Could I have ADHD despite my general togetherness?
May 25, 2010 8:41 AM   Subscribe

I am generally calm, happy, and successful, but lately I am very unfocused. Could I have ADHD?

The good stuff: I am an 8th year lawyer, and have had a pretty good career so far. I like my job and am interested in the work. I graduated with high honors from a good college and in the top 10 students at a top 20 law school. I am happily married with two kids in a clean house and am generally regarded as being a pretty chilled out guy. I would like to think that my wife is satisfied with the level of assistance I provide around the house, and I spend a good deal of time cooking/gardening/fixing stuff and crossing it off the list.

The "bad" stuff: I can relate to LOTS of the comments on this thread about what it feels like to have ADHD, especially at work. I frequently have multiple tabs open on my browser, and will often switch from a telephone call to an e-mail to a contract review back to that e-mail to Google to someone visiting my office to talk. (This just happened as I was drafting this question.) My red-flagged messages in Outlook tend to stay red-flagged until some further e-mail or telephone call wakes up the issue and I turn my attention that way.

I have to date convinced myself that I don't need to see a doctor or take medication because I have been successful in my life so far and have managed to juggle everything. I've chalked up the inattention at work to the nature of my job - I get 100+ e-mails a day, and I am in charge of 50 or so different ongoing company projects. But lately I have started each day with an exhortation that I would make real progress and ended each day with exasperation that I have more flags than I started with, and that I've wasted a good deal of time messing around. I am a little bit scared - maybe without any reason - that taking medication will mess up my brain or turn me into a worse husband or dad.

I should say that I don't at all think that people who have ADHD are always unsuccessful or bad at what they do, but reading most descriptions in prior AskMes suggests that the symptoms have caused some disruption in people's lives.

So after all that, here's the question: could I have ADHD, despite the fact that the symptoms are mostly limited to my time at work and despite the fact that I am on the whole successful in my life and career (and have been for 30+ years)?
posted by Duluth?! I Hardly Know Her! to Health & Fitness (9 answers total) 4 users marked this as a favorite
If you're concerned enough to post this question, then maybe you should seek out a therapist who can conduct a proper evaluation and tell you for sure?

What you describe here doesn't seem to meet enough of the criteria for ADHD, but again, only a qualified professional can actually diagnose you. Regardless, seeing a therapist may help you learn strategies for dealing with your work and time management issues whether you have ADHD or not. I can't see how it would hurt.
posted by zizzle at 8:45 AM on May 25, 2010

One of the criteria for diagnosing ADHD (as per DSM) is that symptoms causing impairment must have been present before the age of 7. Another is that the impairment must occur in two or more settings (in my case, I was experiencing distinct issues at school, work, and home). Short answer: Maybe you have ADHD? Long answer: Maybe you have ADHD, but you may also just have organizational issues with your particular job, and only a qualified diagnostician (i.e. a psychiatrist who works with adult ADHD) will be able to give you an answer.
posted by purlgurly at 8:46 AM on May 25, 2010 [3 favorites]

Hi, I'm a seventh-year lawyer, and have what sounds like a very similar job. And guess what? I have the same problems! I am almost certain that I do not suffer from ADHD--these symptoms have grown as the attention demands of the job have increased. At any given time I am working on dozens of projects across multiple cases, and the high-speed attention switching gets ingrained, I think. My brain starts itching if I have to focus on a single project from more than about 30 minutes. Think of it as a mental repetitive strain injury. While I am still working on solving my organizational problems, I am pretty confident that medication is not a solution.
posted by monju_bosatsu at 8:56 AM on May 25, 2010 [2 favorites]

IANAD/IANAP, but if you were "calm, happy and successful" before this for most of your life, and NOW you are feeling unfocused and less able to function - looking at what you have on your plate I think it is probably stress and/or anxiety. I definitely would talk to a doctor or therapist, and mention all the stuff you are trying to do each day. I'm betting they'd suggest something more along the lines of organizational systems and calming exercises like meditation.
posted by Rosie M. Banks at 9:25 AM on May 25, 2010 [1 favorite]

Nthing what everyone has said about age of onset.

That said: "I am a little bit scared - maybe without any reason - that taking medication will mess up my brain or turn me into a worse husband or dad."

FYI, the purpose of medication is to make you better.
posted by Sys Rq at 11:01 AM on May 25, 2010

Nthing the "if you're concerned, go see a professional" advice, preferably a specialist, not your GP. I initially brought it up with my GP during my annual physical after reading that amazing thread which seemed like my autobiography. She referred me to a psychologist who specializes in ADHD. I met with him for 3 hours over two sessions, and we went through my whole history from elementary school to today, did some computer tests, and had my mom and a friend fill out a form asking for their observations. He also did a smaller screen for depression and anxiety, which can lead to ADHD-like symptoms.

In my case, I was diagnosed with it and just started on Ritalin LA. It hasn't been as miraculous as some of the experiences described in that thread, but for the first time in my life, I can start a task and do it until it's done, even if it's boring. I can keep a to-do list and actually get the things done. I can listen to my boss talk without interrupting her. All of these things are pretty awesome. My plan is to gradually build more structure into my life with the help of a coach, something I could never do before.

FWIW, I know everyone is different, and no two cases of ADHD are exactly the same, but that system you have of flagging emails to be read later? I know it seems like nothing, but I would never in a million years be able to stick with a system like that over the long term. Hopefully I can with treatment, we'll see.

Nthing what everyone has said about age of onset.

ADHD is not something that typically comes on in adulthood, but one thing I have heard is that people with ADHD who were able to do well in very structured environments (like law school?) start to fall apart when their lives get more complicated. That's sort of what happened for me, but it's important to note that I always had these symptoms - it was just easier to cope in school. I could always just write papers or cram for exams at the last minute (can I get a w00t for hyperfocus?), but that doesn't really work in the "real world."

Finally, if it is pretty recent, there are a lot of physical conditions that have ADHD-like symptoms, including simple fatigue or stress.
posted by lunasol at 1:51 PM on May 25, 2010

putting the tl;dr first since this is for a possible ADHD OP. :-)
tl;dr - Yes it's possible, and maybe a starting point is to read about organizational strategies for working with ADHD as an adult if you aren't ready to talk to a psychiatrist or doctor about it.

could I have ADHD, despite the fact that the symptoms are mostly limited to my time at work and despite the fact that I am on the whole successful in my life and career (and have been for 30+ years)?

It is possible. I have read quite a bit about ADHD, and have learned that it is often not diagnosed in many bright people who have been able to coast through school and who have figured out ways to adapt to their ADHD.

I've worked with a psychiatrist on my ADHD, which was never diagnosed until I was 28. I've always had some strong symptoms of ADHD (report cards from first grade indicated that I used to daydream, constantly talk to classmates, sing to myself, and doodle unrepentantly), but I was smart and often got decent grades. Furthermore, I had other stuff going on in my life that most of the adults in my life blamed my lack of focus on. At any rate, I was not OBVIOUSLY suffering (despite my secret but often significant frustrations with myself), and was doing pretty well, so no one really looked into it. An additional factor is probably also that I am female, and females do tend to present a bit differently (less hyperactivity, more inattentiveness).

In addition to being able to coast in school, I also realize now that I found ways to adapt to my brain. Sure, I procrastinated a lot -- but that's because when the deadline was finally close, and I got that rush of adrenaline from the panic of meeting that deadline, I did AWESOME work. I could suddenly focus and produce amazing stuff. It probably also helped that as a child, I went to a pretty strict Catholic school through 6th grade, and then to a public but very academically competitive junior high and high school. I had a ton of structure, I was involved in a million activities, and I did well because I was always stimulated and was given a lot of structure.

Now that I am approaching 30, I consider myself a pretty successful person. I graduated from a decent university with a good GPA, am in grad school part time, and have been gainfully employed and generally seem to be regarded as a good employee. Of course, I hide the constant battle with myself and my ability to focus from the view of others. I do struggle with organizing myself, especially when juggling multiple projects, a deluge of email, and a million things vying for my attention. I find myself getting overwhelmed and lost quite easily, or hyperfocusing on something that if I stood back and really thought about it doesn't really matter in the least.

Once I talked to a psychiatrist about my focus problems, which had previously been chalked up to depression, it became pretty clear that it was ADHD. Medication helps, but I think what has helped more was learning how to work with my brain instead of against it.

I've done some reading on Adult ADHD. One thing that you might want to consider is that not everyone manages their ADHD with medication. There are many books written on organizing yourself and your life to work with your ADHD. While a little cheesy, I like this list of tips for Adult ADHD management. ADDitude Magazine's website has some great articles with advice for work and home. I also really like the books ADD-Friendly Ways to Organize Your Life and Delivered From Distraction.
posted by tastybrains at 2:18 PM on May 25, 2010 [2 favorites]

Dittoing what other folks have said about how you might as well talk with a doctor about it. Or you might find it helpful to do some reading first-- I'd recommend books by Edward Hallowell, Kathleen Nadeau, and/or Sari Solden.

Generally speaking, and I am not a doctor, my understanding is that one of the key aspects of ADHD is that it is not situational but broader. Just because within a specific context (work) at a specific time (now) you're experiencing things that are like what folks with ADHD experience, it's unlikely that you have ADHD if you don't have those symptoms in other contexts and throughout much of your life.

However. You can have symptoms throughout your life and in many contexts, but they may only actually interfere with your life in this one now, and in that case it would seem more possible that you could have ADHD. Mine's relatively mild, and while looking back I clearly see the symptoms stretching back to my childhood (being disorganized and forgetful, hyperfocusing and not noticing when people were talking to me, etc), I was a smart kid and was able to compensate for that and excel in school anyway and it didn't really interfere with my life before college, and even in college although I procrastinated like crazy I could still pull off B+ work consistently at the last minute (although I knew I could've done better if I'd started sooner/worked harder.) And while it definitely interferes with my work when I'm unmedicated, I could also totally imagine myself being in a different kind of job where it wouldn't. If that were the case, it wouldn't mean that I didn't have ADHD anymore (although I suppose it technically might mean I didn't have it to a clinically significant degree according to the DSM), I would still be the same person I am now, it would just be less of a problem in my life.

So. I guess I would suggest you try to understand the symptoms of ADHD, and look for those symptoms in other parts and times of your life, rather than putting too much emphasis on how much they've actually interfered with your life vs your ability to be successful and "together."

And I would definitely suggest you talk to a doctor/therapist about the symptoms at some point, regardless. That awful end of the day "I wasted all that time, I'm a failure" feeling sucks. Even if you conclude that you're pretty sure it's not ADHD, my understanding is that there are other things, like anxiety and depression, which can cause many similar symptoms. Worth looking into.
posted by EmilyClimbs at 8:53 PM on May 25, 2010 [1 favorite]

Nothing in your "good stuff" list necessarily indicate that you are not ADHD. However, given that you have worked eight years as a lawyer before starting to wonder, should give you pause. It may be that your job has (only recently?) forced you to fragment your attention so much that it feels like ADHD.

Here is a good test -- buy a copy of Driven to Distraction, give it to your wife to read, and ask her. Assuming that she has known you for a number of years, she will be far more objective. Plus, she is probalby far less frazzled than you.
posted by UncleJoe at 1:47 PM on May 26, 2010

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