jeff
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Post by jeff on Apr 2, 2009 16:14:44 GMT
I'm incredibly nervous.
I had a dream last night that I told my Mum about ADD and she was just like "For God's sake, everyone procrastonates!".
I'm currently getting different lists of symptoms off the internet and writing down any that I think are relevant to me and how I think they affect me.
I literally don't know what I'll do if he's just like "Sorry mate, I don't think you have it". I'm so sure that ADD answers so many of the problems I've had through life, I feel like it'll destroy me if he brushes me off.
Any words of encouragement? Suggestions?
Thanks!
Jeff.
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Post by adhddirect on Apr 2, 2009 16:23:11 GMT
Hi Jeff, It would be good idea to take someone with you for support and to help give a history of your difficulties. Right things down in terms of symptoms, i.e. attention, organisation, working memory, time management, planning etc. If you have school reports then these would be helpful for the psychiatrist to see. Take a look at the website www.neurotransmitter.net They have adult adhd rating scales you could complete and ones for observers to complete. Good luck tomorrow. Gordon
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Post by annie on Apr 2, 2009 16:57:19 GMT
Hi Jeff
I know it's easy for me to say but it really isn't your job to convince the psychiatrist you have adhd - it's his/her job to help you give a full history of your difficulties and maybe ask you to bring someone else into the assessment process e.g. having a parent/friend corroborate your information. He/she then needs to assess the total information and give you an explanation/dx as to what might explain your difficulties.
It's at this stage (the end of the assessment and this may involve another appointment) for him to give you the dx and recommendations for treatment. If you feel his conclusions don't fit with your knowledge, which is equally important, then you have to go down the route of making sure you are seen by an expert and we can help you with this.
I will have everything crossed for you tomorrow and just remember your knowledge about yourself is equally as important as that of the psychiatrist - I do hope you come back on here tomorrow and tell us you had a good experience and you have met an "expert"
Good luck
annie
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jeff
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Post by jeff on Apr 3, 2009 2:25:21 GMT
Thanks guys. I'm just about to go to bed and have just finished organising a list of symptoms and why I think they're relevant to me. I'm feeling pretty positive!
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Post by annie on Apr 3, 2009 7:18:42 GMT
I'll be thinking of you and great you're feeling positive!!
annie
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Post by lily on Apr 3, 2009 8:16:31 GMT
Hi Jeff
Good Luck today. I hope it runs smoothly which I'm sure it will.
Thinking of you and am looking forward to hearing how it went.
Lily x
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Post by roland on Apr 3, 2009 13:55:53 GMT
Hi Jeff,
Hope everything went okay!
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Post by Deleted on Apr 3, 2009 14:01:37 GMT
Hi jeff,
How'd it all go, was it as bad as what you thought it was gong to be? Good to hear your getting somewhere!!
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jeff
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Post by jeff on Apr 3, 2009 16:25:17 GMT
Hey Guys, thanks for the support!
I turned up and apparently he'd been called away for the afternoon, and the secretary said she'd left a voicemail (which I hadn't got, but my phone does play up sometimes so she probably did leave one)! Bah! So annoying, I was so psyched!
Oh well, it's been rescheduled to next Wednesday, I have five more days of waiting.
I feel like I should try and do some more preperation...
Thanks again.
Jeff.
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Post by roland on Apr 3, 2009 16:45:15 GMT
Oh no How incredibly disappointing for you!!
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Post by Deleted on Apr 3, 2009 17:17:33 GMT
Hi jeff, Yes disappointing! I can understand you getting psyched up for it, but look at it like a trial run. You'll probably find your a bit less apprehensive on your next visit, as you've already gone through the run once! Nothing is ever like it was the first time! And as you said, gives you another chance to do any final prep you weren't happy with the first time around.
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jeff
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Post by jeff on Apr 8, 2009 11:51:51 GMT
Hey guys. I had my session today. It went okay. He said he thought I was just assigning my problems names etc. I have another session booked, it's coming up.
I'm kind of annoyed with myself though because I feel like I came across as way more level-headed and sensibe than I actually am. I was in a pretty good mood and I'm worried that I kind of gave a false impression.
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Post by Deleted on Apr 8, 2009 12:25:01 GMT
Er - this is what psychiatrists do - assign names to problems and categorise these into their 'Diagnostic and Statistical Manual'. The question is whether you meet diagnostic criteria or not - if he has training in adult ADHD, then he'd be able to make an assessment, if not (and it doesn't sound like it), then it seems a bit like just getting you to jump through hoops.
I'd suggest doing the Adult Self Report Scale and using that as a basis. If +ve on that, then really you should be seen by someone with specialist ability to make an ADHD diagnosis. My hunch is they've sent you there because that doesn't mean making an out of area referral which would impact on their budget - but if they don't have competence to make a dx, then it seems like a pointless 'filter' which really shouldn't be there. I'd go see him anyway, but if he doesn't think you have ADHD, and doesn't support a referral, then I'd ask for his assessment in writing, setting out his qualifications and experience in making a diagnosis that you don't have ADHD and with written assessment. Then ask for a second opinion with a specialist - as you are entitled to do. (Sensible medical people don't mind that - after all if they get it wrong, then they can be liable, especially if a second opinion wasn't obtained though the patient sought one).
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Post by lily on Apr 8, 2009 12:25:16 GMT
Hi Jeff
I can't believe the Psych said that to you. No-one has the right to say that to you let alone a Psychiatrist who you would think is supposed to be a professional.
At least you have another chance at speaking to someone about it. I think you should just completely try to be yourself (even though thats hard when youre nervous) and if he or whoever it is your speaking to makes any comments like that again you should definatley say something because its completely unfair and untrue! How do they know when they have sat with you for less than an hour. No-one can truly know how you are feeling except you. Unless the psych is also telepathic!
Hope it goes better next time.
Lily x
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jeff
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Post by jeff on Apr 9, 2009 7:47:48 GMT
Hey. Thanks so much for these replies! I was really down yesterday, but I'm feeling much better now and just can't believe this guy. I was vaguely expecting to come away with a diagnosis, which is a bit-far reached I know, but the more and more I thinking about the session, the more and more frustrated I get with it. The thing is, he seemed like he'd pretty much made up his mind before I went in there. I've got seriously depressed on a couple of occasions in my life aswell, and have been perscribed Citalopram, and without even asking me about my depression in any detail, he was telling me that I have never been depressed and that I was giving labels to experiences. I mean, he literally was coming out with this stuff after sitting with me for 10 minutes! Looking back on the session, he literally didn't give me a chance at all to explain why I thought I had ADD, we spent most of the session talking about an experience I had with a girl about three years ago, which genuinly didn't affect me that much. I had written up a list of symptoms that I thought were relevant to me and why I thought so but only had a chance to show him at the very end of the session. (He said I should email them to him though). He started by asking where I'd come across ADD and I mentioned depression, and then the girl from 3 years ago came up and he just latched onto it wouldn't let it go. It's not even like that's the only time in my life that'd I've been depressed. Everytime I tried to counteract him and say something like "But I got over her really quickly, and I only ended up getting depressed quite a while after that, I really think it was much more about blah blah..." or whatever, he'd just come back with some weird reason how I'd got it wrong. And he mentioned on a couple of occasions how he was the qualified professional, implying how much more he knew than me, and how I couldn't possibly know what I was talking about. Really, looking back on it, he was so unbelievably arragont and unwilling to listen to my point of view even in the smallest possible ways. Thanks Dannz, that sounds like a really good plan of action! In the next session I'm just going to assert myself a bit more and ask him for a referall to a specialist! Feeling much better though! I really don't think this is as much of a set back as I thought it was!
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Post by lily on Apr 9, 2009 8:22:23 GMT
Hi Jeff
I completely agree with everything Dannz has said!
I am so angry for you! Even though its nothing to do with me its still annoying me reading how rude he was to you.
This is what im scared of. Getting seen by someone who is not willing to give me a chance.
I bet you keep thinking of things you could have said to him! I do that a lot but only when an argument/discussion is over and its too late.
The psychiatrist should have been more open minded. If he doesnt know anything about ADHD (which it sounds like he doesnt) then he should just have listened to you instead and then referred you to someone who does actually have the knowledge and experience to diagnose you rather than thinking "hmm well Ive never come across it before so Ill just tell him hes depressed and hopefully he'll go away".
I think the best thing you can do now is prepare yourself for this happening again (if youre seeing the same guy that is) and just be ready to try and assert yourself as much as possible. I am a complete hypocrite saying that because I find it difficult to assert myself when I am around professionals and extremely confident people but we dont really have a choice when were faced with idiots like this.
If he does try and "shoot you down" again then I would strongly advise writing a letter to your PCT and then ringing them also to talk to someone about it. If you have it in writing then they cant deny they have spoken to you but if you also try and speak to someone over the phone then you would hope that theyd try and find a solution a bit quicker. Well thats what I would hope anyway but maybe im being naive!
Again im sorry you had to deal with someone like this but I suppose you have come up against hopefully the worst youre going to have to deal with and next time it will be easier.
Sorry if this doesnt make a lot of sense. Its still very early!
Lily x Lily x
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Post by Deleted on Apr 9, 2009 23:01:22 GMT
Hi Jeff, sorry to hear you had such a rough ride with the psych. Problem is there are crap bus drivers,crap waiters, and yes crap psychiatrists to. We had a similar misfortune with my sons first appointment and I told the guy at the time he was talking rubbish and then saw the GP and demanded a second opinion from a specialist. Unfortunately their was no "specialist "as such available, so we saw another psychiatrist for the second appointment who fortunately had a good knowledge of ADHD AND an open mind, so we got the correct diagnosis (Tuesday this week). I wish you good luck with your quest for assessment, Iwould never have thought it could be so hard to find help, and its little short of a national disgrace that so many people are struggling. Just keep battling on and dont be intimidated by uncaring, superior,professional attitudes. There is a department in local PCT,s called PALS who deal with unhappy patients, and they were very helpful in our case, maybe you could try them with a complaint. Any how good luck, keep pushing spartan
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jeff
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Post by jeff on May 3, 2009 16:01:49 GMT
Er - this is what psychiatrists do - assign names to problems and categorise these into their 'Diagnostic and Statistical Manual'. The question is whether you meet diagnostic criteria or not - if he has training in adult ADHD, then he'd be able to make an assessment, if not (and it doesn't sound like it), then it seems a bit like just getting you to jump through hoops. I'd suggest doing the Adult Self Report Scale and using that as a basis. If +ve on that, then really you should be seen by someone with specialist ability to make an ADHD diagnosis. My hunch is they've sent you there because that doesn't mean making an out of area referral which would impact on their budget - but if they don't have competence to make a dx, then it seems like a pointless 'filter' which really shouldn't be there. I'd go see him anyway, but if he doesn't think you have ADHD, and doesn't support a referral, then I'd ask for his assessment in writing, setting out his qualifications and experience in making a diagnosis that you don't have ADHD and with written assessment. Then ask for a second opinion with a specialist - as you are entitled to do. (Sensible medical people don't mind that - after all if they get it wrong, then they can be liable, especially if a second opinion wasn't obtained though the patient sought one). I'm at uni, and he's the consultant psychiatrist at the student health centre. I've got my next appointment coming up on Tuesday. I've really got the feeling that he's not going to support a referall, he just really seems to have made up his mind already. Can I really do that? Tell him I want to be seen by a specialist? And does he have to give me a referall? I just imagine that he'll say, "I'm not putting you onto a specialist because I don't think you have it". Oh god, it's all so frustrating! Thanks for any advice!
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Post by Deleted on May 3, 2009 16:13:09 GMT
Until you actually see someone who is allowed to diagnose ADHD nobody can say you don't have it - a diagnosis can be either positive or negative.
It doesn't matter if the person sitting in front of you is a scary, experienced and assertive psychiatrist - if they aren't accredited for diagnosing ADHD they can't say you don't have it. They aren't qualified.
Be 'assertive'.
Insist on a referal.
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jeff
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Post by jeff on May 3, 2009 16:15:53 GMT
Really? But surely he's a fully qualified psychiatrist, so able to diagnose this kind of thing??
Also, the other thing that's giving me a real headache is the whole PCT funding thing. Do I need funding to get a referall to Maudsley? My uni health centre is just off the Strand, so do you reckon it's the same PCT?
Jeff
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Post by Deleted on May 3, 2009 16:28:08 GMT
Hopefully someone will come along to back me up in a minute - but a 'fully qualified' psychiatrist might not be qualified enough to diagnose ADHD.
I can diagnose ADHD. But I'm not a qualified doctor. I know more about it than the consulting psychiatrist that allegedly looks after me.
They are not gods and you are entitled to disagree with them.
You will find that a lot of people on here will have (I have on multiple occaisions) and if we didn't we would never have been diagnosed by someone who knows what they are looking at ie an ADHD specialist.
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jeff
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Post by jeff on May 3, 2009 17:02:28 GMT
Yeah, I suppose. What I'm worried about though is him giving a referall which basically just says "I really don't think this guy has ADD, I'm just giving him a referall to shut him up" and then they'll never give me a diagnosis.
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Post by Deleted on May 3, 2009 17:59:48 GMT
hey jeff,
don't let yourself worry too much about what might happen. i find sometimes that i worry too much about all the possibilities, and in the end, it paralyses me into doing nothing.
you need to be polite but firm with this guy, ADHD is an internationally recognised condition, and you have a right to be diagnosed by someone who has specific experience of ADHD. you need to let your current psychiatrist know that you do not want a diagnosis or treatment from him, just a referral. let him know how important it is to you, and if he refuses, which i don't think he will, let him know that you will go through someone else to get what you need.
-you're gonna have to stand your ground with this one mate!
good luck- matt
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Post by twix on May 3, 2009 19:30:27 GMT
What Matt said. And Dave. I had to see a non specialist Psychiatrist from a general team to get referred to a Psychiatrist who does specialise in ADHD and I think thats quite common. Most Psychiatrists spend a lot of time dealing with depressed people (its is a very common problem) and hardly any with ADHDers as there are not so many of us.
I found that putting it in writing meant they had to do something, and is easier if he's not listening to you.
Make sure there is evidence too, list of symptoms and self test.
Basically if you write to him and say you want a referral he will then have to refer you or justify not referring you. It will probably be more work for him to justify why not so you get a referral. (cynical me!)
Anyway good luck.
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Post by annie on May 3, 2009 19:47:20 GMT
Hi Jeff
The problem adult psychiatrist's have (and it's a real problem) is that until recently they will never have been asked to take over the care of a young person with adhd. They will have little if any experience in this field so you are well within your rights to ask your Consultant how many people he has assessed, dx and treated for adhd.
This doesn't necessarily have to be in a confrontational way but more a fact of life. It's only in the last couple of years that there has been a growing body of evidence to support the fact that two thirds of young people will go on to have significant impairment in adulthood. It's understandable therefore for adult psychiatrists to have had little experience. As others have said you need to be firm and say you want to be seen by someone who has the experience so you can rule in or out your difficulties being attributable to adhd. I know that's easy to say but it's like any other "illness" - you want to be seen by an expert.
twix
I don't know if an adult psychiatrist's caseload is mainly taken up with people with depression. However I can bet you a pound to a penny many, many people are being treated for depression when their primary difficulty is one of adhd!!
annie
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Post by Deleted on May 3, 2009 19:48:58 GMT
good move twix! putting pen to paper tends to get them working...
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Post by Deleted on May 3, 2009 20:10:39 GMT
Im going to my first Psych appointment tommorrow at 3. Im a bit nervous, not too bad, but Im pleased the Psych has decided to forgoe his bank holiday monday to see me because I kept shouting CRISIS. Seems like there is a little bit of humanity in there somewhere.
Am I best to just go in there and wing it. Im thinking that if I go in prepared, I will not be natural. Im thinking I could just go in and be me. I will forget loads of stuff, tell him I have an hons degree biology (goes together like a glove), I will get frustrated becos I cant remember, I will fidget, I will butt in when he's speaking. LMAO.
Do you think this is the way to approach it? I think he would seee the real me then, fidgeting and talking like some nervous wreck. It would certainly portray how I look when I go through a real situation under normal circumstances.
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Post by annie on May 3, 2009 20:40:08 GMT
Hi madscot
I hadn't realised your appointment was quite so soon, so good luck with it!!
It really shouldn't be for the patient to feel he has to prepare himself to the degree whereby he has to convince the psychiatrist about reality of his condition. Psychiatrist's are trained, or should be trained to elicit sufficient pertinent history to allow him to arrive at a diagnosis - this may take more than one appointment and in an ideal world should include some psychometric testing to confirm where the difficulties lie.
I think it's sufficient for you to take in the Nice short guidance for Health professionals, plus a list (not too long) about how your difficulties impact on your daily living. The rest should be up to the skill of the psychiatrist.
At the end of the consultation he may not be able to give you a definitive answer but he should be able to tell you what his initial conclusions might be and what further assessment he might want to complete.
I'll have everything crossed for you tomorrow!
annie
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Post by twix on May 3, 2009 20:50:02 GMT
Everything crossed. Just be yourself. I took loads of stuff written down because I was worried about forgetting what to say, but I didn't as usual I talked a lot!
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jeff
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Post by jeff on May 4, 2009 20:45:50 GMT
Thanks guys. I'm feeling a bit better, if I don't come away with a referall tomorrow I'll just do twix's "put it in writing" suggestion and go from there.
I really hope it goes well. I'm incredibly nervous, worried and stressed atm!
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