Immobilized by ADHD and Depression

Reader’s Question

I am stuck in a dichotomy between a self perceived and self evaluated case of ADHD and a deep seated denial of its existence. I have taken numerous test privately, and all indicated that an ADHD diagnosis is not only appropriate but long overdue. I am 29 years old. I think the reasons I have lived so long without outside recognition lies in my extraordinary intelligence, rhetoric, and charisma. Also, my lack of exposure to medical professionals and informed adults only further aggravated the situation. To be candid, when I find something extremely interesting, I usually indulge in an intellectually-inclined mental pursuit of explanation and possibility. Hence, I have enjoyed what others would qualify as scholastic achievement. Yet, inside I know I am not applying myself. In fact, I am closer to pure apathy and ignorance than self actualization in my own mind. These feelings of cognitive dissonance have perpetuated me into a severe depression. But not for my realization that I have severe ADHD, I’d likely continue regressing or possibly end my burden to others with a quick and amoral action. While writing this very letter, I’ve stopped, pondered other topics, fidgeted frantically, and straight out just started paying attention to other stimuli for momentary yet significant periods of time. I went to my primary physician who was, appropriately, overwhelmed with my descriptive discourse about my symptoms and idealizations. He then referred me to a Psychiatrist — qhere I voiced these concerns and revealed another, more frightening confession. I am extremely concerned and/or afraid of being “diagnosed with some DSM-IV disorder. I do not want the stigma or record of having a mental or personality disorder, despite its efficacy or the understood improvement of my prognosis. Even still, she then referred me to three more doctors: a clinical Psychologist, a Cognitive Behaviorist, and a Psychotherapist. So that’s 5 doctors now, all of whom require multiple appointments just to formulate a diagnosis that I already know. So, the fear of diagnosis and the inattentiveness of ADHD resulted in my cancelling/missing the rest of the appointments. I feel like it’s more of a racket than a means to improvement judging from my overly abundant co-pays and the proliferation of doctors. But now, I’m realizing I can’t go on without professional intervention. The ADHD is exacerbating my depression and vice versa. I have had about 8 jobs since my collegiate life concluded, all lucrative and otherwise sought after by many. But I just can’t seem to do it anymore. These oppotunities are not infinte of course, so I need help in a major and immediate way. How can I address these concerns concurrently to minimizing my interaction with health professionals? Or better yet, is there a way I can locate ONE doctor who can help me at least ‘a little bit’ in the first visit, thus increasing my trust and increasing my confidence enough to want to return?

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p.s. I apologize for the lack of a central idea in this question.

p.p.s If I didn’t have spell check every word would be spelled incorrectly.

Psychologist’s Reply

It sounds like your ADHD symptoms have created a long history of intellectual and occupational ineffectiveness. When that pattern is combined with the serious symptoms of depression — you become immobilized and socially incapacitated. Your passing mention of considering a “quick and amoral action” is actually suicidal ideation. ADHD has symptoms of inattention, distraction, and impulsivity while Depression has poor focus, no motivation, poor concentration, and increased thought speed. At this point, your mind is racing too fast to effectively focus on even routine daily tasks.

The depressive aspect of your situation should be the primary focus. I don’t want to sound harsh, but I think your intellectualized and analytical view of your situation is confusing those trying to make an accurate clinical diagnosis. You recognized this in your question, apologizing for the lack of a central idea (actually, that’s solid evidence of exactly what you are reporting!). Professionals are trying to follow your situation as you describe it — and are getting lost.

I would recommend focusing on the psychiatrist first. Take a few depression tests, like those on this website, and review the symptoms of depression. I would then return to the psychiatrist and go down the list to affirm or deny the presence of those symptoms. Your self-description of your inner state may confuse the provider — prompting all those referrals.

Your psychiatrist may elect to take a dual-diagnosis approach to your ADHD suspicions and your depression. In the US, psychiatrists often prescribe Wellbutrin and/or Strattera for your situation. Wellbutrin is especially suited for the ADHD and Depression combination.

At times, a high IQ can actually hinder or complicate our situation. You’ll have plenty of time to process, analyze, organize, and extrapolate once your depression is brought under control. Keep in mind, a trademark of intelligence is the ability to simplify, not always complicate. Drop to your baselines — symptoms of ADHD and depression — and focus on treatment. I would also recommend therapy or counseling follow-up which will help you reorganize after this depressive episode.

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