ADHD and Diagnosis: Things You Should Know

DISCLAIMER: My diagnosis was made when I was known as a pākehā straight male (still in the closet rather than bi). I am likely to have received the best possible version of diagnosis and care. There are many barriers to mental health care in Aotearoa New Zealand at the moment, but these are near universal. I’ve mentioned them here.

If you have just been diagnosed or self-diagnosed:

You are valid. You are a good person. The things that have happened in your past can always be forgiven as long as you embrace a growth mindset, and understand your weaknesses. Things get easier. People with mental health conditions will love you implicitly. There’s a community for everyone. Don’t struggle alone. You are not the productive worth that capitalism has tried to define you as. You are unique. You deserve love.

I’m always on Twitter if you need to vent or talk – if I don’t respond it’s because I am sleeping or busy but I will respond – I will never judge you or share your personal details with anyone. My Twitter is @roryreckons – DMs are open. It’s a safespace – I will never violate your trust. I cannot always offer advice but I can let you know that you are not alone, understand you, and point you where to start on this journey.


My condensed mental health diagnosis timeline

  • 1988-2000 – in school have a conduct disorder I am pretty sure here, teachers dislike me. Also have never diagnosed dysgraphia and dyscalculia – these are never detected in my education anywhere.
  • ~1993 – start showing symptoms of depression I think I had (due to suicide ideation starting at this age).
  • 2001 – Substance abuse problems – during this time someone says if I don’t react like others to amphetamines I might have ADHD (this is the first time I thought about it).
  • 2002 – Have the start of major depressive disorder. I have been messing up in life a lot. Mental health is never discussed anywhere in society, except to stigmatise the “crazy”.
  • 2009 – Diagnosed with depression – started on Fluoxetine (Prozac). No effect.
  • 2009 – Learn about ADHD in university – believe I have it, but most science here says it only occurs in children. I have also been masking behaviour for a long time, and making adaptations to cause depression and anxiety from this issue. I don’t think it can be me.
  • 2010 – I can’t get it out of my head that I have ADHD. It describes me too well. I talk to my doctor about it – they tell me it’s highly unlikely, but I push for a referral to the public mental health system. I take everything I can for evidence – school reports etc. The public psychiatrist doesn’t even entertain a diagnosis – says it’s my existing depression, changes my medication to Venlafaxine. I have a severe adverse reaction to this and I am told to persist for a month before they allow me to discontinue despite extreme suicide ideation and full body central nervous system zaps whenever I move.
  • 2010 – Sleep issues constantly – prescribed Zopiclone [Doctor dislikes this long term]. Switched to Temazepam – severe adverse reaction – no sensation in extremities. Switched back to Zopiclone – been taking it pretty consistently for the last 10 years.
  • 2011 – Switched to Citalopram (Celexa) for depression. No effect.
  • 2013 – Switched to Sertraline (Zoloft) for depression. No effect.
  • 2013 – Switch doctors. Tell them I think I have ADHD. They tell me they know of someone they can refer me, cast doubts on this doctors ability to diagnose. Get a referral. Spend 3 hours in assessment, costs an unreasonable amount of money, take supporting evidence (School reports, Academic records, Work History). Do a TOVA test – this showed ‘moderate’ ADHD-C. Doctor believes I have it and prescribed Ritalin. Go to fill my script for the first time and the pharmacist asks me “Do you really need this? Your doctor is just known to prescribe it.” I say yes – this fills me with doubt about my diagnosis.
  • 2013-2019 – Spend most of my time in denial here – medication is not working, I try short release, long release, combinations of stuff, believe I can “cure” my ADHD symptoms with medication.
  • 2016 – Put on Lorazepam for regular occurring panic attacks.
  • 2019 – My renewal for medication is up, and my Doctor has retired. See new Psychiatrist – he says I definitely have it, switched to Dexamphetamine… IT WORKS.
  • 2019 – 2020 – Become active on Twitter about my ADHD, connect with the mental health activist movement – start relating to autism related memes that talk about specific effects not related to ADHD. Take an online test. Says high chance of Autism Spectrum Disorder
  • 2021 – Diagnosed “officially” with ADHD and autism with comorbid depression and anxiety – only after undergoing a mental health crisis in the previous year related to justice sensitivity which meant I could access free mental healthcare.

Self-diagnosis is valid – if done honestly and correctly

That doesn’t mean to say “everyone is a little ADHD”, or that if you took a quiz on BuzzFeed that said you might have it you have it. But there are a number of self-diagnostic tools – ADHD Self Reporting Scale (ASRS rev, 1,1), Wender Utah Rating Scale (WURS), Mind Excessive Wandering Scale (MEWS) – when taken with honest intent a high score on these tests should indicate that you might have ADHD, these tests are used as part of the ADHD diagnosis process.

I knew I had it, everyone I know who has been diagnosed as an adult knows they have it. The world is not the same as other people experience. People in your life are constantly frustrated at you for things and you don’t know why you do or don’t do them.

There are significant barriers to accessing ADHD diagnosis, until these are addressed – self-diagnosis is valid.


What to expect after diagnosis in my experience

So the instant thing you will feel after diagnosis is relief. There’s a moment of release where suddenly the reason you’ve been struggling on hardmode with tasks that should be simple that you know you want to do but just can’t all makes sense.

This is very short lived. What comes next and how the people in your life treat you will have lasting effects on your outcomes. It’s time to discuss the grief of adult ADHD diagnosis.


The ADHD Diagnosis Grief Continuum (people call it a cycle but it’s non-linear)

Denial

This is what happens pretty much after you get your diagnosis. You get a brief moment of relief, then your ADHD negative self talk brain just goes for it. “You’re lying”, “You are just looking for an excuse”, “Convenient all the bad things you didn’t like doing and play back in your head constantly could possibly be explained by this”. Everyone goes through this. The absolute worst thing you can do to someone here is question their diagnosis. Especially if you are in the medical industry.

It’s really important if you have just been diagnosed to understand that everyone goes through this – it’s a phase – this one does go away.

My pharmacist and primary doctor cast aspersions on my diagnosis both before and after my diagnosis making me believe I didn’t have it – they fed into my self-doubt. That combined with negative conditions in other areas of my life made me question whether I had ADHD, I didn’t leave here til 2019 after getting a second diagnosis with a new psychiatrist.

[NOTE – NOT OFFICIAL MEDICAL ADVICE BUT BASED ON MY EXPERIENCE: If your meds aren’t working after several adjustments – talk to your psychiatrist about changing medications – in recent studies it has been shown that dexamphetamine is more effective at treating adult ADHD than methylphenidate (Ritalin). The reverse is true for children. They only work for ~60% of cases for either medication – don’t be like me, demand change within 12 months if you aren’t seeing effects after diagnosis.]

Anger

This part is going to come up a lot. The denial phase you can get past, however anger will keep hitting you in unexpected ways. Common anger responses are “how did people in my life miss this?”. “Damn x person for treating me this way for having ADHD”. “I can’t believe how many people have been awful to me in my life for this”. These are acceptable things to be upset about – but you will not grow if you allow them to consume you.

The truth is little was known about ADHD, a lot is still not known. The only people you can actually be mad at here is research scientists who never considered how biases might affect their perceptions of ADHD and it’s presentation. They let down the medical field, who let down you – and the snowball effect has made every sector of society buy into the deficit model of mental health. This is still occuring. Science has improved but there’s a lag in the medical field with current practices.

Bargaining

So you have accepted you have ADHD. But now it’s about curing it. You look into therapies, you try everything, there’s studies, evidence – breakthroughs – new tech potentially to ruin your brain with. You start doing everything you can to negotiate your way out of being “ADHD”. You strive to be “normal”. You strive to just be able to do the things that others can without having “this” about you. A lack of support here can really damage people too – they personalise their ADHD failings still as character flaws and think there’s a way to “cure” it. You can not cure ADHD.

Depression

Hello old friend… most people diagnosed as adults will have a comorbid diagnosis of depression.

The bargaining didn’t work, you don’t know how this affects you fully yet – there’s so much information everywhere, you must just be bad at doing ADHD management. You fall into depression. ADHD is still having an effect on your life but you’ve been diagnosed and the meds are helping – why are you so bad at this you ask…

Acceptance

This is the final stage. You can cycle back all the other phases here, or you can accept.

You have ADHD. You are different. Your brain is not the same as other people when it processes and stores information. You have problems with focusing attention, not the ability to focus. You will have bad days. You will have good days. You are an ADHD person, and it affects you in nearly every part of your life. You no longer believe that you have moral failings due to ADHD. You adapt and make what efforts you can to resolve your negative ADHD effects but you understand they will never go away.

Acceptance is the hardest stage to reach. It took me until mid-late 2020 to finally reach this stage. I’ll tell you what can make it easier.


Ways to improve outcomes
[Tools/things I learned that helped me]

YOU HAVE REJECTION SENSITIVE DYSPHORIA

You do not respond to criticism or perceived criticism in the same way that other people do. You have rejection sensitivity from years of being told that you are not good enough, not trying hard enough, not applying yourself. This manifests even when you get good advice – and it can be devastating if you respect the person who gives it – it causes a wild mood swing that makes you feel extremely depressed or angry – but will usually pass within hours. A better article on this specific part of ADHD can be found here: What You Need To Know About Rejection Sensitive Dysphoria – by René Brooks | Black Girl, Lost Keys.

Find a mental health community support group on the internet

This part is absolutely essential. You will be feeling alone, the people around you might not have the condition or have limited experience with it. They will not understand you in a way that other people with this condition do. I use ADHD Twitter, I also use a discord and a Facebook support group. I shopped around a bit for a discord community because there are a number of them. There’s also usually local or regional Facebook pages for support – I do not generally recommend them as they are quite hostile.

Educate yourself – using resources written by ADHD people for ADHD people

It’s very unlikely that you will get good advice from people without ADHD on how to live with ADHD – the quality of material here is bad. It just is, it’s either passively insulting, or suggests stuff for us that will not work. There’s no one right way to manage your ADHD symptoms – but be super skeptical of any claims made by people who are not affected by ADHD. It’s absolutely vital you do this. I kept trying to use tools developed to manage my productivity, cleaning, and general life management USING non-ADHD people backed tools. They rarely will work (if ever).

Radical Empathy

This one I really didn’t learn to do this properly until 2020.

Radical empathy refers to the practice of actively striving to understand the feelings and experiences of others, and through doing this, to improve their lives in a concrete fashion.

Radical Empathy

The act of doing this will make you a better person. Connect with the mental health community. Follow disability activists. Follow racial minorities, Indigenous people and start helping them.

This ended up teaching me how to empathise with those who had harmed me in my life. Especially my family. I am not going to say that you should forgive people who are obviously toxic and show no sign of repentance – but if your family has unintentionally hurt you through a lack of knowledge – practicing this enough in real life will help you to get to this step. The amount of unintentional harm that has occurred in your life will be a lot. We love to commit the attribution bias to protect ourselves – but sometimes people do bad things with good intentions, they are not bad people.

This is incredibly important not only for others, but you learn to turn that radical empathy inward. You start to forgive yourself. You start to heal. You can start to become the person you want to be.

Cut toxic people out of your life if you’ve tried educating them

This is hard too. This will hurt – but you need to assess if people are constantly denigrating you for your ADHD, an occasional joke will be ok in the right context, but people who demean or insult you should be either ghosted if you cannot handle the confrontation – or confronted (this is better and will work sometimes but it’s hard due to rejection sensitivity).

If they are absolutely vital due to familial ties or cultural reasons – mentally prepare yourself before and after when dealing with them – but don’t be afraid to do this – I’ve never regret doing it.

Know your RIGHTS in the workplace. Join your union.

Discrimination of ADHD in the workplace was present my whole career(s) except one job. It’s essential that you know how your ADHD manifests, how it affects you, and how to advocate for yourself. The brilliant Ashleigh the Advocate in New Zealand (very context specific – please research workplace rights in your own country) wrote this guide on knowing your rights: ADHD and Employment Rights – Know your rights.

You have a disability, you are disabled. [There’s nothing wrong with this term – any other version of this term is a form of ableism]. They must make accommodations for that. A union can help you with disagreements – you really don’t want to be facing this stuff alone and they are the best source of legal recourse if you need to actually make a complaint. I repeat you do not want to be alone during this process.

Morality and ADHD

I am a practicing Stoic philosopher. I describe that a bit here: My practice of Stoicism (Redux 2021). There’s a few articles on ADHD and moral development. You will most likely have been stunted in your growth in this area due to how you have been treated, you’ll most likely have a chequered past of bad relationships, potential criminality and substance use – things you attribute to moral failings. It’s kind of essential you learn about this stuff imho – if you already know it that’s fine too.

Here’s some tough love about your actions – ADHD is NEVER an excuse for abusing others, it can offer an explanation but it’s not an excuse. This scene might hurt but you need to understand the importance of accountability – this show is brilliant.

Once you have processed this video. Now take all the bad stuff you might have done, when you get the playback reel that tells you you are awful, if you have changed and grown since it occured or it was related to untreated and undiagnosed ADHD – throw that stuff away – it won’t help you holding on. You take accountability and you move forward – GROW.

My Story – What is a good person? (HINT: There are no good or bad people)

When I started watching The Good Place, I became interested in philosophy. I started listening to a podcast on the history of philosophy – Philosophize This! – This is an excellent podcast – use the 1.2x or 1.5x or even 2x feature to actually have people talk at an ADHD brain interesting speed. Do not force yourself to do this either – you need to have a decent interest or it won’t work.

The Wisdom of Marcus Aurelius

In that podcast I discovered Stoicism. Stoicism had some exceptional quotes. A book called Meditations by Marcus Aurelius (last of the five good emperors of Rome) is something I now carry with me everywhere – please note man could be interchanged for person here – it’s a 2000 year old book that I am quoting verbatim. Here’s a few quotes that I love and try and live by:

“The happiness of your life depends upon the quality of your thoughts.”

Marcus Aurelius

“Waste no more time arguing about what a good man should be. Be one.”

Marcus Aurelius

“If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment.”

Marcus Aurelius

“Accept the things to which fate binds you, and love the people with whom fate brings you together, but do so with all your heart.”

Marcus Aurelius

“If someone is able to show me that what I think or do is not right, I will happily change, for I seek the truth, by which no one was ever truly harmed. It is the person who continues in his self-deception and ignorance who is harmed.”

Marcus Aurelius

“If it is not right do not do it; if it is not true do not say it.”

Marcus Aurelius

“I have often wondered how it is that every man loves himself more than all the rest of men, but yet sets less value on his own opinion of himself than on the opinion of others.”

Marcus Aurelius

“When another blames you or hates you, or people voice similar criticisms, go to their souls, penetrate inside and see what sort of people they are. You will realize that there is no need to be racked with anxiety that they should hold any particular opinion about you.”

Marcus Aurelius

I could honestly quote from this book forever. The advice in this book is exceptional. I was drawn to Stoicism for it’s practice of virtue ethics – or always striving to be the best version of yourself.

Understanding that you are only responsible for your thoughts, feelings, and actions towards other people that you can control is one of the key lessons of Stoicism. This stuff takes a while to sink in and you will fail at it constantly – self forgiveness is the key.

The Good Place (Spoilers and Quotes)

One of the things I like most about The Good Place is it’s main themes. That there are no good or bad people. That with love and support all of us can change. That taking action is how you become good.

Here’s a handful of my favourite quotes from the show to round out this post.

“What matters isn’t if people are good or bad. What matters is if they’re trying to be better today than they were yesterday. You asked me where my hope comes from. That’s your answer.”

Michael

“We choose to be good because of our bonds with other people and our innate desire to treat them with dignity. Simply put, We are not in this alone.”

Chidi

“If all you care about in the world is the velvet rope, you will always be unhappy no matter which side you’re on.”

Tahani

“The fact that it makes you nervous is exactly why you should do it.”

Tahani

“Come on, you know how this works. You fail and then you try something else. And you fail again and again, and you fail a thousand times, and you keep trying because maybe the 1,001st idea might work. Now, I’m gonna and try to find our 1,001st idea.”

Michael

“The point is, people improve when they get external love and support. How can we hold it against them when they don’t?”

Michael

Summary:

  • Get support
  • Trust your judgement
  • Redemption is always possible
  • Never stop trying
  • You can do this.

Published by roryreckons

I am an ADHD/Autism Coach as well as ADHD/Autism/OCD/CPTSD advocate and independent ADHD/Autism researcher. I am an ADHD/Autism Coach who trained through the ADD Coaching Academy. I write mainly about ADHD/Autism/OCD/Mental health issues, but will also discuss morality, abolition, and current affairs occasionally.

4 thoughts on “ADHD and Diagnosis: Things You Should Know

  1. Hi Rory,

    I’ve read a bunch of your posts today, and really thanks for the solid, curated content, including linked resources (I’ve already checked a couple of them).

    I was looking on information about autism and ADHD in combination in adults, and this is one of the most informative sites I’ve found so far – I will definitely be checking back.

    In addition, I really appreciate that you’re attacking this topic in a way that’s informed both about (cis/hetero)sexism and race/BIPOC/culture issues – I’ve found few people who address (or get) all these fronts.

    I’m myself a nb/trans person who is on the spectrum, and I’m reading this stuff to figure out if ADHD might be the name for the side of my personality that tends to produce random impulsive risky life choices and explain the countless career and location and identity changes (not sure so far).

    I’m trying to educate myself about race and the experience/perspective of indigenous people – as a “serial immigrant” (let’s call it that) I highly appreciate anything that’s written (or thought) with an intercultural / interracial perspective, incl. the resources you point to in that area.

    I’ll end my eulogy here, I just figured I’d put in some time to encourage and appreciate when I see what I consider quality content. I suspect I will be referring back to your resources.

    All the best on your continued journey!

    Like

    1. Thanks so much for this feedback.

      Since becoming active on Twitter I have been educated by those before me especially Indigenous friends, BIPOC, and those who live with intersections of issues such as those with disabilities, trans people.

      Admitting fault is something I got used to doing, and correcting, because we always will make mistakes even with good intentions.

      I think if everyone listened a little more and spent more time trying to understand one another we’d realise while each person is unique we share common goals.

      Here’s a fairly recent article of ADHD and Autism comorbidity:
      https://link.springer.com/article/10.1007/s11920-019-1020-5

      Thanks again for your kind words. I really appreciate feed back. 🥰

      Like

  2. Damn.. randomly came across your blog via an NZ ADHD FB group…wow, your experience is very similar to mine 😁 it’s lovely to know I’m not alone! I only got put on one SSRI for my ‘anxiety’… then had little success with methylphenidate for ADHD…but Dex..boom! Things started to work for me… I haven’t read the rest of this article as I was too excited about the first bit 🤣

    Like

    1. Unfortunately this is all too common. I try not to think about that too much because otherwise I just get trapped in the past. There’s a lot of bad stuff there and getting stuck in negative cycles of thinking really undoes a lot of trying to move forward.

      Yeah Dex was just like night and day in terms of difference for me. I am glad you have found it works for you!

      Like

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