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You can't have ADHD if you do well in school? Huh?


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Saw my psychiatrist today and one of the problems I wanted to address was my motivation/energy levels/concentration - which are all very poor at this point, despite the fact that my mood is much better. He told me it sounds like I might have adult ADHD but that I couldn't have a diagnosable problem since I do so well in school (?). I'm not failing my classes, but it is a struggle to hand in work and write exams and I've told him this but he doesn't believe me, obviously. I don't even care if I have ADHD or not (I don't even think I do), I just want to have these symptoms addressed accordingly. He also mentioned that there's not much he can do for me about this (uhm what? people who have ADHD/traits go to therapy and take meds the last time I checked) and said that I should just wait for the Wellbutrin to help in that regard (I've been on the Wellbutrin for over six months). I don't understand why he's being so flippant like this. :closedeyes:

Edited by radicalfeminist
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I find this pretty bizarre. I guess your pdoc is right about the Wellbutrin, it does help some people with ADHD/ ADHD-like problems. 

 

I have ADHD and I do exceptionally well in school, I have an A average in university. This is part of the reason my pdoc won't medicate me. She says I've been "too successful" and I don't need medication because I seem to have done just fine without it all these years. Problem is, I LOVE school. Of course I do well! I can hyperfocus like nobody's business when it comes to my nursing courses. The second I took a statistics class however... I promptly failed the midterm. I attribute failing entirely to my ADHD. I couldn't focus at all during class, I just sat there and drew on my notes. I would get antsy and have to get up and leave constantly. Also, I was incredibly distracted by every little noise around me, I felt very overstimulated. 

 

So, I do well, yes, but my ADHD is still a problem for me sometimes. 

 

I would recommend making a list for your pdoc of all the ways your symptoms impact your life. Talk about how it affects your school work, your job, your home life (such as organizational skills, housework, planning, appointments). 

 

Do you have bipolar by any chance? It is possible your pdoc would be hesitant to give you stimulants due to their ability to cause mania in some people. 

Edited by Parapluie
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ADHD does not mean one does horribly in school, necessarily. Doing well in school does not mean one is fine without treatment. Quality of life matters. It matters a lot. Do you deserve to LIVE your life or is it okay to just keep on surviving? Do you need to apply so much more energy and effort just to do what everyone else is doing (even if they're working hard too?)

Check out the ADHD book 'Driven From Distraction' (not TO distraction, that's a different book) for more on this very subject, written by specialists in ADHD who also have it. Ignore the bit near the end about 'EMPower Plus' 'cause that is some litigious-level-lying bullshit (writers meant well and book isn't super new.)

'Nother great book in general is 'You Mean I'm Not Lazy, Stupid, or Crazy?!' That book is my favourite. But the first one I mentioned actually details the whole ADHD, doing well in school, and quality of life arguments rather specifically.

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Oh and yeah lots can mimic ADHD, not saying you have it... I can't tell you that. But it's awful how many of us ADHDers have to tirelessly hunt and hold tight to recognition and treatment. I've met so many psychiatrists who know way less about ADHD than I do, and that's scary. My pdoc right now knows more than me and I respect her very much - this is how it should be. Specialists, especially those who have it, can be the best for diagnosis and treatment. There are exceptions, some docs are just awful no mattter what. But statistically speaking, an ADHD specialist pdoc (even more so if they have it too) is most likely to help you answer the ADHD question accurately. Like, gdoc sends you to specialists for specific things, right? Dermatologist, surgeons of various sorts, neurologist, endocrinologist... well there are specialist psychiatrists too, and similar logic applies.

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@parapluie 

 

I looked this up, and it makes sense – but the fact that I’ve been on it so long (almost a year – I checked my prescription record) makes it seem very unlikely that it will magically help all of a sudden. Yeah, I’m not sure what the issue is. I’m not even doing exceptionally well, I’ve got around a B average, and that’s not because the material is hard, in fact, when and if I can concentrate, it’s very simple and straightforward and I have no doubt that I could easily obtain an A average. I definitely felt very uncomfortable like I had to defend myself against… not failing? I’m not sure why he thinks I would be exaggerating, that’s definitely not my thing and I’ve never done it before. In fact, I tend to minimize my issues.

 

I have multiple anxiety disorders, double depression. I’ve always had trouble with motivation/focus/energy and when I was younger I was very scattered. I’m not too sure what separates this issue from the others – I passed high school even though I was at the worst point in my life – that doesn’t mean I wasn’t suffering, it just means that I have the willpower to keep going, which is one of the only things I really like about myself. And nope, not bipolar.


@Mirahz

 

Thanks, Mirahz, I agree with what you’re saying and that’s my biggest point – it is frustrating to me. I’m not looking to be cured of anything, but I do want to meet my full potential – I spent so many years miserable and just hanging on and I don’t want to feel impaired or dragged down when I can address these issues.

 

I’ll definitely look into these two books. Like I said, the label to me is so irrelevant. I don’t care if I have ADHD and have always had it, but I do know that this is a problem now, and I’m struggling to work through it and its just so exhausting. My biggest problem is mental organization. I feel like my thoughts are all tangled and by the time I’ve worked through them I’m off thinking or doing something else.

 

The OCD/GAD tendency to obsess doesn’t help because I get mentally stuck on certain thoughts/ideas and that makes it worse. When I can concentrate, I can’t muster up the motivation to do things which is the icing on the cake. I am so easily overwhelmed by everything because I feel like I have no time to get anything done, I don’t know how to start, and my focus/and ability to maintain interest is terrible. It takes me so long to do basic reading and writing for my courses that I pretty much just do that and watch television because it takes the least effort and I’m exhausted (and during television watching I suddenly think it would be better to play a game or read or listen to music and sometimes I try to do all these things at once and end up feeling like my brain has exploded).

 

I always hear about how ADHD/stimulants are so overprescribed in kids – so why are adults with ADHD brushed off so easily? I’m not a big fan of my psychiatrist – I’ve made an appointment with my case manager to see if he really is the only option. I find we communicate very terribly and he is inconsistent with what he tells me.

 

I know there’s an ADHD/learning disability specialist connected to my school’s counseling center but if they confirm and I bring the info to him and he still doesn’t care/doesn’t think it’s a big deal, it won’t help very much.

Edited by radicalfeminist
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Persistance. Specialists aren't always right, despite what I said.

It's a balance between listening to docs who have done tons of schooling and work experience, and knowing yourself better than any doc.

If it's any consolation what you describe of your struggles sounds awfully familiar to me.

I have a preference for pdocs who specialise & have ADHD but there are others who are good.

Stims can be wrongly or over prescribed but that hype is what kept me from a Dx and treatment as a kid, and I try not to be bitter about it 'cause I could have used it even then.

History is important in making a Dx, not that you will have always struggled or in the same way, but as you learn about ADHD you'll notice patterns in the examples and histories that are important.

Part of an ADHD dx in many cases is... *drumroll* seeing how you respond to stimulant therapy! Yep. I've never done a sit-down multiple choice or checklist test, never had a computer test, never been at a learning disability testing centre, nada. IMHO, a good specialist who is attentive and insightful, an educated patient who has learned to communicate their experience well/precisely, time, your history, bit of experimentation... that is how you do it. Not some stupid 'press the spacebar when you see an X' test. But that's just a crazy Internet unicorn's opinion.

Oh the 'over diagnosed/prescribed' hype is just that... hype. Not saying over-Dx never happens, it does, but it's blown out of proportion, and the opposite issue which is very prevalent is UNDER and missed diagnosis. Even in children, especially in adults.

PS: no links for reference but vast majority of what I spout about ADHD is in the books I've read, like the ones I listed.

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Thanks again. You are making me feel better. When I came home from the appointment I felt as if that maybe I had been making it all up in my head but this isn’t normal. At least I don’t think so. The problem with recording a detailed history is that my memory from childhood is incredibly poor and my mother can’t really answer any of the questions – and she still to this day denies my diagnosed mental illnesses, so.

 

I do remember being distractible, have inappropriate emotional reactions, having pressured speech during class that I felt I couldn’t control, etc. I was actually incredibly disorganized, much more so than I am now. I’ve learned and developed skills over time for simple routine things like keeping my room tidy. When I was a kid up until late adolescence I pretty much was incapable of keeping my room clean and remembering to brush my hair, etc. My father is also 100% like this today, he routinely loses his car keys, cheques, and wallets. I feel like trying to not being like this contributed to my development of OCD, I am obsessive about cleaning and clutter but I can’t seem to get rid of my mental clutter and disorganization.

 

Anyway, crazy internet unicorn opinions seem much more rational than anyone else’s right now.  :cool:

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Learning to adapt and cope as you get older is incredibly common.

I know how it feels to come home after seeing a dismissive doc. Oh boy do I.

History can be tricky. One key I found for building a better one is educating myself about ADHD, especially personal experiences. Good books about it will have "personal story examples." Learning about it carries the risk of convincing yourself you have it, treat everything with a high degree of skepticism. But if you're on your third book about ADHD and yet again you've hi-lighted maybe 80% or more 'cause it all keeps reading as if some creepy researcher has been following you around for your whole life... well maybe there might be something there, perhaps?

Some (many) docs are incredibly skeptical of a self-educated patient. Some go so far as to presume that if you've read up about it, you only convinced yourself that you have it. Beware. Doubt yourself, the books, me, the doctors, etc. Mine for data.

Reading examples on a page, so many different ones, that seem word-for-word from your life will tend to jar your memory. Note it down. Bookmark it.

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Also check out my recent post in the 'questions about add (aka what...' thread in this forum. I go on for a while about attention regulation, energy regulation, and impulsiveness. I give a few life examples. It's small, a few things I say could be considered 'controversial' but I swear it's all there in the good books about ADHD, but it's a bit of a start.

I write fast even on my cellphone and tend toward 'incredibly verbose.' My apologies if my posts in here are a tad unreadable, LOL. Some days I can't focus enough to read my own posts. Try again some other time. Ride the interest/obsession wave. If you can hack it, read threads in this forum, you'll come across lots of 'personal example' bytes of data.

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My doc said I had ADHD when I first saw him....I was like what the? when I saw all my diagnoses. But I sucked at school and I don't work SSDI. And I still have yet to find a pill that motivates me....I have had a past drug abuse problem. And I am on ritalin and it doesn't do jack but give me headaches.....Also sometimes we just have to push ourselves harder and there isn't a magic pill thats going to help us on that issue. I know I sound like your pdoc on this but it's true.......I noticed that when I take ritalin that I just sit on the computer longer....It doesn't motivate me to go out and look for a job or do work around the house.....It just puts me in that zone if you know what I mean....I agree with you that if your issues are really bothering you and you need something to help you. and get it. Please don't abuse it for the sake of getting your work done quicker....I made the mistake of abusing it and it just causes more friction between me and my faith.

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  • 3 weeks later...

Mirazh -- I am sorry that some doctors don't like self-educated patients.  I have an undergraduate degree in molecular biology and am studying for a PhD in a health-related field, and finally, my physicians have come to recognize the fact that I am capable of rational, scientific self-care, and with my recent mis/adventures in physical injuries, chronic physical/mental conditions, this respect has allowed my cost of healthcare to go down.  It could just be the part of the North America I live in, where people respect each other for each others' domain-specific knowledge, but I dunno.

 

Anyways, um, back to the original topic and author(radicalfeminist)? Heh.

 

Well, I got a degree in molecular biology (as stated above) with moderate honors at a very tough university, and I have very severe ADD.  Of course, one has to realize that one has to take into account every single co-factor possible resulting in one being "a good student".  What courses you took, how easily you passed them, how much parental pressure there was, and how much you gussied up to the professor/teacher.

 

For one, I'm guilty of having gussied up to the professors and teachers (and still am sort of), and am also guilty of having those so-called "tiger parents" (parents who will do anything to make sure your GPA is high, including emotionally abusing the child and restricting him/her from all activities outside academics until s/he learns how to integrate by substitution in calculus).  I don't know about you, but my parents were Asian, and thus automatically assumed I could calculate an integral faster than a TI-89 calculator.

 

Actually calculus is basically a subject of PTSD for me. :smartass:  Not until about age 25 could I understand integration by substitution (or by any other means, for that matter).

 

Okay, to the point now, seriously... I am sorry your pdoc is so garish on the Wellbutrin before trying any stimulants on you.  It's a matter of his laziness and/or responsibility, since the more potent stimulants (methylphenidate/Ritalin, etc.) are  regulated by the US government as schedule II and require patient monitoring.  I'm on Concerta and I have to pick up my prescriptions by hand from my pdoc (or convince him to mail them to me) each and every month.  It's truly an inconvenience that your pdoc is trying to avoid, even though it works. You might want to talk to him about these medications, providing you can remember to refill them exactly once a month (in the US at least, there's little grace period).

 

Then there's also the argument of "information overload" in society causing AD/HD, which I personally find somewhat respectable.  At least in susceptible individuals, having to do things like being good at every subject at school and getting a job *can* drive one *to* distraction.  In fact, I think I got a 3.8 while doing my Master's degree just by ignoring the clutter in my room... :o

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@LikeMinded

 

Thanks for sharing your experiences and thoughts. I’m on summer vacation at the moment, but during the school semester I pretty much ignore every other aspect of my life just to manage showing up to class and handing in papers on time. I may end up doing moderately well, but a lot of the time it doesn’t seem worth it as I know I’m capable of doing extremely well and wish I had the attention span, energy, and motivation to manage to do even half of what other people I know do in a day.

 

The more I think about him, the more I realize how much I dislike him. I’m grateful to him for prescribing me the meds and getting me access to the therapeutic services, but he himself is actually proving to be an impediment to my progress at times like this. My main issue is that he clearly does not take what I say seriously – even if he said that stimulants or a med change at all wouldn’t be good for me for x or y reasons, that would be better than him brushing me off completely. It is exhausting. I wouldn’t be bringing these things up during appointments if I didn’t think they were pressing issues. The thing that amuses me is that half the time he’s clearly not taking my concerns seriously and the other half of the time he’s chiding me for not being more assertive. 

 

My problems could very well be caused by one of my other illnesses or my major depression which was left untreated for years, and that's fine, I just want to have some recognition that they are issues and support, information, and treatment to get through them. 

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I apologize if this has already been mentioned, but speaking of ADHD I do not do well with a lot of words :P

 

I have ADHD, diagnosed & suffering. However I am not being treated, mainly because my mood & anxiety is stable where my attention/concentration problems are fairly mild. That is one reason that my doctor doesn't like treating me for ADHD. I have attention & concentration problems, however they are intensified with depression & anxiety. And when that happens, actual ADHD treatment methods wont help the low motivation, energy level or related concentration because it isn't just ADHD.

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@radicalfeminist

 

Yeah I know, however personally my depressed low motivation & energy never was treated successfully by stimulants. I have been on Adderall XR, Ritalin, Ritalin LA, Vyvanse and Provigil and they did zilch for those symptoms when caused by depression. The only thing I respond to with those symptoms is Strattera, and only when I am not depressed. And the only meds that treated the depression side of symptoms were ADs or nothing.

 

I realize others are different, I should have clarified I was talking about myself.

 

What I have realized is that (again, for me lol) my depressed low motivation/energy is chemically different from my ADHD low motivation/energy, and I have to treat them much differently medication & therapy wise.

 

And if you are like me and they are chemically different the diagnosis may not be AD/HD, and may not be treated successfully with AD/HD medications. With stimulants, trial-and-error may work out for some people. But it is risky for someone with a Bipolar or possible Bipolar disorder. Figuring out what it is before hand, might be a really good idea.

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@LikeMinded

 

Thanks for sharing your experiences and thoughts. I’m on summer vacation at the moment, but during the school semester I pretty much ignore every other aspect of my life just to manage showing up to class and handing in papers on time. I may end up doing moderately well, but a lot of the time it doesn’t seem worth it as I know I’m capable of doing extremely well and wish I had the attention span, energy, and motivation to manage to do even half of what other people I know do in a day.

 

 

The more I think about him, the more I realize how much I dislike him. I’m grateful to him for prescribing me the meds and getting me access to the therapeutic services, but he himself is actually proving to be an impediment to my progress at times like this. My main issue is that he clearly does not take what I say seriously – even if he said that stimulants or a med change at all wouldn’t be good for me for x or y reasons, that would be better than him brushing me off completely. It is exhausting. I wouldn’t be bringing these things up during appointments if I didn’t think they were pressing issues. The thing that amuses me is that half the time he’s clearly not taking my concerns seriously and the other half of the time he’s chiding me for not being more assertive. 

 

 

 

My problems could very well be caused by one of my other illnesses or my major depression which was left untreated for years, and that's fine, I just want to have some recognition that they are issues and support, information, and treatment to get through them. 

 

First off, I hear you on that "de-motivational" feeling.  I don't know what it is, some on here chalk it up to depression, others the AD/HD, and yet others experience two kinds of de-motivation, one depressed and one that's attention deficit-related.  My current de-motivational feeling is probably due to my AD/HD being exacerbated by having to keep tab on almost every single one of my vital signs whilst recovering from a facial fracture surgery (and simultaneously attempting to lead a research project in grad school -- will let everybody know how much a debacle this one turns out, heh).  I think Cymbalta + Lamictal have my depression under reasonable control.  Going back to the initial topic's spirit, did I mention that I flagrantly fulfill the criteria for AD/HD and am leading a major research project at an academic institution? Heh.  Then again, yeah, I'm medicated with C-II Concerta, and the research project is falling behind a bit, so... :-

 

Your doctor brushing you off like that sounds almost like negligence.  Sorry if that came off a bit more harshly towards him than intended, as I'm not trying to make a statement against his person or career.  He does have a practice (and his own reputation and living) to defend and may genuinely feel that being "weak on meds" is actually best for you.  However, you're obviously the type who's willing to act responsibly for her own healthcare and I suggest you make this fact very clear to your pdoc (if you've not done so yet!).  Unlike most patients your doc has seen, you probably know a lot in depth about these meds anyways.  Your pdoc needs to match your level of intelligence and give you the "whys" if he denies an Rx; otherwise, it's simple laziness on his part.  Okay, that just sounded incredibly judgmental against him, but then again, I'm feeling rather judgmental with your situation.

 

Legally speaking, the doc has ultimate responsibility on your life.  I once had a physician who prescribed me corticosteroids for a severe obstructive asthma attack; the man didn't want to give me antibiotics for that generic fear of bacterial drug resistance.  I warned him that I had a history of intermittent sinusitis progressing to meningitis (I did, kept me out of work for 2 years and probably nearly killed me once or twice!!) and that since the steroids would suppress my immune system (had a track record of them actually exacerbating meningitic symptoms!), that he was putting me in danger.  His response: "Fine.  I'll put in a prescription for ceftriaxone [antibiotic] for 15 days.  Just make sure you see me for an office visit within 3 weeks, no charge."

 

Not that the above logic works for every doctor/patient relationship.  Worth trying? Maybe.  Your doctor could totally be turned off by the idea, and worse yet, you could be putting yourself at risk for yet-unknown side effects of medications you think may benefit you (I've even seen the same thing happen to licensed practicing doctors -- self-prescribing is never the universal best bet for anybody!!).  If you and your doc go the route of following your plan, though, remember that it's ultimately your responsibility for your body.

Edited by LikeMinded
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