getting evaluated... | ADHD Information

Sorry if my post offended you,>>  au contrare, I appreciate your advice.

Your understanding of Japan is correct.   Incidentally I walked into a seishinka (psychiatrist clinic) in Urawa just to see if a face to face appeal would get me a referral... the place was PACKED.   My understanding is that social anxiety (panic disorders) are REALLY common - - treatment with medicine is socially acceptable, but "talk therapy" and support groups are not yet accepted.

to kj2691>   I can speak Japanese but there's a difference between chatting with a cab driver or some friends at a bar, vs. being able to be able to speak fluently enough to really benefit from a therapeutic relationship... and nothing is worse than being in a counseling session and not being able to say what you want to say... even in your own native language.  - - (Its like when people say how much better they felt when they were DIAGNOSED with ADHD... you can't appreciate how valuable words are until you know what its like to live without them.)  - - I know how to say my house is messy and I cant find things and I'm tired all the time, but that's just the first session... going deeper requires vocabulary and grammar that is way over my head and today I got a headache just listening to a plumber try to explain to me what he did my toilet.  - - Now, imagine if that toilet was my head...

I should try to seek out other people with ADHD... I'm sure English speaking people with ADD exist...   incidentally, the EXISTENCE of ADD is generally accepted in Japan... If I talk about it, almost everyone I know has a coworker with the condition.  I always ask, "So is he getting treatment," (as well as why not?) however, cisbrane-san can probably guess the Japanese 3 syllable world beginning with "sh" that's used to describe the situation...　SHOGANAI。。。It basically means, "There is nothing that can be done about it, so I/he/she/it/they are resigned to the situation,"

I see, so you've been there for such a long time.. wow.
Sorry if my post offended you, it's just common misconceptions and it just sounded sooo similar to me.

Yeah... Japan is.... interesting. I find it a little oppressive to those who have internal problems... they feel bad talking about it or feel that they can't talk about it... and due to the honne and tatemae divide that is bred into them it's even worse. If you have a physical handicap... Japan isn't too bad... especially if your blind, they have strips all over to lead you around. Wheelchair... a little harder due to all the stairs and hills...

I wish you the best of luck there... I would like to return to Japan for an extended time, but I have several reasons why I wouldn't as well.

This sums up a lot of Japan, "The nail that sticks out will be hammered down."
cisbrane40251.4251967593
Eddie....  maybe what would do you the most good is finding a "coach".... or as I like to put it, either a "nag" or a "thug" to make sure I get the things done that I must do.   Now, I expect that the chances of finding a real live certified ADD coach in Japan is about as likely as finding, say....an American Bald Eagle....but still, you might find someone who could help you...you know, check up on you, prod you along a bit, and also set up some routines to help you do stuff on your own, on time.  On time is always the killer, isn't it!!
cisbranes>>

Actually, she was an American... and I've been to Japanese doctors before (I have a sleep disorder... surprise, surprise!) and I've lived here for 15 years... nothing shocks me anymore... I mean NOTHING...(test me!)  - - and even by Japanese standards she was pretty bad... Japanese *do* make eye contact, but not in the same way a typical Westerner would and as you say,while they're listening they might look down, but while they're doing it they'll nod their head and go "unnn... unnnn... unnnnn... naruhodu..."  etc. (in other words they'll make sounds to indicate that they're listening... and as you may know, the sounds and body language can be as important as the words) - - My Japanese exists but sucks... however, those "unnnnnnnns" can tell you a lot...

John D>>  Yes  ! ! !  That's what I feel I need... regrettably its hard to find... however, I found a website... Its by a doctor in Shinjuku who says she has ADHD and runs a clinic and has written three books... Although she's a psychiatrist she states that her approach is to do counseling and coaching "and use medicine when necessary..." - - this is rare because in Japan you usually go into a waiting room (sometimes no appointment), the doctor calls you in and asks you what the problem is... takes a few notes, then says to go back to the reception area... you pay, get your script, go to the pharm and wind up with a bag full of pills which more often than not include DEPAS, which to my understanding is the same thing as Xanax.

One time they gave me TOREDOMIN (an SNRI) - - it actually did help a bit, but had some undesirable side effects which I couldn't deal with. 

Of course, as you cisbrane-san may know, the mental health system here is really archaic... I ride on a train line which is famous for its gropers... actually saw a guy grope and undercover cop and get arrested... was groped myself by an old lady... I've ridden on the trolley while a mentally ill person actually took a pee right in the back of the car right while it was going downhill... been to a sushi bar where some guy was playing with something other than his i-phone - - once saw the door of a train open and a crazy guy pull down his pants (from inside the car) and take a pee - - There's a section in Minato-ku where people have signs in front of their shop that say, "Please don't sleep here..." other lines I ride on get delayed quite often by jumpers... I love living in Japan, but if you have a psychological issue and aren't willing to accept it, life is going to be tough...  If on the other hand you're willing to embrace your madness, and live life like its a game of chatroulette, happiness is guaranteed.    People may avoid you... but you'll never get punched out for being a jerk.

Thanks again for the advice ! ! !
I am currently reading "The Disorganized Mind".  It's geared toward self-coaching for the adult with ADHD.  You might want to give that a try also.  It requires a lot of self-discipline and it's going to take me some time to get through it and implement but I'm committed to making my life with ADHD better.

One question came to mind - if you're in Japan for the long haul, won't you have to learn the language anyway?  What could be the harm in attending a support group that's in Japanese?  Or even starting one???

Psychiatrists don't counsel. Their job is to dispense medications.  (Some do counseling but most don't)  And you don't necessarily need medication right away.  Can you check with the universities there to see what kind of counseling services they have for mental health?  Just as anywhere in the world, mental health issues are still a stigma and ADHD is no different.  It's up to us to change those stigmas.

Hang in there.  At least you have all of us here!
[QUOTE=eddiep]Hi !  I have a question...

I live in Japan, and Doctors that actually treat ADHD are rare, let alone ENGLISH speaking Doctors, so I went to one of the few clinics that does serve the English speaking community. 

....she didn't really greet me, make much small talk (prior to getting into discussing the agencies fees) and I can swear she made almost no eye contact for half the session... (incidentally there were no patients before or after me) - - also I didn't feel she was helping me along (for example expressing empathy or saying things to really help me get things out.)  -- In fact, normally I have NO trouble expressing myself (actually, the opposite problem... I express myself TOO much) - - but because I didn't feel any empathy or encouragement, I felt very stilted as I answered the questions... 
[/QUOTE]

I studied abroad in Japan last semester, but I did not bring my medications with me or stating that I had a past with ADHD since they do not really accept it. From what I understand, they see this as an issue that can be overcome or it is a personal weakness.... Something like that. I tried to go there in the Summer during Highschool for study abroad and I was denied for listing ADHD.

But what you describe of small talk, this is typical of how japanese do things. They feel like they must have a little bit of small talk about essentially nothing before doing things to hopefully "get to know you better". I am studying Business Japanese and it's a key thing we learned. It is directly opposite of Western speech where it is important usually to "get to the point".

No eye contact is also typical. It's actually seen as a more polite thing to do. Looking people in their eyes can be intimidating.

Now I'm not so sure on the empathy thing. In Japanese conversation it's typical for the first person to "spill the beans" with the listener nodding, saying yes, and other things. They wait their turn and after you have said everything they will usually begin to talk. A general way to compare is thinking of speaking to Japanese people as if you are playing bowling. You each take your turn. You may comment on what was said, but it's usually taking turns on what you say. In comparison, Western speaking is more like Tennis: You go back and forth. You say something, they respond to have you say something more. You continue to go back and forth like the tennis ball. And to someone on ADHD... having to take your turn is one of the hardest things to do...

So, don't be too discouraged by these points of the doctor's behavior... but the fact that she won't listen and will give you the depression sheet... well I don't know what to say.

What part of Japan are you living in? Near large city centers with large foreign population you have a better chance of finding more english doctors...

Getting this kind of medication in Japan is tricky....All I can suggest in searching and keep trying more doctors.

I wish you the best
cisbrane40250.5581018519 Also, let's not forget the indirect language of the Japanese. They are used to saying things very indirectly, especially negative things to "save face". They don't want you to feel bad so they say very indirect things to really simply say "No". So, just watch out for this type of thing.

I don't know how long you've been in Japan, but if you want to discuss experiences just send me a private message. A lot of what you described in your first post seemed to be a cultural misunderstanding. What stage of Culture Shock are on? Culture Shock can do many strange things to you.
cisbrane40250.5546180556Hi John and Integrtrydispair.  Thank you for your replies... regrettably the situation in Japan for people with any type of psychological problem is very bad... and I'm here for the long haul... complete with poodles and more...

First - - there *is* national health insurance, but it does not cover counseling.
(One of the symptoms of my ADHD or whatever it is effects my ability to work... either I do my first calling and become EXTREMELY high and disorganized and on overdrive (eventually totally unreliable)... or I avoid the specific stimulus, take a job I hate, stay organized, but then I feel tired and fatigued all the time and have no more than a few hours of energy a day...

Second - - When you go to see a shrink, you just show up (usually), wait your turn, the doctor sees you for 10 minutes (at best) and you leave with an Rx for a million pills... and told "come back when they run out!"  - - This is the norm.  Shrinks don't counsel.  

Regarding ADHD... I have heard that no drug has been specifically approved for treatment of adult ADHD in Japan (Stratera is in clinical trial phase) - - however, Ritalin seems to be available... One doctor wrote for it without really testing me, but without counseling (which is very expensive) even that route seems hopeless.

Next - - support groups.   To the best of my knowledge none in English.  Trust me... I've GOOGLED and GOOGLED and GOOGLED... and sent e-mails. 

Regarding Delivered from Distraction, it really helped me... and so did some other books on organization skills for people with ADHD...
Basically if I keep on top of myself, it requires a lot of energy...
Often I get into a pattern... but when I fall off the bandwagon, its like a cyclone effect, and within a week my house looks like it was hit by a cyclone, there's poodle pee everywhere, I can't find my keys, and I'm losing my bus card WHILE its in my hand...  and 10 minutes later praying that I actually locked the door and wondering why I'm still holding my keys, even though I'm at the train station... and where my bus pass went. 

I literally have remind myself of each and every little thing. For example, when I come home I have to REMIND myself everytime to put my keys and wallet in the area they are meant to be kept... If I see a pair of pants in the middle of the floor (...gee, how'd they get there in the first place???) - - I have to remind themselves that the reason they've been peed on by a poodle is because I should have put them IN THE BIG HAMPER a half a foot away... and I have to spend so much time REMINDING myself to do things that should come natural, I pretty much reach the point of utter exhaustion...
When this happens in the morning and I can't find my materials for work and I'm at the 7 minute countdown for the time I have to leave to catch the bus (because I forgot to put the electric bike battery on the charger) I feel like laying down on the floor and doing nothing - - I don't, but I feel miserable...   Because of this, I'm currently only working a few hours a day... and even those 2 hours of working (and 2 hours of travel) feel like 10 hour work days... but when I make it make me feel like I've made a BIG accomplishment... (It is...)   but then something happens like I can't remember the names of people, or have trouble finding something in my bag... and I feel totally bummed out.   - - However, recently I had 6 teaching contracts (I teach lessons at corporations and work by the contract) and completed all 6 with no more than 2 absences in the year and only 1 (uncontrollable) lateness... for me, a MAJOR accomplishment, but the level of effort required to be functional without treatment almost doesn't warrant making any effort at all.   As a result, the difficulty getting help adds to the frustration...


Hi !  I have a question...

I live in Japan, and Doctors that actually treat ADHD are rare, let alone ENGLISH speaking Doctors, so I went to one of the few clinics that does serve the English speaking community.  - - Frankly speaking, I was a bit uncomfortable with the doctor, but before I jump to conclusions, wanted to get some input.

My feeling was that the Doctor had very poor Rapport... and some of her behaviors almost reminded me of people with Asperger's.. I'm not saying this to be sarcastic, but for example she didn't really greet me, make much small talk (prior to getting into discussing the agencies fees) and I can swear she made almost no eye contact for half the session... (incidentally there were no patients before or after me) - - also I didn't feel she was helping me along (for example expressing empathy or saying things to really help me get things out.)  -- In fact, normally I have NO trouble expressing myself (actually, the opposite problem... I express myself TOO much) - - but because I didn't feel any empathy or encouragement, I felt very stilted as I answered the questions... 
and the strangest thing - - She GAVE me the Hamilton Scale (for anxiety and depression) to TAKE HOME... Isn't it supposed to be administered by the interviewer and based in part of their observations of the patient?

Of course, there's some possibility that maybe she wanted the interview to be objective, but she said that we'd meet three times - - she said that there was no objective test for ADD but she wanted to build on my narrative... but to be honest, I left the session feeling very stressed and feeling... almost bad.

Anyway, I'm thinking two things...  My gut feeling, that this just isn't the right doctor for me, even though other choices are available... and the "rationalized" answer, which is that she was being clinically objective and I was feeling defensive because I wasn't being coddled.

Does anybody have any input regarding their own experiences being evaluated???
Keep in mind that my mother is bi-polar and my father might have OCPD, so she was fishing around to see if I had PTSD and if some other stuff may have been happening... Still - - does any of this sound strange?

I'd appreciate your advice ! ! !

Eddie

too much can be made of the formal eval...you soun d like an adult in Japan.  1.  go to a different doc.   2. know that as an adult there IS much help for you.  3.  Read the ever popular book "Delivere3d from distraction and take the screening tests.  get another book and taqke their tests too.  you'll have a strong idea.  4.  your fam hx is an additional risk factor for sure.  5.  did you mean that you do have other doc choices?  take them.  Meds for adhd are VERY hard to get right for many of us.  it takes lots of perservence and experimentation.

How long are youj Japan for?  go to an OPEN (not closed) aa meeting IF you are willing to just listen.  The rec ommended book has a chapter o this idea.

 

Know that you are not alnone and are not at fault.

Post us as you find out more OK?

Best to you

Whether in Japan or good 'ol USA, it's a real crap shoot when it comes to getting the "right" doc the first try!  I brought a list of written questions with me for the doc, plus, I'd taken the W.H.O.'s checklist of ADHD traits and annotated it with my examples.  I had my wife do the same.  In other words---I did my homework (for a change!) and came prepared and ready to see if the doctor really did know ADD.   I suggest that you pick your own strategy, do your homework, and go back "loaded for bear" with your list of questions and topics to discuss.

Topics like: What's this doc's take on using medication for ADD?  If she does use them, what types is she familiar with?  How many adult patients is she working with??   Now, when I tried this, the doc was rather evasive--if I had to do it again, I'd be more persistent.  But I'd also be willilng to go with a doctor not having extensive experience in ADHD if they appear competent and open to working with you and learning along with you--so if that's your best option, don't rule it out just yet!

If this first doc isn't compatible, perhaps this clinic has another doctor familiar and qualified to help you?