This young Indonesian man came to us referred by a psychiatrist, in the referral letter it was written that he’s experiencing some psychological difficulties, poor sleep, mood swing, poor concentration, the diagnosis was dysthymic disorder.
When he came to the counter I can see his face in red and him in such an agitated mood, he said, “I’ve been trying to call you guys but something strange happened.” I told him to call us in front of us and so he did. There was indeed some weird sound coming up after he dialed, of course, as he called our fax numbers. So later he was registered and he took a sit, seemed to have calmed himself down listening music with his earphone in the waiting area.
He said his main objective to come to our clinic is to sort out his poor sleep and mood swing problems. He said even with medication from previous doctor, he can’t fall asleep deeply, he just doesn’t feel that he’s sleeping well. At one point he felt like he could no longer control his emotion. His appetite is considerably ok, acceptable as he said. But he said when he gets angry he feels dizzy in his head. The example he gave was the time he was coming to our clinic, but couldn’t find the place, and couldn’t reach us by phone (well, how to get to us with fax number, unless you’re sending a fax I suppose?). He said he was so angry and then he felt light-headed.
We don’t expect people to be flat in their mood (in fact being flat in mood is a negative symptom of Schizophrenia), so people can be sad, happy, angry, calm, depressed, elated… Yet his diagnosis was dysthymia, a disorder characterized by chronic, consistent low mood (just like depression, but less severe, more long-lasting). He didn’t appear so to us. He laughed when I joked. He was angry when he was frustrated. He managed to elaborate his problems with examples. He has interests- he listens to musics as he waits.
One main problem he has is his poor concentration, he’s a student. For a student to not concentrating, not focusing, not remembering, not memorizing, it’s like end of the world (especially if you do care about your studies!). He really wants to finish the study and graduate from it, as he doesn’t want to waste his father’s money.
So we’re suspecting Adult ADHD. I remember I got a copy of Adult ADHD scale just last week and was thinking “I won’t need this. Who’ll come to clinic for this problem?! Nobody.”
Now I realized one thing, it’s right, nobody will come for consultation and treatment for Adult ADHD. Not because nobody is suffering from it, but chances are it’s far under-diagnosed. If you look at the scale (Adult ADHD Self-report), you’ll realize people nowadays are likely to suffer from it (I can’t concentrate, I can’t sit still, I get distracted easily, I keep forgetting the deadlines, I feel restless…).
See here for more Psychological Rating Scales.