Howdy. First post here and I'm hoping to get some advice.

About 30 years ago, when I was 5, I was hit by a car and hospitalized with a concussion (probably grade 3 as I was unconscious for at least 15 minutes.) My family has said I had a drastic personality change, going from very outgoing and extroverted to very withdrawn, shy and introverted (which I still am to this day.) For a long time, I tried not to use it as an excuse for success or failures in life, but now I'm not sure sure. I hit most of the diagnostic criteria (no headaches, but definitely fatigue, sleep problems, concentration problems, personality change, etc.) I've been diagnosed with depression since I was a teenager. I was diagnosed with ADHD recently, but the symptoms definitely go back to when I was a kid.

Can TBI have effects that last decades? I'm getting to the point where it is harder and harder to function. Meds have helped control my depression, but my ADHD is out of control. I'm taking 90mg of Adderall today and that is still barely enough to let me be functional and productive at work. I can't up my dose and I can't take a "drug holiday" due to the nature of my business (I help run a small family business and am on call 24-7)

I made an appointment for a neurologist next month, but I'd like to know if I'm looking in the right direction. I feel like the cocktail of drugs helps get me by, but doesn't fill me with hope for the future. I know I should also see a psychologist, but the unpredictability of the hours of my business make that difficult (as well as being able to actually sit down, research and find one I like.) If so, does anyone know what hospital/clinic/etc the NYC and Philadelphia has the best PCS program? My wife got a recommendation for a neurologist in Columbia, but I'm not so sure his primary specialty deals with concussions.

Thanks!