I didn’t discover I have ADD until I was 64.
Suddenly, a lot of things made sense – why I couldn’t make model airplanes as a kid, why I killed a pregnant Guppy fish, why I was always losing my keys, why I always carried a pocket full of index cards and an appointment book. I was using strategies that I didn’t realize were strategies cause I didn’t even realize there was a problem, but they made my life easier.
Medications, and the Elderly
I saw Dr. Evaldson, the Santa Fe ADD ADHD expert. He confirmed my diagnosis but was a little reluctant to give me Ritalin because of my age. But I was in good health so we tried a low dose.
The research doesn’t show any real danger of the stimulants – Ritalin (methylphenidate), Adderall, Vyvanse, Daytrana, amphetamines-especially in the absence of heart disease or hypertension. The antidepressants – Strattera, Wellbutrin- may be a little more problematic but we use them in the elderly.
Changes With Age
ADD ADHD by definition begins in childhood. Basically, we’re born with it, but it often doesn’t really show up in symptoms until we start school, or occasionally later. 8% of children have it. I was wrongly taught that we outgrow it in adolescence; we don’t. But due to some combination of maturing, learning strategies, and improved self-control,the symptoms become less noticeable, especially hyperactivity,and only 4% of adults meet the criteria for diagnosis, even though some of the brain abnormalities persist.
Does our ADD ADHD improve as we get older? Or does it become worse? How do we distinguish between the symptoms of normal aging versus ADD ADHD? I’m not sure there are good answers to these questions, but if the only symptoms are of memory or first appeared and old age, it is presumably not ADD ADHD.
In my little research of the net, there’s not a lot of information about this, and most of it comments that there’s not a lot of research about it.
Diagnosing
It is clear that in making the diagnosis other medical problems (hypothyroidism, vitamin deficiency, dementia, etc.) need to be ruled out, but that’s true for younger people also.
I hope our viewing doctors will make some clarifying comments.
doug
Definition of Old:
And it doesn’t get better. And tax season is going to sneak up on us.
Anyone 10 years older than me.
Quote O the Day:
“White hair is a sign of wisdom, if you keep your mouth shut.”
Rant O the Day:
Actually, the stimulants may be less problematic for us than the benzodiazepines that so many of us are on.
Comment O the Day – Three of the Bad Things About Getting Old:
1. Losing your vision
2. Losing your hearing
3. I can’t remember the third
The Links:
Attention Deficit Symptoms in Older People
I didn’t know I had ADHD until I was nearly 40 years old. In talking with my doctors, we decided to forego medication because I felt that if I had been able to cope successfully for that long without it, I’d like to continue to try to stay that route. So far, that has worked well.
ON the question of age, if I look back over my life knowing now that I’ve always had it, I wouldn’t say mine got worse with age, rather it looked different. I find that my symptoms are exacerbated by major life events…new job, marriage, pregnancy and childbirth, buying a home, etc. I think that was probably true all along, in retrospect. Knowing that, I can now be on guard, so to speak, at times when these events might occur. It helps me to hold off some of the symptomology or at least understand why my symptoms are worse at a given time.
And I agree with the statement above (or below, depending on how your comments work) that getting the diagnosis is a huge first step toward a better life. Very true.
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lisa- good observation!
I think life events throw us partly because they’re stressful, partly because there are new challenges and we haven’t figured out our schedule and strategies to cope with them, and partly because they throw us off of our schedule and structure, – we may stop exercising etc.
As you say, being aware of this – “whoops! Here comes a major life event. Maybe I could plan for it..” is a good strategy’
thank you for commenting.
Doug
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I think that’s exactly it, Doug. For those of us who depend on routine and known quantities, those major events are a challenge. They throw us off course and we can’t possibly know how to handle them until we’re in the thick of them. But like the diagnosis, I think understanding that these things affect me is a huge part of being able to handle them better in the future.
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lisa-
that’s my theory. if we can identify a problem, then we can come up with a strategy to cope with it.
thank you for commenting.
Doug
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Doug,
my overall impression is that for many adults who have subclinical but still active ADHD, it does become actively worse in later middle age.
I have been discussing the matter with several colleagues of mine and also closely reviewing my own past history.
My observation overall is that adults usually present for management of their ADHD when something has happened that has reduced the amount of exercise they get. It can be a change in work (with the attendant learning curve and extra hours required to master the job and make a good impression), or it can be an increase in home responsibilities- being the taxi driver to a bunch of teenage children, or even an injury.
I have discussed the matter with my former wife (who, like me, is a general practitioner) and in retrospect we can see a very clear pattern that when I got less exercise I become much less functional. Recently I managed to break a bone in my foot and my amount of walking has halved for about 3 weeks. Whereas I was needing little medication- now I have gone back on it most days, and expect to need the higher dose until I can get back over 10,000 steps per day.(I have been keeping track for months using a pedometer app on my mobile phone).
I have just read a book by the name of “ADHD as a model for brain behaviour relationships”. The standout chapter for me was the one that focussed on the role of the cerebellum in automating and streamlining movement- and the flow through effect that the movement disorder has on making cognition and emotional regulation less stable.
This makes a great deal of sense to me- as I was one of the roughly 50% of ADHD children who would have qualified as developmental coordination disorder. Equally, notwithstanding the recent injury induced setback, my overall function has improved greatly over the last year as I have persevered with regular Tai Chi, and cerebellar retraining exercises- and is still much better than the baseline of 12 months ago.
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mind body – I agree that exercise is very important, as well as structure, sleep, and getting outdoors. I too am coordinationally challenged. My understanding is that we have abnormalities in the cerebellum, and basal ganglia, so it’s not surprising. So maybe part of the benefit of exercise is improving those structures and networks?
Thank you for commenting.
Doug
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It kept my grandma young.
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busy – I’m guessing because it kept her interested and active?
Good for her.
Thank you for commenting.
Doug
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How refreshing to read your entry! I was diagnosed about 3 weeks ago and I’m over thirty. Though in some aspects I too inadvertedly found strategies (which I too didn’t know wäre strategies), a big part of my life is very messy. And though I’m willingly to tackle the bear, I find it to be quite absurd how most oft the adult ADD patients insist in blogging about how they’re the OPPOSITE of victims or suffering Form a disorder, oh no. They are fabulous, special, unique and they are here to tell you everything about yourself because they are experts (from being diagnosed a couple oft years back, no less). Your Down-to-earth bolg entry really was like pouring balm in my heart. Thank you!
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ram-
congratulations on getting your diagnosis. It is a big first step towards making your life better. Glad the blog is helpful
best wishes
Doug
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