ADHD – How I Got My Diagnosis

Since my previous post on ADHD, Life During Lockdown, several folk have asked me how I got my diagnosis. It’s a fairly complex answer, so I wrote another piece specifically about that. Hopefully what’s below might answer some of those questions, but there’s plenty online help too if you need it.

What Has Been Causing My Depression All These Years?

In short, I’ve suffered from bouts of depression for most of my adult life and it was looking for the root cause of this that finally led me to consider ADHD as a possibility.

Over the years I’ve attended cognitive behavioural therapy (CBT) and mindfulness sessions with a psychiatrist. These treatments were for depression (used in conjunction with anti-depressant medication) and helped provide me with a new set of ‘thinking’ tools. They also gave me a degree of stability and calm so I could deal with the day-to-day issues I’d been having. But 2 decades down the line I felt that none of this had properly addressed or even identified the real underlying problem: why is every single thing such a bloody struggle?!

Could it be … ADHD?

It was a friend who suggested I might have ADHD. I hadn’t considered it a serious option before, despite several other’s having made ADHD jokes about my frequent scrapes and misadventures over the years. I did a bit of googling and was surprised by how much of what I read seemed to fit my own life experiences, past and present. It was uncanny!

For example, did you know that folk with ADHD are twice as likely to suffer an accidental death? Most people seem to find it quite easy to cross the road without coming to harm. Alas, not I. I’ve wrestled with cars on 3 occasions and lost each time, twice ending up in hospital for long stays. Yes, I’m very accident prone and rather inattentive.

Just another bump!
Or maybe I am just stupid?

It’s almost inevitable that being told ‘… you’re just lazy/hopeless/stupid/underachieving … and you never listen!’ constantly as a child will lead to low self esteem and depression in adulthood. Over time, these impressions (whether external or internal) can take root and become core beliefs, going on to direct not only how you feel and think about yourself, but also how you live your life in general.

But I knew I wasn’t lazy. I can work ’til I drop when I like what I’m doing. I’m often plagued by a feeling of underachievement though, and in spite of all the effort I put into my work and everything else I never seem to get much done. Yes, I procrastinate a lot and find it hard to finish things I start, but doesn’t everyone? Maybe I’m a perfectionist or do I just fear failure? I drift off a lot during lessons, films or conversations and no matter how hard I try I just can’t do small talk. What is that anyway? Sorry, what’s your name again? Bloody hell, where have I/you left my keys, wallet, phone, camera, car, kids, etc etc ……?

School/Prison

When I was at school ADHD wasn’t yet a thing, so my constant day dreaming, fidgeting and general restlessness began to attract the wrong kind of attention. From about 8 onwards I’d be getting the belt almost daily. Eventually it stopped hurting and became part of my comedy routine. Something else to make folk laugh and pass the time. Me and the other ‘bad’ kids would even compete to see who could achieve the most lashes in a day. This was much more stimulating than lessons, with even some teachers appearing to enjoy their part in it (not naming any names).

At secondary I was sent to remedial classes, on the pretext that it would improve my ‘awful’ spelling and writing. Again, this was really just another form of punishment, by humiliation (the belt having recently been band). My spelling really wasn’t too bad and I eventually got a degree and a job as an editor.

Looking back I was obviously being disruptive at school, but all of that could have been prevented if only we knew then what we know now about ADHD. But for me being at school for 11 years was like serving a jail sentence. The day I turned 16 I walked out for the last time, having failed on every level. And so it went on …

What are the Symptoms of ADHD?

Having a list of typical ADHD symptoms has been handy to help assess myself against. Here’s one complied by the Mayo Clinic and these symptoms can range in number and from mild to severe in any given case (other lists are available):

  • Impulsiveness
  • Disorganisation and problems prioritising
  • Poor time management skills
  • Problems focusing on a task
  • Trouble multitasking
  • Excessive activity or restlessness
  • Poor planning
  • Low frustration tolerance
  • Frequent mood swings
  • Problems following through and completing tasks
  • Hot temper
  • Trouble coping with stress

All of this seemed very familiar to me and, importantly, to the people who know me best. It was pretty much unanimous: you must have ADHD!

Getting A Psychiatric Referral

But a positive diagnosis can only be made when several of these symptoms are a constant factor, you’re clinically distressed by this and they have a significant impact on how you function in everyday life. So I went to the GP and described my thoughts as outlined above. I also discussed how I felt maybe having undiagnosed ADHD could explain the depression. The doctor asked some fairly standard health questions then we talked about my history of depression and medication, childhood behaviour, schooling etc. He concluded we should get a specialist opinion and made the appropriate referral.

A few months later I was invited to attend 2 hour-long appointments with a behavioural psychologist. I imagine his job was to sieve out possible speed freaks (free stimulants … yay!!); or those with other mental-health issues, before passing the more likely candidates on to a psychiatrist. He asked similar but more probing questions about my childhood and whether I had any school reports that might back up what I told him. I did have a few that showed I wasn’t exactly attentive in class or achieving what teachers thought I was capable of: could do better/daydreamer/disruptive/easily distracted and so on.

At the 2nd appointment I mentioned my dad has also suffered from clinical depression, and that he’s similarly super fidgety, forgetful and restless. Overall he felt the case was pretty strong, so referred me on to the man I now thank for changing my life so much for the better, Dr Pipireddy. (I know this might sound over dramatic, but that’s exactly how it feels to me.)

A Few Basic Facts First

ADHD is real. It’s caused by an imbalance/disfunction of neurotransmitters in the brain. In most cases (75%+) it’s genetic, so you have it from birth. Other factors can contribute to how badly it affects you (smoking or use of certain prescribed drugs during pregnancy is thought to be one possible factor). But for the remaining minority it can be caused by a head injury or premature birth. And while some children are able to cope with symptoms at school and remain ‘under the radar’, it can sometimes be in adulthood that ADHD really begins to manifest. This is when the stresses of grown-up responsibilities, serious relationships and work come into play.

It wasn’t really like this!
In the Psychiatrist’s chair

Only a qualified psychiatrist can give an ADHD diagnosis and the process is quite involved. At the 1st session I was initially asked fairly open questions about my life experience and behaviour patterns in various situations. There were no leading questions or any ‘helpful’ information given at this point. And, while I knew a bit about the symptoms and how familiar they seemed to me, I suddenly felt overwhelmed in attempting to provide specific examples to illustrate my concerns.

The hyperactive-brain aspect of ADHD has been brilliantly described as like having 30 tv channels going on at once inside your head, but someone else has the remote. And that’s exactly how this felt!

He was patient though and waited for my thoughts to become clearer. He asked how old I was when these issues began (7 or 8) and about my time at school, my experience in relationships (with parents, partners, friends and colleagues etc). Also about my working and other habits. I was given a pile of questionnaires for me, my parents and partner to complete with about 60 ‘on a scale of 1-5’ type evaluation questions on each form. All this in relation to both the past and present. He finally asked if I could bring someone who knew me well to the next session, so I brought my partner to that.

2nd Session

The others had filled in their questionnaires straight away. I’d done mine on the morning of my next appointment. Of course, I realised I’d left them all lying on the kitchen table as soon as we entered the consulting room. Not a great start to the session but probably another tick in the ADHD symptoms box.

So minus completed questionnaires the doctor spoke exclusively to my partner, which was very revealing but also uncomfortable at times – for me and her. He asked probing and personal questions about my behaviour in various settings and circumstances. “What’s he like on holiday?” proved particularly fruitful! I think along with the questionnaires that this was the most valuable part of the process in helping to diagnose me. It also gave me much food for thought and a lot to work on.

Treatment

I had a final session where I was positively diagnosed with ADHD. He’s since told me it was a clear cut case, and this is backed up by the positive effects of the medication I’m now taking. There’s no talking therapy available for adults on the NHS, but there are lots of very useful websites, books and Youtube video resources out there. So self study and an effort to address some thought and behavioural patterns would form part of my treatment. We discussed the merits of medication and the possible side effects. I decided to give it a go. Initially an 18mg dose of Concerta XL (a slow release form of Ritalin that lasts 12 hours). I described how well the meds have worked for me in the last post.

The whole process has been truly transformative. I went back for review after a month and we decided to double the dosage, which is probably the right level for me (although this will be reviewed monthly for a year or so).

Along with the meds, learning more about ADHD (see below for some excellent Youtube videos) and just knowing it has been the real issue all along has been a huge factor in my moving forward positively.

Medication is not a panacea for all ADHD symptoms, but it’s helping me to to focus on tasks and to think with a clear and calm mind like I never knew possible. I haven’t suffered any side effects and each morning I awake feeling refreshed and ready for the day ahead. And that’s before taking a pill! I’m also much more productive now and in so many different (and finally organised) ways.

And relax …
And finally …

It’s thought around 5% of children are born with ADHD, 50% of whom go on to have it as adults. So chances are you know at least 1 or 2 folk who might benefit from a diagnosis if they haven’t already had one. I’d personally hate to think of people struggling along with this, not knowing that there’s possibly life-changing help to be had.

Please feel free to get in touch if you want to ask about anything I’ve mentioned. Here’s a link to a helpful Attitude magazine article on ADHD diagnosis.

These videos are all well worth watching, even if none of the above applies to you. It might to someone you know …

Jessica McCabe has a highly entertaining Youtube channel, with over 100 very insightful short videos dedicated to ADHD
Beautifully poignant animation about how ADHD can feel
This video provides a very clear definition of ADHD

    Life During Lockdown

    Could this be why I haven’t done much art lately?

    Like a lot of folk, my life during the coronavirus lockdown has involved a lot of spring cleaning. I’ve also been redecorating and making lists of things to do that I’ve been putting off for years. I’ve tidied the shed and just finished making a pond in the garden. But I haven’t painted a picture for a while (see above), though I have painted just about everything else within reach!

    I know I’m not alone in thinking this form of house arrest is an opportunity to see life differently. To consider what actually matters as we go forward, but also the stuff that really doesn’t matter.

    Lockdown Spring Clean

    So in the spirit of making positive changes (and not having much else to do) I decided it was time to tackle my plan chest. It’s where I keep all my etchings, prints and paper-based work. There was so much in it I could barely open the drawers! Here’s a small pile of the pictures that were clogging up just 1 of them. I’ve been carting this stuff around like a heavy load for years without really knowing why. It’s mostly duff prints and paintings that went wrong. This lot ended up in the bin where it should have gone years ago … and it feels like a weight off my shoulders.

    Best to bin it? Indeed it is!

    I used to think it was important to keep everything. Every proof, half-finished picture, sketch etc etc. It might come in useful or spark a new idea, and wasn’t it Picasso who said “Keep Everything!” Well, he had plenty space for it and I don’t.

    Holding onto that stuff holds me back and keeps me tethered to the past, when I need to keep moving forward in life without looking back too much. To proceed with the clarity of mind that comes from having more time and space in which to think, work and live.

    I’ve spent too much of my physical and mental energy over the years searching through piles of stuff (metaphorical and literal, and not just art related!) or trying to fix things that aren’t worth fixing. Staying indoors for 2 weeks during the coronavirus outbreak and giving up non-essential travel and activities has shone a light on just how much non-essential stuff has filled my life up to now. It’s all so distracting!

    Everything in its place and a place for everything – not before time!

    My Chaos Theory

    But trying to make my life neat and tidy is all very new to me. I’ve always lived a fairly chaotic existence on the whole and generally tried my best (albeit subconsciously) to avoid having any real plan or structure. And while on the surface it might look to those who know me that it’s a pretty happy-go-lucky way to be, the reality is that feelings of intense frustration and depression have often far outweighed any perceived benefits. Here’s a silly but illustrative example from my typically chaotic life …

    I often go on ‘sketching’ trips in my campervan and I’ll spend ages packing everything I think I might need … just in case. Watercolours, oil paints, pastels, pens, inks, different papers, canvas boards etc etc. Practically an entire studio! But what if I want to go fishing? Best take sea and fly rods and all the necessary fishing paraphernalia I might need too. And what about the hills? So in go the the boots, jackets, rucksacks full of spare clothing, poles etc etc. Of course, I’ll inevitably arrive at my randomly chosen destination having forgotten something (usually real essentials like food, the cooking stove and even bedding one time!).

    But apart from my trusty camera (begging the question: which one should I take?) almost all of it tends to remain unused and taking up precious space in my already cramped van.

    There’s barely enough room for me in there as it is!

    And why …?

    Well I’ve never even been a sketcher for starters. I’m impatient and impulsive and find it very hard to sit still, so the thought of squatting for an entire hour trying to capture the perfect scene is a vision of pure hell for me! Photography, on the other hand, is instant and I prefer to work directly from photos or memory later on.

    So I must take all that stuff simply because I’ve spent years accumulating it and probably need to justify keeping hold of it to myself. But I’ve recently come to the conclusion that it’s mainly because I can’t (or won’t) make a plan. I tend to lack the focus and powers of concentration that good forward planning generally requires. But it’s who I am … at least it was until recently …

    ADHD & Me

    So where am I going with all this? Well a few months ago I was diagnosed with ADHD. And it has been totally life changing! Both because of the medication I’m taking for it (a form of slow release Ritalin) and also just knowing what ADHD is and how it affects people. (I’ve added an excellent Youtube link below if you’re interested to find out more about ADHD.)

    Now I’m beginning to do things that I assume most people usually take for granted, like concentrating on one task at a time and being able to listen without having to ask for repeats. Just thinking calmly and with 20:20 focus on whatever I happen to be doing is something I’ve always struggled with. This ADHD diagnosis has been nothing short of a revelation and a real ‘light bulb’ moment in my life.

    The effect of the medication has been to literally slow me down to the extent that even the hours of each day seem to last longer – in a good way! (This seems to amuse and confound most people, considering Ritalin is a stimulant.) I just seem to be getting so much more done now. And, while all this means that it feels like I have more time, my energy and concentration levels have also improved way beyond what I thought possible (or ‘normal’, you might say). The upshot is I’ve never felt so happy, confident or, dare I say it, chilled out about the future.

    And the Future is Bright!

    It’s early days and pretty ironic I know, but this lockdown combined with the ADHD diagnosis and treatment have helped me beyond expectations. Together they’ve allowed me to stop, think and plan ahead with a focus and clarity that has eluded me for the past 50 years. They’ve also given me the time and the ‘positive’ energy I need to get things done well and efficiently in the here and now, day by day. (I’ve never been short on energy, but it wasn’t always the positive kind.)

    So I’m really looking forward to getting back to the easel and on with new work. But before I’m ready for that I need to hyperfocus productively on the jobs currently in hand. Next up is to tidy that studio. After all, a tidy house/studio/shed really is a tidy mind!

    ………………………………………………………

    I hope you and you folks are keeping well during the corona lockdown, and that we will all emerge from it having gained something that’ll make the world a happier and healthier place to live. Hope to see you on the other side!

    PS. You might be interested to hear that Picasso, Van Gogh and Leonardo da Vinci are thought to have had ADHD. Here’s another link to a very interesting article from The Charmed Studio about that and some other stuff I’ve mentioned above.

    PPS. If you think you or someone you know might have ADHD and you fancy having a laugh while trying to find out then click here. It’s a hillariously ‘unscientific’ but enlightening self-diagnosis quiz, by comedian and fellow ADHDer Rick Green.