Too smart for ADD?
December 13, 2012 4:14 PM   Subscribe

I think, but I'm not convinced that I might have ADD. When I talked to a psychologist about getting tested, he told me that because I do very well in college, there is very little likelihood that he or any other psychologist would diagnose me with ADD.

After reading MeFi threads and other stuff online, I think I might have ADD. I'm a senior in college and it had never occurred to me before because I have always done really well in school. However, I've also always had huge procrastination issues, constantly lose things, have a really hard time watching a movie or hour long tv show, get distracted in the middle of conversations or lectures, can't finish projects I start or finish them poorly, forgetting when something happens etc. Any paper I've ever written was on the last night before it was due, after hours and hours of procrastination even if it was something I w,as interested in and I basically had to just hope that hyperfocus kicked in.

Based on this, I've convinced and then unconvinced myself of it twice in the last few months and I finally started doing something to figure it out. I talked to my mom and then called my primary care doctor's office and they referred me to a psychologist. My mom called the psychologist to set up an appointment and found out that insurance probably wouldn't cover most of the testing, but she talked to the psychologist and gave a brief explanation. His response was that because I do so well in school, he highly doubted that he or any doctor would diagnose me with ADD.

The psychologist said that rather than go through the whole ADD testing and pay for it, it would be possible to do a 45min screening at a nearby hospital to get an idea of whether it would be worth it.

On one hand, I don't want to cling to my internet based self-diagnosis. I'm not in any danger of failing out, even if I don't write my thesis and I can deal with everyday life, even if I do it differently than other people. I'm not doing this so I can get proscribed Adderall; it's that it's reached a point where it's starting to effect my life and I want to do something about it, whether it's therapy or learning time management skills or drugs.

On the other hand, it's reached the point where it is impacting my life and it's incredibly frustrating not be able to work on anything that doesn't instantly grab my attention. Watching my friends start writing a paper without spending two hours on the internet first or read interesting journal articles without needing to for school literally blows my mind because I cannot imagine doing those things even though I want to.

I also think that part of the reason I've done so well in college so far is that habit from the really structured nature of high school lasted for the first year or so and somehow few of my classes have required long papers. Last year, when I had to write my first 15 page research paper, despite knowing that I needed to start researching ahead of time, I kept switching topics and ended up doing all the research and writing in four days with almost no sleep. Right now, even though I was determined to not repeat the experience and I am extremely interested in my topic, I can't seem to stop it from happening.

Anyway, I am going to do the 45 minute screening and see what they say. I realize YANAD, but I have some questions and I'd like some second opinions on what the psychologist said.

Is the psychologist right in saying that I won't be diagnosed because of my grades?

Has anyone had experience with the full testing vs. a 45 minute screening?

I've always felt that my procrastination and forgetting/losing stuff would either go away with adulthood or was a result of laziness. I'm starting to think that's not true. I'd like to hear from anyone who has similar problems but doesn't have ADD because I feel like I'm getting confirmation bias after reading so much stuff.

Does any of what I've said sound like ADD? It's more than just writing papers, but at the moment, that is the most clear and frustrating thing.
posted by raeka to Health & Fitness (25 answers total) 13 users marked this as a favorite
I went to Harvard for undergrad. I am back in school taking pre-med classes with a 4.0 GPA. I have ADHD.

That doctor doesn't know what he's talking about. Get a second opinion.
posted by ocherdraco at 4:26 PM on December 13, 2012 [10 favorites]

I got a 3.6 in college and I've been diagnosed with ADHD by 4+ psychiatrists. I don't know if you have it but getting decent grades doesn't rule it out.
posted by the young rope-rider at 4:29 PM on December 13, 2012

I went to a doctor who told me pretty much the same thing (though I did far worse in college). He said without signs from grade school that I had trouble focusing/was a distraction, that he couldn't diagnose me with ADD. I let it go as his anxiety diagnosis definitely fit some of my issues.

You should probably see another doctor.
posted by drezdn at 4:29 PM on December 13, 2012

Also, your paper writing travails sound incredibly familiar; that kind of thing is what led me to my own diagnosis several years out of college.

Good grades aren't an indicator one way or another that one has ADHD. The kind of trouble you describe with your work can be an indicator, and you are right to want to be screened. My own diagnosis came from my physician, who was the one who connected the dots of my symptoms. I, too, had believed I couldn't have ADHD; after all, I had done so well in school, right?

Wrong. For me, anyway, life after diagnosis has been so much better.
posted by ocherdraco at 4:32 PM on December 13, 2012

I'm 23, graduated from an ivy league school with a 3.6 GPA, and am working a successful job. I'm a horrible procrastinator, I felt frequent brain fogs, and at times it was absolutely impossible to get any work done. I just got diagnosed with ADD about 2 weeks ago, and am now being treated (adderall). It is wonderful.

I just called up a psychiatrist who took my insurance and set up an appointment. We talked, he gave me a 20 question test, and he told me to try the medication and let him know how I'm doing. I am doing pretty damn well.
posted by taltalim at 4:34 PM on December 13, 2012

Wow, you sound exactly like me and I tested for ADHD into kinda higher percentiles than I thought I would. Does your school offer counseling or anything? I was able to get tested at school. Even though I had been in therapy for a while, since I got good grades, it completely flew under the radar. I didn't get diagnosed until my last semester of college and didn't start taking adderall until after college was over. It makes an incredible difference in my life. Now, I can make a list of goals in a day and get them all at least started, if not completed. Before, if I had done something utterly simple like put my laundry in the washing machine I would have considered that a good day.

Of course, medication doesn't fix everything, it just allows me to better utilize techniques for dealing with my brain. But, if I were you, I would definitely get tested. I think college (and life in general) would have been a thousand times easier had I been diagnosed earlier.

An added benefit of taking adderall is that the residual symptoms of my anxiety disorder that's being treated with Zoloft completely went away.

Grades in school is not the only thing they will ask about, they will also ask about things like what you said, like being able to sit through a movie and how often you lose things. The psychologist is wrong, or I wouldn't be getting treatment right now.
posted by tweedle at 4:37 PM on December 13, 2012

Get a second opinion because that psychologist is wrong and stupid.
posted by elizardbits at 4:40 PM on December 13, 2012 [1 favorite]

He said without signs from grade school that I had trouble focusing/was a distraction, that he couldn't diagnose me with ADD

This is true, but grades aren't the only indicator. I had my teacher dump the contents of my desk on the floor on a regular basis because it was so messy, for example. My grades were excellent but I still had those early indicators of disorganization.
posted by the young rope-rider at 4:46 PM on December 13, 2012 [1 favorite]

Yeah, I couldn't do grade school science fair projects that lasted longer than a day. So I just did short ones, and got good grades on those.
posted by ocherdraco at 4:59 PM on December 13, 2012

Okay, I'll be the voice of dissent: I think ADD is way overdiagnosed.

You just described me. I would lose my head if it wasn't screwed on, and I am the worst procrastinator I know. Ever. And I did great in law school, and I find other ways of coping.

Sure, it's rubbish that good grades = 'can't possibly have ADD'. Of course you can. But I think your psych is probably thinking it's highly unlikely, and you'd be much better served by looking at other avenues (therapy and time management skills, not drugs).
posted by Salamander at 5:10 PM on December 13, 2012

diagnosis =/= drugs

I am achieving my current 4.0 without drugs (though I have been on them in the past and probably will be again). Salamander is right that therapy and time management skills will help, but its still worth it to get screened, so you can use those tools most effectively, whether you have ADHD or not.
posted by ocherdraco at 5:18 PM on December 13, 2012 [2 favorites]

ADD is over and and under diagnosed. People freak out at the first possible signs and get tested. The doctors really have to trust what they're told. Shit, I just told my doctor last week that I've been doing great taking my 2x a day rapid release anxiety meds only once a day. He didn't even switch me to a slow release version.

But yeah, your doctor is full of crap. You can be highly successful with this sort of thing and have ADD.
posted by theichibun at 5:19 PM on December 13, 2012 [2 favorites]

Agreed you need a second opinion. I find school really easy, but I can't study for crap, constantly lose my train of thought, so easily distracted, can't focus on conversations, forget what I'm doing, forget about plans. I started Adderall 10mg 2x/day YESTERDAY and you wouldn't believe the difference it has already made for me. Tonight was the least stressful multi-component dinner I think I've ever made.
posted by agress at 5:20 PM on December 13, 2012

I have ADD and didn't get diagnosed until I was in my mid-20s. Just to echo what tweedle said - had I gotten diagnosed in elementary school, or even high school, my life would have taken a much different (less frustrating) path. My entire pre-ADD diagnosis life was filled with underachievement (barely graduated hs, failed out of community college), procrastination, and feeling like I was completely lost. It took trying medication (something I was loathe to do originally for many of the reasons stated above) and working with a "life coach" AND a professional organizer to develop strategies and workflows to get my life on track. Once I did that I felt like I could finally think clearly and concentrate - I scored an 800 on the quant section of the GRE, got into graduate school, and have a great job and life.

The medication (Concerta) has been a huge help for me, but it was working with people to identify "pitfalls" (i.e. things that I put off or don't want to do) that really helped me get my life together. I'm still working through undoing some of the coping mechanisms I created to deal with my untreated ADD, but I'm finally functioning at a level that most would describe as "successful". Would I be this successful without the medication? Maybe. Would I be where I'm at without therapy and "life coaching"? No way. No way at all.
posted by playertobenamedlater at 5:30 PM on December 13, 2012

I think its definitely worth it to get a second opinion. However, I would recommend seeing a psychiatrist, not a psychologist. Secondly, I would make sure whoever you see specializes in either ADD or ADHD.

In addition, I recommend getting a full physical exam. While you could have ADD or ADHD, something else could be causing you to have ADD-like symptoms.
posted by emilynoa at 5:35 PM on December 13, 2012

It is a glorious thing to be able to pluck an idea out of the thousands buzzing gnat-like around one's head. To be able to make out a day's to-do list, and be able to knock it off in that day. To be able to really hear and be part of a conversation, and not be distracted by anything that moves into one's peripheral vision. To not feel like a lazy-ass because everything else in this world is just as interesting as the stuff you're supposed to be doing.

Whether through CBT, time management or medication, ADHD is a thing. Wish I'd known about the possibility of having it earlier than in my forties. I'm now not running away from complexity at work. Back in university I got straight exemptions in maths because I knew what I was doing, even if the fiddly addy-up bits at the end didn't quite work out.

Take the test, and be happy either way.
posted by A Friend of Dug [sock] at 5:43 PM on December 13, 2012

My psychologist told me that ADD in very intelligent people is often not diagnosed early because they develop strategies to cover for it. I have ADD - diagnosed age 45. My grades were nearly perfect in university.
posted by b33j at 5:45 PM on December 13, 2012 [3 favorites]

I had my teacher dump the contents of my desk on the floor on a regular basis because it was so messy, for example

I would have to sit at the desk next to my assigned spot, because my desk was so unorganized the lid would not close.

(good grades in school; diagnosed ADHD at 38)
posted by Lucinda at 6:10 PM on December 13, 2012 [1 favorite]

The condition has to extend back to your childhood, and it needs to be adversely affecting your life to get diagnosed. Since the effect on your life right now is somewhat minimal, I would hold off on rushing out and getting a diagnosis just yet.

That doesn't mean that good grades == no symptoms. And that doesn't mean you don't have ADHD. This is a gross generalization. There are all sorts of reasons that your symptoms didn't pull down your grades. But I don't think your doctor is incorrect in saying that between your history and the minimal impact of your symptoms, it could be difficult to find a doctor willing to say that you meet the diagnostic criteria right now. Being a high-achieving college student who is doing the bare minimum to get good grades puts you in that overlapping intersection of intelligent people with ADHD and people without ADHD seeking a bit of help. After graduation, there's a significant drop in that second population.

I would start journaling your symptoms. Once I started cataloging my symptoms, I was surprised at how much more they cost me than I really admitted. My grades weren't bad, but I didn't get accepted into a selective school like the rest of my peer group. I was able to stay employed, but I was passed over for a few promotions. Once you can go to a doctor and confidently say that your life is demonstrably worse because of these symptoms, that's when I'd seek diagnosis.
posted by politikitty at 6:14 PM on December 13, 2012

Here's the thing. Different health practitioners have completely different philosophies.

As a psy D your guy is a lot less likely to use drugs with a problem because that's not what his training focused on. A psychiatrist, on the other hand, is far more likely to give you a trial of X/Y/Z and see if it worked. That's just my experience from following tons of doctors around.

Doctors are tightening up a lot on prescribing stimulants because the last few years have seen huge numbers going up in terms of prescriptions and there's kind of a manufacturer shortage going on right now.

There's no single test or collection of tests that can hand you a discrete diagnosis. Just because you're fairly high functioning doesn't mean that a prescription isn't going to substantially boost your quality of life.

The reality of the situation of the health care system in America is that you could just keep going to different doctors until you get what you want.
posted by hobo gitano de queretaro at 6:18 PM on December 13, 2012

Yea, I don't know if anyone has said this yet, but it is REALLY hard to get diagnosed for ADHD in college, especially if you are going to a psychiatrist affiliated with the school. There's extra concern re: drug seeking behavior that you may be seeing her.
posted by murfed13 at 6:44 PM on December 13, 2012

I always had great grades at very competitive colleges, but my organizational and time management issues, plus some social issues (in particular, paying attention during conversations, remembering important events, etc.) was part of the tip-off to ADHD for the therapist whom I was seeing for other issues at the time. I never, ever would have thought I had ADHD. In my mind, ADHD = Erik, the crazy kid in 3rd grade who was never physically still until he dozed off sometime after lunch.

My psychiatrist evaluated me for around 45 minutes and asked the standard ADHD questions (which are pretty much what you find online) and said, yep, it sounded like ADHD inattentive type, no doubt it in her mind, *but* ADHD is often mis- and over-diagnosed, and I had good insurance that would cover it, so she suggested I get the 8-hour neuropsych test for ADHD to confirm the diagnosis and have it on record in case there were any questions in the future.

So, I got the test. I've always enjoyed tests and puzzles, so I found it mostly fun, if rather tiring. You just go to an office and do different tasks, fill out some questionnaires, etc. A week later, you meet to discuss the results. And yep, I am solidly ADHD. This was all in my early 20s, by the by.

I'm really glad I got the neuropsych test because my ADHD is not the classic type and the test results "legitimatizes" my diagnosis in some ways. I've recently used it to justify to a new insurance company why I'm over 19 and need to be prescribed a stimulant.

I think someone else mentioned this, but ADHD does originate in childhood (prior to age 12 is the official cut-off, I believe), so if these issues started after that, I would think hard before shelling out money for an expensive psych test. I'm not discounting your experience, but other physical and mental issues have similar symptoms. Good luck!
posted by Tall Telephone Pea at 4:42 AM on December 14, 2012 [1 favorite]

You might also try going to a neurologist instead of a psychologist or psychiatrist, particularly a neuro who specializes in ADD/ADHD. IME they are much less likely to just handwave away your concerns and will instead actually diagnose you with exhaustive medical histories and testing.

I absolutely admit that a lifelong bias towards psychologists and psychiatrists is at least partially motivating this comment.
posted by elizardbits at 5:45 AM on December 14, 2012

I have ADD and am smart enough to have gotten pretty good grades, and to have developed excellent coping skills that helped me manage ADD for years. Got it diagnosed, and meds have made life a lot easier/ more productive. Wish I'd known earlier.
posted by theora55 at 7:35 AM on December 14, 2012

You could see a psychiatrist or neurologist that specializes in ADHD.

IANAD, just a person with ADHD. I believe the symptoms have to extend back to your childhood for a diagnosis. You say that you are procrastinating, but that you are also starting papers four days before they are due and managing to get work done and keep your life in order.

For whatever it is worth, as a kid I did very well in school (I got good grades, was in advanced classes), but most of my teachers expressed concern to my parents that I exhibiting ADHD symptoms (easily distracted, spent a lot of time staring out the windows, short term memory issues, etc).

What are you hoping to achieve with an ADHD diagnosis? You can go to therapy and learn time management skills without a diagnosis. You don't have to have ADHD to seek therapy to change behavior patterns that effect your life in negative ways. A cognitive behavioral therapist who specializes in ADHD is a good place to start.
posted by inertia at 8:38 AM on December 14, 2012

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