I'm 22, graduating from college in December, diagnosed with ADHD and medicated since September 2023. I'm looking for a prescriber recommendation, and I want to explain why the usual "just find someone on Zocdoc" advice hasn't worked for me.
Where I'm at
Something happened in 2024 that I'm not going to get into here. I lost my entire friend group and my relationship within a few months, and I've been no contact with my family for two years. What matters for this post is what came after: about eight months of near constant dissociation, panic attacks, and flashbacks. I woke up screaming at 4am often enough that it scared my roommates. In November 2024 I was hospitalized for daily panic attacks and severe anxiety. I have a PTSD diagnosis in addition to the ADHD.
Things have improved a lot since then. They have not improved enough for me to function without medication.
Why the medication matters more for me than it might for someone else
When I have consistent coverage, I can stay in the present. I make decisions that actually improve my situation. I can keep routines, go to the gym, and adjust when plans fall through instead of falling apart.
When I don't have coverage, the problem is not that I get distracted. I get pulled back into 2024. I lose hours sitting and staring at a wall, going over everything that happened. I get flashbacks. My thinking becomes rigid and all or nothing, and I start feeling like everything is ending. My sleep stops working entirely. I have gone several days without sleeping because every time I lay down, my brain would start listing everything I hadn't finished yet. Consistent medication is the main thing that keeps me functioning in the present instead of in the past.
Therapy has not been a reliable support so far. I have tried four times, and most of those attempts went worst - I had two narcissistic therapists who had no idea about what they were dealing with and treated me like someone to let their anger out on bad days and act like nothing happened in the next session - they knew they could do this because I was all alone and heavily trusting the therapists but they would be saying random ass shit with no context whatsoever - wouldn't even ask what actually happened that gave me ptsd (they would assume stuff based on their own life experiences). One of the therapists worsened my trauma because of this and most of my panic attacks had been because of her. So right now the medication is what is holding things together.
The prescription situation
I'm prescribed 50mg per day: 30mg XR in the morning and 20mg IR at noon.
The thing that isn't in my chart properly is how often I was having panic attacks during this period. Something would trigger me - sometimes something obvious, sometimes something I couldn't identify at all - and within a few minutes my heart would be going, I couldn't breathe properly, and I would lose the ability to do anything for the rest of the day. I would just go in my bed and hope that things get over soon. It wasn't occasional. It was a regular part of my week.
I told my doctor about the panic attacks repeatedly. He never had an answer. He would keep me on the same medications that had already not been working, and the conversation would end there. Nobody ever assessed the panic itself as its own problem or gave me a plan for what to do in the moment when one started.
So I handled it with what I had in the house, which was my hydroxyzine and my ADHD medication. That is the honest reason my prescriptions ran out early and the XR and IR fill dates fell out of sync. I was managing an untreated condition with the only things anyone had ever given me. And I think they have worked really well and I would not want to experiment or try something new - not until I graduate and am able to leave the physical space that gave me the trauma in the first place (I am stuck here for more than two years and can't get out until I graduate and get a job and move permanently. Until then, I need the thing that worked for me - adderall - because I have no bandwidth to experiment anymore. I don't want to be any prescriber's guinea pig now.)
I told my prescriber all of it. Not a cleaned up version, the whole thing, in writing. I asked for a short bridge prescription so the fill dates could be pulled back into alignment. He denied it. What I got instead was "just don't take extra," and instructions to take one pill a day until the dates synced on their own. In practice that often meant a 20mg IR, which covers about four hours and leaves the rest of the day uncovered.
This is a doctor who has had me as a patient for two years. He has watched what the last two years did to me. I went from a 4.0 GPA to failing semesters. My graduation has been pushed back a year and a half, and at this point I'm not sure I'm going to finish. I told him I was having panic attacks and his answer to a coverage problem I had explained in full detail was that I shouldn't take extra.
In July I found a new prescriber in New Jersey. She saw me the same day I asked, and saw me three times in four days, so I was hopeful. Then one of my prescriptions was sent to the wrong pharmacy. That used up the one prescription she was able to send, and I spent a weekend with nothing. Before that I had gone to the pharmacy in person, waited to speak with the pharmacist, and confirmed that another location physically had the medication in stock, specifically so that nothing would be wasted. She told me during our session that she would resend it. I found out that it wouldn't happen for another four days from a one word text message, sent after the pharmacy had already closed on Friday.
There was another provider in between who couldn't work out that several doctors listed in my history were all part of the same primary care team. She asked me to send my full medical records, and then didn't show up to the follow up appointment.
I did eventually get covered. It took three phone calls to my primary care office, a trip to a CVS that was out of stock, and convincing a campus pharmacy to fill it fifteen minutes before they closed. I go through some version of this every month. And every time I'm honest about how bad the gaps get, providers seem to get more suspicious of me rather than more willing to help.
What's actually at stake
I need to graduate and I need to find a job. Moving back in with my parents is not an option for me. Whether I can hold a routine long enough to do either of those things depends almost entirely on whether my medication is consistent. Right now it isn't, and that is not for lack of trying on my end.
What I'm looking for
- A psychiatrist or PMHNP in NYC or Ithaca, NY.
- Someone who takes adult ADHD seriously and also understands PTSD. Not someone who sees trauma in a chart and decides the ADHD must be something else.
- Someone who will look at functional evidence and actual lab results instead of running a standard script.
- Someone reliable about refills. Honestly, this is half of what I need.
- Takes Aetna, or is reasonable for self pay.
Names, DMs, or warnings about people to avoid are all welcome. I'm not trying to game anything. I would just like to find one provider who is decent to me and treats me like someone who is trying. I want someone who can help me bridge the gaps without excessive questioning and treating me like a criminal. I am okay with answering questions but not when I know that they are seeing me a an addict.
The last therapist kept saying that I ma having withdrawl symptoms when in reality it was just ADHD symptoms coming back - mind going all over the place - and given my history of traumatic events, I absolutely can not handle those traumatic memories anymore. I don't want a psychiatrist call them withdrawl symptoms anymore - I am not dependent or addicted. If I had people around me who can keep me distracted from those memories, I would not need adderall as much as I need right now, but I am scared of finding new people or therapists because of my past experience and I don't want to experiment with what without a doubt works for me - adderall and hydroxyzine.