This COULD be ADD, right? RIGHT?

October 15, 2012 9:30 AM

At this point I’m 90% convinced that I have inattentive ADD. I’m going to see an expert soon, and now I’m freaking out thinking that I’m deluding myself and just looking for a cheap excuse for being such a mess. Also, what could I do if it’s really not ADD? I feel like I’ve exhausted my options. Long and snowflakey.

So here’s why I think I have ADD:
- I feel easily overwhelmed in new situations, particularly in social ones, and it takes me a long time to get comfortable. I get anxious without being able to really tell why. I think it mostly it mostly breaks down to not knowing how I should behave in that situation.

- I’m generally pretty lethargic, without actually enjoying doing nothing. I spend most of my time with reading, video games, movies and the internet, but I don’t get a lot of satisfaction out of that. I DO get satisfaction out of creating stuff (painting, woodwork, sewing and so on) but I never seem to get around to actually do any of that.

- I procrastinate, hard, in various areas. This has been especially harmful in school and university.

- I’ve never been able to establish some ongoing order in my apartment. While I can make it look presentable if I absolutely have to (and this often involves throwing random crap into boxes and hiding them until the visitors are gone), the result doesn’t last more than 48 h at most.

- SO: “Woah, did you see that women dressed in eyeball assaulting neon colors/that guy carrying a monkey on his shoulder/that 20qm billboard we just passed?”
Me: “Huh? Nope, sorry.”

- I can get really excited about something like a new hobby, but the second I face any kind of difficulty I drop it and turn to something else.

- Same with projects. I have an ever growing humongous list with things I want to/need to/should do; once in a while I might even start something, but I rarely finish it.

- “The future” is a very nebulous concept to me; the past is really foggy too. How the fuck can people say what they’ll do in 2 years and remember what they did in 2007?

- I’m terribly inpatient. It took me several years to get some professional help partly because I couldn’t stand the thought of waiting months for an appointment

- I scored badly in several categories in an elaborate concentration/attention-test, in which I participated as a proband about 10 years ago; don’t know which categories exactly because I lost the results sheet.

- I’m clumsy.


Other fun facts about me that could be linked to ADD according to stuff I’ve read:

- I’m a smoker
- I’m obese
- I’ve had eczema from infancy up to my early 20s
- I grind my teeth at night
- I regard caffeine as an essential nutrient
- My muscles are really tense in general


Stuff I tried so far:

- Students counseling which covered work techniques as well psychological problems

- A broad range of countless self-help-books

- I got various medical checkups, my thyroid’s fine, no vitamin/mineral/whatever deficiencies (apart from vitamin D, but I got this fixed. Fewer colds for me, yay!), no allergies.

- Nevertheless I supplement with omega 3’s, b-vitamins, zinc, and magnesium mostly out of vanity reasons

- Dietary changes: I’ve discovered I’m prone to reactive hypoglycemia and that I do better with a low carb diet

- Exercise

- Getting enough sleep

(While a good diet, exercise and sleep make me feel a lot better, they don’t make me more productive. And I have a really hard time sticking to it)

- Therapy

So I was diagnosed with social anxiety and moderate depression. I’ve been in therapy for 2 years now and while it has helped me a great deal and I really like my therapist, my progress has come to a halt and I’m getting more and more frustrated. I feel like we are tackling the symptoms, but not the cause of my problems.
I’ve mentioned the possibility of ADD to my therapist a few times, but he dismissed it. He attributes my problems to 1. Social anxiety 2. Unreasonably high standards 3. Lack of appropriate techniques and routines (all 3 related to my upbringing) 4. Being whiny and lazy (no, he didn’t say that, but it kind of leaks through.) His advice can be brought down to “accept that I’m a low energy person” and be done with it. Why self-acceptance is a good thing of course, this advice fills me with rage. It doesn’t feel like acceptance to me but like defeat.

Why yes, I feel bad that I haven’t gotten my academic degree yet at age 30, that I work in a brainless dead end job where I don’t make enough money to support myself and that I don’t spend any time turning my talents into skills because there’s kittens on the internet to look at. Left and right I see people building their careers, raising kids, travelling the world, pursuing their interests, setting goals and reaching them. People who I KNOW aren’t smarter or nicer than me. I feel inferior and ashamed, and I don’t have anyone to blame but myself. I’ve been deeply unsatisfied with my life for decades, I’ve tried to change and I have little to show for it. I’m losing hope and starting to feel bitter.

So right now I see getting diagnosed with ADD and receiving medical treatment as my last real chance to steer my life in a more positive direction, and that scares the shit out of me.
What if my therapist, friends who tell me that I’m perfectly normal if only a little socially awkward and lazy, and my family who tells me that I’m just a lazy slob who will never amount to anything (Thanks, Mom!) are right? What then?

Also, does medication really make (that much of a) difference? I’ve read a lot about other treatment options and it feels very been there done that (If someone tells me again to break a job into small steps or gee, have you tried writing a to-do list? I’ll scream).

Help, please? Thanks!

posted by akrasia to Health & Fitness (14 answers total)

So I don't know obviously if you have ADD or not, but for me getting treatment for anxiety and depression helped me with my total lack of any concept of the future, not just planning for it but actually like, picturing it, which is something I picked up on in your question as well. My anxiety was giving me a lot of symptoms that seemed like ADD (again not saying you don't have it, or that anxiety issues mimic ADD in any clinical way, this was just my experience).

He attributes my problems to 1. Social anxiety 2. Unreasonably high standards 3. Lack of appropriate techniques and routines (all 3 related to my upbringing) 4. Being whiny and lazy (no, he didn’t say that, but it kind of leaks through.)

I think 1), 2), and 3), are REALLY good insights, and your therapist should be helping you reduce your social anxiety, ease your high standards and develop techniques, NOT just tell you to accept it.
posted by sweetkid at 9:45 AM on October 15, 2012

I have to say that your ADD symptoms don't sound anything like my own. I think that as you eat right, establish a good sleep routine and exercise, you'll probably have more energy, which makes it a lot easier to undertake unpleasant tasks, like getting organized and cleaning up.

Once you get your stuff and living space under control, then you might have room to set up a place to do crafts, sew, etc..--it's a drag to have to haul all the equipment and supplies out just to have to put then all away again. I'd rather not do anything if that's what it takes to make a pillow.
And once this happens, then you can be creative and do stuff, and that's when you start to feel better about yourself. You might also think about joining some sort of group--knitting, dancing, whatever, that will get you out of the house, mingling with new people and that also helps with feeling better about yourself. Baby steps, sure, but that's how you start. I think yoga is also helpful with tense muscles and enjoying your body.
posted by Ideefixe at 9:59 AM on October 15, 2012

ADD/ADHD is a constellation of symptoms, which may or may not have a common underlying cause. There are a series of diagnostic tools, from questionnaires to cognitive tests, that give a better view of what your exact symptoms are.

I've been diagnosed with ADD as an adult (inattentive) and your symptoms overlap with me somewhat. While I tried for a long time to deal with ADD without drugs, finally I kind of admitted that it was beyond my personal control. My doctor agreed with me; he said, "ADD is chemical. Why not use drugs?" I've been taking bupropion since, which helps a lot with both inattentiveness and general anxiety — the biggest benefit it's given me is helping me get over the shame cycle of procrastination where you don't end up following through because you've let things go too far, yet you let those things keep hanging and causing anxiety. It also helps me make lists.

It's not a panacea — I still have many of the symptoms of ADD, but it's easier to manage a lot of them, and I'm generally happier. (My house is still wildly disorganized, though.)
posted by klangklangston at 10:19 AM on October 15, 2012

"So right now I see getting diagnosed with ADD and receiving medical treatment as my last real chance to steer my life in a more positive direction, and that scares the shit out of me."

Don't do this to yourself. This is not your last chance, and putting pressure on yourself to 1) diagnose yourself and 2) decide that you need to get better *right now*, is not going to help you. Maybe try a different therapist? And don't listen to people who lay moral judgments on you and blame you, that's just obnoxious.
posted by facetious at 10:29 AM on October 15, 2012 [3 favorites]

Best answer: A data point for you, which may or may not be helpful: I know somebody with a lot of those symptoms - not every single one but almost all of them (think 95%). He has been evaluated twice by doctors for ADD, and while the doctors agree that some of the symptoms look like ADD, they do not think he has ADD. Similarly to you, he has been diagnosed with social anxiety, perfectionism leading to procrastination, and depression. Treatment for depression helped him a lot, although he was not "completely cured". He has made a lot of progress in his life, though, by confronting the reasons why he procrastinates or is unproductive or doesn't spend time on the things he really values. In think that in some ways, it's easier to say "I have ADD" rather than examining the specific, personal reasons for one's behavior.

Don't lose hope. Your therapist sounds like he's helping to point out your issues, but he's not helping you solve them. (Point being, you may need a new therapist.) I've been there - I've had therapists help me be crystal clear about my problems, but that's reaaaaaaally only half the battle. The next step is making SPECIFIC efforts to deal with your SPECIFIC problems. This takes energy and focus, I know. But you can do it. You just have to be willing to try even when you don't 100% believe it will work.
posted by Cygnet at 10:40 AM on October 15, 2012 [2 favorites]

So unless I'm misreading, it sounds like you haven't tried medical treatment for the anxiety and depression you've already been diagnosed with.

My advice would not be "Seek ADHD medication" but just "See a psychiatrist" more generally. He might say "Yes, I agree with your therapist, this is classic anxiety, and here's how we're going to treat it." He might say "I agree with you, this really looks like ADHD, and here's how we're going to treat it." He might say "There's a couple possible diagnoses, and a couple treatment plans we could try, but here's what we're going to do to find the right one for you."

Any of those would be progress, yes?

(And unless your therapist is some sort of crazy extremist, any of them would be compatible with staying in therapy, which you should totally also do.)

You don't need to convince yourself you have ADHD before going to a psychiatrist. In fact, if you trust the psychiatrist,* it's better not to go with a specific diagnosis already picked out. Just go and be honest about your symptoms and concerns and see what advice you get.

*Having a really good psychiatrist whose judgment you trust makes a huge, huge difference. Some docs are good listeners; some aren't. Some stay up to date on new research; some just read pharmaceutical sales brochures. It would be a very good idea to ask around for recommendations (either in your own circle of friends or here on AskMe or wherever) before setting up an appointment.
posted by nebulawindphone at 10:43 AM on October 15, 2012 [5 favorites]

IANAD and especially not YD, but some of what you describe sounds more like depression that ADD (or ADHD). Especially the anhedonia and difficulty with executive functions: "I spend most of my time with reading, video games, movies and the internet, but I don’t get a lot of satisfaction out of that. I DO get satisfaction out of creating stuff (painting, woodwork, sewing and so on) but I never seem to get around to actually do any of that."

In addition to talking to a therapist, since you've been doing that for two years and feel like you've plateaued, have you talked to a doctor or psychiatrist about getting medication for depression rather than for ADD? The two often go together, and many people respond better to ADD meds after the depression has been addressed. Most ADD meds are stimulants, but they're not intended to deal directly with the "low energy" or social anxiety that often come with depression. In fact they may make your depression worse. One of the paradoxes and dangers of all mental illness is that the distort our perceptions; self-diagnosis is rarely a good idea.
posted by RandlePatrickMcMurphy at 10:49 AM on October 15, 2012

Adhd Medication isn't magic. If you are a smoker, more stimulants may not be very helpful. What is your therapists approach? At they doing talk therapy or CBT?
posted by humanfont at 1:00 PM on October 15, 2012

i don't have a whole lot to help you, but here it goes. ADD, like all mental health disorders, is socially defined, diagnosed. i'm sure someone will comment after me about "something something brain scans" to say there is physical proof like any other disease, but the fact remains the mechanisms of mental health disorders are not well understood. you can look up the diagnostic criteria. what counts as a "significant disruption" is pretty subjective.

so, just because someone says you "have" it or not doesn't mean you actually do or don't. two doctors can have different diagnosis for the same person, and ideology can really color the way people think. as much as it's said that there's a huge boom in ADD diagnosis, it's can be very difficult to get the help you think you need. ESPECIALLY at a college campus, where it's there job to brush you off.

i think if ADD meds can help you they can help you but it may take a long time to find the right doctor.

if you can get ADD meds through some other way, you might want to try that. Unless you think you have a high risk of becoming a drug addict you won't do any harm to try it for a while. you may find it helps you a lot and you'll be more confident in advocating for yourself, or may find it doesn't work well, and you can try something else.
posted by cupcake1337 at 2:04 PM on October 15, 2012 [1 favorite]

oy gevalt, no, self-prescribing medication is not the kind of self-empowerment you need. taking responsibility for your own healing process and busting your ass on your own behalf, is.
posted by facetious at 2:24 PM on October 15, 2012

You have nothing to lose by discussing possible ADHD with your doctor and trying a med for it. Ritalin has made a positive difference for me, and the fact that I reacted so well to it when anti-anxiety drugs and antidepressants had failed me in the past was all the proof I needed that it was indeed ADHD, rather than something similar. Your symptoms sound like mine. Your therapist sounds like a bad fit, by the way. It's not their job to tell you, or imply, that you are simply lazy.
posted by xenophile at 4:24 PM on October 15, 2012

Response by poster: Thanks for your answers so far, time to answer some questions:

My therapist is a CBT therapist. During a session we usually talk about what I did since the last session, how I felt about that, what I could have done better, and what I plan to do until the next session. He doesn't give my explicit "homework" or anything like that, so I don't know in how far this constitutes "proper" CBT.

Just wanted to add that I don't disagree with his diagnosis, and yes a lot of it can be explained by my not-so-ideal relationship with my parents and their behaviour, but I don't think social anxiety and depression are ALL there is. I can't shake the feeling that something is not quite right with me on a biological level, and no amount of talking will change that if that's the case.

It propably didn't look like that in my original post, but my social anxiety and my sense of selfworth have really improved over the years, also partly because of my therapist. For instance, I don't care that much anymore if my job is prestigious and I don't care about accumulating riches, I just want to earn enough to be self-sufficient and do something which is somewhat in line with my interests and abilities. I want to grow, to learn, not for others, but for myself. Which isn't really happening and this lack of self control is what brings me down.

I haven't been prescribed any medication; I selfmedicated with St. John's Wort for a short time, but had a scary reaction although I took a conservative dosage. So I'm wary of selfmedication apart from my usual nicotin & caffeine abuse.

I know I really shouldn't selfdiagnose, yet here I'm doing it again. After further thinking and research (and remembering past research) I think I might be low on dopamine. It matches my symptoms really well, also those I haven't mentioned in my post. The guy I'm about to see is a neurologist, so he should be well equipped to find out if this is true. I guess I should just describe my symptoms and let him take it from there. Or do you guys think it's possible to voice my suspicion without sounding like a hypohondriacal nutjob who believes everything on the internet?
posted by akrasia at 6:33 PM on October 15, 2012

Best answer: Just tell him what you're thinking. Worrying that your psychiatrist will think you're nuts is... well, entertaining irony aside, it's just not all that productive. The point is to be honest with the guy about what you're experiencing.

The things to avoid are (i) getting really attached to a particular diagnosis and setting out to convince him of it; (ii) showing up with a particular med in mind and trying to give the "right" answers so that you'll get it; (iii) spending more time debating about pharmacology or presenting the fruits of your internet research than you spend describing your symptoms.

Your main goal is just to give your doc an honest impression of how you're feeling and what symptoms are bothering you. If talking about stuff you've read or research you've done makes it easier to explain yourself, then do it. If it doesn't, then don't waste too much time on it.
posted by nebulawindphone at 7:35 PM on October 15, 2012 [1 favorite]

If you have anxiety you need to reduce your nicotine and caffeine use. Adding Ritalin or Adderal to the mix is going to be unpleasant. As a former heavy caffeine user with aniety and ADHD, I find mixing any caffeine with ADHD meds is really anxiety provoking. My persona approach was to taper off caffeine over several weeks. Then work with my doctor to find an SSRI to help with anxiety issues. Once that go under control we were able to work on the ADHD problems and assess them for what they were. Also I can't emphasize how much better I do when I stick to healthy eating and regular exercise. The pills have me the ability to focus enough to make those things happen, but if you don't do them the pills are not nearly as effective.
posted by humanfont at 7:56 PM on October 15, 2012 [2 favorites]