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Post by computermandan on Oct 9, 2013 16:40:58 GMT
Tomorrow is the "initial assessment"... Leaving out the {jaw dropping / stumbling on Adult ADHD on the WWW / Do these people know me} - moment Leaving out the GP appointments I forgot and got the times wrong and didn't arrive in time for Leaving out the relief when the GP said "I can see how frustrated you are let me refer you" I guess this is the start of MY personal account... (well I should definitely note it down SOMEWHERE ) Roll on 10am tomorrow (bit nervous/anxious/weird feeling).
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Post by Deleted on Oct 9, 2013 16:45:54 GMT
Beautiful beginnings!
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Post by Deleted on Oct 9, 2013 17:22:06 GMT
gl + hf
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Post by danherts on Oct 9, 2013 17:28:15 GMT
Best of luck mate
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Post by contrarymary on Oct 10, 2013 3:52:42 GMT
good luck!!!
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Post by Supine Incognito on Oct 10, 2013 9:00:59 GMT
It's 10am, you should be at the DRs!!! How did it go?
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Post by computermandan on Oct 10, 2013 10:29:14 GMT
ok... so 50 minute chat with the doc... he was a psychiatrist, he seemed reasonable. we went through everything, marriage, family, school, social through school etc... i even opened up about my nutty driving and for me speed=focus etc etc (i dont own up to that much) "while you display a lot of the symptoms of ADHD there is not really any hyperactivity and not enough impulsivity"wow... really? "I can see all these symptoms point to it but they might just be symptoms not indicative of underlying problem"oh... erm ok "I think you might be on autistic spectrum and maybe a little bit Aspergers you should look it up on the internet and see what you thinkhang on a minute... you're the doc, I'm the IT guy... you're confusing me "I'm prescribing you an anti-depressant that will help you sleep lets see how that goes for 28 days"ok... i guess theres some logic somewhere.... I feel a little bit lost now. He basically kept repeating no hyperactivity, no police trouble, you went through school you're not ADHD. let the motion of the wheels begin...I have been given Mirtazapine in the aim of getting my sleep pattern back? (but doc I've NEVER slept properly!) never heard of it before but I guess I have to go through the motions.
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Post by wolfgirl642 on Oct 10, 2013 10:44:10 GMT
:-( im sorry to hear this. not the outcome you wanted. Maybe if the meds help yours sleeping you can see in 28 days if a reassessment will have a different outcome?
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Post by computermandan on Oct 10, 2013 11:34:17 GMT
I think I thought I could almost talk him round. In fairness to him when discussing the medicine he kind of said lets work out what this is 100% before we go down a specific route. He did throw me a little with the - lookup aspergers and we can discuss next time side of things - even mentioned referring me for that if I identify with it. I know what I'm going to be distracted with now then! I thought I had it sussed.. but he's impartial to it and professional too so I should give him credit really. nervous about my Wife's response to it now.. silly as that sounds I really don't want to hear any kind of told you so, can you stop going on about it now type feedback from her. hoping she can be more sensitive to it - she was very edgy this morning I could tell she didnt know what to expect before I left either... WE SHALL SEE
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Post by contrarymary on Oct 10, 2013 12:24:40 GMT
hmmmm dan hmmmm. on the one hand it's true that not sleeping can do all sorts of things to the brain. on the other hand, not sleeping is a symptom of adhd. i would have been left with a huge number of questions after this appointment, so you're not the only one. amongst those would be: which came first? sleep or symptoms (or is it all back in the mists of time and not able to answer). and was this a general psychiatrist or an adhd specialist? (in which case is he perhaps trying to see if you have something that he can deal with and wanting to investigate thoroughly before handing you on up the food chain) where i struggle with this, is that he has suggested you take a mind-altering chemical aka a drug or medication which is (it sounds) an off-label use of anti-depressant - unless you have been diagnosed with depression? or perhaps that is another thing for which he thinks you may have some symptoms but not indicative of an underlying pathology? and where does that fit with "let's work out what we're dealing with before we go down a specific route" that related to medicine for adhd? AND another thing - if he thinks you have to have struggled with school or been in trouble with the police to have adhd he perhaps does not understand sufficently about adhd to know that he doesn't know enough and could perhaps think about referring you to someone who does? or again, he could be thinking depression or sleep disorder and just trying out these drugs to see if that eases things. but just about everything is marginally easier to deal with after a good night's sleep - not caused or prevented by sleep tho. AND btw, asperger's and adhd frequent co-morbids, on a similar spectrum with plenty of overlap... blah. i would be pretty perplexed right now. that's the problem with these bloody psychs. it's all so subjective until you know what you are doing, and maybe even then. bums. maybe a god will be by with better insight - i have tons of sympathy tho.
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Post by Lesley on Oct 10, 2013 12:54:38 GMT
I'm sorry things went this way, Dan.I feel a little bit lost now. He basically kept repeating no hyperactivity, no police trouble, you went through school you're not ADHD. This bit makes me wonder how much he knows about ADHD.AND another thing - if he thinks you have to have struggled with school or been in trouble with the police to have adhd he perhaps does not understand sufficently about adhd to know that he doesn't know enough and could perhaps think about referring you to someone who does? I agree with Mary, and perhaps would put it even more strongly. Plus, while there does as things stand have to be evidence of hyperactivity in childhood for a diagnosis, it's pretty widely accepted that adults on the whole don't display hyperactivity (and even in childhood it's not universal, in spite of the diagnostic criteria).
You refer to this meeting as the "initial assessment" - I guess that means he's a generalist? And one with perhaps not as great a knowledge of ADHD as he thinks he has. By all means look up autism/Aspergers, but whether that sounds like a possibility to you or not (it's possible and even common to have both) I would be inclined to insist on a referral to an ADHD specialist before agreeing to go down any other route.
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Post by wolfgirl642 on Oct 10, 2013 13:22:32 GMT
From what was told at my consultation if they suspected anything other than adhd they would refer me to someone else. so i have the feeling your may need to request a specialist.
i had a similar problem when i had a general psychiatrist, telling me i had bi polar when i clearly dont. he also told me that adults could not have adhd (another false statement). ive had several doctors tell me its stress or depression , which is hugely frustrating , yes the frustration is depressing but as far as the other aspects of how you tell if someone was depressed i didn't really fit them.
And i felt it was a cop out, so got a second opinion . and then eventually changed GP and finally found someone who would listen to the things i said and not just check some of it off a list but hear the full reasons i was asking for help.
dont give up.
read everything you can until you find what you think fits, and then take that with you to your appointment , ask as many questions as you can. Dont be afraid to question their diagnosis and ask how they have concluded it.
the psychiatrist i seen said he said bi polar as it was they nearest fit to my symptoms - which i didnt see so i research it till i could prove him wrong.
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Post by wolfgirl642 on Oct 10, 2013 13:24:06 GMT
oh and most importantly dont let this hold up get you down !!!
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Post by computermandan on Oct 10, 2013 13:35:52 GMT
thanks guys and gals feedback more than welcome. helps me clear up things and "lay them out" a little. having had time to clear my thoughts (somewhat brisk drive to work) I think he was really focused on the sleep side of things. I don't think that he's sure what is going on in my head. He wasn't a specialist for sure - and having mentioned apsergers etc he talked about speaking with GP for referral to specialist so I think that double proves this as a stepping stone/interim spot. I've read 3 books about me... sorry about Adult ADHD-PI now (ok some were really short) I haven't been able to read books since before the kids arrived - it's just got my attention at the moment. (back when it was silent) The marriage one was scary - even my wife admitted it was. I really think it's too close to be something else other than ADHD. I will tow the company line and rule out sleep and diet for now... goodbye coffee for now. 28 days is not forever. If he proves me wrong fair play to him and the profession. If we're still in the same boat forgetting to keep hold of the oars I will go armed with lists and something about ADHD PI I think he would be reasonable enough to take the NICE guidelines into account without getting upset about it too. He's asked me to look things up after all. Thanks again peoples
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Post by computermandan on Oct 10, 2013 13:42:38 GMT
oh one more thing... I mentioned it to my dad (straight away before I forgot), he caught onto the Aspergers/Autistic part and proceeded to tell me that when he was younger the Doctors tried to "label" him as autistic but it didn't quite fit (this would have been early 1960's definition) found this interesting today.
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Post by computermandan on Oct 10, 2013 16:43:31 GMT
digging around the autism/aspergers info (i literally know nothing about) I stumbled on a little bit on ADHD diagnosis... DSM-IV stipulates that a diagnosis of ADHD can only be made if the child has shown signs of the condition before the age of seven... We've read that bit a million times here, but it then goes on to say this... ...The condition cannot be diagnosed if it occurs solely within the context of a pervasive developmental disorder such as autism.Does this mean they have to rule out autism first in diagnosis now? more followed... That is not to say that a child cannot have both conditions. For the reasons mentioned above it is possible that the child with autism will display signs of ADHD but that this should not be considered as an additional diagnosis until their needs relating to their autism are addressed first.This struck me as the route the chap this morning was following... my social ineptitude was of great concern to him... especially wanted to know about my facebook oddness that often upsets my wife (I can be very odd!) and not keeping in touch with friends and impulsively blurting out comments or inappropriate jokes at silly points. I'm not particularly bad - I know plenty of folk who are particularly good at lowering the tone of a conversation, that I am not. But wrong comment, wrong time when everyone looks at you and you can see the "WTF???" expression on their faces... I get the body language, it's the timing that's wrong... oooh I must remember this comment for next time!
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Post by computermandan on Oct 10, 2013 16:44:54 GMT
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Post by Deleted on Oct 10, 2013 17:08:31 GMT
The proposed changes to the DSM removed all that stuff about autism and ADHD. DSM V is out now, but I don't know what it says about the two conditions together.
I'm an appalling friend - really struggle to keep in touch with people.
Tell-tale signs of autism are struggling to recognise emotional states through facial expressions, and thus lacking empathy.
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Post by Deleted on Oct 10, 2013 19:13:45 GMT
It's a 30 day delay
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Post by supine on Oct 10, 2013 20:22:46 GMT
An ADHD specialist told me that ADHD was not an autism spectrum disorder at all. So if you have one, it isn't the other (I think that's what he meant)
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Post by supine on Oct 11, 2013 16:53:04 GMT
If it helps, I decided to but the idiots guide to body language because I thought it was something I was rubbish at.
Turns out that I'm actually very good at body language, I just don't focus enough at the right time to read it in real-time - even though it obviously does sink in - it doesn't consciously register.
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Post by Deleted on Oct 11, 2013 18:37:43 GMT
ADHD and ADD are separate conditions. I read somewhere that DSM IV was worded the way computermandan quoted to prevent ASD being missed and possibly misdiagnosed as ADHD. The two can look very similar, but the symptoms are experienced in different ways. You can have both, but ASD should be diagnosed or ruled out first if suspected, apparently.
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Post by contrarymary on Oct 11, 2013 19:20:17 GMT
But wrong comment, wrong time when everyone looks at you and you can see the "WTF???" expression on their faces... I get the body language, it's the timing that's wrong... oooh I must remember this comment for next time! been reading a bit on this too - fascinating. most interesting two things so far were this one on diagnosing aspergers in adults www.ncbi.nlm.nih.gov/pmc/articles/PMC2695286/and this one from an add forum where there was a forum member in almost exactly the same situation as you - thought had adhd, went along to psych and was told ?aspergers - go and google it!!! so here is the subsequent discussion had with adhd forum members (some of whom had aspergers or worked with people with aspergers too!) fascinating! www.addforums.com/forums/archive/index.php/t-33307.html
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Post by JJ on Oct 13, 2013 20:40:46 GMT
DSM IV said you couldn't have both but it was already commonly agreed you could and so this bit was ignored anyway.
DSM V says you can have both.
ASD and ADHD are very commonly comorbid (v high percentage). I understand most adhd tests will screen for ASD too as a matter of course - the Maudsley certainly does.
Adhd can still be treated even if there's co morbid ASD - tho the meds might be more likely to induce anxiety apparently - but all this means is that some anti-anxiety meds might be needed in addition to adhd meds. Kathymel's just attended some sessions on this - she'd be able to add more if anyone wants more info.
Also DSM V says the signs of adhd must be apparent before the age of 12 now. DSM IV said before aged 7 - tho again in practice, this wasn't strictly adhered to as inattentives can be easily missed before aged 7 - and things tend to fall apart only once they get to secondary school.
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Post by Kathymel on Oct 14, 2013 9:58:18 GMT
"while you display a lot of the symptoms of ADHD there is not really any hyperactivity and not enough impulsivity. Sounds like he's using ICD 10 to diagnose you rather than the NICE recommended DSM IV/V. If you have the inattentive type of ADHD then of course you won't have symptoms of hyperactivity and impulsivity. More than that though, 'Hyperactivity is of no diagnostic value in adults.' (Barclay). The symptoms of hyperactivity are one of the only symptoms that reliably diminish at adolescence. "I can see all these symptoms point to it but they might just be symptoms not indicative of underlying problem" Symptoms have to be indicative of an underlying something, surely? OK, he has to make sure that there is no other cause for the symptoms, but that statement is nonsensical. "I think you might be on autistic spectrum and maybe a little bit Aspergers you should look it up on the internet and see what you think The DSM IV didn't allow for ADHD and ASD to occur co-morbidly. However, the DSM V has changed that. The word on the street now is that ADHD is seen as co-morbid in 30-85% of people with ASD (Edward Aull). "I'm prescribing you an anti-depressant that will help you sleep lets see how that goes for 28 days" If you have evidence that you had symptoms in your childhood, this is just tiresome. Yes, bad sleep exaggerates the symptoms of ADHD, but ADHD also causes bad sleep. Boring and predictable response from a lazy and ill-informed psych. Unfortunately, this response is dead common. I feel a little bit lost now. He basically kept repeating no hyperactivity, no police trouble, you went through school you're not ADHD. Such a crap assessment. Lots of us have no hyperactivity, no police record and managed to drag ourselves through school and even uni.
I recommend demanding a second opinion. Get a referral to a specialist, because this guy doesn't know nearly enough.
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Post by computermandan on Oct 14, 2013 10:43:27 GMT
Well 4 days in - I forgot to take the medicine on Friday night. Saturday morning was the only morning I haven't caused upset by actually waking up?? Feels like the meds are making me MORE sluggish, not less Certainly my early morning moods have been rubbish to say the least! Will see how it goes for 14 days before calling anyone. Then if still bad will ask for repeat visit/consult if that's how it works. Thanks for the advice everyone... trying to take it in and work out what to do.
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Post by computermandan on Oct 16, 2013 8:18:57 GMT
ok I think I've had enough of this already sluggish simply isn't the word! took medicine as early as 7:45pm last night and I'm now practically asleep still. I came across a little dozy beforehand I must look and sound Zombie-like now! I can't function, don't think driving to work has been a good idea. at work I'm more distracted than I was before and I feel almost drunk all day. think a call to the doc's is in order this can't be right.
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Post by Kathymel on Oct 16, 2013 9:23:48 GMT
Keep at it, Dan. The lower doses are known to cause problems like the ones your experiencing, but these will clear up as you titrate up. You really need to give it a fair go.
Unless there's a reason for your psych to want to proceed carefully, you should be able to increase your dose weekly. How long has yours got you on your current dose?
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Post by jan on Oct 16, 2013 9:40:19 GMT
hi dan am i right - your talking about the effects of mirtazapine ? = not adhd meds as you not dx yet ? sorry if have got that wrong - there;s so many new people on meds on here lately. personally - all anti depressants / anti psychotics that i have taken over years have had negative effect on me and usually as your saying now make me feel like am walking through glue! wouldn't want to tell you what to do dan - but if there's no benefit then whats the point ?
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Post by Kathymel on Oct 16, 2013 9:45:05 GMT
You're right, Jan.
Sorry Dan, should have reminded myself what was happening before I commented.
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