It’s rather odd, but despite having blogged about being ADHD a number of times, I’ve never written how I was originally diagnosed. A couple people have recently asked, so I guess it’s time to do it. Oh look….something shiny! 😀
Life Before ADHD Diagnosis
I was born in 1971, which means I grew up in the 1970s and 1980s. Back then, ADHD was a relatively unknown condition, even though a condition fitting many of the current guidelines was first described in 1902, as per A History of ADHD. Other sources (The history of attention deficit hyperactivity disorder) say something similar was first described as far back as 1798. It was first called hyperkinetic impulse disorder, and the name wasn’t changed until 1980, when I was 9. The first treatment with Ritalin began as far back as 1955. When I was growing up however, ADHD was little known by the public, and it was generally assumed that kids who couldn’t control their impulses just needed better discipline from their parents, and there was a definite stigma attached to it. Because I did well in school and various activities, and because my parents did provide good structure at home, there was no real reason to suspect that I was ADHD. After all, I don’t have the hyperactive component.
In retrospect however, there were plenty of indications along the way. And in retrospect, I sometimes wonder how I made it through college, dental school, and even the first few years of dental practice before finally being diagnosed. I struggled mightily to focus for studying, struggled to focus when practicing piano, clarinet, or trumpet, could only focus easily on something when reading books I loved, etc. And when I say that I “struggled,” I mean that it was sometimes almost impossible to do so. Which is something that I think people without ADHD don’t really understand. Because it’s not a matter of willpower, I promise!
What Prompted Me to Ask?
In my early 30s, during the first few years of my own dental practice, occasionally a parent would comment to me, “You know, Dr. Payet, sometimes you remind me of my kid/brother/cousin/friend’s kid, who has ADHD. Have you ever thought about it?” As someone who grew up when I did, I’d absorbed the general beliefs of the time, that ADHD wasn’t really a thing, but was just people who didn’t have personal self-discipline. Of course, I thought I had self-discipline. Why wouldn’t I think that, after all? I’d graduated with a double-major in Biology & German at UNC Chapel Hill (only 2 courses shy of a minor in Chemistry, too), then graduated from one of the top dental schools in the country. I’d recently started my own practice and thought it was going pretty well (it wasn’t), bought my own house and thought I was financially savvy (I wasn’t). But there were dark undercurrents, which eventually undermined my self-confidence and made me question how well I really was doing. The mounting debts, because I couldn’t manage the people or finances at my practice, the lack of a social life or close friends in town, the hours spent nights and weekends playing World of Warcraft or StarCraft (this was before it was all online, thank goodness). As the struggles grew, I eventually fell into a bout of depression and needed both therapy and Prozac for a time. Both of those helped, but they didn’t solve the underlying problems. If you didn’t know, depression and anxiety are often co-morbid (experienced along with) ADHD, because the inability to stay focused on projects to completion creates deep frustrations and doubts about one’s self-worth. It’s more complicated than that, but you get the idea.
As those doubts and realizations grew, I shared them on a big online dental forum called DentalTown. At some point, a dental colleague in Arizona messaged me to say, he thought I might be ADHD, and he could relate. He told me of how he was diagnosed later in life, and how it really helped him overcome a number of struggles. We had several conversations about it, and he helped dispel some of the myths about ADHD which I held. This really opened the doors to my accepting the idea of being ADHD, but it didn’t quite push me to see a doctor quite yet.
The real tipping point though, was a conversation with one of my patients. This patient, who’s still part of my practice 17 years later, and to whom I will be forever grateful, was in for a check-up and cleaning. I didn’t have a hygienist working for me in those days, so I was doing her cleaning, which gave us more time to chat. At the time, she worked at a private school in the area, helping students with all kinds of learning challenges. She asked me several questions and answered several of mine, but one question in particular struck home. The conversation went roughly as follows:
Her: Do you drink a lot of caffeine?
Me: Me? A lot of caffeine? HA! I define the term, drinking ‘a lot of caffeine.’
Her: But does it affect you much?
Me:What do you mean?
Her: If you drink a cup of coffee at night, does it keep you from sleeping?
Me:Oh no. I can drink a cop of strong coffee at 9:00 and still go to bed at 10:30, then sleep all night.
Her:So basically, you’re self-medicating with caffeine, which is a stimulant.
Me: Light bulb goes off over my head.
The other thing she explained that day, which really made a difference, was how the brains of ADHD people work, and why it’s so difficult for them to stay focused on projects. Because as anyone with ADHD knows, we’re incredibly good at starting projects, but we’re horrible about finishing them. As in, a ratio of starting:finishing that’s probably 20:1 or worse. No exaggeration! And why we often do perform better under pressure – it’s the adrenaline that kicks in and helps us overcome our inertia.
Beginning ADHD Treatment
I ended up making an appointment with my family physician. Back then, screening was much less rigorous than today, but it quickly became apparent, that I was VERY ADHD, just without the hyperactivity component.
Initially, my physician suggested that I try a non-stimulant medication, Straterra. Oh gawd, it was awful for me. The absolute worst, non-stop medicine head fogged brain imaginable. I was told it could take several weeks to be fully effective, but I had to stop after a week. I was functioning worse than without the medication. Then I tried Adderall 15mg XR (extended release), and OMG it was a life-changing event! I’ve never been able to adequately express the dramatic change I felt; I can still feel the reverse effect today, if I don’t take my Vyvanse 70mg. Which is why I basically never skip it; without it, I feel like a non-functional zombie. It’s the worst feeling imaginable. How I ever managed to do anything, when I lived like that every day, I have no idea. Which is why I will be eternally grateful to my patient.
So there you have it. The story of how I was finally diagnosed with ADHD at age 33. For more about my journey with ADHD, you can follow all the links under the ADHD Category in the right sidebar, or here are a few: