View Full Version : Hidden ADHD ?


Aladin
11-06-16, 04:57 PM
Hi,

I am wondering if I have ADHD. I never thought of it until a GP doc who had some knowledge about it suggested that I get tested, (and that I will do, but in the meantime, well, here I am). I looked up the symptoms and a lot of them were not unknown to me.

I am a 22 years old french student. The problem is that I have had social anxiety and a very low mood since early childhood (that turned into real depression at the end of my puberty), and a lot of symptoms overlap. Also, the GP told me that sometimes above average intellect can contribute to hide the disorder and that it may be the case with me (one of my psy also told me that). I am aware it's doesn't sound very modest by the way.

I really want to find out because while I really made progress regarding my SA, thanks to therapies, work on myself and antidepressants, I am still depressed and still have trouble to get a normal social life, way more actually that a lot of people who are more shy than me. And while serotonin antidepressants (SSRIs) had some impact on my anxiety, they were really not that useful. As a result I self medicate with alcohol and caffeine. As I am very cautious it never led to addiction but it still got me a lot of troubles. If I have ADHD, it could mean that I could hope to get more efficient treatment.

Here are some symptoms that, from what I understood, could be those of ADHD: I really lack motivation and envy most of the time, I get bored very fast, I daydream a lot (usually I picture myself conversations I have with others), I always make inattention mistakes (sleep with my keys on the door, take the wrong metro line even if it is my daily itinerary, forget my credit card in the ATM, always has to call to ask appointment times again...), I usually don't go to class I can miss because if it is more than one hour I can by mo mean stay interested and concentrated.

When I speak with people I will concentrate on their face, on my attitude, and it will be hard to look normal unless it is something that interest me a lot. Sometimes I make a phone call to ask something, I talk, I say by and I realized forget to ask that thing (but it could be because of social anxiety).

I have sleep problems, I take a awful lot of time to fall asleep because my mind can't shut up, and then I have to sleep trough the day or I am a zombie. My flat is usually a big mess and my schedule really weird when I live alone.

Also I constantly get enthusiastic about new hobbies or topics and then just lose interest after a while. Same for books, I don't finish most of them. When I start a book that seems very interesting, I usually get excited and have trouble reading it.

And paradoxically, even if I am usually tired and apathetic, I feel nervous and agitated, I feel a lot of tension inside. I am usually quite fidgety (moving fingers, feet...).

BUT: there are some things that do not quite match. I can sit for one hour, it is not difficult for me. I am not hyper, I don't talk much. I has very good grades in elementary school and honest grades later. I entered a good school even if I feel I could have had better without depression because I don't work much but still get trough the years pretty easily. I am usually way better at entrance exams that people expect me to be when they look at my annual grades (because during the year I have no motivation).

I can pay attention to details, actually I am sometimes very observant. I tend to think a lot about the consequences of my actions. I am very analytical.

I can focus seasonably well, for example I wrote this text without any problem (however I am quite obsessed with my psychological problem so it could be why).

So what do you think ?

For me there is two options:

- I only have social anxiety and depression and they are the only culprit of my agitation and inattentiveness.

- I have ADHD and it is party responsible for my SA and depression.

I also thought that my SA could hide ADHD, since I feel so inhibited when there are people around me that I just keep quite and still even if I am not like that at all when I am alone. As soon as I drink a little (or a lot), the anxiety drop and I can get very very chatty and be all over the place (someone told me I was taking too much place once). I often run or climb when drunk. And If I take too much I can get violent (which of course I try to avoid).

Have a good night !

Aladin
11-06-16, 05:49 PM
sorry for the spelling mistakes I did not proofread my post.

20thcenturyfox
11-06-16, 10:12 PM
...
For me there is two options:

- I only have social anxiety and depression and they are the only culprit of my agitation and inattentiveness.

- I have ADHD and it is party responsible for my SA and depression.

I also thought that my SA could hide ADHD, since I feel so inhibited when there are people around me that I just keep quite and still even if I am not like that at all when I am alone. As soon as I drink a little (or a lot), the anxiety drop and I can get very very chatty and be all over the place (someone told me I was taking too much place once). I often run or climb when drunk. And If I take too much I can get violent (which of course I try to avoid).

Have a good night !

I can't tell you whether you have ADHD or not, though when you say you are enthusiastic to start a new book or hobby before losing interest, that sounds to me more like ADHD than depression or social anxiety.

But, if you look around this forum, especially in the sections for Depression (especially Treatment-Resistant Depression) and Social Anxiety, you will probably find many similarities and differences to your situation.

As well, the research strongly suggests there are more than just the 2 possibilities you mention. ADHD frequently co-exists with other conditions; but, because of the typical frustrating life experiences that accompany ADHD, it can also give rise to (cause) both secondary depression and/or social anxiety. So it could be a cause, or it could be a comorbidity. You can see how this could complicate treatment.

For many of us, however, being diagnosed with ADHD was a big breakthrough precisely because medication for ADHD suddenly gave noticeable immediate benefits for that other secondary condition, as well as for whatever inattentive or apathetic symptoms had just been hanging around and dragging us down without being labelled as a distinct problem.

So do get tested. And good luck!

sarahsweets
11-07-16, 06:02 AM
When you say "get tested" what do you mean?

Aladin
11-07-16, 01:54 PM
I can't tell you whether you have ADHD or not, though when you say you are enthusiastic to start a new book or hobby before losing interest, that sounds to me more like ADHD than depression or social anxiety.

But, if you look around this forum, especially in the sections for Depression (especially Treatment-Resistant Depression) and Social Anxiety, you will probably find many similarities and differences to your situation.

As well, the research strongly suggests there are more than just the 2 possibilities you mention. ADHD frequently co-exists with other conditions; but, because of the typical frustrating life experiences that accompany ADHD, it can also give rise to (cause) both secondary depression and/or social anxiety. So it could be a cause, or it could be a comorbidity. You can see how this could complicate treatment.

For many of us, however, being diagnosed with ADHD was a big breakthrough precisely because medication for ADHD suddenly gave noticeable immediate benefits for that other secondary condition, as well as for whatever inattentive or apathetic symptoms had just been hanging around and dragging us down without being labelled as a distinct problem.

So do get tested. And good luck!

I see. Thank you for your insight :)

Aladin
11-07-16, 01:58 PM
When you say "get tested" what do you mean?

I know an hospital in my city where there is a service dedicated to ADHD diagnosis. Actually it is the same hospital my usual psychiatrist works.

sarahsweets
11-07-16, 09:05 PM
I know an hospital in my city where there is a service dedicated to ADHD diagnosis. Actually it is the same hospital my usual psychiatrist works.

Oh, ok. Since there are no tests for adhd- yet many places that claim to do "testing" I was concerned for you.

20thcenturyfox
11-07-16, 10:18 PM
Oh, ok. Since there are no tests for adhd- yet many places that claim to do "testing" I was concerned for you.

I used the term "get tested" because OP used it. But it's good to point out that clinically ADHD is, so far, strictly a somewhat loose constellation of symptoms, and a proper diagnosis is only by elimination of other things. That said, I would guess that typically there is more "jumping to conclusions" or "Hail Mary "Let's try this" than careful differential diagnosis of other things, such as depression, anxiety, learning disabilities, Asperger's, personality disorders, etc. etc. Even though research is closing in on anatomical and physiological differences in the brain, as far as I know there is no application of these observations to effective diagnosis of ADHD.

I guess "evaluation" would be a better term?

And hey, let's hear it for a hospital that does specialized ADHD assessments (gosh, it would be awful to have to go to Paris, wouldn't it?). I have always heard France has one of the best mixed public/private medical systems in the world!

ginniebean
11-07-16, 10:59 PM
Go and get tested. much sounds like adhd but were you this way also as a child? Adhd is a hidden disability. It can be easy to call the child lazy, uncaring, refusing, etc...

Pilgrim
11-07-16, 11:00 PM
If you look back and pinpoint the time that your symptoms started it might be the 4or 5 mark.
I started to have long bouts of anxiety and when I couldn't cope this turned into a depression.
To be honest I think that I started to get concerned when in order to have fun I would go out and drink to excess, I just couldn't turn off without alcohol.
I'm not saying you have ADD but SSRI work on the Serotonin system where as a ADD medications work on the Dopamine System. This is where these conditions become complex because one system effects the other and there are a number of conditions that look similar.
For me treatment with ADD medications was a godsend, they are designed to go in and activate those parts of the brain that just aren't working right.
Trouble in completing tasks, restlessness, anxiety, depression, forgetfulness, shyness, lack of self esteem and motivation were all helped tremendously by ADD meds. When I was younger I was considered an above average student and my grades were good, it was operating in the real world that I found it hard to complete all those different tasks that I had to do.
Actually if I was about your age now that would have been the best time to start real treatment. Ow well, Good luck.

sarahsweets
11-08-16, 05:46 AM
I used the term "get tested" because OP used it. But it's good to point out that clinically ADHD is, so far, strictly a somewhat loose constellation of symptoms, and a proper diagnosis is only by elimination of other things. That said, I would guess that typically there is more "jumping to conclusions" or "Hail Mary "Let's try this" than careful differential diagnosis of other things, such as depression, anxiety, learning disabilities, Asperger's, personality disorders, etc. etc. Even though research is closing in on anatomical and physiological differences in the brain, as far as I know there is no application of these observations to effective diagnosis of ADHD.

I guess "evaluation" would be a better term?

And hey, let's hear it for a hospital that does specialized ADHD assessments (gosh, it would be awful to have to go to Paris, wouldn't it?). I have always heard France has one of the best mixed public/private medical systems in the world!

Yes I agree that evaluation sounds better than testing and I wasnt trying to correct you. I just know we have so many people who come here and say they were told they needed all these expensive tests and computer test that-surprise!- are not covered by insurance. So people get swindled into paying an arm and a leg for something that a good doctor and a thorough evaluation can do.

Aladin
11-08-16, 06:02 AM
I used the term "get tested" because OP used it. But it's good to point out that clinically ADHD is, so far, strictly a somewhat loose constellation of symptoms, and a proper diagnosis is only by elimination of other things. That said, I would guess that typically there is more "jumping to conclusions" or "Hail Mary "Let's try this" than careful differential diagnosis of other things, such as depression, anxiety, learning disabilities, Asperger's, personality disorders, etc. etc. Even though research is closing in on anatomical and physiological differences in the brain, as far as I know there is no application of these observations to effective diagnosis of ADHD.

I guess "evaluation" would be a better term?

And hey, let's hear it for a hospital that does specialized ADHD assessments (gosh, it would be awful to have to go to Paris, wouldn't it?). I have always heard France has one of the best mixed public/private medical systems in the world!


Yeah true test was not the accurate word, I know there is no certainty when it comes to ADHD. Evaluation is definitely more suited.

Our health system is pretty good, maybe not the best in Europe, but I don't have to complain, especially in Paris !

But from what I heard ADHD is a little under-diagnosed here, because it is not taken so seriously. Maybe because France is so fond of psychoanalysis and has always been a little slow when it comes to psychiatry.

When you speak about ADHD, most people will usually think to the US and start telling you how stimulants are given to kids like candies there, thanks to big pharmaceutical lobbies.

Aladin
11-08-16, 06:07 AM
Yes I agree that evaluation sounds better than testing and I wasnt trying to correct you. I just know we have so many people who come here and say they were told they needed all these expensive tests and computer test that-surprise!- are not covered by insurance. So people get swindled into paying an arm and a leg for something that a good doctor and a thorough evaluation can do.

Thanks for your concern :) But no worries, I would certainly not consider that option.

Aladin
11-08-16, 06:25 AM
If you look back and pinpoint the time that your symptoms started it might be the 4or 5 mark.
I started to have long bouts of anxiety and when I couldn't cope this turned into a depression.
To be honest I think that I started to get concerned when in order to have fun I would go out and drink to excess, I just couldn't turn off without alcohol.
I'm not saying you have ADD but SSRI work on the Serotonin system where as a ADD medications work on the Dopamine System. This is where these conditions become complex because one system effects the other and there are a number of conditions that look similar.
For me treatment with ADD medications was a godsend, they are designed to go in and activate those parts of the brain that just aren't working right.
Trouble in completing tasks, restlessness, anxiety, depression, forgetfulness, shyness, lack of self esteem and motivation were all helped tremendously by ADD meds. When I was younger I was considered an above average student and my grades were good, it was operating in the real world that I found it hard to complete all those different tasks that I had to do.
Actually if I was about your age now that would have been the best time to start real treatment. Ow well, Good luck.

Thanks !

4 or 5 ? It's exactly when it began. I was a happy child when I started preschool and you can clearly see on pictures of me that something changed in the following years. Like if a switch was turned off.

What bothers me when it comes to study is that I always change my mind and can't decide which field interests me. I can sometimes take a decision and realize some months later that I wanted to so something entirely different. And that happens a lot. So I often end up in classes where I feel like an intruder because I am not really interested.

I also drink to excess to have fun because the effect is so strong on me. I have so much more energy and drive. Sometimes also in my everyday life, I drink a little before going out of my home, because it allows me to feel so much more confident and interested, but I tend to become a bit hyper I I take too much (talking too much and not listening to others).

SSRIs slightly reduce depression and anxiety but they do only so much. Trying effexor right now, it also affects noradrenaline, maybe it will be a little more efficient. It also affects dopamine but at very high dose and it's not very significant so I don't think it is worth the trouble given the drawbacks.

Cheers :)

sarahsweets
11-08-16, 07:00 AM
I also drink to excess to have fun because the effect is so strong on me. I have so much more energy and drive. Sometimes also in my everyday life, I drink a little before going out of my home, because it allows me to feel so much more confident and interested, but I tend to become a bit hyper I I take too much (talking too much and not listening to others).


Please be careful with the alcohol. As an alcoholic I cant stess enough how being sober and treated is so much better than drinking alot and getting treatment. Night and day really.

kilted_scotsman
11-08-16, 09:43 AM
I just know we have so many people who come here and say they were told they needed all these expensive tests and computer test that-surprise!- are not covered by insurance. So people get swindled into paying an arm and a leg for something that a good doctor and a thorough evaluation can do.

But it's good to point out that clinically ADHD is, so far, strictly a somewhat loose constellation of symptoms, and a proper diagnosis is only by elimination of other things.

Fox is right that ADHD is a symptom group, and a thorough diagnosis involves the elimination of other possible causation. The "expensive tests" can be the mark of a COMPETENT diagnostician ensuring that there are not other factors in play.

Of course this is not always the case....there are swindlers amongst the medical profession as elsewhere.

I would also not say that France is slow when it comes to psychiatry as it is where scientific investigation of the mind and brain began. As a health system France has a more sophisticated view of psychological treatment than the US or UK.

Aladin
11-08-16, 12:25 PM
Fox is right that ADHD is a symptom group, and a thorough diagnosis involves the elimination of other possible causation. The "expensive tests" can be the mark of a COMPETENT diagnostician ensuring that there are not other factors in play.

Of course this is not always the case....there are swindlers amongst the medical profession as elsewhere.

I would also not say that France is slow when it comes to psychiatry as it is where scientific investigation of the mind and brain began. As a health system France has a more sophisticated view of psychological treatment than the US or UK.

What you re speaking about was a long time ago... It's like saying that France is good at photography because we kind of invented it. Today photography creation is way more dynamic in the US.

A lot of disorders really get little attention here compared to the US in my opinion. Social anxiety, ADHD... It's hard to find good specialists unless you are in Paris and there is little research about it. It's like CBT, it is getting common now but a few years ago it was not so easy to get one. But if you want talk therapy or psychoanalysis no problem. It's like the opposite of the US.

I am not for overmedicating and I am convinced that talk therapy can be very useful, especially when combined with meds. WIth still, we are a little slow !



Thank you all for your advice and your support :) I kind of hope I do have ADHD because it would be a huge step toward self acceptance and it would explain so much, for example why I tell way to much things to people I barely know or why I sometimes say very provocative stuff while being shy (things that most non shy people would not dare to say). I am tired of being seen as a self centered ******* when I am just someone who try to connect and being interested but don't know the right way to do it. I am very frustrated, angry (at me and at others, even if I know they are in no way responsible for my situation) and sad.

Have a good evening !

20thcenturyfox
11-08-16, 10:47 PM
...A lot of disorders really get little attention here compared to the US in my opinion. Social anxiety, ADHD... It's hard to find good specialists unless you are in Paris and there is little research about it. It's like CBT, it is getting common now but a few years ago it was not so easy to get one. But if you want talk therapy or psychoanalysis no problem. It's like the opposite of the US.

I am not for overmedicating and I am convinced that talk therapy can be very useful, especially when combined with meds. ...

The question of which psychosocial therapies are useful for reducing the impairments due to ADHD comes up every so often. There are other threads about which therapies have evidence-based research to support their effectiveness with, say, impulsivity, or executive functions. Suffice to say, even CBT (which is shown to be effective for depression and anxiety) --unless tweaked to target ADHD specifically (thereupon dubbed MBT, for MetaCognitive Behavioural Therapy) has not been shown to be effective for ADHD. There are also indications that Acceptance & Commitment Therapy, and Mindfulness-based Cognitive Therapy may turn out to be effective. And there is something called Goal Management Training which has evidence-based efficacy in improving executive functions across a range of conditions with impaired mental functioning, but has not formally studied for ADHD specifically.

But most of us here are limited to research published in English. And from what I have seen, there is no research to support the efficacy of traditional "talk therapies" such as psychoanalysis or Gestalt, etc. for ADHD. So if you come across any research or academic reports related to "talk therapies" for ADHD, would you pass it along to us here? (Even if they're in French or German it would be fine...I can read and translate however crudely, but I'm nowhere close to having the patience to do the research that way!)

Aladin
11-09-16, 09:53 PM
The question of which psychosocial therapies are useful for reducing the impairments due to ADHD comes up every so often. There are other threads about which therapies have evidence-based research to support their effectiveness with, say, impulsivity, or executive functions. Suffice to say, even CBT (which is shown to be effective for depression and anxiety) --unless tweaked to target ADHD specifically (thereupon dubbed MBT, for MetaCognitive Behavioural Therapy) has not been shown to be effective for ADHD. There are also indications that Acceptance & Commitment Therapy, and Mindfulness-based Cognitive Therapy may turn out to be effective. And there is something called Goal Management Training which has evidence-based efficacy in improving executive functions across a range of conditions with impaired mental functioning, but has not formally studied for ADHD specifically.

But most of us here are limited to research published in English. And from what I have seen, there is no research to support the efficacy of traditional "talk therapies" such as psychoanalysis or Gestalt, etc. for ADHD. So if you come across any research or academic reports related to "talk therapies" for ADHD, would you pass it along to us here? (Even if they're in French or German it would be fine...I can read and translate however crudely, but I'm nowhere close to having the patience to do the research that way!)


When I talked about the usefulness of talk therapy, I was not thinking about something like TADH. I think that it can for example help people who have light depression and/or anxiety and who sometimes just need to talk to someone and get a little guidance to get better, rather than just seeing a GP and coming home with a powerful med such as an antidepressant.

I know some people who said they had a better life after starting psychoanalysis. But when it comes to its efficiency against serious disorder such as moderate to severe depression and anxiety, I am skeptical. The thing is, as psychoanalysis is supposed to be long term (of for a life time in some case), it's hard to assess it.


Concerning your request, I did no spend hours searching, but I found a few things. First, there is this study from 2011, translated in English. Here is the introduction: "In France, attention deficit disorder (ADHD) has traditionally met with two opposing approaches (biological and psychoanalytic). This conflict led us to conduct a multidisciplinary observational study, on a group of 36 children over a period of 1 year.". But it's not so interesting because the sample is quite small and it's only one study.

http://www.sciencedirect.com/science/article/pii/S0013700611000133

More interesting is this work from the High Health Authority. It's pretty big (200 pages) so you'll need some courage but there is a part on the efficiency of different methods (from medication to meditation -while there is a lot of things about psychoanalysis theories concerning ADD, talk therapy is not included in the list, so I think there is no consistent data to show its efficiency), some charts and some info to do some research (data, key words...). It also give an overview of the history of this disorder both in France and in other countries.

http://www.has-sante.fr/portail/upload/docs/application/pdf/2015-02/tdah_argumentaire.pdf

I also found a study that concludes that psychoanalysis is effective, but I would not put too much faith in it, because it is not very consistent with what I read elsewhere and because it was conducted by a psychologist working at the Sigmund Freud Institute.

http://www.tandfonline.com/doi/abs/10.1080/15289168.2015.1014991?src=recsys&journalCode=hicp20

20thcenturyfox
11-10-16, 03:06 PM
...Concerning your request, I did no spend hours searching, but I found a few things. ...

More interesting is this work from the High Health Authority. It's pretty big (200 pages) so you'll need some courage but there is a part on the efficiency of different methods (from medication to meditation -while there is a lot of things about psychoanalysis theories concerning ADD, talk therapy is not included in the list, so I think there is no consistent data to show its efficiency), some charts and some info to do some research (data, key words...). It also give an overview of the history of this disorder both in France and in other countries.

http://www.has-sante.fr/portail/upload/docs/application/pdf/2015-02/tdah_argumentaire.pdf...

"scientifically proven" or "scientifically presumed?" I wonder how long it will take for this to change. No wonder we still have people who don't believe it is a real disorder!

BTW the French terms & abbreviations are nice to know: especially the use of "trouble" for "disorder" in TDAH. So some who are annoyed by the term "disorder" in English may prefer "attention-deficit-hyperactivity trouble," which it certainly is!