TL;DR: I definitely have things wrong with me, and it seems that those things intersect substantially but not completely with “ADHD”. I have no idea how to figure these things out without going bankrupt.
In longer form:
I definitely have serious problems with avoidance of work, organisation, disorganised thought processes etc.
I’ve posted about them before here!
I’ve tried many things to fix this, some of which have worked a bit, but the underlying problem is essentially 90% still present
I’m not sure whether these problems are due to ADHD or due to anxiety, childhood trauma etc.
In particular, I am pretty high-achieving, and this makes me doubt my assessment of myself
Friends and family also think it is unlikely that I have ADHD, and seem to find the idea ridiculous
If I have ADHD, the opportunity cost of not taking medication seems extremely high—my inability to concentrate is seriously harming my life
If I don’t have ADHD, taking medication might end up masking my other problems, and I may end up in a worse situation in a couple of years
Here’s the crux: there appears to be no way for me to neutrally discuss these doubts with a psychiatrist
I will have to get a private assessment to have a realistic chance of getting diagnosed in the near-term
The cost of a private assessment is extremely high (in my current financial situation).
If I get such an assessment, I have an incentive to exaggerate my symptoms in order to get prescribed medication. I don’t want to risk losing my investment by discussing alternative possibilities to ADHD.
A cursory glance at reviews of private assessors seem to imply that they are diagnosis-mills
i.e., pay us £1000 and we’ll give you a prescription
They’re not holistic assessments of your place in life with a nice cheap option to continue treatment for something else if you don’t have ADHD
I’ve had quite bad experiences with the NHS (UK public health system), and I don’t think they’re likely to be very helpful whether I have ADHD or not
I am weird in various ways that make therapy useless
I have tried e.g. CBT, talk therapies and found them basically a waste of time, even after sincerely engaging with them
This set of circumstances seems likely to exist for other people in the LW community. I would really like some advice on what to do here.
I notice you seem to draw a distinction between “really has ADHD” and “just can’t concentrate”. You may want to read Scott’s “Adderall Risks: Much More Than You Wanted To Know” to dissolve this distinction and have a better framework for making your decision. Here is a central quote about it:
But “ability to concentrate” is a normally distributed trait, like IQ. We draw a line at some point on the far left of the bell curve and tell the people on the far side that they’ve “got” “the disease” of “ADHD”. This isn’t just me saying this. It’s the neurostructural literature, the the genetics literature, a bunch of other studies, and the the Consensus Conference On ADHD. This doesn’t mean ADHD is “just laziness” or “isn’t biological”—of course it’s biological! Height is biological! But that doesn’t mean the world is divided into two natural categories of “healthy people” and “people who have Height Deficiency Syndrome”. Attention is the same way. Some people really do have poor concentration, they suffer a lot from it, and it’s not their fault. They just don’t form a discrete population.
Maybe it’s just another case of the general: by media we are exposed to exceptional examples of people, our brains interpret that as a norm in our tribe, and as a result we feel inferior.
I have an ADHD dilemma.
TL;DR: I definitely have things wrong with me, and it seems that those things intersect substantially but not completely with “ADHD”. I have no idea how to figure these things out without going bankrupt.
In longer form:
I definitely have serious problems with avoidance of work, organisation, disorganised thought processes etc.
I’ve posted about them before here!
I’ve tried many things to fix this, some of which have worked a bit, but the underlying problem is essentially 90% still present
I’m not sure whether these problems are due to ADHD or due to anxiety, childhood trauma etc.
In particular, I am pretty high-achieving, and this makes me doubt my assessment of myself
Friends and family also think it is unlikely that I have ADHD, and seem to find the idea ridiculous
If I have ADHD, the opportunity cost of not taking medication seems extremely high—my inability to concentrate is seriously harming my life
If I don’t have ADHD, taking medication might end up masking my other problems, and I may end up in a worse situation in a couple of years
Here’s the crux: there appears to be no way for me to neutrally discuss these doubts with a psychiatrist
I will have to get a private assessment to have a realistic chance of getting diagnosed in the near-term
The cost of a private assessment is extremely high (in my current financial situation).
If I get such an assessment, I have an incentive to exaggerate my symptoms in order to get prescribed medication. I don’t want to risk losing my investment by discussing alternative possibilities to ADHD.
A cursory glance at reviews of private assessors seem to imply that they are diagnosis-mills
i.e., pay us £1000 and we’ll give you a prescription
They’re not holistic assessments of your place in life with a nice cheap option to continue treatment for something else if you don’t have ADHD
I’ve had quite bad experiences with the NHS (UK public health system), and I don’t think they’re likely to be very helpful whether I have ADHD or not
I am weird in various ways that make therapy useless
I have tried e.g. CBT, talk therapies and found them basically a waste of time, even after sincerely engaging with them
This set of circumstances seems likely to exist for other people in the LW community. I would really like some advice on what to do here.
I notice you seem to draw a distinction between “really has ADHD” and “just can’t concentrate”. You may want to read Scott’s “Adderall Risks: Much More Than You Wanted To Know” to dissolve this distinction and have a better framework for making your decision. Here is a central quote about it:
Maybe it’s just another case of the general: by media we are exposed to exceptional examples of people, our brains interpret that as a norm in our tribe, and as a result we feel inferior.
Why not discuss openly with one psychiatrist (or therapist!), then choose another to exaggerate if you decide to experiment.
Also, note that I don’t think psychiatrists are particularly averse to experimenting with drugs with few long term consequences or risks.