Top Ten Stupid Comments from ADD-Docs


The Top Ten Stupid Comments
from
[supposed]  ADD Professionals
by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC

Ten Unfortunate [and recent]  Examples of Ignorance masquerading as Information — and
uninformed personal opinion presented as medical FACT.

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The comments on this article add information — take the time to read those too. You’ll be glad you did!
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First Things First:
Let’s not lump the good ADD doctors and the ones who made these stupid comments together!

They are not the same species AT ALL!

There ARE Many Good ADD-Practitioners:

  • Those who keep up with the latest information, are aware of the studies shortly after they are published, read the journals, participate in practitioner-support lists, and more (and, by the way, most don’t receive a penny for the time it takes for them to stay current!)
  • The ones who attend and speak at CH.A.D.D. meetings or ADD conferences, taking the time to meet more of the population they serve (to hear first-hand anecdotal report of the ADD experience) – again, not activities that help them feed their families or pay their bills
  • Doctors and therapists who host or speak at local support group meetings – mostly pro-bono
  • Others who develop podcasts or write books to educate ADDers and add to the ADD/EFD knowledge-base of all ADD Professionals – and BELIEVE me, nobody gets royalty rich from those books!**

Those good ADD/EFD Doctors would not only be as appalled as I by the comments below, they will most likely find it difficult to believe that ANY doctor would think, much less say, many of them.

Unfortunately, far too many of you out there in ADD/EFD-land know differently.

FAR too many of you have been unable to locate a doctor willing to diagnose or medicate what you are pretty darn sure is ADD or EFD – and you have heard one or more of these very comments out of their reluctant, misinformed or down-right IGNORANT mouths.

Our BIGGEST problem is NOT that there are no good doctors to be found, it is that most of the great ADD/EFD Docs** are beyond BUSY!  

  • Some of them are not taking new patients at all
  • Many now work ONLY by referral from a colleague, and
  • Many have l-o-n-g waiting lists for that important first appointment.

So many, many, MANY ADDers have a really tough time finding a good doctor**, including those among us who have been diagnosed for years who must change care-providers for one reason or another.

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**
If you are fortunate enough to be working with one of those ADD-Professional angels-on-earth who is working in “relative” obscurity, PLEASE click on over to Occupy ADD and tell us who they are.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The good ADD Docs have no idea how uninformed some of their colleagues really ARE..

So rather than leaving it to anyone’s imagination, I’m going to list TEN comments that doctors who (supposedly) understand how to work with ADD have said to patients who paid them good money, praying for help.

BY THE WAY – the sources of these comments include:

  • Internet posts of disheartened ADDers looking for help in ADD communities
  • Comments reported to me by clients (in tears of frustration and overwhelm)
  • Comments reported to my students by their clients
  • Comments said TO me or around me – including one said to me by a prescribing mental health nurse practitioner, said directly to her by her “supervising MD”

(Feel free to add your own examples and experience in the comments section – the extent of the ignorance is FAR greater than 10 Stupid Statements!)

ONE LAST THING:

You’ll have to pardon me if my responses to these ten stupid comments seem unnecessarily snide. I normally pride myself on my lack of judgment, overall, and my ability to erase any remnants from written communication.

HOWEVER, after several decades of non-stop ADD advocacy, given a life that will NEVER be the huge success and happy experience it might have been had I been diagnosed and medicated correctly at eight instead of thirty-eight, I have NO tolerance for ANY so-called professional whose lack of knowledge about a field in which he or she practices is likely to extend my circumstances to a new generation.

NOW, on to those Ten Stupid Comments . . .

This article is link-dense – dark charcoal so they don’t distract you —  they’ll turn red on mouse-over.

1.  It can’t be ADD — you’ve “aged out” of an ADD diagnosis.

I find it incredible that there is ANY mental health provider who hasn’t heard the “latest” —
ADD does NOT automatically disappear at puberty.

  • Don’t take MY word for it – Google ADD Books: adults and read the titles.
  • If that’s too much to ask, COUNT the titles.
  • Hey, how about just counting the number of PAGES that return results
  • For extra credit, check out publication dates!!  This is not NEW news!

A Comprehensive Guide to Attention Deficit Disorder in Adults, editor, Kathleen Nadeau (contributions by Quinn, Brown, Hallowell, Tzelepis, Wilens, Murphy – and a TON more, each of whom have publications of their own) was published in 1995 – going on 20 years ago as of June 2014!!

STILL worth buying and reading, by the way.  I refer to it ALL the time.

That “goes away at puberty” myth is a long-since discounted artifact of the placement of ADD in the childhood section of the DSM-II (that’s version TWO, published in 1968 – when child psychology was attempting to clearly differentiate itself from adult psychology).

The entire field developed amnesia for *over* 20 years, despite the back-door credibility lent by the 1990 Zametkin research that used adults for a PET study (positron emission tomography, a type of functional brain scan).

Because the low level of radiation exposure necessitated by PET technology was deemed too dangerous for children, they used ADDults (you know, those adults with ADD “who didn’t exist”) – for a published STUDY how many years ago now?

2. You can’t have ADD — you graduated from college.

Say what?!  Tell that to Drs. Ned Hallowell and John Ratey!!
And if THOSE names don’t spark an immediate aha!   be afraid, be VERY afraid .

3. You can’t have ADD — your job history is far too stable.

See response to Stupid Comment #2!!!

4.  I don’t believe in prescribing psychostims for ADD.

Where is this guy from, the Middle Ages?
Psychostims are first-line medications for ADD.

What does he think we want – to keep ADD alive with some demonstration of belief?
ADD’s not Tinkerbell!

You aren’t allowed to “not believe” in psychostims for ADD!
(At least, you aren’t allowed to call yourself a qualified ADD-doc if you “don’t believe.”)

Related post: Tinkerbell Comments – scorn and disbelief

This one’s from PERSONAL experience, by the way; except for the fact that it would get a friend in professional hot water, I’d put this idiot’s name and number in bold, right here for all to see and pester.

5.  Your former doctor has addicted you to speed.

Not too many years ago, I had to go to bat for a client who showed up at my house, just down the street from a particular clinic, sobbing!  Diagnosed and medicated for several years already, her clinic doctor – who had never seen her before – told her she was addicted to stims, that he was going to begin weaning her immediately, and that she would be given a prescription for only HALF of her medication.

You better believe I called that clinic in a (barely contained) RAGE – oh so sweetly alluding to a VERY public malpractice suit targeting the clinic as well as the doctor.

It turned out this doc was a “temp.”  They agreed they needed to speak to him and that it was a good idea never to use him again. They also agreed they needed to vet their “temps” more closely, and to tell the agency the reason they did not want to see this guy ever again.

Since my client was invited to return to pick up a new prescription so that she could remain medicated and functional for an ENTIRE month, I let the matter drop with the assurance of [relative] confidentiality.

(BE SURE TO READ the comment from Cindy ,
the client in the example above, for an addendum to the story. (quick-link HERE).

6.  We need to rule out a few other things first – we’ll start with anti-anxiety medication, then move to anti-depressants if those don’t work.

The current thinking – for OVER TWENTY YEARS now, boys and girls – is that
PSYCHO-STIMULANTS are the first-line medications for ADDults!! 

The approach described in Stupid Comment #6, is bogus for a number of reasons, only a few below:

  • Diagnosis through response to medication is not reliable, not in alignment with AMA diagnostic protocols, and professionally irresponsible.
  • MANY ADDers have co-existing conditions (a clear majority, according to the studies),
    so the presence of one does not “rule out” others.
  • There DOES NOT EXIST a universal “hierarchy of diagnoses” (with ADD at the end of the line!) In fact, there are a considerable number of documented cases of ADD and depression where the depression did not respond UNTIL the ADD was successfully treated – with stims!
  • This was the thinking decades ago, when – oh-so-slowly recovering from field-amnesia concerning the existence of ADD in adults – some bizarre brand of faulty logic left many doctors reluctant to try adults on successful childhood protocols.

For those who missed the memo:

Among the ADD cognoscenti, belief in the efficacy of that “tiered”
procedure died a well-deserved death in the late 80’s/early 90’s.

There are still a few doctors who are prescribing one of the anti-depressants first and adding stimulants later, “if necessary.”  There are [only] a FEW good reasons why an ADD-knowledgeable doctor might go this way with YOU.  Many, however, are basing their protocols on ancient information.

You need to up your own ADD-education for context, then your doctor needs to explain the rationale behind his or her treatment approach so that it makes sense to you (and you need to ask for a referral to a different doctor if it doesn’t!)

7.  Ritalin is safer than Dexedrine.

Safer for the doctor, maybe, because even the least educated agent of the Drug Enforcement Administration [DEA] is more familiar with the Ritalin/ADD connection and less likely to cast a suspicious eye on doctors who prescribe it – but if a doctor ever says something like this to you, RUN!  

This comment lets you know that this doc suffers under an egregious misunderstanding of BASIC neuropsychopharmacology that ANY half-decent mental health pro should darn well recall and understand.

Dexedrine (ADDerall, Vyvanse, etc.) and Methelphenidate (the generic name of the substance from which Ritalin, Concerta – and others – are formulated) are BOTH psychostims: first-line medications for ADD.

  • Neither medication is, ipso-facto, safer — or more dangerous — than the other.
  • Neither base substance is more or less “risky” in terms of side effects, addiction, abuse potential, or habituation.
  • THEY ARE THE SAME MEDS CLASS.

8.  Strattera is safer than Ritalin. 

This tells you that your doc doesn’t take the time to think things through logically, or that his communication is faulty.

While it is true that Strattera (atomoxetine) is not a psychostim (and less likely to get anybody high), since when is ANY brand-new and relatively untested medication ever SAFER than one that has been in use and studied extensively for a half-century?

And don’t let ’em feed you the line about abuse potential, yada yada.  Since Vyvanse, (Lisdexamfetamine) there is an alternative within the Stims class that covers that argument nicely.

If you’re going to try a new medication, why not start with one that is – just in case anybody missed it the first three times – one of the first-line medications for ADD? 

9.  You tell me your mood fluctuates repeatedly – that’s bi-polar, not ADD

The presence of emotional lability – a.k.a. Mood Swings – is common among ADDers.

They can’t depend on drug reps for their education – diagnosis by “flavor of the moment” is neither advisable, admirable, or professional.  They need to DO THEIR RESEARCH, hire a comprehensively trained ADD coach to bring them up-to-date, or get out of the field.

I saved the WORST for last!!

10.  If you miss your appointment, you must pay for it and make another to get your medication.

WHAT part of ADD don’t these bozos GET?  

  • The part about flaky prospective memory?
  • The part about ADD and financial struggles?
  • The part about how IMPORTANT medication is to reliable Executive Functioning that facilitates FOLLOW-THROUGH.

What in the world are they thinking?

That policy makes NO sense from any perspective. Holding medication ransom to non-ADD behavior from a non-medicated ADDer is not only unnecessarily (and unprofessionally) PUNITIVE, it makes it less likely they’ll get paid, not more!!

Duh!

GOOD ADD-docs set up reminder calls so that their ADDers make it to their meds appointments – they don’t wait to make their life a living hell after they miss one.  The BEST ones call the day before and the morning OF your appointment!!

(Please read my response to comment from Piano teacher
for a clear expansion of the logic)
[link to below]

Many good ADD docs DO charge for missed appointments if you don’t follow up the reminder call with a cancellation, but they understand without explanation that making you wait (unmedicated!) AND come up with double the money to earn the privilege of their autograph on a script so you can function IS NOT OK!!

(Seriously, if this were heart medication, people could DIE — lawsuits and lost licenses aren’t the worst of it!).

If your doctor claims to treat ADD and hasn’t set up ADD-friendly office procedures, start looking for a KNOWLEDGEABLE ADD-literate doctor immediately!  If they really understood the first thing about ADD, they would also understand its implications and wouldn’t pull stunts like this!

It takes a village to transform a world

It is LONG-past time for nonsense like this to STOP.  And what YOU do matters.

Do NOT get into a argument with self-proclaimed “ADD docs” who make the above pronouncements. Don’t mount a defense.  The unprofessional assign little value to information outside their ego-based paradigms.

If you are up for becoming a force for change, print this out and take or send it to the person who made one of the stupid comments above. Request that he or she read it, then file it with the rest of your medical records, giving you a copy of your ENTIRE file to hand-deliver to a more knowledgeable doctor.

(In case they claim not to know this either, in the US, at least, you are legally entitled to a copy of your medical records — they are breaking the law if they don’t say yes to your request.)

You must be prepared to wait for it until somebody has time to do the copying, by the way. Don’t back down if they promise to send it by mail. They won’t – and YOU won’t be able to jump through the hoops necessary to make it happen at that point.  They know that much about ADD, and so do you. Wait for it.

As soon as you have your file, skedaddle!

Maybe you’ll have made things better for the NEXT guy, but don’t YOU stay with this doctor!!

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About Madelyn Griffith-Haynie, MCC, SCAC
Award-winning ADD Coach Training Field founder; ADD Coaching field co-founder; [life] Coaching pioneer -- Neurodiversity Advocate, Coach, Mentor & Poster Girl -- Multi-Certified -- 25 years working with EFD [Executive Functioning disorders] and struggles in hundreds of people from all walks of life. I developed and delivered the world's first ADD-specific coach training curriculum: multi-year, brain-based, and ICF Certification tracked. In addition to my expertise in ADD/EF Systems Development Coaching, I am known for training and mentoring globally well-informed ADD Coach LEADERS with the vision to innovate, many of the most visible, knowledgeable and successful ADD Coaches in the field today (several of whom now deliver highly visible ADD coach trainings themselves). For almost a decade, I personally sponsored and facilitated seven monthly, virtual and global, no-charge support and information groups The ADD Hours™ - including The ADD Expert Speakers Series, hosting well-known ADD Professionals who were generous with their information and expertise, joining me in my belief that "It takes a village to educate a world." I am committed to being a thorn in the side of ADD-ignorance in service of changing the way neurodiversity is thought about and treated - seeing "a world that works for everyone" in my lifetime. Get in touch when you're ready to have a life that works BECAUSE of who you are, building on strengths to step off that frustrating treadmill "when 'wanting to' just doesn't get it DONE!"

37 Responses to Top Ten Stupid Comments from ADD-Docs

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  9. Suzette says:

    My shrink told me that she was so glad she wasn’t me! As in, single mom, facing surgery, possible malignant tumour, numerous advanced tests required…….AND depression and ADHD…..she is SO GLAD she isn’t me. That kind of therapy really really helps……NOT!

    Liked by 1 person

    • I’m sure she meant to be empathetic, but WOW – there are so many other things she could have said that wouldn’t have drafted hope in its wake. I’m so sorry you had to hear that.

      My life is similar to yours – tons of challenges that keep “tossing my salad,” making it hard to run my life.

      I’m here to tell you that, struggle notwithstanding, there is ALWAYS hope. With every tiny step you are able to take, life gets better.

      Thanks so much for ringing in. Hope you’ll be back.
      xx,
      mgh

      Like

  10. Cindy says:

    I’m the girl in story #5. Not only did this happen, it gets WAY better.

    Resident MD returned, took me back off my meds and gave me Zoloft. Zoloft gives me tics so I refused to take it anymore after 4 days. FINALLY he goes on vacation and the visiting MD “gladly” put me back on Adderall.

    So by the time MD returns from vacation I’ve been doing well on Adderall for 2 months.

    Story gets better!—– Over the next year, I began taking him copies of the things MGH had been teaching us. One was Dr. Paul Elliott’s article she reprinted in our book titled “How I medicate ADD” – (which was funny bc it wasn’t the way “he” had been treating ADD – lol) It got to where I was teaching “him” about ADD during our monthly visits.

    And the GRAND Finale!!— One day I arrive for my appointment, He comes in and says….
    “I have a new nurse, I have told her all about you and want her to meet you, YOU ARE VERY KNOWLEDGEABLE (in a very thick Indian accent)

    It had become apparent over that year, “I” was the ADD professional in the room and someone he considered not only an equal but his “go to’ source for REAL information.

    There IS NO other (ADD) coach training but MGH, there are impostors, and the things they teach that “are” accurate? (yes, I’m about to say it) are teachings from MGH that have been repackaged, reprinted without permission or credit, or just plain plagiarized.

    i had no idea HOW MUCH I knew till I got out there with other “pro’s”, and WOW, do I have one hell of an education!

    Liked by 1 person

  11. acer says:

    I like the valuable info you provide in your articles. I will bookmark your weblog and check again here regularly.
    I’m quite certain I’ll learn lots of nnew stuff rght here!

    Best of luck for thhe next!

    url: bleacherreport.com/users/3099336-jennifer-powell

    Like

  12. janesherwin says:

    It never ceases to amaze me that how out of sync and dumb various professionals can be in their own field of expertise. In any other job you would be swiftly shown the door for not keeping up to date with current and relevant information that is paramount for you to be able to adequately do your job.

    Professional pride is a dangerous thing it when affects the mental health of others because you refuse to accept that you should never stop learning!!!

    Liked by 1 person

    • be right back. Sorry – lose posts if I don’t do it this way
      ——————–
      I think “learned arrogance” begins in Med School (ditto in many MBA curricula – not limited to the medical profession)

      You are SO right about how much more dangerous it is when it affects the health and well-being of those they have signed on to HELP.

      Their hands are frequently tied, however — at least in the US – by the Insurance Industry, and the over-focus on money at the expense of health. Short-sighted, but I have nothing to offer to change much about the “as-long-as-I-get-MINE” paradigm that seems to be taking over many in our world today (other than my censure, of course, and we know how well THAT is likely to work!)

      ANYWAY, I don’t know how we can expect ANY doctor to do a decent job in a 15-20 minute appointment (becoming standard in the US)!

      That’s why I encourage “shopping with a list” – going into ALL appts. with a written list of concerns and questions, pencil poised to check things off and write things down. Keeps you focused and moving on through. (it also let’s the pro know, non-verbally and without defensiveness, that you have an AGENDA for the appt. & don’t intend to leave until you handle it!)

      [see comment by – and my response to – JEG700 below – her blog is pretty darned cool too]

      HOWEVER, even in my own life, I sometimes get too busy to MAKE that list – or so distracted I don’t get it into my purse, so arrive without it to my OWN appts. Whad’ya gonna’ do?

      LOVE reading your comments, btw. Thanks so much for spending some of the minutes of YOUR life to leave them here.

      xx,
      mgh

      Like

      • janesherwin says:

        you are more than welcome. In the uk we also advise arriving at appointments with lists and timelines of our children’s difficulties etc but we still get ignored. Lists are often shoved in folders and so on. We will hopefully get there eventually with the correct wave of awareness, information and support, which is exactly what your blog is giving xxx

        ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        READERS:
        Jane’s daughter Mollie has a little-known variant on the autistic spectrum, PDA – Pathological Demand Avoidance, and Jane is one of the leading PDA advocates. Click her name (in this comment above) to jump over to her excellent blog to read about it. ~ mgh

        Like

        • Shoot – I struggle to maintain my OWN sleep-log, for heaven’s sakes – and no one is more aware of how important it is to document.

          What the NTs don’t GET is how very much time in every day is spent compensating – while *they* get to move directly into their tasks & to-dos. Important or not, stuff gets dropped out for lack of time and focus.

          It could be worse, I suppose — but it could also be MUCH better. Half a glass is better than none?

          RE: docs shoving lists into folders – item #1 on each appt list needs to be – “Did you have time to read that article you shoved into my file last time?”

          Then, “That’s ok, when I get through today’s list I’ll give you a verbal – get it out so I can have it in front of me” (and can’t you just HEAR the shudder at the other end?)

          ————–
          Side note: a good friend of mine had a college roommate struggling with something about which little was known at the time [Lupus].

          When the friend came across an article in Newsweek (or one of the popular press sort-of scientific offerings), she ran out of the dorm, jumped into her car, magazine in hand, PUSHED past the receptionist and into the room where the doc was with another patient, saying (with not just a little anger in her not just a little bit raised voice) —

          “How come I am only NOW finding out about this by reading a MAGAZINE available on any newstand?! – I PAY you to keep on top of advances with lupus. This is my LIFE we’re talking about here.”

          Now THAT’s advocacy!!

          xx,
          mgh

          Like

  13. Lea C says:

    As a self employed private piano teacher, I tell you that you need to be responsible for making it to your appointments. You need to work out a system at home for this; it’s no one elses job, unless you want to hire an assistant. I’m sure everything else is quite true, though.

    Like

    • RE: RESPONSIBILITY for appointments
      =================
      Absolutely, Lea – eventually, and primarily – it’s one of the biggest “shoulds” of our society, and few people readily forgive missed appointments, so we MUST work on ways to get to them reliably.

      My point is that any TREATMENT “professional” who expects ADDers to hit the ground running with that particular set of skills, or to never, ever, have a month where their systems go belly-up – and any TREATMENT “professional” who expects to hold ADD Meds “ransom” to meds appts. without a reminder system (EVEN with an [unlikely] regular and recurring monthly appointment time per patient) REALLY doesn’t “get” ADD — and needs to find another speciality or upgrade his or her skill-set!!

      With Executive Functioning Dysregulations, oopses happen. It’s simply part of the profile with an ADD diagnosis, even with someone who knows what and how (and has for decades – like me). To penalize a patient for having trouble with the implications of the very diagnosis for which they are PAYING you for help is unconscionable – I will always call someone out on it!

      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      We would all be appalled to hear of a doctor whose specialty was rehab for leg amputees, for example, who expected his patients to be able to walk up several flights of stairs for monthly fittings, rehab, etc., paying for the session anyway if they couldn’t make it – ever, even after prothestics were in place.

      While the goal is to stretch the boundaries of competency, continued care cannot and MUST not be predicated upon being ABLE to “make it up those stairs.”

      Assistive technology is assistive technology – whether it is a wheelchair ramp, a wheelchair accessible elevator or an appointment reminder system. They “level the playing field,” and make it POSSIBLE for those being “assisted” to show up powerfully.
      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

      To be clear, and this is important, I’m NOT saying that a self employed piano teacher must have a reminder system in place – UNLESS your specialty is piano lessons as part of the treatment protocol for ADDers, you see them once a month (tops), you scheduled each next “non-regular” appointment wherever it fits into both of your calendars — at the end of the current one (as do most doctors), *and* these appointments were HOW the ADDer got the medication s/he needed for improved Executive Functioning.

      Thanks for stopping by and for taking the time to comment, Lea.

      xx,
      mgh

      Like

  14. Great post Madelyn,

    Glen Hogard sent me your way and told me that I would appreciate you! I would love to be able to share this on my web site..would that be ok? (properly referenced and highlighted of course!) Smiles, Susan

    Like

    • I’d LOVE it – the more people who see this, the better! Thanks for asking – and for stopping by and leaving a comment.
      xx,
      mgh
      ————-
      ANYONE ELSE:
      Please DO share – but remember to come back and leave a link to your post. I’m happy to help you up the readership on your blogs, but I don’t have the time to troll the ‘net looking for your content!

      Like

  15. Jane Kramer says:

    Madelyn, you make many interesting observations. Today, I had a coaching client who works in the health care field. She said she was fearful of going to a doctor to get a diagnosis of ADHD because of her perception of the poor quality of care she may receive. Clearly, patients/clients must be questioning their care until they find the right solutions for them.

    Like

    • Unfortunately, Jane, it’s all too true. And I wish that I could join you in the hopefulness of “until” they find the right solutions. Many people (like your client) not only receive poor LOUSY care, they are made to feel like “drug-seeking addicts” when they attempt to explore the possibility of medication, and that stops many ADDers COLD.

      Whad’ya think ADD-illiterates – that kind of nonsense STAYS between you and your patient?

      OF COURSE it gets around!! So the damage YOU cause through YOUR negligence (and that IS clearly what it is!) increases substantially with every report of a lousy experience with a supposed ADD “professional.”

      It makes my blood boil!

      Heaven help them if they have EVER explored any form of self-medication, because ignorance combines with a fear of a DEA audit to corroborate that “drug seeking” accusation in the mind of the ADD clue-free IGNORANT.

      That’s a tricky situation, since one’s health (and safety) rely on honest self-disclosure with your care provider.

      So – what’s you choice? Tell the truth and continue to suffer unmedicated, or keep it to yourself and worry about your medical safety? Neither is an effective approach – especially for a dx (do I have to say “ADD?”) where a propensity for rumination is practically a given. The very idea that there would be ARE doctors whose behavior puts a client looking for HELP at risk makes me want to picket a few offices!

      Like

  16. I will refine your comment a little more:
    I reserve my deepest scorn for ADD clue-free practitioners who SAY they dx and treat ADD, then cop the “don’t have time to stay informed” plea. Don’t hang out the sign if you don’t want to do the work involved to do a decent job with your “speciality.”

    This rewording is closer to what I feel.
    I reserve my deepest scorn for any health practitioners who even imagines that the “don’t have time to stay informed” plea is anything but negligent.
    Don’t hang out the sign if you don’t want to do the work involved to do a decent job with your “speciality.”

    From my point of view ADHD is a common and highly co-morbid condition. No health practitioner should be unaware of it. [mgh comment: this from a DOCTOR!]

    I bet that after intolerable side effects, and genuine concerns about long term safety ( such as with cholesterol lowering drugs) ADHD forgetfulness is one of the commonest reasons for non compliance with treatment in in any condition.

    Liked by 1 person

  17. Great work Madelyn.

    I am highly tempted to post a copy of this to a few stone age doctors I know.

    I just love this comment:
    I reserve my deepest scorn for ADD clue-free practitioners who SAY they dx and treat ADD, then cop the “don’t have time to stay informed” plea. Don’t hang out the sign if you don’t want to do the work involved to do a decent job with your “speciality.”

    I am very glad I am fighting on your side and not against!

    Liked by 1 person

  18. jeg700 says:

    My doctor once told me that “he didn’t have time to read up on all the reports about ADD”.

    When I challenged that statement he qualified it by saying “he only had so many hours in a day and had more important, life threatening diseases to read up on”, with no time for “unproven, controversial” conditions such as ADHD, Crohns Disease, + others that I forget what they are called right now”.

    No, I did not leave his office and find a new doctor (none to be had in this city) but I did come home, researched ADD/ADHD, found medical journal reports and wrote down the links, made another appointment with him and presented him with the info.

    I do it all the time, challenge authority, including doctors, and this doc I’ve been seeing for many years. He did get me tested, accepted the resulting diagnoses and prescribed the meds (Concerta first, then Dexedrine).
    [mgh comment (more below too): excellent response to your info – and NOW s/he won’t make the same mistake with anyone else – “good on you!”

    That day, I took up 45 minutes of his time, making him late for the rest of his day (patients are scheduled 5-10 minute appointments, tops. I wasn’t leaving til he co-operated with an open mind to the possibility, he knew I wasn’t going to let it go until he proved me wrong and it was just plain quicker for him to “give in”.

    This tactic is not feasible for most people, but it is advisable to challenge any doctor that dismisses your concerns as nothing!

    After all, they are only people that went to university…this does not make them geniuses nor does it make them always right. Also, some people graduate at the top of their class, and some at the bottom of their class, with most in the mediocre middle. You, as a patient, have no way of knowing what kind of student your doctor was, nor do you have any way of knowing much of anything about a new doctor that you’ve just met.

    Bottom line…do your homework, bring references they can refer to later and NEVER just accept that they are right just because they are doctors!
    ——————-
    mgh edited: I did not change ANY of the words, I simply added “white space” and a few “bolds” and “italics” to make it easier to read for those of you who struggle to stay tracked. This comment is too important to miss! (more response by me below)

    Like

    • Many thanks Madelyn! We are so much on the same page: village-shaping with fresh info. – and jeg700, well done! Persistence makes a difference, and only an informed unhappy public will change the medical ineptitude. The politics are against rethinking the Paleolithic labeling process.

      And Madelyn – please send me a note thru my services page at CorePsych Blog so that I can ask you an offline question… tnx,
      cp

      Liked by 1 person

    • @jeg700 – OMG! No time, even, to read enough to recall names, huh? “Life threatening” means “it could kill you dead and I could lose my practice in a lawsuit” I guess? No time for those nattering little diseases and disorders that “simply” impair the QUALITY of life, of course.

      Your post is especially upsetting because it means that – even worse than “education by drug rep” – our doctors are updating their medical information base through television and radio reporting — the sound-bite press — which is STILL, being generous, 85-90% biased, misleading or downright inaccurate where ADD is concerned.

      GOOD FOR YOU for keeping on. It’s IS hard to challenge authority, but I second your point about the depth of their education. I remind my students that: “50% of ALL doctors graduated at the bottom of their class!”

      Not that there aren’t good docs who weren’t in the top 10%, but I want to remind all, underscoring the greater point: it’s not much of a stretch that YOUR doctor missed as much as he retained where (as above-referenced doc called them) those “esoteric/controversial diagnoses” are concerned.

      IMPORTANT: If anyone else has to take research to a doctor (and that’s not SO out of line – especially with GP’s – as long as they appreciate the favor and actually READ the stuff), print out the consensus statement “garaged” on Dr. Barkley’s website (Link HERE in this article and on the right menubar of every page of this site). It includes 14 double-columned small print PAGES of citations and references – and names & office contacts of 75 ADD Experts.

      Even if he never READs it, it’s hard for a self-professed uninformed doctor to go up against the expert opinion of 75 of his colleagues who have spent their entire careers in the ADD field.

      Like

  19. wolfshades says:

    Hi Madelyn, and thank you for linking to my blog. Having recently gone through the diagnosis journey (about a year ago), I’ve already run into a few of the items you’ve listed above. Number 9 was new to me – and reading it brought a measure of relief, because that symptom has long been in my repertoire and I was a little worried about it. Nice to know I’m in good company.

    Number 6 – “let’s rule a few other things out first” – starts from a good premise, but then meanders down a fairly dangerous route, I think. Ruling other conditions out is part and parcel of the medical diagnosis for ADHD, but I believe doctors who’ve done their research won’t feel the need to put their patients through “guinea pig” testing of other meds. Instead they’ll rely on evaluations and taking a good long look at the patient’s history – at least that’s what happened with me.

    Unfortunately, in this “instant gratification” world, some doctors are just as guilty as patients for wanting a quick diagnosis. The patient wants fast relief, and the doctor just wants the patient out of the office. Thankfully, most doctors that I know aren’t like that, though they are harried sometimes. In my case, my family physician admitted to me that she didn’t know enough about ADHD to give me much guidance, so encouraged me to find a doctor who did.

    By the way – nice website. Think I’ll stick around for a while and check out the different links. Cheers!

    Liked by 1 person

    • You’re most welcome, wolfshades – and thanks for posting content I can link TO.

      Thanks also for visiting and taking the time to add a comment (especially since you LIKE the blog 🙂 )

      I AGREE totally with “ruling out” – that defines “differential diagnosis” – it’s the METHOD I object to.

      Meds response proves little and rules out less – nothing, really, where an ADD dx is concerned. Since a significant majority of us have co-existing and comorbid conditions, we’d have to eliminate ADD from the DSM if we “ruled out” on the basis of additional problems. They CO-EXIST, not coopt!

      In my 20+ years in the field, I have seen ADD & Aspergers, ADD & ODD, ADD & OCD, ADD & GAD, ADD & Depression (along with “merely” depressed ADDers), ADD *and* Bi-Polar – AND more – some “officially” diagnosed, some MISdiagnosed, and many UNdiagnosed.

      I have great respect for doctors who, when they don’t know, admit they don’t know. Nobody can know everything about EVERYthing – even the brilliant ones who practice at the top of their respective fields specialize vertically. And even those guys miss the mark sometimes. (The difference is that they correct the info and refocus their lenses the MOMENT they become aware of the need to do so – they don’t dig in and defend!)

      I reserve my deepest scorn for ADD clue-free practitioners who SAY they dx and treat ADD, then cop the “don’t have time to stay informed” plea. Don’t hang out the sign if you don’t want to do the work involved to do a decent job with your “speciality.”

      Like

  20. Madelyn,
    Thanks so much for including my audio with Jeff Copper over here! – And what a great job of codifying the stupid questions we hear in the office everyday. The entire picture changes when any of us, coaches, clients, or docs get more completely, more comprehensively into the available science. Too many are simply not paying attention to the meds for paying attention!
    cp
    ADHD Medication Rules

    Liked by 1 person

    • But of course! “It takes a village to transform a world!”

      For anyone who hasn’t visited corepsych.com, “cp” is one of the doctors who not only stays on top of the field, he calls out the docs who don’t! If you aren’t familiar with some of the additional brain-based, science-based information that really GOOD ADD-docs take into consideration, you’ll be fascinated by the “ADHD Medication Rules.” Check him out – TONS of great info on his site.

      Like

  21. Ken May says:

    Great Post. Thank you.

    Like

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