Adult ADHD Advice

Greenmachine wrote: »

Was not aware there were any medicines approved for use in adults in this country for adhd.

Yes, there are, Greenmachine, just to answer you but you need a positive diagnosis because some of them would fall under 'controlled substances' so would have various regulations around them as to how they are dispensed.

cannex wrote: »

Yup, cant talk about it here I dont think. I dont want to cross the line talking about medicines.
That would be a conversation reserved for someone and the consultant psychologist to decide.

Some medicines that are used in other countries are banned here, but not all.

Very interesting, Cannex, very interesting. To be honest that's why I have been hesitant to post in this thread because as I said before my diagnosis is up in the air so I almost feel like an impostor posting here if you understand me because of such confusion and professional disagreement about my diagnosis. I was refused medication so can't even discuss that point thoroughly although a mental health professional that was allocated to me after my second assesment made a case on my behalf in support of ADHD meds. I will refer to something else I found of benefit in another post but won't name specifically.

I was referred by my GP to what is supposed to be a specialist unit for Adult ADHD in this country in a private healthcare institution to see a general consultant and registrar first. My GP, who knows me well and has all my medical history did tell me at the time while my medical history started to make absolute sense from an ADHD perspective, to get a diagnosis in Ireland at my age would be next to impossible. I had heard similar from someone else.

Years ago I was prescibed lithium from a different mental health service here. While I was never given a formal diagnosis of bipolar I was prescibed it to see if it would help with my symptoms. Severe depression with a non-stop thought process and restlessness in situations of overstimulation and intellectual stimulalation which might appear to look identical to bipolar. The restlessness was there from a very young age but it was much more internal than external so would never have been observed. I understand this is actually quite common among people with ADHD.

I remained on lithium for 15 years even when I was no longer depressed but in the belief that it was preventative and maybe there was a bipolar element there but nonetheless I continued to experience all the symptoms and behaviours similar to ADHD and which bipolar alone could never explain. Of course I never even considered ADHD because as we all know that's mostly experienced by young boys with outwardly disruptive behaviour in a classroom. Or is it.

For me something just never added up until it did start to add up. A parent considered one of my siblings to possibly have ADHD from a young age but it was never investigated. Now I can identify so many ADHD behaviours all on one side of my family. It all makes sense and listening to stories and narratives of various relatives when I was growing up I can trace it back possibly even five generations all on one side of the family.

When I asked my GP to refer me for an assessment he believed it would only be a matter of weeks as it was private but clearly he didn't know. As I discovered the waiting list was so long for an assessment with that paryicular ADHD unit I asked them if I got a diagnosis elsewhere could I still avail of their services as they appeared to offer a range of supports. I was told no problem.

So off I went to a separate consultant psychologist who at least claims to specialise in the area of Adult ADHD as well as other specific learning disabilities and lectures in universities here from what I understand. He conducted a thorough interview of my life history, my medical history and I disclosed fully everything about my situation, my cognitive processes, behaviours etc. He administered certain questionnaires but he said in all honesty if you are hoping to avail of the supports of the other service they will still want to conduct their own assessment.

He told me he absolutely believed I have ADHD in the mix of of life circumstances. I also disclosed all significant behaviours of family members whom I strongly believe have ADHD which is relevant as there is such a strong genetic component. He told me if he was working with me he would initially start with six months of behavioural therapy to address the ADHD issues and if that approach didn't work then he would recommend ADHD medication and refer me to a psychiatrist who could prescribe same.

I still wanted to opt for the other service as I felt it would be a one-stop shop with access to doctors, therapy and seemingly various other supports all within the same organisation. In any event I didn't find I could gel with that particular cinsultant psychologist and while he had expertise in the area I feel rapport is essential and half the battle which I know from my own work. Somebody made a similar reference in a thread on Reddit Ireland in relation to ADHD here. Some months later an appointment did come up for an assessment in the original service and I decided to attend which I will describe in the next post.

No, I didn't have any contact with the HSE in relation to ADHD assessments and never intend to. My assessments were all private but I have had a very similar experience to you in relation to differing diagnoses being suggested by both. One saying everything appears to indicate ADHD while the second, a team of doctors, a psychologist and a nurse carried out an assessment and offered a completely different diagnosis instead.

However, another mental health professional they referred me to within their own organisation after that assessment disagreed with their diagnosis. I believed they had got it wrong and he agreed with me that everything pointed towards ADHD and expressed shock that they didn't diagnose me with it after he met with me several times and he apparently has lots of experience working directly with adults with ADHD.

I think any attempts he made to have my diagnosis reviewed again to include ADHD just fell on deaf ears. It seems they would simply not back down and accept their own 'experts' may have got it wrong even when one of their own colleagues disagreed. It was a complete farce and I will post more about my experience and their assessment over the next few days if I can.

I just wanted to reply at least to say I understand completely the stress and frustration in relation to differences of opinon professionally in relation to Adult ADHD and attempts by various doctors to try to invalidate you and twist things around. Been there. I could write a tome on this but I have pretty much given up on mental health services at this stage and don't intend to pursue it further. After my experience with that well known private institution they have absolutely no credibilty in my eyes.

To be continued.....

And yes i was put on a stimulant

Wow Cannex! Lots of stuff there and lots of questions for you.

First things first. So your first assessment was with Prof. Michael Fitzgerald? Are you really saying they wouldn't accept his diagnosis? Is the issue that they wouldn't accept his diagnosis or they refuse to accept any external diagnosis which wasn't conducted within the HSE? It leaves the question as to what's their criteria for an 'approved' assessment and diagnosis.

The assessment you had just recently sounds like it went really well for you. Did you ask him about HSE approval and if he has had any issues with having any of his diagnoses accepted and recognised by the HSE? My guess is and it's only a guess is that you could be the first person to present to the HSE with an adult diagnosis of ADHD and from an external psychologist or psychiatrist so the whole area might be unprecedented for them but do they accept any of his other diagnoses, I wonder?

Are you hoping to access the HSE because of financial reasons? You don't have divulge that if you prefer not to but obviously it has thrown up an issue for the HSE around accepting ADHD assessments which have been conducted privately even with mental health experts who are reputed in the country.

Your most recent assessment seems to confirm the same findings at least from the ADHD perspective although I know you say it has thrown up another issue with being on the autistic spectrum. How did that psychologist come to that finding, I wonder and that it wasn't suggested from your previous assessment? The whole area of psychological testing can be a bit of a minefield producing resulting with sometimes more questions than it can answer.

How did he conduct the ADHD assessment? Did you do the cognitive testing with him as well because the cognitive test results seems to have been a significant issue for me in my second assessment along with a few other factors namely l'ife circumstances', not having access to school reports at 38 years old which they said nobody ever does anyway (go figure) and nobody to vouch for my behaviour.

The most significant person who might have been in a position to answer was entering their death bed at the time but I guess that wasn't a good enough reason for them and who most likely appears to have had it themselves looking at their life from that frame of reference

Interesting about the old 'borderline' chestnut you mention. The last desperate attempt of some incompetent psychiatrists when they can't get anything else to stick. The last psychiatrist I met within that same clinic, and I mean last, was trying her damednest I know to pin a personality disorder on me after only meeting me just once for about fifteen minutes simply because she refused to accept their ADHD team might have got it wrong.

This was in the face of the behavioural therapist I was sent to afterwards for a number of sessions saying 'Hang on, this really does look like ADHD here'. He knew from meeting me several times I don't really fit the criteria for any personality disorder and certainly not borderline which I have extensive knowledge of myself and that's definitely not me. It's insulting as well to others who do genuinely have borderline personality/ emotional dysregulation disorder for the medical profession to lump it around.

I nodded my head about your 'planning issues' and have lots of examples and anecdotes myself on that score. I laughed when you talked about you now being more organised than your boyfriend but you clearly have learned ways to compensate which could potentially go against someone during an adult assessment.

I have seen this with an elderly relative on the same side who clearly has the condition and people over the years thinking how organised he is and with me knowing what I know now he obviously managed to develop coping strategies himself without actually knowing or understanding the quirks in his behaviour.

He never married for those reasons; same with some other members of my family who strongly fit the description. It's almost as if we are being 'bred' out because of our idiosyncrasies being unrecognised and untreated. That is in effect what has happened extensively in my family.

Relationships can definitely be a challenge as understandably some of the behaviours can be frustrating for partners. I have seen a reference to women at least, it might also be true for men but where women with ADHD can end up in abusive relationships. I believe this to be true. I know this to be true. It's not even a case of low self-esteem but a recognition on a practical level I think that finding an understanding partner can be a challenge.

Apologies for the long post but it's a very complex issue; not easy to define or diagnose or indeed measure the resulting effects of being left untreated particularly where there appears to be a generational cycle and legacy of unrecognised ADHD.

Hey everyone. Great thread. Very informative. I saw a lot of myself in the posts where you were talking about the condition and how it manifests itself.

I am in my mid 40's and I was diagnosed with ADHD a year ago. A clinical psychologist did the diagnosis. (Can I say his name?) I presume he is private. I was given his phone number by HAAD Ireland, rang him and made the appointment my self. I did not get a GP referral. I followed none of his guidelines on learning to manage the condition. That was for a variety of reasons....denial, anger, bitterness at all the time I have lost, anger at parents for how they handled me as a child....all kinds of stupid stuff.

Anyway, I am basically back where I started. I still have the same problems with chronic procrastination (hence not following the psychologists guidelines) getting started on tasks and focus and concentration. I am currently job hunting. My ability to sift thru job listings on websites, submit CV's and cover letters etc etc is non existent. I will be penniless and homeless soon, if I don't acquire some coping skills. I have an appointment to talk to the psychologist in the morning, as I try to start the process of re educating myself on what I need to do. Initially, I was very against the thought of taking medication, but I am now willing to do and try whatever the trained professionals think I should do. From reading the HSE horror stories on here, I am a bit worried I won't have access to medication, if that is what is needed to help me get my life back on track.

At my first meeting with the psychologist, he suggested Ritalin as a possibility down the road. He said that my GP would have to be involved in writing the prescription, as he is not an MD. My GP barely knows me. She has only seen me twice, for very flu minor ailments, so she has not been a part of any of this process. I just rang her there, to see what the protocol is that she has to follow, regarding medication. I am awaiting a call back. From reading the HSE horror stories on here, I am a bit worried I won't have access to medication, if that is what is needed to help me get my life back on track. Fingers crossed that won't be the case. I am in Dublin, if that matters.

I'll post again when I have spoken to the GP and the psychologist. I suppose I should have waited until I had updated info on everything. But just making myself concentrate long enough to write all this, is very therapeutic.

Cheers everyone.

Thanks for letting me know about the update, Beffs. I had already seen you had posted in the Personal Issues forum wondering if there are any ADHD online support forums here.

In some ways I'm a bit hesitant to keep posting in the thread even though I'm very much up for talking about it with people who are similarly affected. If you're a regular poster across Boards you can leave yourself open and feel a bit exposed and vulnerable by laying yourself bare when you want to discuss personal/health related issues in more detail and how it affects you personally in order to benefit from support here in Ireland as an adult. I know from even searching threads here on Boards on ADHD where Cannex was getting extremely frustrated with some posters' attitudes towards ADHD.

With other online health forums which might focus exclusively on a particular health issue or disorder you feel more of a wall of protection around you because everybody is in the same boat. I am signed up to another ADHD online forum which is great but is international so obviously you don't get to focus as much on the Irish context and issues particularly relevant to getting a diagnosis or treatment and support here.

I'm not sure if anybody would be interested in having a private forum perhaps here on Boards where you can discuss more openly the issues affecting you but I'm not quite sure how that could be set up or if it would involve having a private hosted forum although there might be a charge involved it that.

It could also be extended to to those with other neurodevelopmental disorders such as those with Asperger's/on the autism spectrum and dyspraxia etc. as I know other posters here do refer to those disorders or thinking about seeking a diagnosis for similar as an adult.

There's probably little in the way of online support here in Ireland for those disorders also for people who have been diagnosed as adults or suspect they may have the disorder. It could be a catch-all forum with dedicated threads for each of the disorders as well as a general discussion/chat thread for all but exclusively for those affected by the disorders or who recognise themselves as identifying with similar issues and suffer some impairment in their lives because of it.

It's just an idea so might be good to hear other people's thoughts on it or if you think you would feel this thread is sufficient. As I say I don't feel particularly comfortable posting openly even though I recognise that other's may benefit from my thoughts and experiences on the topic.

That sounds good, Cannex. I just opened your link only. Have other people discovered it yet? Would people get automatic access as soon as they register or would their access have to be approved first to avoid any trolls?