Adult ADHD

  I've worked with children with ADHD diagnoses before, and have some opinions about that. I've seen kids which fit the criteria and seem to have something organic going on, and also kids who meet the criteria who come from "situations" where if they had some consistency in their lives the whole thing might just go away.  I have also had adults who claim to have ADHD who I think kind of like the meds, or maybe the diagnosis is trendy...
  I had a new client who was middle aged and came in and said he was diagnosed as an adult with ADHD about 6 years ago. I already know that our psychiatrist believes "ADHD must be diagnosed as a child, or it can't be ADHD", so I'm listening closely and critically to this guy.  Keep in mind that when he grew up in the 60s, kids who couldn't sit still were sent to the principal's office, or kind put into a group where they wouldn't bother other kids.  In the case of my client, both parents worked in his private school, and his Dad was the principal.  He had trouble, but he never got too many negative messages because his parent s could run interference for him.   His grades were all over the place.  When he got to college, and was expected to be more responsible, he couldn't manage his time and dropped out after a year.  He married, had kids, and bought a house.  He had a succession of jobs with which he had success, but only when he had the right kind of supports.  His wife tended to like to manage his schedule, and that worked for a while. He had enough success to upgrade from a starter house to a better house, and send his kids to college. Then something unraveled in his marriage, and he divorced.  He ended up in the office of an area psychiatrist who diagnosed him with ADHD, combined type and put him on meds, at higher doses than is typical, and he improved. (this particular psychiatrist has a reputation for prescribing heavily).  The client was able to tell me in detail what was different for him, like each particular task that he couldn't do without meds, and how being able to perform one step of a task (on meds), gave him the ability to complete the whole activity.  The guy was intelligent, articulate and knew more about ADHD than most professionals (including me). I learned a lot from this client, but the intake was difficult for me to write up.  Because of where I work, I am always on the look out for people who are drug seeking, and I already know the opinion of our psychiatrist about ADHD adults.  

    I gave him the ADHD combined diagnosis there was nothing else on Axis I I could consider (with the information I had).  I will find out what the psychiatrist thinks in a few weeks when he has his psychiatric evaluation.