What happened in my ADHD assessment
A few days ago, I was diagnosed with ADHD.
This is quite ironic because I was first diagnosed 6 years ago (twice!). I thought the appointment was for a medication review, but instead turned up to an assessment.
What I also didn't expect was to be back on the emotional rollercoaster of a diagnosis, navigating grief and shame and validation all over again. I've decided to share my experiences of this assessment to raise awareness of how these conversations are not just like having a fun personality quiz.
It also gives a window into the reality of living with ADHD, where it's not a 'superpower', but years of being misunderstood, feeling like a failure, and struggling with the basics.
Here's what happened in my ADHD assessment this time around:
Questions about my family / health history
First off, there were questions about my diagnosis', including where they were from. Then there were questions about my birth, whether my mother drank alcohol or smoked whilst pregnant, my developmental milestones, and my family history. Whether I took medication and had been assessed for, or had any other conditions. What my childhood was like. Whether I'd experienced abuse. Whether I'd ever self-harmed or attempted suicide. Who I'd grown up with and questions about my siblings. If anyone else in my family had ADHD, and their health challenges.
I mildly started to freak out. I kept going on tangents and giving vague, confusing answers, such as dissecting the meaning of self-harm and abuse and asking the assessor to choose whether he thinks my experiences 'count'.
The psychiatrist had to keep asking me the same question over and over again as I kept answering a completely different question, extra anxious about trying to give as much context as possible and not wanting to be 'dramatic'.
2. Questions about my school / educational history
He asked what my primary school was like. I don't remember huge chunks of my life, and how I described it was just being like not present, like I was sitting on the outside of life. I said how I was constantly looking out of the window, becoming hyper-aware of whether I was saying things I thought sounded like ADHD, or whether I was actually the girl looking out the window.
He asked if I did well at primary school and if I got into trouble. I first answered with a long irrelevant story about I was bullied and generally not liked, having had my hand bitten by another girl. I got in trouble for things I didn't really understand, like breaking open a glow stick on a school trip and putting it in my mouth to see if my tongue would glow, ending up in hospital.
Then he asked if I got in trouble at secondary school, and I ended up talking about how I would always fall asleep in class. How a teacher tried to get me suspended on my first day at a new school for accidentally throwing Tippex at her. How I was sent out of class for distracting other people. How I'd smoke before school and go out clubbing every weekend and attempt to get drunk at school, instead spilling vodka over my school bag and books. How teachers told other kids not to be friends with me as I was a bad influence. How I'd listen to music under my hair and text under the table.
He asked about my grades. Straight A's, despite one family member exclaiming their shock at how everyone had always thought I was stupid, and how one teacher asked the whole class if I'd cheated. I explained how I got them, knowing I couldn't do coursework, so picking exam based subjects and learning it all in a week before forgetting it all.
Then we talked about what I did next. University. A 2:1 law degree that I somehow managed to get without going to hardly any lectures, because those I did go to I couldn't concentrate in at all. I explained how I memorised my flatmate's notes that she had painstakingly made the entire year and did manage to 'finish my degree on time'.
It was very confusing to talk about this, because I was suddenly aware of all of the stigma and misinformation around ADHD and being able to get 'good' grades in school. I started to think: am I actually just a lazy cheat? What if I don't actually have ADHD? What if my teachers were right, and I was a bad influence on other people?
3. Questions about my career history
Then I was asked what I did after university. I started explaining my tangential life of going out clubbing several times a week and how my life spiralled out of control, and he had to keep bringing me back to the question of what I did for work.
Fashion modelling, which I really did not want to do, but somehow ended up continuing until I was 25. Alongside applying for a million random jobs and changing careers and moving country every month and falling out with people and becoming suicidal which led to the diagnosis... factors that did not fit into the specific box for this question.
Then I explained how I managed to get a job in law after being diagnosed with ADHD age 26, after being medicated. For 2 years. I started freaking out about the pre and post ADHD life I'd had, because whilst on this medication, maybe my symptoms doesn't qualify for the diagnosis anymore. I have obviously been extremely 'successful' in my career since then and didn't know how much I should share.
He asked what I did after the law job. 'An ADHD Coach'. I suddenly felt very small, and an overwhelming sense of imposter syndrome. This very highly qualified medical professional had the power to give me a completely different label that I'd constructed an entire narrative around in the last few years. I felt terrified to tell him I'd dared write a book on ADHD when I was interrupting him every 5 minutes, questioning my entire life since I'd gotten this diagnosis.
4. Questions about relationships / lifestyle
I then explained how embarrassingly, I had not managed to have a romantic relationship lasting over 1 year in the last 10 years. I gave extra information not asked about, like how I'd move into their house after a month, wondering which 'disorder' this could also qualify me for.
I explained how I live alone and have no children. This is the first place I've lived in for more than a year since the age of 18. I explained how I can drive, but don't, as I've managed to crash 3 cars in the very short pockets of times I have done so.
Friendships and family relationships are also highly difficult. Is this Autism or ADHD or just that I'm not a very likeable person? I have had more friends than I can possibly even count just stop talking to me out of the blue, for reasons I will never know or understand. Sending them feedback forms involves too much administration. I've just accepted that many people just don't (or won't) like me, and I end up 'doing' things to earn my worth.
However, saying it all out loud made it all feel a bit more real, and embarrassing that as a 31 year old woman, I am not 'normal'. That I am potentially destined for a lifetime of loneliness and being misunderstood, even if I now understand the reasons why. (Enter: Rejection Sensitive Dysphoria).
I find it very hard to imagine getting married or having children when I struggle so much with my own life. Although it's easy to reject these ideas conceptually for myself, it's also really sad to think that these are aspects of life that I probably won't have, or will experience very differently to others. 'Adult' experiences like buying a house and having a car feel off limits to me, in a way that I hadn't really properly accepted before that moment.
5. Questions about ADHD Symptoms
Then I was asked if I have lots of hobbies and struggle to maintain interest in them. I answered that I do indeed, glancing at my corner of abandoned rollerblades and candle making kits and stacks of unread books.
It was only at this point I asked him if he was assessing me for ADHD. This was so embarrassing - I didn't even realise I was being assessed. He said yes and he had to.
Then he asked if I make careless mistakes and fail to give close attention to details. I said I do indeed. He asked what the reasons were for this.
WHY?? Because I have ADHD?? If I knew why I made careless mistakes or couldn't pay attention, surely I would just fix these issues. I explained how I don't see the mistakes or process the information. I only realise they are mistakes when I see the very obvious consequences. Every question was also asked in relation to my childhood, requiring examples.
He asked if I find it hard to sustain attention in doing complicated tasks. I said I do, tangentially explaining about how I would forget that I've started something even as obvious as turning on the shower. He asked about tv shows and books. I try not to watch TV because if I watch a TV show then I have to watch the entire 8 hours that moment, and need to have subtitles on, or I will be unable to watch it. Same with books. All or nothing.
Do I seem like I am not listening when spoken to by others?
I said we'd probably need to ask them. But that I was taken to the doctor as a child for this reason, who said it was a build up of ear wax. That I cannot listen at all, including in a hearing test when I had to press a button at the beep and forgot to press any buttons at all. Then I wondered if maybe he too, would put this down to a build up of earwax. Maybe I was lying. I hadn't taken a survey lately of people to see if they thought I was listening to them.
He asked if I can follow instructions. I explained how despite trying my best, I could not follow instructions no matter of the consequences. I'd lost jobs because of this, to simply not using my hot water meter for half a year because I couldn't follow out the instructions to use it.
Do I struggle with tasks and planning and time management?
Indeed I do. I had to set HOURLY REMINDERS, including asking someone else to send me regular reminders, about that specific appointment. I'd managed to somehow double book myself at the same time, then from anxiety about forgetting it, sit for an hour before the call with Alexa reminders every 10 minutes about it.
Do I meet deadlines?
I thought I did, but then an image came to me of waking up at 6am that morning to finish off the work I needed to do for a deadline that morning. I do generally hit my deadlines, but only at the last minute, despite being able to do these things at any point. I get extremely anxious at unread emails, feeling like they all must be replied to immediately, or not at all. I do my tax return as soon as I can (i.e 10 months early), out of fear of not doing it at all.
He asked what kind of tasks I avoid, if any. How do we know what kind of tasks we avoid if we avoid them? I reflected on how I still haven't figured out how to pay myself a salary or get curtains installed in my flat, or remove the mould that's been here for a year. Cleaning, cooking, eating, staying alive, socialising, going outside, socialising, parties, holidays. Those kinds of things. Sometimes.
Do I lose things?
I answered this with a charming anecdote about how the police thought burglars had trashed my bedroom as a child, but actually it was just extremely messy. He repeated the question, which I then realised I hadn't answered at all. Yes, I lose things. Don't we all, though?
'What kind of things?' How would I remember what I've lost? What counts - losing every water bottle I buy? Everything? I have lost most belongings that I have - keys, headphones (painfully 2 days after purchasing them), and I generally do not allow myself to buy jewellery because I lose it all. I hardly buy anything because I assume I will lose or break it, and it hits me that this is not normal.
What kind of things did I lose as a child? EVERYTHING???? Books? Homework? Phones? I settled on explaining how I'd had a variety of phones throughout my childhood due to constantly losing them all, or dropping them in rivers / down the toilet / out of windows. (Not sure this answered the question).
Do I get distracted by noises?
Well. I get distracted by noises, but also extremely upset by them. I once had a huge argument resulting in a family member not talking to me anymore after they refused to turn down the radio when we hadn't seen each other for a while. When someone used to distract me in an office every day with their chatter in the kitchen, I once somehow emailed them telling them to shut up before realising what I'd even done. Noises that I can't control feel like they are drilling into my brain (but again, is this Autism???).
Do I forget things?
Everything (see above). I explained how forgetting birthdays and meetings and conversations makes me not that popular of a person, and feel like a general mess. I forget that people exist if they are not in front of me. I forget to text people back or call them. I forget what I've already said or done, and am forever being told that I repeat the same stories over and over again.
Do I fidget?
Yes. I sit in weird positions and generally fidget with random objects, because I have broken all of my fidget toys and lost them.
I explained how I do not typically get up when expected to sit down, but how I would rock on my chair all the time. How I wouldn't call myself active as a child, but then reflecting on it, how I was out clubbing until 7am every weekend as a 14 year old. And how I actually used to hang upside down from a tree in my garden all of the time, falling out on my head.
I confirmed that I would indeed describe myself as restless and hyperactive, and unable to relax. My brain does not stop. I was asked if I was talkative, and had a very complicated tangential answer about how I'm not talkative with my voice (that I was using to over-share at that moment), but I am through writing. I was always getting told off for writing notes in class. And I have written 4 books. What does not come out of my mouth comes out of my fingers, and I cannot stop it.
As I was speaking very fast, and kept interrupting the poor psychiatrist, he asked if I talk so fast or so much that other people find it tiring. The thoughts of people literally saying this to me immediately appeared in my head. Someone saying how quickly I spoke they couldn't keep up. Or mumbling. Or that they couldn't understand me. I am not a chatty person externally, but internally my brain is exploding. I realised that being bullied for my voice throughout my life may have something to do with my ADHD, a dot I'd never connected before.
He asked if I have trouble waiting my turn. I explained how I will just simply leave instead. If I am in a supermarket (why I try to avoid wherever possible), and get to the end of the checkout after a very painful hour of deliberating over what I actually need, if there's a queue, I will just abandon my basket and leave. When I was driving, if there was traffic or no parking spaces, I would just go home. Maybe this is just really bad resilience. I would rather just live off mini rolls than have to queue up for 30 minutes.
I was asked if I interrupt and intrude on others. At first, I thought that I didn't. Then he said, 'for example, at work, do you do other people's activities?'. I thought back to that morning, at 6am, where I'd somehow managed to do other people's work without even realising that I'd done it until having to explain this to them when they woke up. Then I said that I suppose I also did this to the child who bit me, as I waved my hand in front of her face.
My brain was spiralling about how I interrupt and annoy people when I was asked how my mood is generally. I said 'creative and passionate, with lots of ideas'. This is not a mood, apparently. 'Good and bad'. Very high highs, and low lows, in the same day or hour.
I explained that I sleep around 5-6 hours per night due to a lack of curtains and a brain that will not shut up. Sometimes I wake up working in my sleep, and I'll just get up and start working. At school I used to just fall asleep at random times throughout the day, which as I discovered when writing ADHD: an A to Z, was actually due to my nervous system disengaging - literally falling asleep from boredom.
6. Diagnosis
Then I was told that I had combined type ADHD based on this conversation, on the previous diagnosis', and the forms that had been completed previously by family members for those.
I wasn't sure how to feel about this. Relief that I'd been 'officially' diagnosed, and wouldn't have to cancel myself. It would have been very awkward and confusing to have actually been misdiagnosed, a fear that was always lurking at the back of my head. But what if this was also wrong?
Then I was told I'd have to wait 7 months for the tritiation period to increase the medication, and was assured that my GP would still be able to give me medication in the meantime. The medication is the one thing that has helped to calm my initial rumination of whether I actually had ADHD, because I know that my brain is remarkably different on it, and so am I.
I logged off from the call and sat in a feeling of overwhelm of shame and anxiety. I retrieved the burnt food out of my oven and felt a sense of validation that there was a 'reason' for this. Then I was hit by grief that actually, this validation didn't take away the fact that life was really actually very difficult and having ADHD diagnosed based on this deficit meant I felt pretty bad.
I realised that I had crafted a narrative in writing ADHD: an A to Z which had helped me (and presumably some others) to accept and harness my unique brain wiring, and the strengths it brought me. However, I also realised that by doing this, I had intellectualised my own daily challenges instead of feeling them.
I didn't really know who to tell or what to do with this information. Somehow it felt more 'real' than the 2 assessments I'd had previously, as this was much more scrutinised and detailed. It was far from a checklist of answers that could be satisfied with a simple 'yes'. It felt far more significant but also would be old news to literally everybody I knew.
It was dragging up my entire life, the history of shame and struggles that I didn't even understand, and putting a new lens on them all. It felt weird to have had an assessment that I know so many others are in desperate need of, and to feel so sad. Whilst it was nice to know that I wasn't just lazy and selfish, the diagnostic criteria is framed in a way where you still feel that way.
Like you're kind of just not living up to basic normal human standards. An official reminder that not fitting in means life is more difficult for you. Yes, it might be a good thing to stand out from the crowd, but it can also be a painful, lonely, and sad journey. ADHD is an explanation, but not an excuse.
When I saw a boy being attacked by a huge group of teenagers last week, I had a million things I wanted to say to him. I imagined what I'd say back if I was him: that's nice, but I'd much rather be normal and not being beaten up.
I don't really know what the point of this is, and it's obviously complete oversharing, but maybe you want to share it with someone the next time they think ADHD is a trend or an assessment is a fun personality quiz experience. Maybe you want to share it with someone who thinks ADHD is just normal living in our broken world.
This assessment forced me to go beyond the bits of ADHD I've chosen to bring into my narrative these days, and forced me to acknowledge and recognise how much it impacts every area of my life. Knowing and learning about it, and having medication, has changed things dramatically, but it will always be there. Until I one day maybe don't 'pass' one of these assessments.
That assessor could have just as easily decided that I didn't meet the criteria in his opinion - but the reality would have been the same.
I am extremely grateful that I have been able to live this endlessly curious, creative, colourful life because of having the brain I do, but it is also extremely difficult at times. This was one of those times, when I ironically needed someone to help me figure out what this all meant for me.
Luckily, my life is very different from those 6 years ago and instead of simply ignoring these feelings, I was able to process them. I wrote them out and told someone who cares about me very much how I felt. They reminded me of all of the things I tell others on a daily basis: having ADHD does not mean you are broken.
Being different does not mean you are broken. The diagnostic criteria is outdated and based on little boys. It is not a reflection of who you are. Having ADHD is simply a part of you, and it is a brilliant part at that. It does not define you. You are lovable, and you are brilliant, just the way you are.
These stories we make up about ourselves being 'not enough' or 'too much' are based on our past, but we get to decide the future.
Having someone to sit with me through these feelings of overwhelm, help me to validate my own experiences, and understand myself a little better was one of the most important things I've done recently. I had my own experience of 'ADHD coaching' from someone who simply cared about me, which is a good reminder of why we do all the things we do at ADHD Works .
Not because we're medical professionals or promising to magic away the very intense challenges that can accompany ADHD, but because having someone to sit with you through the storm and get to the other side is so crucial. Having someone to speak to and remind you who you are, that you are brilliant and whole, and that you are not broken, is so, so important.
If you've been through anything like this, please remember how brave you are to have sought out help. ADHD assessments are overwhelming, intense, and anxiety inducing experiences, but you have been able to sit through that storm and understand yourself a little better.
If you know someone with ADHD, I hope this has helped you to have empathy for what may be going on behind the scenes - and that it is most certainly not a trend!