It's complicated..

I ok, I need some advice, this is rare me asking for advice but since none of you know me I guess I can do it.

First a quick background but not enough to bore you.

1987 diagnosed Major Depression, hospitalized, and out patient followed up with a bipolar diagnosis. I was not bipolar.

That is the only official records on me!

Now I have a friend who just happens to be a psychiatrist, yes the real deal phd and all. She won't see me as it would be a conflict of interest. But we have spoke. Originally she would have diagnosed me as BPD, who ever said I was bipolar was on drugs. How ever more recently she said she would have to change the diagnosis to NPD w/some BPD traits.

Officially I have only been treated for depression and anxiety, my records are clean, I know they are. Here comes the problem.

I know what I am, have known and have worked around it for decades using regular primary doctors only! I've been treating my depression and anxiety as needed.

Fast Forward to present. I am having a problem at work staying focus and concentrating and completing task, my pdoc friend is 99.9% sure I also have ADHD. I went to my primary doc but he will not diagnose me with ADHD. So I had to schedule a full psych exam!

I need to be very careful what I reveal. My pdoc friend suggested I come clean on every thing but that would change things dramatically. I would be on more meds and not be trusted with any narcotics at all and may not be able to get the adderall I would need for ADHD, she knows this. The only other alternative is to just play on the ADHD and keep the rest under wrap.

What is the rest? I am most likely according to my long time good friend pysch phd psych doc a BPD AND NPD, I could easily meet the criteria for both if I was honest. In addition to that, very mild paranoia too.

I do like to drink alcohol and never plan on stopping. I will also use opiates for recreational purposes when available, but never benzos. The reason never benzos? Because they do not provide a euphoria and is a waste of time to abuse them. I have severe mood swings, anger issues, and drive recklessly. In short if I was completely honest I would probably be locked up.

Here's the direction I'm leaning towards, just play on the ADHD there is no way they can discover any thing else as I have covered my tracks well. But part of me wants to come clean because I would like to get better. But this is not the time. My job is in jeopardy! I can not be over med to the point of it slowing me down or making me feel retarded. I need to be 100% functional and in complete control. I've been able to get away with this for decades! I'm just worried that they will stop my benzos and not give me adderall if I come clean. And my pdoc friend said that is a verrry strong possibility. They will offer alternative drugs that will do what I do not want, slow me down.

That's about it. I would ask if any one else is in the same situation but kind of feel that I would be waiting a long time to run in to some one who is. Can you at least understand my concerns? Opinions welcomed and will not be shot down.

Your chickens may be coming home to roost. That is, it might be time to pay the piper. That is, you better straighten up and fly right. You might have been able to get away with shite when you were younger, but now they can replace you with someone younger, cheaper, and faster, who doesn't have all these issues. Quit fooling around or you are gonna be out of a job. Take it from one who knows, one who's been there. Good luck.

That is exactly why I need to get on adderall for adhd. I have been neglecting the classes and tests that are required of me to complete each year to keep my job. The field I'm in requires constant training and class room work. I just can't stay focused or concentrate on my own.

If it was just for me I would not care, but I have 3 depending on my check. So you see why I am in a tight spot. I just don't think this is the best time to come completely clean.

The fact that keep using phrases like, "covered my tracks well" makes me think that you should really come clean. It sounds like you are engaging in risky behaviors, and quite possible that your doctor knows this, which is why he is refusing to quickly diagnose you with ADHD and put you on medication. I think if you are able to get a doctor to prescribe Adderall, it is just going to complicate things... as Adderall can be addictive, especially since it sounds like you may struggle a bit with substance abuse already. I would think very carefully about how you approach this. I think you are more likely to receive the ADHD treatment that you need if you go about it in an honest way (meaning telling your professionals everything).

I only abuse opiates, but sure there is a chance I could abuse amphetamines. But benzo's have never been a problem for me so I'm thinking I can handle the adderall too. Opiates are just sooo different. I have no will power for them, but I do have will power over alcohol never abused it, but won't give it up either.

My primary doc has no clue what's really going on, he just lacks the expertise in adhd.

benzos are depressants, right? Adderall is a stimulant... way more likely to give you that sense of euphoria. If that's what your looking for, then it will be very easy to abuse.

The adderall is more likely to produce euphoria if abused, above the recommended dosages. Benzo's are sedatives, the calm me that's all. The two are a common combo with ADHD patients, but I hear you the chance of abuse is there.

The think is I don't know what else to do. I have to be razor sharp and as quick as I can be on my job. I know what the "safer" alternatives do! They make u in to zombies.

It's very depressing for me. I would never be able to find another job that pays this much and even with this job we are barely making it, see my delima? It's not so black and white.

I'm thinking take the risk of abuse to get better and hope I can come out ahead like I always have with alcohol and benzos. I've spoken to people on adderall and they swear if you stay on the correct doses it helps and you won't feel high.

If your primary care doc won't diagnose you with ADHD, then just go ahead with the psych evaluation. But they are going to want extensive psych history from you, which includes past and current diagnosises and medications. Based off of that information, and the results they get from the testing, they may or may not diagnose you with adhd. There's really not much you can do, except be honest.

Got that covered! The only thing on record is a 1987 diagnoses of Major Depression! I've only been treated for anxiety other then that. The beauty of this is I will not have to lie about the ADHD. I suppose there is a chance they will not agree with my psychiatrist friend in which case nothing is lost at least I'm still in the same situation.

Also, ADHD is common along side with just about every major mental illness. The only snag I can see is myself. If I purposely slip and say some thing I shouldn't say because I have such a freaking ego. I am my worst enemy!

Your intent to deceive doctors and continue your substance abuse is a troublesome sign. You need to come clean, get clean, and then see what you can/cannot do or handle when functioning without substance abuse messing you up. Sorry, but can't tell you it's okay to continue to abuse drugs and alcohol and deceive the physicians as they are trying to treat you without all the information. Not at all safe, not a good plan at all.

I think you shouldn't assume that Adderall is the best medication for you. You say your friend is a psychiatrist and has a PhD. But psychiatrists are medical doctors, not PhDs, so which is it?

A prominent feature of ADHD is enduring problems. A person with ADHD doesn't start having problems at work with concentration and focus and never have had them before. If you haven't had this for quite some time, then it probably isn't ADHD. And so a medication for ADHD would not be the best choice.

Do you want to get help for what is wrong or do you just want stimulant drugs? If the latter, why not just buy your drugs from the street? Maybe your opiate supplier can fix you up with some stims too.

Even if you do have ADHD, if you have anger issues, then Adderall is probably not a good choice. Its nickname is "madderall"--that's right, it makes some people quite angry. Certainly not a good choice for you.

What won't your primary care doctor diagnose you with ADHD? Is it that he doesn't have the expertise to diagnose you, or that he did test you for ADHD and found you didn't have it, or that he won't prescribe stimulants for you?

If you want to be 100% functional, not slowed down or retarded, and in complete control, then you would stop taking the benzos and opiates. They are CNS depressants. Don't try to fix one med (the benzos) with another (a stimulant). If you stopped taking the benzos, maybe all your concentration and focus problems would go away.

To be honest, you're not making a good impression with your story here, and I think you'll need to do a better job if you want to hoodwink someone into prescribing stimulants for you. FWIW, the place I work, a medical clinic, periodically and randomly tests anyone who is prescribed a controlled substance like Adderall, for a full panel of drugs. So any alcohol, benzo, or opiate use would show up, and unless these are on your prescribed list of medications, the clinic will drop you like a hot potato. And you will not get your Adderall.

i think you need to come clean but also tell whoever you see of your concerns about the meds. they will work with you to find the right meds for you. you don't have to take something if you don't like the side effects of being slowed down.

honestly, it sounds like you are playing a lot of games. your friend isn't treating you but she is diagnosing you. that really is treating you. you need to go see someone who isn't a friend. like sunnie said a psychiatrist has a m.d. a psychologist has a phd. i don't know which your friend is from your description. of course a person can have more than one degree but a psychiatrist has to have a m.d. stop gaming people and tell them the full story and your concerns about being sharp enough to do your job. they are there to help you and work with you. also, have you considered going to a 12-step program? you would probably be really helped by narcotics anonymous or some other drug users support group.

Sounds to me like you just want the adderal. Not able to concentrate could be for many things. Depression and substance abuse would be my bet. You say 3 poll depend on you- how about getting the help you need for them?
BTW, Getting a dx from your friend is very unreliable matter her credentials. PhD? Really?

I wish my friend would treat me but it would be a conflict in interest. She also knows too much about me too. As for the substance abuse, let me repeat. The only substance I am inclined to abuse is opiates, which I rarely come across any ways. I do drink alcohol but do not abuse it and have no plans to stop even if Jesus Christ appeared in person and told me to stop because I do not drink that much. As for the benzo's they are the only med that reduces my anxiety and I have tried them all too! I take low doeses and never abuse them, as I do not consider them a drug to get "high" on. There is no euphoria, it does not release any dopamine, it is a sedative and relaxes me. If I were to abuse benzos they would simply put me to sleep. That is not a high. Ther adderall has the highest success rate with adhd patients, there are others but all are amphetamines, any non-amphetimine is on the line of wellbutrin and has the same effect as a placibo. Even my doc friend admits this. Also, she know's the only drug I can not be trusted with are opiates, but she knows me! Other docs would not know me as well or be as confident in me. She is in effect trying to maintain being a professional by recommending I come clean but at the same time understands why I would not. She knows I would not abuse adderall or whatever they gave me, just as I do not abuse benzos. If all I wanted was to get high I could buy any thing I want off the streets and it would be so much easier and faster then jumping thru all these stupid hoops for retarded doctors that really are only concerned with malpractice insurance. My friend already knows what I plan on doing and she is still my friend.

I don't know that I would even follow my own advice but I do honestly believe that coming clean would be the best possible solution. But, as you already know, the consequences will then be forced to be dealt with. And if you're not ready for it then - i'd advise you find the best possible way to cope or manage. Because addressing just one area and having multiple other undisclosed or areas can not be beneficial - as one could be exacerbating the other, etc.

In whatever you decide to do - good luck! You have a big decision to make either way! Very scary stuff...

Content aside, I do understand the fear of taking a step in a different direction that has some risky side effects. It's not easy at all to make that leap and takes a lot of support - and a game plan.

If your ultimate goal is to 'come clean' someday, perhaps you can put some energy towards figuring out what you would need in place in order to do that. Instead of identifying what's stopping you from coming clean - use those excuses as ammunition to find a resolution, so they no longer become obstacles. Instead, they can be challenges to face and overcome. For example, I'd imagine a safety net financially would be important, in case you do lose your job.

Answer all the questions truthfully just don't elaborate if you don't feel like it. You want them to know as much So they can be completely helpful. If you don't like there response hire someone new. My son had to go through all the non-stimulants, and any off label ADHD medication, along with an anti psychotic before his pdoc would even think about prescribing a stimulant.

Coming clean seems like the simplest answer, when you boil it all down. You'll crash and burn if you continue to use/abuse anyways.

Not what I am worried about at all. I have been fully functional non-dependent of any drug for over 30 years. The only drug I will abuse are opiates, and I rarely come across them. No, I am worried about running out of time at my job. I am putting of exams and classes because I simply can not focus or concentrate long enough. I'm worried if I come clean, it will take months longer to obtain their trust which I don't give damn of having or not having, I simply do not have the time to play their games.

I don't know if doing it your way is going to be the quick fix you think it is.

I'm at work now taking a mandatory online course which will be followed by a test. You have no idea how difficult it is for me to follow along even for just 2 minutes. I get distracted or lose interest. I just can't stay focused. am unable to retain what I read. I have been putting this off for as long as I could. I have to start taking them now and there are a lot. I don't know what else to do. I really don't care about any thing else except keeping this job. I can not in any shape way or form take any meds that will slow me down even more!

I don't think anybody is saying to "come clean" to anybody at work. I think we're just saying, explain your situation to your doctor - tell your doctor you need the least disruption to your life right now as possible. And figure out afresh what you need to do to accomplish this. Cuz it sounds like you are going down the tubes. You don't sound good, dude. I mean, not like you're gonna crash tomorrow, but you're not headed in a good direction. A lot of us have been there and we can see the signs. You said you weren't gonna argue with our advice, but you're not hearing it either.