ADHD

Some people have ADHD no doubt but can it be defined in any way approximate to objectively? if not, perhaps that doesn’t really matter? anyone with experience of primary school children on that “pathway” got any pearls of wisdom to share? would be much appreciated. 

There are a number of symptoms but what is and what isn’t relevant is incredibly personal so from that pov it’s difficult. There’s a classic idiom of “if you meet one ND person, you have met one ND person”. There’s stuff one will have that another doesn’t. Think of it as a lot of varying Venn diagrams. 

ADDitude is a v good website albeit quite American. 

As someone who has recently been diagnosed late in life with ADHD (with extreme hyper impulsivity which explains A LOT) the key thing I learned going through the process is how many different types of ADHD there are and how different the impacts of those can be, 

Also, how gender fundamentally impacts perceptions and expressions of ADHD. 

Get your kid treatment and support, and if drugs are recommended encourage them to at least try them on a regular basis. The drugs are like magic. 

 

 

Also, both my nephews are diagnosed 14 and 12, and in my view that is too little too late.  

They are both already so far behind their peers with zero incentive to change behaviours or catch up.  The damage has already been done.  

Yes, there is an objective test, called a QB test, see the link below.

I have been diagnosed with ADHD following this test and several face to face consultations with a physiatrist.   Like anything, and as very well articulated above, there are degrees of this and I was sorry to read of Scylla's situation with her nephews,  but as she says, the drugs do make a difference and I  do hope that situation improves.

For me,  it does explain much in terms of my own impulsivity and concentration matters. 

tests/qbtest/#:~:text=Activity%20is%20measured%20using%20an,who%20don't%20have%20ADHD.

 

What Phoenix said.  The QB test is an accurate an assessment as is possible in mental health.

Almost all mental health illnesses are an approximation of symptoms grouped together.  There is no blood test for anxiety, depression etc... either.

Also what Scylla said, apart from gender is irrelevant but sex does matter.

 

From your own link, Warren:

Diagnosis in adults

Diagnosing ADHD in adults is more difficult because there's some disagreement about whether the list of symptoms used to diagnose children and teenagers also applies to adults.

In some cases, an adult may be diagnosed with ADHD if they have 5 or more of the symptoms of inattentiveness, or 5 or more of hyperactivity and impulsiveness, listed in diagnostic criteria for children with ADHD.

As part of your assessment, the specialist will ask about your present symptoms. However, under current diagnostic guidelines, a diagnosis of ADHD in adults cannot be confirmed unless your symptoms have been present from childhood.

Bullace can speak for herself, but what I think she may be getting at is can ADHD be decided 100% with a test, like diabetes or cancer.  The answer to that is no.  Like many other mental illnesses, ADHD covers a wide range of symptoms and while assessments are said to be fairly accurate, it isn't 100% like the others.

As part of my assessment and diagnosis I had to locate and provide copies of all my school reports from  school.

In hindsight … every single comment from my teachers was basically screaming  out for an ADHD diagnosis.

And actually it’s actually gender.. because it’s a reference to socially accepted behaviour stereotypically  associated with sex.

 

I too have an ADHD diagnosis 

I suppose rof probably attracts that kind of mind for obvious reasons

I am not of the orthodox church tho - I am dead against medicating kids unless the alternative is them likely going to prison. I also don't think it's a disorder so much as a way of being that differs from the norm (if the norm is defined as likeness with the majority). 

Since I don't think it's a disorder per se, I don't believe it can be treated away, maybe just temporarily muted, and you just have to find a way to exist with it in a society of people who often can't imagine what it's like to be different from how they are. 

I am not convinced it really matters except that it is good to understand oneself as much as possible.

I think the need for conformity among many humans is the problem.

Sure it's tempting to imagine we'd all otherwise be prime minister but I doubt it. I think kids who are put on a treatment from a young age have a shit time of it and it's not like the difference between being me and being Einstein. I still like fun more than hard work.

And actually it’s actually gender.. because it’s a reference to socially accepted behaviour stereotypically  associated with sex.

No it isn’t gender. All of the studies have compared the impact of ADHD and the lower rate of diagnosis between the male and female sex.  

The fact that the sexes typically display different behaviours does not mean any self-identified gender would have any impact.  If that’s a hypothesis you have, that’s fine, but all studies have been based on sex.

What Dusty said. 

It makes a huge difference to me and  IDGAF about conforming to anyone or anything. 
 

Also given the very obvious struggles both of my severely affected nephews have… go fook yourself with the idea that doesn’t matter and is only about people wanting to conform. 

 

I used to work with a guy who has a son with ADHD and he was enraged when I said I thought I had it (I said this before I knew his son had it) because his experience of it involved really disordered behaviour and he didn't believe someone could hold down a normal, boring job with it. It is funny what a difference sex can make to things.

Clergs I think it’s quite easy for relatively successful people diagnosed late in life to be against medicalising children.  If all you’d seen as examples were the kids who without treatment would slide away in terms of attainment and engagement with society because they couldn’t sit still and were chasing the dopamine hit however they could get it, you might have a different perspective.

Maybe not in primary school but if I could go back and give my teenage self the meds I have now, I absolutely would. It would have saved her a lot of pain and struggling. 

Scylla - I think you are obnoxious, which is a different issue. To clarify, the problem is not YOU wanting to conform, it's society expecting conformity in stupid pointless ways that don't really suit divergent brains and makes it hard to live within the prevalent culture in some ways. Things that most people would tsk and say "just get on with it!" about are genuinely really hard/ impossible for some people but because society expects conformity and takes an attitude of everyone is doing it so why shouldn't you the message is difficult to convey.

I doubt your diagnosis will make much long term difference to how you fit into conformist society, it will perhaps facilitate self acceptance, which is valuable ofc. 

I have a longstanding friend who is a consultant psychiatrist who doesn't believe in adult diagnoses at all. She thinks it's an unethical cash cow. I disagree with her (obviously) but your links don't magic away the fact that there are many different ways of approaching the issue. 

I often wonder how I would have felt about what the medication does as a young kid.

I like the effect of it as an adult.  It sharpens me up, makes me feel positive, helps me focus and not misplace things, move from one task to another without finishing the first.  But I think I might have felt anxious as a kid, not having experienced other substances.

Pinko - the reason I'm against it is that I can see how much the medication affects my adult body. I think there has to be a high high bar to put this stuff into growing children. (I recognise there are trade offs and only parents can decide if the bar is met)

Lol @ Syclla linking a study where gender is used to describe sex and where all of the underlying studies are based on a comparison of the sexes, with gender identity being totally irrelevant.  Great job showing me I'm wrong!

Clergs I understand.  I can see my son has ADHD because he displays many similar traits to me, but I am reluctant to even diagnose never mind medicalise him because he's doing absolutely fine - he's just not very good at some stuff.  That said, I've accepted my psychiatrist's advice to keep an eye on it, because the early teen years are where kids can fall away quite quickly. 

my poor ex is at the end of her tether with her 12 year old.  He has ADHD and ODD (not sure what that is but something to do with being defiant).  They're doing all they can to keep him alive.  He jumped off the roof of the house at Christmas with the full intention of killing himself.  Not his first attempt either.  

I have a friend with a kid with ODD.  It's absolutely horrendous.  Worst thing is they don't even like their own kid, even though they love her.  Heartbreaking.

I have a longstanding friend who is a consultant psychiatrist who doesn't believe in adult diagnoses at all. 

This is interesting. It suggests that they believe in childhood diagnoses. Without a shadow of a doubt I had this as a child and as a teenager it manifested more and more strongly as the external structure in my life was reduced, until I completely fell over. I self diagnosed over 20 years ago but didn't really appreciate that medication was available and promptly forgot about it. Tbh, I didn't even equate it with how direly things were going, besides the fact that I struggled to engage with my studies or revise unless I had a ridiculous tight deadlines and by that point, despite powering through on red bull, it was generally too late to recover.

I have been formally diagnosed as an adult but I could and should have been diagnosed as a child. Denying me the diagnosis of a disorder because no one bothered to check as a child seems a little bit daft.

I also wish I'd had meds in my yoof. I was told time and time again that I could do great things and excel if I could only apply myself. But I couldn't. And the constant failure in studies and so many areas of my life is something I could have happily done without.  

I think the problem is that anyone and everyone is now seeking a diagnosis. The waiting list in Leeds is now about 8 years. It has an effect on Senco provision in schools, which appears to be nothing more than crowd control of the more challenging students, with little support for anyone else. I've moderated this post more than once because, frankly, it does my head in. 

That’s right, Risky. Everyone is unique, including you.

Nobody - not even ICU patients who have been in a coma for two years and whose legs haven’t seen sunlight, and have atrophied through lack of use, has legs as pasty and repulsively thin as yours.  You - and your legs - are utterly unique.

Bentines, this kinda highlights the sex based disparity between those with ADHD. I have never required any sort of crowd control. I have never accessed any SENCO support. Girls with ADHD tend to have the inattentive form. They're not disruptive and they won't cause a fuss but they will fall behind as they struggle to keep their shiz together.

If I'd been diagnosed when I was a kiddler, I could have been taught techniques to manage it. I could have had extra support around structure and accountability. And I could have had meds which would have made a material difference, not only to my grades, but also the quality of life I had trying to achieve them.

Daughter diagnosed and has been on medication for about a year.  The difference it has made has been unbelievable and it's quite inspiring when you see the direct effect of medication in a positive way. Her life is ten times easier and more fun as a result.

What worries me slightly is the hypothesis that children with ADHD have a slightly higher risk of dementia in later life which I find a deeply saddening thought. 

I just think there's a real "I could've been a CONTENDER" problem among high(ish, to sadly adopt pinko's analysis) achievers.

Everyone can't be king of the shytheap and maybe it's fine to reflect happily on what you did achieve. 

I don't believe life is easy, ever. Friend with an ADHD kid on meds has had to deal with several suicide attempts post diagnosis. The human body and brain are complex.

And I definitely haven't achieved what my cleverness might have managed but you know what? Tough shit there's geniuses in Delhi slums right now who can't even read. You have to make the best of things.

I am a high achiever, notwithstanding my ADHD. In spite of it. I'm one rung away from being the king of the "shyteheap" in my area which may change when the elderly king abdicates in a year or two. I don't think it's unreasonable to reflect on what life might have been had I not had to struggle and scrape to keep up. 

Please remind me to tell you shut up and suck up every minor irritation you spout on the board simply because there are other people in the world who have it harder than you. Undoubtedly you would never need to post if that was the bar for sharing disappointment, frustration or annoyances on RoF.

I find it genuinely scary how angry people get about this. I have the same diagnosis as you. I've been told that it doesn't exist/ I'm neurotic/ it's made up on many occasions. I know it isn't but I can't control other people. Tbh I find it hard to imagine what it's like NOT to exist in a brain like this so I can see why others aren't convinced.

But I'm not sure how you think life would be different really. If I'd been born hot and charming my life would be totally different but I wasn't entitled to that.

No one made it happen to us and the ability to recognise and treat it simply didn't exist when we were younger. At least it exists now.

It’s not just about being able to read a 200 page document in one sitting.

It’s also calming and can help take away anxiety of not being able to plan or remember you have a meeting.

For someone who potentially could do with less anxiety - why not try it? 

Interesting thread. Whatever the neuroblip is that expresses as ADHD, ADD and autism, it runs amok in my family - we think from my dad's side. Out of 10 cousins aged between 12 and 26, 6 have been formally diagnosed, with 2 more currently in referral. 

Individual differences are wild. 2 are very academic (maths - autistic lad, medicine - ADHD girl) and achieve stellar results seemingly without doing any work - i.e. "smart" in neurotypical speak - whereas the other 4 (+2 undiagnosed) are struggling because their minds don't mesh with conventional education, but have other talents (mostly artistic/expressive).  My youngest (12) is intriguing: poor performance at school, even with support and various behavioural interventions, yet he appears to possess an eidetic memory for whatever he's interested in (football, planes, movies) and has an EQ and sense of natural justice that is light-years beyond that of most adults. He will sell you that pen without you even noticing. He's 2 weeks into meds (20mg slow-release Methylphenidate if you're interested) and no sign of changes yet.

I think we're only just scratching the surface of what is really going on under the hood here.  Whatever is going on, I'm not convinced that it needs to be medicalised in the way it is today. The "disorder" is not new.

 

 

Thank you everyone - very much - for your input on this thread. So much to think about. School also now talking about autism…… a long way to go and our kid is ok so not going to rush anything. instinctively against meds but we will see. making me think hard (and see in a new light) my own struggles academically and in my career - don’t want my offspring to emotionally break rocks the way I did. 
“He's 2 weeks into meds (20mg slow-release Methylphenidate if you're interested) and no sign of changes yet.

I think we're only just scratching the surface of what is really going on under the hood here.  Whatever is going on, I'm not convinced that it needs to be medicalised in the way it is today. The "disorder" is not new.”

I will also be interested to hear - don’t quite follow the not convinced needs to be medicalised/ 20 mg methylphenidate….. no criticism btw - very difficult to assess. good luck. 

just want my child to be happy and relaxed - that’s not the case at the moment 
 

Bentines, yes of course. Or give me a nonnymail and I’ll contact you direct. 

FYI he was diagnosed in July 2022 after his Year 6 teacher signalled that we might want to have him checked out by a GP… nudge nudge wink wink. But we already knew. Comes with a fun side-order of “Oppositional Defiance Disorder” which he kindly reserves for me and his mum. Everyone else thinks he is the most polite boy ever made - and he really can be that boy when he wants to be, when it suits him, on his terms. Smart kiddo.

Ended up going private as NHS wait lists were 3 years in our neck of the woods (Surrey) and we wanted to know the score before he hit secondary. We held off on the pills for 2 years to see if he could cope but the “H” in ADHD has become - in his own words - “Olympic”, so it’s been a last resort (perhaps wrongly so). 

He is not broken. He is just wired differently, and in many respects better (situational awareness is off the scale). It pains me that his abilities are still measured through the lens of conventional academic performance, which is currently doing an excellent job of destroying his self-esteem. 

Bullace you make an observation that has vexed me for two years. Does it need to be medicalised? On one hand no, because I see it as just another quirk of the human condition. On the other hand, we are grappling with a child who is assessing his worth by reference to measures he doesn’t understand and cannot meet. Meds can help, apparently, so we are trying them.

Really interesting thread to an outsider (or at least I think I am). 
Nice to see some fresh names on the board. 
Plenty of insight to inform those of us who enjoy the absorbing human variety that individual differences create and prefer to consider them attributes. 
Thank you for sharing your personal experiences. 

What MEH said. Every fooking word of it.  

The drugs just allow me to focus and the impact of them is immediate for me. 

It's as if the extreme hyperfocus that I have always had for the things that I enjoy, also now applies to the things I just need to get done, and the constant voice narration in my head is a lot quieter. 

 

I likely have it and my 8 year old daughter likely does too. The only reason I ever thought I did was because my daughter has shown signs and I see myself in her. I was never hyper as a child but my little girl is although she has calmed down significantly since reception year and is now about to go into year 4. 

We have been so lucky with her school, instead of seeing her as difficult they have championed all the positive stuff. She is great, great fun as well as being bright. I think, as a girl, she can conform a little better now (possibly “mask”). She did once tell me she felt her brain was different from the other girls she hangs out with and said “I feel like a purple carrot among orange ones”. Her teacher told us it would be a waste of money to test when she could keep up with the class at the moment. 

In terms of me, I’ve never realised i may have a different brain until recently.  I also like my personality despite being a bit hopeless at finishing tasks and being messy. My school reports will be good on subjects I enjoyed and not so good on ones I didn’t - meant my a-levels were a success far more so than GCSEs. I must dig out my reports. I can focus on things that I love and I do those things well. Would I swap my brain? No. Do I want meds? Possibly once a week to be able to keep house tidy etc. I think championing your children despite their adhd is everything and my folks did do this. 

Fwiw I think adhd is everywhere at the moment and they need to drop the d. So far my sister, sister in law and me are all thinking we have ADHD. We all have one child with it. My sister and sis in law are completely different from me. It must be displayed in so many different ways I’m still not sure whether it’s just a common personality type or maybe mine is so mild it hasn’t significantly affected my life in any meaningful way. 

 

I think when it reaches the point that so many women think they have a disorder you've certainly got to wonder about the characterisation. I'm not sure how we align all this with dopesick either.

The diagnosis of it has exploded because there are drugs now that improve things and we are only allowed drugs to 'treat' 'disorders' not just to make us better at stuff/improve aspects of ourselves. 

I suspect I may come back as having ADHD if I was tested. In some ways drugs that improved concentration would be hugely useful for work and so I am sometimes tempted. But then I have done OK without drugs to date and I guess you don't know what else it would change about you. 

drop the D, recognise simply a normal variant (rather than diversity), accept chemical intervention to improve outcomes for ADH people?

Scylla - would you mind sharing what meds you are taking?

@ Clergs: I am not angry. 

If I share something which is important to me and affects the way that I feel and you are dismissive of it, I'm going to respond accordingly. 

If my hamster died and I was sad about it and you said oh everyone's hamster has died, there's deprived hamsters in indian slums get over it, I would also be irked.

As above, I'm not talking about you, I'm talking about me. I am not sure what the difference is between having ADHD and just being a bit stupider than I'd like and I'm not convinced there really is one. Look how many people think they "have" it. Something is off.

Peeps with kids - do have a look at the ADD website at information around supplements. Yes, I have meds. But I started on magnesium glycinate a couple of weeks ago and that has literally lifted a veil. I also started zinc and iron so that could be impacting too but suspect its the magnesium. There are deficiencies seen more commonly in those with ADHD so that could be a gentle way to support. There's also all sorts of things you can do around implementing structure, boundaries and accountability to help your kids do what they need to do. So many useful strategies out there x

And I think being on prescriptions speed feels good but can't be a long term answer to anything. Except possibly the question how did Hitler end up like that.

It doesn't feel "good" to be honest. The first dose did feel great although some of that related to finally being able to get things done I'd been wanting and failing to do for years.

Now it means I can get my job done properly, I'm starting to catch up rather than drowning more and more being behind, that I have far more control over general life and start to do things that other people take for granted.

But how many other people actually do take it for granted is my q. 

Isnt struggling and suffering and boredom and self loathing and anxiety a very common part of the human experience?

If some people are below one in the social/achievement scale (however that scale is drawn) are they all less good or did they struggle more or are they simply differently motivated? Different opportunities? The wrong way of measuring cleverness/aptitude through exams that don't really align with the reality of the adult world?

I also think as women get older and our hormones drop a bit thinking can become clearer (I think female hormones can be very inflammatory for the brain).

I do think it would be better if there was less of a "why don't you just get on with it!!!" attitude at all stages of life. 

Except possibly the question how did Hitler end up like that.

Hitler wasn't taking low-dose amphetimines.  He was eventually taking mixtures of heroin, cocaine, amphetemines, mixed with vitamins and sometimes bull semen and even sometimes time gun cleaner.

I also think as women get older and our hormones drop a bit thinking can become clearer (I think female hormones can be very inflammatory for the brain).

Maybe you should have identified as a man?

Clergham I know you’re a troll etc and I respect that but I would say to Donny and you that it’s all fun and games when you’ve got a mild dose and are just a bit shit at remembering things (I’ve learned to cope!) but when you have a kid who finds their ADHD distressing and it aggravates / turns into comorbidity (ODD, self harm, anxiety, depression) then as a parent you need to explore the options. This includes Ritalin etc. 

As all mental disorders there is a difference between being a bit odd /quirky and suffering horribly with a debilitating condition. You know this of course.

And yes re Hitler I know it was a joke but I really would like to think a guy in your line had some instinct to interrogate the wisdom of long term controlled substances 

Hotnow - I'm not sure why you think what you just said is inconsistent with what I've written but I'm sorry you're having to make these choices anyway. Life can be really shit.

You seem to thinks it’s just mind optimisation or a lifestyle choice for over achievers

Could say the same for SSRIs maybe sad unwashed unemployed goth is just a personality type

I really would like to think a guy in your line had some instinct to interrogate the wisdom of long term controlled substances

Someone in my line knows that a drug which was first synthesised in 1941 and has been available for use over several decades treating multple millions of patients has not just supporting clinical trial data but real-world study evidence on safety and efficacy, coming from MILLIONS of patients who have taken it over long terms.

Perhaps this summary puts it best:

The International Consensus Statement on ADHD shows that the results from systematic reviews and meta-analyses and large scale studies are clear: methylphenidate is safe and efficacious, but also among the most efficacious drugs in all of medicine; treatment in the long-term significantly reduces or eliminates the elevated risks for obesity, accidental injuries, traumatic brain injury, substance abuse, cigarette smoking, educational underachievement, bone fractures, sexually transmitted infections, depression, suicide, criminal activity, teenage pregnancy, vehicle crashes, burn injuries and overall-cause mortality.

Should I listen to a Scottish tax lawyer, or decades of real-world evidence endorsed by an international committee of subject matter experts?  It's a toughie.

I said explicitly above that I understand there are situations where parents have no choice but to medicate very sick children 

I think that's a really sad choice to have to make because I don't think the medication is safe for unfinished bodies 

But it's like chemo - sometimes the poison is necessary to fight the disease

A lot of people are titrated off methylphenidate almost immediately because it doesn't work for them. What's the position on Adderall?

I think the widespread use of this medication will be a scandal in years to come, pink. 

I think the widespread use of this medication will be a scandal in years to come, pink. 

Wait till you hear about them cutting healthy breasts off confused often autistic kids after giving them hormones which lead to major illnesses!

Might knock Ritalin - which is short-acting, has no effect on the body after it has been used and has been demonstrated as safe and efficacious over a number of decades - out of the headlines.

I'm not.

I'm talking to you as if I don't agree with you about the past, current and future use of methylphenidate in terms of safety and efficacy, and therefore its liklihood of becoming a future national scandal versus other industry and healthcare practices.

But as I said methylphenidate is not the only prescribed medication for ADHD. Why aren't you recognising the others?

When I tried ritalin it reduced my periods from 28 day cycles to 18. When I stopped they went back to normal. So I don't personally agree that they're sugar pills but more importantly they're not the only relevant medication.

But as I said methylphenidate is not the only prescribed medication for ADHD. Why aren't you recognising the others?

I'm not taking the others is the main reason I suppose, and the fact that methylphenidate is by far the most prevelant treatment.  The other reason is that the other main treatment (MAS) has also proved safe and efficacious over a period of decades, albeit with slightly worse short-term side effects (dry mouth, insomnia, weight loss) which would usually lead to use being stopped.

I'm not doubting you had an individual impact, but the safety and efficacy of medicines aren't measured through individual anecdotes - they are measures through long-term real-world large-scale studies, and in the case of these medicines have proved both conclusively.

To me, arguing that dexies4life are bad for you is as intuitive (and bizarre to even have to do) as arguing that sex is not assigned at birth. 

It's a really emotive issue because it goes to the heart of how people see themselves and how they explain all the things that have gone wrong in their lives.

BELIEVE me I recognise what it is to have fooked some shit up on account of my brain.

I am just not at all convinced that we are looking after people properly as a society on this issue or similar ones.

To me, arguing that dexies4life are bad for you is as intuitive (and bizarre to even have to do) as arguing that sex is not assigned at birth. 

What about statins?  Or paracetemol?  Is there any medicine which has been used for decades, observed in millions of patients and which have shown absolutely no long-term side-effects you'd be willing to accept are safe?  How do  you distinguish this class of medicines?

Maybe we should just have you issuing "Clergs common-sense judgments" on whether UK medicines should be given marketing authorisations, instead of the MHRA?  Would speed things up.

I know some doctors who think paracetamol should be more heavily controlled because the damage it can do.

The historical ethical position has been that medication shouldn't be used unless it is clearly necessary. I don't know why we have simultaneously moved away from that while watching biopics about oxycontin saleswomen for entertainment.