New Adult ADHD Diagnosis

On 12. January 2016 by Peter 'ADDSpeaker' Vang

New Adult ADHD Diagnosis

New diagnostic criteria for Adult ADHD makes a lot more sense to me. Read my evaluation and explanation for why I for one, am all for it. I explain how each symptom expresses itself, and well as exemplifiedfy what makes it an impairment.

In the 4th. edition of the ADHD Handbook for Diagnosis and Treatment, Dr. Barkley et al. have suggested that these new criteria for diagnosing Adult ADHD may be used, since the DSM-V is more geared for child diagnosis than adult diagnosis. These questions are derived from his extensive research in the longitudinal UMASS study where he and his teams has followed a very large group with ADHD, from childhood and up, as well as from diagnosis as an adult, for more than 20 years. From that research he has evaluated 99 symptoms for their usefulness in diagnosing Adult ADHD. This is the result.

New Adult ADHD diagnosis – Review

Today, the ADHD diagnosis is geared toward children and their symptoms. But as more and more adults are being screen for ADHD, more and more are realising “what’s been going on” all these years. Getting diagnosed and getting the proper medical and psychosocial behavioural training is key for anyone with ADHD, no matter their age. As I was reading the new 4th. Edition of the ADHD Handbook, I noticed that there was a new suggested symptom list, which was specifically aimed at diagnosing adults. So I thought that I’d give it a test run.

New suggested symptom list for Adult ADHD diagnosis

A List of Proposed Diagnostic Criteria for ADHD in Adults

Has six (or more) of the following nine symptoms or four or more of the first seven symptoms that have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Symptoms:

  • Often easily distracted by extraneous stimuli.
  • Often make decisions impulsively.
  • Often has difficulty stopping activities or behavior when they should do so.
  • Often starts a project or task without reading or listening to directions carefully.
  • Often shows poor follow through on promises or commitments they may make to others.
  • Often has trouble doing things in their proper order or sequence.
  • Often more likely to drive a motor vehicle much faster than others (excessive speeding). (If person has no driving history, substitute: “Often has difficulty engaging in leisure activities or doing fun things quietly.”)
  • Often has difficulty sustaining attention in tasks or leisure activities.
  • Often has difficulty organizing tasks and activities.

Note. Copyright 2008 by Russell A. Barkley, PhD. Reprinted by permission.

Now we’re talking!

I was diagnosed under the DSM-IV with ADD, and although I do qualify for this diagnosis, I’ve often felt like they were more descriptive of me growing up, than me at age 44. But when I saw this new suggested symptoms list, I felt like I’d come home in some sense. I will walk through each of them and explain how this symptom is experienced and which impairment it causes in my everyday life.

Often easily distracted by extraneous stimuli

A lot of people make fun of ADHD with the saying “Look a Squirrel!” as a reference to our symptoms of inattention. However, not many people realize that I am not really inattentive, but actually over-attentive!. As my brain has a defect, my internal filter and sorting system for sensory information has not developed enough, so that I can filter out all the irrelevant sensory input from the relevant sensory input.

This is what is causing me to be inattentive when engaged in conversation with others. If there is a noise in the background or if someone or something is moving within my sensory field, my brain automatically refers my attention towards this distraction. I therefore disengage in my current task, and have to investigate this disturbance and find its source. Before I can find the source, my mind won’t quiet down and let me refocus on the task I was performing.

As a result of this, I have an impairment in social and work settings, since I give out an impression that I don’t care for the topic or the people, in which I was engaged. This leads to alienation and I feel uncomfortable in social situations now, after having spend 40 years of my life, being asked to “show some respect and pay attention”.

Often make decisions impulsively

As I’m not the hyperactive/impulsive variant called ADHD-PHI, but more the Inattentive variant called ADHD-PI, my impulsiveness is not my main issue. However I do have problems not blurting out the answer, before it is my turn, and I am known for always having the “facts for everything”, which either is welcomed or frowned upon, depending on the context.

I remember being at an job interview for an executive position at a management company, and while interviewer where presenting their mission statement, my eyes caught a type-o in the text, and I just instinctively blurted out “there is an error here, I hope that you don’t show this to your customers!”.

Although I got the job, my relationship with this senior management persons, never recovered. In earlier periods of my life, especially in educational settings, I was constantly getting into trouble for “hi-jacking” the Q&A sessions.

I took some night classes at the IT-University and studied with people in their early twenties who had their focus on their social life more than their education, whereas I was mid-30 and full of eagerness and motivation on the subject matters, so I would read everything about a subject, beforehand, and sit in front center and put my hand up on every question. On the breaks, all the other students avoided me.

Often has difficulty stopping activities or behavior when they should do so

If I am really into something that interests me, I can get furious if I’m interrupted by external influences, as the disturbance causes me to lose my “trail of thoughts”, which consequently leads to loss of what I was holding in my working memory, at the time.

Imagine that you’ve been working on a large complicated document, and suddenly some pulls the power cord to your computer and you lose all your work, since it was on stored in the RAM not saved on the hard drive yet. That is what envoke my aggressive response, since “you just pulled the plug on my work”.

So when I am focused, motivated and in a creative state of mind, I tend to take trip “down the rabbit hole” and get engulfed in a subject matter and lose any sense of time, notion of physical needs (food, sleep etc.) and the reality that surrounds me.

This is a very practical skill to have when you research a subject, but does not go well with family life or work life either, for that matter, since I just put on my Bose Noise Cancelling Headphones and “leave reality behind”. I can spend hours, if not days, in this state, and I only emerge when I am physically exhausted. As you can imagine, this takes a toll on my social relationships as well.

Often starts a project or task without reading or listening to directions carefully

This is my “default setting”. I take a quick look at the headline of the task, and begins to organize how I should solve it, even before I have the full picture of the assignment. This is why I struggle with math, since it is all about rules that needs to be followed strictly, and I have n patience for reading the whole damn thing, I just want to get it over with, so I can do something creative and fun instead.

Often shows poor follow through on promises or commitments they may make to others

In a work setting, never, but in my social life, all too often. I will be invited to some gathering and at the time I’m being asked, it sounds interesting and I agree to participate. But when the time comes for me to show up, I’ve forgotten all about, since I’m right in the middle of something exciting right now, that I do not wish to stop, so I simply forget all about my commitments and carry on.

This has detrimental impact on my social life, as I am now either say no to everything upfront or say yes with a stern belief that this time I will make it there, but … no.

Often has trouble doing things in their proper order or sequence

This is not one of my main problem areas, but I do tend to ignore directions and try to solve all tasks my way instead of following the purposed manner.

Often more likely to drive a motor vehicle much faster than others (excessive speeding)

(If person has no driving history, substitute: “Often has difficulty engaging in leisure activities or doing fun things quietly.”)

Before I was diagnosed and medicated, you betcha! I was well off back then, so I had all the fun cars, like the Mini Cooper S, which I would drive like a maniac, but only on high speed highways, I’ve always kept the speed limit in areas where people lived or in towns.

After my diagnosis and subsequent medical treatment, I drive like a old lady, even putting the cruise control on, set to the speed limit, so I don’t forget to keep the speed appropriate.

Often has difficulty sustaining attention in tasks or leisure activities

Oh yeah definitely, especially in social settings where there is no purpose of the “task” other than to socialize and chit chat about nothing. I get mentally tired within the first hour, and need a break, and preferably would like to leave.

Also I’ve even closed the door on my sister and here to kids, when they showed up without an appointment, one Sunday. When I opened the door, I looked at them and said, “this I cannot do today”, and closed the door on them. In retrospect I understand the arrogance in my behavior, but at the time, I was just being brutally honest, since I really did not have the energy for company, that day.

Often has difficulty organizing tasks and activities

If I do not have a list on my Reminders on my iPhone, forget it. If it’s not in my calendar with an two stage alarm on it, forget it. Once I get it in my phone, I am relentlessly following the list minute. But if something externally  suddenly changes my schedule, I go bunkers, if I do not get the time to reorganize my schedule myself, beforehand. And we are talking little things too, like swinging by the supermarket on the way home, without me knowing it in advance. I go mental and get agitated to the point of boiling over with frustration. The trigger is that I thought that I’d finished the previous task and I am already gearing up for the next task on my list, when suddenly something or someone else, hi-jacks my plan, and I guess my autistic traits, make me go bananas.

Conclusion

Whereas I didn’t quite felt that I could relate to all of the diagnostic criterion of ADD, I can certainly “check all the boxes” on this list 🙂

How about you

/ADDspeaker