My Forum Comments
The issue that you are concerned about is called “functional impairment”.
The threshold is different depending on context.
For example, to qualify for special education in the United States, the functional impairment has to be very specific to education and very high.
However, for a clinical diagnosis, it just means that your symptoms prevented you from reaching your full potential.
I was in a similar situation.
However, you could see my symptoms and functional impairment, not necessarily in my grades, but in my injuries and trips to the emergency room, types of behaviors that got me disciplined the few times that I got in trouble, and social issues. You could also see it in the number of physical activities that I engaged in from sun-up to sun-down. I probably would have gotten in a lot more trouble if I wasn’t going from school, to musical rehearsal, to swim practice, to karate all in the same day!
I just assume that I am the one doing all of the interrupting and, that if I think other people are, that I chalk it up to lack of awareness on my part or that it is the only way others can get a word in…
I find that awareness of my diagnosis gets me more than any accommodation.
This is mainly due to the fact that I work under legally mandates timelines.
So, any of the common accommodations would be considered “unreasonable” and grounds for finding me unfit for the position.March 19, 2021 at 11:17 am in reply to: How to get mental health professionals to listen past “Bipolar” #196229
ADHD is a diagnosis of exclusion.
You don’t test “positive”.
You have to meet the profile of someone who meets the criteria.
Then, all alternative explanations need to be systematically ruled out.
Once the assessor has conclusively ruled out every other explanation, then the ADHD diagnosis stands.
Part of the criteria explicitly states, “the symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.”
It is extremely difficult to separate bipolar symptoms (and the medication side-effects, potentially), from ADHD symptoms. It is generally only done when the individual has their bipolar well-controlled and/or there is a lot of time of no depression and no manic/hypomanic episodes between cycles.
Also, you are dealing with a disorder for which a very large percentage of patients are in denial of the need for meds or of the impact of the disorder until it is too late. In fact, the more aggressive the denial, the more likely the therapist is going to brace for a manic/hypomanic episode.
Remember that online self-tests do not do differentiated diagnosis or rule-outs, there are plenty of non-ADD’ers who will score high on these tests if they have anxiety, bipolar, depression, diabetes, sleep apnea, or autism.
Your best bet is a person who is willing to look at your history longitudinally and gets to know you over time.
If I were in your position I would ask for a referral from the neurologist and sign a waiver for them to consult.
I disagree that the majority of the forum don’t believe in meds. There are some that are dogmatic in not wanting them. There are others that I suspect are secretly marketing for non-prescription alternatives. However, there are tons on conversations on what works medicine-wise, getting access to the right meds, etc.
Personally, I openly share that I have self-studied in the ’90’s and in the last 10 years. I am 6 times more productive on my meds than off.
Any update on how it went?
It would be nice to have the ability to get out of moderation.
I have been in this mode for a year or two now.
None of my links have been spammy or personal profit for me.
I tried to take a look, but I cannot see anything of value without actually signing up and taking the assessment.
If someone had a report for me to review, I could make an educated opinion. (My first concern would see if they use industry-accepted assessments, or if they have a “proprietary” (AKA not peer-reviewed or approved) system.)
The fact that they are licensed and can bill insurance does lend some credibility. However, having the license does not mean quality.
For example, just this week, I saw an MD diagnose a child with Autism and ADHD using only 2 parental rating scales and a conversation with a parent (one scale is no longer in publication and neither scale addresses ADHD). Even more frustrating is that this MD (general pediatrician) works in a practice with a pretty impressive behavioral specialty clinic that would do a great job.
I do this for a living, and a bad week is when I feel like a lifetime of having ADHD and 24 years of study and professional experience are no match for the opinion of some idiot on Facebook or friends that parents go to the gym with…
Try to zen out and not overthink it.
If you have an appointment with a professional that diagnoses ADHD for a living, you will have a different experience than a general medical doctor.
If you overthink the evaluation or get too meta by wondering why a certain question was asked and what the correct way to answer it is… at best, you stress yourself out for no reason at worse you show anxiety over anything else going on.
99% of the time, your first thought when a question is asked is how you should answer.
You WILL be asked things not related to ADHD. That is apprpriate. We do not have blood tests that allow you to test positive for ADHD, so the assessor will need to systematically rule out alternative explanations (if they are good).
I would have been a lot more high achieving if I did not need to transfer out the week before my Committee of Academic Performance hearing…
I can tell you what did not help, the stupid planner they gave me when I asked for help from the Student Support Services office. When I transferred from MIT to UMass, they picked up that I needed an eval immediately. My gpa went from a 2.7 to 3.7. I did a self-study twice, once in school and once a few years ago. I am about 6 times more productive on meds versus off on similar workload tasks.
Here is a good reference to see if a high achiever may have ADHD.
Why is it so important to prove this point?
What are you hoping for an outcome?
Let’s say such a product exists.. (probably doesn’t)… would that really change the denial?
If you had proof that said person misses the toilet during urination, and they finally admit it… now what?
I understand that this may be disgusting. The denials are probably infuriating.
However, I suspect that you could get Chris Hansen to do a full-blown Dateline NBC investigative piece to solve this “mystery”. What will improve?
It seems to me that the best answer is to change the chore list so that said person is responsible for clean-up of that bathroom. Then, regardless of the reason why, it is either clean, or it is not.
Ask the evaluator.
As an assessor, I prefer medicated.
I want to get the best possible results of potential and ability in the face-to-face testing.
I am not worried about medication “hiding” the impact of ADHD because I rely mostly on parent and teacher rating scales, history, and real-world evidence of functinal impact.
However, not all assessors take the same approach.
Where in CA?
In the US, the diagnostic criteria in the DSM-5 requires that the symptoms be evident prior to age 7.