Approaching an adult ADHD patient

In My Humble Opinion
41

First of all, thank you very much.

I would like to state a few facts as a reply to the rest of the comments.

1- All the symptoms of adult ADHD written anywhere on the Internet fit perfectly. I find no reason to dismiss them on the grounds of me not being a certified healthcare professional. I understand English, and I have enough clarity and perception to what something is, and the many ways it can be expressed. All the symptoms fit perfectly.

2- This post was harassed because I am her significant other. I would like to state that this isn’t written out of any will to control her, or any other romantic or pseudo-romantic motivations. I am neither a concerned parent, nor a controlling lover nor any of these definitions. I am concerned for her the same way I would be concerned for anyone else. I spent years working with people and I have empathy and compassion towards troubled people, no matter what their trouble be. Even if we break up tomorrow, the thought of her being alone, imprisoned in her lack of consciousness of what she’s immersed into, would keep me up at night for long hours.

3- I did try to talk to her. As I mentioned earlier, I have worked with people for many years, even in the emergency room of a hospital, and I know very well how to talk, what words to use, what facial expressions and body language to attach to my speech, and how to fashion my sentences so that they don’t offend. All of the conversations I’ve had with her about her depression, stress and all relevant matters were dismissed when she’s in a good mood and magnified and degenerated into fights when she was in a bad mood. I initially thought she was bipolar, but the profile simply doesn’t fit.

4- I do not believe that any of her ‘symptoms’ are related to me or how I behave in the relationship. I’m not the greatest guy in the world, but I’m a quiet, considerate motherfucker who keeps a low profile, even while keeping a low profile. I do not think, nor have ever witnessed, a relationship in which someone assumed this behavior intentionally or unintentionally as a response to relationship trouble. Plus, all of this stuff preceded the relationship anyway. She’s an only child with ageing parents and never had any real, long-term friendships. All her current friends are basically people I’ve introduced her to. Again, my presence in her life, although we live together, is very subtle.

5- All I’m proposing is that she goes to see a healthcare professional for her own good. Not for me, not for the relationship, nor for anyone else. Just for own sake based on my opinion, which I believe is sound, logical and based on evidence.

That’s all.

42

I certainly endorse this. When I found out that I was suffering from depression it was like a light going on; many things that I felt now had a name and actually could be treated. What a relief.

Maybe you ought to let her read this thread so she could see all the arguments on both sides and then think about it without having to react to you.

43

There are no frustrations. I’m not angry or pissed off. I am just worried about her. Whenever things are messed up at home, I just clean up without saying anything (not in a passive aggressive way though).

44

You, a lay person, can’t fix someone who has ADHD that’s complicated by depression (almost 1/2 of people with ADHD are also depressed, ftr). Even a trained professional isn’t going to fix her quickly.

But you can fix the mess right now which will make things less stressful for you both - if she’s a doctor, hopefully that means she’s making a decent living so hire someone to clean the house a few days a week. You’ll be less resentful, and she won’t need to feel badly about a. being unorganized, b. you picking up after her/nagging her about it. I’m not saying that you are nagging her, but it’s easy to feel that way when you hear criticism about something you struggle with due to your ADHD.

45

I assume that it is because of this that you are asking this message board for advice. Unfortunately, the only things I can think of to try* would be very risky to your relationship, and therefore probably ineffective (i.e. make it likely that she would break up with you instead of paying attention).

The only other thing I can think of is an intervention. Maybe if there were several people, friends and/or co-workers, in addition to you (or maybe instead of you) presenting this information to her she might pay attention and also might not take it out on you.

*such as accumulating evidence and making lists of the things she does and presenting it to her when she is in a relatively good mood, with the idea that she won’t be able to deny the symptoms. Although I’m uncertain whether this would ever be a good idea.

My final comment is one that you also probably don’t need, which is to remember to take care of your own needs through this. I am also a fairly low key, low maintenance person but I am apparently more sensitive than you are to being taken advantage of; I have had to make that decision about whether I was better off with or without a significant other. The concerns you have expressed here are solely for your partner, which makes me a little concerned about you, that you might reach a breaking point without being prepared for it. Frankly, your lack of any negative emotion (other than altruistic worry) about her behavior sounds a little too good to last.

46

I had a coworker with ADHD - and a PhD. Anything he’d decided to do, he would do and you better not get in his way; anything that was externally imposed… oy vei.

47

Sure, I didn’t mean to offend or mischaracterise.

48

Hi Morphine Poet,

I have ADHD and i’m a woman, mother in her 40s!! Your girlfriend sounds like me! lol You’re a good guy for wanting to help her actually.

I have had it since I was a child and my daughter also has it. Its actually very difficult to live with and people often assume ADHD people are just misbehaved individuals . I did very well in school when I was younger but then again it was in the public school system and curriculum was extremely easy. I had a very successful creative career as an executive and allowed me to multi-task - I wasn’t chained to a desk and I had much liberty and freedom in my job. I demanded high salary and was an extremely proficient - often sought out for jobs.

That was my career and work life though…

I initially was going to be a pharmacist when I was young and worked in pharmacy . Discovered it wasn’t my thing but my knowledge of meds was much more than than the average Joe.

I went to a technical college right after high school to prepare for my former career. I went back to college to get my BA when I was 30 . College was different again and difficult . I had to relearn how to study. Got my BA and went for Masters in TCM. I’m now in a Phd program and also in another masters program.

Is school easy? Hell no. When I was a kid, never was on meds and my parents spank us. I was known to be the bad kid and most likely to not to succeed. However, I’m the most educated sibling and acquired the most assets compared to my other siblings in my family now.

49

Now my home and personal life was always at a disarray! Messy from my bedroom, bathroom, kitchen, every dang room in my house and my car also. But at my jobs - I was neat and organized with paper work and my desk. I guess it forced me to be that way or else it would affect my job.

I hate cleaning and being organized actually isn’t easy for our brains to handle. As soon as we are doing a task, before its finished, we are on to the very next thing. its not easy to control. We get depressed, anxiety, very indecisive, lazy, messy, quick to get angry . we are argumentive as well. always interrupt the conversation. can’t sit still, hyperactive, never finish one task and on to next.

I didn’t take meds when I was young and just got spanked and yelled at constantly. I did try meds when I was in college for a month - I hated it. too much speed and too easy to get addicted to them. Anti-depressants - too many side effects and difficult to get off them.

I am sure your girlfriend knows all about the ADHD meds and its side effects. I’m sure your girlfriends knows something isn’t quite right with her either. My sister at one point thought I also had Bi-polar!

I am currently not on meds. What saved me and made me more different than other ADHD people was my athleticism since high school. Endorphins truly help our brains. I exercise every day and meditation helps a lot. Its not easy though still. If she wants a natural alternative, then really, I would suggest that regimen over med - exercise and meditation. She can try acupuncture too since that also releases endorphins.

Good luck and she can message me if she wants for more info.

50

First of all, don’t ever, ever use the word “patient” in this context.

If you think you are in a relationship with a “patient”, you might have things backwards. Time to rethink whether you should be in a relationship.

51

That doesn’t rule out ADHD at all, trust me. Being highly intelligent can compensate for or mask ADHD symptoms. This is especially true for girls and women, who are underdiagnosed compared to boys and men; girls/women are more likely to have ADHD-I (inattentive type) instead of ADHD-H (hyperactive) or ADHD-C (combined)*. It’s easy to overlook the quiet girl who’s always daydreaming during class but notice the boy who can’t sit still or stop talking.

I have severe ADHD-I and I didn’t get diagnosed until I was 28. I also graduated high school and college with honors and completed 2 bachelor degrees in 5 years. But I’ve never met a flat surface that I didn’t immediately use as a table or shelf for stuff, a conversation with me always takes the scenic route and I’m a horrific procrastinator.

But with that being said, the OP has no business saying he’s “100%” sure she has ADHD. I do think it would be a good idea to broach the idea with her, from a position of concern for her instead of criticism.

  • also, ADD isn’t used as a diagnosis anymore. It’s included under the ADHD umbrella, which makes sense. Former ADD diagnoses are usually type I or C.
52

The OP doesn’t mention, and nobody’s brought it up, but how well does she perform on-the-job?

The problems OP described – short attention span, absent-mindedness, sloppiness, etc. – We don’t know if she is like that also when she’s doctoring. OP, do you know if she’s like that on-the-job too?

I’d be terrified to have a doctor like that, if I knew. She could be making lots of dangerous mistakes with patients’ care due to inattention or general blundering.

53

There is a lot of foolishness going on in this thread! Some corrections, in no particular order:

  1. ADHD meds are not addictive.
  2. ADHD impairments cannot be turned into strengths. People may succeed in spite of them. People may find occupations that do not challenge these difficulties. But these are not potential strengths.
  3. People may very well reach med school and succeed even with ADHD. Think of ADHD as a dimension, not a category. Think of other aspects of functioning as dimensions too. High IQ, for instance, may buffer the impaiments associated with ADHD.
  4. People with ADHD do not thrive on stress. They suffer and struggle and experience depression and anxiety and liability to substance use due to their difficulties.
54

There’s a whole lot of judgment and not much help in this thread! Many people with ADHD have to be convinced to get help. Maybe MorphinePoet’s girlfriend doesn’t have it, but he has to start someplace. It doesn’t really matter where.

MP, Mr. Helena has ADHD which we’ve learned to work with pretty well the last 12 years we’ve been together. He’s also on medication. I read him your post and asked what advice he’d give. He suggested this book for both of you:

It may take some nagging to get her to read it (like someone had to nag him), but he said it really resonated with him and is why he got treatment. I read it, too, and it helped me to understand him.

The “H” is misunderstood. It doesn’t necessarily mean someone’s hyperactive like a four-year-old on sugar, but that it has to do with impulsivity. For him, if he has money, he spends it. So I’m in charge of the money except for a set amount he gets to blow. He can also be a slob. His drawers, closets, any boxes, etc. are organized with an engineer’s precision, but any surface areas (desk, tables, floor) are a disaster. We’ve agreed that he can have one room to crap up with what we call his ADHD piles (no food, though) that I organize twice a year (usually when he’s gone for a week or two visiting his daughter or brother as there’s less squawking that way :D).

He’s a brilliant technical writer. He can take any complicated topic and write about it so others understand. He works in aerospace, but he can do it with pretty much anything. He’s detail-oriented and precise to a level that would drive me batcrap crazy. That’s what makes this such a weird disorder: he can function at such a high level, but in everyday life he’s totally disorganized. I can completely understand how a doctor could have it.

I hope you get somewhere with your girlfriend. Please post if you have more questions about it as it looks like there are a couple people here who are familiar with it.

55

I go to doctors just for a second opinion–one other than my own. But I wouldn’t skip that step.

56

Oh, I know. My wife was diagnosed as an adult and it has changed her life dramatically. But my point was that even though she has some of the symptoms that doesn’t make a diagnosis. My wife only sought medical help when she felt it was impacting her life. Unless the OP’s wife feels the same way it’s going to be difficult to have this conversation.

57

I don’t think you should start with an amateur diagnosis. Talk about the behaviors and how they are a problem for you. Then suggest therapy for one or both of you. Leave the question “for whom” open at first… Keep an open mind. You may get to therapy for her/both of you easier that way than with “You have ADHD–go to a doctor and I’ll prove it!”

You’re so set on ADHD, but I can tell you from experience that that diagnosis takes a long time to confirm and may never really have been the right thing. Step back and discuss the assumptions–how to live in a clean, healthy, loving environment.

58

By “we” I meant those of us that didn’t accept MorphinePoet’s unprofessional and yet almost guaranteed diagnosis of ADHD without question.

“Wow”, indeed.

59

***Very ***likely. Indeed, careers in medicine, including doctors and nurses, are one of the most frequently suggested careers for adults with ADHD. We can often thrive in a fast paced environment with externally imposed control systems like policies that give us routines and regimented paperwork…and then we fall apart at home when no one is the boss of us.

I am super damn organized at work. I have to be, because if I’m not, things fall apart and people die. I’ve created new and improved organizational systems at work that have gotten me awards. I’m a motherfucking genius with creating organizational systems…it’s just very hard for me to keep them maintained unless I have a very good reason (see: people dying) to do so. Keeping myself happy and my husband sane are apparently not good enough reasons.

At home? Holy cats, I’m glad you can’t see my living room right now. It looks like a paper and food bomb went off in here. I’ve got six pairs of shoes on the floor in front of my chair because I keep forgetting to put them away. My dinner plate with chicken bones on it is stacked on my lunch plate is stacked on my cereal bowl. I’ll probably remember to take them to the kitchen before I get to bed, but it’s not a sure thing.

And I disagree with Hentor the Barbarian. The “weaknesses” of some of my ADHD symptoms - primarily the ability to have 23 “tabs” in my brain open at once - actually work as a strength when I’m listening to a patient while I’m writing paperwork while I’m trying to figure out why they’re on this med they don’t have a diagnosis for while I’m looking at the calendar to figure out when they need their next lab ordered. I get much more done - and done accurately and completely - in an hour than most of my colleagues.

Anyway, I’m afraid I don’t have a lot of advice for you, MorphinePoet. Clearly I haven’t figured out how to take care of this for myself. But you’re not off base in your concerns, for what that’s worth. She can be a very good doctor and still have ADHD or Depression, or both, because the two aren’t mutually exclusive. But you may not be able to fix it. There are no magic words to help someone even if (like me) they recognize that there’s a problem. If they don’t recognize there’s a problem, it’s even less likely. At that point, all you can really do is decide if this is something you can live with or not, and if not, leave as gently but firmly as possible.

60

@whynot:

The pertient symptoms of ADHD:

difficulty sustaining attention
makes careless mistakes
Does not appear to listen
Easily distracted
Difficulty with organization
Forgetful in daily activities
Loses things

If you’re doing 23 different things fully and completely without making mistakes, you’re not suffering from ADHD. At least, not from the inattentive symptoms. You could still meet criteria from among the 9 hyperactivity impulsivity symptoms, but that’s not likely and that’s not the claim you’re making.

The ability to multitask, organize effectively and complete complicated mental tasks without error is the OPPOSITE of ADHD; it is not the turning of ADHD deficits into strengths.