The OCD-ADHD Link: What You Should Know When You Have Both (with Roberto Olivardia, Ph.D.)
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- Опубликовано: 30 янв 2022
- OCD and ADHD are distinct but also comorbid disorders that can share similar symptoms, behaviors, and outcomes - for opposing reasons. This overlap can complicate diagnosis and treatment for patients with both conditions. In this hour-long ADDitude webinar with Roberto Olivardia, Ph.D., we explore the OCD-ADHD interplay, as well as treatment considerations when the two disorders are present.
#adhdawareness
Download the slides associated with this webinar here:
www.additudemag.com/webinar/o...
3:05 What Is Obsessive-Compulsive Disorder?
6:31 Prevalence Studies
7:37 Where ADHD Presents in OCD
10:22 ADHD vs OCD Hoarding
14:43 ADHD and Body Focused Repetitive Behavior
16:41 OCD and Executive Functions
21:17 How Could ADHD be Missed in OCD Patients?
27:41 The ADHD and OCD Brains
30:22 ADHD and OCD Genetics
33:00 ADHD and OCD Comorbidity
34:56 Treatment of OCD+ADHD
37:49 Exposure Plus Response Prevention
44:28 Treatment Issues with OCD+ADHD
45:47 Questions and Answers
Related Resources
1. When OCD and ADHD Coexist: Symptom Presentation, Diagnosis, and Treatment: www.additudemag.com/ocd-adhd-...
2. OCD and ADHD: The Polar Opposites That Are Not www.additudemag.com/ocd-and-a...
3. How Are Symptoms of OCD Different from ADHD?
www.additudemag.com/download/...
4. eBook: "9 Conditions Often Diagnosed with ADHD"
www.additudemag.com/product/9...
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ADHD and "Pure O" here. I wanted to correct something you said somewhere in the 9-10 minute mark about Pure OCD not having compulsions. This is a common misconception, but people with supposedly "Pure O" actually do have compulsions. They're just not as discernable as people who do things like repeated hand-washing, etc. For instance, one of my compulsions is reassurance seeking through Googling, another is reassurance seeking from others, another is avoiding certain materials. Knowing what my compulsions are has been essential for better managing my OCD
Great point. I also have Pure O and I can relate with what you said. Ruminating and trying to "fix" problems in your brain can also be a compulsion.
Agree! I have both PureO and ADHD
@@christinem1772do you have fybromyalgia
I have both also, and you're 100% right. I swear it's the worst combination of problems to have.
@@Adam-zw1ck and autism and heds fybromyalgia to
“Its almost like their body is the fidget toy” I cracked ip so hard with this and 100% relate 😂😂😂😂
I think much of my OCD symptoms were originally caused or exacerbated by my pre existing ADHD. For example, when I was a kid I'd forget everything, so when I left home aged 17 and I was accountable for my own mistakes I started writing out lists to remind me. This was an immeasurably helpful coping strategy and still is. However I also started checking for my keys, wallet etc and this spiraled into more and more checking - switches, windows, doors etc. Also I've developed compulsive non religious praying to negate anxious thoughts. Now in my mid to late 40s I've finally been diagnosed with both severe ADHD and severe OCD, and am waiting for a diagnostic assessment of Tic Disorder / Tourettes. It's great to finally understand myself, but also frustrating to think my childhood was made hell by school teachers who would punish me on a daily basis for being inattentive, lazy and hyperactive. My negative treatment at school has affected my whole adult life, made me pathologically avoidant of employment by having it ingrained into my brain that I'm useless. I'm almost 50 with heart issues and chronic pain, I'm not going to put myself under unnecessary stress at my age. Their system screwed me up, their system can support me. It's the least they can do.
I am so sorry that you experienced that and can relate to alot of the compensating. I will also say, if people don't know about manuplulative or the narricistic please look it up (Little Shaman is a great resource.) Being with these types will make your OCD and ADHD & self-worth worse. Whether they are planned on purpose or not, it increases risk of gaslighting, self-doubt, guilt and feeling like you can never get it right. I also found researching this to be helpful to find out how other people think and perceive the world, and what areas of communication, etc.
I'm sorry to read this about your childhood and I can relate. We live in very judgemental times. The system you speak of was created by society. We need to learn to be kinder to those around us even when we don't understand them and then childhoods would be more joyful.
Yes I understand your need for redress and I hope it helps you feel better
God im so sorry for the amount of pain and suffering u have had to gone through... i know i would never understand but a lot of things u said are familiar to me and im happy to know im not alone.. i hope u are doing okay. Take all the time u need and i hope u take care❤
I don’t think that the schools knew any better. Or even my parents. They basically kept my locked up at home and school, because they just didn’t know how to slow me down. It does damage to your self-esteem which is why I think I ended up in abusive relationships. At 63 years of age I don’t waste time blaming anyone. It doesn’t help.
Oh Boooy. I can relate sooooo much to every Single Thing you say in the first 6 Lines you wrote. The writing down everything to remind me, unfortunately spireld so out of control & is no longer a helpful coping skill but rather became my worst ocd- obsession. But i‘ll figure it out i guess.
Can also relate to the school thing but it may have not been as bad as in your times (im very sorry Thai happend to you), still, im 22 Years and by now barely anything has changed in school System. Im from Germany by the way, so maybe that is a sad truth to adhders globaly. But i Do think now that the Topic gets more attention and is widely disscussed, i hope there is going to be change for children in the Future.
I call it productive procrastination... I do it a lot. It helps ease the feeling of guilt and nervousness involved in actually doing the task in which I'm procrastinating on.
😭thank you for this. I'm crying cause I've always joked about having ocd. Others have noticed it as well. I've never been diagnosed for either ADHD or OCD. This is resonating so much. I'm not crazy. It's not imaginary. I'm almost 50 and have struggled for so long without any answers. I feel like a big weight has been lifted off my shoulders! 🙌🏼🙏🏼💜
I can relate. I was diagnosed with ADHD two years ago aged 45 and OCD only two weeks ago. In a way a weight has been lifted, but its been replaced with anger at being bullied and discriminated against my whole life, usually by authority figures who would accuse me of being lazy or difficult. Also, knowing I have ADHD has made me give up on trying to be motivated, because I know whatever I start I'll lose interest in soon after. The OCD diagnosis has been more helpful though for some reason.
@@denelios "authority" figures hate us... Seen enough teachers complain about it
Same sister! Praise God!
So deeply resonate with both of you @gypsymommarose347 and @denelios - 49-yr-old here finally graduating in a few days - diagnosed at 46 during the pandemic and more and more inclined to seek diagnosis for OCD as well - lifelong unexplained struggle (‘you’re so smart’, ‘you have so much potential’, ‘if you only tried a little harder’, ‘if you only stuck with it a little longer’), and although I did experience huge relief through the diagnosis, it brought along much shame, embarrassment, and resentment (e.g., the ‘what if I had I only been diagnosed as a teen’ type of deep sadness). Let me know if you would ever like to connect and brainstorm around the topic.
22 mins in -- thank you! These comorbisities have been hard to navigate. Diagnosed with depression, took another 20 years to get a doctor to actually listen to me and suggested adhd screening. This video is blowing my mind 😳 I feel crazy and like no one believes me because I'm very very intelligent and obsessively self reflective
Wowwwww
THIS!! Me too!!! My mind is blown as well... like holy shit. Diagnosed with ADHD at 30... allllwaysss knew I had it but it hid under the mask of my OCD and how it allowed me to appear to barely keep it all together (but I was consistently a mess on the inside) and people have told me that I'm very very self-reflective to the point of it maybe being too much sometimes... so so interesting. Only recently have I realized, after adhd treatment has not helped my intrusive thoughts and exacerbated my rituals, skin picking, to name a few...that OCD had been the sinister thing hiding underneath all along.
@@KelseyBelovedme too! I’m diagnosed with pure o and strongly suspect I have undiagnosed inattentive adhd-it’s been hard to get taken seriously for my adhd concerns bc of my intelligence. I definitely hear you on the “mess inside” and over self-reflection! I over analyze my actions and always seem to be lost in thought when it’s important😂
My main running thoughts have to do with telling stories about Why I did something, constantly defending myself in various ways, to various people - it could be something that happened recently or things from the past- but pretty much it's a steady stream - like I'm constantly practicing and trying to convince that I'm not a fault, trying to explain my reasoning. It's exhausting.
You describe it so well... My head is in that place most of the time, unless I'm distracting / anaesthetising myself to avoid it.
I’m really struggling with this. I was being treated for my ADHD with a stimulant and now my obsessive thoughts are out of control. Now I’m stuck reasoning with why I am doing or thinking or saying anything!
I have both although I outgrew most of the OCD. It was a compulsion to count and/or do things in 4's. There was never any fearful thoughts that went with it. My best guess is that because the ADHD makes it feel like you are not in control of your own attention span and memory, The compulse counting was a way to have control of something.
Ooh I’ve never heard it described like that but yes. I feel like this could apply to me too.
I have ADHD and comorbid OCD, and Skin Picking Disorder.
This is a perfect representation of how my challenges combine.
The issue I face now, is....am I disabled?
I struggle with my job, no matter where I work. I struggle to stay on top of household responsibilities....
but in my position, I don't have a community and I don't know what resources are available. I feel like I should be entitled to some workplace accommodations, or other benefits, but I don't know what's available for adults.
I am a special education teacher, so I am familiar with accomodations and modifications in the public school system etc.
What exists for adults?
When I get these diagnosis, who is there to tell me that I should look into ADA?
I know to look because of my job. But who out there is diagnosed with the same things I am, and is never directed to look into ADA accommodations?
Inositol helps with ocd
@@tauseefp23 Thanks for letting me know. I suggest fallowing the health protocols from the book Medical Medium Anthony Williams - Cleanse to Heal. Celery Juice and know how hidden virus, toxins and pathogens and food sensitivity are what's really behind most OCD, ADHD, panic attacks and all sorts of inflammation.
At the very least, you're not alone.
I've struggled to work any more than 20 hours a week and have only kept jobs due to nepotism. Even working those minimal hours was stressful (stress is one of the few things I can use to force myself to focus for short bursts). It's exhausting...
It's so frustrating. I don't feel disabled, but no matter how hard I try I can't do basic tasks that are expected in a functioning life. I'm happy on weeks where I actually cook for myself or do enough chores to make upkeep passable. As of now I've tried medications and none have worked without unlivable side effects. Apparently I'm hyper sensitive to almost every medication and I've developed a fear of trying any more after the latest one almost gave me a mental breakdown.
So yeah... I'm in the same boat. I wonder if I should apply for disability help of some kind. No one prepares you for these kinds of problems in life.
@@tauseefp23 I noticed this word on certain energy drinks. There used 2b a non-carbonated orange r9ckstar that had a bunch of ingredients like milk thistle, spiny cactus or something moss I can't remember but I was crazy for those drinks I would buy a whole crate! Looked up those ingredients and they all help executive function AND the thing Dr.russell Barkley said about always having a sugary drink 2 sip on throughout the day.
For some reason no matter what, it seems like everyone in my life has a problem with everything that helps me. Like if I said inositol they'd disagree. Like. ? Wtf?? I don't get it. I need better ppl in my life ffs
@@ThiagoDVazas it helped you
Can you have this doctor back for another few hours of lectures? This one hour helped me tease apart some of the gyri of my gordian knot.
I wish I could have asked him, how trauma symptoms differ from ADHD and how to tell them apart and how they overlap.
Patrick teahan has a video about this here on RUclips. He has a lot of great videos!
I find myself flip-flopping from been totally random and disorganised, to the other extreme of a OCD-ing minimalist.
This was one the best webinars I have watched, thank you!!
Thank you so much for this explanation. Sending it off to all my family with "issues". I made it 34 minutes before I wandered off to another website with you playing in the background! That is a record for me. Congrats ;-) It really was an enlightening talk. Much appreciated.
Lol I made it to exactly 34 as well
I lasted 2 mins. I clearly have issues
Super helpful. Thank you.
this is the most helpful and informative talk i have listened to thank you sooo much
feel seen! ❤️ Thank you for this video! This was brilliant.
Best ADDitute webinar yet! Thank you, Dr. Olivardia!
Excellent presentation!
This was presented so well. I have clients with both and this really helps me understand the nuance differences! Thank you!
Also loved the real world examples and comparisons 👌
I've always found the way executive functioning is described in OCD to be a little not to the point. For me and others in an online support group I'm part of, the crux of OCD - whether compulsive or pure O - is an intense underlying fear/worry or discomfort. In fact, people with OCD experience fight or flight responses in their amygdala - so, it's strong feelings. When you look at OCD through that lens of that fight or flight worry, you understand that OCD is an involuntary and very unwanted response. (It gets more unwanted and prison-like the higher someone's level of OCD is. I think severe OCD is almost a different disorder than very minor OCD and one of the worst things a person can experience.) Executive function deviation in OCD is a byproduct of prioritizing appeasing the fear when it comes up; that's all it is. But I feel like it often is described as a separate issue. Like if a person with OCD without ADHD is doing a task that doesn't involve their OCD symptoms or fear they or others could come up, I bet they would do the task really well. I'm not a scientist, this is just what it always felt like to me as someone who has had OCD.
This was amazing. Thank you!
This is a very useful webinar. The sound, however is horrible.
Yes... quite painful for those with sound hypersensitivity.
omg this was such a great webinar. I have adhd and i sat thru this whole thing. Dr Roberto, you are amazing omg the way you explain the 2 disorders are just amazing. very smart and knowledgeable. loved this webinar so much.
I have been diagnosed with OCD with a tic disorder and ADHD. I have had this since i was a child. I am a hot mess. Disorganization and inability to began projects and also obsessive thoughts of garbage and with things that disgust me. As a middle aged woman, I have accepted that this is what I have and that there will never be anything that i can do about it.
get medicated baby and also sign up for disability checks if ur diagnosed with both
😮 I’m gooped, I’m gagged I’m gafawwed. This explains what I have been experiencing so well
This video was so useful and informative, thank you! I watched it over 3 weeks, because of my adhd though...
That was fantastic. The brain is amazing
I struggle to find sources that highlight the unique features of having both ocd and adhd, this was really helpful, but is there a source that anyone can share that goes more in depth the way the two interact with each other in people with both?
Omg 7 minutes in and I’m SHOOK. Crazy to hear someone describe what’s happening in my brain.
Fascinating video. Thank you, Dr. Olivardia. I have a history of OCD, anxiety, early PTSD, and depression. "Pure O" is the best way to describe my OCD. I could see ADHD elements in my situation--hyperactivity and inattention. the question that i have to sort out is whether adding an ADHD medication to my SSRI make the anxiety and OCD worse, or actually calm and focus me, which would be very appreciated and welcome. I wonder what the safest ADHD medication to add to an anxious--OCD patient might be. My doctor suggested Concerta. Again, thank you for this interesting and important video that looks at seemingly contradictory conditions.
9:30 I’ve been researching ocd again after many years. I figure i had pure o- religious ocd and then ignored it because I thought I he already overcame it, years later I discovered I likely have add. Now I felt led to start researching it again and I started crying a little bit. My mental health has been a very big obstacle in everything I do, specially in my relationship with Jesus. I remember one time when I was abou 11 years old, and my ocd was in its purest form I think any psychologist would have been able to identify it, but my parent didn’t know about it so I was never seen, they just thought it was funny I was so religious (they didn’t think it was cute or even like how it should be, they would often tell me to stop praying “like that” or joke about my compulsions), I guess they thought it was a phase idk. One time a random person that didn’t know me prayed for me and told me “Jesus says that He is please with your heart” and that what I was so worried about all the time with ocd. I’m just so moved right now because He always knew what it was and understood my struggle. Even after it made me step away a little bit from my faith He led me to the right places to find out about this, and now He is doing it again. Hopefully now that I’m an adult I’ll get the profesional help I needed
I do have OCD, this doctor told me this during this video! I also have an Anxiety Disorder for sure , and I also have Social Pragmatic Communication Disorder. And now I’m even being told I have PTSD but it’s more like CPTSD, it’s what has caused the doctors to finally see I have anxiety really badly and my excessive talking is what told them I have bad anxiety. I have no pause mechanism, it’s hard to stop letting others know how I’m feeling and what is bothering me, I also have to tell others so that is partially because I have OCD. I check things and I have repetitive thoughts all day long and I also have the images but that can be because I have PTSD because I’m having certain flashbacks of situations I’ve been through. These doctors need to actually really help us not all these medications are helping us some haven’t been able to fine the right treatment that works. And they have been seeking help for over 40 years!
Fascinating, important insight at 34:09. Can people with OCD, anxiety, and ADHD become distracted by their obsessive thoughts and anxiety because the mind, in its own complex way, finds more energy and dopamine from the OCD and anxiety than the college lecture. In other words, perhaps OCD and anxiety don't just represents serotonin dysregulation/deficits, but dopamine deficits where the mind goes to the obsessions and even anxiety as a source of dopamine. This could explain why some of us are drawn to our fears and obsessions in some way and can't focus on other things. I think there's something to be said for this possibility. Again, fantastic video.
Good video. I fall in the tourettes category, and can relate a lot.
I am reaching a conclusion that the genetic roots of a significant percentage of these disorders could be mutations in the mthfr gene which a large number in the population carry (1/3rd?). Mutations affect a person’s methylation cycles. As I understand it, this has a whole range of effects from being unable to process synthetic versions of B vitamins in particular and becoming deficient in then which causes deficiencies and toxicities in other areas. A mother with mthfr who is seriously deficient can have a baby with spina bifida or a range of other neural tube defects at varying degrees of severity. A child with it may be more prone to damage from heavy metal toxicity from vaccines such as autism or glyphosate toxicity from pesticides.
I think it can be linked to overly oily skin and persistent acne (and therefore skin picking disorders), along with gut & digestion issues and symptoms such as anxiety, fatigue, brain fog and depression. Whether or not it causes physical changes in brain associated with adhd I’m not sure but I suspect it will also have an effect on neurotransmitters like dopamine and serotonin.
43:50 😐 ... I see. Thank you, doctor
🎯 Key Takeaways for quick navigation:
00:00 🎮 *Introduction to the video content*
- The video begins with an introduction to various topics, but it's not clear yet what the main focus will be.
02:33 🚀 *Attention Deficit Hyperactivity Disorder (ADHD) and its importance*
- The speaker briefly mentions ADHD and its significance in the context of the discussion.
07:44 🧠 *Discussion on mental health and challenges*
- The conversation turns towards discussing mental health and challenges faced by individuals.
15:36 📚 *Education and language learning*
- The video delves into the topic of education and language learning.
23:23 🌍 *International communication and technology*
- The discussion revolves around international communication and technology.
30:01 🦕 *Miscellaneous topics and closing remarks*
- Towards the end, the conversation covers various miscellaneous topics, and the video is about to conclude.
39:37 🧠 *Overview of the discussion*
- The section provides an overview of the discussion in the video.
41:06 🤔 *Mention of industry-related topics*
- The speaker briefly mentions topics related to industries and their impact.
42:25 🌍 *Global perspective*
- The speaker discusses global perspectives and the use of traditional methods.
44:15 🎓 *Educational context*
- Reference to education and learning opportunities.
45:29 💬 *Communication and interaction*
- Mention of interactive communication and its importance.
47:35 🌟 *Positive outlook*
- Discussion about staying positive and maintaining a positive attitude.
50:15 🌤️ *Weather-related references*
- References to weather conditions and their impact.
53:02 🌐 *International topics*
- Mention of international factors and interests.
55:47 📚 *Education and learning*
- Discussion about education systems and access to education.
57:36 🌆 *City-related references*
- References to cities and their characteristics.
59:50 🛒 *Markets and economics*
- Mention of markets and economic aspects.
01:01:40 💕 *Emotions and personal reflections*
- Discussion about emotions and personal feelings.
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I thought for months if I heard the word cancer three times that this was a sign that I was going to die. When I heard it for the third time at a AA meeting from the speaker. My heart just dropped into my stomach. I cried that night because I was sure I was going to die of cancer.
I was also obsessed with even numbers; everything had to add up to even numbers. If something was 27, I would add 2+7 which would =9. I would then take the word nine and add the 4 letters to the number 9, which would =13. I would then add 1+3, which of course =4.
I would count and add up phone numbers, count tiles on floors and ceilings. I could not even go to sleep unless I closed my eyes and opened them up on an even number. I have gotten a lot better with this, but my TV still has to be on an even number. I actually called the number 8, my favorite number; I think this is where it started, with the even numbers that is.
I remember when my foster father got sick and he told me not to say anything to my foster mom (I was probably 7 at the time). I got scared and I ended up telling my older foster sister, and my foster father ended up going in the hospital and he ended up dying in the hospital. I felt like it was my fault because I said something. Oh, and the number adding was something I didn't like doing, I felt like I had to do it. I have so many other OCD examples, it's freaking crazy. Even too the point of clutter distracting me, and my hair being a certain way bothering me. When I have my hair in a bun that feels right too me, it just FEELS RIGHT TO ME...I can't really explain it. Oh, and I did a study on tithing, was obsessed on it for over 2 years. Caused me such anxiety. God there is so much I can say, these videos are helping me, but they can be overwhelming because it explains so, so much.
Perfectionism with me in just certain areas, are a huge struggle with me. I really have a lot of work to do. It scares me, but I have resiliance.
Is there anywhere I can learn more about the interaction of ADHD and OCD described around 33:00 (the way that ADHD can trigger OCD symptoms and vice versa)? I'm also interested in the way that activated OCD can make ADHD symptoms seem to be mitigated (the whack-a-mole phenomenon) and would love to learn more about that! I think I've experienced this and would love to understand why this happens.
I have celiac disease and I struggled all my life with iron deficiency. I also developed depression because i didn t know about my condition and I developed many other conditions and I also have Gad 65 antibodies.
How would you define a dopamie/serotonine and gaba deficiency ?
I’m trying to find someone to contact. I’ve been trying again to find the replay of Why is Time so Slippery and it’s not listed here in RUclips. I began watching and now cannot find it again. I’ve been over an hour trying to find it. And to view a video I can pause and back up and fast forward. The link I was se t just jumps in large increments when I try. Please help! Thx
www.additudemag.com/webinar/time-blindness-adhd-productivity-management/
Amazing thank you - does Menopause exacerbate ADHD?
YES!! 💯%
Can ye talk about links with C-PTSD/ADHD!
One way my ocd manifests is I have to put my right contact in before my left one (they are different prescriptions). I'm afraid if I don't my husband will die in a car crash while he's at work or one of my kids will break an arm or leg. Lol! I know its not true but I can't help doing it anyway. Just to be safe.
No mention Asperger's and ocd as well as adhd
This is a video primarily about ADHD. But a quick note - the term "Asperger's" isn't used any more. Everything is now called ASD (Autism Spectrum Disorder) and it's simply a question of where you are on that spectrum. Someone who would have previously been said to have Asperger's would now be said to have relatively mild ASD.
Hey Dr! I just wanted to say thanks for your presentation. It was really interesting! So, I've been reading up on some new research, and it seems like there might be some evidence indicating that SSRI medications could potentially have a negative impact on ADHD symptoms. Just thought I'd share that with you!
Causing what symptoms
The closed captioning for this video is way off.
19
Wellbutrin is NOT an SSRI
I'm confused 🤔 I just listened to a podcast that said OCD is very unlikely to co-exist with ADHD? I have both. I can not take ssri's for OCD. I am being treated for ADHD and now I'm wondering if the medication is making the OCD more pronounced. I pick and pull. My OCD is beginning to affect my ability to get started on a task. I'll sit and pick at my lip and my brain runs wild but I'm inactive physically. I'm especially stressed and just wind up not getting anything done. That vicious cycle starts and now I'm having trouble chilling in the evening before going to bed. I'm not sure if the medication isn't making me worse. I'm not hyperactive. I'm not impulsive. My emotions are not regulated well at all. I'm not making any sense. I feel very confused and uncertain. What if I'm just a mess and no one will ever understand me. How can I get help if no one understands what I'm dealing with? All of this is just overwhelming... And I have chronic pain due to several autoimmune conditions. Is there any help for me?
What autoimmune condition s do you have do you have fybromyalgia
@@Truerealism747yes. I had endometriosis for years. Then fibromyalgia, IC, spinal stenosis, and the list goes on. Why do you ask?
@@RavenVapor873 because all linked to central pain syndromes I've had pelvic pain fybromyalgia IBS migraines curvature of spine DDD but pain isn't coming from there it's subconscious brain Dr lenz Dr schubiner ndo ADHD meds help pain do you have asperger's?
I've also had OCD from 3 as my son and late mother.
@@Truerealism747 I don't believe so. Who is this doctor you mentioned? I sorta wondered but all of this is very expensive to get tested for. I know I would do much better if I were working with someone knowledgeable and trained. I need a permanent body double 😂