This is a tiny snippet of a much longer presentation Dr. Barkley made for parents of kids with ADD/ADHD. It's incredibly comprehensive compared to what is normally available to the public.
I was diagnosed with ADHD in the early 2000's in my mid-twenties and randomly prescribed a new-ish drug called Strattera and shoved out the door after a couple of counseling sessions. The drug made substantial changes to my ability to function, but I had no frame of reference, so I thought that would be it.
Saw this video sometime in the last year and it hit me like a ton of bricks. Contacted Dr. Barkley directly via email and asked him for a recommendation in my area for treatment. Got hooked up with the NYU ADHD program and have been working with the program there for 6+ months and have been on new meds (Concerta) which is like emerging from underground for the last 16-17 years.
If you know someone with ADHD or family with ADHD, watch this whole thing. It's long, but phenomenal. A potential life changer for folks who haven't received help or may be getting the wrong help.
For folks who are poking fun and saying, "I guess have ADHD too!"
That would be like saying you have an eating disorder because you have trouble not eating a box of chips when someone with an actual eating disorder clears out the refrigerator. Or saying you have multiple personality disorder because you occasionally talk to yourself. Or saying you have epilepsy because you get shaky when you are hungry.
Everyone struggles from time to time to pay attention to things and focus on long term goals and lessons learned in the past. That's the human condition.
ADHD/ADD makes it literally impossible to integrate long term thinking into action, both in the future and remembering the successes and failures in your past. Trying to engage structure surrounding things that I am not directly threatened or rewarded by sends me wandering around the room, physically and mentally. Unless I am constantly getting rewarded or punished or don't have some massive impending reward or punishment on the horizon, I can't stay focused on the task at hand.
TLDR: The original video is almost three hours long and changed my life. Don't mock people who have ADHD or pretend to for attention. Attention deficit is crippling. My current treatment is helping a LOT and has changed my life for the better.
I am diagnosed with, as my psychiatrist says, "one of the worst cases of ADHD-C I've ever seen." My life is basically one crisis after another, but after 30 years of dealing with it, I'm at a sort of peace.
I will never tell anyone aside from close friends and family that I have ADHD, though. There are simply too many people who claim to have it and it's become a joke. Nobody in the work place would take me seriously. I just take my lumps, I apologize when I mess up, and when I get fired I keep going to the next job.
I don't ever anticipate that I'll be viewed with anything other than general disdain by more normal-minded people, but I'm okay with that. I wish in the future this disorder (which can actually be measured by mapping frontal lobe activity) will be taken seriously so that others aren't resigned to a 'second best' life.
Why resign yourself? Strattera has made an enormous impact on my life. I went from jobless and single to employed, working on finishing up my higher education, and in the happiest relationship of my life so far.
I've been on medication twice, and both times have ended in disaster, even after trying all the available ones. It always works for the first few months but it ends in complete brain fog during waking hours. I'm married and make a decent amount of money so life isn't so bad. I've learned how to cope. I'm just always falling short of where I want to be.
I'm in the inattentive category myself, and Wellbutrin has done wonders in terms of overall concentration as well as reigning in the more irrational, combustive reactions I used to have when faced with adversity.
It actually does! My self-loathing has lowered to manageable levels. It's not a cure all. I still need to practice discipline, but a lot of the negative feelings have been lifted. I had taken Straterra previously, but it made me too sick to function. The wellbutrin, (or whatever the generic version I'm taking) is working well in conjunction with a small dose of Adderall . I also do talk therapy to work out the rest.
Huh. I tried Ritalin as a kid but it only helped a little bit. It did nothing for my energy/hyperactivity but I could at least focus more and my impulsivity wasn't quite so bad.
Strattera ended up working for me, but ONLY after we bumped it up to 100mg/daily.
I wouldn't describe my state of mind as "brain fog" (though I have had days like that, both on and off meds, and they're the worst) - I do notice that my emotions seem a little more muted, whether positive or negative.
I can't tell whether that's a direct effect of the medication, or just the fact that I'm not constantly a whirlwind of disaster that's finally allowing me to stabilize emotionally. Off the Strattera my emotions become much more severe - I can feel a lot happier, but it's more likely that I'll simply feel much worse since I tend to (irrationally) blame myself for not being able to focus and get shit done.
Strattera's been really helpful for me, a real life-changer and no exaggeration. Sorry to hear it didn't work for you.
Can I ask you about how your current treatment is helping you? How does it overcome this neurological impediment?
It's almost painful for me to integrate long term thinking into action. Every time I study more than a few days or weeks out from an exam I have to induce myself into near panic to focus. I find adderall helps me somewhat, but only on more mundane tasks with a clear end point.
The drugs won't fix it. That's a common misperception.
They simply help you prioritize and focus your energy on building new habits.
Analogy: (because shitty analogies work best for me) You've grown up your whole life with a terrible tremor in your hand whenever you write and (among other things) have terrible, shaky handwriting as a result. It also made almost completely incapable of typing. No amount of effort or focus seems to fix that.
This was okay when you were in elementary school. Everyone struggled. But as you got older, everyone else got marginally better with their handwriting year after year. You resigned yourself to being unable to communicate textually at all. And people notice. You create a bunch of workarounds and cobble together as hoc solutions that allow you to get by.
Suddenly someone gives you a drug that steadies your hands.
Your handwriting improves greatly when you are on the drug, but it is still fucking terrible. You realize, however, that you have the ability to fix your handwriting. Your effort in writing and typing allows you get marginally better year after year and eventually catch up with your peers and become a better writer than many folks who don't have a tremor.
The drug can't fix your ADHD because the ADHD isn't just the lack of attention. It's also (for older kids and adults) the accumulated skill set you've defaulted to and habits you've built while you have been unmedicated.
After I got used to the exhilaration of fulfilling tasks, I started to use an app called "Habitica" to gamify my task list. I had to learn how to break tasks I wanted to do into discrete chunks. This didn't work for me before. I was able to take the newfound sense of purpose and context and focus it into learning how to function with the new energy and mental acuity.
This absolutely helps. Yoru analogy makes things very clear for me. Knowing the skills is one thing, but applying them is another.
Do you have any particular reason why you like concerta? Is it much different than adderall?
Also, one last question. What should I be looking for when I look for a new doctor who understands treatment at this level. I brought this up to my current doctor and he seemed flummoxed.
My son was diagnosed ADHD 10 years back. I saw Dr. Barkley's video a few years ago and have had his book since my son's diagnosis. Dr. Barkley's work in this field is a godsend to parents. I cannot imagine going through the last ten years (or going forward) without his material. (I'd love to email him just to say thanks!)
I see where you found Concerta. We got lucky, this was the first medication that was prescribed for my son and it worked!
Hope things are going well and thanks for sharing your experiences.
Yep. That's what it is. Get yourself in to see an ADHD specialist. Whatever money it takes. You'd be surprised at how insurance covers this if you have it. Get yourself on medication with the help of that person. Get weekly therapy. Rinse and repeat. There is no real magic to it. Get help from professionals.
If you had a leaky roof and you ran out of ideas about how to fix it yourself, what would you do?
You'd find the best roofer you could and get them to give you an estimate and get the damned thing fixed.
Fix your roof. The longer you wait, the more damage you will do to your life. You'll be able to fool people for a while but eventually, if you do have ADHD, you immediate environment will become your priority and you'll end up doing the least amount of work possible.
Try to think of it this way:
It may be expensive now. But how expensive will it be to be out of work with references who won't vouch for you because you failed them and gave them shitty excuses the whole time?
Get specialized ADHD help. Stat. Every day you waste you will throw away opportunities to make your life what you really want it to be.
This happens all the time. A video is posted about a mental disorder or similar and lots of think they have it. Some of the 'symptoms' are super generic and pretty much anyone can relate to them.
For whatever reason Strattera amped up suicidal thoughts in me. I already had suicidal thoughts, but it was like they went from a whisper to a constant roar.
I'm fine. I don't take it anymore. And I think when I first started taking it (which would have been 2004) it wasn't a listed side-effect. But I could be wrong.
I was diagnosed at 16 and put on the same drug. I absolutely hated it. It made me slow down in the worst ways. It sucked the joy out of everything. Even watching a movie or moving was effort. I had to stop taking it. That was 10 years ago.
I've just learned to live with it but it hasn't been easy by no means.
Yeah. My "joy" off meds was primarily focused around really unhealthy behavior that stunted my physical, psychological and mental growth. Weeds video games, overeating shitty food, surfing the net, more weed and cheap sex.
My wife saw something more in me. God knows how. And I have a five year old and two year old now. I run my own business. I only started the Concerta maybe 6 months ago? I had to change something. I was failing her and my kids.
And medication just made all of the difference. My effort started to mean something.
Keep trying different meds. Something WILL work. If you want things to be different, change them.
First, if I could go back in time, I wouldn't start or change medication without the input of a person who specializes in ADHD/ADD. I have been seeing a legit talk therapist for 7 years twice a week now dealing with just basic life stuff. And I also go in about once a month for sessions dedicated to dealing with ADHD and medication to the specialist at NYU.
I know that wasn't exactly your question, but it feeds into the rest of it.
Strattera calmed me down and gave me time to potentially make better decisions and not feel like I was on a bike flying down a bumpy hill barely holding on. I was still going down the bumpy hill but just not as fast. Everything was a little muted. And it took a long time to fully come into effect.
The difference between Strattera and Concerta for me was that Strattera didn't help me reach more deeply into my past and desired/not desired future for guidance when making decisions. Concerta does. It gets a ton of roadblocks out of the way for me.
I was shocked that an amphetamine could make me feel calmer. It's completely counter-intuitive.
If the Concerta or other amphetamines had not worked, I would have tried other options first, but would certainly have not hesitated to stay on it if it were my only option.
I was on Strattera for 3 or 4 years when I was a kid, and it worked really well for me. Idk maybe you realized the effects more as an adult, what were they like?
Hey, I have a couple of questions about NYU ADHD program. Besides diagnosis and medication, what sorts of support do they provide? Is therapy mostly focused on emotional aspect? CBT? Integrating structures and organization (God knows I need that)? How do you like it so far? I considered enrolling in the program but the whole cost of it kinda put me off. Not sure if I can afford to pay regular therapy on top of medication and whatever else out of pocket, you know what I mean?
Whatever info you can provide on the program would be much appreciated. My psychiatrist doesn't seem all that interested and I've been having hell of a time trying to find a counselor who specializes in ADD, accepts my insurance AND accepts new patients.
Honestly, the therapy for me has just been check-ins about the meds. I am working with one of the residents there who is learning under Dr. Adler, the head cheese there. Was on the waiting list just to get a phone consult for months. My insurance has out of network coverage. Initial screening appointment was $200 and subsequent sessions are $70. Once I reached my deductible, they covered about half of the $70 fees.
First visits were weekly for a month with new prescription happening in the third or fourth session. Then monthly sessions to check in play the option of checking in for any emergencies or questions. I could do weekly if I wanted but I am already going twice a week with a therapist I've been seeing for years. They are in communication with one another which helps a ton.
I mean, I would much rather work with a resident there for ~$35 a weekly session than someone who seems disinterested in dealing with my ADHD. Luckily my regular therapist is awesome. She recognizes that she isn't an ADHD specialist and encouraged me to get that more focused help especially to procure proper medication.
I would guess that from there you could probably get a referral to an ADHD specialist that could do weekly talk therapy and accepts your insurance or at least will let you submit your stuff out of network.
Really? Last time I called, sometime last year, I was quoted around $500 for initial testing/diagnosis. Anyway, I'll contact them again to make sure I understood them correctly and definitely look into my insurance and out of network coverage. If diagnosis is $200 and therapy is $70, really I could swing that.
So it seems like it's mostly medication management for you. I was hoping for more behavioral modification. Med helps and I don't plan on going off of it but I could always use more help in that area. Last question, am I correct that you aren't just receiving medical services but you are also participating in researches? Is there a choice in what sort of research is available/eligible for you, after the screening? Thanks again!
That $500 is if you work with one of the doctors. The $200 if you work with one of the residents in training. There are options to participate in research but I didn't look into those too closely. I can't afford to mess around with that with two kids at home.
Like i said, I am primarily using the service for medication, but I know that I could go weekly or more frequently. If I wasn't with a therapist currently, I would definitely do it.
Was the program expensive or is it an on-going study that is free to qualifying nutcases? I was diagnosed with ADHD last year and my insurance has pretty awful coverage so I've going to a psychiatry farm and the doctors there could care less. I actually shot NYU ADHD an email after reading your post to learn more but I'd love to hear more about your experience with them first hand.
I responded to another response with more details. Don't email them. Call them. It took me a couple of months on a waiting list to get screened and a little while longer to get scheduled for an initial visit.
Do you have mood swings with concerta? That is one of the reasons I stopped taking it, because it made me a completely different person (personality wise) and everyone could tell. I don't have ADHD too bad, but I get told by everyone that I'm just lazy, etc and I didn't really even know that this was a common thing for people with ADHD.
I definitely can feel a little short with people and myself when on Concerta. But I also am far more capable of thinking ahead and dealing with stress in a more effective way. It's a bit of a trade-off as I become more aware of my life and the issues I may have left untended. But I am also hungrier to change those things. It's upsetting living in a space where I am dissatisfied and want things to be different. But I would rather have the information and capacity to change things for the better than living in relatively calm ignorance of it.
I suspected I had ADHD and went to a psychiatrist to figure out if it was true. Eventually all the signs pointed towards the assumption that I was.
The treatment was ritalin alongside talk therapy. Truthfully CBT would have been more helpful but I never got that
How long were you in therapy? Was the person you were in therapy with specializing in Attention Disorders? Who prescribed the medication and how often after you started it did you meet with them?
Sorry. Lots of questions, but it might give me some idea of where to direct you.
About 4 months of therapy. A separate psychologist prescribed the medicine and didnt really do much psychology work. Meetings were every week for that period of time.
The guy who was giving you meds was a psychopharmacologist probably. They tend to do that. Not a lot of therapy.
Four months of talk therapy isn't going to make much of a dent, honestly. I've been working with my therapist for 7 years twice a week. I've got some heavier shit than some folks, but less than a lot. Talk therapy takes a long time because it is mostly you doing the work with tiny nudges from your doctor. My therapist probably says 5-10 words for a 45 minute session. Sometimes less.
I dunno. I guess I would suggest trying to find someone in your area that focuses more on ADHD. Find someone who you feel a bond and trust with. It's ultimately going to be mostly you setting small goals for yourself and working through how you sabotage things and why and making changes. Figuring out what you REALLY want deep down and deciding if that is healthy or realistic. Finding your fear, pain, anger and mostly just your habits and learned survival modes of behavior left over from stuff from your childhood.
Folks with ADHD have to build a LOT of workarounds to make their lives work socially, educationally, professionally and in terms of family. It's a lot. And then you bring your normal stuff to the table. I'll not lie: it's fuckin hard.
But I have two kids, an incredible wife, a job I love, an apartment I never thought I'd be able to afford and a positive outlook on my future and my family's.
I wish I could have gotten to it earlier but it wasn't in the cards.
Go watch Russel Barkley's 2:30-3:00 video on ADHD for parents. Reach out to him via email and ask him if he knows anyone in your area who he trusts. Find out how your insurance covers out of network if it doesn't have them in network. Beg, borrow and steal. It's an investment in your future. You'll make the money back.
That's awesome. Just getting things rolling down the road is the hard part. Once you get some momentum, it gets a LOT easier. Just keep pushing. Any time you feel like you are "done", keep pushing.
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u/supercali5 May 30 '17
This is a tiny snippet of a much longer presentation Dr. Barkley made for parents of kids with ADD/ADHD. It's incredibly comprehensive compared to what is normally available to the public.
I was diagnosed with ADHD in the early 2000's in my mid-twenties and randomly prescribed a new-ish drug called Strattera and shoved out the door after a couple of counseling sessions. The drug made substantial changes to my ability to function, but I had no frame of reference, so I thought that would be it.
Saw this video sometime in the last year and it hit me like a ton of bricks. Contacted Dr. Barkley directly via email and asked him for a recommendation in my area for treatment. Got hooked up with the NYU ADHD program and have been working with the program there for 6+ months and have been on new meds (Concerta) which is like emerging from underground for the last 16-17 years.
If you know someone with ADHD or family with ADHD, watch this whole thing. It's long, but phenomenal. A potential life changer for folks who haven't received help or may be getting the wrong help.
https://www.youtube.com/watch?v=SCAGc-rkIfo&t=2428s
For folks who are poking fun and saying, "I guess have ADHD too!"
That would be like saying you have an eating disorder because you have trouble not eating a box of chips when someone with an actual eating disorder clears out the refrigerator. Or saying you have multiple personality disorder because you occasionally talk to yourself. Or saying you have epilepsy because you get shaky when you are hungry.
Everyone struggles from time to time to pay attention to things and focus on long term goals and lessons learned in the past. That's the human condition.
ADHD/ADD makes it literally impossible to integrate long term thinking into action, both in the future and remembering the successes and failures in your past. Trying to engage structure surrounding things that I am not directly threatened or rewarded by sends me wandering around the room, physically and mentally. Unless I am constantly getting rewarded or punished or don't have some massive impending reward or punishment on the horizon, I can't stay focused on the task at hand.
TLDR: The original video is almost three hours long and changed my life. Don't mock people who have ADHD or pretend to for attention. Attention deficit is crippling. My current treatment is helping a LOT and has changed my life for the better.