Can you say that last part one more time?
June 23, 2020 5:14 PM   Subscribe

Should I get tested for ADHD as a 30-something adult woman? Also, if I have ADHD, what are the next steps?

I am struggling with my job, which for Reasons transformed a few years ago from a very hands-on, field-based job to a desk-chained office job in the same industry. I'm also working from home.

This job-misery, plus reading some comments on other Asks, has got me thinking about some of my own patterns and wondering if perhaps I -- an adult woman -- have ADHD, and if so could I benefit from diagnosis and treatment of some kind.

Some things that made me think I might have ADHD, or not:

I did very well in school, until I hit upper-level college classes. (At the time I had undiagnosed celiac disease and was very, very sick, with neurological symptoms to boot, so that on its own is probably a sufficient explanation the dip in my academic performance.) I sometimes feel like my long-term follow-through does not match my "potential".

I obsessively research potential alternate career paths. When I was younger I changed careers every 6 months.

I am very talkative. Too talkative, especially when excited. It works well with some friends but robs me of satisfying interactions with others. I'm embarrassed by this but can't seem to reign it in as much as I'd like despite an awareness that it's a problem.

I have trouble listening to others. I regularly have to ask the person talking to repeat whatever they just said because either I'm daydreaming, or I'm still processing the implications of their last sentence. I'm smart and motivated, and do well with written information especially while physically taking notes. But sometimes instructors or bosses think that I'm goofing off because I can't process their oral instruction quickly enough.

I like variety. I am always going in 10 directions at once. I have a lot of good ideas and I often am unexpectedly successful at smaller projects. But I have trouble following through with bigger ones. I have had many different jobs -- math student, youth homeless worker, emergency services caseworker, municipal policy consultant, farmhand, skilled construction tradesperson, office-y version of skilled tradesperson doing trades stuff design virtually... I seem to have a pattern of doing unusually well early in a job, as I learn everything there is to learn about that job. Once I'm relatively up to speed, I often feel bored and feel trapped.

I get frustrated, angry, and emotional at work more than I feel like I "should" (there is also definitely the gender dynamic of a woman in a very male-dominated workplace at play here, but even with that I feel like I am more easily frustrated by certain things than I ought to be).

I HATE when things aren't organized, especially things like tools, or tedious, detailed information, because then I can't process the info or find what I'm looking for, and I get frustrated and confused. My current job has lots of tedious specific details I need to find out to do my design work, and these details are buried haphazardly in multiple places and sometimes with multiple conflicting versions, and it's driving me COMPLETELY bonkers.

My own paperwork for my taxes, etc., though is... not organized. I sort of go back and forth on this. My paperwork is pretty much uniformly bad, and my filesystem situation on my computer is atrocious, but I do like having a pretty orderly physical space. Right now my drawers have all the clothes meticulously folded upright (Marie Kondo-style), and my tools are very organized.

I have gotten training in lots of different fields and after decades, finally found some hobbies that I'm very excited about focusing on that are both broad and deep. This is a source of much happiness for me.

I can fake it (sometimes? maybe?) but I often feel socially anxious/awkward about large gatherings. I wish I found it easier to be around strangers and connect with them, without feeling compelled to anxiously over-talk. I want to be better at active listening and learning about others.

Social contexts I enjoy and find less anxiety-making are somewhat structured and allow me to have a role or a task -- community singing, social dancing like blues or swing (even if asking and being asked to dance are stressful, there's still the pleasant crutch of structure), camping trips, scuba diving -- stuff that in general involves a shared task or physical experience.

I have paperwork that never gets done because I'm too stressed about it to do it. Health insurance reimbursements, taxes, etc. I eventually do my taxes because the government is scarier than paperwork, but I'm not organized about where all my tax stuff is and it ends up being a major pain in the ass.

I don't lose my keys nearly as often anymore because there is a hook by the front door and this is Where The Keys Go. But when I go out in my truck and have to do something in the tailgate involving having the keys with me but not in the ignition (because the truck will beep and complain constantly and also possibly lock itself), I am CONSTANTLY stressed about putting them down somewhere or in a weird pocket or whatever and losing them and getting stranded, for example, in a January snow flurry while winter scuba diving in the great frozen north. (Seriously, losing my keys is probably the thing most likely to get me killed.) I have too many different outfit styles to have a dedicated Key Place when out and about (pants, skirts, pockets, no pockets, belt loops, no belt loops). Also, writing this paragraph is making me think I ought to just put a Command Hook for temporary key storage in my tailgate.

Generalization of the previous point: When something is in my hand, often it's suddenly not in my hand anymore, and I have no memory of where I put it.

Caveat: I don't know how much of my forgetfulness is celiac-based brain fog, and how much is something else. (My celiac is well-controlled these days, in the sense that I am scrupulously, religiously gluten-free down to the micron, but not in the sense that my body feels like it's completely healed.)

So... thoughts? Should I get tested? Are these just "normal" personality quirks that I need to work on like everyone else? If I do have ADHD, what are some options to improve my worklife and life-life? How can I turn my defects into superpowers?
posted by octopodiatrist to Health & Fitness (14 answers total) 21 users marked this as a favorite
 
Oh, one more: I also free-associate a bit when storytelling. I've turned it into a sort of Style, and have friends who enjoy my weird stories, so it's not all bad. But it's definitely a thing I do.

I have trouble filtering for what is considered sufficient/normal levels of detail and what is unrelated/excessive detail when telling stories.
posted by octopodiatrist at 5:16 PM on June 23


Heh, you sound like me, an adult woman who got diagnosed with ADHD in my 30s after reading a bunch about it on Ask Metafilter. We have a bunch of other things in common, too. Too many to list.

It's funny because you are asking if you should get tested, but then sorta asking us to diagnose you. What's the harm in getting a diagnosis? It doesn't doom you to take medicine. It might help you find non-pharmaceutical approaches or you might find other solutions to things that are currently stressful.

As I understand it, ADHD tends to be under-diagnosed in girls when we're young because it can appear more like chattiness and daydreaming rather than as disruptive as with boys.

I'd say, if you have insurance that will cover it, go ahead and get tested. No harm in knowing either way.
posted by bluedaisy at 5:27 PM on June 23 [4 favorites]


I think I'd wait another 6 months for your celiac situation to resolve a little more. To me, this sounds like brain fog forgetfulness. It could be both, but I think that you might have a clearer picture going forward if you hold off a bit. I say this because the "it's not in my hand but I don't know where I put it" is a classic severe short-term memory problem. You should also consider a sleep study if there's ANY indication of apnea.
posted by Rock 'em Sock 'em at 5:41 PM on June 23


Yes, you should get tested. Why? Because you just wrote more than a thousand words asking whether you should get tested.

You're not required to do anything with the diagnosis. This is clearly a topic that worries you and has given you a lot of thought. What's the harm in getting tested?

I was diagnosed with ADHD in my 30s, and getting treatment for it - both medical and non-medical - has made a marked improvement in a lot of aspects in my life.
posted by ZaphodB at 5:47 PM on June 23 [11 favorites]


I will say, I talk about my ADD, and the suggestion that it might explain things came from a therapist and my prescribing psychiatrist. But I have never had the Official Neurological Tests done, because I don't think it's going to make a difference. What DOES make a difference is A) having terminology and a framework to talk about the experience of living in my head, B) having experts who have an idea what it's like and ideas on how to live with it, and C) occasionally meds.

I don't actually take meds much, because so far they interfere with my sleep and I've found a nice groove with work and things that works okay for me. But being able to talk to other people about ADD (or executive dysfunction, which I sometimes say when I'm talking to someone who I think is going to be pedantic about whether I've gotten an official diagnosis, which I honestly don't know if I have or not) and think about situations through that lens is hugely helpful.

So I say yes, talk to professionals about it. It might be a huge help. I also finally found a job that fits my personality--working with people in very short, pointed interactions that require quick problem solving but no keeping track of anything at all, really. (I'm a library circulation clerk. The pay is crap but after decades of office work it's amazing to feel good at my job.
posted by gideonfrog at 6:48 PM on June 23


So... who do I talk to about this? I'm a bit confused because even if I had a primary care physician, it's not clear they'd be an expert in ADHD. I have pretty flexible insurance but I'm not sure what variety of professional I should even be looking for.

If the short-term memory issues are in fact related to long-term celiac damage, I don't think they are going to get any better -- I have been religiously gluten-free (living alone, traveling with my cutting board and food gear, only eating a dedicated restaurants) for around five years. And on the occasions in the past when I have been glutened, before I got so strict about things, my short-term memory took a dive in a way that was substantially worse than my sort-of-flighty absent-minded day-to-day reality.
posted by octopodiatrist at 6:53 PM on June 23


Your insurance company may be able to tell you what kind of doctor could test for this and also refer to one that takes your insurance.
posted by soelo at 7:05 PM on June 23


Hell yes, get tested. Getting diagnosed - even at 55 - explained SO MUCH.

Find a therapist who will give you an actual test. Mine took 3+ hours, over two appointments, and included a lot of different kinds of questions, from simple (repeat a list of words) to more complex (she read me a very long story, and I had to tell her the important points - totally bombed that one). It also tested different ... senses, I guess? For example, I am completely awful at listening and understanding spoken directions, but I do ok with reading instructions.

Now I have a better understanding of how my brain works. And I also have Adderall, which makes my brain work better.
posted by SuperSquirrel at 7:06 PM on June 23 [2 favorites]


If the short-term memory issues are in fact related to long-term celiac damage, I don't think they are going to get any better -- I have been religiously gluten-free (living alone, traveling with my cutting board and food gear, only eating a dedicated restaurants) for around five years. And on the occasions in the past when I have been glutened, before I got so strict about things, my short-term memory took a dive in a way that was substantially worse than my sort-of-flighty absent-minded day-to-day reality.

Ah, okay. I was sort of thrown off by you saying that you don't think your body has completely healed. You know your body best, and if you feel like you're stable and settled then this is definitely a good time to get this checked out. Even if it is celiac brain fog, frankly, if a stimulant helps, it may be worth it. I personally don't think that clinical ADHD is the only reason to use a stimulant to improve functioning!
posted by Rock 'em Sock 'em at 7:09 PM on June 23


Seconding getting tested. It can't hurt.
posted by cnidaria at 7:11 PM on June 23


IANAD, but you have ADD. You might have some trouble getting a doctor to believe that because you're female and got through school OK, but you have it. Long post ahoy!

Process:
* Get diagnosed by a psychiatrist or a psychologist who do adult ADHD evaluations, general practitioner if you can't get into a good psych. Local parenting groups, CHADD chapters or disability resource programs (local community college or university will probably have one) may be able to help you ID a good doctor, whether a psych or a GP.

A good doctor believes you when you report your symptoms and will work with you to try different medications & doses to ID what's right for your specific brain. If they give you a bad vibe or dismiss your symptoms, they're a waste of time. A good GP will be much better than a bad psych.

* Sort out meds via a psychiatrist, if possible, or GP. This will mean repeated appointments / consults to zero in on the right dose. With a GP, you will need to do more medication research, but it's cheaper and faster.

* Get refills from a general practitioner.

Resources:
CHADD is one of the best US ADHD organizations, with a national organization and local chapters. They have guides for adult diagnoses: https://chadd.org/for-adults/diagnosis-of-adhd-in-adults/

And a directory! NOT exhaustive, but a starting point: https://chadd.org/professional-directory/

ADDitude is OK for basic info presented quickly, but they're more cutesy than cutting edge: https://www.additudemag.com/category/explore-adhd-treatments/

Medications:

ADD means the brain throws up everything with the same priority level & reacts to boredom like pain (pretty literally). A tool has to be innately interesting, because the brain can not remember or recall in the same way a normal brain can.

Medication stimulates various systems, raises neurotransmitters, and generally makes it harder for your brain to drop the ball. It's the most effective approach. There's 2 major flavors which each have multiple formulations, plus Strattera. Different people need different formulations and dosages to see an effect. Many people need a smaller-than-available dose, and many people need a higher-than-available dose. Your doctor should be willing to help you try different formulations and zero in on the right dose.

Things To Try Pre-Diagnosis:

Embrace sparkly planners, RPG todo apps, buy color-coded supplies, whatever will jump out at you instead of you having to try and remember it.

Brute force executive functioning tricks like KEYS IN THE KEY PLACE can help. But they're hard to burn into your brain and, as you've discovered, really depend on the situation to work.

Phone alarms are a blessing. I put meals, sleep, toothbrushing, calling friends & family, paying bills, everything on there. My phone remembers for me, and it interrupts me so I don't get too focused and forget to, say, eat dinner.

Exercise can help a bit too. The trick is, it has to be done regularly, so *shrug*. If I could do things regularly I would be a different person.

It's more a matter of setting up life to work with your brain than changing your weaknesses into strengths? Our brains are badly suited for many aspects of modern life. The only way to deal with it is to arrange life to work with the brain you have instead of the brain people assumed you would have. On that note, is there any way you could transition to a job that fits you better?
posted by Ahniya at 8:10 PM on June 23 [4 favorites]


I got tested and am in the middle of arguing with my psych over the testing. My scores do not fit the normal profile but also are not what was expected for non-add and it has been frustrating. Just be warned that if you have a medication reluctant doctor who has treated very few adult adhd cases ,you may end up as I did with a photocopy of a pamphlet on organisation skills. See someone who specialises in adult women even if it takes more time. I like my psych but this is a speciality area.
posted by dorothyisunderwood at 8:37 PM on June 23 [3 favorites]


I was diagnosed in my 20s. Always great scores on tests, always bad on school organization and homework.

The psychiatrist who tested me did not initially think I had it, because of my presentation. But the battery of tests and their results was unmistakeable. Also, a diagnosis of a visuo-spatial learning disorder as compared to my other skills.

Took medication for years. It did help, but I no longer take it, because it is a grind getting it every month.

Biggest gamechanger for me was getting into a series of roles that suit my skills - big picture, telling stories, engaging people - with minimal focus on minutiae. Although, yes, I sometimes still have to do the minutiae.

Get the test(s)- why not? Just know that having the answer isn't your magic bullet, but a way to decide how to cope with your unique and wonderful way of thinking.
posted by heigh-hothederryo at 9:26 PM on June 23 [3 favorites]


I've been tested for ADHD and was just barely short of a clinical diagnosis (I don't remember the details but it was something like "you're positive on 7 measures, 8 measures is the minimum for a Dx"). But it was still useful information! It confirmed that I have attention difficulties and my problems weren't some kind of morale failing. So I also encourage you to get tested because you could learn something helpful about yourself even without a Dx.

As others have said, you may be prescribed medication and you will almost certainly get pamphlets of dubious value on organizing your life. But there's another complimentary way that doesn't seem to be talked about much: being kind to yourself and organizing your life around your natural inclinations rather than trying to force yourself into a square hole. Meds and organizing your life aren't bad, and you can practice kindness for yourself at the same time. What I mean is: admitting (for instance) "I know myself, there's no way I'm going to do this takes for 3 straight hours today. But I can phone it in for 20 minutes and revise tomorrow." You may find that you're very effective working in shorter bursts and you'll rarely need to put in the grind that people seem to expect. That's largely what I do — I work in short bursts and tell myself "I'm going to churn out some real garbage and fix it later." Turns out my hastily-assembled garbage is usually more than good enough to get the job done. Or you may find other ways of working that defy society's expectations but are perfectly productive.
posted by Tehhund at 4:19 AM on June 27 [1 favorite]


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