Hi,

I went to the psiquatrist today, through the social security, (almost an hour with her) Right now I live in Spain and the public health system is supposed to be one of the best in the world. My next appointment is in 20 days.

I had been diagnosed with ADD in the States, 8 years ago, after being misdiagnosed with depression and bipolar and confirming those were indeed mistaken. At the time I though I had anything but ADD, knew nothing about it, and simply ignored it, refusing to take any meds, and moving on with my life.

Later on my symptoms got worse but I developed the ability to see myself objectively and what was going on in my head, and through a lot of research I concluded that I indeed had ADD of the inatentive type with a few hyperactivity sysmptoms too, ranging from when I was very small, (im 33 now) This is hard to explain but I am sure of this. I have most of the symptoms everyone has, but hey are stronger and stronger and it's hard to cope any more.

I prepared a long document writing down all my sysmptoms. My psichiatrist will read it by next appointment. In the meantime, and at the end of today's meeting, I felt completely devastated.

My psichiatrist indeed seems like a very intelligent woman, i got a great impression from her and we got along fine. But some of the things she said truly desarmed me:

"You have a history of misdiagnosis and that is usually a sign that it is mostly your personality involved and that no pill is gonna solve this for you."

She asked "Does tea make you mervous?" I told her i drink lots of it. I said "yes" she said well see, thats it, tea and stimulants arent supposed to make you feel nervous if you really had ADD, they would calm you down. Then I said, well I guess I must drink it for a reason, nobody wants to be nervous, besides, I have felt so bad in the past month that to even get out in the street I have to take a ginseng capsule, which really gets me to cope with my morning, and that is a stimulant. Ginseng really has a miraculous effect on me, and my sysmptoms, but it gives me headaches and makes my teeth hurt if I take a lot of it.

She was very reluctant to agree that I have ADD and kept on saying : "well, will a diagnosis make you feel better about your life? she said this in a way that truly disarmed me, I felt absolutely awful, I cant even remember what I answered, something intelligible most likely after being momentarily paralized.

She prescribed me Rivotril, although I kept on telling her i didnt want tranquilizers as they make my symptoms worse. I dont even know what Rivotril is.

I went for a walk to the pharmacy (23 cents of an euro for box of 60 pills) then for some groceries, by the time I was home the effect of the ginseng pill was starting to wear off and I had a long cry that seemed to come from the depth of my stomach like I haven't had in years.

Any advice? I feel awful still, I am not planning on taking this Rivotril until I've made some research on it.

Thanks for reading all of this.

Hi Lostinspace!

I'm sorry your appointment with your psychiatrist didn't go as you hoped it would. Attention Deficit Disorder in adults is still not real well known to many doctors even here in the states and less so in Europe. I had a counselor who I really liked who kept insisting I was just depressed, but I knew in was more than that and when I got a full workup done, in turned out to be ADHD. Sounds like you've already been through that in the states. You may need to educate your doctor a bit or see if there is anyone who you can see who is more knowledgeable about ADHD in adults.

It's not unusual to be misdiagnosed before receiving your ADHD diagnosis because it's really only recently that medical professionals realized ADHD could persist into adulthood, so an awful lot of people were misdiagnosed (let's see over the years I've been labeled with generalized anxiety, post traumatic stress disorder, an adjustment disorder, and depression before they finally got at what was at the root of all of it). I can't offer you an easy solution other than hanging in there and reading and learning all you can about ADHD and also non medication approaches to it while your finding someone who knows how to medicate it properly.

Drs. Edward Hallowell and John Ratey's book Delivered from Distraction has lots of good tips and information. Dr.Hallowell is ADHD himself and the standard ADHD medications aren't effective for him, so he has some useful things he's discovered that help over the years. Their book and my own experience is that exercise multiple times a day, relaxation breathing, a spiritual connection, social support and education on ADHD are extremely helpful in helping focus problems and emotional dysregulation. Being 12 years older than you and not diagnosed until recently, they were all I had for a long time and were helpful.

Take gentle care of yourself!
Scattered

In some cases, a history of misdiagnosis is evidence of "malingering," the term psychologists use to define an individual trying to get diagnoses (sometimes unconsciously) for whatever motive. However, her statement about stimulants not having the effect of causing anxiety in ADHD populations is not accurate; they do have those effects, though less frequently than in non-ADHD populations.

I'd stay the course. Rivotril is a form of tranquilizer, generically called Clonazepam. It is effective in treating anxiety disorders, sleep disorders, and in some cases, attentional and behavioral disorders, such as ADHD. You can get more information about it by asking your pharmacist...I'm sure in Spain they are as well if not better trained than in the United States.

I've been to Spain several times and spent a great deal of time in Greece, and I'm familiar with Mediterranean attitudes towards neurological and mood disorders of all kinds. There are still stigmas attached to any kind of mental/emotional issues and a great deal of misinformation out there. Don't get me wrong, there are wonderfully trainned, intelligent doctors there as well, but if you need support for your adult ADD you may have a tougher time of it there than in other countries.

I'm just shaking my head here at the "history of misdiagnosis" - misdiagnosis of ADD patients is every common, especially the bipolar/depression tags. I'm sure she's intelligent, but that does not make her informed.

I really feel for you. I remember what it was like looking for help myself in a foreign country, and explaining my problems in a foreign language. It's daunting, especially to a person with attention/impulse issues. My advice would be to tell the doctor you are not looking for a diagnosis - you already got one. You are looking for treatment for your preexisting condition, and if she is not qualifed to treat it then you would like a referral.

The alternative is to fly to the States, get treated there, and arrange to have your treatment continued in Spain. You sound like you are suffering and the relief will be well worth the price of a ticket.

Thanks for your replies the three of you, :)

I was actually born in Spain (living in USA on and off for about 16 years) and have papers to work and live in both places so the language isnt a problem but the stigma you talk about, beeblebrox, is very much there, with very few people outside my family I can discuss this with. It's the southern European thing of "living in the street" or being the social machine thing, that so many people like I guess. I don't like it.

The attitude of the psichiatrist this morning really made me think, im still replaying in my head her comments, her gestures, all she meant. It made me doubt a lot of the research I've done even though it's kind of obvious she hasn't had many (if at all) ADD cases to work on. Like so much other stuff, I forgot to ask her that.

From her words I could kind of infer "Hey, if you are single and dont have a passion for life, no pill is gonna give it to you! it's ok! it's fine to lead a mediocre life, because it's yours! the cards were dealt already, concentrate on the present! Absolutely chilling stuff.

I should think less.

In the meantime I was on and on about my concentration problems, the only ones I had time to get into, following some notes I had taken so as not to lose myself in irrelevant stuff.

She is reluctant to agree that I have ADD as much as I am sure I have it. I think I should wait for the second meeting to make any conclusions really. When I was diagnosed with ADD 7 years ago, it was after 2 meetings.

just a remark, that I am indeed very passionate about life, never stopped being, and now more than ever, I think I must have looked very confused.

PLEASE look into reading up on the history of ADHD;either online thru one of Russell Barkley's continuing education courses that Forum member...... scuro......has posted or going to a library and looking into one of his books. In particular, his 1997 book, ADHD and the Nature of Self-Control. It's really written for professionals but it's the HISTORY part I want you to read.

Some time during the 1960's, there was a HUGE split between European psychiatrists and North American one's regarding ADHD. I found my copy and this is what I'm referring to.

On page 6 of ADHD and the Nature of Self-Control, Dr.Barkley writes :

" Another important distinction was the assertion that the condition seemed developmentally bengin, diminshing as it did at adolescence. Also, the recognition that the disorder was NOT caused by brain damage seemed to follow a similar argument made somewhat earlier by prominent (US) child psychiatrist Stella Chess (1960) and created the

...beginnings of the major conceptual shift between professionals in North America and those in Europe that continues to some extent the present."

He goes on to say (still on page 6):

"European clinical professionals continued to view hyperkinesis as a relatively rare condition of extreme overactivity often associated with mental retardation or evidence of organic brain damage."


He does add that the "discrepancy does seem to be abating as of this writing, at least between scientists (not psychiatrists) on both continents".

He then lists some references and points to the use of the Diagnostic & Statistical Manual of the American Psychiatric Association -Fourth Edition (DSM-IV) as an example.

I had the priviledge of hearing a neurodevelopmental pediatrician from Philadelphia (Yardley ) Pa. on Monday night and this topic came up.

What she said is that in the UK, the psychiatrists and physicians don't use the DSM-IV criteria.Instead, she said that most of them use the (old) DSM-II criteria, which is different that the DSM-IV.

To be honest, I havent seen a DSM-II in years. My guess is that it's weighted towrds hyperactivity (hyperkenesis ).

What that does is overlook the last 15 -20 years of research that has helped establish ADHD as (among other things), a "neurobiological disorder."

Russ Barkley PhD is widely regarded as the world's leading expert/researcher on ADHD. He was on the committee that developed the DSM-IV criteria that's based on much of that same research.

Important to that is the operational definition of what constitutes a "disorder."

If you go to either his website or www.chadd.org you'll see a link for a research article entitled: "International Consensus 2002."

It is THE definitive research study supporting ADHD as a "real" disorder and is signed off on by over 80 of the world's leading scientists.

It's important to you because it's based on the current DSM-IV criteria (and NOT the old DSM-II one's).

It shows European support for the current criteria!!!

Lastly, here's what the article defines a "disorder" as (I'm paraphrasing because I really want you to check the references out ):

"Impairments in major life activities that cause harmful dysfunction."

For adults, that means academic problems throughout your life, diiificulty holding a job, traffic accidents, relationship problems, etc.

Since research has shown ADHD to be 80% genetic, the thing to look for is that these problems/impairments have "ALWAYS" been a problem.

For kids thats school and friends and then later on driving problems.

If you read the article that will make more sense because it pertains to ALL disorders the world over and not just ADHD.

Lastly, I'd really like you to get a copy of Sandra Rief's 2003 book....... "The ADHD Book of LIsts."

She's taken all the research I referred to and put it into list form with specific categories and the references.

It saves a ton of time and makes your point .

Barkley's & Rief's books are available at Barnes & Noble or Amazon, etc.

I'd suggest getting her book, as I've just posted the part I wanted you to read. The online continuing ed courses from Barkely are still a good idea to look at just to get a better idea of the history.

I hope this helps and I wish you lots of luck.:)

take care

mctavish23 (Robert)

http://www.continuingedcourses.net/active/courses/course003.php

Have you checked out www.adders.org (http://www.adders.org)? They are based in Britain but have a section featuring websites and resources from throughout Europe and Asia. To find "ADDers" in your area who may be able to recomend ADD specialists, just click on Support Groups, then choose Spain.
(Of course, listings posted in Spanish might put a crimp in things, but :soapbox: learning to ask for and receive help graciously is one of the first "helpful accomodations" those with ADHD need to learn.)
JRJ

Im so sorry,but it is horribly typical for this to happen.It happened with me and it nearly crushed my soul.I never gave up!!! I knew what the problem was,I just needed the help to fix it.Do what you have to do,you know what your going through and thats what drives you for help.Keep trying,keep pushing.Good luck to you....

Lostinlspace, I think one huge problem is that ADDers lack a skin - an extra skin that keeps them from feeling hurt, offended or safe from the comments that others make. You do not need to doubt what is going on inside you. Doctors - even highyl intelligent ones, even ones who have it all together - are human beings who make errors. One of my close friends is a doctor and she admits that she is woefully uninformed on many medical subjects outside her immediate area of expertise.

As for the feeling she left you with - that you should accept your ADD-inflicted mediocrity - that's ridiculous. Your ADD makes you suffer and causes you pain - and if you are clever and that helps you perform to a certain extent anyway, it still does not remove the level of discomfort you feel at having a neurological disorder that causes you to run on adrenaline all the time, make poor decisions and feel every jab that someone might choose to hand out.

You deserve better. Stick up for yourself - tell your psych next time that you already have a previous diagnosis. Ask her what experience she has with adult ADD. Bring information with you, and demand treatment.

Good luck. I hope you feel better soon. :)

Thanks scuro and JRJ for the links.

I don't know if your psychiatrist in Spain has that same belief system. That is merely a description of the Eurpean mindset described in ADHD and the Nature of Self-Control.

I was thinking about this last night. To the best of my knowledge, I think the DSM-II came out in 1968.

That would mean the criteria being referred to as the (generally) accepted standard would be 37 years old !

Hopefully, that is not the case with your psychiatrist. However, the information does give you something to discuss if there's a discrepancy between the US & Spanish disgnoses.

Good luck again and please keep us posted.:)

The DSM-ll states that homesexuality is a mental disorder too,,,,, should I add that one to my list of diagnosis lol. Mctavish, you are right, it was puplished in 1968 and revised in 1980. Hey lostinspace, ask your Dr.,,, if I come to Europe, do they have a pill that will make me straight? Just curious lol

Let me emphasize one point already made : A Dr can complete a psychiatric residency and still know precious little about ADHD. My Dr told me of a young colleague of his in this category. He has taught her virtually evrything she knows about ADHD tretment.

DBR

Thanks again for all your help. To everyone.

A lot of the support I need right now I am getting from this forum and you people. :)

Thanks mctavish23 for all that info. Reading right now.

The essence of my ADD of whatever kind it may be manifests itself the most at the time when I am sitting there in front of my doctor: amazing hyperfocusing to begin with, turning to forgetting things to say or ask even with my notes in front of me, towards the middle of the conversation my focus turned very strongly to be coherent in my sentence structure then to get along well with the doctor. I need to do some work in being efficient at that very important time. Any tips that work for you all? Believe me, it is usually not this kind of disaster when I am trying to get something done. I guess I feel this is somewhat of a turning point and I'm full back in self sabotage mode.