I posted a couple weeks ago about an upcoming mental health evaluation that I was anxious about. That evaluation was today.
For background, I am a middle aged white guy, previously untreated for any psychiatric condition except a < 2 month stint on SSRI’s about two decades ago after a nasty breakup.
I was seeking an evaluation for what I thought from my online research might be mild to moderate ADHD symptoms, which were starting to affect my job. I also have suffered from irrational anxiety for a couple years now, but it got really bad over the last year or so. I had tried going through my primary care doctor but, despite being a great GP, they were not helpful with this. I bounced off a few other attempts over several months before finally getting referred to a psychiatrist who specializes in ADHD. I saw them this morning.
I utilized the advice I was given and let the psychiatrist know very early in the meeting what my concerns were around rehearsing/masking, and that I was extremely anxious, not about the ‘interview’, but about the outcome. Mostly how I was very worried that I would appear to ‘have it together’ to such an extent that they would send me home to live with my issues without any help.
This was supposed to be a general mental health eval for about 50 minutes, but the doctor kept me there for about 85 minutes and I walked out with a fresh diagnosis of mild ADHD and three prescriptions. I’ve been prescribed daily low dose Focalin and a SNRI, along with an anti-anxiety sleep aid that I can take as needed. I had trouble finding a pharmacy that had Focalin in stock but eventually found one and I’m waiting for the prescription to get transferred by the doctor, so I likely won’t start that until next week.
I don’t know what’s next, I don’t know how these meds will affect me or if they will help at all, but I’m hopeful. I’ve very nervous about the SNRI because I did NOT like how I felt on SSRIs 20 years ago, but I’m willing to try what the doctor recommended. It feels like a new chapter is about to start, for better or worse.
Thanks to all that gave me advice in the other thread. I don’t know why I felt like I had to write all this out, but thanks for reading this, too. For everyone out there struggling, please don’t give up. It took me almost a year from when I knew I had a problem that needed some attention, until today when I finally saw someone who listened, agreed with my concerns, and took action. Keep trying.
Well done for pushing for this and following through. Getting a diagnosis in itself must be a real weight off.
And the pills? Just see how they go but don’t be shy about telling them they don’t work and you are allowed to do your own research and discuss treatment options. Ritalin and similar medications (like Focalin) have a bit of a bad reputation but they can work effectively, so give them enough time, however, if they don’t work look at alternatives, including off-label ones - modafinil has been used as an alternative, for example.
Good luck.
Thank you for the good advice. I am certainly nervous about taking stimulants but I won’t give up if this doesn’t help.
I also got put on an SNRI, and I can safely say that it really changed my life for the better. I hope you have similar results.
Thank you for sharing your experience. I hope so too! I am probably most nervous about the SNRI because I really, really hated how I felt when I was on SSRIs for just a few weeks. It did help with the depression I had at the time, but it also sucked all the color out of life. Fortunately I don’t think I’m suffering from any severe depression right now so I’m hoping I have a better outcome this time.
I’m so glad you’re checking back in with an update! And it’s good news you have found a psychiatrist willing to take the time to work with you. And that you have a handle on what’s “off,” and a starting point to getting you back on track.
SSRIs, as you know, suppress the re-uptake (grab that molecule & recycle its components) of seratonin, the happy-feel molecule. SNRIs suppress the re-uptake of seratonin, and norepinephrine as well, essentially adreneline (the “I can face the day with confidence” molecule, which in larger amounts becomes “I wanna bite your head off” molecule.) In other words, it will probably feel different than a straight SSRI—I hope in ways that address the discomfort you had previously.
I’m not familiar with the other Rx you mentioned; but again, it sounds like your doc is starting with small doses. Always a plus to start out conservatively and see how they affect you.
I’m happy for you!
Thank you. Yes, he started me on the lowest dose of everything. He even said we could cut tablets in half for some of the meds if even this turns out to be too much. He took my concerns about the medications very seriously which was a big relief.
How did your evaluation go? I hope well.
I think it went as well as it could have. I envisioned something much more regimented and stressful than it turned out to be.
Incidentally, while I hope SNRIs work for you, they can be somewhat rougher to get off. If you ever decide to stop them, make sure to do so with the backing of medical pros, and take it nice and slow. Purely anecdotally, I found that mine worsened my anxiety a bit compared to SSRI - but you might not have that issue at all, or it might be a decent tradeoff still.
Thank you for sharing your experience. I just started the SNRI today, and I’ll be watching myself like a hawk for the first week to see how it goes. Fortunately I’m not having a lot of anxiety problems lately so hopefully I can weather the adjustment period.
So glad you came back with an update, and that it wasn’t quite as bad as you thought it would be I hope your meds work out well for you. If they don’t, I’m sure you can let the doctor know and they will switch you to something else.
I feel you. I am having worsening symptoms myself. I’m middle aged white guy, too, and have been living with ADHD for years, but I’ve been unemployed for 6 months and am also having increasingly hard to dismiss anxiety. For the first time ever, i went throigh a whole night without sleeping at all.
I’m going to change up my meds, and I have a therapist finality after months of searching. I had to hammer home that while I want explore all the shit I’ve suffered, the key thing now is to get me functional so I can solve some immediate real world problems like imminent financial ruin and potential homelessness.
Ageism sucks.one day you are a star performer, the next you’re unhireable. Shortly after that, your broke and alone, and nobody cares.
Thank you. My doctor was very clear about this being a starting point, and not to be afraid to call him and talk about issues or things I think need adjusting. I’m very happy with how he approached all of this because I am by nature a person who doesn’t particularly like to take medications when there’s an alternative. But he thinks this is the best course to try first, and I’m listening to the expert.
Happy to hear your story. Getting that initial diagnosis is difficult. I kept being told that there was nothing wrong with me and the GP refusing to make a referral. I gave up with our health service and paid for a psychiatrist diagnosis. Even that was an extremely anxious time because up to that point everyone had denied that ADHD had anything to do with my lack of executive function. I went into the interview thinking they would deny the evidence. No wonder we typically have poor self esteem. The experience has radicalised my view of society in general. We are really bad at treating mental health and need to reckon with it.
