I think you read a bit of your own mood into everything here.

I have severe ADHD. I’d be unemployed without stimulants. In an ideal world that wouldn’t matter. But that’s not the world we live in.

I also have generalized anxiety disorder. Without medication, my body just decides that I’m going to spend my days and nights in fight or flight mode.

To think! I didn’t explain the universe of psychopharmacology and caveat every clause of the original post. the horror. I spoke authoritatively because the original author’s pattern of behavior matched my own experience. If someone wanted more information from me then, because this is a forum… they can just ask. You know, instead of going on an emotional screed, then falling victim to the exact same logical fallacies you got so mad about me for. You don’t know me or what my credentials or experience are. But here you are, making judgments about me based off of a few dozen words - The exact same thing you accuse me of doing in my original post. And not even for a good cause! For an imagined scenario, borne out by no reality but the universe in your own head.

To elaborate more on my original post (because I really do want to provide extra context and commented just before going to sleep originally), in my experience a lot of psychiatrists tend not to go straight for an ADHD diagnosis because they want to treat the symptoms that are presented to them initially. From the mouth of my own psychiatrist, he wouldn’t have tried to screen me for ADHD until about 2 years of other treatments not working to alleviate the symptoms of depression and anxiety.

I say this is someone who has visited maybe a dozen psychiatrists and tried about 25 different medications at multiple doses for my own issues… BEFORE being diagnosed with ADHD.

In a nutshell, the pattern goes like this for neurodivergent people (ADHD/'tism) (personal sample size of 4):

Early in life and maybe into early adulthood, you can manage pretty well or struggle along just fine to get through school. If you’re very intelligent, then you might even do really well at school since you never have to study.

At some point, neurotypical expectations become too much to handle. Since you’re young and not burnt out yet, you stretch yourself 110% to meet the demands on your cognitive ability.

Eventually it becomes too much. It might happen slowly or all at once, but it does happen. For me it was around age 25, just after I left college.

In the background of this pattern, You’ve always had a low level of anxiety or a fear of doing something wrong, along with the everyday stressors of things that are very difficult for a neurodivergent person to do but very easy for neurotypical. That low-grade anxiety just ratchets up over time and never quite goes away.

Long-Term anxiety, when left untreated, turns into depression just about 100% of the time- and that’s according to my current psychiatrist.

Some of the symptoms of depression are not necessarily suicidal ideation or tons of crying. It can manifest as you just sitting in your room and staring silently at a wall for 4 hours after work. Typically, the loss of enjoyment in everyday things such as typical hobbies, is a classic sign of depression. That’s straight out of the DSM-5. The same pattern holds for other typically dopamine-inducing activities not producing the same result in the depressed person. The inability to feel emotions in the moment is called alexithymia if eventually you do actually feel the feelings. The inability to feel joy is called andhedonia. These may have underlying causes other than depression, but they usually are comorbid with depression regardless of the underlying cause.

Adhd at its core is a lack of dopamine. Stimulants directly raise dopamine in the brain. What stimulants don’t do is change your behavior; stimulants change the hardware. Behavior change is up to you.

Starting the reversal of all that is like putting a supermorbidly obese person on a diet. All it does is start a trend. There will be other health problems and issues and medications and interventions that need to take place to fully heal if that’s even a possibility. You may need to treat the anxiety and depression and get them to manageable levels before you can ever start a stimulant, just like you can’t do gastric bypass surgery on someone who weighs 800 lb.

But the root cause, The start of everything, is some sort of neurodivergence.

The unwillingness of the mental health industry to investigate ADHD (and/or autism) at the outset, unless their patient demands it or mentions it, is a huge barrier to getting the real help that you need when this is the root cause.

One of the biggest tools you can have is knowing the patterns of behavior and information to connect these medical diagnoses and the language they use to your own experience so that you can communicate to a healthcare professional and get the help you need.

I’ve personally read the DSM-5 cover to cover. I don’t claim to be a medical expert and I retained almost none of it except for what was relevant to me and the people close to me. What I can say is that the diagnostic criteria in the DSM-5 for ADHD and autism are woefully inadequate. If you go see a mental healthcare professional that doesn’t specialize in these things, then the 10 points for each diagnosis that are listed in the DSM-5 inadequate tools for your healthcare professional to make an accurate diagnosis (or to accurately rule the diagnosis out).