6 Aug 2020

Klein EJ. Psychol Serv 2020; Epub ahead of print

In this personal narrative, Edwin Joseph Klein, a graduating medical student and incoming psychiatry resident discusses his own diagnosis of and treatment for ADHD, including the impact of the disease and the stimulant medications used to treat it on his education, career and personal life.

Klein first sought help when he began to fall behind with his studies at medical school and admits that he initially dismissed the diagnosis, believing that he was “too smart” to have ADHD. However, on reflection, he realised that his symptoms had started a long time ago and had gone unnoticed when he was younger because he did well at school, completed his work quickly and appeared to listen. Because his symptoms are considered “predominantly inattentive“, rather than hyperactivity, he did not fit the stereotype of an unruly child with ADHD.

Klein goes on to explain that he was diagnosed with ADHD during the first few months of medical school, after he had difficulties passing the first few courses. He then began treatment, but he was worried about the potential dangers associated with the stimulant drugs that he was prescribed – as the stigma of the abuse potential of such drugs was well known. However, he clearly appreciates their effectiveness in treating his ADHD symptoms, and commented “I feel clarity … a stilling of the flurry that typically clouds my mind”.

Once his symptoms were being adequately treated and he began to excel in his studies, he then began to fear that his sense of self was “becoming distorted by feelings of drug-induced competence or confidence”. Indeed, he even began to question whether his passion for psychiatry was drug-induced. However, when an abrupt change in his medical insurance meant that he lost coverage for the medication that he had been taking for over a year, he began taking old prescriptions with different dosages or different formulations or even skipping doses. He found that it was much harder to focus and complete notes quickly. Even though his undertreated condition was clearly a barrier to his success, he realised that his passion for psychiatry was still apparent even without effective medication.

Although Klein’s personal experience as a patient gives him unique insight into issues such as the side effects of medications and enables him to empathise more deeply with patients, he admits that the stigma associated with mental health conditions is a barrier to him disclosing his diagnosis and asking for simple accommodations to manage his learning disability.

Returning to the subject of stimulant medications, Klein acknowledges that although the medication works and improves his ability to focus, he does worry that his ability to “not focus”, including his humour and spontaneity, has been diminished. However, while he occasionally feels nostalgic for distractions, he recognises the immense joy that comes from his work, his relationships and his life when he is able to pay attention.


Read more about a future psychiatrist’s perspectives on ADHD here

Klein EJ. When the edges blur: a future psychiatrist’s perspectives on attention-deficit/hyperactivity disorder. Psychol Serv 2020; Epub ahead of print.

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