We see depression leads to difficulty with concentration
PEORIA - If you spend time on social media, chances are you’ve seen an ad asking, “Do you have ADHD?”
The ads lead to a self-diagnosing quiz and often provides viewers with misconceptions about attention deficit hyperactivity disorder (ADHD), before they ever see a medical provider.
That’s where Kyle Boerke, PsyD, director of Behavioral Health Outpatient Services for OSF HealthCare, hopes to provide clarity.
ADHD starts in childhood, not in adulthood
“Are adults being diagnosed with ADHD? Absolutely, yes. Is it that they are developing ADHD in adulthood, that’s a no. We know enough about the research, that in order to receive a diagnosis of ADHD, we have to have symptoms starting in childhood. Somewhere near 7 years of age,” Dr. Boerke says.
If you’re having symptoms as an adult that appear to be ADHD, such as lack of focus, inability to sit still, fidgeting, or excessive talking, but you didn’t have these symptoms as a child, Dr. Boerke says you may be experiencing something else.
“We see depression leads to difficulty with concentration,” Dr. Boerke says. “Something inside of them will ring true (if they have ADHD), like if they always struggled with paying attention to their teacher in elementary school.”
What to do about an ADHD diagnosis?
“The easy answer is, we need to seek treatment from a professional,” Dr. Boerke says. “If you have thoughts that you’ve had ADHD symptoms for a long time and you take one of those online quizzes, that’s fine, that can be a starting point.” But he stresses, “I wouldn’t take that quiz and all of a sudden say ‘I have ADHD.’ A great place to start is with your primary care physician.”
Dr. Boerke adds that there’s no official test for ADHD. It’s a whole set of symptoms that include how it’s impacting your daily functioning and for how long.
There are three types of ADHD1: Predominantly Inattentive
“They’re not going to be jumping all over the place, moving from activity to activity,” Dr. Boerke says. “It’s just going to be some hard times focusing, concentrating or finishing a task because your mind gets switched over to a different task all of a sudden.”
2: Predominantly Impulsive/Hyperactive
“These are the kids that just can’t sit still. They’re up out of their seats in the classroom, and this is really where ADHD in children to adults’ changes,” Dr. Boerke explains. “As we age, we do a better job managing the motoric end of things. It’s not uncommon to see kids have a hard time sitting still, it’s more uncommon to see somebody in a business meeting get up and walk around the room.”
3: Combined Presentation
Dr. Boerke describes the third type this way: “You have inattention, plus you have hyperactivity and impulsivity,” Dr. Boerke says.
Do I need to take medicine if I have ADHD?
Dr. Boerke says medicine alone isn’t the answer.
“The analogy I’ll use is Bear Grylls from Man vs. Wild. He’s an adventurer on a TV show where he goes out into the wild and he has to survive for a number of days,” Dr. Boerke says. “I liken ADHD to being on a Bear Grylls survivor show. He can do it. ADHD management without medication is like Bear gets dropped in the middle of the Florida Everglades and he has to trudge through the swamps, battle the alligators, get past the snakes and manage to get out. Can he do it? Yes, he does. Is it easy? It sure isn’t.”
Dr. Boerke says ADHD medication is as if Bear Grylls was in the Florida Everglades and producers drop him a rescue boat.
“But the reality is, he still has to get himself into the airboat. He has to start it, steer it, and do the work. It’s just easier to do the work,” Dr. Boerke adds. “Medication is not the fix. It can help, but if you don’t change your lifestyle, put in some organizational tools and do the things necessary, we’re still not going to get better and you’re going to rely on the medication.”
If you’re an adult and think you have ADHD, Dr. Boerke says seeking medical attention by a professional is the best first step. Then, your medical provider will help map out a plan moving forward. This can include ADHD medication and working to keep a strict routine to help you manage any ADHD symptoms.
DANVILLE - Lavender Zarraga, APRN, a behavioral health provider at OSF HealthCare, says it’s not uncommon for her patients to ask for a medication that isn’t the right fit.
The culprit? She says symptoms of common mental health issues like depression, attention deficit hyperactivity disorder (ADHD) and bipolar disorder can overlap. So, it’s important to stay in contact with your provider to make sure you’re on the best treatment plan.
On depression mimicking ADHD: “You have changed executive functioning. You can’t decide. You feel dull. You can’t concentrate,” Zarraga says. “You have a hard time learning new things. You can’t remember things or forget things easily. Attention and concentration are low. You think ‘Why am I processing everything so slow?.’”
Lavender Zarraga, APRN
Zarraga adds that she’s seen people with depression take prescribed medicine and feel better, but then residual symptoms that mimic ADHD creep in. And, she says, ADHD can seem like bipolar disorder.
“If you start somebody on an antidepressant and they have an underlying bipolar disorder that they have not been diagnosed with, that can trigger mood symptoms. It could potentially trigger mania [a high energy period where high-risk behaviors can occur],” Zarraga says.
It’s a lot to sort out, and it may make the person feel like they have a whole new set of problems.
“Talk to a provider. See what’s going on,” Zarraga says to people in that situation, noting that kids should not have to carry these issues into adulthood.
“There’s a lot of talking involved,” she adds. “Let’s start from the beginning. Let’s go back to your childhood. How were you doing then? And we relate that to how you are now.”
From there, Zarraga says treatment could include more counseling or different medication. She says medicine for children is more straightforward. But for adults, a provider will make sure the pill isn’t impacting the rest of the person’s body.
There are also science-backed written tests that can help diagnose someone with ADHD. Questions along the lines of: Can you sit still in class? Does your mind wander all the time?
And a word for caregivers, friends and family members: watch for symptoms of these disorders in your loved ones and have a conversation, if needed. Don’t ignore things, Zarraga says.
“There’s nothing wrong with just talking about it. It’s not going to hurt anybody to discuss it,” she says, noting that society is now more accepting of mental health issues.
Signs to watch for in your close companion: irritability, aggression, anxiety and trouble sleeping. If you or someone you know needs to talk to a professional quickly, the national suicide and crisis lifeline is 9-8-8.
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