6 ms·

Ok serious question: Every one of these points is very applicable to me, especially 1,2 and 3. I haven't been to a doctor in years outside occasional emergency

Ok serious question: Every one of these points is very applicable to me, especially 1,2 and 3. I haven't been to a doctor in years outside occasional emergency trips. How do you bring this up without seriously. I don't want to come off as the guy who compulsively self diagnoses based off what they read on the internet.

laurex 6y ago
Go to a psychiatrist. Report your symptoms. They will give you a diagnostic and make the call. As long as you go in without stating your suspected diagnosis, you're not "diagnosing."
stevewodil 6y ago
Do you have a PCP? You just say that you want to get referred to someone to get tested for ADHD because of x, y, and z and you think a diagnosis would help you
robmerki 6y ago
There's nothing wrong with using self-diagnosis as a way to inform a professional inquiry. In my unqualified opinion, you probably have ADHD.
anon9001 6y ago
No problem, serious answer: This is the DSMV criteria: https://www.cdc.gov/ncbddd/adhd/diagnosis.html https://www.cdc.gov/ncbddd/adhd/diagnosis.html Doctors are typically screening with a quiz that looks something like this: https://psychcentral.com/quizzes/adhd-quiz/ https://psychcentral.com/quizzes/adhd-quiz/ It's perfectly reasonable to say "I think I may have ADHD based on what I've read online, my symptoms match and people who know me have suggested I try adderall". Some doctors are fine with letting everyone have stimulants, because they're pretty harmless unless you're really binging on them, and they won't give you enough to do that for very long. Other doctors would prefer to put you on an SSRI or SNRI or wellbutrin or some other "non-addictive" medication (which ironically are more addictive, dangerous, and less effective), so avoid those IMO. You may have to shop around a bit, but your primary care doctor technically can write the prescription, but some prefer not to and you might need to find a specialist. Contraindications for stimulants are if the patient has a history of heart conditions, complains about racing heart rate, excessive sweating, trouble sleeping, trouble eating, etc. You generally want to start with a low dose of "instant release" as opposed to "extended release" pills, so you can have more fine grained control over the dose. IR pills can be broken in half, XR cannot. Some doctors are more nervous about IR than XR because they think it has more abuse potential (not true, but it's a common belief). With all that said, stimulants will fix the problems OP described, but don't mistake that for a pleasant experience. The truth is that amphetamines are extremely mentally exhausting, and if you don't take good care of yourself (planning proper meals, staying hydrated, resting at appropriate times, not taking more pills when you shouldn't), you can quickly spiral out of control. It's hard to explain to someone that doesn't do drugs, but stimulants can leave you feeling like a shell of yourself, and it's really disconcerting. It's sort of like being over-tired where you're awake but your judgment is clearly impaired and you don't feel like "you". If you stay on them long enough, you'll start to feel like a zombie just going through the motions (successfully, mind you), but without identity. I make sure to take weekends off to preserve their efficacy for the work week and to make sure I don't become too dependent. I'd 100% recommend having stimulants in your toolkit, and chances are you're already supplementing with worse stimulants (like mountains of coffee or soda), so do give them a try, but be careful.
- hanniabu 6y ago
  > IR pills can be broken in half, XR cannot You can always take the XR pill apart and split it into blank capsules. Or you can just dump a little out and take it without the capsule.
  - georgespencer 6y ago
    I think this depends on the actual formulation of the drug, right? For example two of the titrations of Concerta (XR methylphenidate) which I have experienced first-hand are a hard candy-like tablet, and the pharmacokinetic result is that you receive 25% of the dose within a couple of hours, and then over the course of the rest of the day the remaining 75% hits your bloodstream. But I now take an XR lisdexamfetamine which looks like it would be possible to split into smaller doses, but it's a prodrug so it's a totally different experience. I know it's a luxury some folks can't afford, but there really are a great range of optimised formulations of the treatments for ADHD out there, and rather than guessing yourself, it'll be better to have an honest conversation with your doctor about the ability to mix XR/IR in a way that works for you.
    - anon9001 6y ago
      This is correct. Concerta is interesting because it's a laser-drilled time release. Vyvanse is interesting because it's a prodrug of amphetamine that releases chemically over time.
  - projektfu 6y ago
    The XR part is usually the particles inside the capsule. To make them faster acting you also have to pulverize those.
- blaser-waffle 6y ago
  > I'd 100% recommend having stimulants in your toolkit, and chances are you're already supplementing with worse stimulants (like mountains of coffee or soda), so do give them a try, but be careful. I'll second this. I've got an old friend and former coworker who clearly has serious ADHD and self medicates with tons of coffee/soda/cigarettes. He's killing himself and he knows it, but hates doctors and has a negative view of shrinks. Anec-data: I cut out carbs and only eat during certain windows and that has done wonders for focus and stick-to-itiveness. Coffee and alcohol hit me extra hard, and I've cut back on them.
georgespencer 6y ago
Shoot me an email if you wanna chat about my experience in more detail! Email address in profile :)
tikhonj 6y ago
I was in a similar position. I did a bunch of reading on ADHD, convinced myself that I probably had it then I found a clinical psychologist who specialized in ADHD and reached out for an initial appointment. Apparently this is a pretty common story for people with ADHD who weren't diagnosed as children, so a specialist won't be particularly surprised by it. The initial appointment is probably going to be an in-depth interview with the specialist, coupled with filling out some self-assessments and, possibly, getting somebody who knows you well to fill out an assessment as well. (Apparently people with ADHD usually drastically underestimate their own symptoms, which is why a third-party perspective is important.) After I got diagnosed, the specialist gave me useful advice, learning materials and resources, including recommendations for psychiatrists to reach out to for treatment. This is pretty important because a combination of psychiatric treatment with learning new skills, coaching... works better than only doing one or the other. If you can afford it or it works well with your insurance, I would highly recommend reaching out to a specialist instead of (or in addition to) talking to a normal doctor.
- georgespencer 6y ago
  > this is a pretty common story for people with ADHD who weren't diagnosed as children This was an extremely meaningful datapoint for me in feeling "seen". One of the steps was to ask my mother to fill in a survey recalling how she experienced me as a child. When I told my mother it was for ADHD diagnosis she laughed, and said, "You didn't have ADHD. You just liked to run around. In my experience 10% of kids are just wired that way." Cue the psychiatrist telling me that ADHD prevalence is now thought to be around around 10%. A good psychiatrist will not diagnose you with ADHD unless you have it, and they will not sit on the fence and say "maybe" if they believe you have it. Mine was emphatic with me. > Apparently people with ADHD usually drastically underestimate their own symptoms, which is why a third-party perspective is important Absolutely! The way people experienced me was totally different to the way I thought that they did.
- koreth1 6y ago
  > Apparently this is a pretty common story for people with ADHD who weren't diagnosed as children, so a specialist won't be particularly surprised by it. This is very true. And it's not even just due to lack of access to mental health care as a child: everyone over a certain age will have grown up before "ADHD" was a recognized disorder, and thus couldn't have been diagnosed with it no matter what their symptoms were.
neutronicus 6y ago
If you are like 30 and employed they don't dick you around about ADHD the way they do with college students

laurex 6y ago

Go to a psychiatrist. Report your symptoms. They will give you a diagnostic and make the call. As long as you go in without stating your suspected diagnosis, you're not "diagnosing."

stevewodil 6y ago

Do you have a PCP? You just say that you want to get referred to someone to get tested for ADHD because of x, y, and z and you think a diagnosis would help you

robmerki 6y ago

There's nothing wrong with using self-diagnosis as a way to inform a professional inquiry. In my unqualified opinion, you probably have ADHD.

anon9001 6y ago

No problem, serious answer: This is the DSMV criteria: https://www.cdc.gov/ncbddd/adhd/diagnosis.html https://www.cdc.gov/ncbddd/adhd/diagnosis.html Doctors are typically screening with a quiz that looks something like this: https://psychcentral.com/quizzes/adhd-quiz/ https://psychcentral.com/quizzes/adhd-quiz/ It's perfectly reasonable to say "I think I may have ADHD based on what I've read online, my symptoms match and people who know me have suggested I try adderall". Some doctors are fine with letting everyone have stimulants, because they're pretty harmless unless you're really binging on them, and they won't give you enough to do that for very long. Other doctors would prefer to put you on an SSRI or SNRI or wellbutrin or some other "non-addictive" medication (which ironically are more addictive, dangerous, and less effective), so avoid those IMO. You may have to shop around a bit, but your primary care doctor technically can write the prescription, but some prefer not to and you might need to find a specialist. Contraindications for stimulants are if the patient has a history of heart conditions, complains about racing heart rate, excessive sweating, trouble sleeping, trouble eating, etc. You generally want to start with a low dose of "instant release" as opposed to "extended release" pills, so you can have more fine grained control over the dose. IR pills can be broken in half, XR cannot. Some doctors are more nervous about IR than XR because they think it has more abuse potential (not true, but it's a common belief). With all that said, stimulants will fix the problems OP described, but don't mistake that for a pleasant experience. The truth is that amphetamines are extremely mentally exhausting, and if you don't take good care of yourself (planning proper meals, staying hydrated, resting at appropriate times, not taking more pills when you shouldn't), you can quickly spiral out of control. It's hard to explain to someone that doesn't do drugs, but stimulants can leave you feeling like a shell of yourself, and it's really disconcerting. It's sort of like being over-tired where you're awake but your judgment is clearly impaired and you don't feel like "you". If you stay on them long enough, you'll start to feel like a zombie just going through the motions (successfully, mind you), but without identity. I make sure to take weekends off to preserve their efficacy for the work week and to make sure I don't become too dependent. I'd 100% recommend having stimulants in your toolkit, and chances are you're already supplementing with worse stimulants (like mountains of coffee or soda), so do give them a try, but be careful.

hanniabu 6y ago
> IR pills can be broken in half, XR cannot You can always take the XR pill apart and split it into blank capsules. Or you can just dump a little out and take it without the capsule.
- georgespencer 6y ago
  I think this depends on the actual formulation of the drug, right? For example two of the titrations of Concerta (XR methylphenidate) which I have experienced first-hand are a hard candy-like tablet, and the pharmacokinetic result is that you receive 25% of the dose within a couple of hours, and then over the course of the rest of the day the remaining 75% hits your bloodstream. But I now take an XR lisdexamfetamine which looks like it would be possible to split into smaller doses, but it's a prodrug so it's a totally different experience. I know it's a luxury some folks can't afford, but there really are a great range of optimised formulations of the treatments for ADHD out there, and rather than guessing yourself, it'll be better to have an honest conversation with your doctor about the ability to mix XR/IR in a way that works for you.
  - anon9001 6y ago
    This is correct. Concerta is interesting because it's a laser-drilled time release. Vyvanse is interesting because it's a prodrug of amphetamine that releases chemically over time.
- projektfu 6y ago
  The XR part is usually the particles inside the capsule. To make them faster acting you also have to pulverize those.
blaser-waffle 6y ago
> I'd 100% recommend having stimulants in your toolkit, and chances are you're already supplementing with worse stimulants (like mountains of coffee or soda), so do give them a try, but be careful. I'll second this. I've got an old friend and former coworker who clearly has serious ADHD and self medicates with tons of coffee/soda/cigarettes. He's killing himself and he knows it, but hates doctors and has a negative view of shrinks. Anec-data: I cut out carbs and only eat during certain windows and that has done wonders for focus and stick-to-itiveness. Coffee and alcohol hit me extra hard, and I've cut back on them.

georgespencer 6y ago

Shoot me an email if you wanna chat about my experience in more detail! Email address in profile :)

tikhonj 6y ago

I was in a similar position. I did a bunch of reading on ADHD, convinced myself that I probably had it then I found a clinical psychologist who specialized in ADHD and reached out for an initial appointment. Apparently this is a pretty common story for people with ADHD who weren't diagnosed as children, so a specialist won't be particularly surprised by it. The initial appointment is probably going to be an in-depth interview with the specialist, coupled with filling out some self-assessments and, possibly, getting somebody who knows you well to fill out an assessment as well. (Apparently people with ADHD usually drastically underestimate their own symptoms, which is why a third-party perspective is important.) After I got diagnosed, the specialist gave me useful advice, learning materials and resources, including recommendations for psychiatrists to reach out to for treatment. This is pretty important because a combination of psychiatric treatment with learning new skills, coaching... works better than only doing one or the other. If you can afford it or it works well with your insurance, I would highly recommend reaching out to a specialist instead of (or in addition to) talking to a normal doctor.

georgespencer 6y ago
> this is a pretty common story for people with ADHD who weren't diagnosed as children This was an extremely meaningful datapoint for me in feeling "seen". One of the steps was to ask my mother to fill in a survey recalling how she experienced me as a child. When I told my mother it was for ADHD diagnosis she laughed, and said, "You didn't have ADHD. You just liked to run around. In my experience 10% of kids are just wired that way." Cue the psychiatrist telling me that ADHD prevalence is now thought to be around around 10%. A good psychiatrist will not diagnose you with ADHD unless you have it, and they will not sit on the fence and say "maybe" if they believe you have it. Mine was emphatic with me. > Apparently people with ADHD usually drastically underestimate their own symptoms, which is why a third-party perspective is important Absolutely! The way people experienced me was totally different to the way I thought that they did.
koreth1 6y ago
> Apparently this is a pretty common story for people with ADHD who weren't diagnosed as children, so a specialist won't be particularly surprised by it. This is very true. And it's not even just due to lack of access to mental health care as a child: everyone over a certain age will have grown up before "ADHD" was a recognized disorder, and thus couldn't have been diagnosed with it no matter what their symptoms were.

neutronicus 6y ago

If you are like 30 and employed they don't dick you around about ADHD the way they do with college students