Catch-22 is a satirical novel written by Joseph Heller in 1961 which chronicles the attempts of an American bombardier to stay alive during World War II. The “catch” which the book is titled after is a strange Air Force regulation which asserts that a man is considered insane if he willingly continues to fly dangerous combat missions but that if he makes the necessary formal request to be relieved of such missions, the very act of making the request proves that he is sane and therefore ineligible to be relieved.
After the book’s publication, the phrase became widespread in the English language to describe a problematic situation for which the only solution is denied by a circumstance inherent in the problem.
ADHD can be difficult to diagnose, especially when you are an adult. Someday we may be able to test it using an MRI, as an ADHD brain does have noticeable differences in comparison to a neurotypical brain, but because we are still in the relatively early stages of ADHD brain research, there is not really enough data to be able to normalize the findings to truly make it a method worth using. Which means the best method we have is still self-reporting.
As you get older, ADHD gets more difficult to diagnose, especially into adulthood, as there are other issues that may develop which have similar symptoms as ADHD, including anxiety, PTSD, sleep apnea, and addiction, which can make it more difficult to assess since ADHD is not something you can diagnose exactly by the symptoms alone, but rather it is a diagnosis of being able to eliminate other possible diagnoses. If you have ADHD and also one of these other possible causes of ADHD-like symptoms, then that is doubly so.
I was diagnosed with ADHD the first time at 12 years of age, but because I stopped taking medication after graduating high school, I had to be re-evaluated as an adult when I decided it may be worth my time to look into getting medicated again. The whole process was not very ADHD friendly. First, they required you to take a class, which was either offered over multiple days or as one class with extended time on a single day. At this class, they gave you information about what ADHD was and wasn’t and explained how the ADHD brain worked, how testing for it worked, and the paperwork required in order to get the assessment. I felt like if I had not had the educational background that I have which made me already familiar with the diagnosis, I may not have understood very much of it.
The next step was to fill out the packet of information which consisted of one questionnaire that I had to fill out about myself, including several number scale questions and some open-ended questions about what my life was like, when did I notice my symptoms, what was school like for me, what was work like, and so on. Questionnaires were also to be filled out by two people with whom I have a close relationship. I chose my mother and my husband, knowing that they would back me up with sufficient evidence that I am exactly the way I say I am. After that, I had to turn the paperwork into the Psychiatry office, at which time they would decide if I had enough ADHD symptoms and a low probability of actually requiring a different diagnosis. Only then would they set me up with a Psychiatrist for further assessment.
Surprisingly, this whole process took about 5 months, and most of it was waiting. I actually had to call them and make sure they were doing their part. It made the whole thing feel like a huge catch-22, where if you could make it through from one end to the other, that would be proof that you didn’t actually have ADHD, whereas if you couldn’t, then you probably had ADHD, but of course, would never receive treatment for it due to not making it through to the assessment.
Even when I did finally make it to the official assessment, the Psychiatrist wanted to believe that I was experiencing these symptoms not due to my ADHD, but my anxiety. My anxiety, I explained to her, was a symptom of my ADHD. It is my most predominant symptom. However, seeing as I was still nursing my (now) 4-year-old at the time of my assessment, she could not offer me ADHD medication, anyway. So we agreed that I would try some medication for my anxiety, which was safe for me to take while breastfeeding, and go from there. While taking the anxiety medication did end up reducing my anxiety at least somewhat, it did little for my other symptoms except make them less exaggerated, and when we met again to assess how they had worked, she agreed that I did likely have ADHD, which she would be happy to treat once I was no longer breastfeeding.
Getting my son’s diagnosis was a lot easier. We still had to go through the process of taking the class (yes, even though I had already taken it. It is apparently a requirement for each diagnosis.) and filling out the required forms, but the wait time was much shorter and the psychiatrist had already confirmed that it was very likely he had ADHD by the time he was halfway up the stairs. I did tell the psychiatrist that I had already been diagnosed with ADHD, and that likely sped things up for her because ADHD tends to be genetic, but I also still feel that there is this stigma with boys, that boys will be more likely to be seen as having ADHD because they have boyish behavior. This brings up a whole host of other issues that I will discuss in a later blog.
For now, just let me say that, while I understand that being diagnosed with ADHD is purposely difficult for an adult, it should not be so difficult that people who genuinely need help are unable to make it through the process. Scientists are trying to find innovative ways to offer a more effective diagnosis, but these methods are still in their early stages and some of them might not be very effective at all. Still, let’s keep trying, as more adults are receiving a diagnosis of ADHD every day, and many more will receive a diagnosis of ADHD in the future. It won’t help anything if the reason we need the help is the very thing preventing us from being able to access it.
