A few weeks ago I mused about my remaining active, not total, lifespan. As I was pondering the second half of my life, I also thought about health and fitness, which I briefly mentioned in that article as well. This was part of a bigger personal project during which I took stock of my health, starting with a proper assessment of the status quo, and following up on every potential issue. I will briefly go through this, and afterwards describe the sometimes lengthy sessions I had with a psychiatrist as this is probably the most interesting aspect for you.

As a starting point regarding your health, checking your height, weight, blood pressure and resting pulse are probably sufficient. For a more through, data-driven approach, though, you will have to go to a doctor. I asked for an electrocardiogram (ECG) as well as a full blood screen. All my values were great so there was no immediate issue to take care of. However, there were a few other observations about my body I wanted to clear up. First, I sometimes have a tingling sensation in the fingertips of my right hand. It took me six months to get an appointment with a hand surgeon, but now I know that I was right at the border of developing carpal-tunnel syndrome. For a few months I have been wearing wrist braces at night, and this has helped a lot. There is a test regarding transmission speed of your nerves. According to the last assessment I have done, my values are optimal, not just optimal for my age.

Another minor issue was that I sometimes get a headaches, really quite rarely. I was curious to see what would happen if I approached a doctor about this. They seem to have different approaches. Some just start talking about various kinds of medications they could put you on, but another doctor said that I could consider getting an MRI of my head done. This is a noninvasive procedure, so it cost me only time. There is nothing wrong with my brain, according to these images. I was not really worried about it, but I found it nonetheless reassuring to have a neurosurgeon tell me that my brain looks fine. On a side note, I surprised by how far this branch of medicine has evolved. The level of detail in these images was impressive.

There was another open question I had about myself. In the past, we have spoken about Asperger’s and I sometimes even wondered whether I meet the diagnostic criteria. Well, as part of this project, I thought I should get a professional to make this assessment. I looked for a competent psychiatrist, i.e. a white, middle-aged man who seemed to have a great professional standing as opposed to some shady pill pusher. Honestly, I had not idea what I was getting into, but I was very open-minded. In my first visit, we just had a very open conversation. I told him that I have been wondering whether I have Asperger’s. He clarified that this is no longer a diagnosis that is being used. Instead, the overarching term is autism-spectrum disorder. He asked me why I thought this applied to me and he also asked a few questions about my personal and professional life. He quickly narrowed down the potential diagnosis, stating that if I am on the autism spectrum, it can only be at the highly-functional end of it. He also remarked that it is rare that highly-functional autists are married and getting married a second time, as I have done, would be even rarer. Nonetheless, he humored me and put me through a pretty high number of tests.

I saw this psychiatrist multiple times as he took the diagnosis very seriously. More importantly, he pointed out that he also wanted to check all relevant comorbities, so I would have to commit to a somewhat lengthy process. The foundation was some physiological assessments, e.g. an ECG, an ultrasonography of the blood vessels in my neck, an MRI of my brain, and a full blood screen. Then there was a battery of psychological tests, some of which were quite interesting. These were standardized tests. One was on identifying emotions, based on faces and body language of a single person as well describing actions of two people in an image. I found some of these to be genuinely difficult. One image showed a guy raising his hand at a frightened woman, and the pretty non-politically-correct question was whether he wanted to hit or merely intimidate her.

There were also tests to check whether I am depressed or suicidal, or whether I have any phobias. As I later learned, if you you score poorly on the suicide test, you will be quickly put on a different track. These tests were done via questionnaires. Obviously, it is in your best interest to answer truthfully. My psychiatrist also asked me whether I had done any IQ tests, and as I had, I brought him copies. In addition, he wanted to see my school reports as well as degree transcripts. The most time-consuming request was writing a somewhat detailed biography for him, in which I should present a narrative account of my life and highlight any challenges I have faced.

To be quite honest, had I known, after the first visit, how much time all this would take, I am not sure whether I would have followed through. As the saying goes, in for a penny, in for a pound. I was also very impressed by how thorough this guy was, so in the end curiosity probably got the better of me. He also did an ADHD assessment. I am not hyperactive, at all, but I am a borderline case for the attention-deficit-disorder part of ADHD, so he brought up medication as a possible treatment. Here, I have to say that I was genuinely surprised about this outcome. As it turned out, I engage in so-called masking behavior to structure my days and get things done. Before getting a prescription, I had to get the aforementioned MRI, though. We also had a conversation about any addictive tendencies I might have. The outcome was that he said he would recommend that I try 10mg of methylphenidate and see if it helps. Most impressively, he did not push this medication on me at all. Instead, he said I should read up on it, perhaps even look at a few scientific studies, or talk to people online or in real-life who use it. I sat on this decision for a few weeks, and even after I had gotten my first prescription, it took a few more weeks before I finally opened the pill bottle. These days, I take it semi-regularly, and I find the effects genuinely helpful.

This was my journey to get a prescription for methylphenidate. It was not even my goal. Instead, I only wanted to know whether I have Asperger’s. My understanding is that a good psychiatrist will check for comorbidities, so even if you ask for an ADHD diagnosis, you may have to go through quite a few tests. That being said, my experience is from an advanced Western European country. I have also read about psychiatrist in other countries where you just have to ask them to give you a prescription. I would not feel comfortable with such an approach, just as I would not recommend methylphenidate if you do not have any ADHD symptoms. The effect of this medication is apparently different for regular people, who may experience a high — it is referred to as “euphoria” in medical literature. This does not happen to me at all. I also do not experience the side effects I have seen in people I have good reason to have gotten methylphenidate via illicit means, such as excessive talkativeness or some bizarre scatterbrained hyperfocus where their mind jumps around like a ping-pong ball among topics of interest. The people I am thinking of are at best moderately intelligent and resort to such drugs in the hope of boosting their intellectual performance. These pills do not make you smarter, though. However, if you are someone who craves constant intellectual stimulation, so much so that you get bored easily, then maybe have a conversation with a psychiatrist about ADHD, and if you engage in masking behaviors to structure your day, apparently you almost certainly are at least a borderline case.