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ADD / ADHD (Expert Forum)
24 y/o F with possible ADD
Answered by
Rebecca Resnik, PsyD - Parenting Instruction, Developmental Disabilities, Psychological Assessment
MindWell Clinical Psychology
Chantilly - VA
Questions in the Attention Deficit Disorder (ADD–ADHD) forum are answered by Rebecca Resnik, Ph.D.
24 y/o F with possible ADD
by ilaria_agape, Jun 16, 2009 11:49AM
My question is: is it possible for me to have adult ADD if I don't struggle with hyperactivity? ... and would a doctor be willing to give me a prescription for medication based on my inability to focus and stay on task along with several other symptoms? I exercise every day, eat well ( organic) , and don't do drugs or drink too much alcohol - I get 8 hours of sleep a night. I have also read a lot of books about time management, productivity, meditation, and things like "Power of Now" and "New Earth" to try and zero in on my thoughts and calm them down.
Symptoms:
*IMPULSIVENESS- I stress this because once something gets into my head - I have to purse it - like spending money or eating something I'm not supposed to
*Forgetfulness - i have to always check for my keys, sunglasses, phone - I forget plans and cancel last minute
only being able to focus if it is something that I'm actually interested in
*starting new endeavors and not being able to finish them once the thrill of starting is over and I'm no longer interested
*losing, dropping things
*being overwhelmed by little things... it's like I think about it too hard - small things like getting something out of my car or refilling my water bottle or sometimes even taking a shower - seem like such daunting tasks
I should mention that Hyperactivity does NOT seem to be a symptom.
I did well in high school and college because it fosters an environment where the process was not important, it was getting it done. So I procrastinated a lot and finished work on pure adrenaline. So because I did well.. my parents never noticed. Plus, they are Christian Science and practice homeotherapy… there was no way they would even address this as more than a need to make a change in diet and do some fasting. I have my own health insurance now and I would like medication. I need a little help to get over this. I can’t do it by myself… it is so hard, depressing, and frustrating. I have tried everything.
What should I tell my doctor?
Symptoms:
*IMPULSIVENESS- I stress this because once something gets into my head - I have to purse it - like spending money or eating something I'm not supposed to
*Forgetfulness - i have to always check for my keys, sunglasses, phone - I forget plans and cancel last minute
only being able to focus if it is something that I'm actually interested in
*starting new endeavors and not being able to finish them once the thrill of starting is over and I'm no longer interested
*losing, dropping things
*being overwhelmed by little things... it's like I think about it too hard - small things like getting something out of my car or refilling my water bottle or sometimes even taking a shower - seem like such daunting tasks
I should mention that Hyperactivity does NOT seem to be a symptom.
I did well in high school and college because it fosters an environment where the process was not important, it was getting it done. So I procrastinated a lot and finished work on pure adrenaline. So because I did well.. my parents never noticed. Plus, they are Christian Science and practice homeotherapy… there was no way they would even address this as more than a need to make a change in diet and do some fasting. I have my own health insurance now and I would like medication. I need a little help to get over this. I can’t do it by myself… it is so hard, depressing, and frustrating. I have tried everything.
What should I tell my doctor?
Doctor's Answer
by Rebecca Resnik, PsyD, Jun 16, 2009 12:50PM
, Jun 16, 2009 12:50PMTo: ilaria_agape
Hello,
As you may have discovered in your research, hyperactivity is less commonly observed in adults and females of any age with ADHD. Individuals diagnosed as children tend to display less hyperactivity as they age. Typically, hyperactivity diminishes as people age to the extent that symptoms no longer significantly impact day-to-day functioning. Individuals with ADHD also tend to choose jobs where they can move around or where there are frequent changes or exciting challenges. Intelligent people with ADHD can be successful in college or graduate school, yet they generally continue to have organizational and time management problems. Just as you described, many people with ADHD wait until the last minute to do work so that the adrenaline 'rush' will help them focus. Some call adrenaline a 'natural Ritalin.' Your symptoms related to impulsivenss, forgetfulness, organizational problems, and struggles with self-motivation are part of the diagnostic criteria for ADHD. A diagnosis of ADHD includes an onset of symptoms prior to age 8, as well as impairment across settings (e.g. home, work, school).
Many primary care providers treat symptoms of ADHD with stimulants or alternatives such as Atomoxetine (Strattera). Often, physicians and psychiatrists will prescribe stimulants to treat symptoms after they conduct a diagnostic interview with you and/or perform an examination to rule-out other factors that could be creating these symptoms (such as a mood disorder or thyroid problem). Stimulants are generally considered to be very safe, though side effects can be unpleasant. Expect to try more than one stimulant to find one that works well for you. You can also expect to keep in contact with your prescriber to adjust the dosage or the schedule for how the drug is released into your body. Some stimulants come in clever capsules designed to release the medication over time so that it will remain in your system at a therapeutic dose throughout the day. Keep in mind, however, that many people experience cognitive enhancement from stimulants, not just individuals with ADHD. Just because stimulants help, that is not in itself diagnostic.
Some of your symptoms, such as your mild compulsions, are not necessarily associated with ADHD. I recommend that you ask your primary care provider for a referral to a psychologist who can provide testing and therapy. A psychological assessment can determine if you have impaired attention and executive functioning, and allow you to obtain accommodations at work as a person with a disability. Testing can also help you and your psychotherapist determine how to help you overcome problems or maladaptive behavior patterns that have been getting in your way, regardless of whether they are the result of ADHD or other factors. While medications do mitigate symptoms, learning new behaviors and coping strategies will give you long-term benefit without the side effects.
Best Wishes
Rebecca Resnik
Disclaimer: The information in this post is for informational purposes only. It is never intended to replace face-to-face psychological or medical care. This post is not intended to create a patient-clinician relationship, nor to give or rule-out a diagnosis.
As you may have discovered in your research, hyperactivity is less commonly observed in adults and females of any age with ADHD. Individuals diagnosed as children tend to display less hyperactivity as they age. Typically, hyperactivity diminishes as people age to the extent that symptoms no longer significantly impact day-to-day functioning. Individuals with ADHD also tend to choose jobs where they can move around or where there are frequent changes or exciting challenges. Intelligent people with ADHD can be successful in college or graduate school, yet they generally continue to have organizational and time management problems. Just as you described, many people with ADHD wait until the last minute to do work so that the adrenaline 'rush' will help them focus. Some call adrenaline a 'natural Ritalin.' Your symptoms related to impulsivenss, forgetfulness, organizational problems, and struggles with self-motivation are part of the diagnostic criteria for ADHD. A diagnosis of ADHD includes an onset of symptoms prior to age 8, as well as impairment across settings (e.g. home, work, school).
Many primary care providers treat symptoms of ADHD with stimulants or alternatives such as Atomoxetine (Strattera). Often, physicians and psychiatrists will prescribe stimulants to treat symptoms after they conduct a diagnostic interview with you and/or perform an examination to rule-out other factors that could be creating these symptoms (such as a mood disorder or thyroid problem). Stimulants are generally considered to be very safe, though side effects can be unpleasant. Expect to try more than one stimulant to find one that works well for you. You can also expect to keep in contact with your prescriber to adjust the dosage or the schedule for how the drug is released into your body. Some stimulants come in clever capsules designed to release the medication over time so that it will remain in your system at a therapeutic dose throughout the day. Keep in mind, however, that many people experience cognitive enhancement from stimulants, not just individuals with ADHD. Just because stimulants help, that is not in itself diagnostic.
Some of your symptoms, such as your mild compulsions, are not necessarily associated with ADHD. I recommend that you ask your primary care provider for a referral to a psychologist who can provide testing and therapy. A psychological assessment can determine if you have impaired attention and executive functioning, and allow you to obtain accommodations at work as a person with a disability. Testing can also help you and your psychotherapist determine how to help you overcome problems or maladaptive behavior patterns that have been getting in your way, regardless of whether they are the result of ADHD or other factors. While medications do mitigate symptoms, learning new behaviors and coping strategies will give you long-term benefit without the side effects.
Best Wishes
Rebecca Resnik
Disclaimer: The information in this post is for informational purposes only. It is never intended to replace face-to-face psychological or medical care. This post is not intended to create a patient-clinician relationship, nor to give or rule-out a diagnosis.
