“Could try harder!”: Self-control, cognitive control and ADHD


I saw an interesting article the other day in the BPS research digest. The author states that although the term “cognitive control” and “self-control” are often used interchangeably, a new study claims that they do not involve the same mental processes.

“Cognitive control” is usually defined as the ability to “ignore distracting information or stimuli”, presumably while completing a task. It involves executive functions of task-switching, working memory and inhibition. “Self-control” is usually associated with the ability to defer immediate gratification in favour of a better long-term outcome.

Deficits in executive functioning are generally held to be a major part of the difficulties faced by a person with ADHD. This lack of executive functioning ability can carry an upside too, but that’s for another blogpost 😉. The article made me think of how potentially damaging the confusion between cognitive and self- control can be. Many ADHD’ers are constantly told by others that they lack self-control, when the real culprit is probably an impairment in cognitive control. More worryingly, when I have discussed the nature of ADHD with others, I all too often get a reaction along the lines of “ADHD, huh? Just sounds like a lack of willower to me!”. This reaction is usually accompanied with a sneer. Not helpful when it comes to de-stigmatising an oftimes controversial, but well-researched neuro-developmental condition.

The notion of self-control carries a value judgement along with it. It is something that our society values very much, with those that are seen to lack it earning disapproval and stigma. This stigma can be seen in terms such as “feckless” and “good-for-nothing”,  which often make their way into mainstream media. It’s not hard to see how this can be very damaging to a person with ADHD who, no matter how much self-control they feel that they are exerting, understandably fall down when it comes to tasks involving cognitive control. Such tasks could include switching attention to one’s housework, or homework. (Or even switching attention from the blogpost that I’m writing to the reading that I know I should be doing). That sets the scene for feelings of guilt and shame, and over time, poor self-esteem and learned helplessness.

Hopefully, if the body of evidence for cognitive control as a distinct process from self-control is built upon, more effective interventions and management strategies can be developed. In addition, it would be nice if it hit the mainstream to the extent that people with ADHD, many of whom are doing their damnedest to manage their difficulties, can get a bit of a break.

World Mental Health day: black dogs and avoidance

It’s safe to say that I have neglected my blog somewhat of late. The reason for that will, I hope become apparent. That said, it’s World Mental Health Day today, so I felt it appropriate to write something.

For the last 3 months or so, I’ve been experiencing low mood, which has tipped into depression. I say “or so” because it came on gradually, and I really wasn’t sure where anxiety left off and depression began. At first I thought it was just a typical ADHD-type mood swing. I usually just wait for those to go away, but this one didn’t. It just got worse and worse until last week, I was crying every moment that I was alone. I cried on the way to the mental health classes that I help to run, I cried on the way back. I cried at work, for some strange reason every time I walked past the Christmas fabric and ribbon. I hardly ever cry, not even when I’m mightily fed up, so this was really strange.

It’s different for everyone, but depression doesn’t make me feel particularly sad. Instead it just washes all of the colour out of life leaving me flat and indifferent. I just can’t be bothered with anything, even the things that used to get me really excited. And the aches, oh, the aches. Stress puts the body into “fight or flight” as the brain cannot tell the difference between a physical threat, like an oncoming car/angry person that wants to hit you/sabre-toothed tiger, and a psychological one like, erm, struggling to see any hope for the future because, no matter how hard you try, nothing seems to get any easier, and being unable to see a day when, perhaps it will.

Well, that fight or flight response isn’t going to help me much in this situation. So my muscles are getting ready to fight or flee, and there’s nothing to fight or run away from, so I get more and more tense. And exhausted. I wake up, barely able to get out of bed as I feel as though I’ve already done ten rounds and dragging myself through the day just longing for my bed.

It’s not much in the way of fun and games, is depression. But all is not lost. I am, after all, an assistant psychologist, and I’d be a pretty lousy assistant psychologist if I hadn’t learned a thing or two along the way.

For a start, in this particular case, there isn’t actually anything “wrong” with me, in that, the low/depressive mood that I’ve been experiencing is a perfectly normal and appropriate reaction to what has been a very tough few years with very little in the way of let-up. I’ve been steadily losing hope, and to maintain good mental health, all human beings need hope. I’ve simply run out of cope. There is little that I can do to improve the situation that I am not already doing. Despite what that idiot Jeremy Hunt says, I’m doing all I can, and simply working through the night as well as mornings, afternoons, evening and weekends is not going to help matters. So I’m going to stop beating myself up for feeling like this.

The next step is to tackle the avoidance that commonly comes with depression. Avoidance is lovely. For those of you not familiar with the term, it’s when you turn down invitations, or avoid the things that you should do because you don’t believe that you will cope with them. Avoidance makes you feel great, in the short term. You snuggle up under a duvet and watch TV instead of seeing your friends. You feel safe, and comforted. And then you feel regret, because you might have had a good time. Your friends might think you’re boring, you get annoyed with yourself, and self-esteem drops. And your brain has had no opportunity to learn that you will, in fact, deal with the situation just fine. So you avoid again, and again, until your comfort zone becomes very small indeed, and you get more and more isolated.

So I’m not gonna do that. I’ve been saying “yes” to things. Putting in fun stuff into the diary, even if I haven’t really felt like it because, that’s another things human beings need, things to look forward to. Which is not compatible with the notion that it’s ok for people to work like slaves and have no dignity or disposable income at the end of it. (Hear that, you bloody Tory creeps, this is why every psychologist I know hates you.) For a musical version of this notion, listen to the song “Bread and Roses”, and you’ll learn why the rose is a symbol of the Labour movement. Sometimes, if there’s nothing to look forward to, you have to create it yourself.

So I’ve been doing fun stuff, and ok, so the resulting pleasure isn’t what is normally would be, it’s a bit like listening to music with foam earplugs in, but it’s better than nothing. And gradually, I find that I’m crying less, and taking more pleasure in things again.

I’ve also told a couple of people, including one of my colleagues. She saw how sad I was looking and asked if I was ok. I wasn’t going to tell her, but it came spilling out. She simply said that she was sorry I was having such an awful time, and that any time I wanted to get a coffee and have a rant, she’d be there for me. It wasn’t much, but it didn’t need to be. She didn’t try and fix anything, or offer solutions, and knowing that she had my back meant everything.

I’ve been dealing with the muscle aches by making an effort to walk more, take hot baths and getting back rubs from my lovely fiancé. There’s only so much I can do about the stiff muscles when I’m tense all the time,  but at least I know why they are stiff in the first place.

Slowly, I’m starting to feel better. I hope that sooner, rather than later, I’ll be back to my usual self. I wanted to share my experience to let anyone else who experiences the pain of depression know that they can take action, there are things that can be done, and even if the depression doesn’t go away, life can be a lot nicer. I’m not saying it’s easy, it’s like when you first start to learn a musical instrument, everything is difficult and the sound is awful. But if you can keep going until you’ve learned the basics, putting your skills into action becomes a great deal easier.

I’ll leave you with this video that I came across when delivering the Stress Control course, I Had a Black Dog

Happy World Mental Health day!

What I did on my holidays

It’s so good to not be tired all the time. What have I done on my hols?

Well, I bit the bullet and applied for my DClinPsy. I wasn’t going to apply this year, but had a chat with the admissions team at Cardiff University and they encouraged me to apply right away, with the caveat that most people don’t get in first time round. I figured that I had nothing to lose by doing that, so set up an application with the Leeds Clearing house and did the necessary with 2 weeks to go.

I was initially pretty daunted as I had heard about people who spent months on their application, but actually, it was no worse than applying for any other job that requires a form to be filled out. I spent a fair bit of time  on the personal statements, but learned a lot about myself and my experience by doing so. To my surprise, roles that I would not have thought of including have actually helped to build the skills that I believe would make me suitable for training, once I reflected on them. My third year university supervisor, whom I contacted for an academic reference was wonderfully supportive, even though I haven’t seen him for fifteen years. I also received a good deal of support and guidance on the form from friends that kindly agreed to look at my first draft for me. It’s lovely to feel that I have people behind me that want me to succeed.

The other encouraging occurrence was the job that I didn’t get. A week or so before Christmas, I saw a job ad for an assistant psychologist post in my local health board. Now these jobs are as rare as hen’s teeth, mostly due to a lack of funding as far as I can see. They often close within a few hours of being posted due to the volume of applications they receive. As I have to work, and usually don’t have access to the net at work,  I don’t get a look in. Plus the fact that I’m not really in a position to relocate for a short term post, as many of these are, so I can only look for jobs that are within a commutable radius.

For this one, however, they wanted applicants to write a 500 word piece on accessible mental health services in Wales. I guess that must have stopped applicants from simply copying and pasting their latest job application, because it was still open when I got home. Knowing that time was of the essence, I sat myself down and bashed out an application, with no expectation of getting an interview.

Imagine my surprise when I got an interview for the next week! Imagine my horror when I remembered that I hadn’t had a formal interview in several years, they are not usually required for music or sewing work. And what to wear?? Musicians and costume makers don’t often wear office suits either. I was in Birmingham for an MU meeting, so took the chance to run round the shops. Except that it was a week before Christmas, everything was glitter and sparkles. I don’t know too much about traditional interviews, but I do know that turning up looking like Elsa from Frozen would probably not go down too well.

I did what I always do in this situation, rummage around my fabric stash. I found a couple of metres of dark brown wool-mix and a smart but simple dress pattern. I had managed to get a brown blazer in Birmingham, in the clearance section of House of Fraser and decided to team it with a dress rather than go for a suit. The dress came together quickly and was lovely and warm. I usually don’t like office wear as I feel so uncomfortable in it, but it makes all the difference when it actually fits you. I’ve got to the stage where it’s quicker to make something than spend all day looking for an outfit that’s me-shaped.

The interview itself was lovely, really relaxed and I felt very at ease despite being sent to the wrong building on arrival. I felt that I might be in with a chance, but got a call later that day to say that I hadn’t got the job. However, they were very nice about it and said that they had deliberated for a long time and might be able to offer me some voluntary work. The fact that I hadn’t got an NHS reference went against me, and that was a possible solution. More feedback was that my knowledge of research methods and stats was rusty, but, as they said, hardly surprising considering that I graduated 15 years ago! I had tried to revise research methods in advance of the interview, but only had a few days in which to do so and was juggling a lot of work in the run-up to Christmas. That too is fixable, I had a good google and found a distance learning Masters level course on research methods for behavioural sciences at my old alma mater. It will wipe most of what little savings I have, but the investment will be worth it, not only will the revision be worthwhile, but it will (hopefully) grow my somewhat stunted academic confidence.

I am hopeful, though. I don’t think that it will be the bewildering nightmare that university was. It wasn’t the work that I had a problem with, I loved that. It was the rest. Often, I didn’t realise that an essay had been set at all, or if I did, I didn’t know when the deadline was, or which articles/books to read. Where I was supposed to go for lectures, which lecture was at which time, or even which day of the week it was. I inexplicably forgot everything that I needed to remember. Everyone else seemed to know what they wanted to do after university, but I didn’t have a clue. And as for day to day living as an independent adult, house hunting,setting up direct debits etc, it all seemed like some weird dark art. And I tried so hard. At times I was convinced that there were secret meetings that everyone attended that I didn’t know about where they all talked about this stuff. But most of the time, I thought that I was just plain stupid.

Of course, if our Abnormal Psychology textbook had contained more than a paragraph on ADHD, and it was realised that it affected adults as well as kids, and not just disruptive boys at that, history may well have been very different. I might not have left university thinking that I had nothing to offer the field of psychology, or any other field for that matter. I might have been able to put strategies in place for finding out the things that I needed to know so that my life was not some endless swirl of confusion and fear. At least I would have had some explanation for the way that I felt.

But it didn’t, and I didn’t, so I graduated believing that a career in anything other than music (I knew where I was with that) was an not option for me. I don’t regret my path through life, it’s brought me to where I am today, but I could have done without the psychological fallout, misery and emotional pain of having undiagnosed ADHD. I sometimes get angry when I think of how unnecessary it was. But no one was to know, not my teachers, parents and not me.

And now, although I face my new direction with some trepidation, I need to remind myself that I’m not that lost, confused 19 year old girl that somehow felt disconnected from the world and most of the people in it. I have a new-found brain, and so help me, I’m gonna use it!


“I don’t believe in ADHD”

…said the doctor (a breast specialist) when I told him about my interest in the subject. I sighed inwardly. This was not the first time that I’d heard this from someone, and it’s a common response that several others have encountered. In “Delivered from Distraction”, Ned Hallowell, a psychiatrist who specialises in ADHD makes the point that ADHD is a well-documented neurobiological condition, not a religious persuasion. So why the deniers? After all, no one denies the existence of autism.

A few weeks ago, I met with a researcher, a psychiatrist, at the University of Cardiff to chat about ADHD. We both agreed that ADHD has an image problem, that it’s not “sexy” and that no one seems to be interested in it. I have to say that I fail to understand why something that arguably affects one in 25 people attracts so little interest, especially when it is implicated in so many social ills and economic costs (Young et al, 2013. read the White Paper here)

It then occurred to me that many of the groups in which ADHD is very prevalent are exactly those groups that politicians and the media love to hate. The unemployed, the underemployed, the homeless, the prison inmates; all these groups contain more people with ADHD than the general population. It also occurred to me that classic symptoms of ADHD like impulsivity, mood swings, disorganisation, procrastination and a lack of concentration in boring situations, are very often portrayed as moral failings by the social norms of western society. It’s far easier to say of someone you don’t like that they are morally deficient in some way than to acknowledge that they may need help. Acknowledging that unpopular groups of people may need additional help would make it less easy to use them as a convenient scapegoat for all that is wrong with society. Witness the demonisation of any vulnerable group from immigrants to social security claimants for examples of that kind of thinking. There may well be a political aspect to the chronic neglect of ADHD.

I was interested in why the breast specialist did not “believe” in ADHD. He explained that, all too often, it is used an an excuse for bad parenting. Now we are all responsible for our behaviour, but if a child has ADHD, then it is likely that at least one of their parents does too. Undiagnosed and unsupported ADHD may well lead to the kind of parenting that we class as “bad”. Of course, there are great parents with ADHD and bad parents without ADHD, but a parent whose kids are always late for school, whose house is messy and who smokes and drinks pretty much fits the “bad parent” stereotype, especially if they are on a low income.  I wonder, does it ever occur to anyone that some of those parents may be struggling with ADHD themselves and could use some support to manage their lives, rather than condemnation? ADHD may be just one factor among many that a parent may need help with, but is a factor that should not be ignored.

Actually, with some probing, it became apparent that the breast specialist did “believe” in ADHD. He called it “true” ADHD, as opposed to the kind of ADHD that a kid may be wrongly diagnosed with for simply acting up. We both agreed that ADHD is over-diagnosed in some areas and under-diagnosed in others, especially in girls and women. It reinforced for me the importance of people that assess for ADHD understanding what ADHD is and what it isn’t. In my opinion, it’s no good simply ticking off a list of behaviours. Many people with ADHD simply don’t display many of those behaviours to the outside world as they have internalised the notion that they are unacceptable/immoral and spent almost all their time and energy struggling to “fit in”. What must be looked for is the operating system that that person is running. What is their working memory like? How well do they do on a test of creative thinking and idea generation?  What do their friends/teachers/parents say about them and their social functioning? How does the person describe their own thinking? It must be taken in the round, and in some quarters, I would like to think that it is. However, if there are so many false positives happening that clinicians begin to doubt the existence of ADHD, something is wrong.

There are some that claim that ADHD does not exist because it is a culturally defined disorder. And, in some ways, they are not wrong. In another culture with different definitions of what constitutes “good ” behaviour, ADHD may not cause any problems, and may even be a desirable trait. However, that does not take away from the fact that ADHD is neurobiological in origin, and many people with ADHD struggle to thrive in modern society without appropriate support. Much as I would love to change the society I live in, make it value creativity more and overhaul the mainstream educational/workplace systems so that they meet the needs of more people, that isn’t going to happen any time soon. Besides, you could easily broaden the definition of “culturally defined” so that it encompasses nearly all disability. In “The Country of the Blind” by HG Wells, a book that I would love to read, a man stumbles on a society where everyone is blind. Their society is set up for blind people to thrive in, and, in that context, the sighted man is considered to have a disability. By the same token, a society set up by, and for, people that could not walk, would look very different to the one that we have now, and the ability to walk may also be considered a disability. Just because some people believe that ADHD is culturally defined does not excuse denying help and understanding to people that are struggling.

Many people also see ADHD as something that was invented by “Big Pharma” for the purposes of selling medication. I’m sorry, but we have had writings on ADHD (under a different name, perhaps) going back two hundred years, long before Ritalin was invented (Melchior Adam Weikard, 1775) . And yes, pharmaceutical companies have a vested interest in selling their products. It doesn’t mean that ADHD does not exist. What it means is that clinicians and practitioners should be careful to diagnose ADHD properly, and not use it as a lazy catch-all for certain types of behaviour. Big Pharma cannot give a person ADHD if they do not have it already.

Ironically, there is plenty of evidence to show that ADHD medication is very effective, and does pretty much what it says on the tin, ie improves concentration. That won’t help a person develop strategies for managing their ADHD, but it might just help them concentrate for long enough to implement them, or hold down a boring job until they are in a position to move to a more fulfilling occupation. There are also several ways of managing ADHD that do not involve medication eg. exercise, psychoeducation, and these should be part of any attempt at intervention as a matter of course.

In conclusion, something needs to be done about ADHD’s image problem. There are people out there not getting the support that they need to live happy, fulfilling lives because of misinformation and prejudice. Yes, assessing for ADHD needs to be treated with caution, but so should all psychiatric/mental health assessments. The responsibility should be on practitioners and the wider society to educate themselves so that prejudice, suspicion and fear can be replaced with tolerance, understanding and proper support.



Psychology volunteering!

At long last, I’ve finally started volunteering in a psychological capacity! Today, I helped to facilitate a Stress and Mood Management course run by an IAPT in Bristol. The participants were a lovely lot and there were some really fun moments. No where near as nerve-wracking as I was expecting, but then again, I’m used to standing in front of groups of people. Some nice feedback too.

It was very reassuring to see that many of the skills that I have developed as a musician are transferable to this sort of work. Team work on the fly is one, the other facilitator and I were able to pick up each other’s points and add to them, running the session without any prior rehearsal together. Confident presentation skills are another. After this many years of cowering on a stage with expectant eyes on me, presenting the course to complete strangers was like second nature.

There are things that I would like to improve on next time, I’d like to have the time to digest all of the material, rather than just the bits that I was presenting, so that I can get a feel for how the course hangs together as a whole. And as I get more familiar with the material, I hope to be able to make it flow a little more naturally.

But, on the whole, I’m pleased, and looking forward to next time!

Dude, I learned something today…

There’s nothing like a bit of pressure to really focus the mind.

It’s safe to say that I have been a little down in the dumps of late. Feeling like a helpless leaf blown in the wind, at the mercy of the malevolent powers that be. That most unhelpful ADHD assessment was the icing on the cake.

I finally finished reading “Irrelevant Experience” The main character didn’t endear herself to me any more than she had done at the start (Spoiler alert). I have picked up some helpful information about getting into clinical psychology, so it was useful, but the main character, grr!

She went on to steal another girl’s boyfriend (who of course turned out to be a lying, cheating ratbag. The latter part of the book was filled with the other aspiring psychologists falling by the wayside and giving up their dreams due to the difficulties they faced while little-miss-perfect got a place on a clinical training course. That depressed me somewhat.

As my best friend pointed out recently, I have a habit of picking the hardest path, refusing to compromise and then complaining that it’s not fair. She’s right, of course, and I needed that insight.

However, in the words of Kyle from South Park, I learned something today.

For the last few months I have been planning to make a medieval bellwedge tent so that Terry and I can camp on the IC (In Character) field at LARP events. It’s a pain having to traipse from one field to the other every time you want to get something, especially if it rains. Besides, when you are trying to get into costume, having a tent that you cannot stand up in is a nightmare.

These tents cost the best part of a grand, which we just don’t have at the moment. I do sew, though, and managed to source all the materials that we needed to make one. We ordered tent poles, pegs, rope, and fabric and eyelets, which came from a supplier in the Netherlands. The tent poles, pegs and rope arrived without a hitch, but the fabric was delayed. A look at the confirmation email revealed that the delivery address was wrong. Not to worry, I contacted the company and gave them the correct address. They said that they could contact the delivery company and get it send to the right place.

I have to say that I think the problem lay with the delivery company rather than the supplier.  The package seems to have gone back and forth, there were no notes left to say that they had tried to deliver it. The business downstairs, that said that they would receive it if we were out, hadn’t seen it, and any attempts to contact the supplier were met with “we’ll keep you updated”. I asked to be put in contact with the delivery company to no avail.

We didn’t get our tent for the first event of the year. We borrowed one instead, and the experience made me more determined than ever to get our own as the experience of sleeping IC  was lovely. I thought to myself, at least I’ll be able to take my time over making it.

Weeks and weeks went by and still no fabric, I sent email after email. This week, I tried to resign myself to the fact that we wouldn’t be getting it in time for the next event in May either. I tried to accept it and think about what I could use the time for instead. There were some items of costume that I wanted and a couple of commissions to complete. We had managed to source some cut price canvas that could be used for an awning, and I was thinking about damage limitation in terms of traipsing back and forth between fields.

But something was wrong. I was feeling angry, resentful and helpless. I was also feeling overwhelmed by the sheer amount of making that I was planning to do. I couldn’t get any of it started. A frustrated facebook post had resulted in a raft of comments recommending a UK supplier of fabric, but I figured that it was all too late.

Then something snapped in me yesterday, I had had enough. I called the UK supplier, explained the situation, and asked how soon they could get the fabric to me. Friday was the answer. I found a source of eyelets. Again, they could deliver by Friday, or Monday at the latest.

I called a sailmaker pal of mine, who had agreed to let me use part of his workshop for making the tent. I could use the workshop in the early part of next week.

I called the Dutch supplier and said that unless they could get my goods to me by Friday, I would be ordering my fabric elsewhere. He said that he’d keep me updated. I said that I’d need to order my fabric in the next twenty minutes. He got on the phone to the delivery company and emailed me in ten, offering to send out a new order, but he didn’t know when I’d receive it.

Sorry pal, but no cigar. He could have done that weeks ago when I made it clear that I needed to make my tent this month. I appreciate that the problem wasn’t his fault, but to keep me waiting for 6 weeks when he knew my deadlines was too much. I asked for a refund, and called the UK supplier.

So. I have a medieval tent to make in three days next week. Plus commissions, plus the stuff that I need for the event. I should be feeling overwhelmed and scared. But I don’t. I feel great. More focused than I have in months. I feel as though I have taken control. I feel as though I’m in my element. The pile of work that I have to do, now that I take a proper look at it, is actually doable if I get my head down. I find myself excited, unable to sleep, hence me drafting this post at 6.30 am.

I am starting to learn that managing ADHD is all about being true to yourself. This, of course goes for people without ADHD too, but for us, it’s even more important. I truly admire people who can accept things and move on, who let go, and take things in their stride. But that’s not me. If there is something that I want, I am of the mentality that I will get it, or die trying. Perhaps that way lies frustration and madness. I certainly wouldn’t advocate that approach to anyone else. But it’s what I have to do in order to feel like myself.

There is a neurobiological explanation for all this. The mundane, the boring, the path of sensibility, simplicity and acceptance simply isn’t stimulating enough to kick my prefrontal cortex/executive functioning into action, leaving me sluggish and fed up.  I need the pressure in order to stay focused. As I say, not the healthiest plan long-term, but as long as I understand what is going on, I can work with it. Maybe by balancing intense activity with adequate rest, rather than feeling as though I have to be on fire all the time.

There will always be obstacles. I will try to find a way under, round or over them. But sometimes, I have to go through them.  It wasn’t the circumstances that were getting me down, it was me and my lack of faith in myself. Letting myself be messed about, feeling like a victim.

This tent will get made if I have to stay up til midnight each night hand sewing after the workshop has shut. And every time I stay in that tent, it will remind me never to take anything lying down. For my own sanity, if nothing else.






Where do I start…the non-ADHD assessment

I don’t even know where to start.

I had the “ADHD assessment” that I have been trying to get for over a year. I may as well have spoken to a little old lady at a bus stop.

Don’t get me wrong, the psychiatrist was lovely, a positive, upbeat individual.  It was clear that she was a wonderful human being with a strong desire to help people. Had we met at a party, we’d have been putting the world to rights over a warm chardonnay until 3am. It was also as if the last 20 years of research into ADHD had never happened. As Terry said, when I told him, it was barely one step removed from drilling a hole in my head to let the evil spirits out.

No assessment tools, not even the self report scale (ASRS-V1.1) that is readily available on the internet. No reference to the DSM-V or ICD-10 diagnostic criteria. A brief skim over why I think I may have ADHD (it’s lucky that I have a psychology degree then) and a discussion in which I tried to impart that not everyone with ADHD presents in the same stereotypical way, and that yes, it’s possible for a person to have ADHD even when they were not the “naughty kid” at school and managed to get a degree. She happily admitted that she wasn’t an ADHD specialist, as there aren’t any in Monmouthshire. Really, if I’m going to be assessed for something, I’d quite like it if the assessor knows a bit more about the issue than I do.

The non-assessment ended with some friendly, positive and utterly unhelpful advice about finding a stable part time job. I have a part time job thanks, in fact, I have four (another ADHD flag if ever I saw one). I’d like one job, I’d like it to be full time, and have some sort of career prospects. Trouble is, I have problems getting done what I need to do to make it happen. And have done for nigh on the last 13 years. Progress is sporadic and inconsistent.

I’d like some support, please. I’d like to see if meds will help me concentrate for long enough to implement new strategies and finally get my life together. They may, they may not, but I’d like the option to try. Not be scared off with unfounded claims that they might affect my fertility or that I might get addicted to them. I do know a bit about these meds, and I know people who know a lot about them. Like most people of a psychological bent, I’m not a fan of psychiatric interventions for which there is very little or very shaky evidence. ADHD medication, however, is one of the most successful psychiatric medicines that we have. I’d also like some kind of psychotherapy to address the psychological damage that struggling with ADHD has done, namely lack of confidence and constant feelings of inadequacy which are holding me back. I would like to progress to a stage where I am in a position to help others.

I despair for all the other people who find their lives complicated by ADHD who do not have psychology degrees or a wonderful, supportive partner who understands ADHD. Who cannot argue the toss, or spend a year pushing for an assessment. Who go to their GP, at the end of their tether, only to be told a year later by a lovely non-specialist that they have nice lives, and would need to be on the verge of a prison sentence before they would qualify for any help. I don’t blame the psychiatrist, she was only doing her job as best she could, with the resources and training she had. Maybe the Aneurin Bevan health board could enter into a public-private partnership with Homebase next and buy a few drills?

I despair. I really do.