Source: www.americannursetoday.com
Mental illnesses in Malaysia are still misunderstood by the public, and many cases remain undiagnosed. One of the least talked about conditions is ADHD.
As an ADHD sufferer myself, I’m writing this article is so potentially undiagnosed adult ADHD sufferers can get the help they need. I also hope that family members and friends of existing ADHD sufferers can be more accommodating and understanding of their condition after reading my story.
First of all, what’s ADHD? According to mayoclinic.org, it’s a disorder which includes difficulty sustaining attention, hyperactivity, and impulsive behaviour. You can read the full list of symptoms here.
ADHD can’t be cured, but it can be managed. However, due to the lack of awareness in Malaysia, many ADHD sufferers remained undiagnosed. Only a handful will eventually be diagnosed in their adult years.
Now that we’ve scratched the surface, let’s get to know more about ADHD. How has ADHD affected my life so far?
1) Those with ADHD may seem ‘lazy’ or unorganised while doing routine work, but they blossom in creative work they’re passionate about.
Before I knew I had ADHD, I was always struggling to read long essays. Yes, those karangan and long questions in PMR and SPM? I struggled to even finish those!
That was because I was unable to focus for long, especially if it’s not related to my interest. I was also easily distracted by external elements, such as noise or other people’s conversations.
This applied to my previous work in research as well. However, I survived there because there were targets to be met, which ignited my passion to chase after those goals.
I always had to rely to stimulants, such as coffee, sugar and coca cola to get things done. I eventually realised that this was a bit odd, so I started reading up about it.
Since I was passionate about health topics, I found out about dopamine, which is a chemical in the brain which affects mood and the brain. Consequently, I always wondered if my problems were related to that.
Long story short, an ADHD sufferer would struggle to do dull work. There has to be a good enough motivation behind it, whether through passion or through stimulants. It allows them to focus and complete their work.
2) ADHD has 3 different subtypes
If you’re not confused yet, you might be now. Don’t worry, I’ll walk you through it, slowly.
In a nutshell, ADHD has three different subtypes or variations. The first subtype is when the sufferer is inattentive. The second subtype is when the sufferer is hyperactive, while the third subtype is a combination of both subtypes.
Most cases of children ADHD in Malaysia fall under the hyperactivity subtype. However, due to the lack of awareness in the 80s and 90s, many adults in Malaysia remain undiagnosed. Many may not even realise that they have adult ADHD, just like me.
At first, there were problems when I tried to get diagnosed in a public hospital in Kuala Lumpur.
The first doctor I met is the psychiatrist. However, due to the large number of patients and few psychiatrist, government hospitals often have to rotate the psychiatrist, which slowed down my initial diagnosis.
At first I didn’t know what I had. However, when I came across ADHD in one of my readings, I asked to be tested specifically for ADHD, which was rejected. However, when I went again to get a second opinion, the second psychiatrist believed I did have ADHD and referred me to a clinical pscyhologist. The clinical psychologist will then do an ADHD assessment, and consult with my psychiatrist.
Now they believed I have ADHD, but which subtype? This is where it gets slightly complicated.
Unlike other mental illnesses, ADHD is accessed by both the psychiatrist and the psychologist, who will provide a full report after an assessment on the patient.
Then, the psychiatrist will assess the report before taking the next course of action. If it’s not ADHD, the psychiatrist will probe further. If it’s ADHD, they will customise the medication dosage to suit the patient’s needs.
However, I’ve yet to know my subtype because the clinical psychologist hasn’t released the full report. There aren’t many clinical psychologists in Malaysia, so getting an appointment is hard, which means I’ve only have a partial report which states ADHD, subtype not confirmed.
Even though it’s only a preliminary diagnosis, having ADHD finally made sense to me because I do face a lot of problems associated with short attention span.
For example, I used to interrupt people’s conversation, wander off when others spoke, and ramble on without getting to my point. I would even ‘switch off’ if a joke or magic trick took too long. I would always misplace my keys and wallet, and sometimes I don’t even notice when I wear my shirt in reverse!
There’s more to the list, but you get the idea.
3) It’s difficult for an adult ADHD patient to get medication
Most of the times, a patient who goes to a government hospital is able to get the medication from the hospital’s pharmacy. However, it’s slightly different in my case.
Since the quota for the ADHD medication is full, I could only get a prescription to buy the medicine from an outside pharmacy. Did I also say ADHD medication is a controlled drug? A very strict one at that!
My first experience trying to purchase it led me to at least 10 different pharmacies, unsuccessfully. I finally understood why it was so difficult to buy it, even with prescription.
You see, because it’s a highly controlled medicine, most pharmacies won’t order it due to the lack of demand. It’s too much hassle. If there’s one miscalculated / missing tablet from their stock, the pharmacy will be in hot soup with our local enforcement agency.
It makes sense for them not to sell, right? The profit margin isn’t that great either.
Going back to my story, I finally found a pharmacy after a long search. Even then the process was thorough – they double-checked everything from my prescription, to my appointment book, as well as their own shelves to make sure everything is 100% compliant with the law.
4) Bipolar and ADHD share similar symptoms.
What’s bipolar disease? According to NIMH, there are four types of bipolar conditions, all involving changes in mood, energy and activity levels.
“These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes), to very sad, “down,” or hopeless periods (known as depressive episodes).”
So how is it similar with ADHD?
The similarities can include increased energy, being easily distracted, and a tendency to interrupt others, among other things. However, the biggest difference is that bipolar affects mood while ADHD affects behavior and attention.
However, what’s more confusing is that someone can have ADHD and bipolar disorder (or other mental illness) at the same time too. They call this ‘coexisting conditions’.
Add that to the fact there are no blood test or physical diagnostic tools for mental illnesses, things can get very complicated.
I should qualify this by adding a disclaimer – respect our medical professionals even if you strongly disagree with their opinion. I’ve been there, so I know how it feels to disagree, or feel like you’re being misdiagnosed.
Regardless of how convinced you are of your own illnesses, you still have no right to argue with professionals. Just because you did some research online doesn’t mean you know more than they do.
The fact of the matter is, sometimes we may not be able to explain our symptoms accurately to the doctors. This affects their diagnosis.
If you’ve done all you can and still disagree with the doctor’s diagnosis, please seek a second or third opinion. That would help in confirming your diagnosis.
5) Life has improved after getting diagnosis and treatment
One would have thought being diagnosed with ADHD would be a big slap on my face. On the contrary! Not only does it not impact my self esteem, but discovering that I have ADHD provides me a sense of relief.
Knowing what I have and getting the proper treatment allows me to work around the disadvantages that comes with ADHD. I’m no longer interrupting people, I’m more patient and respectful, and I’m better at delivering my point.
Do I feel any different? Of course I do! I wake up energised. I’m more productive, and I don’t lose my things anymore.
Yes, the medications do help. They give the motivation, organisation, and focus to ADHD sufferers. To others without ADHD, they might feel better in those areas, but not so much.
However, one downside is, when I’m off my medication, I go back to being lethargic, clumsy, and disorganised. My loved ones can tell I’m not my usual happy self. Also, I can be impatient – it usually comes out as road rage while I’m driving on the road.
But it’s not a magic pill that solves all problems. I still need to put extra thought into not misplacing things, and work on decluttering as well as organizing my daily routines, which the medication cannot do for me.
So what’s next if you think you might have ADHD? Or any other mental illness for that matter?
I would highly recommend you talking to a person who also has that illness, so you can get first-hand experience, something you can’t get from the Internet. However, take it with a pinch of salt, since everyone with the same mental illness experiences different symptoms and reacts differently to medications.
Personally for me, here are some things you should look out for which may point to you having ADHD. Of course, please understand that these are just my personal opinions, and not an expert diagnosis.
First, if you’re dependent on stimulants like coffee just to get even basic tasks done, it may be a sign of ADHD. Also, if you’re so easily distracted that you struggle to finish a project, that could be a sign too. Add that to a tendency to ramble on without getting to the point, and having extremely short attention span, and you might want to get yourself checked out.
However, for a proper diagnosis, you should head to a government clinic or official medical institution. Explain your symptoms to a medical professional, who will then refer you to the psychiatric department at the government hospital.
This link provides you with the necessary details, such as the working hours, address and requirements.
This article should not be taken as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a mental or medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website.
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