I have questions for anyone with ADD diagnosed as an adult

[Beth in OH]

I've just finished reading Delivered From Distraction and would like to encourage an adult family member to seek evaluation. This person's quality of life has been affected, and I think ADD may well be at the root of it.

 

Where do we start? This person has already seen a family practitioner and been checked for thyroid, etc. The Dr. also prescribed medication for low level anxiety/depression. Dr. was less concerned about possible ADD, although I think the Dr. was perhaps beginning to peel back layers of issues. Rather than go straight to meds through our family Dr., I would like to pursue a more thorough eval.

 

For those of you who have experienced an adult eval, which professional did you go to? How long did it take to get in? Tell me about your experience, including warning me of any likely missteps.

 

Thanks,

Beth

[asta]

It is my personal opinion that psychopharmaceuticals should only be initially prescribed by a psychiatrist or neurologist (obviously depending on whether the problem is psychiatric or neurologic in origin). Once a person is stable on their meds, then (and only then) should a general practitioner write refills for said medications.

 

Diagnosing ADD is in the purview of either a psychiatrist or a neuropsychologist, not a GP. It usually involves a brief paper exam and a thorough discussion exam (an initial appt. should be an hour).

 

As far as getting an adult to treatment: good luck. Unless and until a person believes they have a problem (barring a court order given because the person is presenting as one who is considering immediate harm to others or themselves), it is near impossible to get appropriate treatment.

 

Good luck,

 

 

asta

[Beth in OH]

As far as getting an adult to treatment: good luck. Unless and until a person believes they have a problem (barring a court order given because the person is presenting as one who is considering immediate harm to others or themselves), it is near impossible to get appropriate treatment.

 

:iagree: In this case, the adult knows there is a problem and is seeking help. I'm merely hoping to guide this person in a direction that will avoid a potential medical runaround. Where should I look for a psychiatrist recommendation, other than the from our regular physician? I would like to make sure the Dr. is well versed in adult ADD as well as the related disorders that often present along with it.

 

Beth

[asta]

:iagree: In this case, the adult knows there is a problem and is seeking help. I'm merely hoping to guide this person in a direction that will avoid a potential medical runaround. Where should I look for a psychiatrist recommendation, other than the from our regular physician? I would like to make sure the Dr. is well versed in adult ADD as well as the related disorders that often present along with it.

 

Beth

 

A couple of things, first. Depression and anxiety can both present as a type of "scatteredness". In the depression realm, studies have actually proven that people suffering from depression will "drop" things out of their memory. Unfortunately, for people suffering years-long debilitating depressions, huge chunks of time may be simply lost (think: a mom forgetting a couple years of her child's life).

 

Anxiety, because of the physiological effects (increased heart rate, cascading effect on the hypothalmic/pituitary axis due to release of stress hormones) can also cause spots, both in memory and in the ability to move steadily from one task to the next.

 

That said, any psychiatrist worth their salt can diagnose ADD in an adult. They simply ask some simple questions about how the adult did/operated in school and basic situations as a child. This is the key, as a person who is truly suffering from a psychiatrically based attention deficit will have done so prior to puberty (the general theory is that it is genetic).

 

If the attention deficit is adult onset, then there are other things to consider, such as an underlying neurological issue, thyroid (which was already checked in this person's case), reactions to different medications, and environmental factors (stress from work, family, and basically anything else in the behavioral, rather than psychiatric, realm).

 

Different conditions generally arise at different points in a person's physical development. For example, schizophrenia is a condition that onsets in late puberty/early adulthood (18-22). Bipolar usually rears its ugly head at puberty's onset (though it has been found as young as 4 - and that is true, suicidal depression, not just someone who wanted to medicate rather than parent).

 

As far as finding a psychiatrist, there are a few different avenues. If you have insurance, your insurer will have a list of docs that they have pre-screened to insure that the doc is legal, has all their paperwork in order, etc. If you don't have insurance, and need something more on a sliding fee scale, your county health department should be able to refer you to a clinic that works on that basis (if they don't run one of their own). Most people don't realize that there are actually some really sharp docs and psych nurse practitioners working in county health depts. It's that whole "labor of love" thing.

 

You can also go to the American Psychiatric Association's website, find your state, and call the local branch. They will be able to tell you who, in your area, has what type of specialty (addiction, pediatrics, general psych, etc.). One thing to ask for is if there are any "psychopharmacologists" in your area. This is a type of psychiatrist who has done extra training in psychopharmaceuticals. They are generally better equipped to fine tune meds, as that, rather than "talk" is their focus. Just don't expect them to be incredibly personable - they may very well be, but they are very specialized (think: neurosurgeon), and tend to be brisk as a result.

 

Finally, don't be afraid to interview psychiatrists. Everyone in the mental health field has their own "angle". Psychologists come from different schools of thought and it comes out in their counseling techniques. Psychiatrists do also, and it comes out in how they treat patients.

 

Best of luck to you,

 

 

asta

[Beth in OH]

Thanks for taking the time to give such a thorough response! I feel affirmed in looking for a comprehensive answer, and now I have some direction on where to look.

 

Beth

[asta]

You're welcome!

:001_smile:

[Orthodox6]

You already have received on-spot advice. If it's ok, I'll add a couple of things from my experience of being diagnosed at age 46 (nearly eight years ago) with ADHD and two other dx's.

 

The "old school" (which includes the DSM-IV -- or is a new volume out yet?) insists that ADHD is impossible unless symptoms are present prior to age 7. Psychiatrists with more up-to-date information will tell you that sometimes the patient, especially if highly intelligent, all on his own develops coping skills which hide the ADHD from detection. Only when the individual finally ends up in a situation which is "just TOO hard", do the symptoms break loose and the ADHD become obvious.

 

That is what my diagnosing psychiatrist told me. Together, we "worked backward" and I recognized that the ADHD, as a crippler, broke loose when I entered a highly competitive university and, for the first time, struggled with academics.

 

As posted, depression often appears "comorbid" with ADHD. I had the major depression very obviously from early childhood on. If I were to belabour the point, I think it fair to say that some of the ADHD characteristics were present, just unrecognized by my parents and others -- the "blabbermouth" who spurted remarks simultaneously with their formulating in the brain, the inability to wait until it was my turn to speak, etc. . . . but one must remember my age, and that ADHD was not much discussed or noticed back then.

 

Hope all goes well with your relative, and that he or she finds good assistance. ADHD is NOT "fun", a "blessing", a "creative impulse", or any other such nonsense. It is horrible and destructive of ones life. More than one fruitful treatment avenue is out there.

 

Best wishes !

[Beth in OH]

Thanks for sharing your story--it sounds like it could have come directly from Delivered from Distraction. I am hoping that my family member will feel empowered by correct diagnosis. The issues have a name, and it's not laziness or underachieving. Your story is encouraging and hopeful!

 

Beth

[Orthodox6]

Glad that it was useful for you !

 

The book you reference is very good. I have the second edition.

 

If your relative is a woman, then I strongly recommend the books by Sari Solden, who writes with a focus on women with ADHD. Once I lent one of her books to my husband, who had not read very many pages before he asked if the author had interviewed me for the book !

 

Reading her books has been comic relief, as well as practical. My favorite memory is reading her discussion of how things just "stack up" (physically) in the household world of an ADHD woman. At one point, she mentioned things never getting put away. I howled with laughter, remembering the time that a friend came over, expressly to help me tackle the wreckage in the house. After she had put away all of the nonperishable groceries, which had occupied a couple of dozen paper grocery bags sitting on the kitchen floor, she determined that I now had thirty-four 15-oz. cans of tomato sauce. (Why? If you can't find something, you just go buy it.)

 

I know that I spoke harshly of living with ADHD. I meant what I said. At the same time, however, I generally stay tuned to the humorous side of all my diagnoses. Being able to laugh at things, when appropriate, is a major coping aid for me.

Edited May 15, 2009 by Orthodox6

[Beth in OH]

I strongly recommend the books by Sari Solden, who writes with a focus on women with ADHD. Once I lent one of her books to my husband, who had not read very many pages before he asked if the author had interviewed me for the book !

 

 

Thanks for the recommendation! I just reserved one of her books through my library system. I am learning so much!

 

Beth