Friday, February 12, 2010

Diagnosis--Do you have the inattentive subtype of ADHD? Part I

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A'ight. Let's break this thing down.

First off, though, let's just be real. Self-diagnosis is a tricky thing. It's hard to be objective, and everyone experiences a dose of "med school syndrome" at times where any disorder we hear about, we find the parts we can relate to. By the same token, though, if you're like me, self-diagnosis will be an instantaneous revelation, like having your entire childhood and present life summarized in a one page list. To do it the right way, though, you need even more than that. You need to be able to provide substantiating evidence for what you claim, and you need to pay attention to ALL of the criteria, not just the ones that you feel connected to, or that support your hypothesis.

That being said, let's move forward with the actual criteria. First, to have ADHD-I, you need to have six of the following symptoms apply to you (this is actually just one criterion). Now, the DSM doesn't necessarily say this, but I'll just interject that the six that apply shouldn't be "sometimes" or "kind of" or "well, when I'm really tired." These should be absolute truths to who you are as a human being, and should describe you now just as they described you in every year of your life. They are:


1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
2. Often has trouble keeping attention on tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
5. Often has trouble organizing activities.
6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
8. Is often easily distracted.
9. Is often forgetful in daily activities.


There is a reason that someone with ADHD-I needs to clearly demonstrate six of those behaviors. (Most sub-criteria requirements aren't nearly as rigorous.) It's a tall order, and not a lot of people can legitimately claim to have experienced six or more of those things on a daily basis in a debilitating way since before age seven.

Oh yeah, did you hear that? The next criterion I'll share is that it has to have been happening since before age seven. This is where a lot of people get some clarification. If, as a child, you were really neat and organized and tidy and always did your homework, and didn't lose things, then what's probably happening to you now is not ADHD-I.

This is where I would recommend finding substantiating evidence. A lot of us don't remember life before age seven. Substantiating evidence could be talking to your parents and getting their assessment of what you were like and whether you fit the criteria. That's somewhat weak, but it can serve to bolster one's case. For me, I wanted to be really, really sure I was correct in my diagnosis. So, I actually busted out old report cards and looked at behavior comments. Of course I remember the words teachers said, and the behaviors I exhibited at that age. But there's now no disputing the very obvious running thread I found, documented year after year, of me having the above symptoms.

Sorry, don't mean to make this a cliff-hanger, but I've gotta run to a meeting, so I'm going to do this in two posts. But, you've gotten most of the meat of the DSM diagnosis--definitely enough to sink your teeth into if you suspect you might suffer from ADHD-I. Tomorrow we'll talk about the remaining criteria, as well as any rule-outs that might apply.

May your day be merry and bright.

8 comments:

  1. I think part of the diagnoses should be if you cry during Sylvan learning commercials. I got teary- eyed watching those. The idea of getting help and being able to come home and say, "MOm, I am doing my homework now and I got an 'A'" seemed like a dream come true. (P.S. i am not 100% sure if I had the symptoms before age seven, although I do remember having homework in 1st grade. I don't know. I know we decided I have it, but do I?)

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  2. I was about to go get my vehicle inspected and then get my car registered, but then I saw your post on facebook... next thing I know I'm creating a google account just to be able to post a comment after spending close to an hour reading your posts, the comments, and looking at the pictures. So I stopped what I was doing and ran out the door. Let's just say my car still needs to be registered. Also I never finnished creating that account. I don't think I need to explain why. Really, I'm lucky to have finnished this post.

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  3. So, my first grader regularly cleans out her desk and brings home piles of unfinished work. I've rarely seen her bring home an actual completed assignment. That, along with other things, makes me wonder about a diagnosis. Her teacher apparently doesn't care about the assignments (it is first grade), but I worry that school is going to be much harder as she gets older. It's hard because her teachers have all universally loved her because she's very friendly. But also very spacey.

    Anyways, I thought the 'before 7' caveat was interesting because I assumed these were normal behaviors for the under-7 crowd and that she'd grow out of them. But, as our other children grow up we're realizing maybe not. It doesn't help that both her parents are hyper-focused and anal-retentive about everything. Sigh.

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  4. Thyme--that's funny about the Sylvan commercials, and also really sad ;-(. About whether or not you technically have ADHD-I, according to the current DSM criteria, you could not because of the age thing. I've heard word that the DSM-V might contain an adult-onset version of the disorder, which I personally believe is possible, but much more rare. (I actually think there is probably a version that hits around puberty--pure speculation on my part though.)

    Anonymous--I feel like I know you, but you didn't leave your name! Who are you ;-) Sorry you didn't get your car registered. I totally feel your pain. But thanks for taking an hour to read my blog. I really appreciate it.

    Foxy--Oh man, I feel for her. That's so hard. Maybe she'll be lucky and just grow out of it, though. Definitely possible. The good news is that you're catching on early to what might be happening, and you're a supportive, concerned parent who won't inflict her with misguided labels about laziness and irresponsibility. So many ADHD-I kids don't get that. But, if it turns out she does fit the diagnosis, it might drive you both nuts, just like it did my very-organized, always-on-top-of-things mom!

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  5. -chris. Love ya bro.

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  6. So let's say someone only meets 4 or 5 of the criteria, rather than 6. It wouldn't result in the diagnosis of inattentive sub-type of AHDH ... so such a person couldn't really chalk things up as "symptoms." Therefore, that person really IS just lazy and stupid? :) (BTW I'm talking about myself here in case that wasn't apparent.)

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  7. Haha, that's a really good question. One thing to look at would be how you would have answered those questions (or even better, how someone would have answered those questions for you) when you were under age seven. As adults, we learn certain strategies that help us to cope which might mitigate the symptoms, even if the disorder is still present.

    Whatever the case, I'm pretty sure you aren't just lazy and stupid. If you experience 4 or 5 of the criteria on a basis that hampers you, then there is likely something going on.

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  8. maybe my shrink was right. maybe i DO have adhd.

    just discovered your blog. had to start at the beginning. LOVE IT!

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