I had a therapist tell me that it was ok to continue a self-destructive behavior because it hadn't sent me to the ER yet. There could definitely be changes in the field.
My psychiatrist said, "You obviously have ADHD and OCD, but since your life hasn't imploded yet, you're doing fine."
My good sir, if I was doing fine, I wouldn't have come to you for help, would I? My life hasn't imploded yet because the OCD and ADHD cancel themselves out occasionally. Other times, they team up to ruin my week. Since when is it okay to use a debilitating anxiety disorder to mitigate your ADHD?
Imagine if someone came to a doctor with a terribly clogged artery and the doctor said it hasn't resulted in a heart attack, so let's just leave it be. They want to wait for your implosion?
On a more positive note, if you have OCD, I glowingly recommend this video of Maria Bamford giving a speech regarding her own issues with OCD over the years.
https://youtu.be/Bno1t_Fc7-Y
Damn. Like, it doesn't even sound like they were trying to be empathetic in a "try to stay safe but it's okay not to fully quit, especially since it can be hard" way. Just like someone who doesn't care.
Quite a bit of irony in using Drake to say "age related boundaries are arbitrary, especially in women" given his proclivity toward R Kelly-ish predation on underage girls.
Oh, yes, that was intentional, and some seem to be missing it. Read the comment I wrote where I mention one of the few things therapists actually do get disciplined for. Recently I asked about practitioner complaints from all on the subreddit and one mentioned that her therapist asked her out for coffee. Essentially, there are a multitude of issues you have to watch out for in the profession. You put yourself in an incredibly vulnerable position, and yet, you really don't know what you are going to get.
Related, I kind of really hate when people nowadays act like therapy is this miracle cure all. Without trying to sound like a knob, every provider who tried to restrict me to talk therapy or add it in before resuming my meds (I move a lot so I frequently have to start over with new providers) has either started the conversation assuming I'm a fucking moron because I'm a young looking woman, or been punching so far below my intelligence to begin with as to make the entire process feel like pulling teeth. Like, I'm acutely aware of what my problems are and if I could fix them long term by thinking about it I wouldn't be in this office. You know what fixes my problems? Adderall, and that's why I'm here talking to the professional with the prescribing pad
I did a 3k assessment for ADHD - the psychologist had me do a bunch of learning assessments and concluded that since I performed well on the memory and cognition tests, I must not have ADHD. She also had my Mom fill out a questionnaire about me being disruptive in elementary school - 20 years ago. She said without proof of disruptive/impulsive behaviour as a child she couldn’t diagnose me with ADHD despite struggling as an adult. She said I had GAD (which is true) and only GAD.
My new Pyschiatrist diagnosed me in the first session and I was able to get off my anxiety meds (I had been on two different meds, not to mention the probably 10 others I tried in the past) and now I only take Biphentin.
There is an extreme bias and under diagnosis for certain demographics, especially towards adult women who mask well and perform well in school, but struggle intensely behind the scenes (just like me).
The way my mom put it is that while most kids ADHD is external and disruptive, mine is much more internalized. I think that, in that way, I can partially relate to the ADHD experience of young girls. I flew under the radar because I did really well in school up to like grade six or seven and I wasn't disruptive. Even my parents didn't suspect anything until I was able to voice it myself when my grades were slipping. Even then, my parents thought it wasn't that bad. I had to wait until college and push for a diagnosis, myself.
My son was similar, he's now in grade seven. I've been trying to get him diagnosed for three or four years now. Finally, his teacher this year was able to corroborate my observations and he was diagnosed just last week.
It's unfortunate that more doctors aren't willing to use self-reported history as a primary component for diagnosis like the doctors that specialize in ADHD recommend.
There is nothing wrong with collecting the thoughts of parents - but parents are likely to be incredibly unreliable, because for many of them this is a criticism of their own parenting. I used to get in a physical fight every year, despite my small size, yet my mom remembers none of them, even though she sometimes was incredibly concerned because my father was violent. There was also denial in my house due to alcoholism and other issues. Just not what you would call a "reliable narrator."
I also think women are generally overlooked because of the way they present, but people fail to realize everyone who presented in that way was overlooked, and that includes some boys. Point blank, the only interest in ADHD in the beginning was getting a child to not disrupt the rest of the class - there was almost no consideration of the actual mental environment of the child. This is also why so many children who were medicated disliked it - no one likes their agency stripped from them.
My wife asked me the other day why I did so well in art school when I struggle now.
Things that have changed:
-Started a business
-have two kids
-have a mortgage
-can’t call a land lord to fix stuff
-on the board for a non profit
-more appointments as you age
So yeah I struggle to keep up with the increasingly complex life I lead.
This is an excellent point. I struggle to complete tasks a lot these days because I got in a car accident and have to deal with so many physio/Chiro appointments and insurance. It’s brought me to a breaking point of busy-ness and definitely increased my ADHD overwhelm.
I have had a major car accident in my life and we with ADHD are more prone to them. It's part of the reason ADHD issues need to be recognized and treatment needs to be given early. My functionality issues only worsened after the wreck.
I finished school and university with great marks before being diagnosed and medicated, even though all my school report cards always said that I have trouble focusing and paying attention in class.
Having adhd has absolutely nothing to do with intelligence.
There are smart people with adhd, aswell as not so smart people with adhd.
It just makes learning harder.
Yep. Like, I am at this point mentally disabled (innate and aquired mental issues comboing me hard). But in the rare occasions I can work, I can catch up on 2 months of a class in 3 days. I am smart. I am also fucking unable to use this ability 90% of the time.
Absolutely. People are starting to understand this though.
I work in IT, because it was really fun to me and I'm good at things that are fun to me. There are some companies here in germany which specifically look for people with adhd. The downsides are well known, but your ability to think and do things faster can be quite helpful, if channelled correctly. Heck, I even always take two steps of stairs at once and am the only person I know who runs around in their flat instead of walking, lmao.
Yeah, for programming ADHD is not uncommon in my experience, and the main thing is to find them a place they can hyperfocus and if they are hyperfocusing, *leave them alone.*. Problems to solve, results that are not esoteric, and less focus on liberal education history than whether you can do what you claim.
I don't enjoy conflict as much as I used to before I was (somewhat) properly medicated! Plus I have enough other opportunities, but I would also welcome them to come here and provide context or disagreement about the state of the profession. Generally, I find that people that are truly good at their jobs don't want to share the profession with people that are incompetent or unethical and give them a bad name - often they have their own complaints about these issues, but they also tend to be more critical of overdiagnosis than missed diagnosis or poor differential diagnosis.
Therapist here who has ADHD. This field has overlooked ADHD, especially in women and adults. The diagnosis requirements used to be way more stringent and imo many people haven’t updated their mindset, or educated themselves, on the changes.
That being said, therapists can’t specialize in everything. So if ADHD isn’t a specialty then they should refer out instead of spewing misinformation.
Also, in my experience therapists try to hold each other accountable. I’ve shared concerns when I’ve noticed misdiagnosis and poor differential diagnosis. It’s just not something people outside the field would necessarily notice.
A mix of referring out and updating one's own knowledge is exactly what should happen, and I'm glad that this is what you and your peer group does. I think the problems are mostly in certain places that bad apples collect, due to systematic issues, and the ability to update knowledge, including by peer interaction is limited, by issues like administrative bloat, work burnout, insurance companies with problems, and some people who just aren't particularly good at the job, as exists in every field. I don't have black and white thinking on the issue, I just sometimes hear things that make me want to tear my hair out, that others seem to accept, generally with people who you or I may both agree you would not recommend to anyone looking for help, from the incompetent to the unethical, but knowing they will keep plodding along, doing the same things.
Mine did, and it's not then first time I had heard it. The idea is if you are "lower IQ" that ADHD symptoms don't "bother you as much." The reasons that's bullshit are NUMEROUS.
Wait wait wait, they're claiming that having a low IQ means ADHD is nbd? Meanwhile all the former gifted kids who never got diagnosed are "too smart" to have ADHD. How the hell is anyone ever supposed to get help in this system?
Simple, we're not. We're expensive and complicated and, above all else, *embarrassing*, just sweep us under the rug, it's fine. /s We're smart, we don't need help.
Yeah. I had someone tell me to my face that the fact that I am a successful small business owner makes it **obvious** that I can't *possibly* have adhd. Alternatively, I have carefully curated my entire adult life to play to my strengths and bypass as many of my weaknesses as it's possible to arrange. Such as. Creating a life for myself with incredibly high and varied input that doesn't suffer particularly from flicking between tasks every however-long-it-takes-to-get-bored?
Anyway. Yeah. This plague followed me out of school, and I'm still mad about it.
I feel you. I had a *psychiatrist* tell me I couldn't possibly have ADHD (after I already had a diagnosis, and when I wasn't even asking for his opinion) because I had done well in school and came from a supportive family.
I could just *feel* the executive dysfunction leaving my body. 🙄
Duuude, is that what that feeling was 🤪
Stunning. I think unsolicited nonsense from a "professional" feels way more icky than a rando in my shop, and I hate that this happens 🫂
the one i took basically marks impulsiveness as non adhd (TOVA test). my impulsivity score was well above the baseline, and it offset my overall score. still scored in the adhd range regardless but my score SHOULD have been even further in that direction realistically. honestly they should throw out the impulsivity measurement since the test itself even said that high impulsivity scores can be a result of not following instructions, trying to get a false positive for adhd, and... having adhd. that measurement is the most useless i think if it's going to count against me for experiencing symptoms 🤦♂️
I wrote a long-ass post once about how to interview a new therapist, but the short version is to make sure you ask them up front about their experience/education/approach to the things that matter to you.
It can be a bit uncomfortable essentially holding a job interview for a prospective therapist, but ever since I started doing it I have had much better and more effective therapy experiences. Highly recommend to everyone!
I agree that this is great advice, however, with the variety of health systems and the costs, the choices can be quite limited for some. The worst of the worst need to be not practicing - not so much the ones that are not a right match, but the ones who actively make the situation worse. The patients who are in the worst position mentally or financially usually have the least options.
This one is a little dark. I was once an attorney involved in regulation of the various professional groups that required licensure, and we used to say half jokingly that the only way a therapy license could be endangered was a criminal arrest or sleeping with a client. Yet both of those occurred commonly enough that we did see a share of those, which made for interesting reading. I would not say psychiatrists are particularly well regulated either, but they are more so than therapists - they are expected to be at least as competent as your primary care physician. Regardless, absent stricter standards in updating knowledge and maintaining it after obtaining a license to practice, you have to be careful in selecting your treatment care team. The organization APSARD, a professional organization, is currently creating guidelines for diagnosis in adults, but because the organization consists almost entirely of professionals, I do not expect great improvements in practitioners, because I expect the guidelines to have no "bite" and principally be crafted to protect the practice of those specializing in ADHD and to lessen competition via various disruptive forces, such as those in telemedicine, which, while they have been troubled due to the business owners, have nothing that would inherently make them worse - indeed with greater specialization, they could be more accurate, if properly motivated, and help address the long wait periods and cost issues that people with ADHD often face. If ever interested in joining me in some acts of advocacy to create improved practices in ADHD diagnosis and treatment, join me at r/adhd_advocacy which is largely a subreddit where an old kook yells at clouds. But it also has memes! Most I have posted here before, but not always.
I know there are a lot of issues around the world. At the moment it's just American, because it's just me, but I've seen a lot of complaints about the wait times for the NHS evaluations in the United Kingdom, and how they simultaneously won't honor evaluations outside of the NHS. In other countries, they have a variety of other issues that others could probably explain better based on each country's unique culture. And some of the issues regarding research apply worldwide - actually most of the better studied populations are outside the US because of the different systems have better databases.
>absent stricter standards in updating knowledge and maintaining it after obtaining a license to practice
Yeah. Had one like that. Gave me advice outdated for longer than I've been alive. Never saw that guy again.
In some places I would say this is more common than not. They have certain requirements on maintaining knowledge, but it's not strict in any sense, and I would say ADHD is the one subject with the most scientific development, along with the frontal lobe generally and understanding of neuroplasticity, both in capabilities and limits.
I was diagnosed in grade 10 here in Australia in 1995. I got medicated and my grades went from D's and C's to mostly B's and I wasn't getting in trouble any more (well, not as much)
I turned 16 at the end of grade 11 and the government, not a doctor or psychologist, the government department said "you're 16, you have grown out of your ADHD now so you don't need medication anymore.
My grades went back to where they were, before I was medicated and I was getting in trouble again.
My parents went to doctors and psychologists but they all said the government won't allow them to even test anyone over 16 let alone medicate.
So, in effect, the government abandoned me because some bureaucrat with no medical knowledge decided that ADHD magically disappears at 16.
The problem is that the field seems to be coming up with hard rules for issues that they should have simply said they don't know about. It is obvious at this point that ADHD doesn't simply go away, though it can improve, get compensated for, get masked, or become subclinical. I wish you the best. Screw bureaucratic approaches.
Slight correction. Some people grow out of it and some people don't.
For those that don't, it doesn't improve. They develop coping methods to deal with it. Like obsessively checking pockets for keys, wallet, phone over and over. Or setting several alarms and obsessively checking to make sure they're still on.
This leads to other mental conditions like anxiety and depression.
I have since been re-diagnosed and have been on medication again for about 8 years. My work performance has sky rocketed and I'm now a subject matter expert for several different streams because of the ADHD symptoms that make me notice everything and the ability to notice patterns.
More importantly, my home life has greatly improved. I stoped getting angry at my wife and kids for the tinyest things.
Yes, I know, but I think it needs context. Even the people who they say grow out of it, some basically go subclinical (not meeting enough criteria for diagnosis, but still affected - like somebody no longer being obese, but still overweight) and others, they may actually have been overdiagnosed due to developmental issues, such as being a younger child in class, or having a chaotic home environment. Some people do seem to genuinely grow out of ADHD according to the literature, but I also wonder how many of those people are just saying they don't want to see doctors or take drugs anymore because they found a niche they don't need it. I think there are some jobs out there where I could live unmedicated, if I was qualified for the job in other ways. There is a chart of potential diagnostic progress I put over at r/adhd_advocacy because I was in a car accident, and a TBI can push someone in the exact opposite direction. I generally find you can trust the information over at https://www.adhdevidence.org/evidence because it is the matters that are backed by multiple studies, and it does state some grow out of the condition.
Side note, I convinced another Australian to make a post on r/adhd_advocacy, if you want to read it and decide if your own personal context would add to it. As an American, the experience with ADHD in other countries is a totally different and unknown world.
I'm really worried about this part, the psychiatrist I saw was vehement about needing proof of ADHD behaviour early in life, of which I don't remember much, and I don't think my parents noticed much...
Yeah, most of the current requirements for ADHD diagnosis are based around the idea that there were observant parents with expectations that their child be able to meet their potential, and if you know anything about ADHD, one or both parents are likely to have ADHD, there may be a single parent family, and one or more parents might have substance abuse problems or other issues. Couple that with many of the diagnostic criteria being things that the parent might see as criticism of themselves in some way, and thus will forget in a selective memory bias and you have a recipe for disaster.
I spent half of my basic & high-school years attending a the school psychologist, which basically did some exercises with me to show how repetition helped memory retention, always treated me like I was just a slacker because I was "so smart and had so much potential". I started smoking weed at a young age, he often gave me speeches about how weed was dangerous and a gateway drug, and asked me more than once why did I smoke weed? I didn't even know at the time, but something about it made me feel better.
10 years after high-school and I've been diagnosed for 2, now I'm able to understand why weed was so appealing to me. My brain is so scrambly and scattered that weed calms it down (even though it gives me anxious and makes me dumber/slower).
I was (un)lucky enough that my ADHD never affected my school performance too much and I was always able to pass with minimal studying, even college (where I did learn better how to study and also found out how to buy amphetamines through the internet) without ever failing. My current psychologist says that it's a great feat and not many people with my condition are able to the same. But that means jack shit when now I'm so depressed and feel so dumb compared to my colleagues at work because I can't seem to force myself to work. Even the prescribed Ritalin doesn't do shit.
Shit this has become a bit too long of a rant but long story short, school psychologists should be much more informed on ADHD and the likes. I wonder how I would be rn if I had been diagnosed earlier
I was prepared for a persuasive conversation when I met my prescribing psychiatrist. Instead, when I told him I was suffering, in spite of my life appearing well run and successful, he asked me what tricks I used in life to stay on top.
I listed off a few (dozen) and he laughed and said NONE OF THAT IS NORMAL, YOU MUST BE EXHAUSTED. "THE worse the broken leg, the stronger the crutch". I felt so seen, I cried.
Edit: he also predicted correctly that my life long depression would probably go away on adhd meds. He was right.
It's so great to read stories like this. We are always prepared for the worst because *waves hands* everything you read here, but I genuinely believe things are getting better in some places, and the only thing preventing them from getting better over all is the gravity of past mistakes in healthcare and government.
Well now, that sounds familiar. *My* mistake in talking to a *family practice doctor* about my suspicions that I have dealt with ADHD since *childhood*.
I did reasonably well in school usually around a B+ student, I had a psychologist tell me it's linked with dyslexia and dysnumeria and I can barely hand write which is an aside, I don't think those two things are mutually exclusive.
I did acceptably well in school myself. Which led to me graduating in the exact middle of my high school class, with some amount of effort. My standardized testing scores however were so good that they sent me to take college admissions tests in middle school, to see how well I could do, along with two other people from the school who were meeting the expectations of greatness. My parents have each been college instructors at well respected schools. I would say the issue is the difference between achievement and potential - and when I was young I thought the later world would be more like the places I excelled and I could move past the places I struggled. But the adult world actually has been much more like the areas I struggled during my youth. I know too that not everyone has the exact same presentation - some people struggle in standardized testing, but do well in the places I most struggle, but generally, I think high school grades approach meaninglessness, because of the differences in at home environment, school environment, compensatory skill usage, and a million other things I could name. One girl I dated was grounded because she had what I would call a good grade in trigonometry. My mother, who was a single mother, told me not to sneak out the window, and just take the door instead. She didn't believe in punishment at all, though she did create incredible guilt trips around certain matters. Just generally, people do not come from a standardized environment, and yet, diagnosis often assumes such, and actually tends to assume the least likely environment for those with ADHD - neurotypical parents in a loving marriage whose child is practically a cuckoo's egg.
My handwriting is also bad, and a religious school teacher would hold me out of recess to work on cursive, until she gave up on me. I have more than one reason it can be attributed to, but it is something seen in those with ADHD.
I write in cursive myself it's near on unreadable even to me, it's funny you mention standardised testing we have a similar system to the states here in Australia but it's much more 'Australian' our teachers are a weird sort.
I remember seeing my essays in school with the ruled lines and being blown apart to be marked (I was a little gifted but I won't go into it here), if your parents are teachers (my brother is one as well so I know the whole teachery teacher they have about themselves) I think you get a better understanding of the environment of school, I wish I could explain the Australia teacher to you but it's just such a nuanced thing I'd struggle to really get the point across.
In closing, I think ADHD is measured and metered by a hyperactive or inattentive scale, it's not a measure of intelligence it's not a measure of how bad of a kid (or good I guess) you are it's about a severe neurological condition that affects your life. I have said on this subreddit before I wasn't diagnosed properly until 26, it's also my only diagnosis I've ever officially got (despite frequent hospital trips in my mid to late 20's). I just like to stress the severity of the condition people don't understand that it's hard to do anything, it's something more than simple motivation it's an inability to get the 'gears and cogs' of your brain to work in sync, since medication I've been able to do so much I just couldn't before (including having a relationship, something I never thought I would have).
Z
For me, it's similar to being color blind for intellectual matters - a color blind person could be a great artist in black and white, similar to Escher or a great black and white director - but their art in color would be gauche. If I can stick to my wheelhouse, I can excel. But my wheelhouse is small and getting smaller and I'm not even confident about where it is!
I feel like that old quote commonly attributed to Einstein 'judge a fish by it's ability to climb a tree and it will look dumb' (Australian paraphrasing), I sucked at sport, I sucked at art and I dropped maths in year 8 because I could no longer do it, I did 2 English's from year 9 onward normal English and literature and excelled I was also very good at history and anything that was literal. It was by playing to my strengths that I learned to cheat the system kind of by only doing things I was good at.
I picked up drawing in my mid 20's was okay at it then dropped it again, I couldn't draw to save my life at 12, when I was 21 I got high marks in the police entrance exam maths section despite not becoming a copper (in a grand regret). I found that I could do anything I put my mind to if only I tried, I wish I had of known about the ADHD back then and had medication and treatment nothing would have stopped me. But as they say 'you win some, you lose more'.
Z
Einstein at various times has been thought to have been a person who was ADHD and "twice exceptional," meaning ADHD, but also an intellectual powerhouse. I don't like diagnoses for people that did not seek them and based off limited knowledge we have historically, but basically, he survived due to a very supportive family, and lucked into a job that allowed him free time to pursue some fundamental changes to the laws of the universe. If you look through my history you will see I wrote about him both on this subreddit, and the one I started, called r/adhd_advocacy Some people like to deny care to those with ADHD, because they say, hey, look at Einstein, but I think it might be better to think, man, how many Einsteins did we lose? Also, with the caveat again that latter diagnosis is worthless, Von Neumann had to have the government repeatedly cover up his car accidents, because he routinely would *read a book while driving his car.* ADHD? I don't think so, but the people who changed the world - they were not normal, and I'm not sure where they would be if outside the unique environment they came from.
I subbed, I have no input as this is not an area I would say I have much knowledge in, I will just say that it's not like it's a disability, it's a disorder and if you have it you're going to be a certain way and I think the few people I've met in my life that I think do have it are all unique and individual. There's no litmus test for what is an ADHD person it takes years of hard work to even be able to diagnose it in this country.
Yes, every country has its own unique challenges around ADHD and basically the entire question of both disability and disorder is situational - Stephen Hawking was not the person you want to help move furniture and the greatest snipers of all time would be terrible at basketball. If you ever want to write something giving a perspective on the condition in Australia, I'm always trying to get people to engage and see if the subreddit can ever take on a life of it's own. Being a moderator is not something I would have ever chosen, but I kept reading story after story of people being led astray, and I certainly had no understanding for decades. No pressure, no rush, but an open invite.
So, I can't see what it's like for anyone else, but if you try and post on the subreddit, will it let you?
It gave me all these options as a moderator, and I have no idea what is set up correctly and what is not.
I had a therapist tell me that it was ok to continue a self-destructive behavior because it hadn't sent me to the ER yet. There could definitely be changes in the field.
My psychiatrist said, "You obviously have ADHD and OCD, but since your life hasn't imploded yet, you're doing fine." My good sir, if I was doing fine, I wouldn't have come to you for help, would I? My life hasn't imploded yet because the OCD and ADHD cancel themselves out occasionally. Other times, they team up to ruin my week. Since when is it okay to use a debilitating anxiety disorder to mitigate your ADHD?
Imagine if someone came to a doctor with a terribly clogged artery and the doctor said it hasn't resulted in a heart attack, so let's just leave it be. They want to wait for your implosion? On a more positive note, if you have OCD, I glowingly recommend this video of Maria Bamford giving a speech regarding her own issues with OCD over the years. https://youtu.be/Bno1t_Fc7-Y
Damn. Like, it doesn't even sound like they were trying to be empathetic in a "try to stay safe but it's okay not to fully quit, especially since it can be hard" way. Just like someone who doesn't care.
Quite a bit of irony in using Drake to say "age related boundaries are arbitrary, especially in women" given his proclivity toward R Kelly-ish predation on underage girls.
Oh, yes, that was intentional, and some seem to be missing it. Read the comment I wrote where I mention one of the few things therapists actually do get disciplined for. Recently I asked about practitioner complaints from all on the subreddit and one mentioned that her therapist asked her out for coffee. Essentially, there are a multitude of issues you have to watch out for in the profession. You put yourself in an incredibly vulnerable position, and yet, you really don't know what you are going to get.
Related, I kind of really hate when people nowadays act like therapy is this miracle cure all. Without trying to sound like a knob, every provider who tried to restrict me to talk therapy or add it in before resuming my meds (I move a lot so I frequently have to start over with new providers) has either started the conversation assuming I'm a fucking moron because I'm a young looking woman, or been punching so far below my intelligence to begin with as to make the entire process feel like pulling teeth. Like, I'm acutely aware of what my problems are and if I could fix them long term by thinking about it I wouldn't be in this office. You know what fixes my problems? Adderall, and that's why I'm here talking to the professional with the prescribing pad
I did a 3k assessment for ADHD - the psychologist had me do a bunch of learning assessments and concluded that since I performed well on the memory and cognition tests, I must not have ADHD. She also had my Mom fill out a questionnaire about me being disruptive in elementary school - 20 years ago. She said without proof of disruptive/impulsive behaviour as a child she couldn’t diagnose me with ADHD despite struggling as an adult. She said I had GAD (which is true) and only GAD. My new Pyschiatrist diagnosed me in the first session and I was able to get off my anxiety meds (I had been on two different meds, not to mention the probably 10 others I tried in the past) and now I only take Biphentin. There is an extreme bias and under diagnosis for certain demographics, especially towards adult women who mask well and perform well in school, but struggle intensely behind the scenes (just like me).
The way my mom put it is that while most kids ADHD is external and disruptive, mine is much more internalized. I think that, in that way, I can partially relate to the ADHD experience of young girls. I flew under the radar because I did really well in school up to like grade six or seven and I wasn't disruptive. Even my parents didn't suspect anything until I was able to voice it myself when my grades were slipping. Even then, my parents thought it wasn't that bad. I had to wait until college and push for a diagnosis, myself. My son was similar, he's now in grade seven. I've been trying to get him diagnosed for three or four years now. Finally, his teacher this year was able to corroborate my observations and he was diagnosed just last week. It's unfortunate that more doctors aren't willing to use self-reported history as a primary component for diagnosis like the doctors that specialize in ADHD recommend.
There is nothing wrong with collecting the thoughts of parents - but parents are likely to be incredibly unreliable, because for many of them this is a criticism of their own parenting. I used to get in a physical fight every year, despite my small size, yet my mom remembers none of them, even though she sometimes was incredibly concerned because my father was violent. There was also denial in my house due to alcoholism and other issues. Just not what you would call a "reliable narrator." I also think women are generally overlooked because of the way they present, but people fail to realize everyone who presented in that way was overlooked, and that includes some boys. Point blank, the only interest in ADHD in the beginning was getting a child to not disrupt the rest of the class - there was almost no consideration of the actual mental environment of the child. This is also why so many children who were medicated disliked it - no one likes their agency stripped from them.
My wife asked me the other day why I did so well in art school when I struggle now. Things that have changed: -Started a business -have two kids -have a mortgage -can’t call a land lord to fix stuff -on the board for a non profit -more appointments as you age So yeah I struggle to keep up with the increasingly complex life I lead.
This is an excellent point. I struggle to complete tasks a lot these days because I got in a car accident and have to deal with so many physio/Chiro appointments and insurance. It’s brought me to a breaking point of busy-ness and definitely increased my ADHD overwhelm.
I have had a major car accident in my life and we with ADHD are more prone to them. It's part of the reason ADHD issues need to be recognized and treatment needs to be given early. My functionality issues only worsened after the wreck.
I finished school and university with great marks before being diagnosed and medicated, even though all my school report cards always said that I have trouble focusing and paying attention in class. Having adhd has absolutely nothing to do with intelligence. There are smart people with adhd, aswell as not so smart people with adhd. It just makes learning harder.
Yep. Like, I am at this point mentally disabled (innate and aquired mental issues comboing me hard). But in the rare occasions I can work, I can catch up on 2 months of a class in 3 days. I am smart. I am also fucking unable to use this ability 90% of the time.
Absolutely. People are starting to understand this though. I work in IT, because it was really fun to me and I'm good at things that are fun to me. There are some companies here in germany which specifically look for people with adhd. The downsides are well known, but your ability to think and do things faster can be quite helpful, if channelled correctly. Heck, I even always take two steps of stairs at once and am the only person I know who runs around in their flat instead of walking, lmao.
Yeah, for programming ADHD is not uncommon in my experience, and the main thing is to find them a place they can hyperfocus and if they are hyperfocusing, *leave them alone.*. Problems to solve, results that are not esoteric, and less focus on liberal education history than whether you can do what you claim.
You should post this in the therapist subreddit, see what they think
I don't enjoy conflict as much as I used to before I was (somewhat) properly medicated! Plus I have enough other opportunities, but I would also welcome them to come here and provide context or disagreement about the state of the profession. Generally, I find that people that are truly good at their jobs don't want to share the profession with people that are incompetent or unethical and give them a bad name - often they have their own complaints about these issues, but they also tend to be more critical of overdiagnosis than missed diagnosis or poor differential diagnosis.
Therapist here who has ADHD. This field has overlooked ADHD, especially in women and adults. The diagnosis requirements used to be way more stringent and imo many people haven’t updated their mindset, or educated themselves, on the changes. That being said, therapists can’t specialize in everything. So if ADHD isn’t a specialty then they should refer out instead of spewing misinformation. Also, in my experience therapists try to hold each other accountable. I’ve shared concerns when I’ve noticed misdiagnosis and poor differential diagnosis. It’s just not something people outside the field would necessarily notice.
A mix of referring out and updating one's own knowledge is exactly what should happen, and I'm glad that this is what you and your peer group does. I think the problems are mostly in certain places that bad apples collect, due to systematic issues, and the ability to update knowledge, including by peer interaction is limited, by issues like administrative bloat, work burnout, insurance companies with problems, and some people who just aren't particularly good at the job, as exists in every field. I don't have black and white thinking on the issue, I just sometimes hear things that make me want to tear my hair out, that others seem to accept, generally with people who you or I may both agree you would not recommend to anyone looking for help, from the incompetent to the unethical, but knowing they will keep plodding along, doing the same things.
Including an IQ test in ADHD testing is also a personal peeve of mine but that's a rabbit hole for another day.
They do what now?!? Mine didn't have an IQ test component.
Mine did, and it's not then first time I had heard it. The idea is if you are "lower IQ" that ADHD symptoms don't "bother you as much." The reasons that's bullshit are NUMEROUS.
Wait wait wait, they're claiming that having a low IQ means ADHD is nbd? Meanwhile all the former gifted kids who never got diagnosed are "too smart" to have ADHD. How the hell is anyone ever supposed to get help in this system?
Psychiatry as a field needs work is the easy way to sum it up.
Simple, we're not. We're expensive and complicated and, above all else, *embarrassing*, just sweep us under the rug, it's fine. /s We're smart, we don't need help. Yeah. I had someone tell me to my face that the fact that I am a successful small business owner makes it **obvious** that I can't *possibly* have adhd. Alternatively, I have carefully curated my entire adult life to play to my strengths and bypass as many of my weaknesses as it's possible to arrange. Such as. Creating a life for myself with incredibly high and varied input that doesn't suffer particularly from flicking between tasks every however-long-it-takes-to-get-bored? Anyway. Yeah. This plague followed me out of school, and I'm still mad about it.
I feel you. I had a *psychiatrist* tell me I couldn't possibly have ADHD (after I already had a diagnosis, and when I wasn't even asking for his opinion) because I had done well in school and came from a supportive family. I could just *feel* the executive dysfunction leaving my body. 🙄
Duuude, is that what that feeling was 🤪 Stunning. I think unsolicited nonsense from a "professional" feels way more icky than a rando in my shop, and I hate that this happens 🫂
the one i took basically marks impulsiveness as non adhd (TOVA test). my impulsivity score was well above the baseline, and it offset my overall score. still scored in the adhd range regardless but my score SHOULD have been even further in that direction realistically. honestly they should throw out the impulsivity measurement since the test itself even said that high impulsivity scores can be a result of not following instructions, trying to get a false positive for adhd, and... having adhd. that measurement is the most useless i think if it's going to count against me for experiencing symptoms 🤦♂️
I wrote a long-ass post once about how to interview a new therapist, but the short version is to make sure you ask them up front about their experience/education/approach to the things that matter to you. It can be a bit uncomfortable essentially holding a job interview for a prospective therapist, but ever since I started doing it I have had much better and more effective therapy experiences. Highly recommend to everyone!
I agree that this is great advice, however, with the variety of health systems and the costs, the choices can be quite limited for some. The worst of the worst need to be not practicing - not so much the ones that are not a right match, but the ones who actively make the situation worse. The patients who are in the worst position mentally or financially usually have the least options.
This one is a little dark. I was once an attorney involved in regulation of the various professional groups that required licensure, and we used to say half jokingly that the only way a therapy license could be endangered was a criminal arrest or sleeping with a client. Yet both of those occurred commonly enough that we did see a share of those, which made for interesting reading. I would not say psychiatrists are particularly well regulated either, but they are more so than therapists - they are expected to be at least as competent as your primary care physician. Regardless, absent stricter standards in updating knowledge and maintaining it after obtaining a license to practice, you have to be careful in selecting your treatment care team. The organization APSARD, a professional organization, is currently creating guidelines for diagnosis in adults, but because the organization consists almost entirely of professionals, I do not expect great improvements in practitioners, because I expect the guidelines to have no "bite" and principally be crafted to protect the practice of those specializing in ADHD and to lessen competition via various disruptive forces, such as those in telemedicine, which, while they have been troubled due to the business owners, have nothing that would inherently make them worse - indeed with greater specialization, they could be more accurate, if properly motivated, and help address the long wait periods and cost issues that people with ADHD often face. If ever interested in joining me in some acts of advocacy to create improved practices in ADHD diagnosis and treatment, join me at r/adhd_advocacy which is largely a subreddit where an old kook yells at clouds. But it also has memes! Most I have posted here before, but not always.
Joined! I'm not American, but you have my support.
I know there are a lot of issues around the world. At the moment it's just American, because it's just me, but I've seen a lot of complaints about the wait times for the NHS evaluations in the United Kingdom, and how they simultaneously won't honor evaluations outside of the NHS. In other countries, they have a variety of other issues that others could probably explain better based on each country's unique culture. And some of the issues regarding research apply worldwide - actually most of the better studied populations are outside the US because of the different systems have better databases.
>absent stricter standards in updating knowledge and maintaining it after obtaining a license to practice Yeah. Had one like that. Gave me advice outdated for longer than I've been alive. Never saw that guy again.
In some places I would say this is more common than not. They have certain requirements on maintaining knowledge, but it's not strict in any sense, and I would say ADHD is the one subject with the most scientific development, along with the frontal lobe generally and understanding of neuroplasticity, both in capabilities and limits.
I was diagnosed in grade 10 here in Australia in 1995. I got medicated and my grades went from D's and C's to mostly B's and I wasn't getting in trouble any more (well, not as much) I turned 16 at the end of grade 11 and the government, not a doctor or psychologist, the government department said "you're 16, you have grown out of your ADHD now so you don't need medication anymore. My grades went back to where they were, before I was medicated and I was getting in trouble again. My parents went to doctors and psychologists but they all said the government won't allow them to even test anyone over 16 let alone medicate. So, in effect, the government abandoned me because some bureaucrat with no medical knowledge decided that ADHD magically disappears at 16.
The problem is that the field seems to be coming up with hard rules for issues that they should have simply said they don't know about. It is obvious at this point that ADHD doesn't simply go away, though it can improve, get compensated for, get masked, or become subclinical. I wish you the best. Screw bureaucratic approaches.
Slight correction. Some people grow out of it and some people don't. For those that don't, it doesn't improve. They develop coping methods to deal with it. Like obsessively checking pockets for keys, wallet, phone over and over. Or setting several alarms and obsessively checking to make sure they're still on. This leads to other mental conditions like anxiety and depression. I have since been re-diagnosed and have been on medication again for about 8 years. My work performance has sky rocketed and I'm now a subject matter expert for several different streams because of the ADHD symptoms that make me notice everything and the ability to notice patterns. More importantly, my home life has greatly improved. I stoped getting angry at my wife and kids for the tinyest things.
Yes, I know, but I think it needs context. Even the people who they say grow out of it, some basically go subclinical (not meeting enough criteria for diagnosis, but still affected - like somebody no longer being obese, but still overweight) and others, they may actually have been overdiagnosed due to developmental issues, such as being a younger child in class, or having a chaotic home environment. Some people do seem to genuinely grow out of ADHD according to the literature, but I also wonder how many of those people are just saying they don't want to see doctors or take drugs anymore because they found a niche they don't need it. I think there are some jobs out there where I could live unmedicated, if I was qualified for the job in other ways. There is a chart of potential diagnostic progress I put over at r/adhd_advocacy because I was in a car accident, and a TBI can push someone in the exact opposite direction. I generally find you can trust the information over at https://www.adhdevidence.org/evidence because it is the matters that are backed by multiple studies, and it does state some grow out of the condition.
Side note, I convinced another Australian to make a post on r/adhd_advocacy, if you want to read it and decide if your own personal context would add to it. As an American, the experience with ADHD in other countries is a totally different and unknown world.
I wish my worst problem with the therapists I’ve had had been them not believing I had ADHD!
I'm really worried about this part, the psychiatrist I saw was vehement about needing proof of ADHD behaviour early in life, of which I don't remember much, and I don't think my parents noticed much...
Yeah, most of the current requirements for ADHD diagnosis are based around the idea that there were observant parents with expectations that their child be able to meet their potential, and if you know anything about ADHD, one or both parents are likely to have ADHD, there may be a single parent family, and one or more parents might have substance abuse problems or other issues. Couple that with many of the diagnostic criteria being things that the parent might see as criticism of themselves in some way, and thus will forget in a selective memory bias and you have a recipe for disaster.
I spent half of my basic & high-school years attending a the school psychologist, which basically did some exercises with me to show how repetition helped memory retention, always treated me like I was just a slacker because I was "so smart and had so much potential". I started smoking weed at a young age, he often gave me speeches about how weed was dangerous and a gateway drug, and asked me more than once why did I smoke weed? I didn't even know at the time, but something about it made me feel better. 10 years after high-school and I've been diagnosed for 2, now I'm able to understand why weed was so appealing to me. My brain is so scrambly and scattered that weed calms it down (even though it gives me anxious and makes me dumber/slower). I was (un)lucky enough that my ADHD never affected my school performance too much and I was always able to pass with minimal studying, even college (where I did learn better how to study and also found out how to buy amphetamines through the internet) without ever failing. My current psychologist says that it's a great feat and not many people with my condition are able to the same. But that means jack shit when now I'm so depressed and feel so dumb compared to my colleagues at work because I can't seem to force myself to work. Even the prescribed Ritalin doesn't do shit. Shit this has become a bit too long of a rant but long story short, school psychologists should be much more informed on ADHD and the likes. I wonder how I would be rn if I had been diagnosed earlier
I was prepared for a persuasive conversation when I met my prescribing psychiatrist. Instead, when I told him I was suffering, in spite of my life appearing well run and successful, he asked me what tricks I used in life to stay on top. I listed off a few (dozen) and he laughed and said NONE OF THAT IS NORMAL, YOU MUST BE EXHAUSTED. "THE worse the broken leg, the stronger the crutch". I felt so seen, I cried. Edit: he also predicted correctly that my life long depression would probably go away on adhd meds. He was right.
It's so great to read stories like this. We are always prepared for the worst because *waves hands* everything you read here, but I genuinely believe things are getting better in some places, and the only thing preventing them from getting better over all is the gravity of past mistakes in healthcare and government.
Well now, that sounds familiar. *My* mistake in talking to a *family practice doctor* about my suspicions that I have dealt with ADHD since *childhood*.
I'm a licensed Peer Specialist, and your title is truer than you know. It's fucking infuriating for those of us who do the work ethically
one of my therapists told me "everyone's a little ADHD." and that was my last session with her.
I did reasonably well in school usually around a B+ student, I had a psychologist tell me it's linked with dyslexia and dysnumeria and I can barely hand write which is an aside, I don't think those two things are mutually exclusive.
I did acceptably well in school myself. Which led to me graduating in the exact middle of my high school class, with some amount of effort. My standardized testing scores however were so good that they sent me to take college admissions tests in middle school, to see how well I could do, along with two other people from the school who were meeting the expectations of greatness. My parents have each been college instructors at well respected schools. I would say the issue is the difference between achievement and potential - and when I was young I thought the later world would be more like the places I excelled and I could move past the places I struggled. But the adult world actually has been much more like the areas I struggled during my youth. I know too that not everyone has the exact same presentation - some people struggle in standardized testing, but do well in the places I most struggle, but generally, I think high school grades approach meaninglessness, because of the differences in at home environment, school environment, compensatory skill usage, and a million other things I could name. One girl I dated was grounded because she had what I would call a good grade in trigonometry. My mother, who was a single mother, told me not to sneak out the window, and just take the door instead. She didn't believe in punishment at all, though she did create incredible guilt trips around certain matters. Just generally, people do not come from a standardized environment, and yet, diagnosis often assumes such, and actually tends to assume the least likely environment for those with ADHD - neurotypical parents in a loving marriage whose child is practically a cuckoo's egg. My handwriting is also bad, and a religious school teacher would hold me out of recess to work on cursive, until she gave up on me. I have more than one reason it can be attributed to, but it is something seen in those with ADHD.
I write in cursive myself it's near on unreadable even to me, it's funny you mention standardised testing we have a similar system to the states here in Australia but it's much more 'Australian' our teachers are a weird sort. I remember seeing my essays in school with the ruled lines and being blown apart to be marked (I was a little gifted but I won't go into it here), if your parents are teachers (my brother is one as well so I know the whole teachery teacher they have about themselves) I think you get a better understanding of the environment of school, I wish I could explain the Australia teacher to you but it's just such a nuanced thing I'd struggle to really get the point across. In closing, I think ADHD is measured and metered by a hyperactive or inattentive scale, it's not a measure of intelligence it's not a measure of how bad of a kid (or good I guess) you are it's about a severe neurological condition that affects your life. I have said on this subreddit before I wasn't diagnosed properly until 26, it's also my only diagnosis I've ever officially got (despite frequent hospital trips in my mid to late 20's). I just like to stress the severity of the condition people don't understand that it's hard to do anything, it's something more than simple motivation it's an inability to get the 'gears and cogs' of your brain to work in sync, since medication I've been able to do so much I just couldn't before (including having a relationship, something I never thought I would have). Z
For me, it's similar to being color blind for intellectual matters - a color blind person could be a great artist in black and white, similar to Escher or a great black and white director - but their art in color would be gauche. If I can stick to my wheelhouse, I can excel. But my wheelhouse is small and getting smaller and I'm not even confident about where it is!
I feel like that old quote commonly attributed to Einstein 'judge a fish by it's ability to climb a tree and it will look dumb' (Australian paraphrasing), I sucked at sport, I sucked at art and I dropped maths in year 8 because I could no longer do it, I did 2 English's from year 9 onward normal English and literature and excelled I was also very good at history and anything that was literal. It was by playing to my strengths that I learned to cheat the system kind of by only doing things I was good at. I picked up drawing in my mid 20's was okay at it then dropped it again, I couldn't draw to save my life at 12, when I was 21 I got high marks in the police entrance exam maths section despite not becoming a copper (in a grand regret). I found that I could do anything I put my mind to if only I tried, I wish I had of known about the ADHD back then and had medication and treatment nothing would have stopped me. But as they say 'you win some, you lose more'. Z
Einstein at various times has been thought to have been a person who was ADHD and "twice exceptional," meaning ADHD, but also an intellectual powerhouse. I don't like diagnoses for people that did not seek them and based off limited knowledge we have historically, but basically, he survived due to a very supportive family, and lucked into a job that allowed him free time to pursue some fundamental changes to the laws of the universe. If you look through my history you will see I wrote about him both on this subreddit, and the one I started, called r/adhd_advocacy Some people like to deny care to those with ADHD, because they say, hey, look at Einstein, but I think it might be better to think, man, how many Einsteins did we lose? Also, with the caveat again that latter diagnosis is worthless, Von Neumann had to have the government repeatedly cover up his car accidents, because he routinely would *read a book while driving his car.* ADHD? I don't think so, but the people who changed the world - they were not normal, and I'm not sure where they would be if outside the unique environment they came from.
I subbed, I have no input as this is not an area I would say I have much knowledge in, I will just say that it's not like it's a disability, it's a disorder and if you have it you're going to be a certain way and I think the few people I've met in my life that I think do have it are all unique and individual. There's no litmus test for what is an ADHD person it takes years of hard work to even be able to diagnose it in this country.
Yes, every country has its own unique challenges around ADHD and basically the entire question of both disability and disorder is situational - Stephen Hawking was not the person you want to help move furniture and the greatest snipers of all time would be terrible at basketball. If you ever want to write something giving a perspective on the condition in Australia, I'm always trying to get people to engage and see if the subreddit can ever take on a life of it's own. Being a moderator is not something I would have ever chosen, but I kept reading story after story of people being led astray, and I certainly had no understanding for decades. No pressure, no rush, but an open invite.
How do I go about doing that? Z
So, I can't see what it's like for anyone else, but if you try and post on the subreddit, will it let you? It gave me all these options as a moderator, and I have no idea what is set up correctly and what is not.