ADHD ADHD / PTSD

[barefoot]

So…I have thought for a while that I have ADHD - mainly the inattentive type, I think, but with aspects of hyperactivity and impulsivity.

I spoke to my GP and she has referred me, but it’s going to be 3+ years wait on NHS, so I think I’m going to have to bite the bullet and pay for a private assessment as it is causing a lot of stress and challenges, especially in my work.

Part of me wants to book an appt asap and get it done so I know what’s what and can then move forward with that knowledge and any potential treatment plan.

But I also feel some anxiety and resistance. Mainly due to the following, I think:

- if I get an assessment, I will either get a diagnosis of ADHD or they will decide I don’t have it. Both of these options would be stressful, I think, and require some emotional processing! I am already finding it difficult not getting caught up in thoughts around which would be the ‘better’ outcome and what I should therefore say. Intellectually, I understand that the best outcome would be the accurate one! But there is a loud part of my brain already trying to work out what I should/shouldn’t say and how that might influence them. And having that thought makes me feel manipulative, which creates more stress!

- I guess there is also a third option: I may get diagnosed with something else. And I feel extremely fearful about that prospect.

- I’m very anxious about seeing a psychiatrist and (potentially) having a formal psychiatric diagnosis made and recorded on my medical files.

- It took me a long while to accept my therapist’s view that I have PTSD. A long time! (Because what happened wasn’t bad enough etc etc) But I guess, however I tried to argue it, I couldn’t ultimately deny the symptoms. But I think a lot of symptoms of ADHD/PTSD may overlap (eg procrastinating/avoidance) So, I am also worried that, if I get an ADHD diagnosis, I am going to end up more confused about historical trauma stuff…whether things my T has put down to trauma/PTSD (and I have now accepted as that) are now going to be explained by something else. So, I am worried it might cause confusion at best…and also potentially undo or undermine years of therapy if things can now be explained by something else. This aspect makes me feel stressed and teary. Something about maybe years of therapy has been based on the wrong things?! I don’t know…hard to describe the feeling about this…

For those of you who have both ADHD and PTSD - any insights/thoughts on any of the above?!

And a few more specific questions:

- How do you unpick what is ADHD and what is PTSD? And how does that inform what you do about it/how you manage things.

- I am really just looking to get an adult ADHD assessment, but I’m unsure whether/how to bring PTSD into the conversation. Do you think it’s important to do this? Or will it just confuse things?

I’m aware I’m over-thinking a lot, which is probably feeding the anxiety. But my brain is very busy with this! And it’s stirring up a lot of feelings. (Also aware that I’m getting ahead of myself seeing as I haven’t made an appointment yet, let alone received a diagnosis!)

I can talk to my T about some of this - but would feel awkward telling her that I’m worried an ADHD diagnosis would potentially impact how I felt about PTSD/our therapy.

Thanks for reading and for any thoughts.

 

[Charbella]

- How do you unpick what is ADHD and what is PTSD? And how does that inform what you do about it/how you manage things.

You don’t, there is overlap and after reading The Body Keeps the Score I’m not entirely convinced I am ADHD vs traumatized. Genetically I have a lot of people in my family with ADHD, also these are people who were traumatized. None of them have a diagnosis of PTSD but one does wonder. One thing is I was diagnosed ADHD before PTSD (actually not really but I was asymptomatic at the time and had never believed the PTSD diagnosis) and I relate to it so it’s a diagnosis I share whereas PTSD is not. The ADHD diagnosis makes sense to me, it explains a lot, so I’ve connected with it.

- I am really just looking to get an adult ADHD assessment, but I’m unsure whether/how to bring PTSD into the conversation. Do you think it’s important to do this? Or will it just confuse things?

I’d definitely bring it up so the evaluator has a complete picture. It’s like going to the doctor and saying you’ve had a stomach ache for weeks but failing to tell them you’ve been diagnosed with stomach cancer. They’re going to look into but first they’re going to think horses not zebras. Just say you’ve been diagnosed with PTSD from ____. Let them decide the importance of it.

Good luck, I hope whatever happens brings you peace.

 

[Friday]

- How do you unpick what is ADHD and what is PTSD? And how does that inform what you do about it/how you manage things.

Practice. Full stop.

But the thing about different disorders? Different things help, do nada, make worse. So whilst most of the time I can “feel” if it’s PTSD or ADHD weighing in? Sometimes I just have to throw shit at the wall and see what sticks. And other times a single symptom is being sourced by 2 places, and I HAVE to use both skill sets to back things down.

- I’m very anxious about seeing a psychiatrist and (potentially) having a formal psychiatric diagnosis made and recorded on my medical files.

For real or just because? For real would be you’d lose your job, family, etc. other seriously important shit. Meanwhile ‘Just because’? Pfft. f*ck that noise. You are exactly who you’ve always been. A better way to describe it only gives you tools. Whether it’s the modern ADHD (high spirits, historically) or PTSD (historically ‘a soldier’s heart’ or ‘histrionic’)… makes no nevermind… unless? It cuts you off from your family or career.

Real fear. Foundless fear.

***
More later. I’m just a bit in it, now.

 

[arfie]

i started my recovery from child sex trafficking in 1972 at the age of 18, more than 20 years before the "shell shock" theories coalesced into what is now called, "ptsd." i have a proverbial smorgasbord of official dx'es for the myriad of psych symptoms manifested by the child sex trafficking experience. i believe i received my most effective therapy under the moniker, "manic depressive/bipolar." i was nearly ready to graduate to "therapy maintenance" by the time i was reclassified as ptsd in the late 90's.

my takeaway from all that is, "don't worry about which file cabinet other people put you in. treat the symptoms."

but that is me and every case is unique.

steadying support while you find what works for you.

 

[Freddyt]

Pfft. f*ck that noise. You are exactly who you’ve always been. A better way to describe it only gives you tools.

my takeaway from all that is, "don't worry about which file cabinet other people put you in. treat the symptoms."

Yup. same as we all were with PTSD. Think its a label when it describes what needs to be treated. Scary as hell when they trot out the list of all the parts and pieces but knowing what it is and what needs to be treated? Means you get treated rather than stumbling around not knowing.

Learned that with my chronic illness. My doctor at the time was surprised. He had another patient who had acted like their life was ending because they had the same thing. I was just like - OK, got it, how do I treat it, what don't I do, what do I do, how do I medicate it, how do I know I have a problem? Then its just get on with it.

A diagnoses is a description - nothing more.

 

[arfie]

Think its a label when it describes what needs to be treated.

the hardest part of my recovery from child sex trafficking was finding names for all the psychoses(pl) attached so that i could talk about them in healing tones. the names available in 1972 when i started my recovery we unflattering, at best. they were even scarier and more stigmatic than the current list attached to "ptsd."

believe it or not, we've come a long way. i'll take "ptsd" over "one of those girls" any day of any year.

 

[Tinyflame]

@barefoot I don't think there's anything to be scared of, and AD(H)D isn't a bad thing- check out Ned Ottowell's new reasearch and terminology of calling it VAST ( stands for Variable Attention Stimulus Trait, I think). Or even something like ADDMagazine articles, symptom-checker too. He said attention-deficit is the worst terminology ever, it's excess-attention, not a deficit.

- How do you unpick what is ADHD and what is PTSD? And how does that inform what you do about it/how you manage things.

I think as @Friday said they overlap a lot, as does ADD and childhood trauma. Also some things (chemo etc) in rare cases can cause ADD. And there's a kazillion things that can mimic ADD (physical issues, cognitive ones, even some people react to food allergens, etc. Such as too for example a UTI can mimic cognitive issues, or hearing loss can, or simply grief/ fear/ worry.)

But my understanding is it's been there all one's life in most cases, strong genetic component (over 80% heritability, and lots of parents get diagnosed after their child is), and people work with it without even knowing. I think @Friday taught me that (such as using visiual cues to remember). Or a person calling themself overly sensitive vs knowing about Rejection Sensitive Dysphoria, or gravitating towards OTC stimulants (smoking, sugar etc, or depressants like alcohol to unwind) without noticing, or being bored to tears with some things and excited by others, and going generally too hard on one's self for not being 'average', etc .It can also often be co-morbid with other things, especially anxiety, depression and sensory or processing differences. I think there's lots of benefits to it also, tbh. Although I have been awful to others sometimes before especially, not understanding. But learning about it to not cause damage has helped me both to understand others and myself a bit better. (Seems my whole family has been this way though only one was diagnosed, one one might have been Innattentive subtype). I asked a sister once if she thought either/ both of our parents were hyperactive and she said, "You're kidding right?" Even my grandma or aunt (diagnosed) lived with more energy and action and speed and active mind (and distraction) than people in their 20's as seniors.

My understanding is that it will have usually been there all your life, though if physically hyperactive it often goes more underground as you age, though the hyperactive thoughts can continue. It can present different ways, some parts like impulse control more related to the H part for example. Also Big Emotions- not incorrect ones for the situation, but large. But out of the box thinking, often huge-heartedness, great energy, great youthful-quality as one ages. I pefer being with people who have it. (Even one of my sisters split from one fiance because she said he was a good man but 'their motors simply ran on different speeds'. She intuited correctly there I think.)

It's also nice to find out the things I thought were 'weird' or 'sensitive' about myself are just 'normal' or good hacks. (Like leaving out a sock (pre-puppy) on the floor to remind me to flip or get the laundry; color-coding for interest; using reminders; reversing phone numbers; going crazy with clothing tags; difficulty sleeping (not realted to trauma). Or needing coffee to get to sleep. I remember even seeing a video of me camping at about 3 throwing rocks in the water and asked my mom why it was in fast-motion, and it wasn't.

I think the biggest difference I can think of, is like forgetting because being distracted by many things (shiny, 'rabbit!'- like @Friday said, also makes for good snipers - one of my sisters wasn't a sniper but she needed that ability in her work), versus being distracted by a FB, or turning trauma thoughts (and hence re-enactments) over in (my) head, even though it's the 'present', etc. And aging, menopause, exhaustion, worry, illness etc also impacts.

This post is kind of all over the map but I hope it helps. No matter what you seem like a wonderful person just as you are. If you can get clarity or help from it great, if it doesn't apply re: a diagnosis that's ok too. Whatever works and helps.

 

[Tinyflame]

Sorry @barefoot I forgot too, just meant to say it's all good- for example, if something like ADD applies (or even if it doesn't, executive functioning issues apply to all of us, and have their own challenges re: ptsd too), there can be useful helps to learn. For example, how to deal with procrastination (it isn't really, and certainly not laziness), or the like. If you can understand more of what's behind your own inclinations you can find more tools to manage.

Good luck!

 

[Tinyflame]

@barefoot , sorry, one last booboo- should say Hallowell, not Otowell. Ottowell was my coworker.

 

[Freddyt]

the hardest part of my recovery from child sex trafficking was finding names for all the psychoses(pl) attached so that i could talk about them in healing tones. the names available in 1972 when i started my recovery we unflattering, at best. they were even scarier and more stigmatic than the current list attached to "ptsd."

believe it or not, we've come a long way. i'll take "ptsd" over "one of those girls" any day of any year.

My point was that some people take that diagnoses and wear it like a bandage over a mortal wound. They use anecdotal knowledge to judge what it will do to their life. Rather than getting on with life they stop their life and obsess over whats wrong rather than getting on with life.

I spent my share of time around hospitals and doctors in the mid 70's as well and yes, most of what was there was crude and held as much that harmed patients than helped them. Matter of fact that's where my first trauma happened - in a hospital - as a result of carelessness. And the dehumanizing treatment during that event was part of what made it cPTSD.....

The biggest problem is - we still don't teach doctors how to translate physical illness to mental health problems. Matter of fact for most its a last ditch effort. It took 45 years for me to get in front of someone who told me it took 10 minutes for them to be sure I had PTSD........

 

[RachelBigby]

I went to a psych testing center for my first consultation last week. They said they'd start with their "usual" first-visit questions. They were screening hard for ADHD. Asking about my focus, impulsiveness, school performance, etc. The guy seemed to assume it's why I came in. I got through to him he was barking up the wrong tree, and then he was confused. He literally asked me "what are you here for then?" When I said I was there for trauma treatment, he acted almost surprised.

 

[Roland]

I feel you on this. I don’t have ADHD, but going in for my psych eval, I was nervous of getting diagnosed with BPD or Bipolar or otherwise misdiagnosed. I thought I had autism, but I don’t. It is stressful and nerve racking and it takes a huge adjustment. I was diagnosed with PTSD (with disassociative symptoms, including splitting) and Avoidant Personality Disorder. But the insight was really helpful, Having someone else look at what’s going on. My advice is screen your psychologist on the front side. Check your options and go with your gut. The one I went to was further away and probably more expensive than my other options but it just “felt right”. And it was, I felt my evaluation was almost spot on. And really gave me direction for what to do next. As far as separating different symptoms of ADHD vs. PTSD, I’d say learn about both individually, but recognize that the overlap will be huge if not impossible to decipher since it’s all in one person. But knowledge is power, check people who have ADHD and check people who have PTSD and check people who have both and you’ll start to see the parallels.