As a mother of a young adult male with ADHD, and as a teacher who works with many children in the first, second and third grades, I applaud you for your honesty and your ability to gain knowledge about the disorder. I have lived with a husband with adult ADHD, who was never medicated, a child with ADHD who was but is not now and many students, some who use medications and many who do not. I would like to let everyone know that there is help out there with therapy and with medications. It just takes time and understanding to work through the issues and a team effort is the best approach, parents, counselors, neurologists, doctors, and teachers who want to help can make a difference with students and people with ADHD. Tahnks for your great article and interview. DLH
Mr. Laskoff made a statement, which I don't believe is quite accurate. He stated, "but I had learned that child psychologists are often the best trained and most knowledgeable when it comes to diagnosing and treating ADHD in adults".
While it is certainly true that child psychologists are well versed in diagnosing kids with ADHD, the Adult form of ADHD often presents quite differently. In addition, the DSM-IV-TR diagnostic criteria are based on pediatric populations, not adult ones.
Perhaps one of the biggest gaps is that many adults with ADHD only began to experience such impairment in their teens, as uip until then, either their world was very structured and/or their raw intelligence buffered them from the demands of life, which they later experience.
The rule, rather than the exception in Adult ADHD is that, typically, attentional problems have largely to do with disorganization, poor time management, procrastination, and an inability to multi-task. Hyperactivity in adults is typically expressed as inner restlessness.
Perhaps, most striking, is that in Adult ADHD, the rule, rather than the exception, is that of the overlap other disorders, including mood disorders (depression and bipolar illness), anxiety disorders, impulse control disorders, substance use disorders, behavioural addictions, and certain personality disorders.
Dr. Teplin,
You seem to be one of the rare adult mental health professionals who knows anything about ADHD in Adults. From what I can see, even today it isn't taught in med or grad school. Those who know can see that ADHD often underlies anxiety and depression. But, it you don't think to look, an SSRI is given for those conditions. At best, this medication will relieve some of the unhappiness but it won't help the underlying problem. The old joke is "If you give a kid with ADD an SSRI, s/he still can't do anything, but now s/he doesn't care."
Or, the SSRI will relieve the depression and anxiety enough to re-activate the underlying silly kid. That silly kid is then called bipolar and treated with mood stabilizers, which also don't help the underlying problem.
Any thoughts on how we can move this knowledge into the wider world of psychiatry?
Thank you.
Dr. Teplin:
Cathi Z. has already made a lot of very good points, but I should start with an apology. When we did the interview, I should have used the word psychiatrist instead of psychologist. Child psychiatrists, in general, certainly receive more training in ADHD than their counterparts who deal with an adult population. That is a generalization, however, that is not meant to apply to every individual.
What the world could use are more trained professionals who have your level of interest, knowledge and perspective. Unfortunately, for everyone who has accesses to psychologists of your apparent professionalism, there are many, many more who don't. Until that happens, people in need will have to find help wherever they can. T
MBL
Hi Ms. Z,
The short answer is that I think it is a process, like anything else in life.
It was not too long ago that we thought the world was flat, and even more recently in time, we called people who stared up at the moon! Wonder if the Crew aboard the Apollo Spaceship in the late 1960's would concur??
The best way to "fight off" conspiracy theories about ADHD is through replcated and well designed and methodical clinical research, including that of neuro-imaging.
DT
DT:
I appreciate you saying so.
It's funny, I've talked about having ADHD lots of times before that, but it was only when I mentioned it in the context of pot smoker and the pundit that people suddenly took notice.
Frankly, I was appalled that someone who is so vocal about living better through daily cannabis use and another who had multiple teachers suggest that more than one teacher suggest that two of her children had ADHD could be so closed minded about the possible benefits of pharmacology.
Oh well, it's a strange world.
MBL
Hello Doctor Teplin and welcome to our site!
You make some good points here especially about the great overlap of disorders. In addition to writing for this site, I also write for My Depression Connection and Anxiety Connection and I can tell you that many of our members coming to those sites present with symptoms typical for ADHD. I am going to be writing about the problems with diagnosing ADHD in the weeks to come. I hope you come back to discuss your insights and knowledge on the problems with diagnosis.
What you say here makes me wonder about my son who is 14 now and still has so much hyperactivity...will he eventually grow out of it? I am hoping that will be the case.
Thank you so much for your time in coming to read and comment! We hope to see you more on this site.
Hello Merely Me!
Thanks very much for giving me the opportunity to post.
I will be sure to continue to check into the site, and others like it, as this is where it is reinforced that a person isnt their diagnosis; rather, they meet diagnostic criteria for something we call ADHD.
The greatest lesson I have learned along the way is that behind EVERY diagnosis (ok, except for the very small minority of psychopaths in the world!!) is a human being trying to do his/her best to function/cope with the major areas of his/her life.
Best,
David Teplin
All I can say is hang in there. I have spoken to a few adults who did not find out about their ADHD until their children were grown. The revelation helped both parties enormously, but it was a slow process and not always easy.
Knowing that you have ADHD will not erase some of the hurt that others feel – rightly or wrongly – have built up over time. Fortunately, insight into who you are and why you are gives you more capacity to develop and improve relationships.
This is am amazing & eye opening article to read on Adult ADD...
I've read many many articles, but this one hits it on the button!!!
I so often feel the need to explain myself and be on the defense to everyone as to "Why I'm Lazy..." , "Just can't get my act together...", "Alwyse Late", "Such a Mess" and all that stuff ... No one ever believes me :( .... But I don't blame them...
But I will be passing along this article to them, maybe things will become a bit clearer for them!
Anon:
Educate, yes. Get the word out, let people know, etc. Just don't stop there. There's a massive gulf between understanding what "might" explain your condition and verifying that it's the case. Only after you do the latter can you take action that will improve your life.
ADHD is neither an excuse nor a reason while anyone will cut you any slack. Knowledge of ADHD is, however, power if you choose to use it in a way that will allow you to live a better, happier life.
Get to it.
MBL
It has been 10 years since my diagnosis of ADHD (I had always known that there was something different about me). I realized I had it when my 7 year old son was diagnosed and I started reading about it in order to help him.
After 10 years you forget the amazement and significant impact the knowledge, counciling and medication made. It was a whole new world...this article brought back that feeling more than anything else I have read. I am a very different person now, I like myself.
My son has grown into his teen years and is really comming into his own. He is on medication and has had counciling since his diagnosis. I have always tried to focus on the positive impact that ADHD can have when you are capable of compensating for the difficulties and focusing on your positive qualities.
I am an Artist. I am a much better Artist than I once thought I could ever be. My son is also very creative in the Arts, I strongly encourage this. To those who dismiss the exhistance of ADHD, I wish you could see the amazing change medication and compensation counciling has made through my eyes. You would never doubt it again.
Hi there Kathy and welcome!
You all have me wondering about myself now...some of my son's traits I do see in myself as well. My son is artistic as well...he has been drawing since the age of four and...I am just so thrilled that he has this passion and creative outlet. I think your point of finding some sort of creative expression is right on the money. For my son it is art...for me it is my writing.
Anyways...nice to meet you and I do hope you stay on with us to share more.
When people ask my why it's worth treating ADHD if you've lived with untreated for so many years, they expect me to answer that it helps me to cope with work or allows me to finish tasks, etc. That's all true, but it's not why I take medication. I take medication to live a happier and more fulfilled life. And you know what, it works.
For those people who need more practical convincing, I talk about the difference between parallel and serial processing. Like many people with ADHD, I believe that coping with the condition has made me more creative. This is a direct result of having to 'problem solve' to complete tasks that most people find mundane. Since my brain is wired differently, I have to find alternative ways to what most people would consider the obvious. That can be an imperfect process, which registers as a deficit. (I can't spell, remember names and always keep my mouth shut when I should.) But in a pinch, when the way forward is not clear, that capacity to consider multiple, seemingly unrelated possibilities, can be highly useful. We call that creativity, and I believe that it's really just highly refined problem solving (on a deadline).
Parallel processing is ideal for people – like me – with short attention spans, but it never allowed me to realize my greater ambitions, like building a new business from scratch. To do that, one needs to be both creative and able to build on past accomplishments – consistently and over a long period of time. In other words, fulfilling my dreams and ambitions requires a capacity for both parallel and serial processing. ADHD forced me to become good at the former; medication has allowed me to become better at the latter. The result is AbilTo, which I hope will help many others who are struggling with ADHD and other behavioral challenges.
The result of achieving at least some of my long-term goals is that I feel more fulfilled and less restless. That helps me to be happier and better able to relate to my family, friends, colleagues and the wider world around me. That's not only good for me, it's good for all the people around me – those with and without ADHD alike.
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Hey Michael!
Just wanted to say thanks again for doing this interview. I think anyone who has adult ADHD will be very interested in what you have to say and how you have coped so very well over the years.
You are a true inspiration!
I hope you will stick around our site, we could definitely use your insights and knowledge about ADHD.
Actually, I'd like to point out that Merely Me raises two kids, stays current on all the ADHD happenings and finds time to write about it. My suspicion is that it's not highly paid work, but it's simply fantastic to have a trained professional with a positive and practical disposition out there writing on our collective behalf. A big, figurative round of applause for Merely Me. MBL
That's really nice of you Michael! Many thanks.