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  #1  
Old 11-25-17, 01:54 AM
Essa96 Essa96 is offline
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Can you explain how inattentive ADHD is different?

I see a lot of people discussing Hyperactive/combined symptoms but never inattentive as it's own.

Those with ADHD-PI exclusively, can you explain your symptoms and give some scenarios as to how it interferes with your day-to-day life?

Also, can you even have ADHD-PI if you meet all the symptoms except forgetful and loses things?
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Old 11-26-17, 07:42 AM
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Re: Can you explain how inattentive ADHD is different?

Though I have a combined-type diagnosis, I do believe I am predominantly inattentive.

These are my common difficulties when I am unmedicated or medication is ineffectual:

- 'Spaciness'. It's difficult to explain but I don't feel quite with it and merely appear as if I am paying attention when in fact my mind is elsewhere.

- Brain fog. I can't seem to process things correctly to the point where I won't remember anything I have watched read, seen or heard. It's perhaps my most debilitating symptom but it may not be ADHD-related? My brain is essentially a foggy/hazy mess where nothing seems to be absorbed.

- Forgetfulness. The amount of times I walk into a room only to forget what I went in there for is laughable.

- Zoning out. But this could be connected to some of the above or an overly sensitive nervous system from autism.

- Missing important details.
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Old 11-26-17, 08:16 AM
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Re: Can you explain how inattentive ADHD is different?

The dsm v (I think) did away with the subtypes and Im glad. I was considered combined but at different points in my life I would have more inattentive symptoms of hyperactive symptoms. In fact a lot of the hyperactive stuff I have going on is more mental than physical which makes sense to me. Sometimes I think the PI Vs combined vs H turns into a p**sing contest which doesnt help anyone.
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Old 11-26-17, 04:55 PM
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Re: Can you explain how inattentive ADHD is different?

Many of us on this board are what was traditionally called "inattentive."

I don't say that in all my posts, but that's the same for others. So there's a ton of talk about attention issues on this forum.

When I read posts, I don't make a distinction. The behavior issues are so so similar.

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Old 11-27-17, 12:34 AM
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Re: Can you explain how inattentive ADHD is different?

Quote:
Originally Posted by Barbrady1 View Post

- Zoning out. But this could be connected to some of the above or an overly sensitive nervous system from autism.
Perhaps tangential, but it's driving me mad trying to figure out where to draw the line between Inattentive ADD and autism.

Can profound inattention with poor executive functioning lead to the rigidity and inflexibility characteristic of autism, as a false-positive?

Or does autism itself lead to severe inattention?

Could the rigidity and resistance to change actually be unrelated to the inattention/executive dysfunction?

I just think no good answers are available for this, right now; I wonder how much longer it will be before this confusion is cleared up..!
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Old 11-27-17, 10:14 AM
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Re: Can you explain how inattentive ADHD is different?

daydreaming--mind wanders involuntarily even when being directly spoken to; thinking of a completely unrelated subject and or event while performing a task and thus making lots of mistakes because you were only half paying attention when the instructions were explained, and now only half paying attention to the task you are performing, the instructions of which you got half screwed up.
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Old 11-27-17, 12:13 PM
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Re: Can you explain how inattentive ADHD is different?

Quote:
Originally Posted by Batman55 View Post
Perhaps tangential, but it's driving me mad trying to figure out where to draw the line between Inattentive ADD and autism.

Can profound inattention with poor executive functioning lead to the rigidity and inflexibility characteristic of autism, as a false-positive?

Or does autism itself lead to severe inattention?

Could the rigidity and resistance to change actually be unrelated to the inattention/executive dysfunction?

I just think no good answers are available for this, right now; I wonder how much longer it will be before this confusion is cleared up..!
I'm no professional but I do know some people with Asberger's (or ASD or whatever the official name is now) and in my experience they aren't quite the same. Asberger's generally has more severe symptoms. For example, I miss social cues simply through inattention, but I can understand them if I can pay attention long enough to notice them. People I've known with Asberger's don't just not notice them, they have difficulty interpreting them even when they do notice them.
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Old 11-27-17, 12:50 PM
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Re: Can you explain how inattentive ADHD is different?

Quote:
Originally Posted by sarahsweets View Post
The dsm v (I think) did away with the subtypes and Im glad. I was considered combined but at different points in my life I would have more inattentive symptoms of hyperactive symptoms. In fact a lot of the hyperactive stuff I have going on is more mental than physical which makes sense to me. Sometimes I think the PI Vs combined vs H turns into a p**sing contest which doesnt help anyone.
It did not do away with them...they are specifiers that go along with the diagnosis. From the DSM-V

Quote:
Originally Posted by DSM-V
Specify whether:
314.01 (F90.2) Combined presentation: If both Criterion A1 (inattention) and Criterion A2 (hyperactivity-impulsivity) are met for the past 6 months.
314.00 (F90.0) Predominantly inattentive presentation: If Criterion A1 (inattention) is met but Criterion A2 (hyperactivity-impulsivity) is not met for the past 6 months.
314.01 (F90.1) Predominantly hyperactive/impulsive presentation: If Criterion A2 (hyperactivity-impulsivity) is met and Criterion A1 (inattention) is not met for the past 6 months.
The entry:

Quote:
Originally Posted by DSM-V
Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria

A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with
functioning or development, as characterized by (1) and/or (2):

1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
e. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
h. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
i. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).

2. Hyperactivity and impuisivity: Six (or more) of the following symptoms have persistedfor at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or a failure to understand tasks or instructions. For older adolescentsand adults (age 17 and older), at least five symptoms are required.
a. Often fidgets with or taps hands or feet or squirms in seat.
b. Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
c. Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)
d. Often unable to play or engage in leisure activities quietly.
e. Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
f. Often talks excessively.
g. Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).
h. Often has difficulty waiting his or her turn (e.g., while waiting in line).
i. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).

B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).
D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

Specify whether:
314.01 (F90.2) Combined presentation: If both Criterion A1 (inattention) and Criterion A2 (hyperactivity-impulsivity) are met for the past 6 months.
314.00 (F90.0) Predominantly inattentive presentation: If Criterion A1 (inattention) is met but Criterion A2 (hyperactivity-impulsivity) is not met for the past 6 months.
314.01 (F90.1) Predominantly hyperactive/impulsive presentation: If Criterion A2 (hyperactivity-impulsivity) is met and Criterion A1 (inattention) is not met for the past 6 months.

Specify if:
in partial remission: When full criteria were previously met, fewer than the full criteria have been met for the past 6 months, and the symptoms still result in impairment in social, academic, or occupational functioning.

Specify current severity:
Mild: Few, if any, symptoms in excess of those required to make the diagnosis are present, and symptoms result in no more than minor impairments in social or occupational functioning.
Moderate: Symptoms or functional impairment between “mild” and “severe” are present.
Severe: Many symptoms in excess of tliose required to mal<e tlie diagnosis, or several symptoms that are particularly severe, are present, or the symptoms result in marked impairment in social or occupational functioning.

Diagnostic Features
The essential feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Inattention manifests behaviorally in ADHD as wandering off task, lacking persistence, having difficulty sustaining focus, and being disorganized and is not due to defiance or lack of comprehension. Hyperactivity refers to excessive motor activity (such as a child running about) when it is not appropriate, or excessive fidgeting, tapping, or talkativeness. In adults, hyperactivity may manifest as extreme restlessness or wearing others out with their activity. Impulsivity refers to hasty actions that occur in the moment without forethought and that have high potential for harm to the individual (e.g., darting into the street without looking). Impulsivity may reflect a desire for immediate rewards or an inability to delay gratification. Impulsive behaviors may manifest as social intrusiveness (e.g., interrupting others excessively) and/or as making important decisions without consideration of long-term consequences (e.g., taking a job without adequate information). ADHD begins in childhood. The requirement that several symptoms be present before age 12 years conveys the importance of a substantial clinical presentation during childhood. At the same time, an earlier age at onset is not specified because of difficulties in establishing precise childhood onset retrospectively. Adult recall of childhood symptoms tends to be unreliable, and it is beneficial to obtain ancillary information. Manifestations of the disorder must be present in more than one setting (e.g., home and school, work). Confirmation of substantial symptoms across settings typically cannot be done accurately without consulting informants who have seen the individual in those settings. Typically, symptoms vary depending on context within a given setting. Signs of the disorder may be minimal or absent when the individual is receiving frequent rewards for appropriate behavior, is under close supervision, is in a novel setting, is engaged in especially interesting activities, has consistent external stimulation (e.g., via electronic screens), or is interacting in one-on-one situations (e.g., the clinician's office).

Cheers,
Ian
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Old 11-27-17, 12:56 PM
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Re: Can you explain how inattentive ADHD is different?

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Originally Posted by aeon View Post
It did not do away with them...they are specifiers that go along with the diagnosis.
This is true.

Unlike in the past, however, the "top-level" diagnosis of ADHD is the same in DSM-5, regardless of current presentation. The presentation can also change over time without the overall ADHD diagnosis (or the diagnostic code for billing puproses) having to change with it. (I think the different codes given in what you quoted are the old codes from DSM-IV and the ICD[?], given for reference, but I could be wrong.)
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Old 11-27-17, 01:42 PM
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Re: Can you explain how inattentive ADHD is different?

To go back to the original question on this post... my main difficulties with ADHD-PI:

- Absent-minded, always losing things, much more than is normal for someone in their 30's (one coworker kept asking me if I was going into early senility just because I kept misplacing things)
- Having difficulty paying attention when people are talking, especially if they are talking a lot about subjects boring to me.
- Not noticing stuff around me, even things in my own neighborhood that I walk by every day.
- Difficulties making decisions - I can be very indecisive at times.
- Social issues, because of missing social cues due to not paying attention.
- Difficulties finishing projects I have started. If it is something I am required to finish for work, I usually make myself do it because I'm conscientious about getting my job done, but left to myself, I start a lot of things without getting around to finishing them.
- Reacting slowly to things ... presumably because my brain was half-distracted to respond quickly.

There are more things but that is a pretty good list for now.

I have described it this way: Imagine someone who normally doesn't have any attention problem, who has a family crisis or other major disaster, and he or she is worried and distracted because of it. Maybe they are more absent-minded, don't always follow mundane conversations, less organized, etc. Well, that's how my brain works all the time, even when I'm not worried about anything. This explanation seems to help people to understand me a bit better. :-)
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Old 11-27-17, 04:20 PM
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Re: Can you explain how inattentive ADHD is different?

It's a good question... They are very different like a lot of different things on this forum.. thats why we have different sub forums and sub topics devoted to different issues... Even just things we encounter on a daily basis not even necessarily related to ADHD but maybe just related to for instance to parenting .. we have a lot of parents on this forum.. actually we have a lot of children too... well I guess everyone is someone's child so it goes without saying.. I hope that helps.
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Old 11-28-17, 01:18 AM
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Re: Can you explain how inattentive ADHD is different?

Quote:
Originally Posted by Ronelh View Post
I'm no professional but I do know some people with Asberger's (or ASD or whatever the official name is now) and in my experience they aren't quite the same. Asberger's generally has more severe symptoms. For example, I miss social cues simply through inattention, but I can understand them if I can pay attention long enough to notice them. People I've known with Asberger's don't just not notice them, they have difficulty interpreting them even when they do notice them.
That's a decent explanation, but it doesn't really describe the actual reason for "not noticing social cues" within autism (leaving aside the problem of interpretation for a moment.) Sensory hypersensitivity is one possibility; if you can't separate extraneous noise or visual distraction from the social encounter, that could lead to missing cues. Another possibility is the tendency for autistics to only process ONE channel of communication--focusing on what's spoken, to the exclusion of everything else. Maybe another reason someone with autism misses social cues is because they're not very interested in that aspect of socializing.

But the problem is that everything I've said right here could equally apply to someone who has ADD. People with ADHD can have sensory processing issues. Some ADDers describe a tendency of only being able to focus on one thing at a time, as they are easily distracted. It's also possible for someone with ADD to simply be disinterested or overwhelmed by socializing.

Adding further complication to the mix, many with autism report increased ability to socialize when they take the right stimulant drug. Sounds to me that inattention could be just as present in autism as it could be in ADD, and have equally detrimental effects on social ability.

I'm not trying to say "I know better" than you or anyone else--I hope you don't get that impression. Merely I'm trying to suggest this is more complex than it seems. How can you know what you really have, when you have symptoms of both ADD and autism? I don't think there's a good answer available for this yet. Either that or the answers are out there, and I'm just stupid and out of my depth (equally possible.)
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Old 11-28-17, 12:56 PM
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Re: Can you explain how inattentive ADHD is different?

Quote:
Originally Posted by Batman55 View Post
I'm not trying to say "I know better" than you or anyone else--I hope you don't get that impression. Merely I'm trying to suggest this is more complex than it seems. How can you know what you really have, when you have symptoms of both ADD and autism? I don't think there's a good answer available for this yet. Either that or the answers are out there, and I'm just stupid and out of my depth (equally possible.)
From what I've read, even professionals are known to get the two disorders mixed up, so it's not just you. Anyway, they are indeed similar. I wonder if it's possible for one person to have both?! We could just hedge our bets and say we're just wired differently from most other people, which is true of both disorders. But I know that doesn't help much if you want a specific diagnosis or medication. But it might help as an easy explanation to friends and family.
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Old 11-28-17, 02:18 PM
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Re: Can you explain how inattentive ADHD is different?

Quote:
Originally Posted by Ronelh View Post
From what I've read, even professionals are known to get the two disorders mixed up, so it's not just you. Anyway, they are indeed similar. I wonder if it's possible for one person to have both?! We could just hedge our bets and say we're just wired differently from most other people, which is true of both disorders. But I know that doesn't help much if you want a specific diagnosis or medication. But it might help as an easy explanation to friends and family.
Currently it is thought that at least two thirds of those with ADHD also have at
least one comorbid condition, depression, anxiety, autism the most common.

And it is thought that up to half of those with ASD also have ADHD.
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Old 11-28-17, 02:19 PM
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Re: Can you explain how inattentive ADHD is different?

I was diagnosed (at age 41, am 48 now) as ADHD, primarily inattentive, severe degree.

Without medication, I am scattered, and it is as if I am in a mental fog. I will stare into space, daydream, drop non-sequiturs like no tomorrow, do the whole “ooh, a squirrel” thing. Sometimes there is a noise in my head that sounds like the static of a dozen poorly-tuned radios, with bits of songs playing alongside each other. Meds ameliorate all of those things.

When it comes to an individual task, I am, in general, very precise and I don’t miss details. That said, in my job, the sheer number of tasks and sequential tasks is sometimes overwhelming. I keep my desktop organized so that nothing goes missing, and I make use of the Microsoft Outlook tasks function, yet, from time to time, I am oblivious to/forget about/misplace the details of a task. This is in part fueled by the constant interruptions that my job provides. Without medication, I could not do this job, for multiple reasons related to ADHD presentation.

Sustaining my attention on cognitively easy but boring tasks, especially if they involve paperwork, is near-impossible without medication. Music can help, but only to a degree. Meds make it possible, and I can even perform like some kind of machine, and really bang it out. Without meds, my mind wanders, I’ve got 27 tabs open, and I am doing everything other than what I need to, because the mental anguish of doing boring work is so great.

I listen well, even without meds, but without them any distracting stimulus can shatter my concentration. With meds, I can sustain even in the presence of other would-be distractions.

I follow through with things, but even with meds, sometimes things take longer than they should because of issues of initiation, sustained attention, persistence of focus, and distraction. At work anyway. At home…well, follow through is sometimes lacking.

I used to be poor at organizing tasks and activities, as well as time management and estimation, but over the years I have learned (from failure) some skills on how to do these things properly. And yes, meds help a lot.

“Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.” – Yep, that’s me…off of meds…on Dex, I can dive right into, e.g., deep paperwork, construction of complex Excel spreadsheets, and so on. And to some degree, if it is of interest to me, it is easier…if it is pure work for someone else, it is more difficult. It helps to make everything a challenge or game, because then it can feel like play…sometimes.

I misplace things, but when it comes to the mission-critical stuff, I do not, and I have never lost my keys, wallet, phone, and so on. Okay, I once lost a glucose meter…still scratching my head about that one and how I managed to do it.

I am easily extracted by external stimuli…and when trying to focus on something, sometimes sound will just shatter my concentration. With meds, this completely changes…the difference is night and day.

Forgetful in activities? Sometimes…but after a lifetime of frustration, I try to plan and be neurotic so this rarely happens. When it comes to work stuff, I have to address them as they present themselves…reply to emails right away, return calls right away, enter bills right away…and I keep a list of routine tasks in Outlook so I can be reminded, over and over…and my bosses know they are welcome to remind me of anything that is important to them, and I will always be glad for the reminder, and that they will never bother me in the slightest by doing so. Perhaps that is my biggest “accommodation” at work.

The only impulsive symptom I have is that (without meds) I detest queueing and slow traffic. I can wait my turn but it feels like torture. In line, I fidget, and when driving, I swear and implore other drivers to move their you-know-whats. I don’t drive like a jerk, but I know I have pulled a jerk move a few times due to misjudgement. On Dex, this goes away almost entirely…I can queue with endless patience, and I can relax in traffic and only protest the most egregious violators.

I know this was long but I did not have the time to make it shorter.


Cheers,
Ian
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