Do I need to be medicated or am I just a lazyass?
October 22, 2012 9:20 AM   Subscribe

Should I maybe get evaluated for ADD or ADHD?

I'm starting to wonder if I need to make an appointment with my primary care physician or ask for a referral to a psychiatrist to be evaluated for ADD or ADHD. History: since childhood I've had a hell of a time buckling down to focus. In particular, schoolwork: I was not an unintelligent child, but I sometimes lagged behind my classmates in completing things because I could not make myself concentrate. Examples: I became a voracious reader and loved books later on in elementary school, but the unstructured, go-at-your-own-pace reading comprehension exercises assigned to us during 2nd grade meant I was going at a frickin' snail's pace, because it was, y'know, soooo boooring and my 8 year old brain could not manage to stop checking out. Unlike reading, math never got easier, because my attention span for any given problem was flea-like. Short assignments took an unreasonable amount of time to finish, because I'd be repeatedly distracted by... anything else my brain could think of that was more interesting than this long division problem.

When I was 12, a cousin my age was diagnosed with ADD, and there was some discussion about that being something I might have, but while my issues were problematic, I was still actually an okay student and it was never anything that was severely debilitating my progress.

But my issues with focus and concentration are still around. I'm now 30, and in my last semester of my undergraduate degree. I've maintained a good GPA and am still a decent student, but I think I could have done so much better these past few years. I'm a TERRIBLE procrastinator, extremely avoidant about assignments I'm not really interested in, to the point where I will just not check my email for several days in a row to avoid emails from partners or profs. To fulfill my last few credits, I'm doing research with a prof, which involves some unstructured paper writing on my part, which I'm way, way behind on. And it's not even like it's a difficult paper? I just can't bring myself to work on it. (I actually should be working on it right now.)

Prior to returning for my undergrad degree, I was working as a receptionist. There was some amount of paperwork that I completed as part of my daily routine and I could have easily taken on more work, but instead it took me a really long time to complete easy but monotonous tasks, because there was always something I needed to look up on the internet, or Metafilter to refresh, or email to check, or whatever. Anything to avoid working on actual work for more than ten minutes at a time. I actually think probably made existing issues with concentration worse.

So, I can identify that I have issues with a) lack of structure to keep me on task, b) focusing on things that I find monotonous or boring, and c) procrastinating and avoiding things that I know I'll have trouble concentrating on, d) I also, embarrassingly, every few months will let unpaid bills pile up. Not because I can't pay them, just because I... don't want to deal with it? I don't know. Again, it's like I just can't bring myself do just open the envelope, take out my checkbook, and write the check. It's... dumb. I think everyone sort of has some of these things, do some degree or another, right? So it possible that I'm simply extremely mentally undisciplined and need to start some meditation regime or something? Or does this sound like it could be an ADD or ADHD thing? I'm basically doing alright in life, I keep my apartment clean, I'm generally healthy otherwise... I just wonder if I could be doing better.

Hivemind, your thoughts, please? I'm not trying to oversell my case here, but should I make the call to the doctor?
posted by hegemone to Health & Fitness (14 answers total) 5 users marked this as a favorite
So it possible that I'm simply extremely mentally undisciplined and need to start some meditation regime or something? Or does this sound like it could be an ADD or ADHD thing?

I really don't see a reason why it can't be both. If your insurance covers it, talk to your doctor. It does sound like it could be ADD or ADHD or whichever, and there's no harm in asking.
posted by FAMOUS MONSTER at 9:27 AM on October 22, 2012

Best answer: I received my ADHD diagnosis this year (I'm 31 and could have written every word of your post) medication has helped a lot, although now I'm fighting 20 years of ingrained bad habits. That said, at least I can fight it now.
posted by dadici at 9:29 AM on October 22, 2012

Best answer: You sound very similar to me: voracious reader as a child, yet had trouble getting schoolwork done, "routine" tasks at work can take forever, had trouble getting bills paid, etc.

I got diagnosed at age 31. According to the psych who diagnosed me, I'm an "edge" case, but I've found the lowest dose of meds to be really helpful both at work and in things like getting bills paid.

Anyway, it sounds like attention issues disrupt your life enough that it couldn't hurt to go ahead and get screened.

So it possible that I'm simply extremely mentally undisciplined

Here's an interesting thing - ADHD impairs the "executive function" area of a person's brain. So, in a way, ADHDers are "less mentally disciplined" - it's not mutually exclusive and there shouldn't be a value judgment attached to that.
posted by lunasol at 9:31 AM on October 22, 2012

medication has helped a lot, although now I'm fighting 20 years of ingrained bad habits. That said, at least I can fight it now.

This, definitely. Don't look at medication as the "easy way out" - look at it as a way to develop the good habits you were never able to before.
posted by lunasol at 9:32 AM on October 22, 2012 [3 favorites]

where I will just not check my email for several days in a row to avoid emails from partners or profs

I don't think that's ADD as much as it is immaturity and avoidance of conflict. Meds might help, but so might CBT or just working on growing up.
posted by Ideefixe at 9:50 AM on October 22, 2012 [1 favorite]

I finally got diagnosed in my last year of undergrad at age 27, and finally started getting treatment about two years ago. I take bupropion, and it's made a pretty big difference, especially at getting rid of the shame cycle that comes with procrastination. I still dread admitting that I've slacked off, but I'm better at it and better at just getting things done now. Go get tested — even if you don't end up having ADD/ADHD, it's a good thing to know, because then you can focus on other remedies.
posted by klangklangston at 9:57 AM on October 22, 2012

Best answer: Look into it. Don't listen to those who tell you to that lack of discipline is the problem and all you really need to do is force yourself to focus. Been down that road. "Muggles" do not understand.

It's worth getting help finding out if you are ADD or not. It is a brain-wiring thing, not a made up disorder.

One way to know for sure is how you react to a trial dose of, say, Concerta. Concerta is basically an amphetamine. When I take a dose, my mind is calm and I can focus. I do not get jumpy or hyper. I do not go into overdrive and get tons accomplished. I can simply focus on what I need to do without having to entertain every stimulus that crosses my periphery. People with true ADD react to that kind of stimulant differently than "muggles."

My wife took one dose of my med just to see. That day, after cleaning the whole house, she chopped down a dead tree in our yard, cut it up, bagged it, and dragged it around to the front yard for the heavy trash guys who weren't coming for four more days. Then she crashed.

When I take the same dose. I can spend an hour with a spreadsheet without driving myself crazy fighting distractions.

Anyway, it's a physical thing. You'll know it if you got it. Worth finding out.
posted by cross_impact at 10:24 AM on October 22, 2012 [2 favorites]

Of course, not endorsing illegal drug experimentation at all. Go the legitimate route.
posted by cross_impact at 10:28 AM on October 22, 2012

You could be extremely mentally undisciplined from a lifetime of ADHD. I got diagnosed this past March after attempts at disciplining my mental habits kept failing. I actually taught these self-management skills to ADHD children as my job, but couldn't apply them myself. After some self reflection that sounds a lot like yours (except I had medicated/unmedicated grade school children to compare myself and my history to) I spoke with my primary care physician.

He ended up giving me a 10mg daily dose of Adderall. It's not much, it's not even a full day's worth of a dosage, but the change it has made in my ability to function is magical. It's like it bores little holes in my wall of inattentiveness and my self-management skills finally have a way to grab hold instead of sliding down a slippery slope of stimuli.

It's so worth it to ask.
posted by teslacoilswoah at 11:28 AM on October 22, 2012 [1 favorite]

If you're asking the question, the answer is almost always yes. It never hurts to get the opinion of a professional.
posted by empath at 11:50 AM on October 22, 2012

If you're asking, you should be evaluated.

Here's a self-reporting scale to complete and bring with you.

Look at the CHADD Directory (my dad was a member for decades!) for folks who are dedicated to helping people with this disorder and who are up-to-date on the latest trends.
posted by Ruthless Bunny at 1:55 PM on October 22, 2012

I got diagnosed at 21 and started Adderall shortly thereafter; I'll be 23 in a month and am now in a doctoral program. I wish so much that I had started taking Adderall earlier, and have noticed recently that even on days when I haven't taken it or after it's worn off, I'm still better at paying attention to things and not getting distracted.

I take 15mg of extended release either once or twice a day; it depends on my schedule and how I'm feeling.
posted by naturalog at 8:39 PM on October 22, 2012

To directly answer your question: maybe neither?

It takes a lot of practice to keep on top of stuff as an adult. Judging by the number of non-diagnosed adults who love using ADHD meds off-label to get stuff done, there's no clear boundary between those who require meds to function period and those who experience distinct but marginal productivity improvements.

One thing to keep in mind is that if you start taking Adderall, Ritalin or any Schedule II US drug daily, the burden to maintain your prescription is high: you can't be prescribed more than a 30 day supply at a time, you can't get refills over the phone, you must visit your doctor in person once a month, and your pharmacy might run out regularly. Some doctors will require you to undego monthly urinalysis. If you develop a dependence on these drugs, as almost everyone does, running out is pretty hellish. It's unfortunately something to consider in the cost-benefit analysis.
posted by SakuraK at 11:00 PM on October 22, 2012 [1 favorite]

You sound like me. I was diagnosed last month and have been taking Ritalin. It calms and focuses me and helps me be more organized. It does help with the bill-paying thing, too, which I can relate to. If you aren't sure you have it, and you take a med like Adderall or Ritalin, your reaction to the med can be confirmation. Amphetamines relax me, so yeah...pretty sure my diagnosis is legit.
posted by xenophile at 11:11 AM on October 23, 2012

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