Misdiagnosis .... ADD or Depression? | ADHD Information
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pilgrim38637.2863078704I knew there was something about him I liked Misdiagnosis .... ADD or Depression?
By Judie Gade
Over the past year, I have been fielding calls from women and men from all over the Australia, after a story was aired about women with Attention Deficit Hyper-activity Disorder (ADHD) on A Current Affair, a prime time, top rating current affairs program. ADHD is primarily an inherited disorder and affects a part of the frontal lobe of the brain. It is a neurological disorder, not a behavioural one as many believe. Inappropriate behaviour is a result of the quirky brain we possess.
Most stories seem to be concerned with little boys who “bounce off walls”, destructive little people who are out of control! This is the media perception, and for some parents it is the way it is. It is not, however how it really is on the whole. The kids I have been dealing with need understanding and compassion for the confusion that they feel, and so do the parents who may be unknowingly ADHD themselves. Education and learning about ADHD is part of the key to living as an ADDer.
There has been much in the media from so-called experts, especially about the over diagnosis of Attention Deficit Hyper-activity Disorder. This has mainly been concerned with children, nearly always boys and not adults, of which there has barely been any coverage in the media at all. Unfortunately the same opinions have been manipulated to involve adults as well. The issues are very different for an ADHD adult. Many learn coping mechanisms from years of struggle, but still “it” is there, making life a real problem at times, just contending with the little things that most people make appear easy can be stressful. Things such as remembering a birthday, paying bills, cleaning the kitchen, even remembering to pick up the kids at school!
Most of the big studies have been male orientated, to do with children & with no real thought about the females who are ADHD. So, if this is true, how can they say if it is over-diagnosed when the opposite appears to be very much the case regarding adults? In ADDventurous Women, an Australian based e-mail support group, the main concern for members is educating the public about ADHD in a positive manner.
The way the general public sees people with ADHD has been a negative one, which is extremely unfortunate, as many of these adults are highly intelligent & very talented in their areas of expertise. The positives about the disorder are many. I would rather be ADHD than not!
The public perception is a negative one….. and why? Because the media prefers to go with the sensationalism instead of the truth; the negative instead of the positive! Never mind the response from the public, which they have invoked, & the fact that they are the main source of education for the general public. No, they would rather see people fighting it out in the public arena. These are mainly people who will benefit financially from the uproar through the sale of books, zealots whose religious sect benefits from the sale of tapes and videos via web sites, denouncing the very existence of ADHD. Some experts, with university degrees that flaunt an apparent understanding of ADHD (eg. Neurologists, psychiatrists & psychiatrists), prefer to put the blame squarely on parenting skills or an effort to take the easy way out.
The only person in the media spotlight that has come close to the truth has been Oprah Winfrey. The interviews were tasteful, full of empathy, humorous & insightful. She also had experts and adults with the ADHD to interview, people who were highly successful such as actors, Olympic gold medallists & even a Harvard university Professor of Psychiatry! I have been told by various newspapers and media groups that they are not interested in doing a story, unless someone came forward, preferably a family or perhaps a noted public figure, before they would even consider doing a ‘story’. Forget the truth & the many positive aspects of ADHD, they just prefer to give any negative that can be twisted to appear like the truth! Better still if these people are professionals! Many people are too scared to come forward because of the threat of public ridicule and bad reporting by the media, and this is such a shame as there are thousands of children who could benefit form a more positive self image.
Recently there have been stories on Depression in women being on the rise. If anything, this is an illness that is being misdiagnosed. Many of the women who called me were prescribed anti-depressants. Many were refused a referral by their Family Doctors for ADHD assessment (which is not covered for adults by Medicare if done by a psychologist), and when they were referred to a psychiatrist, they encountered someone who did not believe that ADHD even existed! Some of the women walked out of these unsympathetic offices worse than when they went in looking for answers.
This is the first stumbling block that many people face, especially women… their trusted practitioners & specialists who are supposedly “in the know”. Without their approval there can be no assessment by a psychiatrist. In Australia, an assessment may be made by a psychologist, but they are unable to prescribe medication. Only a psychiatrist (or paediatrician in the case of kids) is able to prescribe medication & do a full diagnosis even if they do rely partly on a report from a suitably qualified and knowledgeable psychologist.
Although the story on A Current Affair was about Mothers with ADHD, many people identified & the penny dropped: “that’s ME! It finally all makes sense why I am the way I am!” was the comment I heard from the people contacting me. Some were so excited they could not get the words out quick enough to explain the way they felt. Many felt plain relief at being finally able to open up to someone who could understand what they had been trying to tell doctors for years.
A few concerns came to light from these phone calls. The main one was the problem getting a referral to a psychiatrist from the family doctor. Women who called, who had children diagnosed with ADHD, had never been asked the question with regards to family history. Considering there is a very strong genetic link, I cannot understand why this had not come up. Family doctors, if there is a diagnosis by a specialist of a child, should be querying the parents, especially if there is a substance abuse or an addiction problem of some kind evident, or if a parent has been treated for depression. Better still, the paediatrician should be looking at the parents and referring them, if indications are there, to a psychiatrist that is knowledgeable in the ADHD area (many are not). When I was assessed, after demanding an assessment, I was asked all these things. My parents came in as well (they are in their 70's) and it became evident that ADHD was on both sides of my family.
Another problem has been the location of a support network or the fact that one of the family members does not believe in the diagnosis. They prefer to believe that it is a “cop out”. It is not uncommon for a family member to lose contact with the ADDult due to personality traits & misunderstandings. Many women have found themselves on their own when their partner has left. There is a high incidence of divorce amongst families where there is undiagnosed ADHD.
Let me explain what it is like to be a woman with ADHD symptoms….. We are not stupid, lazy, crazy, space heads, nerds & not worth knowing. We have difficulty in organising our minds when things appear boring. Our brain effectively bombards our minds with so many possibilities that it almost becomes impossible to choose! So where it has been thought that we are not paying attention, really what can be happening is that we are trying to process the information just heard. Unfortunately that means we could well miss pieces of the ensuing conversation, whilst this is going on, and it may appear we are not listening or ignoring what we are supposed to be hearing! Also in stress situations we can space out, or we can hear one word that can trigger a whole different mode of thought in our minds. Daily tasks become overwhelming, and if there is an impulse to do something, like a hobby or shopping for instance, we find it very difficult to not do the activity “calling to us” without treatment. There is an addictive side to our personality. This can come out as an obsession with a hobby that has a creative edge to it such as painting, writing, ceramics, cross stitch or website design to an addiction such as food, shopping, alcohol and drugs. It is all addiction of one form or another.
Women have many different issues to contend with in their life, especially if married & with children. Keeping the house clean is a major obstacle in many cases, organising lunches, school excursions, bill paying & cooking. Remembering birthday and Christmas cards, picking the kids up at school, after school activities…… well it can all get a bit much even when treated! Untreated this can become an absolute nightmare! By our very nature we are perfectionists, we expect to do our best and when we cannot, stress sets in.
If the children are gifted, as many ADDlets are in some area, and the same can be said of ADDults, the concerns become even more complicated. Teachers do not see the ADHD symptoms for the intelligence. These “Little Einsteins” are forgetful, untidy (or excessively tidy), argumentative, do not study as it all comes so easy & find everything is boring. They go on the computer and don’t come off, glued to the screen and being totally oblivious to all that is going on around them. A bomb could drop, and they would not notice it, so intent they are on the particular activity they are involved in. (how can a child be ADHD when they can concentrate so intently??) They make friends, but cannot keep the friendship going if untreated. Some gifted children with ADD can also have a learning disability such as dyslexia. Sometimes they are gifted or very advanced in all areas of the curriculum but still cannot organise themselves to hand their work in on time & they constantly lose things.
One of the behaviours exhibited by ADHD people is risk taking behaviour. The risk element may not necessarily be dangerous. It can be related to a business, an idea that they have and believe in that they pursue relentlessly (there is a fine line to be drawn between obsession and focus!) or travelling away to live in unfamiliar surroundings without family support (immigrating to another country). However, the risk taking can also lead to injury or death (extreme sports, drug taking, alcohol abuse, doing stupid dares to fit in with their peers or getting into a car hitch hiking when knowing the dangers).
Experts, the world over, agree that somewhere between 2 and 15% of the world’s population would be ADD/ ADHD. A conservative estimate is 5%. Taking into account Australia’s beginnings as a penal colony, our gold rush history and immigration policies of the years gone by, and our rate of youth suicide per capita ~ the second highest in the world~ our percentage could be significantly higher than this. In fact, a recent federal government document on the mental health of our youth (ages 6 to 17) in the school system indicates that the figure is an average of 11.2% Australia wide! Did they publicise these figures? NO! They did publicise the mental health issues figure of 15% though. It is cheaper to treat depression than ADHD.
Let’s get down to facts…… Australia has nearly 20 million people living in it. Take 5% of that and you have nearly 1 million people that could be ADHD. Let’s halve that because some of these people are only mildly affected. That leaves 500,000 people in our country, conservatively, with ADHD, diagnosed or undiagnosed & needing treatment. It is very expensive to be assessed in most cases, if you are an adult. The assessment by a psychologist is not covered by government subsidies although the psychiatrist’s appointments do have a rebate. Treatment & assessment would make a huge dent in the wages of most people. To me, this amounts to discrimination by the government.
The ones that are disadvantaged most are the low income earners, & those on government benefits. About 50,000 Australian children are now believed to be taking stimulant medication to help with their symptoms. How can ADHD be over-diagnosed when this only attributes to 10% of the total expected, conservative figures? One would presume that there would be less adults than children diagnosed, unless the adults had children. Besides, children are normally easier to pick up on their symptoms compared to adults, who in may cases have learnt coping mechanisms so that their symptoms are less obvious. Yet life is still difficult and they strain to cope with the multitude of stresses that being an adult can bring. Even moreso if there are children involved and ADHD ones at that!
What came to light, after the ACA story last year, was that many had sought treatment from their Family Doctors (and I had over 160 phone calls & e-mails until I stopped counting!) . Many had been put on anti-depressants and told that adults do not get this disorder! You mean that the ADHD fairy comes along at the age of 18 and says “you are now an adult, you do not have ADHD anymore …. Be gone! Cope! GROW UP!”? Sorry, but this does not make an ounce of sense...
Another thing that TOTALLY amazed me was that only two of the women with diagnosed children were asked what they were like as children, ending in a referral to a specialist for themselves. Many had to bring up the possibility of their ADHD with the doctors. The possibility that it came from an inherited element is extremely likely; 90 to 95% probable. How can a mother help her child with their problems, when the mother cannot handle her own? Compare this to flying in an aeroplane; the word from the captain is…. It is going to crash land! You have your toddler with you… what do you do? Put the oxygen mask on your child first or on yourself? You put it on yourself first, otherwise who will help the child when you are dead? The same applies to ADHD mothers (and let’s not forget fathers!). You need to be able to help yourself before you can help your child, otherwise your stress levels go out of control, the marriage is affected and you are yelling incessantly at the child who only rebels even more. You are in a no win situation.
Anti-depressants do not address the root cause of the depression, although they can help immensely in some cases. Unfortunately family doctor’s are, on the whole, not very astute at treating or even detecting this condition. I have spoken to grandmothers who finally twig that they may be ADHD like a couple of their grandkids, especially after their own child will exclaim to the grandchild “you are just like Grandma!” Why wasn’t the question of a possible ADHD diagnosis asked and explored, especially when the mother was obviously stressed to the point that she needed anti-depressants? Why wasn’t the question asked when, in extreme cases, the problem between mother and child has come to a stage where the parents give up their children to community services, as they cannot control their own moods let alone help their child?
Mind you, these “mother’s little helpers” called anti-depressants, only help stop the mother from stressing so much. It does not help with all the other things she has to cope with such as being disorganised at home, having her finances in a mess & no motivation. It just stops them from worrying about it as much. Take care of the problem (ADHD) and a lot of the time they do not need the anti-depressants. I have seen women emerge as a cleaning machine within 20 minutes of their first time on medication. It is like a fog has lifted, being able to “see” things that need doing for the first time, and being able to sort through the steps that you need to take to do the job.
Due to government constraints and policies, these people cannot get the treatment they deserve & need to have a productive life. Now this is what is so confusing to me……… How can a government recognise ADHD as a disability? In fact, some people are so severely affected by being ADHD that are on a disability pension. More often than not these are people who cannot afford the best treatment possible.......... specialist psychologists, counsellors and coaches, people who can help reframe the way they think, teach new living & social skills, helping them to gain confidence in themselves and their often innate abilities.
Yet still, if Methylphenidate is prescribed, it is not covered by the government subsidy whether you are on a pension or not. The government has made it so hard for people to afford treatment by medication, that many just give up. And trying to get treatment without medication, getting counselling, psychologists etc., well it is nigh on impossible for the average person, let alone someone on unemployment or a pension! The governments offer no solutions, only obstacles to people who just wish to be comfortable in their own skins.
There are two main stimulants that are prescribed in Australia. One is dexamphetamine (Dexadrine), which with a health care card is cheaper, and methylphenidate (Ritalin, Attenta brand names) which is not subsidised at all. Many people have no choice but to be prescribed Ritalin because of side effects with Dexamphetamine, yet they still have to pay the exorbitant prices charged for methylphenidate. If you have a family of ADDers, the cost is truly frightening. In the USA there is a huge range to choose from. (go to the www.add.org site for info) Hopefully, one day, the government in its wisdom will approve what is essentially the same drug in a different delivery system. (Methylphenidate in the USA comes in once a day form, great for teens and kids who have to face the stigma attached to having lunchtime medications)
I would like to add here, that in many cases medication, I believe, can be used as a learning tool, not as a crutch. How can a person learn an appropriate action if they have never experienced the normalcy of a lineal brain? In other words, if you constantly are thinking outside the square in all manner of things, how can you think “straight”? Medication allows people to know how it FEELS to think in an organised fashion. From this we learn how to react in different ways, recalling the experience. Like an Olympic athlete, we have to train our brains & this often takes years of work. Sometimes we just have to forgive ourselves for our little failures (like housework…….. I still cannot get my head around it unless I have someone doing it with me!). However, there are certain individuals whose hyperactivity is so great they find it hard to function in "regular" society without medication. Everyone has different needs.
Many ADDers have severe allergies as well that need medication…. Asthma, eczema, sinusitis, food allergies such as lactose intolerance etc. Often they have bowel problems such as diverticulitis, lower back problems, ulcers & migraines. Treat the ADHD and often some symptoms, especially stress related ones, cease to exist. Australia, compared to the United States, is extremely limited with medication treatment and it will be a long time before we actually see an improvement in the situation. In the meantime, we will just muddle along, hoping that we have said the right thing, haven’t forgotten to pick up the kids at school, remember to take out the night’s dinner from the freezer & to stock up the toilet paper……… Life goes on!
With a little understanding from the general public, education of family doctors and teachers, correct media reports (especially by academics without a limited viewpoint), increased government involvement and acceptance for our “quirks” by the people who we come into contact with, then maybe we can just ‘be’, enjoy our ‘selves’ & have happy, stimulating & productive lives – something everyone has a right to.
I underwent assessment in June and July of 2000. I knew that there was a problem & had actually booked in for assessment 4 years prior to be assessed, but the cost was so great that I could not afford the testing. This is required for a correct diagnosis; you have to know where your problems are, your weak areas, so that you can have a plan for yourself. Being the true ADDer that I am, I procrastinated until I could not cope with the way my life was heading any further. Perhaps if I had taken up my parent’s offer to pay for the assessment, I would have been better off, maybe not. All I know is that my kids would have been happier, my husband would have had less to deal with because of my lack of household organisational skills, and yes, I would have been happier.
You can't think like an ADDer anymore than an ADDer could think like you. Their brains work in a totally different way to the norm. In fact it is strong ADD traits that have been found in world leaders (Sir Winston Churchill, the Kennedys) and some of the world’s biggest, scientific brains (Edison, Einstein, Marie Curie). Musical geniuses (Mozart), war hero’s, leading entrepreneurs (Richard Branson) and of course some of the funniest people to grace our planet (Robin Williams, Billy Connelly, Whoopi Goldberg, Cher) have either been diagnosed, or have presented, with Attention Deficit Disorder traits! It is amazing how many of our favourite TV programme’s are based on ADHD type characters such as The Simpsons, The Osbournes (Ozzy, Kate and Jack are all diagnosed), Malcolm in the Middle, Friends (Joey and Phoebe…), Just Shoot Me and the cartoon Pepper Ann, to name a few.
I had the opportunity to meet with Professor Richard Silberstein from the Brain Sciences Institute at Swinbourne Institute of Technology, I viewed scans of an ADHD brain and listened to this passionate man explain his views on the matter. In essence he said that ADHD is a difference, a type of brain that has a purpose. This is supported by his good friend Thom Hartmann, (author of ADD A Different Perception and my mentor), who has a theory that ADHD people had the traits necessary in a Hunter’s society…… easily distracted, live in the moment, lateral thinking, short attention span, risk taker. In fact without these traits Hunters could easily have been killed! It is a difference, just like there are different coloured eyes, hair and skin, there are different ‘coloured’ brains!
No, I don’t find
being ADHD negative, not at all. The only negative thing I can see
are misinformed people and those with no compassion. The sooner
people can see that ADHD is an ADDition and not a CONdition, the
happier, healthier and a more accepting our children will grow to be.
I am in good company and with all the little quirks….. I like me just
the way I am!
http://www.mindspace.bravepages.com/misdiagnosis.htm
countrygirl, are you related to davieboy?? 
he whinges about the same thing too!!!!
pilgrim... danke
Yeah, SSRIs for depression does help me with some of the memory problems ,but I still
feel like I'm moving through a fog bank with no end in sight.