You do like to question.
The “depressed, stressed, thinks lowly of herself” sounds more like depression than ADHD to me, and depression can manifest as not caring about appearance or environment much - not that I’m diagnosing her, but I’ve know several adults with ADHD who nonetheless managed to keep house on a better level than you describe for your girlfriend.
I think some of the objection in this thread is not “I think my girlfriend has a serious problem” but rather your leap to it being AHDH. There are probably several disorders that could match her symptoms.
I don’t know if an approach of “Hey, honey, I’m concerned about how depressed, stressed, and low you think of yourself, and that you’re not really taking good care of yourself or your environment. Have you considered getting some help with this?” would work with her or not, but it might be more productive than “I think you have AHDH go to a doctor”.
Depression and untreated ADHD are co-morbid. Based on what the OP describes, using my experience with ADHD (both in the classroom, in pre-medical students and science students) and in my experience with one of my children’s evaluation and treatment for ADHD, I think the OP’s GF sounds like an extremely good candidate to be ADHD. Obviously she could very well not be ADHD, but I think the OPs analysis and description makes it a likely starting point not a foolish thing to be concerned about.
It could also be subclinical- ADHD becomes a problem when it interferes with the person’s ability to do what they want/need to do, and that’s personally subjective. She may be content with how things are so a diagnosis of ADHD wouldn’t be meaningful. But if these symptoms are interfering with how she wants to live (neater, more organized house, for example) therapy or medication might be warranted.
Thank you for the correction regarding amphetamines. I’m surprised to learn you’re a psychologist. Your replies towards WhyNot were cold and clinical and lacked compassion. Isn’t your job to help people? Instead you chased her from the thread. Whether she was wrong or not, you didn’t treat her very well.
There are a number of posts in this thread that are more about other posters than about trying to answer the question in the OP. Please focus your responses on the original question if you wish to participate.
If you can’t keep your responses polite and on-point, please take it elsewhere.
Rather than telling her that you think she needs to see a psychiatrist, which:
- She might find rather offensive, and
- She might want to avoid in case word got out at work,
maybe you could ask if her workplace has a confidential counseling program.
Indeed. And if she is ADD, just finding that out is often enough to boost a person out of a mild depression. Thus the title of a popular book on ADD: You Mean I’m Not Lazy, Stupid or Crazy?. A lot of us with ADD still suffer from depression, but treating the condition is a huge help.
Doesn’t mean she’s not ADD - I knew a psychiatrist with raging ADD. He just figured out some - admittedly extreme - coping strategies to get him through med school.
This is not my job. I’m here for the education and condescention.
No. I’m stating that, just as with an Alzheimer’s diagnosis, an ADHD diagnosis should not obviate the diagnosed person’s right to say “no thank you” to intervention. At least up until the point that the person is not longer competent to manage their own affairs and is given a court-appointed guardian.
And, by extension of the same, it is also the right of the prospective patient to say “fuckit, I don’t even want to go see the damn doctor in the first damn place, I’m not bothered by my condition whatever it may or may not be”. That’s also their choice to make.
Yup. I agree with all of this.
Dear Morphine Poet,
Some of the people posting here are being really asinine, so I PM’ed you. Check your private messages 
While certainly not as tough as med school and a residency, I managed to graduate cum laude from one of the nation’s top 10 (at least, at the time) pharmacy schools, and I didn’t get my diagnosis of ADHD until well after graduating (though to be fair, it was suggested I be evaluated for it by a with-it family practitioner in the middle of my second year, but I poo-poo’ed the idea at the time). It has since been confirmed by a second family practice MD, a clinical counselor (unknown credentialing), and two psychiatrists, on separate occasions.
Like WhyNot, I’m extremely detail oriented at work, because I know that if I fuck up, I can kill someone or make their health worse, and because I like (and am arguably good at) what I do. Provides strong motivation to keep me focused, despite not currently using approved ADHD meds. And since I like what I do, my ADHD symptoms tend to be at least blunted (if not outright eliminated) while I’m working, which occurs in at least some of us when we’re feeling rewarded by our tasks, but they come back with a vengeance when it comes to tasks I’m indifferent to or even hate (hello apartment carpet which hasn’t been vacuumed in 3 months, and office which is still boxed up 9 months after moving in).
So perhaps the OP’s girlfriend really loves being a doctor, loves medicine, how the human body works (and breaks down), and that provides all the motivation and salience she needs to function at work, while still failing to do so at home.
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Some of them can be, though probably not immediate or extended release forms of clonidine, guanfacine, or atomoxetine, due to their mechanism of action and where they are reported to work in the mammalian brain. I’ll even grant you that It’s rare in individuals with ADHD being treated with the psychostimulants, though this is more likely due to the doses being used and the titration schedules (if being prescribed properly) involved. But Adderall, Dexedrine, Dextrostat, Ritalin all CAN result in addiction, so yes, at least SOME ADHD meds are addictive–they just don’t seem to cause it all that frequently in typical use scenarios.
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I agree to a point. I think the overwhelming deficits in those of us with ADHD are net negative, but I do think there are some aspects that can be turned towards being advantageous in limited circumstances.
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QFT
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I agree, if we’re talking about all forms of psycho-social stress, lumped together, though I do think some individuals do get benefit from certain stressful contexts, provided those situations are limited in scope and duration. I certainly do when things briefly get busy and I’m by myself (I don’t get tech help in the middle of the night) at work.
While our ADHD brains do appear to be “wired differently” than those without ADHD, we are, if anything, more likely to become substance use dependent than the general populace, due to our deficits in impulse control and executive function deficits. The reason why we are probably less prone to abusing or becoming addicted specifically to the psychostimulants is that at doses within the therapeutic range, we’re augmenting the control exerted by the executive function “hub” of the brain (the prefrontal, along with the orbitofrontal and anterior cingulate cortices), while only modestly enhancing tonic dopamine transmission in the so-called (and oversimplified) “reward” pathway in the ventral striatum (nucleus accumbens), without appreciable effect on phasic dopamine transmission. Overuse and use of too high of a dose could put us at risk for an addiction, like those without ADHD, but the doses are probably higher for us than for “normal” people.
And those few hours more of sleeping per day when your friend is off his meds ARE signs of at least a mild withdrawal. Which is fine, because dependence/withdrawal, while frequently associated with addiction, are not addiction in and of themselves.
Yes and no. Dose and route of administration play the largest roles in addictive potential, with low-dose, controlled release, oral preparations being fairly low risk, while high dose, immediate release, injectable preparations carrying the highest risk. The faster the onset, and higher the phasic dopamine rise in the ventral striatum, the greater the risk of development of addictive behaviors. So yes, the majority of ADHD meds (all but Daytrana are oral, and Daytrana, which is topical, has even slower on-off kinetics than all but Vyvanse), when dosed appropriately, are unlikely to cause addiction due to their formulation as oral or transdermal preparations. Administer those formulations in high enough doses or by non-oral means (insufflation, injection), and the addictive risk goes up. Following the instructions of a qualified prescriber is probably not gonna lead you into addiction territory, but oral amphetamine and injected amphetamine are both the same drug, working the same way to block DAT and NET and reverse the direction of VMAT2, so the potential is at least there to enhance/drive the formation of drug-seeking and drug-taking behaviors, in susceptible individuals.
One does not need to actually abuse a medication to become addicted to it. That may be the stereotypical view of an addict, and many addicts probably fit the profile of someone abusing a drug for a subjective “high”, but a diagnosis of a substance use disorder doesn’t require it.
So yeah, actually, they do. Far less frequently than with insufflation or injection, but even oral amphetamine or methylphenidate can result in maladaptive behaviors characteristic of an addiction/subtance use disorder. To say it can’t occur at all is simply wrong.
JayRx1981, abuse and dependence are defined diagnostic terms. Could you cite for me any studies that show anything more than a negligible level of abuse or dependence occuring with prescribed medical use of ADHD medications? (I’m excluding non-prescribed use by someone snorting large amounts.)
I don’t want this to sound like an award-winning speech, but I’m grateful for the support and advice I received, as well as for two very considerate private messages from Turpentine and Gray Ghost.
I did talk to her last night. She took it well, and I have to admit that she sat and listened throughout without interruption. I did approach her with the ADHD/ADD idea – I couldn’t not to – and I sat down with her through all of the behavioral and organizational issues – but not a condescending or accusatory manner. She listened carefully, then spent a couple of hours reading about it online. She did know a lot about the issue – naturally – since she’s both a physician and a writer. It seemed that she was rediscovering ADHD in terms of the degree to which it applied or did not apply to her, and I used in the process an analogy of my own situation with alcoholism (having been on-off going to AA meetings over the years but haven’t done that recently, reasoning that I only drink in the evening while alcoholics drink anytime and can’t control it, not knowing that the disease assumes different forms to adapt to a person’s lifestyle, thus becoming invisible).
By the end of the night I made her promise that she would seek help and she did. But I’m not a fool, and I know these celebratory promises made at the end of an optimistic session of self-realization – if that is what it is; if she does have ADHD, not to be presumptuous – and I intend to gentle coax her into actually taking a solid step towards seeking help. She initially seemed to be very opinionated against psychiatry or psychology (the same way many people hold irrational opinions against things related to their field somehow), dismissing therapy as “just a way for these guys to bill insurance companies” and “not really effective.” However, she did give in and promised to do it.
Also, several posts suggested specific places in the US to visit, but I’m not based in the US. I’m an Egyptian expat living in the UAE, and she’s a UAE citizen.
She’s a pediatrician who loves children, and I’m not aware of how she is at work, although I do know she cares about what she does very much, in addition to the fact that there is are strong regulations on medical practice in the UAE.
Finally, I don’t think she was offended. I am very careful about what I say, but I generally have a no-nonsense approach when it comes to these things.
Sounds like a productive conversation. One word of caution: you need to leave room in your mindset that she may not want to seek treatment. As an independent person she’s entitled to make that decision. I think you’re entitled to address issues that affect both of you (you having to do the bulk of keeping the house organized) but you can’t make her “fix” herself. You’ve put it in her hands and unless she asks you to nudge her to get help, respect her enough to leave it be.
I’m really happy that it has (so far) turned out well, at least as the preliminary discussion goes. Here’s to continued success!
Y’know, guys, I ping nearly all of the symptoms and was all set to see a doctor about it, both to help my brain and because I really like speed, but if I’m to be in the same group as most of those people I think I’ll pass. A lotta people would avoid using Glen Beck, Paris Hilton, and Howie Mandel as examples of people treated successfully for a mental illness.
I thought she was pretty much saying that. Several times. Workarounds are what we do. It’s a skill we develop to function specifically because of our ADD.
Nonsense! I can switch tasks several times a minute. Not all of them, often none of them, are what I’m supposed to be doing, but I can switch like the wind.
Friend to friend, you coulda dialed back the condescension a bit in this thread. Just sayin’.