This might sound counter-intuitive but - tell your therapist exactly this.

That you don't feel heard (ideally, why that is), how you feel about her stance on medication, that you're tired of therapy and don't know how to benefit of it right now (maybe coupled with what beneficial would look like to you) and whatever else is in your head in regards to this session.

This may seem confrontational, but it really isn't (or doesn't have to be). It is providing crucial information to a professional about where your head is at in regards to the therapeutic process the both of you (ostensibly) want to start together. It will help her understand where you're coming from and maybe her reaction will help you get a better feel for if you are indeed a good fit, or not.

I wish you good luck!

I have received the result of my ADHD diagnostics, and did not receive the diagnosis for various reasons. Those reasons are valid when viewed through the lense of a diagnostician and I understand why the decision is being made that way. But I still do have many of the symptoms and problems in every day life, which fit the bill (also according to the diagnostics, but that's not enough), and the alternative explanation they offered is basically ineffable due to lack of research, and in practice this just means that I will not have access to med treatment, even though they might still be helpful. In truth, I think I'm mostly disappointed that I cannot benefit from the well-established treatment protocol for ADHD, and don't know how hopeful I can now be to get a handle on my life at any point in the future.

I don't stand alone in this, my therapist is still going to give me a cognitive-behavioural training designed to help with executive function deficits. And I have already learned, that I'm allowed to stay 'round here even without the label. :)

But together with some other stressful stuff happening, I'm not doing so well, I think.

Ich sekundiere, dass du hinfahren solltest - Terminservicestelle funktioniert in der Regel, auch ohne Bestätigung von der Praxis. Die Termine, die dort vergeben werden, werden meines Wissens nach von den Praxen zur Servicestelle als frei hingemeldet, und die kriegen dann wieder bescheid, wenn der Termin vergeben wurde, um sich drauf einzustellen.

Ich versteh aber auch, dass du dich rückversichern möchtest, vor allem bei dem Fahraufwand. Es ist aber leider tatsächlich so, dass wegen der extremen Überlastung der Therapie-Praxen (habe ich dir bei deiner letzten Frage ja schon beschrieben) der Service für noch nicht aufgenommene Klienten meistens absolut minimal ist - d.h. keine Rückrufe, keine Mail-Bestätigungen, kaum Telefonsprechzeiten, AB nur für schon aufgenommene Klienten. Das ist weder schön noch emotional förderlich für die Therapie-Interessenten, aber eine Psychotherapeutin, die ich privat kenne, hat mir bestätigt, dass es ihr zwar sehr unangenehm ist, das so zu handhaben, aber einfach absolut nicht leistbar ist, das neben der Vollauslastung auch noch anzubieten, weil sie dann 12 Stunden Tage hätte, von denen 4 unbezahlt wären. Und Sprechstundenhilfen, die das übernehmen gibt es auch eher selten in der Psychotherapie, selbst bei psychotherapeutisch tätigen Ärzten. Dafür ist das Feld auch einfach i.d.R. nicht lukrativ genug, außer man hat z.B. über Gutachtenstellung noch einen Nebenverdienst oder eine gut laufende Gemeinschaftspraxis.

Will sagen: dass du da keinen erreichst, ist nicht persönlich, und hat auch nichts mit Desinteresse aufseiten der Ärztin zu tun. Das sind in aller Regel Finanz- und Sachzwänge und Überlastung. Das Terminvergabesystem funktioniert aber trotzdem gut genug, um zum Termin zu fahren.

Noch positiver Erfahrungsbericht für die Hoffnung: Ich habe letztes Jahr nach 9 Monaten intensiver Therapieplatzsuche (war krankgeschrieben, hatte also auch nicht viel anderes zu tun) über den Terminservice tatsächlich nicht nur ein Erstgespräch, sondern auch einen freien Platz, der auch noch gut passte, gefunden. War Glück und Timing, aber es kann funktionieren.

Viel Erfolg! :)

Yes, she is! I personally am just so glad I could help at all and not have her watch go through that ordeal by herself... and to have managed to make a significant difference for her, she says. That doesn't always happen when trying to help and support, and I am so happy that this time, it did :)

I feel fantastic right now - in the last week, I have hyper focussed for several days to help a dear friend prepare for a court date (the kind of task that has "important/interesting to me" and "urgent" written all over it), and due to our preparation, it went really well for her. And I am happy, relieved and quite proud of us - while also feeling completely trashed from overtaxing my physical ressources in the process.

Absolutely worth it, though. I will, however, now take a break of several days.

There's a difference between signalling the brain to release its own dopamine and taking external dopamine. (Important note: All of this is a simplification, I am not an expert!)

The first could be done with drugs (legal and illegal) or other dopamine-stimulating activities with instant rewards, and it absolutely has the ability to change our reasoning (like "Oh yeah, I'll definitely feel better if I sit motionlessly for hours scrolling memes I don't even find that funny, and should not, as logic and knowledge dictates, maybe go outside and move my body a little, because that won't feel as good (doesn't release as much dopamine)"). So here, the answer is yes, totally. Which is why for example ADHD medication tries to effect an easier release of dopamine to make it easier on the brain-carrier to make different choices, away from instant reward towards delayed gratification.

For the second thing - dopamine's precursor, L-Dopa, is the straightest way to actually add more dopamine to the brain (since dopamine itself can not pass the blood-brain-barrier, but L-dopa can and is then synthesized into dopamine), which is done in Parkinson's patients and helps them tremendously. Interestingly however, if you overdose it, you can fall into a drug-induced psychosis, a state in which one could argue that logic and reasoning are indeed affected, so that's another yes, but not in the way you mean, I think.

In conclusion, brain neurotransmitter chemistry is pretty complicated, but interesting, and the answer to the question if changing something about it will lead to different ways of thinking is very often yes, which is why medicine is doing it :)

I wanted to let you know that your story resonated deeply with me. We had a similar family dynamic in parts (esp. the teaming up by apparent neurotypes), only nobody is officially diagnosed (I'm still waiting for results), which made it even harder to make sense of for a long time. So I feel for you!

During my university years especially, I also struggled heavily with keeping up with household stuff, which made me quite the unpopular flat mate... it's a huge source of shame for me, and still affects me to this day (though I'd like to believe I've gotten better).

Thank you for sharing, even if it is uncomfortable, it made me feel less alone with these experiences - so please don't feel like you have to apologize :)

Anyone else? Yes.

(Thanks for the reminder! :D)

This week as well as last week, I am still waiting for my diagnostic report to tell me if I have ADHD or not - the sessions were in September. The wait time has been announced, but I am still impatient, which is kinda fitting, I guess... While it is clear to me, my therapist and the diagnostician that I likely have some kind of neurodivergence, it's not quite clear if ADHD is the ticket. Which also makes sense - if it was super-obvious, somebody would have noticed before my thirties, I hope. I guess I'll know soon enough.

Either way, I still find the ADHD communities such as this one very, very relatable, so if it's alright, I'll just stay on even if I didn't meet the diagnostic criteria. :)

4-5 / 0-1 / 4-5 / 0-1, repeated for at least 1 minute, better 5 minutes or more. (not too deep or light-headedness can happen)

This is resonance frequency breathing (at round about 0,1 Hz) which maximizes heart rate variability and activates the baroreflex (blood pressure). It's usually used with a HRV biofeedback device to find the best individual breathing frequency, but it's not strictly necessary. Just find the speed around these marks that feels good (without feeling like you're out of breath or getting dizzy). Breath into your belly.

There's tons of studies for its effects, but mostly it activates your vagal control, and thus tones down anxiety, can help with depression and PTSD symptoms when done regularly, and also helps with high blood pressure, can make recovery after heart surgery easier, is used in professional sports, may help with IBS etc. Look for papers on "HRV biofeedback effects", if you're interested.

The most immediate effect I personally have is feeling both more relaxed and more alert, similar to after meditation.

I don't want to scare you, but seriously, do NOT just try to push through the burnout by yourself "until life lets up" and leave it at that - I tried that, and all that happened was a break-down, and afterwards not being able to work, period, for several months. My life back then was not sustainable for my body, and it told me through burnout as a last measure to get me to stop living like that.

In recovery, I've also met people who went farther than me (often medication-assisted) and did themselves literal organ damage - one lady had a nearly complete shut-down of the adrenal glands, another had a series of mini-strokes due to elevated blood pressure... it gets bad.

You say there are only two weeks to go, and I wish you the best to get there in one piece. Do try exercising, avoiding screens for two hours before bed, listen to an audiobook to fall asleep, try lavender tea or something, use all the tips.

But please know that afterwards it will not necessarily be over, the exhaustion may stay or come back easily, and you really, really need to reach out to a professional, your GP or psychiatrist and look into treatment options, not just coping options.

Wish you all the best!

When you feel the burnout building up, you really should not try to stick it out "just until this project is done and I can get some rest"...