do I have ADD ?

Ok, seriously I know that you folks don’t know me but in an attempt to explain myself:


I am constantly figety (i can’t keep still at my desk or at the movies, or even talking on the phone at home)


I have alot of nervous energy all the time! can’t stop moving around and moving my leg back and forth (girlfriend has noticed this when i’m sleeping) or when she’s “trying to sleep”


I can’t seem to focus on anything. tried to read first chapter of chemistry the other night- after a few pages I get very anxious and want to get up and move around.


My job is probably the worst for someone like me. they’ve got me as a project manager for multiple projects and I can do enough just to keep up with one at a time.


I really want to learn but I need ALOT of focus


i’m thinking of going to my doctor and letting him know what I’m about to undertake and if he can recommend anything to help me. as the doctors or soon to be doctors here… what do you think? and do you know others or yourselves who have had this before and if so… did medication help? would it be helpful for someone who really needs it in a situation like this- attempting to get into med school and beyond? Thanks- I feel like I’ve been like this all my life but am just not realizing that medicine might help me. (I guess maybe I’m my first diagnosis… YAY!!!)

It’s probably most helpful to think of things like ADD as being on a spectrum, rather than you either have it or you don’t. Self-diagnosis of ADD has been going up lately because of some popular (including some genuinely helpful) books about adult ADD. And I think there is a wide range of different modes of attention and focus and executive function. What part of that range we call ADD and what part we just call normal variation is a moving target.


The plus and the minus about how we think about ADD these days is that the diagnosis is expanding to people we would have called normal variation in past decades. That’s good because some people may find the diagnosis helpful; it’s bad in that it creates the false suggestion of an expanding disease rather than an expanding concept.


I would not go to a normal primary care physician about this, and I say this as a future primary care physician. Consider seeing a psychologist and/or a psychiatrist. One of the very important and often subtle things for a clinician to evaluate is whether your behavior is consistent with ADD or something on the bipolar disorder spectrum (again, it’s a spectrum, with variants). This is an especially important piece of differential diagnosis because medications you might take for one can be unhelpful or even dangerous for the other. The difference between these two things is going to be tough for your primary care physician to tease out effectively, unless you’ve got someone with a real interest in psychiatry. In that case, you might as well go to a psychiatrist anyway, I think.


It also sounds like you are starting to get overwhelmed by job and school; while you’re getting evaluated figure out everything you can do to cut down on the stress. Cut out extraneous stressors. And get as much sleep as possible; stay well-fed; do things that make you feel happy and confident. These things are useful for people with ADD (or bipolar disorder), and people without it.


Medication can help, and actually I do know of several medical students who are taking medication related to an ADD diagnosis. However, medication is only a small part of dealing with this if you’re going to go into something as structured and ordered as medicine. I really do recommend getting specialized evaluation about your learning and attention, and then making a plan based on that evaluation. You may have other learning disabilities that you are not aware of.


I would also strongly urge you not to start with the medication but start with the assumption that you don’t want to take medication and figure out what kind of behavioral steps you can take first. Then start thinking about medication after that. The many medicines used to treat ADD all have some things in common: they all have side effects, and they are not cures. They are blunt-weapon instruments to flog what are probably really subtle and complex variations in how our brains process stimuli, acquire information, and pay attention to things. Some of them can be very helpful to some people, but there is no free lunch. So take this one step at a time.


Finally, on the one hand I want to encourage your enthusiasm for making a diagnosis!–but on the other hand, all diagnoses are provisional. You should try to prove a diagnosis true or false by considering all reasonable alternatives and weighing them against the diagnosis, before accepting the diagnosis as true. (As in the above example where, as your clinician, I’d want to prove that you DON’T have bipolar disorder before I’d want to try to prove that you DO have ADD/ADHD.) This is an important process for any diagnostician, including self-diagnosticians. And this kind of thing is really difficult–I think it calls for some expert consultation and help. (That’s why psychiatrists and neurologists have longer residencies than internists–the brain is freakin complicated. I learned that in med school–pretty good, huh?)


Good luck!


joe

You might want to try meditation. I’ve found it increased my ability to focus. Also, I’ve had great success using these recordings on headphones while studying, sleeping, and meditating.


If you feel too physically restless to meditate, an alternative for you might be a moving meditation such as Tai Chi, Chi Gong or yoga.


You might also try cutting back on stimulants such as caffeine and sugar. I found that a low carb diet freed me from the sugar high/crash cycle that I used to experience several times a day. Switch to organic vegetables and naturally raised meats, in case you are reacting to some chemical. Likewise, check out the plastics around your home, office, and car, in case you’re allergic to some smelly substance in your environment.


Just some ideas to try. Best of luck,

Not to make too light of something that rightly concerns you, but I can’t let it pass entirely…


One of my plagues is to be cursd with a bad sense of humor and to always connect to the bad joke I heard that relates in vague ways to the topic:


so here goes (At the risk of being thought hoplessly insensitve)


How many people with ADD does it take to change a lightbulb?


ans





Lets ride bikes


(but seriously – the suggestions offered above were excellent)

NO WORRIES, LMAO


I am the local poster boy and advocate for ADHD!


Yours,


Richard

Greetings,


I started to elementary school in 1968 and graduated high school in 1981 (the year after ADHD was added to the DSM-IV). By hook or by crook, I “discovered” many of the behavioral strategies to maximize study effectivness over the years. These certainly reduced the consequences of ADHD as an adult (I finished an AD nursing program over 4 years), but IN NO WAY eliminated the effects and consequances. Finally at the tender age of 39, at the start of my second undergraduate year, I got in over my head with the course load. I went in for tutoring (one of the strategies) since I am an inveterate “waiting room reader”, “All about your herpes diagnosis”, “Your first pap smear”… you get the idea. THIS day I picked up an “information sheet” dealing with ADHD.


I first read the “study techniques”, guess what? “Damn, I INVENTED most of these and look I am not cited anywhere…” “HOLY crap look at that list, man I OWN 16 of the 18 here; you mean people CAN actually listen to a whole lecture?”


OK there are several criteria for diagnosing adults, one of the first and persistent with several revisions (AAFP guidlines)is the Utah criteria developed by Dr Paul H. Wender MD (the one that I was evaluated with).


Having been the focus of some media attention, (post #47248) I found myself in the position of interacting with a boatload of VERY worried parents, so with the guidance of both KU psychology and psychiatry faculty, I put together a paper (extra credit on psychiatry clerkship) with my story with current information and guidlines intermixed. The following are some pertinent snipits which I shall share with you. I have the references and will be glad to forward a copy of the entire work to you, just drop me a note!


“The difference from the DSM-IV is that the Utah criteria include the emotional aspects of the syndrome. The episodes of hot temper, typified by frequent angry eruptions out of proportion to the precipitants, often “blow over” more quickly for the patient than for coworkers and family members. Affective lability is characterized by brief, intense affective outbursts ranging from euphoria to despair to anger, and is experienced by the ADHD adult as being out of control.”


“Diagnosis of ADHD in adults necessarily places emphasis on two critical factors: documenting childhood onset and examining for other psychiatric disorders. The first step is particularly important, as a diagnosis of adult ADHD cannot be made in its absence. Obtaining a history from the patient’s parents or examining old school or medical records is critical".


“Deficits in sustained attention and concentration are likely to remain and may become more apparent in late adolescence and early adulthood as responsibilities increase. Appointments, social commitments and deadlines are frequently forgotten. Impulsivity often takes the form of socially inappropriate behavior, such as blurting out thoughts that are rude or insulting. While many of the symptoms are reported by others in the patient’s life, the problem often expressed by adults with ADHD is frustration over the inability to be organized.1 Prioritizing is another common source of frustration. Important tasks are not completed while trivial distractions receive inordinate time and attention.”


The best thing to do, is examine the above, in my case, I found my old elementary school report cards, from the FIRST day they were simply LOADED with stuff like, these (just a sample) are all DIRECT quotes:


“Richard daydreams”,


“Richard does not pay attention in class”,


“Richard talks out of turn”,


“Richard can be disruptive”


“Richard does not turn in (or even do) homework”,


“Richard is very bright; he masters complex concepts easily but does not seem to be able to follow through”,


“Richard is very smart but he continues to demonstrate rather disappointing progress”.


“As with children, stimulants are the first-line treatment in adults, except when the ADHD patient has an active substance abuse problem. The physician should treat the patient with stimulants (i.e., amphetamine mixed salts [Adderall], dextroamphetamine [Dexedrine], methylphenidate [Ritalin]) before trying the nonstimulants (i.e., tricyclic antidepressants, bupropion [Wellbutrin]). Adults with ADHD may also benefit from cognitive behavior therapy, provided it focuses on developing higher-level organization skills. Spouses may benefit from therapy that suggests what they can do to help organize their distracted partner.”


Dig around and get the documentation then get a referal to Psychology/Psychiatry. The simple generic drug methylphenidate changed my life. The difference for me was evident by THE SECOND WEEK, it took me about 13 months to get the doses tweaked just right (I have not had a change from that in 5 years). It was like the appreciation nearsightedness and POOR vision ONlY when one gets glasses.


Yours,


Richard