When the edges blur: A future psychiatrist’s perspectives on attention-deficit/hyperactivity disorder.

Abstract

A graduating medical student and incoming psychiatry resident reflects on his diagnosis of attentiondeficit/hyperactivity disorder (ADHD) and his treatment for this condition. He also examines the impacts of ADHD and stimulant medication on his career, education, and personal life, as well as the impacts of individual and systemic mental health stigma on mental health care providers as prosumers. Impact StatementThrough personal narrative, a soon-to-be psychiatrist discusses his own diagnosis of and treatment for attention-deficit/hyperactivity disorder. He also discusses the stigma associated with mental health conditions and the barriers it presents for health care providers seeking and utilizing mental health care. This piece serves to demonstrate the impacts of personal mental health diagnoses and stigma on mental health providers' careers and lives.

Attention Deficit Hyperactivity Disorder in Medical Learners and Physicians and a Potentially Helpful Educational Tool

“…First, it is possible that a significant number of medical residents and practicing physicians with a confirmed diagnosis of ADHD do not report having this diagnosis out of fear of being stigmatized or scrutinized by colleagues or supervisors, or because of concern about legal or licensing ramifications. 38,39 Second, many medical residents and practicing physicians, despite https://doi.org/10.2147/AMEP.S398196…”

“…42,43 Fourth, as with many mental health conditions, significant inter-and intra-individual variability affects assessment of severity and functional impairment of ADHD symptoms, 44 and many medical residents and practicing physicians, prior to medical training, may have compensated for ADHD symptoms by relying on strong intellectual ability, the flexibility of teachers/professors, the support of significant others, and selected areas of study or activities that either provide a level of structure protective against academic, athletic, or social floundering, or are sufficiently void of tight deadlines and/or the need to regularly prioritize or multi-task that goals are achieved successfully despite the presence of inattentive symptoms. 38,40 These compensatory mechanisms then become challenged when the volume and complexity of material to be learned and applied increase dramatically during medical training. 38,44,45 Finally, although varying across studies, reported prevalence rates of ADHD in medical students 27,28,[30][31][32] are comparable to rates in the general adult population, making a precipitous drop (on the order of 10-15 times less) in such rates among residents and practicing physicians difficult to reconcile.…”

“…38,40 These compensatory mechanisms then become challenged when the volume and complexity of material to be learned and applied increase dramatically during medical training. 38,44,45 Finally, although varying across studies, reported prevalence rates of ADHD in medical students 27,28,[30][31][32] are comparable to rates in the general adult population, making a precipitous drop (on the order of 10-15 times less) in such rates among residents and practicing physicians difficult to reconcile.…”

“…First, it is possible that a significant number of medical residents and practicing physicians with a confirmed diagnosis of ADHD do not report having this diagnosis out of fear of being stigmatized or scrutinized by colleagues or supervisors, or because of concern about legal or licensing ramifications. 38 , 39 Second, many medical residents and practicing physicians, despite long experiencing symptoms of ADHD, may not seek formal evaluation and treatment for these symptoms, either because of lack of recognition by themselves, family members, or friends that these symptoms represent ADHD (eg, symptoms are exclusively attributed to personality traits or are dismissed because the individual was accepted into medical school) or an internal belief that as a future or current medical provider, having a neurodevelopmental disorder warranting treatment is unacceptable. 39–41 Third, even when medical residents and practicing physicians do seek evaluation and treatment for ADHD, they may face resistance by mental health providers to diagnosing and treating the condition due to cognitive and affective biases on the part of psychiatrists about prescribing medications like stimulants.…”

Clinicians with lived experience of mental illness: Introduction to a special section on prosumers, in honor of the late Dr. Fredrick J. Frese III.

“…The last article is from the perspective of a student. Klein (2022) discusses his experience of living with Attention Deficit Hyperactivity Disorder (ADHD) as a medical student and future psychiatrist. The tension between focused discipline and constant distraction had long been a part of his life, but became an issue when his education became much more challenging as a medical student.…”