[Storyteller.]

Disclaimer: I haven't been diagnosed with ADHD, so I'm far from an expert on the subject.

Unfortunately, ADHD is one of those conditions that tends to be overlooked or misdiagnosed if it doesn't present in a certain way, so it's not uncommon for the more inattentive traits to go unnoticed or be attributed to other causes (such as anxiety). It also means that finding someone with both the knowledge and ability to diagnose it can be tricky, so it might be worth looking into your psychiatrist's specialties to get a sense of whether he's likely to be receptive. Even if you do advocate for yourself here and it doesn't turn out the way you're hoping for, it doesn't necessarily mean you don't have ADHD and it definitely doesn't mean you should give up on trying to seek support.

That said, you'll likely have to demonstrate that your symptoms:

• have been present since before age 12
• are evident in multiple settings (work, home, school, etc)
• significantly interfere with your functioning/quality of life
• aren't better explained by another condition

To that end, it can be helpful to have specific examples of how these symptoms have affected or are affecting your life. Saying something like "I often forget things" will have less of an impact than being able to say "I forgot x thing and y happened as a consequence". If possible, it might also be useful to talk to people who knew you when you were younger and/or have known you for a long time, since they might be able to provide further examples or at least an outside perspective so you're not solely relying on self-reporting. In particular try to have examples for different contexts, e.g. your forgetfulness has caused friendships to deteriorate, your restlessness made studying difficult, your executive dysfunction forced you to leave a job. That way you can show that it's something inherent to you, rather than due to the situation you're in.

If you have the time and the inclination, you might also like to look up stories from people who have similar symptoms or experiences, particularly those with your AGAB and those diagnosed later in life. Knowing that other people have gone through similar things can be validating, for a start, but might also give you some ideas of how to navigate the diagnostic process. Depending on your psychiatrist's expertise/viewpoint you may get some pushback, so doing some research beforehand can help you counter that if necessary. If you're comfortable with it, you could also see if your therapist would be willing to talk to your psychiatrist about it, since sometimes mental health professionals are more likely to listen to other professionals than they are to listen to their patients.

In terms of your psychiatrist wanting to focus on decreasing self-harm, I'd recommend highlighting how these symptoms have been contributing to your reasons for self-harming. Obviously I don't know enough about those reasons to be able to properly weigh in, but it could be something like "part of why I self-harm is because of low self-esteem, and part of the reason for that is my issues with executive functioning". If you can directly trace a line between these potential ADHD symptoms and the behaviour your psychiatrist wants to focus on, it might make him more willing to hear you out and act on what you're telling him.

You could also tie it in to any goals you may have, in an "if I wasn't struggling so much with these issues I'd be better equipped to work towards my goals, which would increase my overall mental health and decrease my desire to self-harm" kind of way. Is there anything you want to achieve or work towards that the focus issues/inattentiveness/executive dysfunction is preventing you from doing? Would you feel more confident in striving for them if you were able to effectively treat the symptoms? If you show that you're thinking of the future, and that you want to work with your psychiatrist to achieve the same results (e.g. less self-harm), you can approach it from a collaborative standpoint rather than a potentially combative one (not that you advocating for yourself is combative, just that sometimes things can get tense if a mental health professional and their patient have different priorities/points of view).

Overall, remember that you know yourself better than anyone else does, and that one psychiatrist's opinion isn't going to change who you are or what you've been through. If he ends up being supportive and takes your concerns on board, fantastic! But if he doesn't, or if you have to fight for a diagnosis/treatment, that doesn't mean you're wrong or difficult or making excuses. Your brain's wired the way it is, regardless of what any psychiatrist or anyone else might say. I hope your appointment does end up going well, and that you feel heard and respected by your psychiatrist. If you're up to it, you're welcome to post an update after the appointment, I'd be interested to see how it pans out. Best of luck with it all.