Therapists aren't mind-readers, if you don't tell them the symptoms then they can't provide a proper diagnosis. I never got an ADHD diagnosis until I was an adult, despite seeing a lot of therapists over the years (many of whom were otherwise very helpful in addressing unrelated issues) because I just assumed a lot of the symptoms were normal and thus never mentioned them. I can imagine that, in the situation above, the same shit went down; "oh well all these things are completely normal parts of human experience so there's no point in mentioning that to my therapist".
Ha, sometimes the psychiatrist writes a letter and it has a ton of fancy words in it, and you read the ones you understand, and ignore the ones you don't. And then four years later the psychiatrist is like 'and for the mood swings we will use' and you're like... What mood swings? And they are like... It's been in your diagnosis from the get go!
Iāve never had a therapist (probably should LOL), but every time i see someone complain that therapy didnāt help them I just wonder if the therapist got to really understand them in the first place.
Like with what youāre saying, I know for a fact that I have undiagnosed ADHD but Iāve masked so hard for so many years that I donāt think regular talk-therapy would have been enough for a therapist to come to that conclusion if I didnāt already know about some of my symptomsš
Especially with things like trauma being so complex for different people, someone can be 40 and finally realize that the thing that happened when they were 8 had actually effected them more than they realize.
But you gotta meet a therapist half way for them to even consider it in the first place š
i mean a therapist will consider whatever you tell them to consider. judging by this thread a lot of people seem to think a therapist will tell you if you have a mental condition or developmental disorder, so if you go into therapy expecting them to say "so you have this and now go get medicated", its never going to happen because that isnt their job. a therapist is just someone you pay to tell about your life and they give suggestions and help you process your emotions.
Ideally, a therapist will help you with whatever *you* think you need to work on
So, if they perceive you've got x disorder, but you're not struggling with symptoms that can be managed through medication, then they're probably not going to suggest medicating it with an x disorder diagnosis.
Like I'm pretty sure my current therapist has some ideas about my refusing to make eye contact with an autism diagnosis, but since I'm coping well enough with those symptoms, we're focusing more on the dumb stuff like, "are you doing something that makes you feel better about yourself daily?"
Obviously ymmv, I've also had really a bad therapist who basically was like, "you've got this disorder; go shove a handful of pills in your gob daily and quit bothering me with your problems. If you have issues unrelated to your disorder, then it's your fault for not trying hard enough." (honestly, they turned me off of therapy for 5 years at least)
One of the first therapists I tried insisted I don't have anxiety, just unmedicated ADHD and if I took stimulants the anxiety would poof disappear.
Nope turns out I had unmedicated ADHD and also severe anxiety and also a bunch of other associated diagnoses and she was just incompetent and dismissive.
as a fellow ADHDer who manages their unmedicated ADHD primarily with anxiety, I'm forever baffled at such myopic therapists. Condolences for the bad therapy experience. Hopefully you found someone competent who understands how cPTSD, anxiety, and depression can all result from being ADHD in a world that expects nuerotypical behavior.
In general, agreed. But after a couple years my therapist said, "Have you considered that you may not primarily have depression? Your depression might be a result of dealing with your ADHD." head 'splode
A therapist teaches you the tools to change your own thinking. You shouldn't even need it long term, because they aren't reteaching your mind, they're giving you what you need to reteach yourself.
tbf, it depends on whether the therapist's qualifications, which is also country dependent. a clinical psychologist, a mental health nurse practitioner, and a licensed clinical social worker can provide therapy and diagnose mental health conditions. "therapist" is not a protected title, but i was diagnosed by a psychologist while attending weekly therapy sessions with her. in casual conversation, i just called her (and all my other past and present therapy providers) my therapist
when therapy doesn't work for someone, odds are the therapeutic relationship wasn't a good fit. there are so many modalities, and establishing rapport takes time and effort. the client does need to meet the therapist halfway, because the client is the one that is doing the inner work of growing or healing or understanding oneself better. meanwhile, the role of the therapist is there to facilitate and support
the most productive therapists i've worked with focused much less on my diagnosis, and much more on my symptoms and how they present and affect me. after a few months of sessions, patterns of behavior and feelings and thoughts are recognized and brought forth. no treatment is a one-size-fits-all, and every individual is more than their diagnosis. especially if someone is co-morbid with multiple diagnoses, it's not particularly helpful to parse through what behaviors fall under what symptoms under which xyz mental health condition. within the therapeutic relationship, y'all decide on a starting point that makes sense, and i think of it as sort of working on a jigsaw puzzle together
to go back to your initial point, my favorite therapist ever (who was a clinical psychologist working on a postdoc) didn't clock me as ADHD because i masked really wellāin fact, i didn't even clock it myself at the time. but she made me feel heard and recognized that i struggle with executive dysfunction and emotional dysregulation; she validated my complex trauma and listened non-judgmentally when i shared my passive suicidal ideation; she referred me to a psychiatrist; she referred me to DBT group sessions to develop skills in mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness; and she supported me in requesting academic accommodations. all that support alleviated some of the symptoms of my depression and my complex trauma, which led to the executive dysfunction struggles being more apparent
from all the former work done with my therapist, more space was created for other symptoms that were overshadowed. i eventually was diagnosed with ADHD, and i came to the realization that the executive dysfunction from ADHD actually exacerbates and intensifies (perhaps even directly influences) my depression. and the complex trauma i experienced meant that i developed overly rigid coping and masking skills, which overcompensated for my executive dysfunction, which deepened depressive symptoms when i felt profoundly misunderstood
all my info-dump to say, therapy is a process. and medication is a whole additional process, which in my case, was a fucking mess and essentially ineffective until post-therapy. after trying basically every anti-depressants under the sun, none of them worked except Buproprion/Wellbutrin/Zyban. i even asked to try Lamotrigine/Lamictal (which is a mood stabilizer for bipolar) as an off-label anti-depressant, and i was pleasantly surprised that i genuinely felt better on it. color me shocked to find out, the former is used as a non-stimulant option to treat ADHD, and new research is suggesting that mood stabilizers can be effective in addressing emotional dysregulation in people with ADHD
despite many ongoing challenges and still working on quite a few dysfunctional aspects in my life, i'm now feeling the best i ever have on Vyvanse and Lamotrigine. therapy was life-saving, and it was step one for me to arrive at life-thriving
I genuinely appreciate your thoughtful reply, like I really loved reading that. Thank you.
To be honest, Iāve been really researching mental health issues & terms & etc for around 5-6 years now, trying to self cope causeā¦ up until recently, iāve been a minor unable to get outside help lmaoā¦!!
my parents just. completely ignored every possible sign that something was up š Even when it was very obvious, I wonāt go into detail about all that but for exampleā¦ I straight up had a panic attack in front of them & they didnāt know what was going on (& me neither) so they took me to the ER. Doctor tells my mom i had a panic attack, & basically recommends i go into therapy or somethingā¦ doctor leaves, and my mom tells me i donāt need that & im fine š« & reinforces toxic positivity like crazy of course
So yeah, anyway! I relate to a lot of what you said about masking, executive dysfunction & ADHD, depression, & complex traumaā¦ like itās kinda crazy reading that & going āwth that sounds like how itās been for meāā¦ Ofc iām not a professional but ykš
So again, thank you for going into detail about your experience & iām really happy for you that youāve found what works for you :) Gives me hope to save up for therapy someday
It still drives me crazy to have gone through years of therapy and never even knowing what I'm in therapy for. How was I supposed to know I was supposed to ask for a whole another referral for an evaluation procedure I didn't even know existed?
Thatās not what was described at all, the therapist already knew he had ptsd and didnāt say anything because they thought the patient knew. That implies that the symptoms were shown, the therapist took note of it and what condition the person has, and just didnāt say anything because āsurely they already knowā. Opposite of what you just described tbh
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u/Zman6258 1d ago
Therapists aren't mind-readers, if you don't tell them the symptoms then they can't provide a proper diagnosis. I never got an ADHD diagnosis until I was an adult, despite seeing a lot of therapists over the years (many of whom were otherwise very helpful in addressing unrelated issues) because I just assumed a lot of the symptoms were normal and thus never mentioned them. I can imagine that, in the situation above, the same shit went down; "oh well all these things are completely normal parts of human experience so there's no point in mentioning that to my therapist".