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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Mike1988 on June 15, 2010, at 19:16:38
Hi,
to tell this story in the most accurate way possible i shall state some facts before hand, im a 22 year old male medical student whose currently in school and pulling of average grades
here we go , this whole story started 2 months ago when my professor assigned a paper to be done on a random psychiatric disorder. as i was in the process of selecting a topic i was keen on the disorder of attention deficit hyperactivity disorder as a topic for my paper.
as i was researching the disorder and reading more about it .it was really hard to ignore that i do fit the diagnostic criteria to the word, that's not to say that it wasn't noticed from friends and family that i could be ADHD but i neglected that as a possibility. i was extremely hyper as a child and i did have some trouble focusing at school ,but with time it wasn't as extreme as it used to be. but i do have this feeling that i could be much better off if was treated with ADHD medication.Now here's where my problem lies .
i think people might not take my ADHD seriously just because im doing fine in school and i might over exaggerate thing
but every fiber in my being knows that it could be the answer to my life long torment .
i such a case what would you suggest would be the appropriate way to address this .by the way im not from the states but i might go there to better manage this .
Posted by chujoe on June 15, 2010, at 19:32:43
In reply to My doctor doesn't believe i have ADHD, posted by Mike1988 on June 15, 2010, at 19:16:38
I was diagnosed with ADHD at age 58. Ever since first hearing of the condition 20 years ago I sort of suspected I fit the criteria, but it seemed like such a sixth-grader's disease I had a hard time taking it seriously. Besides, I was a successful professional. But I'd always had the sense that I could do more if I could stick to projects longer, if I could complete things, if I could concentrate on ideas in a sequence. Finally, while being treated for anxiety / depression I mentioned some behavior to my psych NP and she remarked, "That's classic ADHD." She gave me a questionnaire to fill out and when she looked it over the following week she prescribed Ritalin. It hasn't been that long, but I can already see that I am following through more effectively, staying on task, sitting still longer, etc. I haven't sat down and written the Great American Novel yet, but at least now I can imagine what that might be like.
Posted by Mike1988 on June 15, 2010, at 19:50:30
In reply to My doctor doesn't believe i have ADHD, posted by Mike1988 on June 15, 2010, at 19:16:38
i really appreciate your replay chujoe , its really saddening how disregarding something as ADHD by people who are not familiar with the disorder because of its stigma for affecting only little children.
it just makes you realized the potential which could be attained if you only knew better .
Posted by Christ_empowered on June 15, 2010, at 20:39:22
In reply to Re: My doctor doesn't believe i have ADHD, posted by Mike1988 on June 15, 2010, at 19:50:30
Some shrinks are more cautious with stims, just like some shrinks hate rx-ing benzos (some flat out refuse to do it, even in private practice). A lot of them seem to think the diagnosis has lost all validity and that there are other treatment options, like Tenex, high-dose stimulating antidepressants, Straterra, etc.
If you really think taking a stimulant will improve your life, get a new doctor. In larger cities, some shrinks even advertise themselves as ADHD Specialists. If you "really" have ADHD (this is impossible to determine, since ADHD doesn't show up on bloodwork or brain scans..its like asking if man "really" has a soul), then one of these docs will probably help you out. They might be inclined to try some other therapy first--Straterra, tenex, high-dose burpropion or effexor, whatever...but, then again, they may go straight for the stimulants, especially if they operate on a "cash only" basis (self-pay shrinks tend to be more...accomodating).
Keep in mind that there's no indication that stimulant-treated children actually *do* better than non-treated kids; there's no indication of an improvement in academic performance or test scores, at least on the aggregate level. Also, the stimulants are schedule II substances. Psychosis, mania, agitation, anxiety, and dosage escalation are potential risks.
Posted by Phillipa on June 15, 2010, at 21:15:09
In reply to maybe its b/c 'ADHD' is too popular..., posted by Christ_empowered on June 15, 2010, at 20:39:22
Seriously Cujoe what symptoms led to to this dianosis? What meds were you on before. I've read that if not add as a child not as an adult? True or false. Phillipa
Posted by linkadge on June 15, 2010, at 21:21:43
In reply to maybe its b/c 'ADHD' is too popular..., posted by Christ_empowered on June 15, 2010, at 20:39:22
The criteria for ADHD is (in some ways) made to fit as many people as possible. In today's fast paced world, its increasingly common that people feel distracted and have a hard time focusing on one thing at a time.
This is not to say that you are not ADHD, but to be honest the medications are a lot of ups and downs, cardiac risks, addiciton potential, increased anxiety. If you can get by without them.....
Linkadge
Posted by violette on June 15, 2010, at 21:38:07
In reply to Re: My doctor doesn't believe i have ADHD, posted by Mike1988 on June 15, 2010, at 19:50:30
There seems to be a lot less stigma associated with ADD/ADHD than with other mental issues. Strangers, meaning people who I just met, will come out and say "I have ADD". I've observed this on several occasions. Rarely do I meet people who announce that they have depression or bipolar disorder.
My child was diagnosed with ADHD/ADD, to a T, at age 8. Sometimes I think ADD is a type of anxiety, much like OCD is a type of anxiety (as well as PTSD), a malfunction of brain circuitry. Some people who I know with ADD are very OCD (I don't think of OCD primarily as the common belief of washing hands excessively, etc. People can have the O without the C.
Maybe it would be taken more seriously if it was referred to as AOCD. OCD symtpoms are also the leading mental health complaint, or so I have read at one time or another. But then again, as it is now, people unfamiliar with mental health seem to seperate ADD from being 'crazy' unlike other mental disorders. I see that as a mixed blessing.
Posted by chujoe on June 16, 2010, at 5:41:15
In reply to Re: maybe its b/c 'ADHD' is too popular..., posted by Phillipa on June 15, 2010, at 21:15:09
> Seriously Cujoe what symptoms led to to this dianosis? What meds were you on before. I've read that if not add as a child not as an adult? True or false. Phillipa<
Hi P -- Looking back it's really obvious that I was undiagnosed as a kid. (How could I have been, since the condition hadn't been identified?) As a child I had a hard time focusing on tasks, was by turns aggressive and needy, suffered from scrupulosity, went off on tangents; as an adult, beginning in college, I missed deadlines, dropped classes, turned in rushed work that could/should have been better, procrastinated -- these behaviors continued into my professional life & though I'm smart enough to have compensated for them over the years, I have always known that I was handicapped, not by lack of intelligence, but by something that kept deflecting me from my path. In the past this would have simply been chalked up to a failure of character, of course, and many people still think of it that way. Now that I'm taking a stim, I can focus in the way I imagine other people do without effort.
For example, I was building a trellis in the yard yesterday and i noticed that whereas in the past I would have stopped and started six times and maybe not finished for several days, I simply slowly and methodically went from one task to another and finished the job before noon. In my professional work, I have begun to organize years of notes and ideas and put them into shape for productive writing projects -- it's early days, but I'll let you know hot that goes in the coming months.
So it may be true that ADHD always manifests in children, but for my generation, they just said, "He's scatterbrained" or something like that. I also suspect that the ADHD dx is now overused, but that's another discussion.
(BTW, It's Chujoe, not Cujoe. Chujoe means Uncle Joe in Vietnamese.)
Posted by chujoe on June 16, 2010, at 5:47:52
In reply to Re: My doctor doesn't believe i have ADHD, posted by violette on June 15, 2010, at 21:38:07
>>My child was diagnosed with ADHD/ADD, to a T, at age 8. Sometimes I think ADD is a type of anxiety, much like OCD is a type of anxiety (as well as PTSD), a malfunction of brain circuitry. Some people who I know with ADD are very OCD (I don't think of OCD primarily as the common belief of washing hands excessively, etc. People can have the O without the C.<<
This may be the clearest and most accurate few words I've ever read on the subject! My ADHA dx came about because I was being treated for severe anxiety with obsessional thinking (the O w/o the C) and it's very clear to me that the two are intertwined -- a combination of brain "wiring" and early environmental / experiential factors.
Posted by violette on June 16, 2010, at 12:00:12
In reply to Re: My doctor doesn't believe i have ADHD » violette, posted by chujoe on June 16, 2010, at 5:47:52
Hey there,
The thought that sparked that description came from a picture of an OCD thought pattern model I saw in a psychodynamic manual or somewhere, in addition to giving this a lot of thought from observing my child, reading, etc..I wish I could find that picture to pass along to you, but I can't find it. Here's a model I just found:
http://beyondpsychology.org/disorderlinks/Obsessive_Compulsive_Disorder.shtml
I didn't read the article, just was looking for a visual model of OCD. Anyway, I think there should be a model like that for ADD/ADHD. Maybe there is one and I don't know of it?
You know how people with ADD get tics in addition to the OCD symptoms? That led me to think through this more and I think ADD/OCD is more related to autism. Like people who have an autistic gene(s) combined with environmental/psychiological factors end up getting ADD. Does anyone in your family have autism? I have similar thoughts about schizophrenia being more in the autism family rather than the "axis I" disorder it is classified in.
I also have wondered if right brain dominated people might end up with different manifestations of mental disorders than left-brained, either as contributing to the cause of the disorder or as a result of the way the brain has adapted. I know I have problems with left brained thinking and have become aware that I had compartmentalized my thoughts--seperating emotions from thought, rather than integrating them. Its a dysfunction; it might be schitzoid related, I have to think about that more. I didn't notice this until I started psychodynamic therapy, then realized I had been doing that for years.
I was diagnosed with ADD in middle age; I developed the symtpoms but I know I don't have ADD...it's just that I have had every type of anxiety that exists and for some unknown reason, my anxiety changes-its ranged from GAD, to panic disorder to PTSD, OCD, to ADD..those are just descriptions of symptoms that reflect how my brain deals with fear and other emotional crap. I think the diagnostic criteria used by mainstream psychiatrists is detrimental to treatment in many ways.
I never thought anyone would be interested in any of my goofy theories, but there you go. I have to quit thinking about this stuff and get back to living my life. This is a bad habit for me!
Posted by chujoe on June 16, 2010, at 13:52:34
In reply to Re: My doctor doesn't believe i have ADHD » chujoe, posted by violette on June 16, 2010, at 12:00:12
Violette, I hope you won't completely give up on thinking about this stuff -- I find that your information and speculations rhyme with my own! Let me respond to a couple of specific things:
1. I have a cousin with mild autism. A lot of my family tree is lost to me (bad marriages, abandonments, etc.) so there might be others, or none.
2. People tell me I'm very right-brained, which makes sense -- I'm an artist and writer. Richard Bentall in his book "Madness Explained," cites studies that suggest a link between certain forms of mental illness and "over-lateralization" of the hemispheres -- your theory may have empirical support. (Aside: I think there are two kinds of writers: those who write because they are so fluent, and those who write because language is such a struggle for them they need to write and rewrite in order to get their thoughts straight. I'm the second kind of writer.)
3. I learned very early to compartmentalize feelings, but this was largely due to a family dynamic in which most kinds of emotional display were off-limits. This is another case, perhaps, of psychology influencing neuroanatomy.
4. You'd also like Bentall's book because he insists that the names we have for most of these diseases don't really name any single thing, but constellations of underlying symptoms.
Posted by mike1988 on June 16, 2010, at 14:08:03
In reply to Re: My doctor doesn't believe i have ADHD, posted by Mike1988 on June 15, 2010, at 19:50:30
Hi,
i really appreciate your feedback guys and it really shows you how important this subject is . ADHD as a disorder has never been fully understood there are a lot of theories of why it is so prevalent in our modern day society from environmental to its genetic factors. This being said I guess reading about it youll come to realize that it is a sea without shores.
I guess trying to figure out what it is does little help if any to people afflicted with the disorder. it is my personal opinion as an ADHD patient I really don't care what it is as long as it is treated!!! We could waste hours and hours debating what is the exact origin of the disorder are and it could be beneficial for psychologist/psychiatrist for research. I do think its not of any benefit of the patient to be the victimized for such an endeavor. I do believe the disorder has being treated and is manageable regardless of its nature.
Again this is my own personal opinion
Defining it even more and trying to label it correctly has never favored ADHD patients.
ADHD is such a life ruiner people who are not afflicted with the disorder my regard us as stupid/unorganized/vulgar or failures if you were to ask to be judged as such no human being would ever agree to that.
people Who are being treated for ADHD i think the most appropriate word said is (this is a god send ) i don't know if Mr.chujoe would agree with me or not but i think this is by far the most blessed period of his life after being managed with the disorder .
Psychiatrist should think of this as a disabling disease not a label
Posted by mike1988 on June 16, 2010, at 14:29:07
In reply to maybe its b/c 'ADHD' is too popular..., posted by Christ_empowered on June 15, 2010, at 20:39:22
> Some shrinks are more cautious with stims, just like some shrinks hate rx-ing benzos (some flat out refuse to do it, even in private practice). A lot of them seem to think the diagnosis has lost all validity and that there are other treatment options, like Tenex, high-dose stimulating antidepressants, Straterra, etc.
>
> If you really think taking a stimulant will improve your life, get a new doctor. In larger cities, some shrinks even advertise themselves as ADHD Specialists. If you "really" have ADHD (this is impossible to determine, since ADHD doesn't show up on bloodwork or brain scans..its like asking if man "really" has a soul), then one of these docs will probably help you out. They might be inclined to try some other therapy first--Straterra, tenex, high-dose burpropion or effexor, whatever...but, then again, they may go straight for the stimulants, especially if they operate on a "cash only" basis (self-pay shrinks tend to be more...accomodating).
>
> Keep in mind that there's no indication that stimulant-treated children actually *do* better than non-treated kids; there's no indication of an improvement in academic performance or test scores, at least on the aggregate level. Also, the stimulants are schedule II substances. Psychosis, mania, agitation, anxiety, and dosage escalation are potential risks.
I dont know if this is based on personal experience or not, if so can u provide the steps needed to see a specialist in the disorder and are there any prerequisites I.e. do I have to bring my medical recorders or a referral from my own psychiatrist.
I have spoken to my psychiatrist today and he agreed that the diagnosis is valid and hell start me on concerta 18 mg.
I want to talk to some one who is specialized in ADHD or at least has experience dealing with it. Just to have a broad view of the modality of treatment
thanks
Posted by violette on June 17, 2010, at 17:57:30
In reply to Re: My doctor doesn't believe i have ADHD » violette, posted by chujoe on June 16, 2010, at 13:52:34
Chujoe,
You know, I bet being an artist and writer helped you cope with ADD all these years. In fact, I think ADD is an asset in many ways, despite how difficult as it is to deal with. It sounds like having a creative channel/outlet may have helped you.
I watched a movie recently about Temple Grandin--the first autistic person to complete college (it's based on a true story). She got a PhD. She saw the world from a different perspective...if you are not familar with her story, she innovatively redesigned cattle slaughterhouses to not only be more efficient, but to be more humane. Her autism gave her the ability to see things differently. Well, you have to watch the movie to get the full sense. Cattle slaughterhouses are not the most interesting topic, but the story was very provocative.
Sometimes I think medicating for ADD can take away from the benefits of less common ways of thinking. Of course that's a personal decision, but it does cross my mind. It's difficult when the world around you is designed for non-ADDers; so you have to fit in with society rather than the other way around...And since more people are left brain dominant, public school cirriculum is designed for that type of thought pattern (at least it was when I attended public schools). It wasn't until I went to college that I was able to truly be intellectually engaged at school. I had poor grades in high school, but I noticed colleges that are more inter-disciplinary are of much greater interest to me and my grades were much better.
I could be your twin-not as in Kohut's twin transference-but literally:
- I also have a cousin with autism (not mild)
- My family tree is also lost to me for similar reasons (I have future thoughts of marrying someone who has a large, well-connected family)
- Also a very right-brained/lateral/holistic thinker
-Compartmentalizing feelings, imo, is an adaptation developed to cope with emotions, which can result from not being able to express emotions as you stated, ranging to negative parental reactions and all in between...Except: I'm not an artist or writer, but an artist-writer 'wanna be'...I'm creative but I don't think I'm talented enough to make a living off of art, but I do think about it often.
- The 2 'types' of writers is a very interesting observation...but another way to look at the 2nd type of writing is that you think abstractly and visually, and writing allows you to crystalize those thoughts into more concrete terms.
Thanks for the book recommendation. I haven't read a book in a long time (concentration/focus issues), but I put this book on my list after reading this excerpt from a review: "For Bentall, these classifications have little more scientific value than astrological predictions based on zodiac signs." (in regard to DSM diagnoses)
Then after reading Jaspers' concept, noting he was a psychiatrist and philosopher, I moved the book up to #2 on my list of books to read....
This stuff does distract me from work, so I do have to lighten up, but thank you for your post.
:)
Excerpt from book review:
"The philosopher Karl Jaspers, who was trained as a psychiatrist, made a distinction between `understanding' and `explaining' madness. He argued that in the case of psychoses, the most severe form of mental illness, no attempt should be made at understanding what appears as incoherent speech or meaningless behavior by investigating a patient's background and making sense of what he has to say. Rather, psychologists should try to explain psychotic behavior by dividing patients into discrete categories and establishing causal links that should ultimately point towards brain malfunctions or genetic defects.
Richard Bentall shows us that attempts to explain and to understand mental symptoms are inextricably linked. Rather than postulating an unambiguous dividing line between the mentally sane and the insane, he proposes that irrational beliefs and abnormal behaviors manifested by psychotic patients can be seen as the far end of a continuum on which people are distributed. The differences between those who are diagnosed as suffering from a psychiatric disorder and those who are not amount to relatively little, and these differences appear to be understandable when viewed in the context of what we know about normal human psychology.
The classification of psychiatric disorders into neuroses (such as benign forms of depression or phobias) and psychoses (such as manic depression and schizophrenia) dates back to Emil Kraepelin and a number of Karl Jaspers' contemporaries. Although the concepts originally formulated by German psychiatrists at the turn of the twentieth century underwent a series of transformations, the idea that psychiatric disorders fall into a finite number of categories remain the organizing principle for psychiatric practice and research, as evidenced by the successive editions of the DSM diagnostic manual. For Bentall, these classifications have little more scientific value than astrological predictions based on zodiac signs. According to his rather extreme contention, we should abandon psychiatric diagnoses altogether and instead try to explain and understand the actual experiences and behaviors of psychotic people."
Posted by chujoe on June 17, 2010, at 19:13:55
In reply to Re: My doctor doesn't believe i have ADHD » chujoe, posted by violette on June 17, 2010, at 17:57:30
Violette, you're right -- partly. Until about ten years ago being a writer / professor gave me the freedom to set my own schedule and I did pretty well, though I habitually missed deadlines, left important tasks unfinished, etc. Finally, it got so bad I could hardly do any creative work at all. The medication of course is not going to fix this instantly, but it seems so far to be giving me the ability to return to doing what I want to do and to focus enough to be able to work steadily for extended periods. Meds are only the door: I still have to walk through.
Posted by violette on June 17, 2010, at 21:02:44
In reply to Re: My doctor doesn't believe i have ADHD, posted by mike1988 on June 16, 2010, at 14:08:03
I hope the medications help you both achieve your full potential. From observing my child's situation, it seems depression symptoms themselves are a side effect of dealing with ADD. Much like my anxiety, where mild depression seems to be more of a side effect...
Stimulants help, for sure. Although I likely don't have ADD, the stimulants helped me with ADD symptoms; unfortunately, they quit working so well and I just have to manage (as opposed to trying more drugs). That's a concern-what happens when stimulants no longer control symptoms?
That's something I don't hear about too much. What happens when those with ADD develop a tolerance to stimulants? I suppose you move on to another medication, or are there adaption mechanisms people develop to cope? Acceptance? Acceptance, I noticed, is helping me deal with my mental health situation. I'm starting to accept myself more, with 'flaws' and all, realizing both the good and the bad can positively contribute to my overall disposition in how I relate to the world.
I came across this blog; Zoe's posts seem inspiring to me:
I thought I'd pass it along after coming across it in case anyone is interested. I also wanted to congratulate the 2 of you for recognizing the cause of your obstacles.
ps - Mike, I know the causes, symptomology, or overall nature of ADD can be debated over and over, but it seems to me that research is based upon classification and labeling; the result: solutions/treatments are derived from those original classifications. Maybe I'm a bit obsessive about this, who knows. Anyway, good luck with your treatment plan. :)
Posted by morganator on June 17, 2010, at 22:33:39
In reply to Re: maybe its b/c 'ADHD' is too popular..., posted by mike1988 on June 16, 2010, at 14:29:07
If you are functioning fine and doing well in school, why take medication??? Have you ever considered that your ADHD is a manifestation of other deeper issues that make it hard for you to focus as well as you think you could? Anxiety alone can manifest in ways very similar to ADHD symptoms. Then there are the deeper issues that are causing the anxiety. This is where therapy comes in. There could also be underlying anger and depression. You don't necessarily have to feel like you have a problem with depression/sadness, anger, or anxiety for any of them to be present and affecting your behavior in some way. Just food for thought. Things are usually much more complex than what we want to believe in this blame everything on the way I was born and simply take a pill to make it better world.
Posted by linkadge on June 18, 2010, at 21:13:59
In reply to Re: My doctor doesn't believe i have ADHD, posted by violette on June 15, 2010, at 21:38:07
People will say they are "so ADD" even if there is no formal diagnosis. Its as if it is just used as an unsubstantiated excuse for poor work performance or motivation.
Linkadge
Posted by chujoe on June 19, 2010, at 6:22:13
In reply to Re: My doctor doesn't believe i have ADHD, posted by linkadge on June 18, 2010, at 21:13:59
> People will say they are "so ADD" even if there is no formal diagnosis. Its as if it is just used as an unsubstantiated excuse for poor work performance or motivation.
>
> LinkadgeWhich is surely unfair to those of us who have a formal dx. Many of us, btw, have spent years figuring out how to work around our ADD in order to do well in our jobs, but it is nevertheless a huge relief to not have to exert all our energy on countering our ADD.
Here's a hint: if you take a stim and after the first couple of days it amps you up you probably don't have ADD; if it calms you down, you probably do.
Posted by morganator on June 22, 2010, at 0:23:08
In reply to Re: My doctor doesn't believe i have ADHD, posted by chujoe on June 19, 2010, at 6:22:13
> > People will say they are "so ADD" even if there is no formal diagnosis. Its as if it is just used as an unsubstantiated excuse for poor work performance or motivation.
> >
> > Linkadge
>
> Which is surely unfair to those of us who have a formal dx. Many of us, btw, have spent years figuring out how to work around our ADD in order to do well in our jobs, but it is nevertheless a huge relief to not have to exert all our energy on countering our ADD.
>
> Here's a hint: if you take a stim and after the first couple of days it amps you up you probably don't have ADD; if it calms you down, you probably do.I personally don't think it is that simple. We all want the simple explanation that is easily fixable with some pill. Very few want to dig deep for the complex and sometimes painful truth. I'm not saying that many cases of ADD/ADHD are not rooted in some genetic predisposition, I'm just saying that there most likely is so much more that contributes to the ultimate development of symptoms. This is the same with such disorders as bipolar, schizophrenia, and anti-social personality. It's the truth, and the truth usually hurts. As they say, "Ignorance is Bliss".
This is the end of the thread.
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