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  • How many times must we go through this?

    I understand that there are restrictions on ADD drugs and why sometimes doctors are reluctant when it comes to them. That does not however get rid of the frustration really. I was tested and diagnosed with ADD when it was in 2nd grade and was put on medication. Late middle school/early high school, I realized I generally wasn't happen. Honestly a lot of it was my situation and the fact that I hadn't figured out the coping mechanisms I needed for the ADD and for my situation. I didn't realize that was the cause at the time, just that I wasn't happy. My mom responded by taking me to a doctor and having me put on antidepressants. I always hated being on them. I know that they work for some people but they don't work for me. After my first semester of college, things changed a lot. I suddenly moved out of my parent's house for the first time, I stopped attending college for the most part so I wasn't insured either. All the changes and the money issues meant that I slowly went off all the medications. I eventually started seeing a therapist who was amazing. The self understanding and coping mechanisms helped amazingly and I started understanding more and more how I worked and how to adapt to that and make the improvements I wanted to. I no longer was generally unhappy and I started enjoying life.

    I had mostly managed without the ADD meds during this time but it was tricky. I had a lot of trouble being productive outside of work and I only managed at work because it involved moving around and was slow enough that I could randomly decide to reorganize things or become super focused on something and it wasn't a problem so long as it was helpful to the workplace. I would have liked to have gotten back on the meds but still no insurance so the idea got set aside. After a while I started working a desk job that required a lot of data entry and sitting still and also provided insurance.

    I figured with the new strain on my focus and the added insurance, it was a great time to see about getting back on the meds. That's when I had my first delightful experience at being told that I was a liar and I didn't have ADD, I had depression. This was by a doctor who barely knew me and had only seen me a couple of times before. He was so rude about it that I immediately started looking for a new doctor. I managed to find one who wasn't too bad and who was willing to prescribe ADD meds to me, but only if he was continuing a current prescription. He suggested I go to the psychiatric department of the hospital/clinic and see if they would prescribe them to me to start with. I did and was told that I would have to go through $3,000 out of pocket ADD testing to prove I had it, despite my history with it. That wasn't an option but luckily my therapist recommended a different psychologist to me who was nice and prescribed me Vyvanse which has been working wonderfully for me. He started me out on the lowest dosage and ended up moving me up to the middle dosage within a month.

    I think I've been on it for about 4 years or so at this point and I've been noticing that it's been less effective than it had been so I started asking about getting upped to the top dosage. My doctor said that that wasn't something he was comfortable doing either (usually he doesn't handle these types of drugs at all, even as continuing prescriptions) but referred me to the psych department again. I had an initial appointment with one of their therapists which wasn't bad and he seemed to actually listen to what I had to say though he found it surprising that despite the ADD, I had no trouble with alcohol and didn't have a criminal record, so I'm not sure what kind of patients he normally has to deal with.

    Finally had an appointment with the psychiatrist and it was bad. She seemed to have decided right off the bat that I clearly had depression and not ADD. Despite describing all my symptoms, she only seemed to hear "concentration issues" and wouldn't move beyond that really. She had me take a 15 or so question long printed out survey pertaining to depression near the beginning and a 6 question long one on ADD near the end that she found on the internet. I was told at one point that anyone can look up the symptoms of ADD online and claim to have them. At another point, I was told that I don't present typically which I guess means that I'm not only a liar, I'm really really bad at it. It seems that my learned coping mechanisms and ways of dealing with ADD are biting me in the ass. No I don't seem fidgety. I've learned to hide it when I am out in public. Hands in jacket pockets or allowing my toes to move but not my feet. Channeling things and such. It's not easy but a severe hate of feeling like I wasn't in control of myself for so long when I was younger has resulted in a lot of effort being put into managing this. It doesn't mean I don't need the help. Also of course I don't seem as bad, I'm on medication that is partially working and just needs to be increased. She kept going on about the risks of dependency on the drugs. I sometimes forget to have them refilled before I run out and I don't always take them on the weekends if I'm not needing to be productive. I also have no other addiction issues with any other substances so there isn't a history of it. I almost got the feeling that she thought that dosage should never be prescribed and that ADD drugs were bad from how she kept talking about them. Yes, it is a drug that can effect your system. I know that if I go off for longer than 5 days, my body definitely starts noticing the lack of it in my system but it's not anything huge. I get a bit grouchier or more impatient but otherwise, I'm fine. I know how they effect me and sometimes I even go off them for a day because I just feel like doing something more creative that I know the meds block. I know about the side effects and how they effect me. What the pros and cons are with that and how to manage the one or two that slightly show up.

    The result is she wants me to get ADD testing. This may now be covered for me due to a change in the mental health section of the insurance plan, but I'm not sure. I am however exhausted with having depression on my chats repeatedly bite me in the ass. It has come up a number of times where I'll have problems with something and it'll get automatically decided it must be my depression that I don't actually have. A lot of her questions seemed actually geared in that direction and despite all of my answers otherwise, she seemed stuck on the idea from the start. The psychiatrist said that she would be willing to look over the testing from 2nd grade (though made it clear that it wouldn't change her requiring new testing) but flat out said she had no interest in seeing anything from the doctor that put me back on the drugs. She also wants me to get blood work done to see if maybe the concentration problem might be caused by something else. I found it fairly amusing that cholesterol was on the list of things they were checking me for. It was probably the only thing I found funny during the whole thing and I have since told my sister several times "it must be my cholesterol messing with my focus again." Most of the things she is testing me for, I have been tested for in the last year or two and it all came back fine.

    I'm still waiting to hear if my insurance will cover this or not. I was told by the nurse that I had to call the business office, get the procedure codes, call my insurance, and verify coverage rather than the hospital preauthorizing me. This whole things has started to feel more and more like the process of getting things set up and getting to the testing appointment is the actual test. I mean clearly if I can manage all of this, I must not actually have ADD right? :P I finally remembered to call the business office woman yesterday. I should note that my appointment was originally today but I had already had to reschedule it for Feb. It turns out that what I was told wasn't quite right. When the appointment is set up, the doctor is supposed to email the business office with all the information so they can get things preauthorized. However they don't guarantee coverage and request that patients call the insurance themselves to verify what will or won't be covered. Also, the business office had never gotten an email about me so none of this process had already been taken care of and my insurance requires hospital preauthorization it turns out so it's a good thing I had rescheduled and didn't just risk it due to the doctors repeatedly telling me that they were sure it was now covered.

    I have no doubt in my head that I have ADD. I've done a lot of research on it and anxiety and depression and I do know there is plenty of symptom overlap but I've been dealing with this my whole life and I've worked very hard at an already strong sense of self awareness of how I work. But I've also since after high school been dealing with doctors who just decided I was depressed and didn't have ADD without even talking to me. All of this dealing with this now has me worried. What if the testing doesn't go good? It would completely fuck me over. And I know that's partly an irrational fear. I have it and the testing will show that but then again, it's not like a blood test where you either clearly have it or you don't. At least having the new test results on my side would help me shut down any further issues but I'm just stressed dealing with it. If I'm able to get tested, I do plan on going off the meds the day of and the day before. No matter what happens with the insurance or the test results, I don't think I want to go back to that psychiatrist again even if it makes it look like I'm just trying to find a doctor who will give me pills. What's the point in a psychiatrist who doesn't even listen to you?
    "Man, having a conversation with you is like walking through a salvador dali painting." - Mac Hall

  • #2
    A possible suggestion- print out this post, and take it with you on your next visit to that psychiatrist. Give it to her and tell her "Here, read this. I'm done trying to talk to a brick wall. If you're actually willing to listen to me when you've read that, maybe we can actually communicate for once." Then sit down and quite clearly wait for her to actually read the thing. Flatly refuse to respond to any conversational gambits she tries to throw out, just sit there and stare silently at her projecting 'I'm waiting' as strong as you can.
    You're only delaying the inevitable, you run at your own expense. The repo man gets paid to chase you. ~Argabarga

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    • #3
      If you don't have depression now, they're going to give it to you. Seriously, what is wrong with these people? Have they never seen anyone with ADD that doesn't fit the exact textbook description?
      When you start at zero, everything's progress.

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      • #4
        Unfortunately, a lot of people DO fake these symptoms to get Ritalin or Adderall.

        That Shangrilas Child is asking for neither of those should be a clue to the doctor. Clearly it is not.

        Demand a meeting with the psychiatrist and the psychologist, and a psychiatric nurse. Basically what you need to ask for is an interdisciplinary team meeting.

        The psychiatrist still doesn't have to listen to the other professionals but in a group meeting they may be more persuasive than on paper.

        You might also talk to whoever manages the practice.

        Getting an another opinion won't hurt you. It only becomes a prescription if you are getting scripts for controlled substances from every doctor; that's what doctor shopping really is.

        If you tell the new doc "I need help because I can't get anyone to listen to me" and show that you are not seeking controlled substances, you should be able to find a doctor who is more willing to work with you. It can be time consuming, unfortunately.

        There is no other aspect of the medical profession that elicits my disgust as psychiatrists. Damn pill pushers, the whole lot of them.
        They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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        • #5
          Quoth Sapphire Silk View Post

          There is no other aspect of the medical profession that elicits my disgust as psychiatrists. Damn pill pushers, the whole lot of them.
          I've been there, done that. I would rather have my GP prescribe a medication and monitor me while I'm on it rather than a psychiatrist who will only see me once every so often or whenever I have a major breakdown.

          What didn't help was that I wound up visiting psychiatrists on 3 different occasions for reviews-I walked away with 3 different diagnoses each time and in the latter case, the psychiatrist wound up getting my GP to do the prescription instead (which we both wound up disregarding based on my history). The first diagnosis was generalised anxiety and major depression, the latter of which was eventually downgraded to dysthymia. The second diagnosis was borderline personality disorder (and I'd been prescribed an antidepressant and an antipsychotic for it, albeit only a small dose and to be taken at night-we're talking 1/4 of Seroquel here) and the third diagnosis was a "mixed state."

          Did I mention that all of these diagnoses were done by different psychiatrists-the first two were after hospital visits, the third one was at my request and supported by my psychologist who believed that my symptoms were ADHD but needed someone to confirm it. Thankfully my GP (a lovely woman) did not follow up with the prescription in the third case (I was meant to be put on either ziprasidone or topiramate), but instead opted to put me on a chronic health management plan which would work on me taking better care of myself to manage my anxiety and depression.
          The best professors are mad scientists! -Zoom

          Now queen of USSR-Land...

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          • #6
            Quoth Sapphire Silk View Post
            There is no other aspect of the medical profession that elicits my disgust as psychiatrists. Damn pill pushers, the whole lot of them.
            I need to address what I said here, because I should not have said it. It's not the right thing to do to paint a group with a broad brush because of personal bad experiences.

            Shangri laschild's post hit a nerve with me. I've had horrible experiences with psychiatrists. I can't think of a good one I've ever had, quite frankly. One of them practically experimented on me when I was in a deep depression, giving me anti-psychotics when I don't have a psychotic disorder because she was afraid anti-depressents and anti-anxiety medications I genuinely needed would "rev me up too much." They made me disastrously sick. Even though I'm a highly experienced nurse, when I was in that depression I was too sick to make rational decisions and ask good questions about the medications this "doctor" was prescribing for me. And if a nurse has that kind of issue, what protection does a member of the general public have?

            I'm still pretty angry about it, and that's where my post came from.

            However, my experiences don't mean there aren't good shrinks out there. It doesn't mean you can't find one who will listen and do the right thing by the patient. What it does mean is sometimes you have to keep looking . . . and sometimes you need to have an advocate who will ask the right questions about medications, do the research on how they work, and get you away from the quacks and help you find the right practice where you can get the help you need (Evil Empryss's husband, the Evil Overlord, did this for me) because people who are struggling with severe mental health issues aren't always in a position to make the best decisions.


            I hope Shangri-laschild can find the right provider. I'm sure there's one out there. And that's the frustrating thing; sometimes you have to look for awhile, it can be expensive, and in the meantime you're not getting the right treatment for your problem.

            And that truly is sucky.
            Last edited by Sapphire Silk; 01-17-2015, 01:57 PM.
            They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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            • #7
              I'm in the fortunate situation where I have a cousin who's a shrink, and Bast's shrink, who can both give us advice on potential psychiatrists.

              Unfortunately, neither can treat us personally: or rather, Bast's shrink can only treat Bast. My cousin can't treat any of us, because of the whole legal and ethical restriction on treating family.
              He can't treat ME because of too many shared experiences: same grandparents, shared Christmases, his mother is my aunt, my mother is his aunt ... blah blah blah.
              He won't treat my husband or my best friend because one of their closest relationships is with me, and that brings back the shared experiences and (conversation devolves into psycho-medical jargon).

              BUT! He can know which of his colleagues he would trust to treat me. So if I - or Toth - ever need psychiatric help, or Bast's shrink retires, I'll be emailing Cousin J.


              So my advice for shortcutting the process of hunting for a suitable psych (-iatrist, -ologist, -iatric nurse, etc) is to hunt among friends and family for anyone who is in the field or works with someone who's in the field, and trade home-made chocolate chip cookies for recommendations.

              If you find someone who seems like an honest, reliable and trustworthy person, but you just can't find yourself wanting to reveal your deep, dark secrets to them; tell them so, and ask them for a recommendation.
              Unfortunately, one of the best indicators for talking therapies working, is having a good relationship between client and psych. So the good psychs (mostly mental health nurses, tbh) that I have met have all been more than happy to trade patients around among each other until there's a decent working relationship.


              All of that said; I have had disappointing experiences with psychiatrists; and one actual bad experience.
              I'll leave the disappointing experiences, because mostly it amounted to 'the psychiatrist's particular skillset was a bad match for what I needed'.

              The bad experience: well, did you all know that I have Narcissistic Personality Disorder? Yep, apparently Toth and Bast don't look after me because I'm physically sick, they do so because I'm a manipulative, self-centered bitch.
              Seshat's self-help guide:
              1. Would you rather be right, or get the result you want?
              2. If you're consistently getting results you don't want, change what you do.
              3. Deal with the situation you have now, however it occurred.
              4. Accept the consequences of your decisions.

              "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

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              • #8
                The bad experience: well, did you all know that I have Narcissistic Personality Disorder? Yep, apparently Toth and Bast don't look after me because I'm physically sick, they do so because I'm a manipulative, self-centered bitch
                Seshat, I would take the person who said this out behind the woodshed and smack them around for you. And that's having never met you, but what I know of you from this forum tells me that this person was WAY OFF.
                When you start at zero, everything's progress.

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                • #9
                  Thank you, Mooncat.

                  My mental health nurse, my doctor (family doctor aka general practitioner), Toth, Bast, and an assortment of friends all also disagree.

                  The psychiatrist spent less than an hour with me, and disregarded a great deal of the physical side of my patient history; presumably he deemed it irrelevent, or has one of the misunderstandings of 'fibromyalgia'.

                  And I asked him, when he'd finished talking to me, what I could do about my suicidal ideation. Apparently it's 'just an aspect of my personality', and I have to learn to 'live with it'.


                  So ... yeah. Not the best psych in the world.
                  Seshat's self-help guide:
                  1. Would you rather be right, or get the result you want?
                  2. If you're consistently getting results you don't want, change what you do.
                  3. Deal with the situation you have now, however it occurred.
                  4. Accept the consequences of your decisions.

                  "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

                  Comment


                  • #10
                    I have heard of many horrible experiences. I have been very lucky not to have been in any of them.

                    I have ADD and am on Adderal. Luckily for me, I have been with my current Doctor for *checks watch* 20 years now. He was not my Doctor when I was diagnosed by a specialist, but he is smart enough to know I am not faking. I love the small town Doctors, they actually know us.

                    Heck, I was off meds for 8 years. When I decided to get back on I just went to my Doctor and asked to try it again, he wrote the prescription right then.
                    I might be crazy, but I'm not Insane.

                    What? You don't play with flamethrowers on the weekends? You are strange.

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                    • #11
                      the absolute best mental health professional I ever had was a social worker, because all he could do was help me talk through my problems. I was in the "I just want to stop everything" mindset, due to depression. He recognized that it was situational, and likely wouldn't be helped by anything other than coping skills(which I lacked at the time), and helped me develop them.
                      Honestly.... the image of that in my head made me go "AWESOME!"..... and then I remembered I am terribly strange.-Red dazes

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                      • #12
                        Quoth Kittish View Post
                        A possible suggestion- print out this post, and take it with you on your next visit to that psychiatrist.
                        I will definitely keep that idea in mind if I can manage being around this one again. My dad said if I couldn't, I should try his psychiatrist instead.

                        Quoth MoonCat View Post
                        If you don't have depression now, they're going to give it to you. Seriously, what is wrong with these people? Have they never seen anyone with ADD that doesn't fit the exact textbook description?
                        Yeah and the amusing thing was that of course they forget to get my vitals like my blood pressure until after the appointment. Hmmmm I wonder why my blood pressure was so high

                        Quoth Sapphire Silk View Post
                        I need to address what I said here, because I should not have said it. It's not the right thing to do to paint a group with a broad brush because of personal bad experiences.
                        I wish this one was a pill pusher, it would make life easier I do get what you mean though, it can be very frustrating. The one who was prescribing me the anti depressants was like that. Any time I tried to talk about my feelings or what was upsetting me, she'd nod and make notes and then up my dosage or change my meds rather than being willing to talk to me. I got insanely lucky when it came to finding a therapist. The first one I saw ended up being perfect for me. She talked just enough to get me talking and thinking about my issues and guided me through figuring them out myself which was exactly what I needed. I can definitely understand why you would have some bitterness towards all of that though. It's frustrating when things are even slightly not working out with a mental health provider, let alone when things are going very wrong.

                        Quoth fireheart View Post
                        I've been there, done that. I would rather have my GP prescribe a medication and monitor me while I'm on it rather than a psychiatrist who will only see me once every so often or whenever I have a major breakdown.
                        Yeah, I would mostly rather stick with my gp on this stuff. Best case scenario, even if I did end up with a psychiatrist I liked, I would see them maybe once or twice and then continue the prescription through my gp until I needed the meds changed at all. I grew up seeing a peds neurologist I think? ADD was something he worked with a lot anyway and he wasn't just a regular gp even though I had all my checkups and appointments of any kind with him. That was really nice and he was awesome but he's retired now and I'm pretty sure only dealt with kids. Though that does give me the thought that I should find out if I can get any notes he may have recorded on me in my charts to help with my argument.

                        I would just like to say that you guys are all awesome and it's nice being able to vent about this stuff
                        "Man, having a conversation with you is like walking through a salvador dali painting." - Mac Hall

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