Hi! I believe I can be of help with this issue.
I can imagine how frustrating this situation must be for you. You are clearly capable young person and instead of this being the most exciting time of your life, it's full of anxiety. You're 19 and this should be the time when you're flowering and life is full of potential. And that it isn't is a shame and I'm sorry you're going through this.
There are 3 main possibilities going on. So you need to start with having them assessed and evaluated, okay? Let me present them in a methodological order for diagnosing by ruling out possible disorders. They are first, a neurological/cognitive issue; second, ADHD; third, an anxiety disorder or some other mood disorder.
Please don't be scared by these disorders. You're at the age where they become most easily diagnosed. The treatments today are much more advanced than in the past.
You need to be clear with your doctor. That's your first stop. You need to say in a complete and straightforward way all your symptoms. You need to then be referred to a neurologist or neuropsychologist for neurological and cognitive issues. This is something that needs to be ruled out. Most likely, there is no neurological issue, but again, it needs to be ruled out diagnostically.
Then comes ADHD. Let me paste in for you the diagnostic criteria for ADHD. This is what would be used by the psychiatrist to evaluate and diagnose your situation. Psychiatric diagnoses are based on rather subjective criteria. After the neurological exam, this would be the next problem to rule out or confirm. This may be more likely as a diagnosis.
If so ask the doctor who he/she would refer someone to if it was their son/brother. You want not just a psychiatrist from the insurance list but someone who is very highly regarded in adult ADHD and adult anxiety disorders. Because you are interested, tell him or her, not just in medication but in getting the best treatment options available related to you and the correct diagnosis made.
Then you need to work with the psychiatrist not just on medications but repeat the same process with the psychiatrist. What psychologist who is highly regarded in working with adult ADHD or anxiety disorders (if that is what is diagnosed) would he/she refer you to if you were his/her son/brother? The idea again is that you want to not just get meds and be left on your own to deal with your problems. You want to be given tools, techniques, and insight into how to manage and deal with your problems. You want someone who will oversee the progress of the treatment. And that is a psychologist.
If ADHD is ruled out, then you need to explore an anxiety or mood disorder being present. This would most likely be done by the same psychiatrist or psychologist as above and very often in the same evaluation. So that makes it easier.
So, this step by step process is important. It is how you as a patient can take charge of your disorder and make sure that as a young man you are getting what you need from the professionals. Okay. I wish you the best and the DSM-IV criteria will be at the end.
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Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder
A. Either (1) or (2):
(1) inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
(a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
(e) often has difficulty organizing tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities
(2) hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often "on the go" or often acts as if "driven by a motor"
(f) often talks excessively
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or games)
B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.
C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.