It's a Two-Fer. And they're both pretty bad (sources are the reason)

[Anonymous]

Btw, my first post. I feel like I’ve found the oasis in the barren desert! Now, on to the terribleness:

1) My first time through college (a community college, but we won’t hold that against it), I went to see a ‘learning specialist’. I sat in her office and told her I was an ADD kid (note the lack of the H). She smiled reassuringly and told me it was ok, “ADD is a myth. It doesn’t really exist. The best way to overcome the problem is to put your nose to the grindstone and keep pushing forward.” Now, I understand that for most people this would probably be good advice. I, however, had a diagnosis that was at least nine years old by the time I found myself in her presence. Half of my life was spent dealing with this, with no differential diagnosis that would even come close. She was the first person I thought of when I dropped out the following semester.

2) A few years back, I went to see a psychiatrist about getting my life in order with the help of some fancy magic pills (I’m not discounting medication; I’m medicated now, and the results have been truly amazing). I told him my mind races when I need to focus and that it causes problems in every facet of my life. I think he heard ‘racing thoughts’ as a trigger word. He prescribed Wellbutrin, an antidepressant, to calm my mind. Since I wasn’t depressed to start, I became what I affectionately call ‘antidepressed’, which found me reading a two hundred page book in an hour. the downside was that now my brain was going absolutely berserk, and I couldn’t settle down. It was like going from ADD to ADHD in a single week. When I returned to this quack, he prescribed Depakote, an antipsychotic. I read the diagnosis he gave to his secretary, and it said “Bi-Polar-Manic”. I never told him I had mood swings (because I don’t). I never told him I had any manic features (because I don’t). I just told him I had trouble focusing. I later found out that this guy was called “Doctor Depakote” behind his back because that’s what he gives to just about all of his patients, regardless of their actual diagnosis.

Anyone else get treatments like these? From professionals, no less?

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[trashman]

OH my, I read stories like this and I am so THANKFUL, I have a good psychiatrist! I don’t always agree but she at least seems to know what she is talking about and is thinking of my best interest.

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[ashockley55]

I’ve come to learn that ADD/ADHD and Bipolar Disorder symptoms overlap to a great extent. Because it is so empirical, the practice of psychiatry seems more of an art than a science and is dependent on many variables, not the least of which is what and how the patient reports to the doctor.

For many years, I reported only emotional symptoms to my doctor, as these were the most distressing to me, and included: extreme bouts of depression, low self-esteem, high anxiety, moments of restlessness and high, excited mood. As a result, I was diagnosed, over the years, with the following: depression, social anxiety, obsessive-compulsive disorder, bipolar II disorder and borderline personality disorder. I was prescribed nearly every class of pychiatric drug available, specifically Paxil CR, Risperdal, Seroquel, Remeron, Zoloft, Wellbutrin, Effexor, Ativan, Depakote and Lamictal.

My psychiatrists were doing the best that they could for me with the information that I gave them. They are doctors, but in what is admittedly an incredibly maddening and backwards situation, they are, in many respects, completely reliant on the patient, and what they report, to make their diagnosis. Of course a skilled professional will ask the right questions, in the right ways, to arrive at an appropriate diagnosis, but, like I said earlier, more of an art than a science.

For me, I realize that I presented as a young woman suffering from depression, or bipolar disorder, or borderline personality disorder. The fact alone that I was a young woman contributed to these diagnoses, before I even spoke one word to my doctor. The symptoms that I reported to my doctor, when taken at face value, could point to those diagnoses.

What you leave out, however, is just as important as what you tell. I did not report to my doctor the many frustrations that I experienced on a daily basis. I didn’t even think to report them. I thought they were small, or just stupid, or a result of my depression or anxiety or inferiority. Both I and my doctor were too concerned with my very severe depression and some larger issues in my family and history to give any attention to the fact that I was often very scatterbrained. Of course I was scatterbrained! Who could think straight when they were so depressed?

Or who wouldn’t be depressed when they were so scatterbrained? Ah. New lens.

Bipolar Disorder and Borderline Personality disorder both fit me, somewhat. Once I started educating myself about ADD as it presents in adults, as it presents in women, as it presents in girls, however, I was continously amazed at how my actions, thoughts, and feelings lined up with this disorder.

With Bipolar Disorder, and especially Borderline Personality, I would read about them and identify with some aspects, but shake my head in a “No, that’s not me” way at others. The more I read about ADD, the more I find myself wide-eyed and flummoxed at just how well ADD knows me, or how well those that know ADD know me – how they point out things that I do that I wasn’t even, well, paying attention to. Ha!

There are definitely doctors out there that are heavy-handed with certain diagnoses or medications, or are too quick to conclude their detective work. Part of this comes, ironically, from their fear to misdiagnose, and to be sued and/or lose their license as a result. Certain mental disorders carry more potential for major harm than others. Bipolar Disorder is one of these. It is a Big Deal, and if a doctor suspects it, and if he is a good, responsible doctor, he is going to err on the side of caution and medicate for it. He’s going to offer a mood stabilizer, and potentially save his patient’s life. Reacting in a hyperactive and/or hyperproductive way to an antidepressant is a tip-off for bipolar disorder.

In your case, as in mine, if my doctor had persued a diagnosis of ADD/ADHD rather than Bipolar Disorder, I would’ve started to educate myself about it, and I would’ve gained more insight into my own behaviors and symptoms, and would have been able to report back to my doctor in a way that would have confirmed and satisfied the diagnosis. I might’ve then been prescribed a medication, or otherwise receive appropriate treatment.

However, in other cases, if my, or your doctor had persued a diagnosis of ADD/ADHD to the point of prescribing a stimulant medication to someone truly suffering from Bipolar Disorder, the results could be absolutely devastating. And this rightly scares many doctors whose first rule is to “Do no harm.”

For ADDers, erring on the side of caution, which often means diagnosing Bipolar Disorder, prevents the person truly suffering with ADD from living a full, productive life. However, erring on the side of caution, diagnosing Bipolar Disorder, also prevents someone truly suffering with Bipolar Disorder from ending their life. People who suffer from Bipolar Disorder are highly susceptible to suicide, at a rate significantly higher than those with ADD.

It is a sad thing that these disorders, or, the treatment of these disorders are at odds with one another. Give a stimulant to an ADDer and you (usually) greatly improve his life, give a stimulant to a person with Bipolar Disorder and you could set off a series of events that result in that person’s death. Because Bipolar Disorder is so severe, and the consequences are life and death, it is often hands-down treated in deference to the other, resulting, unfortunately, in continued years of suffering and misunderstanding for those that are misdiagnosed with it.

But, you can see why doctors would be more afraid to miss one over the other.

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[Anonymous]

I see your point with the argument for putting forth a ‘safe bet’ diagnosis. In a relative vacuum, that’s an almost perfectly legitimate course to follow. The problem with my case is that I told this psychiatrist that I had a diagnosis of ADD already, one I had been living with for at least fifteen years up until that point. He seemed to hear me, but kept asking mood-related questions. Some examples:

-Do you ever get depressed? (My answer: Well, sure. Sometimes things make me sad. Isn’t that how everybody works?)

-Do you have racing thoughts? (Answer: Do I!? I’ve thought about four different subject since I sat down.)

-Do you have trouble sleeping? (Answer: Of course I do. The smallest activity can interrupt me and then I’m wide awake.)

-Have you had trouble keeping a job? (Answer: I drift from job to job. I can’t focus on any given activity for any real length of time)

-…and so on.

These questions all relate to Bipolar Disorder. The problem is that my answers (and the answers of many others, I suspect) point directly to an ADD diagnosis. What makes matters worse is that the guy I was answering these questions for had just been told, by me, that I already had a diagnosis, but he felt comfortable chucking that information out the window in favor of using my answers to fit his previously manufactured notion. Comfirmation bias is not a good quality to have if you’re in the business of diagnosing ailments, mental or otherwise.

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[ipsofacto]

ashockley55, Thanks for a great post.

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[Anonymous]

Ashockley55, I’m glad to hear you could open up to the right people and get diagnosed and medicated correctly.

I went through the same thing and only in the last 6 months have I been seeking more extensive help from myself and everyone around me. I was resisting help and resisting my own problems, dismissing them merely as weakness.

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[ashockley55]

Oh yes, when a doctor acts more like a hound dog locked on a scent rather than a careful and studied detective, well then, you’ve got youreself a problem.

I’ve had a psychiatrist throw out a previous diagnosis before; he threw out Bipolar Disorder and diagnosed Borderline Personality Disorder (both wrong, ultimately, but in any case…). He also threw out my previous medication and started me on a new one, without any titration off of the first one or onto the second.

Result? I was a hectic, crazed, weepy, greasy-haired mess within 36 hours. Bad, bad stuff.

Doctors don’t always get it right. They are subject to stubbornness and ego, and even the best of them are subject to the fears I discussed previously.

My question now, having gone through all this – the misdiagnoses, the drugs that did more harm than good, the years spent in ignorance of my real problem(s), is what can be done to make sure this doesn’t keep happening?

How do we educate and alert (though not in a scary way, but more just, make aware) everyone, and the right everyones? I think this website, and their movies especially, are doing part of that work, but what more can be done so we don’t have stories like this?

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[ashockley55]

Also, I think part of the issue is this sense of authority that doctors have over their patients. In my case, at least, it has kept me from speaking up when I have felt like the doctor wasn’t hearing me. In many cases, I would take their diagnosis, and take the medication, sometimes to my severe detriment. In other, better cases, I would slink off to another doctor who seemed to have more insight to me and my problem(s).

Never have I spoken up and said, “Well, no, that doesn’t feel right. I’m not connecting to or recognizing what you’re saying.” Because who am I? They’re the one with the degree, the years and years of study, and I’ve only read, well, a couple books (and performed thousands of Google searches, but…..nevermind that).

Certainly have I never stood up, pronounced, “No, sir. You are incorrect.”, grabbed the nearest umbrella and proceeded to beat the doctor about the head.

Barring that, though, there’s got to be something that can be done.

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[Anonymous]

I think it comes down to open minded interventions. When I was diagnosed, my parents were asking (not in a cruel way, that’s important to note), “What’s wrong with him?” We went to a team of doctors, and after an extremely extensive process, they handed down three of our favorite letters (ADD). That’s part of what really shocks me about the ignorance and arrogance of some doctors who choose to ignore what a team of other doctors came up with.

What I’m planning on doing with my kids (since we know that ADD is hereditary, and my oldest is showing the signs), is getting them looked at early. I’m gonna play close to the vest and see what the doctors come up with. If they suggest something that’s not ADD or ADHD, then I’ll drop that bit of info and see if they have anything to say about it. If they reach for ADD then I’ll know that we’re on the right track. I’m not suggesting that I’m going to test the doctors, just that I want to see what a professionally trained doctor has to say and if revealing the possibility of heredity changes anything.

Of course, if they claim that ADD doesn’t exist, I’ll have words with them before never taking my children there again, but I hope it doesn’t come to that.

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[Geoduck]

YES! This happened to me, and I was diagnosed with depression, which I actually didn’t have, at that time. My doc said she didn’t diagnose ADD, because she thought it was over-diagnosed (I’m still trying to wrap my head around that one). So she put me on zoloft, which did nothing, and may have made things worse, actually, as far as focus went, now that I think about it.

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[Anonymous]

Yep, have also collected depression, borderline, and bipolar diagnosis. (Also young female presenting for mood symptoms.)

After 6 years of trying different treatments (while holding down a full-time fire-fighting job, training and licensing as a paramedic, and getting into medical school) I finally figured out that the only med that worked for me was Wellbutrin, and only when I was depressed in the far-north wintertime. SSRI’s really messed me up, impulsive mood swings/spending/eating/alcohol/suicidal. Took me years to figure out that it was the anti-depressants themselves that made me feel so weird. Of course the answer was always to up the meds, but my symptoms only improved when I stopped them.

Of course I had a classic family history for “some-kind-of-mental-illness-god-knows-what”

Finally heard about ADHD in third year medicine during a (very difficult) psychiatry rotation. (I skipped all the classes on ADHD in the first couple of years. ) It was hard to stand on the other side of the fence during psychiatry and I was saved by a talented and rational teacher who really helped people. Not a single doctor had ever suggested ADHD as a diagnosis when I was seeking help despite a near-perfect history of ADHD symptoms. In fact, I ran into my old psychiatrist the other day and when I told him happily that I had finally figured it out, he said that he had suspected it but didn’t think I needed to know.

I think that most doctors, and psychiatrists know very little about ADHD. Because they aren’t looking for it they don’t see it when it stares them in the face. If our coping mechanisms are out-of-whack, unhealthy, or overwhelmed we can present with classic symptoms for other disorders.

It all came full circle when I treated a young female in the psych ward for an impulsive suicide attempt. The psychiatrist had labeled her as borderline and was putting her into the standard outpatient therapy on discharge. She was bright, talented, and had a very functional history despite her recent admission (which had occurred under VERY stressful circumstances.) It just didn’t fit. I asked her if she had ever lost her cell phone. Answer: 27 phones in three years. It felt really good to suggest that she discuss and consider ADHD along with other diagnosis in followup.

Its a journey, but I am very glad that I had my problems with diagnosis and treatment prior to studying medicine. I know how it feels to be labeled, and to get the wrong treatment. I really hope that makes me a better doctor in the long run.

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[Anonymous]

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[Anonymous]

My psychiatrist seemed reluctant at first to diagnose ADHD, and even when he did, kept telling me that I didn’t seem interested in making my life better. At this point my marriage had all but fallen apart. He suggested I talk with a psychologist about the emotions I was dealing with. The referral letter for the psychologist only stated that I had ‘relationship issues.’ *sigh* The psychologist, when I presented my diagnosis, and the emotional fallout(not to mention the related depression from personal feelings of being apathetic) had to reach behind her for her copy of DSM IV, as she admitted not having any previous deallings with the disorder. I thanked her for her time and left. I have since been getting most of my support/information from peer-based organizations and this site. I am just glad that I have answers for so many questions now, and that my past life now makes sense.

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[Robbo]

What a great thread, lot’s of good information. And another squirrel to add to our Zoo of cats, dogs, horses, a butterfly, a wolf with shades on, a fox or two, a duck, some penguins, lot’s of cartoons, and some kind of cheetah like cat thing with big ears that kc5jck uses.

If ya got ADD, this is the place to be!

I thot I saw a puddy tat!…. I did I did i did!

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[Misswho23]

I too have gone down the road of lets see if this diagnosis fits? not that one? Well lets try this one….. Like a deck of cards being pulled out “was this the card you are?” Queen of hearts? NO? Lets try Jack of spades.

So in the years that I have been seeking help depression was always the first one shrinks would go to. And a spattering of mood disorders and am I an alcoholic or General Anxiety etc.? Mostly because when I would go to seek help something in my life had collapsed again I would be to tired and lost to get out of bed. Which happens to a lot of Adders. When I would list all of the stressors that were happening ( I tend to gravitate to the dramatic side of life) the shrinks were often surprised at how I could manage. So lets try an anti-depressant. And this should help you focus.

Finally a licensed clinical social worker diagnosed me. This was when my mother was going through a lot of heart problems and is elderly so there was so much family stuff to deal with I thought I should have someone to talk to to help me organize and deal with all the emotions of a parent getting older. But I’m fine really. Not depressed just going through a lot of stuff. Oh and by the way I hate my job, my house is a mess, my boyfriend is worn out from all my “projects” and oh I’m putting together a master binder of all my mothers insurance info etc. so everyone will have one and stay on track, and oh did I mention I need to get my finances under control because my credit cards all have variable APR’s and I didn’t get that last raise I was hoping for? Now where was I? Did I bring my keys in with me? Oh I need to walk the dog, he’s looking depressed.

So after about 6 months of him trying to get me to stay on topic, stop fidgeting on the office couch and suggesting every meditation method to get me to relax he finally offered up the ADHD diagnosis. I may find that this might be the missing pice to the puzzle he said. I had always thought I had the inattentive side. SInce I can also stare out a window for hours and contemplate the color blue in the sky. Ok I really didn’t want to finally admit I had it. So I actually was a bit reversed in that the therapist was the one on the ADD side. But once he explained that for years Adders have been diagnosed with depression tried anti- depressants but they don’t work. They will not help a person with ADD focus. Even though it took him six months to convince me to try medication and come to terms with ADHD he just kept patiently letting me work my way though it and point out where I was on track and where I had drawn a misinformed conclusion. In the end he let me decide when it was time for meds.

I’m still working on getting along with medication. Mostly because I hate taking pills. But when I stay on track with a low dose of a stimulant med. and a dose of anti-depressant because I do have a subset of anxiety and mood swings the combination takes the volume down.

I wrote to my therapist that this is the puzzle piece that fits. And really fits. Not a piece that sort of did or I had to jam it into place and then the whole puzzle was off. So I guess that is my positive ADHD diagnosis. Even though it took into my mid-life to get it.

Hope this helps. We’re all in this together.

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[Author]

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