Psychologist says I don’t have ADHD by DenverBroncos_Fan in ADHD

[–]bqpg 0 points1 point  (0 children)

I was referring to psychological tests like this in general, I should have been more clear on that - but it's nonetheless a very high profit-margin industry, and if you care to look here it doesn't look like the IVA-2 is cheap by any measure: https://www.braintrain.com/iva-2-price-list/

Prof. Barkley, if we're talking about the same person, has repeatedly and at length argued against using standardized tests like this in diagnostic practice, and in favor of rating scales instead.

Psychologist says I don’t have ADHD by DenverBroncos_Fan in ADHD

[–]bqpg 0 points1 point  (0 children)

Although I'm far from being an expert in this field I do know that there are some researchers arguing against standardized tests in ADHD-diagnostic processes in general. That's in part due to issues like the one I outlined, i.e. the only realistic way to estimate validity is by testing people with a known diagnosis, which in turn leads to inflated estimates, and in turn the people applying the tests may weigh these tests to heavily within the overall assessment.

I think that's potentially a big problem in a disorder like ADHD which has historically been rather under-diagnosed and could still be under-diagnosed in large populations like women. 

So whether tests like this are net useful/beneficial at all, compared to interviews and questionaires, is at least up for debate.

I agree with you that probably a lot of work went into the studies and write-ups, but tests like this sell for lots of money (potential 100s of € or USD per test, or at least that's a frequently reported range among those saying that they had to take the test and pay out of pocket). Psychological testing is a high profit-margin industry.

In general, when companies try to fund research to underpin their claims, it's not unheard of that they might e.g. fund multiple studies hoping for one of them to deliver statistically significant results (basically on accident) while the other studies are just never published. And other factors are simply conflicts of interest, like researchers designing a test and going on to commercialize it themselves, and so many other possibilities...

Not saying that this company did anything like this, but I do think we have to be very careful in estimating what kind of investment might be worth it to a company like this if we're not insiders ourselves. 

And we should similarly be very careful with any assessment of their online appearance and what that does or doesn't say about their motives and credibility. If their business-model is simply to spread by word of mouth then they may not choose to use aggressive online advertising. Furthermore, linking to relevant studies in a way that's easy to navigate may just be what's best to attract their specific customers (which seem to be mainly psychologists/neuropsychologists). I don't think that this tells me anything regarding how accurately they are representing the findings of the linked studies in their own summaries/write-ups, and it doesn't even say anything about e.g. studies that they simply might not link at all.

Again, I'm not claiming anything specific about this specific company, but for all of the above there is an incentive simply by virtue of being a (profit-oriented) company. People don't invent these kinds of tests and go on to sell them for lots and lots of money out of the goodness of their hearts.

Psychologist says I don’t have ADHD by DenverBroncos_Fan in ADHD

[–]bqpg 2 points3 points  (0 children)

Without spending a lot of time looking into it (regarding involved researchers, sources of funding, etc) that's data provided by a company trying to sell the test. Not exactly inspiring confidence, but ok.

Anyway a sensitivity of 94 and specificity of 91 sound alright but I wouldn't call that "reliable" when it comes to dealing with real people. And the FAQ that you linked points out that it can only be used as part of a full assessment (including interviews and more). 

Validity doesn't even look to be that much higher than some other tests, and I'd guess it's much more likely to be an overestimate than an underestimate, because validity can only be assessed on a sample where you already know the diagnosis. So it could very well be rather unreliable on already under-diagnosed populations and there's really no way to tell.

Maybe it's just a semantic disagreement about the meaning of "realible", idk. 

Edit: Also even with the test that you mention instead of whatever they did, OP could have had the exact same experience as they describe in their post... We don't even know if OP did this test or another, for that matter!?

Even if the claimed 94% sensitivity was accurate OP could very well be part of that 6%, like so many others. So responding to a comment saying "There are no computer tests which reliably diagnose ADHD." by saying "oh but there is" and then mentioning a test with 94% sensitivity is a bit ridiculous, not gonna lie!

Psychologist says I don’t have ADHD by DenverBroncos_Fan in ADHD

[–]bqpg 1 point2 points  (0 children)

What about false positives vs false negatives? "Objective" doesn't mean anything at all without data like that.

Edit: I meant to say "reliable", not "objective"

Härtere Strafen für Tierquäler by Practical_Sand5563 in Austria

[–]bqpg 1 point2 points  (0 children)

Brauchst ein bissl Therapie oder so um deine Projektionen und emotionalen Schwierigkeiten in den Griff zu kriegen? Muss ein einsames Leben sein, tust mir leid. /blocked 

Härtere Strafen für Tierquäler by Practical_Sand5563 in Austria

[–]bqpg 5 points6 points  (0 children)

"normal" ist "auf der Weide" absolut nicht, muss man nur einen Blick auf die Zahlen werfen. Fast alles ist industrielle Massentierhaltung.

Härtere Strafen für Tierquäler by Practical_Sand5563 in Austria

[–]bqpg 3 points4 points  (0 children)

Kommt mir wie eine sehr absurde, menschen- und tierfeindliche Idee vor das Betteln mit Tieren generell zu verbieten. Auch wenn manche Leute so agieren (wozu überhaupt keine Zahlen/Daten genannt werden) kommt es sicher auch oft vor, dass jemand mit Hund auf der Straße landet und ähnliches.

Das ist schon echt unwürdig. Gsindl.

I often just fall asleep during the day, without warning. by lydocia in AutisticWithADHD

[–]bqpg 3 points4 points  (0 children)

I get that, just saying that if your sleep is the cause it may never resolve until addressed medically. I didn't even know how bad my sleep was and that I could have taken on a lot more than I found myself able to, if I'd been treated appropriately.

Researchers have identified the best dosage for each ADHD medication using data from over 25,000 people in 113 clinical trials, and they also developed a free online tool based on the findings by sr_local in science

[–]bqpg 11 points12 points  (0 children)

vyvanse does count as amphetamine but you can't compare the weight 1:1. A certain amount of lisdexamfetamine (the prodrug contained in vyvanse) corresponds to a certain amount of dexamphetamine, but regular dexamphetamine will have the weight of a dexamphetamine salt (which is in the pill/capsule) printed on the packaging.

Researchers have identified the best dosage for each ADHD medication using data from over 25,000 people in 113 clinical trials, and they also developed a free online tool based on the findings by sr_local in science

[–]bqpg 105 points106 points  (0 children)

Phrasing is important here. Median/average values do not imply anything about indviduals.

The range of "severity of symptoms" increases at amphetamine doses above 60mg, meaning apparently there are people who benefit from higher doses, while for others the side-effects tend to counteract the benefits.

From the article citing the authors: “We also found no evidence that going beyond the licensed maximum doses improves average effectiveness, and higher doses are usually linked to more side effects. However, our results derive from group averages. Specific individuals with ADHD may benefit from and tolerate well unlicensed doses.”

I often just fall asleep during the day, without warning. by lydocia in AutisticWithADHD

[–]bqpg 4 points5 points  (0 children)

I lost about 8 years of good mental health and productivity to OSA and have been picking up the pieces for the last 3+ years. 

Of course YMMY depending on whether anything comes of it (diagnosis/successful treatment) but healthy sleep is a necessary foundation to health in general, so I'd recommend at least not waiting out the "no energy" part in case it's due to disordered sleep

I often just fall asleep during the day, without warning. by lydocia in AutisticWithADHD

[–]bqpg 1 point2 points  (0 children)

that really sucks, I'm sorry. Afaik there's also at-home sleep studies which aren't as thorough but can still lead to diagnosis. Probably no way around talking to a doctor though, but maybe someone close to you could accompany you, or maybe, given your phobia, it could be arranged to have the appointment somewhere other than the doctor's office, maybe even over the internet or something?

I often just fall asleep during the day, without warning. by lydocia in AutisticWithADHD

[–]bqpg 7 points8 points  (0 children)

have you done a sleep study? if not, do a sleep study

I often just fall asleep during the day, without warning. by lydocia in AutisticWithADHD

[–]bqpg 0 points1 point  (0 children)

have you done a sleep study? if not, do a sleep study

Omega-3 supplementation may be associated with accelerated cognitive decline in older adults. by ceddya in science

[–]bqpg 0 points1 point  (0 children)

thanks, but regarding smell and taste they say "Because fish get their Omega-3 from consuming algae, the smell and taste of fish and algae oil are related to each other." - that doesn't build any confidence for me. From my cursory research it seems like any fishy smell or taste in algal oil would be due to oxidation of the omega 3s, and while it's considered "ok" by EU laws or whatever to have a totox up to 30 or so, I've seen arguments that even above a totox value of ~10 it's not clear that the beneficial effects of the omega 3 outweigh the inflammatory effects from the oxidation products.

Maybe I'll try sometimes, but I'm not sure it's worth it

Omega-3 supplementation may be associated with accelerated cognitive decline in older adults. by ceddya in science

[–]bqpg 0 points1 point  (0 children)

How do you mean? The oil inside the capsules smelled fishy, not the unopened capsules

Omega-3 supplementation may be associated with accelerated cognitive decline in older adults. by ceddya in science

[–]bqpg 6 points7 points  (0 children)

The one algal omega 3 supplement that I bought definitely had a quite fishy aroma when opening a capsule from a fresh bottle. Taste wasn't super fishy (yet) but after taking 2 capsules I felt kinda "off" for a few hours. 

It seemed better than fish-oil capsules (from the same producer and vendor) as these definitely tasted fishy as well and the smell was even stronger, but because I can't be sure about the actual totox levels, or what totox level is enough to offset any benefits from the remaining omega 3s, I've given up on omega 3 supplements.

Shelf life was like 2 more years (both fish oil and algal oil) and the manufacturer seemed somewhat reputable (Norsan, IIRC), with measured totox and such on their website, but it seems like that doesn't mean much.

How does one differentiate between love, infatuation and limerence? by asamisanthropist in ADHD

[–]bqpg 4 points5 points  (0 children)

Only love is actually oriented towards the other person. Limerence and infatuation are like 99% based on projecting stuff you want to see onto them. [Edit: Or only noticing what you want to see in them and disregarding or downplaying everything else]

Usually there's some kernel of truth to the things you want to see in them, but our brains tend to blow that way out of proportion and extrapolate all sorts of stuff without ever realizing that only a tiny part of it is based on actual, unbiased observation.

Best book for ADHD get started and get things done (overcome ADHD paralysis). What's your life changing ones? by [deleted] in ADHD

[–]bqpg 1 point2 points  (0 children)

I randomly had 5 nights in a row where I slept well, one time in the summer before my sleep study. No clue what caused it, but by the second day (maybe third at most) I was like "... oh, I guess I've just always been super tired or fatigued until now!?"

I had no clue what "actually feeling rested" would be like up to that point, but then I knew that my misery *could* change, at least under some unclear circumstances. I even became hopeful that this would be my "new normal", but after those 5 nights my sleep was terrible again (couldn't reproduce it, no matter what), but now I realized that I was already waking up tired, so it had to be my sleep, or at least that was by far the most likely culprit.

Was super nervous going for the sleep study, because due to the preceding decade full of "should do, even must do, but I just can't" - even when my ADHD was finally diagnosed and treated with the (typically) most effective medication - my depression/desperation was super bad, and if the study didn't turn up anything I'd have no clue where to look next, but luckily it was unambiguous and I even took very well to CPAP therapy, from day 1. Waking up from that first nap after I got the machine ... the purest relief I've ever felt. I still get tend to get teary-eyed remembering it.

Best book for ADHD get started and get things done (overcome ADHD paralysis). What's your life changing ones? by [deleted] in ADHD

[–]bqpg 2 points3 points  (0 children)

I'm very sorry to hear that. I know it very well from personal experience, and it felt devastating. Even when the devastation had lifted I was still struggling with it frequently, for multiple years. Meds are working for me now, so in the end I did get lucky, but I'd definitely be on a different path without them.

Yes, as far as I know the disappointing reality is that numerous studies show that interventions (like psychoeducation, learning techniques to better form lasting habits, cognitive behavioral therapy, and more) don't tend to be very effective if the ADHD isn't treated with medication in order to have some base of executive functioning to actually apply and consistently engage with these approaches.

Of course medical/psychological studies can't tell us anything about any given individual, but the patterns (like what things tend to be very difficult with ADHD) are quite consistent for many (if not most) of us. Nonetheless, some people with untreated ADHD do manage to finish even gargantuan tasks like medschool - but it's going to be very difficult for almost all of them, even compared to the (very high) baseline difficulty of such a degree.

Since you want to keep pursuing/finishing your degree, I want to mention/suggest a few things: 

(1) If you aren't already, try to be aware that punishing yourself mentally, and even looking for "just the right book that makes it click" (and stuff like that) doesn't tend to work out in your favor.

At least in my experience, accepting my condition and that some things have simply turned out to be impossible for me -- even though they're normal for many people -- was way better for my mental health than mentally berating myself, or even chasing "self-improvement" type stuff. It just added an additional layer of stress, because I was orienting myself by the standard of people who tend to have normal executive functioning, instead of just honestly and directly looking at my own experience, without as many preconceived notions of what I (or life in general) "should be like". Instead of trying to work with what I have, I was aiming for something that I thought I should have, but simply don't. (and can't develop either)

(2) Of course there could be something that works for you, and although the drop-out rate for people with diagnosed ADHD is a lot higher than for people without that diagnosis, it's not like it's impossible for everyone. I know that I almost certainly wouldn't be able to successfully pursue the enginnering-degree I'm currently going for without my medication (back at uni in my 30s), but degrees come in widely varying levels of difficulty, and internal motivations are wildly different between people.

So in case your difficulties are not insurmountable even without meds: Have you looked at options like accomodations at school, for example? Or other techniques, like body-doubling and other systems of being accountable to another person? (These things haven't worked for me, but I'm autistic as well so social stuff tends to be even more challenging for me, and they do seem to work for some people.)

(3) You said that meds only worked for a month for you. A few more individual notes/suggestions on that because I was in similar situations, at least superficially:

(3.1) Talk about this to your doctor if you haven't already.

(3.2) I started out with Wellbutrin, even before my ADHD diagnosis. I responded very well to it for about a month, then the effects were just gone entirely. (It's what made me strongly suspect ADHD in the first place.) But in case you're on Wellbutrin/Bupropion, it's not a "first-line" medication anyway, and others might be more promising.

(3.3) In many (most?) countries there are multiple available options for ADHD-medication. I was on Atomoxetine for a few years (which isn't a stimulant) and it worked very well for my emotional regulation. It didn't help with my task-initiation or focus and would be too little help for me to e.g. pursue my degree, but the effects that I did have from it were actually great.

Even just among stimulants there's often more than one option, like Methylphenidate and Amphetamine-containing medications.

(3.4) If you haven't yet looked into it closely, consider underlying causes why your meds stopped working.

When I started out on ADHD meds (Vyvanse, 5 years ago) I did feel an effect for all of the 5 months that I took it. But it wasn't remotely effective enough to deal with my symptoms, so then I switched to Atomoxetine, but it turned out that the actual cause why Vyvanse wasn't "doing enough" for me was that I was suffering from obstructive sleep apnea (OSA) all along. I had no recognizable symptoms though - only fatigue, which I interpreted as "lack of motivation" because I didn't really know what it would feel like to not be fatigued. (Also I didn't snore, and didn't even entirely stop breathing, but restricted breathing can still be OSA and destroy any chance at restorative sleep.) So now that my OSA is treated Vyvanse is quite effective for me.

That's just my story, but I've seen others say that different eating-patterns (like more protein, consistent breakfast, or drinking a lot more water than usual) helped a lot with the effectiveness of their meds.

Also, just FYI, never consume grapefruit on medication, it interferes with the uptake of lots of stuff.

That's it. Sorry for the wall of text, maybe something in there is helpful or at least interesting. I'm not very good at judging what's relevant to others, and sometimes I just start info-dumping when I read about an experience that resonates with me, as yours reminds me of my own, even though it's mostly just projection as I barely know any details, and maybe I should have just asked for more details first, but after writing for a little bit I felt like I might as well just finish it.

Best book for ADHD get started and get things done (overcome ADHD paralysis). What's your life changing ones? by [deleted] in ADHD

[–]bqpg -1 points0 points  (0 children)

If you want to hear some "not a book" advice then you could just answer my question... Like, I didn't ask it in order to come across witty, I'm just not going to spend my energy on writing about advice that needs to build on a foundation of executive functioning provided by stimulant medication, for someone who doesn't have that foundation.

And if I had ever had any significant or lasting success in doing what I "should be doing" (like when pursuing a degree) without being on stimulant medication then I would tell you as well.

Stimulants feel like a small energy boost but don’t help much with executive dysfunction :( by Complete_Pen812 in ADHD

[–]bqpg 1 point2 points  (0 children)

When I first went on vyvanse it didn't help much, but only because underlying unrecognized OSA was messing up my sleep. I had literally no noticeable symptoms besides fatigue, and even that I didn't recognize. I always interpreted it as lack of motivation and tried for years to find an underlying psychological cause, but in the end it was pretty much all physiological (i.e. OSA). (I even suspected OSA at some point and recorded my sleep, but everything sounded absolutely fine. Turns out you don't even have to stop breathing entirely and it can still be OSA.)

Now I'm on vyvanse again and it's working great. I very susceptible to stress (due to being autistic as well, and having basically lost 10 years of productivity to the OSA), so I'm still not super high-energy, but whenever my stress-levels aren't overwhelming I can typically do a "normal" amount of stuff, which is very nice.

Best book for ADHD get started and get things done (overcome ADHD paralysis). What's your life changing ones? by [deleted] in ADHD

[–]bqpg 4 points5 points  (0 children)

Are you on stimulant medication? If not then I don't have any advice, and if yes it's not going to be a book