$1700 and a Neuropsychological Screening Later…

I swear I’m not a mental health hypochondriac. Something is clearly wrong with me and I wanted to get to the bottom of it. Although I initially sought to find an in-network therapist, my insurance results were filled with doctors that no longer were covered or didn’t serve adult populations. When I found Dr. W., I was getting pretty hopeless and further depressed. Dr. W. didn’t provide weekly therapy – he offered neuropsychological testing for the low price of $1700 and, since he was actually covered* by my insurance, I thought, what the heck, might as well see if this would help me identify what’s really going on so I can attack those issues head on.

It’s rather frustrating to go through a neuropsychological test and to be told that it’s impossible to know if insurance will cover it because that all depends on the results of the test. Usually these tests are used for children or young adults who are struggling in school, so a part of me felt like this was going to be a huge waste. However, I wanted answers, and insurance may pay for this exam – or it may not – or it may go towards my deductible. Who the hell knows. By going through insurance at all I’d be adding one more pre-existing condition to my repertoire, meaning that once Obamacare is repealed and if I ever want to consult again for a living I won’t be able to get insurance. However, since I already have pre-existing conditions on my medical health history it doesn’t really matter at this point. I’m screwed either way.

The test consisted of a four hour screening including a life profile interview, IQ testing, attention testing, and mood disorder questionnaires. It did not include blood work or brain scans, but I felt the testing was relatively comprehensive. It’s goal was to break out all the issues to figure which comes first – the chicken or the egg – the depression or the distractibility – the anxiety or the depression – and if there are any co-morbid issues or cognitive impairments at play.

This week, I went in to the doctor to review my results. He seemed pretty astounded by my profile, which resulted in a diagnosis of Persistent Depressive Disorder with Anxiety. The most surprising part of the test was that I wasn’t (re) diagnosed with ADD. He explained that my ADD symptoms are just part of my depression.

The other very interesting / sad part of my test results was how poorly I performed on the memory portion. The doctor says this is due to the depression and self-doubt, but given I literally performed in the <1% for one part of the memory test, I’m concerned something more substantial is wrong with my mind. I’ve always said I have a bad memory, but this test proves it.

When the doctor went over the report with me, he highlighted sections in green regarding my “high average” or “superior” performance, and marked in red all the sections where I was clearly impaired. Most of the report was green — my processing abilities are extremely high, and I’m very good at anything visual (as long as it doesn’t require memory.) Then, the entire memory section is a giant sad block of red. The doctor basically said my profile was impressive because I’ve been able to do so well in life with these impairments (mostly the mood impairments causing the memory issues) and that it clearly has something to do with my IQ (which tested at 117, which isn’t brilliant or anything, but is still “above average” with some specific areas testing in the higher end of the population.

I’m not saying this to brag, it’s just interesting to see that my perceptions of myself are fairly true — I’m intelligent enough, but my working memory and short-term memory are major flaws in my mind’s design.

So what do I do with this knowledge? The doctor doesn’t offer follow up therapy, but recommended that I see a therapist who offers “Acceptance Behavioral Therapy.” I’ve probably done some of that before with therapists who haven’t called it that, but it sounds like something that might help. Of course, I’m back to the drawing board on finding a therapist who takes my insurance, only now I am looking for one that offers this specific type of therapy. He noted drugs may be effective–but as I’m trying to get pregnant now is not the time to start anti-depressants.

We discussed writing a letter to my work for accommodations but I’m not sure what I’d ask for at this point. Mostly I just cannot focus in an open-office environment and thus I prefer to work from coffee shops and home. With a new boss starting soon, though, that isn’t realistic. Meanwhile, everyone else in my office is there five days a week, so it looks very strange when I am not. I have a little bit of flexibility since I travel a lot for work so people may not know if I’m home or at a work event, but I really need to focus on more face time if I’m going to save this job, not less. I also hate making excuses for any failures. Plus, if I ended up having ADHD that would be an easier thing to explain to HR and my boss regarding the accommodations. It’s a lot harder to explain depression in a way that doesn’t sound like a total cop out.

Perhaps I should really focus on getting a lower stress job until I can get my depression under control. However, I don’t know what a lower stress job (that I could get) would be. Pretty much every job is stressful. Being able to context switch so frequently helps me focus on micro sprints of projects and when I am focusing I can get a lot done in a short amount of time. Any repetitive jobs will not only pay a lot less and be harder to get at this point in my life, they also will likely not arouse my mind in the way required to keep it focused and not making careless mistakes.

Work is really a struggle right now. I made my “year,” which feels somewhat good given I didn’t think I was going to last this long, but now I’m in quite the state of limbo. My boss, who had told me that I’d be involved in the process of hiring my new boss, flat out lied to my face, and has been having all of my peers interview candidates while I’ve been kept out of the entire process. The sad thing is I understand why this is the case (my boss is worried I’d say something too honest and scare away the good candidates / he doesn’t think I’m polished enough to put in front of these high level folks until they sign on and then they can decide if they want to keep me or not) – but I’m just really upset but how this whole situation went down. The open calendar didn’t help – it made me obsess over this situation that my boss clearly doesn’t care if I know about but doesn’t want to deal with any conflict around telling me what’s going on. I’ve been able to bring the topic up organically in other conversations and at that point he’ll admit to what’s going on (in this case, my new boss has a job offer and they will be accepting, or not, by next week.) Thus, my first interaction with said new boss will be on his/her first day of their job. They clearly already have some idea of the team and what they get to work with, and I have no idea what they’ve been informed about me or my team. I can only imagine that they will take one look at my salary and output and decide to replace me as quickly as possible. My only saving grace is that I’ve been doing better at achieving my agreed-on goals so perhaps that will save me for a little while longer. But I don’t want this new boss of mine to be bitter that she has to keep me for longer than she wants to. I really feel like I need to start aggressively looking for my exit route…

I just don’t want to jump into the next thing I won’t be able to do well. I’ve turned down one job offer for a similar title and lower salary, just because it didn’t feel right, and I backed out of interviews for a manager level role in a small company because it felt like it would just be rehashing more of the same with much lower pay and a lower title. I’m in interviews for one very senior role that I actually think I could get if I worked my ass off to make it happen, but I also feel like that is a bad idea as now is not the time to move UP in my career either. In fact, everything points to the best thing to do is nothing at all. It’s extremely difficult to removing my ego entirely and focus on earning my keep – but that’s what I have to do if I’m going to stay. I need to make sure that I’m producing in value at least how much I cost as an employee, otherwise they have ever right to kick me to the curb.

Thus, I need to provide about $20k in value per month (salary + benefits, etc). I should provide more value than this — but basically every single day I should be making the business $1000 in value, or ~$130 an hour. If I’m not doing this, than I owe it to the company to walk.

It’s impossible to really figure out what value I’m bringing the business, but I generally know the value of specific contributions so I can break it out that way. As a manager, I’m not sure how to quantify my value, as I’d have to include my team’s salaries and such and then determine a total number and value, but they may end up adding more value than I do – if that’s the case I still should not stay. I’m not sure how to measure my value, but I need to in order to have the right conversation with my new boss who is probably going to think I’m overpaid for my current “demoted” role. Hopefully she/he is making a lot more than I am so it still seems like a significant step down to my salary bracket (i.e. if they are making $300k or even $250k then I think I’m ok – and I can’t imagine they are making much less given how qualified and senior these candidates are they are trying to hire.)

Anyway, what I really need to figure out is what’s up with my memory. I tried really hard to do well on the test and I did do well on many parts of it – but every single memory test was shot. Even my visual memory was bad (I had to look at a paper with 6 shapes on them and then redraw those shapes after the paper was taken away) and I could not for the life of me get that right. I was frustrated because I’m otherwise really good at visual-type things. I was extremely frustrated and sad to prove that my memory really isn’t normal. It’s extremely impaired.

At this point, I want to focus on trying to provide $60,000 of value to my company this quarter. I won’t be able to measure that effectively but I can get some idea. I’ll know this by having a boss that is happy with my work and who isn’t actively planning to fire me or waiting for the ideal moment to let me go. That would be success through the end of February or March. Then I likely need to move on. But I need help. I’m stuck in this state of depression and it destroys my mind-my concentration, learning ability, and focus. I really, really need help.


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One comment

  1. Christine says:

    Hmmm…. i need to find someone who can do a Neuropsychological screening for my child and I. My daughter has terrible working and short term memory. It definitely affects her schooling .

    thank you for sharing your results. as for therapy, I pay out of pocket but using my pre-tax health acct. although I have found insurance coverage therapist (pretty darn good one) in the past. I used psychologytoday.com to find her.

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