmoon
Well you sound exactly like me when I was coming to the realisation that I migt have adhd.
I had all the same worries.
Yes you can do all of the above: bypass the Gp nd make a private appointment for a private assessment and not go through the public health system but as far as I know the GP needs to write the prescription for the pharmacy to dispense. I could be wrong here but I cant think of any other way, unless, I think, you would have to pay privately or full price for the meds.
You mentioned you were a student, is ti possible to speak the the GP in your area who deals with student patients?
You could just turn up at your GP with the diagnosis letter and a prescription and say nothing more. This is my experience, my GP practice/GP is fine with writing the prescription but I dont discuss the meds with them really. If your GP is not, change GP.
In regards to follow - up: there is none really, it is up to you to follow-up, oh the irony, I get it
I learned that the hse is too bogged down in "real" mental health issues and adult adhd isnt top of the priority list.
I followed up by emailing to discuss some medication issues with the Prof and he responded promptly.
Other than that I strongly suggest you look for adhd focused therapy and/or CBT for adhd.
Its a long journey but reaching goals and staying on track feels really good0 -
emilymemily wrote: »Hi all, im undiagnosed but have suspected for years that I have ADD and its really causing me some issues lately in my new job. Im a teacher, terrible career choice for someone with attention deficit. I arrived on the first day and was given a very brief rundown of whats expected, paper work that has to be done every day, classes I take, lessons I give etc. Another teacher who started on the same day said she felt overwhelmed with the info and needed time to process everything but we wearnt given that time. So I know im not the only one which is making me feel slightly better but I feel its taking me longer to get it together.
Its a few days in and im really struggling to keep up, Im filling out wrong forms, bringing lesson plans into wrong classes, photocopying wrong handouts for wrong lessons. Ive to do correcting, feedback report was meant to be submitted at 6pm today latest. Im still working on it and just realised that some of the kids didnt give me their work. I also have so many classes in one day I lose track of which class I had when and what students are in each class. The staff and principle are beginning to notice and I caught a member of staff standing outside my class watching me teach. - very uncomfortable. Im only in the school 3 days and its a temp position. I keep making stupid mistakes, forgetting things, missing important details and its messing everything up. Does anyone know of anything that can help with attention, memory and organisation? they think im incompetent.
Hi Emily, I am so sorry to hear you have been having such a tough time. Has it improved at all since you posted? Any new job for any person is tough, and can take getting used to, but teaching, in particular requires a lot of executive functioning skills, especially in the beginning, which is unfortunate. I think PPNs and other suggestions are excellent, are you a secret occupational therapist PPN??! These are environmental behavioural prompts, and work very well!!
In your case Emily i might even suggest using free time at the weekend, not ideal I know, but using free time on your weekend to get organised, may reduce anxiety, stress and worry, and make things feel less pressurised during the week. Are you primary or secondary? this impacts tasks a lot, and the demands in terms of lesson planning
With some teachers I've worked with, we looked at the structure of their day, and not always being prepared the day before, and needing some time in the morning to get organised. this can cause conflict too when you are settling in at a new school i.e. there can be pressure to go to staff room, but a quiet half hour before classes can leave you time to put correct lesson plans with correct handouts etc, and any last minute photocopying that needs to be done. I think less is more too i.e. while you have to keep classroom management in mind, try to just have the basics covered and don't worry too much about planning the most interactive amazing class ever.
For the poor working memory inclined, i think it's a good idea to keep a notebook, or post its at teachers desk to quickly jot down any thing you think of during the day that needs to be done that evening or before class tomorrow. If possible, then, stay and complete these tasks at school in the classroom before you go home, as they can easily get forgotten when you go home. In relation to memory, again post its, phone reminders, even a note on the hand, whatever helps you remember what needs to be done, but it is good to get in the habit of using one thing, e.g. a diary, and then keep using this. the more you use it, the more habitual it will be, the more automatic, the less likely you will be to forget to write in it or check it.
In relation to which classes had what, again either using a paper or soft copy, have a daily schedule of what you did with who, like a daily planner. And even take 1 minute to jot down what (if anything!) worked well with this class group.
I think it's ok to seek advice from other staff too, if you feel comfortable to do that. Everyone had to start somewhere, and you don't have to tell people that you are struggling, you could say something like "i'm really enjoying teaching x, but have you any ideas how to manage y?". Also consult with your college colleagues, they will have ideas, and probably be struggling too!
http://www.hadd.ie/adhd-adults recommend a range of treatment approaches, including relaxation and stress management, and I really agree with this. For many of the people i work with, although not all, worry about poor performance really affects their mood, and their sense of self efficacy, and so i really don't think that the mood side of things can be underestimated. And of course, when mood is affected, it can be hard to perform how you'd like, so it is a vicious circle.
If you are Dublin based, you might also consider attending the HADD support group, which i know some people have found helpful for support, and also suggestions and tips!
If you any specific questions Emily, just throw them out there!The only thing that's ever helped me is daily lists. I have a whiteboard in my bedroom that I write down everything I need to do for that day the night before. I'm always afraid someone will see it because I genuinely need to write down stuff like "brush teeth" and "eat breakfast" on it so I can cross them off or I will forget. I keep a small notebook with me for out and about reminders but vibrating phone alarms can also do the trick.
It might be worthwhile taking half an hour in the evenings to organise what you need for the next day. Figure out what photocopying you need done a couple days in advance so you can have it ready the night before. Don't fret though. It's still early days for you. It's not an easy job and you just started.brianblaze wrote: »Yep, lists and whiteboards are great!
Also, the Kanban method is great, if not the most important system I use. (I'm self employed so I need to be pretty on the ball or I could really make problems for myself!!)
Also, if you look up jobs for ADHD people, teacher is one of the frequently reccomended ones, so go you!
I have seen Kanban work miracles when people take it on, https://www.digite.com/kanban/what-is-kanban/ and it also featured in Silicone ValleyADHD coaching is supposed to be really good for organisational difficulties you're talking about. If your memory is the biggest issue though, it may be that meds are the way to go.
http://adhdcoach.ie/ is the only ADHD coach I am aware of in Ireland. I do not have any first hand accounts of people that have worked with her, so i can't speak to the efficacy, but may be helpful for some people. I have heard of people here skyping with ADHD coaches in UK/US.0 -
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