Inattentive ADHD: Why ADD is Misdiagnosed and the Best Ways to Treat It (w/ Thomas E. Brown, Ph.D.)
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- Опубликовано: 10 фев 2022
- People with inattentive ADHD can pay attention and focus on things they find captivating or exciting, but they struggle to sustain attention adequately on important non-preferred tasks, like schoolwork or assignments at work. In this hour-long ADDitude webinar with Thomas E. Brown, Ph.D., and Ryan J. Kennedy, DNP, explain how inattentive type ADHD is diagnosed and how to effectively treat it. It will also correct common misunderstandings about medications for ADHD and why they need to be “fine-tuned” to be effective.
Download the slides associated with this webinar here: www.additudemag.com/webinar/i...
2:44 ADHD Inattention Involves More Than Failure to Maintain Focus on One Thing
3:52 "Focus" and Executive Function Impairments of ADHD
5:05 ADHD Symptoms Overlap With “Executive Functions” (EF)
6:20 Brown's Model of EFs Impaired in ADHD
13:50 The Mystery of ADHD: Situational Variability of Symptoms
15:12 2 Hypotheses re: Motivation in ADHD
15:23 Context Matters!
16:26 In the Human Brain
19:52 “Is Brand Name Better Than Generic?”
21:46 Menopause and ADHD Symptoms
25:59 When Are 2 Meds Better than 1?
32:56 How Do ADHD Impairments of EF Usually Respond to Medication?
34:34 Set Realistic Expectations for Treatment: Medications Do Not Cure ADHD!
Related Resources:
1. Read: What Is ADD? Inattentive ADHD Explained www.additudemag.com/slideshow...
2. Download: Your Free In-Depth Guide to Inattentive ADHD www.additudemag.com/download/...
3. Webinar: "Focus on Inattentive ADHD" with Dr. Mary Solanto
www.additudemag.com/webinar/i...
4. eBook: Your Complete ADHD Guide
www.additudemag.com/product/a...
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Video starts at 4:28.
🤣 Thank you
thank you
Thanks 😊
Thanks 😊 😂
Thanks
So much inane babble at the start!
The irony of an Inattentive ADHD video being nearly an hour long! Please can you do shorter clips?? Like a series perhaps?
Yeah I'm 30 seconds in and I'm out lol
I hope ADDitude explores ways to make these videos more ADHD-friendly. Chapter markers and better slides would be a good start.
Absolutely. I love that they're educating about ADHD but us inattentive peeps have no chance of getting this info. I'm on my third try of listening to this and retaining very little information.
This is why I do 2x speed on every video I watch lol
I watched it in segments. About 30-40 mins at a time
I can't even pay attention to this WONDERFUL slideshow.
Play it ×1.5 speed...
🤣🤣🤣👍
Literally ME right now
same, gotta rewind the vid every half a minute
The paper shuffling? Ugh!
Hyperfixating on some coding while listening to this. Tuned out for the entire thing, then reset it; this is attempt 2.
so much this: I hope the code is at least the project you should be working on. my hyperfixation almost never is...
Who else has lost interest and is reading the comments 😁
Ok, you caught me.
Dude! The Paper-Shuffling!!! 😳😵💫😵
Putting it in 1.5 playback speed made it easier for me to focus.
Lol same
Medication doesn’t help me, but exercise and relaxation training with biofeedback did. This taught me what relaxation was after the trauma suffered from exasperated and over reactive parents. Learning ina quiet environment with lights off and overhead projector enabled me to learn algebra after math anxiety all my school years.
If your adhd is only about schoolwork/taxes then in my humble opinion you have a extremly mild adhd or something else / or a combination, BUT you might not know how impared you are so easily since depending on the people surrounding you and the complexity you might have big truble making sense of it all. Smarter and more famous people have made huge miscalculations even if its just limited to some area accoriding to history/biographys.
Example: My life is fucked in every way imaginable. Gaming is fucked, interessts (if any) are fucked, relationships (if even any) are fucked, how i feel things is fucked. My drive is fucked. I even lack feelings/thoughts and many mental abilitys that can easily come back with medication/somethimes showing me that they are totally not lost forever or "died off" they are there somehow i just am fucked. Its extremly broad / complicated / long storry wont bore you today with details.
Now with some doses / depending on what med all of that increases dramatically, If you thought thats its only about focusing on writing something + without moving then i would not be surprised if you are massively/gigantically/unbelivably/insanely wrong/unaware/mild/lucky. But then again you are in large company and many many many people think like that. + Natural Fallacy
@@hanskraut2018 I feel and iam this way too. The way i live my life is so fucked up and unhealthy, im fatigued and im scared my mind and body is dying and getting damaged to the point where its irreverisble. I cant focus i cant control my impulses all i wanna to is stimulate myself. I have become an master at making myself dopamine and chasing kicks in form of video games, movies, youtube, sex, drugs, alcohol, conversations. I cant get myself to finish something i procrastinate everything i want to do with my life and just keep on being in a loop of short stimulia. Ive had so weird sleep schedule for many years now and cant keep a job because of it. I need disicpiline. I need to rewire my brain somehow and keep a good habit for longer than 3 weeks at a time. Im tired im confused and scared. Somewhere ive always believed i will become successful and live healthy and i still do beilive that...
Ryan did not get to add his thought toward the end with regard to non-pharmacological treatment. I suspect he was going to mention that exercise can help to increase dopamine; however, you can only exercise so much, and it is not always feasible.
I agree. It sadly became annoying and a loss.
Yes. I kept hoping the moderator would call on Ryan for some of the comments-he obviously had things to add-but she would go on to starting the next question. I was especially annoyed by this in the last part when he obviously had something to add and tried to jump in but wasn’t allowed to add his comment and it never came back to him.
These talks are so incredibly helpful. 59 year old female, diagnosed late with two daughters with ADD. Education is everything. Thank you!
I really appreciate these uploads! Thank you! I love the magazine. It is so helpful.
There are distracting, clicking / page-turning (?) sounds throughout the presentation & discussion of this valuable & needed information.
Yes, say this to Ryan :):):)
Very informative and interesting! thanks to both experts
Guanfacine ER at 5 mg is working wonderfully for my son so far. He had alot of emotional reactivity. He was having trouble sleeping but I learned through this talk that it has a delayed onset so I will give it to him earlier than 9. He couldn't tolerate stimulants at all. He became wept and almost seemed psychotic on the lowest of doses. I wish there was more info on Guanfacine
Idk how many accidents I've almost gotten into looking at something interesting on the side of the road.
Ha ha, same. Which is why my wife insists on driving.
I'm curious, based on a lot of other sources, such as books from Sari Solden, it sounds like women that may be reporting in their 30s, 40s and over that they DID NOT experience ADHD symptoms as a child, most likely are underreporting due to the nature of ADHD-inattentive type symptoms and the gender differences involved in masking those symptoms. Does this sound correct?
For those without a science or medicine background, or very tired, this video may be difficult. Skimming a document with same info may be easier for you, so you could follow at your own speed and not be distracted by sounds. Not sure if downloadable document is available by itself; might help those with auditory processing or delayed processing difficulties. Nice to hear the updated awareness noting women with midlife onset. My medical center has GPs or Internal Medicine doctors cover psychiatric drugs, with 15 min med appts, so expecting these providers to be fluent and current in handling all med details and adjustments, is an unfair expectation, as compared with psychiatrists. Thank you for these informational podcasts, so patients can gain some general understanding. Case examples were very helpful to hear.
Thank you for the amazing upload.
Love the info, hard to listen due to her voice.
I have to work at jobs where you’re moving around a lot and not managing adults or doing administrative tasks. I just have to focus on me and let the rest of the politics of work go. It’s bad for my ego-I’ll never be rich. But I can only manage myself at work or else I’ll get overwhelmed.
Many inattention only people milder versions some s.c.t polluting the adhd pool and more motivated/charming molding the field
Interesting about the slow impact of some medications. For me Concerta helped a bit , but while it is meant to take about 30 mins to work and then last for 7~8 hours for me it would take 3+ hours to work then last 12~14 hours
🎯 Key Takeaways for quick navigation:
02:42 🧠 *Understanding the essence of inattention in ADHD*
- Inattentive ADHD focuses on more than just hyperactivity; it delves into the nuances of attention difficulties.
- ADHD isn't just about not being able to focus on one thing; it's akin to multitasking while driving, constantly shifting attention between various tasks.
- Executive functions serve as the brain's conductor, allowing integration and prioritization of cognitive functions moment by moment.
05:07 🎵 *Executive functions: The conductor of the brain's symphony*
- Executive functions play a crucial role in coordinating various cognitive processes, much like a conductor directs a symphony orchestra.
- The brain's executive functions ensure that different tasks and processes work harmoniously together.
- These functions are dynamic, integrated, and mostly operate unconsciously, ensuring smooth cognitive operations.
08:02 🧺 *Six clusters of executive function challenges*
- There are six primary clusters or areas where individuals with ADHD commonly experience challenges in their executive functions.
- These clusters range from difficulties in activation, focus, and effort to challenges in managing emotions and impulses.
- Each of these clusters, although presented separately, operates dynamically and interconnectedly within the brain's cognitive processes.
14:09 🔄 *Situational variability: The central mystery of ADHD*
- Situational variability refers to the phenomenon where individuals with ADHD can focus well in specific situations or tasks that interest them, contrasting with their challenges in other areas.
- ADHD's situational variability isn't merely about willpower; it's deeply rooted in motivation and unconscious processes.
- Understanding situational variability helps debunk myths around ADHD solely being a matter of willpower or focus.
21:37 🌸 *Women, Menopause, and ADHD Symptoms*
- Women and girls with ADHD often report that during low estrogen levels in their menstrual cycle, ADHD medicines seem less effective.
- Estrogen plays a significant role in modulating dopamine in the female brain, impacting ADHD symptoms.
- Studies have shown that women may experience the onset of ADHD symptoms during menopause, and ADHD medicines have been found helpful during this period.
24:14 🏠 *Weekend Struggles and Medication Concerns*
- Rory, a lawyer in his late 30s, finds medication beneficial at work but struggles at home, leading to concerns about addiction.
- The importance of addressing the underlying fears and assumptions about medication usage for ADHD symptoms at different life stages.
- Managing symptoms both at work and home environments is crucial for maintaining a balanced life.
26:11 📚 *Considering Multiple Medications for Treatment*
- Some individuals may benefit from taking multiple ADHD medications for optimal symptom management.
- Erica, a high school sophomore, found that a combination of medications offered better symptom relief than a single medication.
- Strategies like alternating between medications or combining them can be explored to find the best treatment approach for some individuals.
28:05 🎨 *Exploring Alternative Medication Approaches*
- Frank, a graphic artist, tried various medications over several years, with varying levels of success and side effects.
- Introducing different types of stimulant medications, like generic amphetamine, can sometimes offer relief when other options have failed.
- Fine-tuning medication dosages and combinations is essential to finding the right balance for each individual's unique needs.
30:27 🕰️ *Individualizing Medication Dosing for Optimal Results*
- Jeff, an entrepreneur, faced challenges with extended-release medication's duration and found success with a customized dosing regimen.
- Tailoring medication timing and dosage based on an individual's specific needs and responses can lead to better symptom control.
- Collaborating closely with patients and continuously monitoring their responses allows for fine-tuning of medication regimens to achieve the desired outcomes.
45:07 🧠 *ADHD diagnosis in older adults and treatments.*
- The discussion revolves around adults in their 50s and 60s realizing they might have ADHD symptoms later in life.
- Some individuals discover their ADHD tendencies when their grandchildren are diagnosed.
- Research suggests that older adults with ADHD can benefit from similar treatments as younger individuals.
46:01 💊 *Treatment considerations for older adults with ADHD.*
- Addressing concerns about stimulant medications in older adults with cardiovascular issues.
- Emphasis on consulting with a cardiologist for safety evaluations before prescribing medications.
- Not all older adults with ADHD require daily medication; some may need it for specific tasks.
48:23 🚺 *Hormonal changes in women, menopause, and ADHD.*
- Exploring the connection between estrogen levels, menopause, and ADHD symptoms in women.
- Some women experience midlife onset of ADHD-like symptoms, potentially linked to estrogen fluctuations.
- Treatment with ADHD medications might be effective for women experiencing these midlife symptoms.
50:01 📋 *Impact of job responsibilities and age on ADHD symptoms.*
- The role of changing job descriptions and added responsibilities in exacerbating ADHD symptoms.
- Individuals with ADHD might function well in specific roles but struggle when administrative tasks increase.
- Aging can amplify ADHD symptoms, making certain tasks or memories more challenging over time.
52:39 🛠️ *Non-medical treatments and their efficacy for ADHD.*
- Addressing the limited scientific evidence supporting non-pharmaceutical treatments for ADHD.
- Discussing the ineffectiveness of dietary changes, nutritional supplements, and other non-pharmaceutical interventions.
- Emphasis on understanding ADHD as a fundamental issue in brain chemistry, indicating medication as a primary effective intervention.
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A lot of good info but very hard to listen to with all the phone disruptions, the difference in volume between guest and host, and the host having a scratchy voice. A good podcast editor could help smooth these things out.
Who has this and can't watch 56+ minutes of data, even at 2x? Raise your hand.
Ok can someone help me? For my whole life, I’ve gotten straight A’s in school. But in class, I can never focus on anything at all. Even at home every single day, no matter the task, I get distracted and/or totally forget what I’m doing. It’s literally getting out of control. The thing is, my parents don’t think I have adhd because my moms a therapist and she said it’s unlikely because “I get such good grades”, but I’m struggling so much with the basic thing in life and don’t know what to do anymore. Im also terrified of ppl think I’m self diagnosing which I’m really trying not to do. Please help.
You're still talking parents so I don't know if you're a minor, but if not, try to find a local psychiatrist & describe your reasons (if so....may just be a bit more complicated to get their sign off on it, but parents generally have a propensity to carry a too close effect to be terribly objective). Chances are they'll at least try prescribing you adderall to see how you respond, and regardless of the treatment plan you want to take from there involving medication, you'll get your answer pretty quickly. ADHD brains don't respond to the SSRI the way an NT brain does, so if you get an improvement in focus, you know your condition & can work from there, seeking more formal evaluation or whatever you find most helpful.
@@Kelos7 I am a minor, but thank u 🙂
@@paytontimmons2009 sure: at least as a therapist, your mom ought to appreciate the need / benefit in your seeing one, and should well appreciate it needing to not be her.
You may be lucky there in some ways. If you can find sufficient reasoning beyond this to approach her about starting to see one, therapy helps in general, but you need to do a lot to research someone who's a good fit for your wants / goals. You'll want to find out who your provider is, find local practitioners you feel aligned to / responsive toward the therapies they believe in that are also in network, so there ought not be a whole lot of objections. It is important for you to do that legwork yourself for a few reasons though. Mostly, you want the assurance that they're someone you've researched you can trust being open with (obviously enough, with a parent in the field, I'm sure that privacy concerns will be simpler on both ends if it's not from her referral), but also it's just something you need to get comfortable with as a general life skill to prep for needing adult treatment in the worst case.
You're probably also lucky to be considering this early at least, while you're a more appropriate age for people to recognize the symptoms in, one way or the other (wish I'd considered the possibility younger myself too, I thought I was just a gifted slacker like I was told I was). Don't forget no one's perfect & no one person's advice is absolute either though: psychology / psychiatry is an ever evolving field, and everyone gets into it for their own reasons. some will be better suited to help someone with your concerns than others, and you're likely to hear a lot of opinions as a consequence. Just keep an open mind & listen to the commonality, trying to parse what in that message resonates for you.
My 2 cents, if you lack direction there: more & more study shows CBT is the best you can go for, & a lot of other things can just bring up a lot of memory distortion, and cause you trouble with reliving past traumas; reinforcing their significance in less than helpful ways. The why of the past isn't really something we can change, or as helpful to focus on as a lot of it has historically thought to be. We're good at looking for patterns & seeing what we're looking for as humans, & what keeps us moving forward best is staying present in the moment as much as possible, focused on what we actually want to do to help manifest a future we're hoping for.
@Kelos7 you are giving very wise advice. Kudos to you.
Gifted inattentive ADHD/2E may be. Do a cognitive test. ADHD masked by giftedness
What was the other doctor going to say towards the end when he interjected as far as there being one exception to some thing that helps other than medicine? Thank you for this talk.
Not helpful if you can't take stimulants. Caused irregular heartbeat. Taking WB XL 450 generic. Can't get out of bed unless I have to. Add w/severe clinical depression. Used to take brand name. 20 yrs. What else is there that's affordable? Used to take MAO. I'm very tired. No interest and I have to work. My house was destroyed during Michael. Help me. I'm miserable and have to live at Westminster oaks which is basically a nursing home because my house is not been repaired and it's not livable. My life is a nightmare
That does sound awful. Sorry to hear you lost your house. Prayers 😥🙏
I’m a 45 year old woman, I retrained as a chiropodist and now worry If I’ll cope.
I’m married with 2 teenagers, and concerned that it may push me over the edge, particularly coming up to menopause!
I Tried to listen... and fell asleep 🤦♀️
Not true i struggle with attention even in the most loved things - its just easyer but still less than normal people
Can someone post a link on medication to take? I lost track during the first 10 seconds. Space cadet ADD sucks.
where can i find more information about adhd and menstrual cycle
Watch Dr Berg on ADHD vit B and NAC works wonders
What about Provigil/Nuvigil to treat ADHD?
Watching and wondering if I might have watched it already a few days ago. Oh well 🥴
I benefitted GREATLY from taking half a dose of my daughter’s adderall…but because of my blood pressure being high when I went to the mental health doctor she wouldn’t give me adderall but did prescribe strattera…my problem is that I’m not motivated to get up and do things but that all changed when I took her med…will I have any success with Strattera?? I don’t want to take something that will bring me down
It will really depend on how your body reacts. It's trial and error. I personally struggled with Strattera (also unable to take stimulants because of blood pressure). I couldn't get up to a therapeutic dose of strattera because the side effects were too bad. But others obviously take it with success. Give it at least a few weeks before you see improvement.
I was already on Wellbutrin for depression/anxiety, and Wellbutrin can also be used for ADHD. I'm just trying to get by with that and counseling right now. On a side note I never tried Adderall but I did take phentermine for weight loss, and my mind was much more clear and focused during that time. I suspect that Adderall or something would probably help way more.
You might have to lean more heavily on counseling and cbt or other non-medication strategies.
Strattera sucks! It did not work for me, nor did it help my daughter.
Is this doctor a specialist like a neuropsychologist… they are the best when it comes to diagnosis of ADHD and communication disorders and Bi polar. They are better…
Would you still use stimulants even if you are not hyper active? I’m pretty low key and very introverted. I also drink like 3 energy drinks a day(trying to quit ) cause I’m always so tired
You would take a stimulant combined with an SSRI antidepressant.
You are self medicating with the caffeine....
My psychiatrist will not prescribe stimulants. Would Estrogen therapy help? I'm 72. S young 72. Did Brain Stim. in 2019. I don't know if it helped. Coaching doesn't help unless you address the chemicals.
Have you been diagnosed with ADHD? If so, I would find a new psychiatrist as ADHD can be very debilitating.
Greatly disappointed to see all the treatments in the cases exampled here were about adjusting medication. I am not against medication, but access to clinicians who can prescribe it and the accompanying sessions of therapy are simply not an option for a lot of folks. I was hoping for some alternatives to consider.
Can hyperactive ADHD or combined ADHD become predominantly inattentive ADHD later in life? Could someone naturally lose the hyperactive symptom of ADHD when they get older?
I have been diagnosed with PTSD, c-PTSD, generalized anxiety, panic disorder, and major depression over the last 15 years. Cbt has helped but no medication has really. My new psychiatrist believe I have ADD/ inattentive. I have no hyper activity other than the fact that I jump from interest to interest and hyper focus on the new interest until I guess I don’t like it anymore. I have a 4.0 in college and am graduating suma cum Laude . How is this possible is I have add? I assume because I hyper focus on my college because I love psychology and counseling? I want to move forward and see if medication helps because my life is a mess with how forgetful and inattentive I am. Ideas?
So how are you doing now? I'd just give it a try. You could have ADD/inattentive type for sure. Maybe you have a high IQ which masks the problems. It's not uncommon to hyoerfocus on things you really think are interesting.
It could be something else of course (hyoerfocus is not adhd only) but yeah you could have adhd and still get good grades. A lot of people with untreated adhd have anxiety, depression because of the adhd not bing treated. It's actually something they check after you get the diagnosis.
So yeah, I'd go for it. Could be something else! But it could be the silver bullet.
32 seconds in, and fwd. Ha
Anyone else distracted by wondering whether these two guys were actually in the same room? Same wall color...same couch...same lighting...just saying!
No, but now that you mention it...it seems to be quite a coincidence that they have the same color scheme. Perhaps they are in the same office or building, but in different rooms.
They are in the same room, the computers are back to back.
This woman’s voice at the end. 😮 sensory overload. Holy cow. It’s like tin foil and nails on a chalk board
Struggling to remember to remember - bingo.
Being born this way haven't been funny, during my college days I got tired of taking the medications so I stopped. And my condition got worst. Which made me start looking for a permanent solution when Dr Iyhere's herbal medical page popped up. I took the dosages and followed the prescriptions. I haven't been this active and better in my life.
Someone without adhd please watch and give me the cliffnotes
Hack: I play videos at 2x speed 😂😂😂😂
Amazing how the dude on the left has barely moved in the first 10 minutes.
He definitly moved frequently in the first 10 min. Maybe you are comparing to yourself? Or you wrote because his pic was frozen for 30 sec in the beginning you commented and lyed about watching the hole 10 min
Hi guys I am Maverick, my adhd symptoms, move hands randomly from left to right, look at any kind of light source with the left side of my vision, always itchy, struggling to sleep and keeping a conversation with the help of Dr Iyhere I have been sleeping and I can look at the light source directly now.
I have to wonder about who you are prioritising as an audience when most of your videos are over an hour long. It can't be people with ADHD themselves.
It is a good info commercial from ADDitude for the specialist
Dr Brown charges $400 per hour Dr Kennedy $300 plus initial diagnosis of $1,500 They do not take health insurance Is the system working from “we the people”?
A world famous guy taking 400 opposed to what? 100? Some random young guy fixed my washmashine by putting a plastic ring in and wrote some papers i think it cost around ~400
And they dont take ANY Health insureance none or just your super cheap american plan that does not want to pay that much?
Not saying you are nessesarily wrong btw
Yea I wasn’t watchin this whole thing I used the “key moments” feature
That woman hosting this has a horrible raspy voice.
Does not bother me. (But im also on too low meds already. I remember some stuff that bothered me/pain getting less to some extent in some areas.) :) Maybe adhd med helps not feeling everything negative so much and being able to reduce onwanted stuff and focus on other stuff. Who knows
I think she has a horrible mic that makes her voice sound really sharp. I found it painful