Treatment for ADHD seems engineered to be difficult specifically for those with ADHD to obtain.
Treatment for ADHD seems engineered to be difficult specifically for those with ADHD to obtain.
Disclaimer: I'm referring the the US medical system, but I imagine people in other countries may encounter similar things.
I cannot be the only one who has had this experience, but all my dealings with the medical industry feel like they were refined by a group of psychologists to exploit the weaknesses of those with ADHD.
The volume of calls, appointments, and paperwork I had to full out to get a diagnosis and prescription for treatment is completely unreasonable to expect someone with poor working memory and attention issues to navigate.
Then, to stay on medication, you need to schedule and make appointments with a psychiatrist every month, for the rest of your life, and if you miss a single one, you will run out of meds (and likely charged a fine), which will make it even harder to remember to make the next one. If you miss too many, that psychiatrist will refuse to see you again and you have to go back to your PCP to get a new referral.
Look, I understand that their time is valuable, but this system couldn't be designed any other way to be more accommodating to people who clinically forget things?!
It's like designing a wheelchair ramp that's actually just stairs that are 3x as steep as the regular stairs. Also, if you fall to the bottom, someone takes your wheelchair until you can climb back up.
This is one of the benefits of being on non-stimulant meds, the hoops to jump through are way less (I still had to fight insurance for a prior auth, which took nearly a month). I use an online Psychiatrist (Talkiatry) and have been really happy with my doctor. I also only need to see him as often as we think is medically necessary since atamoxetine can be refilled. It's been shown in trials to be as effective as methylphenidate and works well for me so far.
The diagnostic piece though is indeed hard, but I can sort of understand that. It's a pathway to drugs with a high probability of abuse, and no sure fire way to diagnose. So from a liability and care viewpoint I get why psychologists do due diligence in evaluating people (especially adults) for ADHD. It still sucks if you need help, but in theory you only have to deal with that process once to get a diagnosis. Also, as many people have pointed out, many PCPs are willing to fill scripts for controlled substances if needed, especially once you are on a stable dose that you know works. Like many things, the start up is the hardest and it gets easier once you hit steady state.
Shout out to all my spiritual siblings who skip days to stockpile meds because we live in a nightmare world.
I've been self medicating for decades with nicotine and THC. It works well for me. I guess I'm lucky.
THC helps a lot in very low doses (20mg or so) but I build a tolerance to it after 2-3 weeks, and also it makes me completely stupid. Its great for getting chores and shit done but terrible for my job. It also makes me really really wordy, which is kind of annoying for everyone involved.
The shit that pisses me off is the 4 week refill time because over the span of several months the refill date and appointment date get out of sync. Just make it so you can't fill more than three times in 90 days or whatever and it would accomplish the exact same shit but with way more flexibility.
Chances are someone did make it as hard as possible on purpose. US is the source of eugenics...
maybe i got lucky, but my psychiatrist is private practice, and she lets me skip every other month and i just text to remind her to fill my meds. she's great.
oh, and offered to see me quarterly because she is encouraging me to find a therapist and i told her my budget is too tight to add another bill.
..yeah, i think i got lucky.
Germany here. It’s kind of similar here. The system is rigged against us.
My strategy is to use medication to enable me to build a support structure and learn techniques that help with dealing with symptoms. E. g. meditation, physical exercises that help mind-body connection, CBT, routines, etc. So that when I’m without meds, I can fall back on skills I acquired and trained.
What I also do is hoard medication. Ask for a higher dose or more pills, than I actually need. That way I can miss an appointment and still have enough for the next month or so. I even hide pills in different places around my apartment.
Also in Germany, undiagnosed.
There is an ADHD clinic close to me - They sent me a bunch of forms to fill out. Not form-fillable PDFs. They expected me to go to a print shop, print it, fill it out, scan it, and email it back. About 8 months later I ended up just learning how to write texts into PDFs because I kept forgetting and postponing. Now to wait "up to 24 months" for the first appointment, what a joke.
There is a private clinic that is more streamlined: GAM Medical. You have to pay out of pocked, but honestly, even without a high paying job, it's easier to get the money than it is to jump through all those hoops. My insurance (GKV) costs me € 1100 per month, but I still pay a few 100 out of pocket for meeting their psychiatrist once and paying for my meds.
It's not perfect, though. They too seem to miss the point that it's hard for us to keep pushing and prodding for the next step. I wish it were just a series of automatic appointments. It's slow, you'll have to keep pushing, mailing, calling them for the next and the next and the next step, but in like 6 months, there's a good chance you got your diagnosis and your treatment, be it therapy, meds or both.
I got pretty frustrated with them, but unlike every other option I tried, they delivered - eventually.
You could, in theory, also use them just to get diagnosed. Then, it would be easier to find a psychiatrist for the prescription, because at that point, that's a lot of money for very little effort for a doctor. Could even have insurance pay. Extra work, though.
Do it like I did: fail so hard at life that lose your job, lose Bürgergeld welfare, and are in danger of losing your apartment. Have a mental breakdown and go to a psychiatric hospital crisis center.
Do yourself a favor and buy a used brother laser printer. The toner lasts ages and they support universal PCL printer drivers. I bought one new 16 years ago and never bought new toner for it, only paper. It cost less than 100 € back then. Still prints.
Damn. I don't know where you live but I live in VA and my pcp just refills my prescription every month. We check in via what are basically text mesages and I do telehealth visits every 3 months.
Healthcare shouldn't be political currency. Healthcare care is an inherently political issue, as each government has to determine the best strategy for them, but like many things in the US politicians see it as just another talking point and something that actually impacts people. This leads to policy being made by people who aren't knowledgeable about healthcare for people who have strong about healthcare but often aren't impacted by these policies and don't have a strong understanding of the topic.
While it would still be a horrible thing to have happen, I'm starting to think that having a bunch of LLMs run/control the government wouldn't necessarily be worse than what we have now (at least in the US).
My anxiety, depression, and executive dysfunction prevent me from talking to a therapist and getting a diagnosis. I am so sick of this...
Yes.
You guys don’t have repeat prescriptions?
I just order mine on an app when I get a reminder and then pick it up from the chemist a few days later when I get a ping.
Your use of "chemist" makes me think you're out of the US.
Most ADHD meds in the US are "controlled substances" and that means our doctors can only prescribe up to three months at a time. After three months we have to have a follow-up appointment, then they can prescribe three more months of meds.
Plus the federal government decided that too many people were taking medications like Adderall. So their "solution" was to instate a cap on how much Adderall manufacturers can make. Which means there's now a national shortage of Adderall. And that shortage means folks with ADHD are frequently going without their meds entirely or are forced to call multiple pharmacies in the area to ask who has their meds in stock. (My health insurance through work requires me to use a mail-order pharmacy because it means cost savings for them. But that means I don't have the luxury of shopping around different stores to see who has my meds in stock - at least, not to fill the prescription through insurance and get the lower price. So if the mail order place is out, then I'm screwed.)
Our healthcare system is so fucked.
I have to go in every year to get refills on my epi pens and my migraine meds. I have to have a doctor sign off on those and I don't really know why. I am not on ADHD meds but I imagine that would be the same.
My old doctor used to require monthly check-ins to get my ADHD meds.
It's every 6 months for controls.
Oh yeah.... I should probably refill my epipens....
As someone with unmedicated ADHD and a severe heart condition, I feel this rant deep, deep in my soul but more for my heart stuff.
You mean I have to call for follow ups every three months and also remember to fill my multiple medications every month or else I am sent on a death spiral? And you also mean to tell me that I can't take any of the typical ADHD drugs because it might hurt my heart?
Win win.
100%
It took me years to realize I had it, even more years to get a diagnosis (I was told I had "severe ADHD" btw") and even now, I'm out of medication more often than I have any due to logistical and financial barriers.
It's designed that way, because it has the same effect on everyone. People with ADHD are just starting with a lower capacity for it. The goal is to get as many people as possible to give up on getting what should be theirs in order to "save money". It's the same thing you'll see in certain software when you try to do something they don't like, for example, opening a link in an external browser, or contacting an actual support representative. Suddenly, this app is really poorly designed! It's not a bug, it's a feature
No, it's entirely a DEA thing. They have such a stick up their ass that must doctors and pharmacies are terrified of writing/filling too many controls because the DEA can fuck them in the ass for actually providing the meds people need.
Shoutout to ADHDcentral. They tried to make the process as clear and accessible as possible. With automated reminders.
What is this? I searched this in Brave search and got like no relevant results.
I'm curious as well. This is the closest relevant result I got, sadly it is for The Netherlands.
My biggest fear living in the US was falling off meds and being unable to get back on them. If your life situation allows you should absolutely rely on friends or family for help. You don't need to do this alone, ADHD is a disability and you're allowed to need assistance.
you should absolutely rely on friends or family for help.
Aw, I wish. There are two types of people in my family. The first type is people who also have ADHD (unmedicated, at that) and/or autism. The second type is people who believe the first type are jUsT bEiNg LaZy.
There is no in-between.
I feel your pain precisely. Also, most of the people who clearly have ADHD/autism or other, much-worse things are often the ones denying it's a thing.
Well fuck, my apologies then.
I've never seen a psychiatrist - I was diagnosed by a psychologist and prescribed by my general practitioner doctor. My doctor doesn't make me come into the office regularly, I can generally just message him for a refill. I realize I am extremely lucky (not that lucky - I can't seem to tolerate stimulants), but I encourage people to try a different route.
I think state regulations might vary. Where I am, every three months I HAVE to have an appointment to get a refill prescription for my Adderall. But fortunately my psych is still doing virtual appointments, which is a lot less disruptive to my workday.
I've never had a doctor or therapist take me serious. If I had access to the drugs I could self medicated diagnose better.
I'm extremely happy with the process I've had, but I understand it's very likely not representative of the rest of us here.
By and large, you're right though. My wife has gone through similar struggles and hasn't been medicated for over a year because of it.
"Zocdoc" is a great app to make appointments when possible.
Treatment for ADHD is meditation.
Sorry you got downvoted so much, because you’re not 100% wrong. Meditation can actually help with some ADHD symptoms, however
- Meditation can be especially difficult for those with ADHD, because it requires doing the exact thing their brain has trouble doing. If you are able to overcome that hurdle, it can be very helpful—exercising a part of your brain that is underdeveloped. But “just meditate” is useless advice for many people.
- This comes across as dismissive to the original post, which is about healthcare systems not just lacking accommodation, but full of extra challenges for the most vulnerable. There is much more to ADHD treatment than medication. For example, many people, especially those who went undiagnosed, have years of trauma to unravel, and therapy comes with all these same challenges.
I have ADHD. I was diagnosed 32 years ago. In all that time, nothing has helped me but meditation. Of course it’s difficult. That’s not an excuse to not help yourself and treat the symptoms instead of the disease. People are so quick to accept a diagnosis and believe there is something wrong with them that can’t be fixed and use that perspective as a basis to over medicate themselves. It’s completely unnecessary. Regular meditation physically restructures the brain and can repair the abnormalities that cause ADHD. I know this for a fact. I guarantee not a single person downvoting me has tried meditation in any serious capacity, or done any research on its effectiveness. Imagine if people actually put effort into helping themselves instead of doping themselves with amphetamines!
yeah and getting it is hell. either you go for the pharma version, and there are so many hoops to jump through that you basically can't if you have ADHD, or you try to go with the street version, which is really hard to synthesize and you end up wasting a day on ego death if you dose too high.
This is why I got off the schedule 1 stuff. There are other options.
Not really. I’ve tried some other solutions like antidepressants and they didn’t help because they don’t address the core issue. AFAIK only stimulants are proven to be an effective treatment for ADHD.
Also, that only alleviates one of the problems I mentioned.