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*raises hand*
I tried to get through grad school without having to go back on stimulants, but that ended up being a battle of futility. In my prior career I had advanced high enough that I could control my day and how I did things, but in grad school you are at the mercy of your mentor/class schedule/supervisor, etc. I still struggled at times in my prior career off meds (even with having a personal assistant to handle my schedule, a quiet office to do my work, etc), but grad school off meds for me was like trying to study organic chemistry while sitting in the student section of a college football game.
When I decided to go back on stimulants, it was important for me to have all of the recommended paperwork and the support of my prescriber because it took awhile to adjust for the right dosing, etc. It was amazing how different my experience became when I was finally on a stable dose and I could incorporate all of the strategies I built up during my time off meds. Be warned that if you need any kind of accommodation down the road (e.g. EPPP), they will probably require paperwork out the wazoo before they grant them. It took an extra 3+ months of dealing with my state licensing board to sort it all out.
Be warned that if you need any kind of accommodation down the road (e.g. EPPP), they will probably require paperwork out the wazoo before they grant them. It took an extra 3+ months of dealing with my state licensing board to sort it all out.
...The biggest problem I have now is the internet. Much too readily available distraction...
(as a youngster, I frustrated my teachers because I'd re-interpret their assignments into something I found interesting instead of what they assigned)
Just curious--what kind of accommodations are you talking about?
I was hit with this when I was in 1st grade. Interestingly, psychiatrist said ADHD, psychologist said high IQ/bored.
I never had any accommodations. Took stimulants when I was in 1st grade for about 2 weeks, but parents didn't see the point (performance was fine). I did bomb out of my private elementary school. They got tired of me not doing assignments. Felt bad for my poor mother. On open houses, parents sat at their child's desks. Mine was within arm's reach of the teacher, of course. The school also took away all of my writing implements during class and made me sit on my hands. And I think there were some rules about getting up. I don't remember.
My biggest issues were always organization, staying on task (as a youngster, I frustrated my teachers because I'd re-interpret their assignments into something I found interesting instead of what they assigned), and hyperactivity.
I don't have ADHD (although I bet my boss thinks I do).
But, I have participated in diagnosing ADHD/LD in folks obtaining advanced degrees (i.e., medical school). Documentation is really important, so I would make sure you have updated information on file from your physician and ideally psychiatrist or whoever is in charge of your ADHD medications (in the future).
They also may want testing on file for things like the EPPP and licensure, although perhaps a student who got accomodations could tell you more specifically. They are requiring these things just for undergraduates, so I would imagine some formal evaluation will be needed if you pursue any sort of accomodation.
Things didn't really click for me until middle school when I was put in the "gifted" program. Then, school was much more fun.
Wow. I have been working with a psychologist/coach and a psychiatrist for this, and was feeling very alone as being a woman in grad school with ADHD. I'm encouraged to see I'm not alone.
I've found that a low dose stimulant, a plan for my days to help me get through assignments, studying etc., organization, and having a lifestyle that supports ADHD management (how I eat, sleep, exercise, etc) all have helped a lot- though I have my up and down days/weeks.
I haven't needed any specific accommodations, though I am working really hard/struggling to get through writing sections of my dissertation now.
The biggest problem I have now is the internet. Much too readily available distraction.
Exercise is a good point. Exercise has been shown to improve executive functions in some populations already. There are some recently published articles showing positive effects, even acutely, for ADHD symptoms. It certainly affects mood. To that end, along with keeping mentally sharp as I age, and staying pretty 😉, I work out 6 days a week.
You mean you can't just work harder/longer to overcome it? <--I was stuck on this for a number of years bc I had shown some ability to be off meds and function (if I had control over my job, hours,etc).
Be warned that some providers (GP, FP, some psychiatrists, etc) hold some very biased views about a Dx of ADHD as an adult....even if the person had the Dx as a kid. Depending when they trained, it was often framed as a childhood only issue (bc of early age Dx criteria), so they don't know how to approach an adult case. It took me awhile to find a specialist, but it made all of the difference in the world.
How dare you suggest my exercise routine may be improving my judgment and decision making...😀
But yep, the "planning trap" can be just as bad for procrastination as complete avoidance of the task. Like my advisor said back when I was spending hours and hours reading, and absolutely no time writing, during my dissertation prep: "dammit, just sit down and write something." And that's what I started doing. Even if I erased it all the next day, I just started getting things out of my head and into written form.
Also, regarding restricting internet usage, I believe there are programs that you can use to set timers so that you can't access ____.com during the hours of 8a and 9p, for example. Or something like that.
Do we have the same dissertation advisor? 😳
I myself don't have this diagnosis, so I can't speak to any of the specifics of your questions. However, I wanted to let you know about a mental health related board called psychcentral.com (which I think is partnered with SDN in some way) where there are lots of chat boards with people asking and answering questions like yours. You will get a lot of responses there and not run the risk of infringing on SDN 's no medical advice policy.
Also, please see a real psychiatrist and not a PCP. PCP's training in mental health issues is so minimal and I cannot even count the number of clients I have had who had PCP's give them terrible advice on meds. Further, since you are self-diagnosed, a psychiatrist will be able to confirm the dx and discuss in detail treatment options. Also, my sense is psychiatrists are much more aggressive with meds, so if you need them, they won't hold back.
Best,
Dr. E
I would encourage you to seek out a formal diagnosis. As I'm sure you aware, numerous psychological conditions have symptoms that are similar to ADHD.
I would encourage you to seek out a formal diagnosis. As I'm sure you aware, numerous psychological conditions have symptoms that are similar to ADHD.
There is also a secondary consideration of outcome response being sufficient reason to use a psychostimulant, but that becomes more of a philosophical argument of treating dysfunction v. Optimizing/maximizing abilities.
I do a fair amount of adult ADHD formal assessment. The two things that repeatedly come up as sticking points are the impairment criteria and age of onset. It is possible to have sub-clinical symptoms of inattention that do not require treatment. Additionally, a good number of people I assess have no childhood history. By definition symptoms need to be present in childhood. I think schools are getting better at catching ADHD (and sometimes going overboard). This seems to result in fewer adults in their 20's and 30's being diagnosed for the first time.
It seems like the folks who think they have adult ADHD and don't frequently have anxiety disorders instead.
Not saying that any of this applies to you, just contributing to the discussion.
Best,
Dr. E
I am wondering if the fact that one knows the criteria may interfere with the process of evaluation and accurate diagnosis as one is more likely to report symptoms they think they may have based on that knowledge ( and I do mean honest reporting; not manipulating the process due to prior knowledge).
Also, your guys made me question myself so I just opened my DSM and checked again: I still meet current criteria for ADHD combined type and I do not meet criteria of any of the differential diagnoses. Never received any formal diagnosis for anything and was never on any medication. But I do not think I am imagining things. Just learned how to compensate really well and hyper-focus but it is taking its toll on me and leaving me drained and unable to function properly in other areas of my life.
I do a fair amount of adult ADHD formal assessment. The two things that repeatedly come up as sticking points are the impairment criteria and age of onset. It is possible to have sub-clinical symptoms of inattention that do not require treatment. Additionally, a good number of people I assess have no childhood history. By definition symptoms need to be present in childhood. I think schools are getting better at catching ADHD (and sometimes going overboard). This seems to result in fewer adults in their 20's and 30's being diagnosed for the first time.
It seems like the folks who think they have adult ADHD and don't frequently have anxiety disorders instead.
Not saying that any of this applies to you, just contributing to the discussion.
Best,
Dr. E
Most ADHD evals should involve some type of sustained attention task, such as a CPT. Those aren't self-report measures and I would imagine that unless you intentionally try to do poorly on the test, your knowledge regarding ADHD should not impact the validity of your performance.
I find myself constantly questioning ADHD as I conduct more and more ADHD eval testing. Honestly, is it really so pathological that a child forgets his homework, is poorly organized, and can't sit through a full day of school without fidgeting? Would these have even been issues a few centuries ago? Granted, I know that some kids really do have strong hyperactivity and inattention that severely impairs school performance, but a lot of these kids I've been testing who are diagnosed and on ADHD meds don't seem to meet that. I don't even know how well I would do on an uber-boring CPT.
Sorry to go all Szasz on you guys 😉
If this thread is going to stay open, you prob. should delete all of the recent personal info as it feels like you are pulling for med/psych/neuro insight for your own Dx/differential Dx, instead of the more retrospective and academic examples others (myself included) have posted. Jut my 2 cents.
The age criteria is not perfect, but I think it fits the neurological dysfunction theories currently out there. There can be ADHD-like symptoms due to other organic reasons (TBI, substance abuse/dependence, etc), as well as psychiatric reasons (most commonly anxiety and/or OCPD, though other Dx's can fit). I believe there is an over-dx of sub-clinical presentations, but more severe presentations are still much clearer (assuming organic conditions, LDs, and similar factors are controlled for prior to assessment). I saw some borderline cases while working in a school setting, but then I did some research w. mod. to severe Sx's and it was night & day compared to age/ed equiv. peers (elementary school ages).
It gets a bit stickier w. an adult dx bc there tend to be noted differences in presentation btw the most prominant symptoms exhibited by a child & an adult reporting symptoms. Sustained attention tasks can help tease out some of the attentional difficulties common in both age groups, but they are far from conclusive. *edit* Cara..the CPT, TOVA, and similar are brutal for non-clinical populations.
Coping strategies are probably more prevalent w. adults, but there should still be a ceiling effect that can be observed, particularly when considering performance on higher-level/more complex exec. functioning tasks. I think one of the biggest limitations w. assessment of something like ADHD is that the traditional setting for NP assessment provides more implicit and explicit structure than may be typical for the person. If the child or adult can be observed doing school/work tasks, I think the qualitative data would be more compelling. I'd love to get/see an imaging study looking at activation of the neuroanatomical correlate areas, particularly when recruitment for more complex tasks is needed. I'd suspect to see some major differences.
Just my 2 cents...lw. Some edits to clarify and fix some errors.
Thanks for enlightening me about this! Would both psychologists as well as psychiatrists utilize sustained attention tasks for the purpose of diagnosing ADHD? ( I am a MHC, so formal testing was not part of my training).
Compassionate1
"the CPT, TOVA, and similar are brutal for non-clinical populations." Hi, I am curious about this statement. Do you care to expand?
I'd love to get/see an imaging study looking at activation of the neuroanatomical correlate areas, particularly when recruitment for more complex tasks is needed. I'd suspect to see some major differences.