View Full Version : "Superior" working memory-Does this contradict ADHD?


aur462
05-14-17, 03:47 PM
THE SHORT VERSION OF MY POST:
I had an IQ test one time and on the working memory portion scored "superior" or "very superior" - can't remember, no pun intended. I've been diagnosed as ADHD in the last 1.5 years (I'm 44). My contention is that I feel as if it's "required" to have poor working memory in order to have ADHD - all literature speaks as if its a given. I was thinking "hyper-focus" could account for the working memory score. I'd be curious to hear from those more enlightened.

DETAILS ON MY BACKGROUND/PROFILE:
Generally, throughout my life I don't feel like I've was "gifted" with great working memory. My college GPA was 2.3 and school was always a struggle, despite putting in the effort. I repeated kindergarten for God's sake. Who repeats kindergarten? My childhood seems to fit perhaps all of th symptoms listed for ADHD-PI. I have learned to compensate for some of the disorder as adult and until pretty recently, attributed most of my shortcomings to anxiety problems.

I have excelled at underachieving in adulthood, though I'm making progress toward self-actualization since starting ADHD meds/stopping anti-depressants - since the first dose (especially the early doses) I recognized improvement in my sense of well-being (e.g. anxiety significantly reduced). Stimulants are the only meds that have EVER helped. In 17ish years I tried most SSRI's, some SNRI's, and several atypical antidepressants - none seemed to touch anything. The amp reduces anxiety and distracting thoughts. They've been great.

I'm not sure how vigorous the first psychiatrist I had (she's no longer practicing) was in diagnosing me. I'm going to pose this question to my new shrink who works in the same office (who's an ADHD specialist) when I see him next time. I'm just looking for more confidence in the original diagnosis; the "working memory" score is just curious.

aur462
05-14-17, 04:34 PM
Update: I just did a google search and found some conversation on this topic that happened to be on this forum (7 years ago). This is, ostensibly, the most informative response:

http://www.addforums.com/forums/showthread.php?t=94669

"Yes, of course it is possible. The working memory index is not diagnostic for ADHD, and at the moment there are no diagnoses for SCT. In fact, it's unofficial, with very little - too little - research conducted.

Generally, Digit Span is the most ADHD-sensitive, but again, it has no utility in differential diagnosis in the sense that it can only corroborate a positive ADHD diagnosis, but not ruled out a negative ADHD (based on Barkley's empirical findings)."

VoxPopuli
05-14-17, 05:28 PM
Early-on in my career I was identified as a candidate for career advancement. I was given a battery of psychological tests. One I scored "off the charts" on was working memory - but the test was not administered verbally - I SUCK at verbal recall, especially dealing with digits.

I perused the page from the thread you linked - I identified with the poster who said they did very well in subjects related to subjects she was interested in - struggled with those with a dull professor, or subjects they found boring.

My psyche evaluation actually used the line "remarkable recall when interested, no use for subjects NOT interested in..." History was like story time for me: complete recall of dates, names, activities. Science as presented by an interesting/understandable professor/teacher/grad student = excellent. Things that were NOT presented in story form -like most math classes, I found them to be a G-R-I-N-D, with the exception of some Geometry/Algebra II classes.

I found this fascinating, so I tried to incorporate that learning into my searches for the types of business books to read. I found it did quite well, started with Richard Marchenko - a former Navy Seal who laced stories about his time in the military running a Red Team (counter-insurgent/intelligence) and how that story related to some success in business (supplied by his co-author). He wrote several of the books. If any are in a business field, I recommend them, I don't know how competent of a business teaching tool it is, or how relevant it is for today - but I'd recommend trying the angle of business story-telling.

...and I wouldn't get hung up on the idea of NOT being able to read books. I'll bet if you haven't challenged yourself with trying to read during your hyper-focus periods - you probably have missed the fact that most of you are pretty good at it!

For those who have found they can't read, try a book from audible.com. I have several books I have "read" this way, especially if I have a long plane/road trip (...with the added benefit of allowing you to still play your favorite non-thinking/shoot-em-up style video games...).

aur462
05-14-17, 09:04 PM
Thanks for the reply, VoxPopuli.

I have a seasonal job that requires a good deal of working memory (wife paying the bills) and I've always been able to mow through my work when I keep anxious thoughts at bay; taking the time every 5 minutes (or much less) to appease those thoughts like crying babies - if that makes sense; moreso before I was medicated properly. I always knew that if I could just quiet my mind I could achieve so much more.

I feel so out of touch with myself in some ways - enigmatic regarding WTF is wrong with me, yet feel on the brink of epiphany. I've been told by a therapist before that I was "addicted to thinking". Neither therapy nor nonstim meds have had even been a little helpful either. My current psychiatrist is the first guy to ask me a question that I found insightful or mention something that I didn't already know; an ADHD shrink, he asked if I had obsessive thoughts. I've only had one meeting with him.

I sucked at college algebra, but I don't SEEM to fit the criteria for that "dyscalcula" thing. In college, I didn't do better than C's in history - that wouldn't happen now. There's no reason why I shouldn't have done better since it's memorization. The presentation was pretty dull as I recall. I remember being very sidetracked when I would read books in college and would make my best formal, conscious effort to not let myself be distracted by very competitive, anxious thoughts. I always thought it was anxiety, and there was a period I had textbook OCD, which over a few years became moderate BDD (body dysmorphic disorder). It's attenuated quite a bit over the years, but I'm not sure it's ever "cured". When I take those OCD tests online I actually score below what even an average person is supposed to. This is strange, but at least part of it is that I have an understanding of the thoughts being benign. I actually think OCD MAY be more nuanced than the criteria used; maybe including more criteria or subtype. That's pretty a pretty ambitious proposition though. ADHD muddies the water quite a bit, which may be a more likely explanation than any "nuance" not yet established in the DSM.

Speaking of reading, as you mentioned, I have discovered audio books - love them (audible subscription). I find that sitting down and reading a book is less time efficient (can't walk the dog with a book) and perhaps more demanding and when I think of it, the word that comes to mind is "confining". The books I've chosen lately have been science related. For various topics, "The Great Courses" is good one. It's funny you mention plane trips regarding audio books. I don't understand how people can just sit there without anything to occupy their mind. If I don't give my mind an outlet, it will find one inside my head - at my expense ;)

I tend to concentrate well in bursts rather than marathons, hyperfocus notwithstanding. E.g., aforementioned job requires scoring essays; I think it favors me because while scoring student essays is usually boring, I can "turn the page" pretty quickly by only needing to spend a short time on each one; thus "short bursts" of attention are required, and having aptitude helps too, of course.

Conversely, I like reading scientific papers on the Internet on medical and mental health topics, etc. I suppose the difference is that the articles don't require the demands of a book, and I can go from one topic to another at will, and youtube documentaries, etc. When I'm not obsessing and ruminating with an anxiety "backdrop", which used to be much worse, I find myself attracted to dense subject matter for stimulation.

....Video games..hmm..There might be something there. Haven't given those a chance in a long time.

VoxPopuli
05-15-17, 10:02 AM
I know the correlation between listening to certain types of classical music while studying certainly proved true for me when I had to study...but probably because it helped calm some of that extra anxiety you experience. My father, who has never been diagnosed with ADD, but obviously just as (if not more) smitten with it as I am...was recently placed on an anti-anxiety medication also used for ADD patients who don't/can't tolerate stimulants well, and the difference in him is amazing!

Lunacie
05-15-17, 11:06 AM
Also, when taking a new kind of test we tend to hyperfocus and do better than
we usually would. Once a situation becomes routine, it's less interesting and
doesn't hold our attention as well.

Fuzzy12
05-15-17, 11:25 AM
I've recently discovered audio books too. I can't sit down and read anymore because I lose interest in 2 minutes but I love listening to an audiobook ot youtube lectures while I'm doing g something g else like going for a walk or boring household chores. I have just bought a great courses audiobook as well.

You can also download entire lecture videos from MIT. I normally don't watch the video but just listen to them. Some of them are brilliant. There's also course by my second favourite scientist dr John Gabrieli, which is an introductory course to psychology and it's absolutely fascinating and perfect for just listening to. He's a brilliant lecturer.

Link to.mit open course ware

https://ocw.mit.edu/index.htm

I'm also better at reading papers than books but 9nly if they are both interesting and very well written. I had to read tons of papers for my work and with many I never got beyond the abstract.

aur462
05-15-17, 08:56 PM
I know the correlation between listening to certain types of classical music while studying certainly proved true for me when I had to study...but probably because it helped calm some of that extra anxiety you experience. My father, who has never been diagnosed with ADD, but obviously just as (if not more) smitten with it as I am...was recently placed on an anti-anxiety medication also used for ADD patients who don't/can't tolerate stimulants well, and the difference in him is amazing!

My dad was an accountant.......................My mom on the other hand...She's got some things happening - though she has always been very functional, even if theoretically compromised - including but not limited to ADHD I would imagine. Because of her beliefs, she doesn't go to doctors who would have diagnosed her. My mom has had psychotic episodes that occurred in 1973, 1994, 2003 and 2016 - random and enigmatic stuff. All of them lasting several days and kept my dad very busy and extremely stressed. By 2003, it was like, "oh, she's having another one of those things..OK, just ride the storm out pops." As much as I've struggled with my problems, I'm very grateful I didn't inherent psychosis. Supposedly her first "episode" was 1973. I was born in 1972. Maybe I drove her crazy?

VoxPopuli
05-15-17, 09:17 PM
@aur462:

Agreed, but psychosis without meds... :eek:

...thats conjuring Tom Cruz-ish (I know, different form of pseudo-science) behavior...

I do like the "The Great Courses" series...and I have been puzzled that I seem to have PARKED my Amazon digital library since setting up my audible membership...I have over 60 digital books that I seem to have lost ALL interest in, gradually, for the past several years. I'm hoping the desire comes back, so far...nada. Although I did find it hard to give up that tactile stimulus of holding a book, turning it's pages, the difference in smells of new books vs used books...but once I got through that part of the transition, the ONLY drawback to digital books: NOT remembering to charge my iPad...:eyebrow:

@Lunacie:

That's an interesting point, I do find that my working knowledge seems to wax and wain at different times. Some weeks it remains consistent and I seem to keep track of everything...then the next week the mental fog can begin creeping towards me ...even regardless of medication. I don't fight it, I have a position that allows me to change my work pattern to focus on something else until I'm better suited.

aur462
05-15-17, 10:55 PM
@aur462:

Agreed, but psychosis without meds... :eek:

...thats conjuring Tom Cruz-ish (I know, different form of pseudo-science) behavior...

It's amazing how otherwise intelligent people

That's an interesting point, I do find that my working knowledge seems to wax and wain at different times. Some weeks it remains consistent and I seem to keep track of everything...then the next week the mental fog can begin creeping towards me ...even regardless of medication. I don't fight it, I have a position that allows me to change my work pattern to focus on something else until I'm better suited.

Only recently did I start a consistent regimen of only stimulants (no AD). I've generally noticed the same thing with "on/off" switch. It's been weeks since I've felt in the zone like I was for a while (when my med regimen was consistent). I took a drug called EMSAM (MAOI patch), which is Latin for "The Devil, himself", for 2 weeks when I stopped after insomnia and being unable to function. This was preceded by discontinuation of 2 AD's - because EMSAM interacts with EVERYTHING except vaseline..or something; my system had to be clean before starting it. I'm not quite back to where I was before the EMSAM, but a lot closer. Brain fog, spaceyness and exhaustion were extreme. It may have also spawned a heartbeat irregularity of some sort. EKG's are negative, but I got a "halter monitor" today to detect if one actually exists over the next 2 weeks. :yes:

I'm glad to be off all AD's as the best they ever seemed to provide was side effects. I'm waiting to get back to my enthusiasm for learning the guitar and listening to "riveting" audio books such as "The Philosophy of Science". It's been about 5 weeks and looking forward to more than just the occasional hyper-focus session.

VoxPopuli
05-16-17, 04:45 PM
It's amazing how otherwise intelligent people



Only recently did I start a consistent regimen of only stimulants (no AD). I've generally noticed the same thing with "on/off" switch. It's been weeks since I've felt in the zone like I was for a while (when my med regimen was consistent). I took a drug called EMSAM (MAOI patch), which is Latin for "The Devil, himself", for 2 weeks when I stopped after insomnia and being unable to function. This was preceded by discontinuation of 2 AD's - because EMSAM interacts with EVERYTHING except vaseline..or something; my system had to be clean before starting it. I'm not quite back to where I was before the EMSAM, but a lot closer. Brain fog, spaceyness and exhaustion were extreme. It may have also spawned a heartbeat irregularity of some sort. EKG's are negative, but I got a "halter monitor" today to detect if one actually exists over the next 2 weeks. :yes:

I'm glad to be off all AD's as the best they ever seemed to provide was side effects. I'm waiting to get back to my enthusiasm for learning the guitar and listening to "riveting" audio books such as "The Philosophy of Science". It's been about 5 weeks and looking forward to more than just the occasional hyper-focus session.

Because my dad started exhibiting some severe anxiety related to my mom's treatment/recovery from a medical ordeal, HER doctor (his anxieties began to complicate her recovery) asked him to discuss Ativan (a Valium derivative) with his doctors at the Veterans Hospital.

After a brief Q/A, his doctors agreed/proscribed a low dose.

His turn around was remarkable. I'm sad to say that I had not yet considered that his behavior is consistent with an untreated ADHD adult in his 80's. His transformation after taking Ativan is what caused me to consider it. Although he doesn't appear as sharp. He doesn't follow stories/explanations any better than he used to...but instead of getting up mid-sentence and heading out to his garden - he now asks what I mean when he hears something he doesn't understand!
I'm guessing that is because the Ativan acts differently than a stimulant in that it achieves focus by slowing the brain activity, and because it enhances a natural brain chemical that produces a calming effect, the anxiousness caused by the hyperactivity is lessened.

In my particular case - I'm wondering if the hyperactive aspect of my ADHD (which drove everyone around me NUTZO for most of my life), is diminishing as I age? I have to say that if it the old feeling I related to "drive" and the need to constantly stay busy/constantly move - was hyperactivity - then I miss it. Although it was unfocused - I at least knew I would eventually move to something else. I can't say I miss that hyperactive sensation of 'feeling my skin crawl' during long periods of inactivity (i.e., important meetings, tests/exams, etc.,). I can now sit for long periods - but without focusing on...anything. I have to carry a (leather-bound) notebook with me, and I write down where I was going and who I am supposed to speak with (as well as my purpose for the contact). Because I now find my ADD is characterized by the thought "how long have I been here...?" or "WHAT time did you say it was...?" - my sense of time is generally way off...formerly, I'd characterize my AD(H)D by the statement: "I can't sit here any more....!

I'm concerned my executive functions aren't what they were just a few years ago.

aur462
05-17-17, 07:37 PM
After a brief Q/A, his doctors agreed/proscribed a low dose.

I'm guessing that is because the Ativan acts differently than a stimulant in that it achieves focus by slowing the brain activity, and because it enhances a natural brain chemical that produces a calming effect, the anxiousness caused by the hyperactivity is lessened.

He might feel great on a stimulant. That might be a "hard sell" though for him.


In my particular case - I'm wondering if the hyperactive aspect of my ADHD (which drove everyone around me NUTZO for most of my life), is diminishing as I age? I have to say that if it the old feeling I related to "drive" and the need to constantly stay busy/constantly move - was hyperactivity - then I miss it. Although it was unfocused - I at least knew I would eventually move to something else. I can't say I miss that hyperactive sensation of 'feeling my skin crawl' during long periods of inactivity (i.e., important meetings, tests/exams, etc.,). I can now sit for long periods - but without focusing on...anything. I have to carry a (leather-bound) notebook with me, and I write down where I was going and who I am supposed to speak with (as well as my purpose for the contact). Because I now find my ADD is characterized by the thought "how long have I been here...?" or "WHAT time did you say it was...?" - my sense of time is generally way off...formerly, I'd characterize my AD(H)D by the statement: "I can't sit here any more....!

I'm concerned my executive functions aren't what they were just a few years ago.

As you may know, by adolescence the outward hyperactivity lessens and manifests more inward. Getting older isn't fun. I speak from experience. It sounds like your ADHD symptoms are getting "gray hair" and the more energetic components aren't what they used to - sounds like aging ADD :) Sense of time, generally from what I understand, is something that is frequently a problem for many ADDers.

I'm the "space case" as a couple kids called me in 6th grade:umm1:so I am unfamiliar with the what hyperactivity is like :)

Cyllya
05-22-17, 06:53 PM
Indeed, working memory is not in the diagnostic criteria at all. Technically, the diagnostic criteria consists mostly of observable behaviors (and other circumstances), with very little about the symptoms as actually experienced by the patient. I suspect WM impairment, more so than actual attention problems, are the driver behind most people's fit of the "Is often easily distracted" symptom.

Besides, you don't need every symptom to meet the criteria. You need 6+ from the "inattention" list OR 6+ from the "hyperactivity/impulsive" list, or 6+ from both.

That aside, sometimes I question the ability of neuropsych assessments to give an accurate idea of our abilities in "the real world." Do you know what kind of test they gave you for measuring working memory? Might've been a digit-span test? In a quiet, distraction-free testing environment, without meds, I can easily remember enough digits to fit in the "normal" range, maybe even above-average on a good day. But if I'm on my computer at work and need to open another program, I'll forget what I needed that program for by the time it opens. Or sometimes, I'll forget which program I needed by the time my mouse gets to the task bar! And then while I'm retracing my mental steps to try to remember what I was doing, I'll forget what I was trying to remember.

aur462
05-22-17, 08:14 PM
That aside, sometimes I question the ability of neuropsych assessments to give an accurate idea of our abilities in "the real world." Do you know what kind of test they gave you for measuring working memory? Might've been a digit-span test? In a quiet, distraction-free testing environment

Yes, the test was as you described. I didn't get a neuropsych test, just IQ - when I was about 27. I remember trying very hard :). I repeated the numbers she would give me out loud, and as the backward repetition came into play, this was key to doing well. I think any test that purports to give your IQ is far reaching. I'm sure for some it's very accurate, and for others it's not even in the ballpark - I would think this would be more true of a lower test score than a high one. But there's this oppressive thing that happens when clinicians want to fit everything nice and tidy in a box with a bow on top - "we have enumerated you" :)

Kunga Dorji
05-23-17, 02:28 AM
THE SHORT VERSION OF MY POST:
I had an IQ test one time and on the working memory portion scored "superior" or "very superior" - can't remember, no pun intended. I've been diagnosed as ADHD in the last 1.5 years (I'm 44). My contention is that I feel as if it's "required" to have poor working memory in order to have ADHD - all literature speaks as if its a given. I was thinking "hyper-focus" could account for the working memory score. I'd be curious to hear from those more enlightened.

DETAILS ON MY BACKGROUND/PROFILE:
Generally, throughout my life I don't feel like I've was "gifted" with great working memory. My college GPA was 2.3 and school was always a struggle, despite putting in the effort. I repeated kindergarten for God's sake. Who repeats kindergarten? My childhood seems to fit perhaps all of th symptoms listed for ADHD-PI. I have learned to compensate for some of the disorder as adult and until pretty recently, attributed most of my shortcomings to anxiety problems.

I have excelled at underachieving in adulthood, though I'm making progress toward self-actualization since starting ADHD meds/stopping anti-depressants - since the first dose (especially the early doses) I recognized improvement in my sense of well-being (e.g. anxiety significantly reduced). Stimulants are the only meds that have EVER helped. In 17ish years I tried most SSRI's, some SNRI's, and several atypical antidepressants - none seemed to touch anything. The amp reduces anxiety and distracting thoughts. They've been great.

I'm not sure how vigorous the first psychiatrist I had (she's no longer practicing) was in diagnosing me. I'm going to pose this question to my new shrink who works in the same office (who's an ADHD specialist) when I see him next time. I'm just looking for more confidence in the original diagnosis; the "working memory" score is just curious.

No, it does not contradict the diagnosis.
See this article by the neuropsychologist Leonard Koziol:
leonardkoziol.com/publications/Attention_Evolution_Revolution_2015.pdf


<style type="text/css">P { margin-bottom: 0.21cm; }</style> And in this regard, we completely agree with Carmichael and colleagues’ (this issue) bold statement that from a neuropsychological perspective, ADHD does not exist.

There are absolutely no broad-based neuropsychological test batteries that can ever lead to that diagnosis nor is there any ‘‘litmus test’’ for the disorder called ADHD (Koziol, Budding, & Chi- dekel, 2013; Koziol & Stevens, 2012).


However- before everyone goes up in flames - the next sentence is:

<style type="text/css">P { margin-bottom: 0.21cm; }</style> However, the fact of the matter is that from the behaviorally defined DSM system, ADHD does exist. It has remained alive and well ever since this categorical diagnosis was introduced into the DSM


on page 2

<style type="text/css">P { margin-bottom: 0.21cm; }</style> The second issue in this section concerns the failure to identify a ‘‘global’’ attention system or network. This is also true for the diagnosis of ADHD.


In short there is no single neuropsychological test and no combination of neuropsychological tests that can reliably diagnose, or exclude ADHD.
So some individuals with ADHD will have a normal or high working memory,

And in this regard, we completely agree with Carmichael and colleagues’ (this issue) bold statement that from a neuropsychological perspective, ADHD does not exist.



There are absolutely no broad-based neuropsychological test batteries that can ever lead to that diagnosis nor is there any ‘‘litmus test’’ for the disorder called ADHD (Koziol, Budding, & Chi- dekel, 2013; Koziol & Stevens, 2012).

sarahsweets
05-23-17, 06:01 AM
I'm guessing that is because the Ativan acts differently than a stimulant in that it achieves focus by slowing the brain activity, and because it enhances a natural brain chemical that produces a calming effect, the anxiousness caused by the hyperactivity is lessened.

That is interesting because one of the theorized mechanisms of action of stimulants is to also slow the brain down, at least that tends to be why they work with someone with adhd and those racing thoughts.


In my particular case - I'm wondering if the hyperactive aspect of my ADHD (which drove everyone around me NUTZO for most of my life), is diminishing as I age? I have to say that if it the old feeling I related to "drive" and the need to constantly stay busy/constantly move - was hyperactivity - then I miss it. Although it was unfocused - I at least knew I would eventually move to something else. I can't say I miss that hyperactive sensation of 'feeling my skin crawl' during long periods of inactivity
You know, its my personal theory that the hyperactivity is more mental as we get older, at least it is for me. Not quite racing thoughts but multiple layers of thoughts with difficulty focusing on one or two but trying to focus on a zillion. i wonder if thats true for others.