ADD / ADHD

NoraM13
on 12/16/17 1:41 pm, edited 12/18/17 9:32 am
VSG on 08/21/17

I had an appointment with my therapist this morning (this was only my second appointment). She suggested that I might have ADD. I went home and researched ADD symptoms in women and I had every symptom on the list. It was a light bulb moment. No wonder I always feel so scattered and disorganized. I also found articles on ADD and obesity - links between impulse control and weight (duh) as well as ?food chatter?. I?m going to call my primary care physician on Monday. Does anyone have experience with this? Questions I should ask? Advice or insights?

Edited to say: I was planning on contacting my PCP because I assumed (incorrectly) that I would need a referral. I did text my therapist who said that she could diagnose me, but if I wanted medication I would need to see a psychiatrist. I've been calling psychiatrists in my insurance network, and everyone has a 2-3 month wait - super frustrating.

5'2" VSG: 8/21/17 HW: 261 SW:243 CW: 193

Pre-Op: 15 M1: 19.8 M2: 10.5 M3: 13.7

peachpie
on 12/16/17 4:49 pm - Philadelphia, PA
RNY on 04/28/15

How was school for you? Did you get in trouble often? We're you chatty? Did you have trouble winding down? Was studying difficult? How was your focus? My son is dx'ed adhd- inattentive type. It often becomes most evident during the school in years- which is why I ask. We are able to manage my son's dx without medication, but with other types of supports and interventions. (We have tried meds- he didn't like them).

Never heard of an adhd/obesity link though.

Personnally, I'd work with a psychiatrist/psychologist if you can. PCP's generally won't delve into the details like this need to diagnose and treat.

5'6.5" High weight:337 Lowest weight:193/31 BMI: Goal: 195-205/31-32 BMI

NoraM13
on 12/16/17 6:01 pm
VSG on 08/21/17

I didn't have problems at school. It came easily and I did well. As long as I took notes, I didn't really have to study. I have a lot more trouble now with staying focused and organized. I also get really overwhelmed when there's too much going on (parties, crowded stores, etc). I can't have a conversation if the TV is on. From what I read, those are more common symptoms for women, and they are often diagnosed much later (college or beyond)

ADD came up at the end of our sessions today so we didn't have a lot of time to discuss it. I see her again on the 28th, and ADD will be the focus. I was hoping to make an appointment with my PCP the day after to discuss meds or a referral to a psychiatrist. What was the process like for your son?

These are the articles I found about obesity and ADD/ADHD: http://drjohnfleming.com/adhd-articles

5'2" VSG: 8/21/17 HW: 261 SW:243 CW: 193

Pre-Op: 15 M1: 19.8 M2: 10.5 M3: 13.7

peachpie
on 12/17/17 2:45 am - Philadelphia, PA
RNY on 04/28/15

It's different with kids. We worked with a developmental pediatrician Intially and the special education team at school. There are a broad range of services available for kids and he's been getting supports since he was 2- I don't think it's their is any sort of equivalent for adults.

5'6.5" High weight:337 Lowest weight:193/31 BMI: Goal: 195-205/31-32 BMI

Travelher
on 12/18/17 7:18 am, edited 12/17/17 11:20 pm
Revision on 10/04/16

I am identical. Not officially diagnosed, but my son is and he gets it from me. I've always joked about having it, but as we were learning about it while going through my son's diagnosis I realized it was not really a joke. I'm also adhd.

I have recently thought about going for an official diagnosis. I find mine is much worse to manage in times of high stress.

Band-RNY revision age 50 5'4" HW 260 SW: 244 (bf healthy range 23-35%) bf 23.7% (at 137lbs) cw range 135-138.lbl with butt lift and mastoplexy March 23, 2018...2.5lbs removed.

Pre-op-16lbs (size 18/20...244) M1-16lbs (size 18...228) M2-15.6lbs (size 16/18...212.4) M3-10lbs (size 16..202.4) M4-11.4lbs (size 14...191) M5-10.8lbs (size 12...180.2) M6-8.4 (size 8/10...171.8) M7-6.4 (size 8...165.4 lbs) M8-11.6 (size 6...153.8) M9-5.6 (size 4/6...148.2) M10-5.8 (size 4....142.4) M11-4 (size 2/4...138.4) Surgiversary -1 (size 2/4...137.4) M13-2.6 (size 2/4...134.8) M14 (size 2/4...134.8) M15 (size 2...135) M16 (size 2...131.4) M17 (size 2...135) M18 (size 2...135) M19 (size 2...138) M20 (size 2...135) M21 (size 2...138)

Gwen M.
on 12/16/17 7:55 pm
VSG on 03/13/14

There are definitely links between ADHD and Binge Eating Disorder. Which seems obvious to me in retrospect but wasn't something I became aware of until I started taking Vyvanse for BED.

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

Citizen Kim
on 12/17/17 8:29 am - Castle Rock, CO

A diagnosis is not really a diagnosis until it's been done by a psychiatrist. The drugs used to treat these are often a big incentive as they're basically legal amphetamines.

I have several friends who are suddenly diagnosed in adulthood.

If you really feel this is valid, you'll need a psychiatrist to give you the diagnosis and prescribe drugs long term. PCPs should, and usually are, very reluctant to prescribe psych drugs long term

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

Donna L.
on 12/17/17 2:23 pm, edited 12/17/17 6:24 am - Chicago, IL
Revision on 02/19/18

You are definitely not alone if it's the case. :) Relish the fact your therapist probably saved you years of misery by bringing it up. I spent 39 years without my diagnosis, and it would have saved me so many issues.

I was recently diagnosed with ADHD because so many things were up in the air. I was like, I wonder... and sure enough, I have ADHD. ADD is ADHD, just typically the inattentive subtype. It's the same disorder.

ADHD and BED have the same underlying mechanics; they are impulsive and compulsive disorders. They are also very frequently comorbid, something which is neglected by many clinicians. Even without BED, those of us with ADHD are prone to obesity because eating regulation is poor. I'm actually writing an article for a magazine elsewhere about this now for other clinicians...it's extremely common, and almost always neglected in terms of diagnosis. Not all psychiatrists will diagnose adults with ADHD, too, further complicating matters. It's very hard to get a diagnosis as an adult for some of us.

A bit of my history: I was diagnosed with BED as soon as the DSM criteria changed, but I did not get medical treatment until 2016. Honestly, it changed my life. I was not depressed for literally the first time ever, too. The fact that I have ADHD makes sense, because with ADHD, I have mood dysregulation (depression/anxiety) when it was untreated. That's just how my neurology works. TAntidepressants never worked nearly as well. It was literally like a switch was flipped and I was a different person overnight. At first we thought it was BED, and then my own therapist and bariatric surgeon were like "you know Donna, we think you have ADHD..."

After a four hour assessment, it was formalized, and they were right. My psychiatrist would not diagnose it without it, and moreover was not sure prior to the assessment. This is kinda funny because the assessment was like "oh my god level 10 ADHD" heh. And, he was even a child psychiatrist for goodness sake. He's an excellent doctor, actually...but you must understand this is very recent research, and so many doctors are not well-versed in ADHD in adults.

I would talk to your PCP if you really want, however I strongly encourage you to get a neuropsychological assessment. This is something only a psychologist (a PhD/PsyD) can do. Typically psychiatrists don't do them. The thing is that I can diagnose ADHD as a therapist and so can a doctor or NP or psychologist. However, ADHD can be masked by many other disorders, and further other disorders can mimic ADHD. It's what we call standard good practice to have a psychologist do an assessment for ADHD to rule out other factors. Only psychologists do these types of assessments. The best psychiatrist in the world is not as effective as a comprehensive neuropsych eval, because the eval picks up on things that no clinician can without impersonal assessment metrics.

It is somewhat of a misnomer that therapists don't diagnose - our ability to diagnose is largely variable and depends on state laws as well as the therapist's license. So, if the laws support their license diagnosing, that diagnosis still is valid. For instance, when I diagnose it's considered no less valid and is a medical diagnosis. This is not necessarily the case, say, in Michigan, where only social workers, psychologists, and psychiatrists can diagnose. Even there, often doctors sign off it and don't do it themselves, necessarily, at the first point of access...like inpatient. It really depends where you live. Welcome to healthcare?

Having said that, even in states where we can't officially, many times we are the ones that catch disorders long before psychiatrists do. Having said that, I would start with the neuropsychological assessment if you have coverage for it. I have even been asked by psychiatrists to confirm their diagnosis - this is because I spend far more time assessing and evaluating someone than they do, just because you see a therapist weekly (usually) and a psychiatrist once every few months. It really depends? Some of us are really good at it and others...not. However, definitely at least take it into consideration.

So, I would find out what your mental health benefits are via your insurance, and if neuropsychological assessments are covered, even if you see a psychiatrist for evaluation, I'd request one if you can afford it/if it's covered.

Consider also signing a release with your therapist so she can speak to your other providers. Due to confidentiality laws, we cannot communicate with physicians unless you sign a release, because it's illegal for us to speak with other providers without consent. However, their observations will assist with the diagnosis and any assessments they do. My therapist helped me get correct diagnoses for my BED and my ADHD - without her I would have never got diagnosed correctly in either case.

ADDitude is probably my favorite news/blog about ADHD. And, as you can see, there's literally a ton of stuff on ADHD and obesity.

The good news about ADHD is that despite it being a neurological disorder, habit and strategies help very much so, and there are many ways to work with it and improve both with and without medication.

I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!

It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life

NoraM13
on 12/18/17 9:34 am
VSG on 08/21/17

Very helpful. Thanks!

5'2" VSG: 8/21/17 HW: 261 SW:243 CW: 193

Pre-Op: 15 M1: 19.8 M2: 10.5 M3: 13.7

Sparklekitty, Science-Loving Derby Hag
on 12/17/17 8:12 pm
RNY on 08/05/19

Seconding the suggestions to find a psychiatrist. Medication management REALLY needs to be done by an expert, and your PCP really isn't equipped to do that.

Also make sure the psychiatrist can confirm your diagnosis. I know of several people (including here on OH) who've essentially self-diagnosed with something or other and ask for treatment based on their own, non-expert, assessment. Psych meds are Serious Business and should be managed by someone *****ally knows what s/he is doing.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

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