It wasn’t *exactly* what I expected, and I’m still processing it.
I initially sought out insight from a team of psychologists because I was accumulating symptoms that concerned me. I noticed anxiety during my last 2 pregnancies, but after my son was born 14 months ago, I couldn’t shake the intrusive thoughts, to the point where I thought they might be pathologic. I also started noticing issues with concentration, brain fog and thought organization, and I started to put together a puzzle in my head of what this confluence of symptoms could mean. I am always trying to figure things out. Things can never just “be hard.” They can’t just BE anything. They have to have a cause and a solution. So, I came up with the theory that I possibly had ADHD. After all, I was evaluated for it as a kid, per my teachers’ recommendations. I ended up NOT being diagnosed with it at the time, and to this day my Mom denies any signs of it. Since it can manifest somewhat differently in adults, and I seemed to tick off a LOT of the symptoms (see my previous post on this), I decided to seek a differential diagnosis. I wanted to know- was this Postpartum Anxiety, or ADHD? Anxiety is often included within adult ADHD symptoms, so I just wanted to know so I could have the best strategy to treat it. I was tired of feeling unlike myself. I figured if the doctors felt it was severe enough (whatever it was), they’d even prescribe medication.
After several hours of testing, it turns out I did not meet the threshold of criteria for ADHD. They validated my symptoms that could have suggested that dx (I’m going to use this abbreviation for diagnosis here), but determined that those symptoms likely were influenced by other factors, and I agree. While I suspected ADHD, I was not tied to that dx and there is a sense of relief with ruling it out.
They also chose to not diagnose me with GAD (Generalized Anxiety Disorder) or PPA (Postpartum Anxiety). This is because, by their determination, my symptoms are still acute vs. chronic, and also don’t seem isolated to postpartum. They explained that, with changes in my current situation and use of coping strategies, I have high potential to improve my symptoms and come out of this, essentially.
They spoke to me for an hour and a half, explaining each assessment that had been conducted, reviewing my scores, asking if I had questions, and allowing me to reflect out loud to them on their feedback. I felt seen and understood. After all was said and done, they gave their overall opinions and recommendations. They diagnosed me with Adjustment Disorder.
Johns Hopkins describes an adjustment disorder as an emotional or behavioral reaction to a stressful event or change in a person’s life. In my case, the ‘event’ being more the life change of parenting (I think) vs a single incident. In my case, they feel that I likely did have PPA, but it has since improved somewhat, and in conjunction with my other symptoms they felt Adjustment Disorder was most appropriate.
In order to organize my thoughts around this, I recapped the following summary to them and they agreed: Essentially, I am an intelligent perfectionist who has such high expectations that I have pathologized myself for not being able to meet those expectations, and thus came seeking a dx to cover such shortcomings. It couldn’t possibly just be ME and how I am handling a tough period in my life. It had to be the ‘fault’ of a diagnosis. In a way, I’m shaking my head at myself, while I also don’t regret going through with this assessment.
I don’t think its “bad” to be a problem solver, but to have my complaint turned back on me as a diagnosis feels somewhat embarrassing. I’m not even sure that’s the right word for it. This diagnosis is both a revelation and a “No shit, Sherlock” kind of moment at the same time. It’s like the answers were right in front of me, and I was so blinded by my theories that I didn’t see that I’m not really special at all. I am just another mom who is struggling during this small-kids phase, and seemingly I am not handling it very well. I do not mean to say “everyone’s a little ADHD,” because that is dismissive of the struggles of those with the actual diagnosis. I do think, though, that it is some level of normal to have intrusive thoughts, have difficulty managing on little sleep, and adjust expectations during a difficult or overwhelming season of life. I also believe that, regardless of diagnosis, talk therapy can be extremely helpful.
The psychologists told me, “You’re not sleeping, you’re working full time, you have 3 kids, you are trying to start a business, you have a very active social and family life and you have extremely high expectations for your performance in all areas. Of course you have anxiety, but if you participate in talk therapy and can learn to use coping strategies, you have high potential to overcome it. They also suggested making improvements in sleep hygiene, joining parent support groups, reading self-help and parenting books, and committing to adequate self care practices. I was doing all of those things prior, with the exception of talk therapy (which I believe they called ‘psychotherapy’ but that sounds scarier). I count my bestie text threads as my mom support groups, as they are a valued lifeline for me, as well as my one safe-space mom FB group (most are full of judgment).
They did not recommend medication at this time. They explained that anxiety in my situation is often very amenable to therapy and coping strategies, and they predict that medication will not be needed to achieve significant improvement in my case. They left the door open to medication, though, in the event that I feel my anxiety is unmanageable or needs to be brought down in order to participate in the coping strategies and therapy. I very much appreciate their compassion and the agency I felt I had over my own care and treatment. I will not be seeking medication at this time, but will continue to have an open mind about it.
The professionals I had the privilege of working with in my pursuit of a diagnosis were caring, thorough and thoughtful in their evaluation of me. I worked with a Clinical Psychologist as well as a doctoral resident, which is why I have said “they.” They administered all the testing they felt was warranted, they reviewed my case like I am a whole person and not just the sum of my symptoms, and they delivered their report to me over the course of an hour and thirty minutes, taking the time to explain each test, what it signified and what that meant for my big picture. I trust their judgment, and I came away from this experience very grateful for the opportunity. From my perspective, they are right, after all.
I apologized for wasting their time, and they said that was my perfectionism talking. I actually don’t think it was a waste of time. The process itself was enlightening. Leaving the hospital after my assessments, I already suspected the results would indicate no ADHD, despite that being my initial suspicion. Seeing and participating in all of the questionnaires and assessments, I gained some clarity. Despite having difficulty concentrating on some tasks and knowing I didn’t perform perfectly at times, I didn’t think I would cross a threshold into dx for attention deficits.
What surprised me more was that I didn’t come away with an anxiety diagnosis, especially since they confirmed I clearly have symptoms of heightened anxiety. I so appreciate their insight into the nuances of my specific case, though, and overall I feel a great sense of relief and gratitude.
Details of the testing process for those interested are listed below:
- Initial interview: background, explanation of complaint and symptoms
- Questionnaires focused on my symptoms, my perceptions of myself, my relationships
- Attention tests: number and letter recall, number identification with distractions, pattern matching
- Intelligence tests: (WAIS standardized test) which included vocabulary definitions, explanation of abstract concepts
- “Games:” (which I realize are tests, but I am not sure exactly what they were targeting)- Pattern completion, ring tower designs, block designs
- Followup appointment to discuss results, test scores, interpretations and outcomes, as well as recommendations for treatment
Feel free to message me with any questions about my experience!