View Full Version : OCPD or ADHD or Both or Else - help me with a diagnosis please


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10-18-16, 11:57 AM
Hi guys,

Below is a list of symptom that I brought to an initial consultation with a psychiatrist last week. (The list is a bi modified so it's now meant for you.)

Initially she asked me, based on the points on the list, if I have a suspicion for something. I said ADHD and she said that this is what the items on the list would suggest.

However, by the end of the consultation she gave me a provisional diagnosis of OCPD.

Where do I go from here? I will meet her again tomorrow - what questions should I ask her?

Here's the list

- I canít hold attention in classes and tutorials (Iím in college)
- I canít concentrate and focus on what I actually have to do
- I canít concentrate at home and I canít concentrate in the library either.
- No comprehension when I read things and need re-read things multiple times.
- I have to re-read even if I am reading something that I wanted to read in the first place
- Attention is similar when I listen, especially in group conversations - I just space out
- Time management is a disaster
- I use my time super-ineffectively. Best case scenario is if I get the small stuff done, but not what really matters. That is always left for the last possible minute.
- Always late. Since I started college, Iíve been late for probably 80-90 percent of my first-for-the-day lectures. Sometimes I was so late that there was no point going to the lecture.
- I submit assignments late or submit them in the very last minute (literally). And that is even if the assignment is really important and it was the same with applying to colleges.
- Never want to start on assignments, especially essays.
- I donít want to do the mental work (So what am I doing in college then?).
- Not the best at organising my life
- Cannot prioritise tasks
- I donít follow up on things
- I do have to-do lists but donít do the stuff on them. I do most stuff and the rest of the stuff I drag for days, weeks and sometimes multiple months.
- With regards to the to-do lists, I wouldnít say that I have a preoccupation with them
- Canít say no to unimportant things and almost never do whatís important.
- Cannot finish timed (in-class) assignments/tests
- In general, I take on more tasks and information than I can process - everywhere - emails, to-dos, read-it-later things, commitments
- I get overwhelmed by information quickly
- Buying books and never reading them. Starting books and never finishing them.
- Canít stop doing things in the evening and rarely go to bed (i.e. I canít stop doing whatever I am doing and just go to bed)
- There is a history of academic underachievement and I am now back to college and underachieving again. And am considering dropping out because I donít know what am I dealing with (i.e. mental health/condition) and am struggling (incl. anxiety and depression)

- Slow processing speed. This was discovered through a test my former psychologist did on me and it's a real problem.
- Motivation is down to zero.
- According to a test by Piers Steel on procrastination, I am a Master Procrastinator (it does not get worse than this)


Do you think a diagnosis of OCPD explains the things on my list?
Is it just me or does it sound like I have a problem with Executive Function?
If you look at the table here (https://en.wikipedia.org/wiki/Executive_dysfunction#Education) I would thick most of the symptoms in the table.

Thank you for your help!

Tetrahedra
10-18-16, 03:21 PM
That doesn't sound at all like OCPD to me. Obsessive Compulsive Personality Disorder involves more of the "anal retentive" things that people associate with OCD, and is often characterized by a need for control. I'm not sure how one could derive OCPD from your list at all.

The only thing I can think is that maybe it wasn't the list but the way you presented it. Not that you presented it "badly" but I'm saying that there could be something that we can't see because we're not talking to you face-to-face like your doctor was.

Can you ask him why he chose OCPD?

midnightstar
10-18-16, 04:13 PM
That does not sound like OCPD to me but like everyone else here I am not a professional.

I agree that you should ask why the doctor chose the diagnosis, also maybe as what treatment the doctor advises? I know from my own personal experience, some professionals if they get out the personality disorder labels they're like "can't treat personality disorders, off you go and just get on with it with no support"

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10-18-16, 07:59 PM
Thank you for the replies Tetrahedra and midnightstar! I will add the suggested questions to my list for tomorrow.

Tetrahedra, the doctor asked mea lot of questions and I guess it is based on those questions that she gave me the provisional OCPD diagnosis. Tomorrow I will ask why she thought it is OCPD. To be honest, that diagnosis could be accurate. The least that could be said is that I do have OCPD tendencies.

So if that is the case, I was wondering if the symptoms from my list could be explained at all with OCPD or should I insist that she considers a further investigation and perhaps a dual diagnosis?

Other things that are not on my initial list of symptoms are:
- I can never relax - I am always doing something or if I'm not, then it is probably because I am exhausted.
- Since I started college, I am constantly not "present" in lectures.
- I am getting lost in time. Or if I am doing something, I forget about everything else.

Greyhound1
10-18-16, 08:02 PM
I am no Dr. but it sounds more like ADHD or another executive dysfunction disorder to me.

These are typically prime symptoms seen with OCPD which you didn't really mention. Obsessive-Compulsive Personality Disorder is characterized by a preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.

bullet
10-18-16, 08:27 PM
Thank you for the reply Greyhound1.

I do have perfectionistic tendencies, sometimes very pronounced. I am dreaming of being orderly and sometimes do achieve it, but a lot of the time I am a mess and the physical space I occupy is messy. I don't know what mental control is? I would be controlling interpersonally (unless I am weak and depressed, then I might bottle up my frustration). I'm not very flexible and certainly not efficient.

Here's another question - is not going to bed on time and ADHD thing?
Since I live on my own and look after myself (i.e. since I grew up and am not being looked after by my parents), I always go very late to bed. I just can't stop doing stuff in the evening. Even now, for example, here it's 1:30 a.m. and I am up and doing this and am planning to do more stuff afterwards. I have gotten myself to this place where I don't really go to sleep anymore, but just fall asleep at some random point during the night. And that is with me having to wake up early and go to college (/go to work).

Greyhound1
10-18-16, 09:23 PM
Here's another question - is not going to bed on time and ADHD thing?
Since I live on my own and look after myself (i.e. since I grew up and am not being looked after by my parents), I always go very late to bed. I just can't stop doing stuff in the evening. Even now, for example, here it's 1:30 a.m. and I am up and doing this and am planning to do more stuff afterwards. I have gotten myself to this place where I don't really go to sleep anymore, but just fall asleep at some random point during the night. And that is with me having to wake up early and go to college (/go to work).

There does seem to be a correlation. I have always been a night owl and never a morning person. I have heard many other here claim the same thing. I think many of us probably have undiagnosed sleep disorders is my guess. Here is some info about it.
William Dodson, M.D. names the four most common sleep disturbances associated with ADHD:
1. Initiation insomnia. When your head hits the pillow and your mind refuses to shut down, you may be experiencing the mental restlessness of ADHD. Many people with ADHD describe themselves as ďnight owlsĒ and they tend to have more energy as soon as the sun goes down. ďMore than 70 percent of adults report that they spend more than one hour trying to fall asleep at night,Ē said Dodson.
2. Intrusive sleep. Also known as hyperfocus, this is a condition where someone with ADHD finds him or herself suddenly drowsy and immediately falls asleep. This occurs because the person has disengaged from an activity and shifted to extreme boredom, which results in quickly falling asleep. A person with ADHD may only be falling asleep due to boredom. This type of sleep disturbance is hard to study because of the difficulty reproducing it in a laboratory.
3. Restlessness. Even after someone falls asleep they may tend to toss and turn all night, waking at any noise in the house. They donít find sleep refreshing and awaken as tired as they were when they went to bed.
4. Difficultly waking up. ďMore than 80 percent of adults with ADHD in my practice report multiple awakenings until 4 a.m. Then they fall into Ďthe sleep of the dead,íĒ said Dodson. This causes these individuals to sleep through multiple alarms and have difficulty becoming fully alert until later in the day.
What can you do about catching some extra Zs? Here are a few tips for falling asleep with ADHD:
- Find a routine that will help your body prepare for sleep. Maybe itís drinking a cup of warm tea (caffeine free), packing your lunch or getting out your clothes for the next day. Set a bedtime. Our bodies crave routine and will start adjusting to going to bed at a certain time.
- Get into bed. Let your mind wind down and be ready to slip into sleep by already being in bed.
- If noises are waking you up at night, try listening to soft music or use a sound machine to drown them out.
- Set multiple alarms around your room or invest in an ADHD-friendly alarm. If you have to get out of bed to turn it off, most likely youíll become alert enough to stay up.
- Just get up and make it to the bathroom. As soon as your alarm goes off get out of bed and take a shower. The water will help wake you up quickly.
Thereís no doubt that sleeping with ADHD can make sleeping a challenge. Itís important to see a physician regarding both sleep and ADHD guidance.

Tetrahedra
10-18-16, 10:33 PM
Other things that are not on my initial list of symptoms are:
- I can never relax - I am always doing something or if I'm not, then it is probably because I am exhausted.
This sounds like it could be OCPD.

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10-19-16, 08:40 AM
So what happened today is that she keeps holding on to the OCPD diagnosis and said my symptoms could be due to many different things. She prescribed me Paxil (20mg/day).
Now that I thought about it, I don't really want to get the medicine. I have an appointment with another psychiatrist in 10 days, so will perhaps wait until then.
Is is normal to get a prescription without an official diagnosis?

Tetrahedra
10-19-16, 11:13 AM
So what happened today is that she keeps holding on to the OCPD diagnosis and said my symptoms could be due to many different things. She prescribed me Paxil (20mg/day).
Now that I thought about it, I don't really want to get the medicine. I have an appointment with another psychiatrist in 10 days, so will perhaps wait until then.
Is is normal to get a prescription without an official diagnosis?

I once went to see a psychiatrist and he gave me a prescription within ten-fifteen minutes of talking. I saw a psychologist from that same location several times, but he never diagnosed me with anything ("diagnoses are crutches"). So I don't know about normal, but it happens.

Still, a second opinion would be good. Never doubt the power of the second opinion.

bullet
10-19-16, 12:00 PM
OK.

I guess in order for the second opinion to be unbiased, I shouldn't tell the new doctor that I have consulted with the former?

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10-20-16, 01:55 PM
I have a question.

At my appointment yesterday the doctor said that my symptoms could be caused by a lot of different things (/conditions.)

But what happens if I go to a psychologist/psychiatrist who specialises in ADHD and they diagnose me with it? Is it possible to get diagnosed with ADHD without having it (based on the way I present my symptoms)?
Or does it make sense to go, eventually get a diagnosis, get help and if I still have other problems after that, then look for how to solve them too?