Help Psychiatrist tells me my ADHD is mild if at all, and I should just force myself to build better habits (CBT)

[ImogenHeap]

CBT = Cognitive Behavioral Therapy, not CTB.

My clinical psychotherapist thinks I might have adhd, but that it's not severe. They haven't given me a written diagnostic yet (nor the psychiatrist that referred me), guessing they're holding out or something and hesitant bc I'm an adult? Idk.

Whatever they ostensibly acted as though I had ADHD and just told me to do CBT.

I've tried CBT on my own in the past and tried out most tricks, it usually works for attention but not for executive dysfunction. The advice she gives is also insanely generic or borderline bullshit, I've heard not using my phone or pc a million times, I've heard not studying on my bed a million times, I've heard not having too many tabs open a million times. She told me to literally study using books preferably, and to do it on the floor which is what *she* did as an undergrad.

I value exec dysfunction far more than attention, it fucks me over in a LOT of intellectual tasks despite having attentional capacity.

IDK wtf I should take, or do, but my psychiatrist told me she wants me off my meds after 3 months, and to just go thru CBT. Just sucks all around.

History: took bupropion felt amazing best drug ever, but made me suicidal and gave me liver damage (told psychiatrist about). Psychiatrist gave me eslicarbazepine, and atomoxetine like 14d ago, haven't really felt much difference, tbh. My anxiety is still present, too.

 

[spøgelse]

See another one. Why haven't you been offered methylphenidate or an amphetamine yet?

Atomoxetine is known for being useless in about 50% of people who try it, which is why it's not a first line treatment.

On another note, neither of those medications work for anxiety (properly). Eslicarbazepine has been shown to reduce it a little, but it's not effective. Atomoxetine is just a diet antidepressant since it lacks the serotonin modulator. It only 'helps' in some cases of ADHD.

What the fuck is your psych doing?

 

[ImogenHeap]

See another one. Why haven't you been offered methylphenidate or an amphetamine yet?

Atomoxetine is known for being useless in about 50% of people who try it, which is why it's not a first line treatment.

On another note, neither of those medications work for anxiety (properly). Eslicarbazepine has been shown to reduce it a little, but it's not effective. Atomoxetine is just a diet antidepressant since it lacks the serotonin modulator. It only 'helps' in some cases of ADHD.

What the fuck is your psych doing?

They said it isn't severe at all bc of a digit span test they took verbally (not joking). Amphetamines are a no-go regardless because they aren't approved for adhd here for some reason.

Bupoprion was for anxiety and it worked *insanely* well apart from giving me suicidal ideation, and liver damage. I might just hop on it again seeing these are kinda bullshit lines of defense.

 

[ladidabi]

The severity isn't only dependent on whatever test results they receive, but how your symptoms affect you on a day-to-day basis.

Sounds like the psychiatrist or another doctor in the facility doesn't quite catch what medications may be needed for you. Like lack of info or incompetence. A lot of the time psychologists rush with info to the psychiatrist, and many of them are not aware of the affects alone, they just follow orders after they've received info. Happens more often than it should.

Before you go on the same meds that caused you damage, I would suggest requesting changing treatment area. CBT only works if the patient actually manages to go the homework, and usually requires tasks that are realistic, and effective the patient. CBT isn't a one and true solution. It doesn't work for everything and everyone.

 

[ImogenHeap]

The severity isn't only dependent on whatever test results they receive, but how your symptoms affect you on a day-to-day basis.

Sounds like the psychiatrist or another doctor in the facility doesn't quite catch what medications may be needed for you. Like lack of info or incompetence. A lot of the time psychologists rush with info to the psychiatrist, and many of them are not aware of the affects alone, they just follow orders after they've received info. Happens more often than it should.

Before you go on the same meds that caused you damage, I would suggest requesting changing treatment area. CBT only works if the patient actually manages to go the homework, and usually requires tasks that are realistic, and effective the patient. CBT isn't a one and true solution. It doesn't work for everything and everyone.

Right, I know digit span is an extremely bad indicator of ADHD let alone ADHD severity.

Should I talk to them again about this?I'm afraid of bringing up meds bc it'll be seen as drug seeking which is a big no-no here and will be extremely counterproductive.

I've tried CBT-esq methods in the past, they just seem like glorified study tips advice, but even during that period I had executive dysfunction. For eg, I could be ahead of my homework, but my focus was a bit fucked alongside feeling issues w/ processing things in-depth (they were sufficient for just finishing things but I felt I had a lot in my tank that refused to give). It was extremely exhausting, and minor things would throw me off my routine entirely.

I had an extremely depressed few days in Aug last year and right after that I stopped any and all means of task tracking, whereas before I was more diligent re that.

 

[spøgelse]

They said it isn't severe at all bc of a digit span test they took verbally (not joking). Amphetamines are a no-go regardless because they aren't approved for adhd here for some reason.

Bupoprion was for anxiety and it worked *insanely* well apart from giving me suicidal ideation, and liver damage. I might just hop on it again seeing these are kinda bullshit lines of defense.

Were all your other tests normal or are they just throwing it away because of the digit span test? Digit span was one of the tools used to slap the label severe on me but I also come from a country with outdated diagnostic standards.

Either way... methylphenidate is still a solid option and from what I've seen online it is an option for ADHD in India.

Bupipron is an option for anxiety. It also works well for a lot of things and then there's the other side of it where it completely fucks over the body (and/or mind which is also very common). I don't know what your psychiatrist was thinking when deciding the next course of action was Eslicarbazepine instead of another antidepressant as this isn't uncommon with bupipron.

 

[ImogenHeap]

Were all your other tests normal or are they just throwing it away because of the digit span test? Digit span was one of the tools used to slap the label severe on me but I also come from a country with outdated diagnostic standards.

Either way... methylphenidate is still a solid option and from what I've seen online it is an option for ADHD in India.

Bupipron is an option for anxiety. It also works well for a lot of things and then there's the other side of it where it completely fucks over the body (and/or mind which is also very common). I don't know what your psychiatrist was thinking when deciding the next course of action was Eslicarbazepine instead of another antidepressant as this isn't uncommon with bupipron.

She only took a digit span lol, nothing else. Yeah it's the only option. Yeah, IDK why they did that, too.

 

[ladidabi]

Right, I know digit span is an extremely bad indicator of ADHD let alone ADHD severity.

Should I talk to them again about this?I'm afraid of bringing up meds bc it'll be seen as drug seeking which is a big no-no here and will be extremely counterproductive.

I've tried CBT-esq methods in the past, they just seem like glorified study tips advice, but even during that period I had executive dysfunction. For eg, I could be ahead of my homework, but my focus was a bit fucked alongside feeling issues w/ processing things in-depth (they were sufficient for just finishing things but I felt I had a lot in my tank that refused to give). It was extremely exhausting, and minor things would throw me off my routine entirely.

I had an extremely depressed few days in Aug last year and right after that I stopped any and all means of task tracking, whereas before I was more diligent re that.

You can talk about this issue you have with the treatment you're offered if you know if psychologist would side you. They're wasting their time too if there is no improvement after all. If you want meds, expressing awareness of the side effects of the meds, but weighing the pros and cons can go in your favour. If you've already discussed this without luck then I don't see the point though.

How did you get psych treatment to begin with? Usually going to the source for feedback helps with switching psychologist or the whole office.

 

[ImogenHeap]

You can talk about this issue you have with the treatment you're offered if you know if psychologist would side you. They're wasting their time too if there is no improvement after all. If you want meds, expressing awareness of the side effects of the meds, but weighing the pros and cons can go in your favour. If you've already discussed this without luck then I don't see the point though.

How did you get psych treatment to begin with? Usually going to the source for feedback helps with switching psychologist or the whole office.

I don't think they will, tbh, but I could try regardless. I guess I know the side effects the biggest is just addiction, but it has a lower risk of being addicting for people who have ADHD right? Could I also not mention how digit span alone might not be enough, or something like that?

I went to the clinic to see a psychiatrist, and she referred me to the psychotherapist. The psychiatrist sided w/ her, said it probably isnt severe and I should just do what she says, and then 3mo later she'll taper off the medication and after that I'll have monthly or every few month visits w/ the therapist about any issues I'm having etc...

 

[ladidabi]

I don't think they will, tbh, but I could try regardless. I guess I know the side effects the biggest is just addiction, but it has a lower risk of being addicting for people who have ADHD right? Could I also not mention how digit span alone might not be enough, or something like that?

I went to the clinic to see a psychiatrist, and she referred me to the psychotherapist. The psychiatrist sided w/ her, said it probably isnt severe and I should just do what she says, and then 3mo later she'll taper off the medication and after that I'll have monthly or every few month visits w/ the therapist about any issues I'm having etc...

I'm not familiar w ADHD medication, so I don't know about how hard it is to taper off the one you're referring to. How addicting a medication is does vary, for some it's much easier to taper off than others, but they generalize it to stay on the safer side. Whatever response you get from what you tell them really depends on how they usually respond to you. If the person isn't understanding to begin with and has been very strict with their opinions (not opening for discussion), that may cause more issues for you. Hence I mentioned going to the person who initially got you into this, like your GP for example.

The psychiatrist is specialised in medication and management of meds, they're often not involved in much of the therapy itself. Professionals usually side with each other, especially if they have a history of working together. I would suggest going out of that box if you catch my drift?

You can cooperate if you want to give that a go, if you can handle it. If you feel that may be too rough on you, then it really isn't solution, but rather a challenge that may be harmful.

I was met with pretty horrible psychologists who drove me absolutely insane last year, they disregarded my physical health, treatment and ignored previous traumatic experiences, but rather encouraged me to go through it again (literally). That was completely unacceptable for my GP who sent me there in the first place. The psychologists refused to let me switch to other people or another office, but my GP documented the harm they did on me and forced them to sign me into a completely different office so I could avoid their presence.

There is a lot of horrifying malpractice that isn't spoken enough about. Just look out for how they word things, and see if you can get a second (or third) opinion form someone you can trust that can also overpower them. CBT isn't universal, and as for medication, if you feel it keeps you stable, finding an alternative that isn't harming you needs to be considered. If a patient is able to be a part of this discussion, it should be heavily taken into the decision if the reasoning is sound and available.

 

[ImogenHeap]

I'm not familiar w ADHD medication, so I don't know about how hard it is to taper off the one you're referring to. How addicting a medication is does vary, for some it's much easier to taper off than others, but they generalize it to stay on the safer side. Whatever response you get from what you tell them really depends on how they usually respond to you. If the person isn't understanding to begin with and has been very strict with their opinions (not opening for discussion), that may cause more issues for you. Hence I mentioned going to the person who initially got you into this, like your GP for example.

The psychiatrist is specialised in medication and management of meds, they're often not involved in much of the therapy itself. Professionals usually side with each other, especially if they have a history of working together. I would suggest going out of that box if you catch my drift?

You can cooperate if you want to give that a go, if you can handle it. If you feel that may be too rough on you, then it really isn't solution, but rather a challenge that may be harmful.

I was met with pretty horrible psychologists who drove me absolutely insane last year, they disregarded my physical health, treatment and ignored previous traumatic experiences, but rather encouraged me to go through it again (literally). That was completely unacceptable for my GP who sent me there in the first place. The psychologists refused to let me switch to other people or another office, but my GP documented the harm they did on me and forced them to sign me into a completely different office so I could avoid their presence.

There is a lot of horrifying malpractice that isn't spoken enough about. Just look out for how they word things, and see if you can get a second (or third) opinion form someone you can trust that can also overpower them. CBT isn't universal, and as for medication, if you feel it keeps you stable, finding an alternative that isn't harming you needs to be considered. If a patient is able to be a part of this discussion, it should be heavily taken into the decision if the reasoning is sound and available.

I don't think there are any issues w/ addictions but there might be withdrawal symptoms. When I left bupropion it sucked ass for 2 weeks, I felt insanely anxious all the time, and over time it reduced. I imagine it can't be as bad on atomox and eslicarb, tbh.

Oh that's what you meant, I just went on my own to the psychiatrist vs being ref. by a GP. Psychiatrist referred me to a therapist. I guess I could talk to them about this, and tell them about my experience on CBT?

To be honest I haven't given them my entire history re CBT-like procedures bc I feared it'd fall on deaf ears or something like that, it didn't seem like she was interested in hearing that, so I didn't say it.

I'm sorry about your situation that sounds ruff, glad your GP was nice!

 

[ladidabi]

I don't think there are any issues w/ addictions but there might be withdrawal symptoms. When I left bupropion it sucked ass for 2 weeks, I felt insanely anxious all the time, and over time it reduced. I imagine it can't be as bad on atomox and eslicarb, tbh.

Oh that's what you meant, I just went on my own to the psychiatrist vs being ref. by a GP. Psychiatrist referred me to a therapist. I guess I could talk to them about this, and tell them about my experience on CBT?

To be honest I haven't given them my entire history re CBT-like procedures bc I feared it'd fall on deaf ears or something like that, it didn't seem like she was interested in hearing that, so I didn't say it.

I'm sorry about your situation that sounds ruff, glad your GP was nice!

They in should document everything in your journal. You can verbally request having your opinion and preference with reasoning documented in your journal. That way if a doctor/psychiatrist/therapist looks at it, they can get your side as well. I suggest requesting to see the journal as well so you know who you're dealing with. They usually act very different face-to-face vs journaling, and correct if they have written things you have never said and done (it happens).
I think giving feedback is very useful, even if they disagree, that's really not for them to decide if they themselves don't see any improvement. Make sure to word yourself in a way that's less in the emotional side, but more factual. Because they disregard that as you likely not being reasonable if you talk to much about feelings, sometimes there can be good progress even though one is emotionally low, so word yourself right. <3

 

[ImogenHeap]

They in should document everything in your journal. You can verbally request having your opinion and preference with reasoning documented in your journal. That way if a doctor/psychiatrist/therapist looks at it, they can get your side as well. I suggest requesting to see the journal as well so you know who you're dealing with. They usually act very different face-to-face vs journaling, and correct if they have written things you have never said and done (it happens).
I think giving feedback is very useful, even if they disagree, that's really not for them to decide if they themselves don't see any improvement. Make sure to word yourself in a way that's less in the emotional side, but more factual. Because they disregard that as you likely not being reasonable if you talk to much about feelings, sometimes there can be good progress even though one is emotionally low, so word yourself right. <3

Thanks for the advice!

I'll try asking them for their notes, and start taking notes too of my thoughts or whatever on CBT processes that they tell me to do (I think this is what you meant? Idk.) I'll talk to them about the things I have disagreements w/ them about too!

 

[spøgelse]

She only took a digit span lol, nothing else. Yeah it's the only option. Yeah, IDK why they did that, too.

I mean to be honest with ADHD there isn't much you can 'test' for that is 100%. But no questionnaires you had to fill out? None you were meant to give your parents to fill out? Nada? That's insane.

 

[ladidabi]

Thanks for the advice!

I'll try asking them for their notes, and start taking notes too of my thoughts or whatever on CBT processes that they tell me to do (I think this is what you meant? Idk.) I'll talk to them about the things I have disagreements w/ them about too!

By journal I meant your medical journal. :)

They take notes during appointments to not forget important things you may say, and then after the appointment they write a report summarising what you guys were talking about, and sometimes the employee's opinions on the appointment.

In your journal your will also find other information regarding the tests they have taken, what results they have shown, and reflections they make regarding that. You should also find meetings they make without you where they talk about your case. In my country at least, you can't see it unless you send a formal request.

 

[ImogenHeap]

By journal I meant your medical journal. :)

They take notes during appointments to not forget important things you may say, and then after the appointment they write a report summarising what you guys were talking about, and sometimes the employee's opinions on the appointment.

In your journal your will also find other information regarding the tests they have taken, what results they have shown, and reflections they make regarding that. You should also find meetings they make without you where they talk about your case. In my country at least, you can't see it unless you send a formal request.

Oh I see, okay. It's much more decentralized here, there's no centralized journal or something like that, but I could ask them for their notes, and try looking over it.

 

[ImogenHeap]

I mean to be honest with ADHD there isn't much you can 'test' for that is 100%. But no questionnaires you had to fill out? None you were meant to give your parents to fill out? Nada? That's insane.

I talked to my parents, and asked them how I was as a kid, no particular questionnaire I was given by them to ask my parents, for eg, and none for me either. I was asked questions, though, but it wasn't pen-n-paper

 

[Hollowman]

You can talk about this issue you have with the treatment you're offered if you know if psychologist would side you. They're wasting their time too if there is no improvement after all. If you want meds, expressing awareness of the side effects of the meds, but weighing the pros and cons can go in your favour. If you've already discussed this without luck then I don't see the point though.

How did you get psych treatment to begin with? Usually going to the source for feedback helps with switching psychologist or the whole office.

Their time is never wasted, they're profiting.

 

[ladidabi]

Their time is never wasted, they're profiting.

They can only accept so many patients. Most people are placed on dangerously long waiting lists. They profit anyway. As for public psych hospitals, they are assigned a very small amount of patients per employee.