How to CORRECTLY Diagnose Attention Deficit Hyperactivity Disorder (ADHD) in Adults? - Dr Sanil Rege

In this video, Dr Sanil Rege outlines the clinical evaluation of Attention Deficit Hyperactivity Disorder (ADHD) in adults. He uses a diagnostic hierarchy in his evaluation to ensure other comorbidities are taken into account.
ADHD is a diagnosis of exclusion and requires a longitudinal assessment.
Attention deficit hyperactivity disorder is a neurodevelopmental disorder characterised by inattention, hyperactivity, impulsivity or both. It has traditionally been recognised as a childhood condition.
However, the current population estimations put 4.4 to 5.2% of adults aged 18 to 44 years old as currently suffering from ADHD.
ADHD can impair psychosocial functioning and impair quality of life significantly.
Clinical assessment should be supplemented with questionnaires for the patient including collateral information and childhood history.
Step 1: History Taking
Step 2: Medical Review Including Review of Diet and Lifestyle
Step 3: ADHD Specific Interview if ADHD is suspected
For the full article visit psychscenehub.com/psychinsigh...

[@leoparddog84]

I like that you speak at a reasonable speed. So many times when people try to explain things they speak too slowly which makes them impossible to understand as by the time they finish their sentence, I've forgotten how they began.

[@brieannaladara4802]

Not speaking ill on your perspective at all! But after reading your comment I expected him to speak quickly and since he didn’t, I felt like he was speaking soooo slowly lol

[@Dancestar1981]

That’s what the speed up option on videos is for

[@ReyRey.00]

Exactly. I hate it when people speaking is slow

[@MDMC313]

1.25 Speed for me.

[@justinward3218]

I usually listen at 1.5x-2x speed.

[@CptRoboto]

Man I wish I could see someone like you. Just the attention and care to detail you give in this video is so refreshing. I’m still in the middle of narrowing down diagnosis and am sooooo tired of the run around. This seems so thorough and matter-of-fact. I love it!

[@PsychiatrySimplified]

Thank you for your feedback. 🙏🏼. A psychiatrist should be able to work with you to run through all aspects comprehensively. We wish you good luck in your journey.

[@user-lw8kv3vn7d]

I'm suffering from adhd in childhood and now my daughter suffering from adhd .

[@lilbrit1811]

I have c-ptsd and a panic disorder, but was also diagnosed with “long term depression” which I didn’t agree with. I mentioned how I have always been messy, I physically sometimes cannot bring myself to complete a fast like clean, I’m either 0% or 110%, sometimes I take a nap to avoid dealing with things like cleaning etc. Noises cause physical pain in my brain, I feel like my brain moves extremely fast so when people are teaching me something or training me on something I get really frustrated because my brain is already 10 steps ahead of what they’re saying. Work during the week is painful for me, by 9-10am my brain is done. I can’t focus, concentrate and also have to take a nap during my lunch break and also take a nap right after work. I have pernicious anemia (autoimmune b12 deficiency) that went missed for many years to the point where I was falling over and had severe vertigo. Interesting to hear you talk about those vitamin deficiencies and also estrogen

[@PsychiatrySimplified]

Thank your sharing your personal experience. You may be interested in the articles on psychscenehub.com on Females with ADHD / chronic fatigue syndrome and Complex PTSD as there is a substantial overlap as you highlight. You can use the search box on website to search for these articles.

[@Dancestar1981]

The only thing I haven’t had checked yet is my hormones which I was due to do before we went back into lockdown. Everything else comes back normal. The only other option which I have been saying for years is an mri scan of the brain.

[@meniversal]

imagine going through adhd videos/symptoms but cant even focus on what this shi really is

[@Mohammad-xl7cg]

🥺 I feel so sad may God bless you

[@ashleycoss1988]

Same

[@violetpotato864]

Wah i thought i was the only one

[@raapyna8544]

@@Mohammad-xl7cg what

[@ebonyalexis32]

🙋🏿‍♀️

[@haraluppnow3534]

Had to listen to this at 1.75x, then it was pretty good content!

[@kracklinkamphyre7142]

I really liked going through all the other things that could be going on with me. I have an assessment tomorrow for ADHD and am just watching these videos to learn a bit more. I have a hard time admitting I might have ADHD but have to admit that i. I'm definitely losing the battle in certain areas of life and work and if a medication could help me get stuff done that that would be worth while. But I also want to make sure I'm not missing something else, so going over these other possibilities was helpful. I don't think any of them explain away what seem to be true ADHD stuff, but that makes me feel more confident in what it is.

[@MiloBuffo]

Do you have any update on your assessment?

[@kracklinkamphyre7142]

@@MiloBuffo I received my diagnosis and am trying concerta. It's helping when the amount in my system is just right. I was given a prescription for 18mg and was supposed to take that for two weeks and then up it to 36 (taking two pills). I've found the 18 helped at first, but after about a 5 days of taking it it now just kinda messes with my head, and 36 is too much. Waiting for my next Dr apt to try to get my Rx changed to 27mg as I think that will be just right. It's pretty low for my size, but I'm a bit of a lightweight with medications and alcohol and stuff. It's affirming when you take a med like that and get really calm and quiet. If you don't have ADHD and take a stimulant it makes you really wired. I think that's something that really solidified in my mind that I had ADHD, kinda like diagnosis by treatment (I'd already been diagnosed, but I just mean it confirmed the diagnosis for me). It's very weird feeling your brain be quiet. Being able to just sit and 'be'. Crazy that that's how most people are. Being able to tackle something like cleaning the kitchen and have it just feel like a single, straightforward task rather than 100 separate little decisions is so nice! Being able to stop myself from saying something feels like a super power. I don't have any less urge to say what I want to say, the meds don't help with that at all, in fact it's almost a bit worse, but I can reason that what I want to say isn't important or interesting to the person I'm talking to and just *not* say it. If you don't have ADHD that sounds super lame, but when you get that compulsion under control it feels really nice! It takes away a lot of anxiety in social settings because I know I won't blurt something out as easily. There's other things I've noticed, but that's generally where I'm at right now.

[@PsychiatrySimplified]

It’s extremely important to rule out hyperarousal and sleep dysfunction. Often a reason for side effects or non effectiveness. Response to stimulants does not rule in adhd and non response does not rule out. Stimulant response isn’t the final diagnostic pathway - a longitudinal history and formulation is. Stimulant response can help support it but then stimulant non response does not rule it out

[@HollywoodTarah]

I got overwhelmed by how slow he was talking as soon as the video started because I knew I was not about to pay attention😭 well I guess there’s my answer

[@mermish4]

best talk on adhd iv heard, so much info in such little time , thanks for posting

[@PsychiatrySimplified]

Thank you for your feedback. You can always visit the more detailed articles as well. psychscenehub.com/psychinsights/neurobiology-of-adhd/

[@alanberkeley7282]

It was a better diagnosis method than this 14.45. Just watch kzbin.info/www/bejne/aYKqhoyMgrR-sM0

[@AK-vx4dy]

My head spins around... I have much respect to you that you can discriminate this symptoms!

[@PsychiatrySimplified]

It’s pattern recognition and ruling out along with hypothesis testing. The brain areas controlling cognition, activity are common ; the constellation of symptoms that occur along with those give an understanding of treatment .

[@AK-vx4dy]

@@PsychiatrySimplified Yes very common, it almost screams "start at something more specific to adhd", but as i understand as a doctor first rule is to help whatever it could be, beacuse it maybe more serious condition.

[@PsychiatrySimplified]

@@AK-vx4dy yes that's right. Minimise harm.

[@en-mainvocalheeseung1731]

My grades have been flunking for years I have severe procrastination and zone out often I can't focus even when I want to, even if I turn off all distractions I still am not able to focus. Also I tend to complete sentences of other people when in a conversation When I'm on a one to one conversation, I zone out in between and I have to bring myself back to listen to the person I forget things very very often, and I think it is because of the lack of focus For me sleep does not come at night even when I'm tired maybe because I think alot before sleeping and even if I've slept well I want to sleep again in the afternoon, sometimes I think I have narcolepsy I am 23 and this has been going on for 7 years Should I go see a doctor if I have ADHD ?

[@PsychiatrySimplified]

It seems like there are many symptoms that would be affecting your life. It would be good to see a doctor for a complete evaluation.

[@prakrititamang4896]

Did you get your diagnosis because I too have such symptoms?

[@sallyjane8274]

Relatable.

[@eirini98]

Wonderful professor and psychiatrist. I learned a lot, and the video actually confirmed a lot of what I have been thinking about in relation to ADHD. I have ADHD and OCD, but lisdexanfetamine lifts my OCD to the point that I can finally function in life. Before, I would be paralysed by compulsions for hours every day. I'm not sure if this is widespread, but what you said about the link between dopamine and OCD really touched me. I hate SSRIs and I refused to take them anymore as they made me feel worse. My ADHD diagnosis led to the prescription of Vyvanse, and over a year later I'm still experiencing the benefits of productivity, low impact of OCD on my everyday life, better relationships, etc. After all this, my question is whether the link between dopamine and OCD is widely accepted among psychiatrists, and if it is, why are people mostly restricted to SSRIs or SNRIs?

[@PsychiatrySimplified]

Thanks for your feedback. Here is a review on OCD - you are correct about the Dopamine pathways being significantly involved . They are modulated via DA agents as well. psychscenehub.com/psychinsights/obsessive-compulsive-disorder-a-primer-on-diagnosis-and-treatment/

[@eirini98]

@@PsychiatrySimplified Thanks, Dr.

[@eirini98]

I hadn't read your whole article. Just saw the answer to my question 🤦. Thanks, again

[@lucyking3750]

As someone working within an adult ADHD service this video is excellent and informative - thank you.

[@PsychiatrySimplified]

Thank you for your feedback.

[@charleskpodo3959]

Very helpful video

[@wzwcat]

Great info. I am searching for this info for helping diagnose my patients.

[@glassyjosh]

Great stuff I love how thoroughly key points were so well addressed, and always nice to hear words that can confirm the conclusions that I've thought

[@PsychiatrySimplified]

Thank you for your feedback. 🙏

[@DheerajKattula]

I could listen to you for hours 👍🏽

[@PsychiatrySimplified]

Thanks for your feedback 🙏

[@cynzix]

I couldn't because of ADHD

[@ddumida]

TYSM for the video!!!! It was sooo much information that i craved to know I'm really exited to watch your other videos

[@PsychiatrySimplified]

Thank you for your feedback (:

[@dantarradellas7351]

Fantastic. Thank you. !!!

[@kimdefluke8249]

Thank you.

[@paulcousins6535]

Absolutely fascinating and i understood you perfectly. And so ruled me out of having adhd.

[@Littlemouse_]

Being a girl or a woman makes it almost impossible for you to be properly diagnosed honestly. I had several reports from the school psychologist pointing my inhability to pay attention or focus + all the trouble in class with teachers and no one ever considered it. Now I am 29 and I’ve had all kinds of difficulties in every aspect of my life that could have been avoided or controlled better…

[@PsychiatrySimplified]

You are correct. There are significant gender differences between clinical presentations and delays in diagnosis are more common in females. We cover gender differences here - psychscenehub.com/psychinsights/attention-deficit-hyperactivity-disorder-in-females/

[@katherinelewis2815]

Very well explained. Thank you

[@pongop]

Excellent lesson. Thank you! I am trying to determine whether I have anxiety or ADHD (comorbid with anxiety). This is helpful and gives me other related issues and diagnostic procedure to consider. After watching this, I just found your video on Generalized Anxiety Disorder, so I will check out that next!

[@pongop]

@@danadavis3647 I'm trying to figure out if I experience RSD. Now I'm very certain that I have ADHD - combined subtype. I have never heard of SCT and CDD. I just looked it up. I have always been slow at work/tasks. It is interesting and I will have to research more. Thank you for your reply and information. I wish you well too!

[@djohntalks]

Thank you...very well explained.

[@leen8430]

I've been living and struggling with ADHD since early childhood, spent years with medication and therapy, and yet I still learned so many new things from your video that might help me make an actual difference in the future... very well done, thank you so much.

[@PsychiatrySimplified]

Thank you for your feedback. 🙏🏼

[@ajmed5531]

If I got distracted by my thoughts on multiple occasions and had to rewind the video what does that mean for me? 😅👀

[@pjezdik3591]

Where can I get a analysis in Newport south wales .?

[@sarahrivkas8400]

Wonderful video! Would there be a name for this specific testing that would cover all these aspects? Would really like to contact one who does this.

[@PsychiatrySimplified]

Thank you for your feedback. This is the basics of a psychiatric examination in any presentation. It’s not a structured test as such but a structured diagnostic examination.

[@Majella1984]

Where in Australia are you based and how can I get a referral to see you?

[@drshreenie]

Thanks, its a wonderful explanation. Kindly skip the intro and outro (beats) done in a 100 plus Db, it breaks eardrums and antagonises the beauty of your calm poised narration.

[@PsychiatrySimplified]

Thank you for your feedback. 🙏🏼. We have changed the opening music in subsequent videos.

[@xaviespi5761]

Impressive explanation. Very clear and useful 👏👌

[@PsychiatrySimplified]

Thank you for your feedback.

[@larryqueen1638]

Should the individual concern be first addressed with the PCP, Psychiatrists, or Therapist?

[@PsychiatrySimplified]

Depends on age , severity and ofcourse country regulations differ. In general if medication is required a psychiatrist input is recommended and mandatory in some counties.

[@here2thrive]

I really just want a thorough cognitive testing and a definitive results, where can I go and what do I ask?

[@PsychiatrySimplified]

See a psychiatrist who specialises in ADHD. Neuropsychologists can carry out testing but it's not needed for the diagnosis and treatment. It's indicated only if the assessment reveals a need for it.

[@jenniporras0312]

Thank you for the video, very informative. I have ME/CFS, fibromyalgia, depression and anxiety. However I wonder if I've been misdiagnosed, when I was a teen I was diagnosed with ADHD. All of my kids have been diagnosed with ADHD and a couple have different fathers. Which leads me to believe that they got ADHD from me.

[@PsychiatrySimplified]

Thank you for your feedback. While it is a heritable disorder - it is not necessarily hereditary. Heritability means how much do genes account for variance in behavioural traits. We have done a video on ADHD separately and also on CFS. Individuals with ADHD have a higher risk of CFS, especially females. ADHD - kzbin.info/www/bejne/d6qxfId-rLJmnJI CFS / ME - kzbin.info/www/bejne/kKC9dZ-tq66qabM

[@alzyn8661]

Good choice because many similarities between diagnosis

[@alzyn8661]

But we can say Adhd is bussy with many incomplete projects

[@Nehaprathap]

I forget things very often I always thought I'm not paying attention.. I thought maybe I'm not focussing as I should it'll be fine once I start focusing.. But idk I can't focus I forget things in a weird way like someone asked me to bring something when I come back from my room and I'll remember it for 2min and then boom I'll forget it totally and will remember only if someone ask me I won't remember by myself I don't have hyperactivity in general.. But I have anxiety And RSD

[@PsychiatrySimplified]

What is RSD? Adults usually will not present with hyperactivity ( only 30 per cent) - you can read more about adult presentation here psychscenehub.com/psychinsights/diagnosis-and-management-of-adult-adhd/

[@Nehaprathap]

@@PsychiatrySimplified I've gone through the article so I'll point out my problems Careless mistakes: Last one I recall is when I was doing a DC of wbc I took the value for correction when the sum of the cells was not even 100, Miss literally screamed at me and I was like what was I thinking.. This is something that just disappointed me a lot, while preparing for entrance exam I used to make many silly mistakes in mcqs , I probably know the answer but I'll somehow bubble the wrong one.. Not just by bubbling the wrong column I'll read a word as something else, or omit some words? I'll read "which one is NOT the option" as "which one is the option" And many more like that, It was so depressing everyone else was scoring high and I was lagging behind bcz of my stupid mistakes.. Ok in physics and chemistry it's normal to make mistakes but I used to make mistakes in bio too. I was really disappointed with myself.. I'll forgot that I kept the water for boiling.. Idk how many times I did that. This was when I was 13 or so, I didn't notice the qns on the next page.. I don't know if that count cz this is so stupid😂 I remember crying my eyes out cz I knew the ans but I didn't flip to backside to see if there's any qns 💀 I can't with myself😂 Low Attention span: the reason why I hate offline lectures. I can't concentrate more than a certain point but it doesn't affect me the way it should cz I record classes✌. . Come to think about it maybe it's because of this that I can't draw for long hrs as many other artists complete a portrait in 4hrs I'll take a week.. Firstly bcz I'm slow, in 2hrs I'll just complete the outline secondly cz I can't sit for more hrs continuously.. I don't usually zone out of conversations.. But I still remember when my physic's sir used to ask qns I'll just stare at him and I could hear him saying something but I was not able to comprehend it and then I'll come to my senses and asks him again and again to just get the qn inside me..(This was when I was 16-17) Same happened few day's back but I think everyone have that problem , when my friend was reading the text book for a group and I was just hearing her voice like I can comprehend a few words that's all, all others just went over my head and I had to force myself to understand it.. But other than situation like these I don't remember normal conversation where I zoned out

[@Nehaprathap]

@@PsychiatrySimplified I wrote an essay for 2 points I don't think you'll have the patience to go through all the points so I'll stop here for your sake😅

[@Nehaprathap]

@@PsychiatrySimplified Rejection sensitive dysphoria (RSD) is the reason why I started to search more about ADHD bcz RSD is usually seen in individuals with ADHD

[@tbainbridge]

Hey Dr Rege, would a diagnosis of ADHD be a reportable impairment to AHPRA that they think one could not be a health practitioner? I am a high functioning adult, suspect I have ADHD , I would get assessed but not if the diagnosis or the psych could affect my ability to be registered. My understanding is that in Victoria there is no patient confidentiality as far as the law and AHPRA are concerned. But in other states there is patient confidentiality.

[@PsychiatrySimplified]

No a diagnosis does mean an automatic reporting. Reporting to AHPRA needs fulfilling specific criteria of harm / compromised patient care etc. there are several doctors with mental health issues that do not need AHPRA notifications. One can discuss this with medicolegal insurer . This should in no way stop someone from seeking medical care. Evn prior to notifying another doctor insurers recommend focussing this with the insurer so that reporting is done responsibly. One can also call doctors health advisory, AMA , other bodies to seek advice here. Wish you well.

[@chrisfree6372]

Ive ran into issues where health insurance doesnt want to cover these tests as they deem them NOT medically necessary

[@iveneverseenahealthyvegan.9885]

I am 52 I was diagnosed with ADHD in December 2020. I have had anxiety and depression for many years. I have been targeted at work for many years, it's not because I have not been underperforming Just office Politics. I don't have the skills to address this and feel vulnerable. Any advice???

[@PsychiatrySimplified]

Hi Mark, we can't give advice here however, it would be good to get a referral for a psychiatrist who can look at medication and psychological strategies for the issues you have mentioned. Depending on severity they can decide if psychological or medication or both are required.

[@Dancestar1981]

Find another job it’s a toxic work environment

[@lt9773]

What if you have anxiety , depresssion, fibro , ptsd , sleep disturbances .... Can you still have ADHD? And where do you start to treat ? I believe I had ADHD as child , and developed different comorbidities throughout life due to traumatic events and addictions . I don't even know where to start ..

[@PsychiatrySimplified]

The conditions you mention can be comorbid with ADHD ( coexist with ADHD). A psychiatrist evaluation can help as a psychiatrist develops a formulation and then develops a prioritised and individualised treatment plan.

[@philuin9594]

Dr rege, I have adhd, I have been told I have sleep apnea 3 reps per hour, but self correct. I have a history of epilepsy. had psychosis prescription drug induced. and now I am suffering with bad fatigue although I'm on a stimulent which seems to kerb the impulsiveness. my question is where do you even start because there's a number of things that could be causing the fatigue there?

[@PsychiatrySimplified]

Yes, it would require a complete evaluation as there could be a number of causes of fatigue. Obstructive sleep apnea is one of them.

[@caiocostalouback1866]

Very thorough. Thank you for providing me with understanding myself even better. The exclusion criterion made me think this disturbance I've had all my life and never really payed attention was always there, but putting away or procrastinating never really liberated me from prejudices... Because, before I went back to psychiatric treatment, I was an alcoholic in denial and now basically six months sober now, thank God. I used to be, in my teenage years way too intelligent for my own good, as my mother would say. But certain aspects, such as insomnia, diabetes, hypothiroidism, high IQ, alcoholism and drug abuse virtually destroyed my academic life - because I joined the University at 16 -, and now I understand why. I have a question: is it common for ADHD to present itself differently, with aspects not touched in this particular video; e.g high IQ and brutal honesty, a socially non-existent life and disinterest in "boring conversations"? Thank you, doctor. And cheers from Brazil. I've liked and subscribed to your channel. I like methodical content creators.

[@PsychiatrySimplified]

Thank you for your feedback and sharing your thoughts and experience 🙏🏻

[@caiocostalouback1866]

@@PsychiatrySimplified could you read it again, Dr., please, I have put new questions and commentaries. Cheers

[@PsychiatrySimplified]

ADHD may have an overlap with ASD ( or some traits ) which you describe. Yes it is a phenotype associated with elements you describe.

[@caiocostalouback1866]

@@PsychiatrySimplified oh, really? Interesting to become aware

[@panchodeez6573]

video is too long i keep just reading the comments😏

[@GodofAbraham]

🤫 I'm trying to pay attention stop being a distraction.

[@Stardust414]

Best succinct, direct talk on diagnosing Adult ADHD & the first that I've watched from start to finish!! You mentioned "fibromyalgia & chronic fatigue" as underlying inflammatory conditions. This made me to wonder if any or all autoimmune diseases (inflammatory in nature) have the same or similar effect as fibro & CF? I ask this as a 43 y/o female Dx with ADHD at age 33, 3yrs post Dx of Rheumatoid Arthritis & Ankylosing Spondylitis. EDIT: Do you have a video on the Tx of Melancholic Depression and NeuroBio issues with Dopamine & Norepinephrine?

[@PsychiatrySimplified]

Apologies I saw this one late. Here is a video on melancholic depression kzbin.info/www/bejne/lX3Jm2qjjd2Im5I

[@PsychiatrySimplified]

More on chronic fatigue syndrome psychscenehub.com/psychinsights/chronic-fatigue-syndrome-myalgic-encephalomyelitis/

[@PsychiatrySimplified]

Detailed article on melancholic depression - I cover the dopamine noradrenaline aspects and broad spectrum antidepressants

[@Dancestar1981]

I have chronic folliculitis that I’ve had for over 30 years

[@joyarora007]

Does Libido go down if ADHD is undiagnosed till adulthood??

[@PsychiatrySimplified]

Loss of libido is not a core feature of ADHD but occurs in depression which can be comorbid with ADHD

[@micah1754]

This seemed like all the things you would use to rule out ADHD as the underlying condition, not rule it in? Wasn't what I was expecting. I've been putting off getting an assessment for many years. Its prohibitively expensive where I live, and I'm worried about having another label. Being reliant on medication is also quite scary to me. If I couldn't access it for some reason or it was no longer funded. So many things that are making me a bit paralysed to take any action. My family and GP are encouraging me to address it.

[@PsychiatrySimplified]

ADHD has a 60-80% comorbidity. Without ruling other things out as outlined in the video - medication may work initially - then it stops working especially if comorbidities are present. When solving an issue it helps to ensure a broader perspective is implemented to ensure long term success.

[@micah1754]

@@PsychiatrySimplified yes that makes sense. I just thought it would cover more on what would rule in ADHD, not only what would rule it out.

[@vortex_wolf2555]

If I am diagnosed with adhd and take medicine for it, will it change my personality? I’m 80% sure I have adhd I don’t want to be a different person on medication. I also don’t want to gain weight from any medication.

[@PsychiatrySimplified]

Adhd treatment does not change personality. Also stimulants are not associated with weight gain- th opposite. Weight loss can occur and lisdexamphetamine is evidence based for binge eating disorder.

[@scarred10]

Medications cannot change personality.

[@AK-vx4dy]

I don't know why doctors stick to this. For ADHD first question should be about executive function for example motivation to do task: if it is interest, challenge, novelty, urgency, passion works and importance, rewards/punishments, consequemces not works it is clear that something is diffrent, maybe it should be differentated with some other conditions but all points about slep apnea, thryoid and other physical conditions can be excluded as primary diagnosis

[@PsychiatrySimplified]

Sorry not sure what you are trying to say? Can you be more specific ?

[@AK-vx4dy]

@@PsychiatrySimplified I was listening to Mr William Dodson webinar (kzbin.info/www/bejne/rKrGiHywireakK8) part of it starting at 13:00 to about 25:00 struck me like lightning. Explanation that nervous system is diffrent and engagment is case of adhd is driven by intereset, challenge, novelty, urgency(right now), passion and things that drive neurotypical people engagement: importance(own or from/for others), rewards(even far in the future), conseuences(even far in the future) are useless and/or meaing less for ADHD people. I had shock and had to sit for a moment when this fragment sink in... Some time ago I come to conclusion that something wrong with me and on my own i tried to investigate it by many years, but as you wisely explained it is almost impossible, many diagnoses fit, some can be ruled out, but still range was wide: sleep apnea (wich i excluded by treating by proffesional), anexiety, depression, dysthymia, narcistic, borderline, bipolar, adhd... as time went and i know more some where less probably, some officaly diagnosed (PDD/dysthymia), but still not all was explained and few candidates still on table. I hope it is easier for professional with all you wisdom and knowledge. I had to wait for few people wich looked from diffrent direction than dsm criteria or explained how neuroatypical preson should understand questions from diva or other screening tests.

[@killuamexe]

I have every single one of these symptoms, especially extreme fatigue (why im here researching) yet my psychiatrist says i dont have adhd bc i wasnt born a specific way. Even the hyperactivity was terrible growing up and no i always look dead with a racing mind..

[@PsychiatrySimplified]

Not sure what ‘born a specific way means’. Birth aspects aren’t a prerequisite for a diagnosis. It may be good to discuss with a psychiatrist specialising in ADHD. Many psychiatrists may not receive adequate training in ADHD - in some countries this appears to be the case . Wish you good luck.

[@mickbowe4252]

this guy is legit. I'm surprised you tube lets him speak.

[@PsychiatrySimplified]

How do you mean? Or maybe reading too much into that comment?

[@Alex-bo5cp]

@@PsychiatrySimplified I think it's a compliment.

[@PsychiatrySimplified]

@@Alex-bo5cp ha ha thanks

[@wendyhannan2454]

This is an excellent presentation, I think Dr Sani is spot on. Thank you Dr ✅

[@farsideofthehill6771]

@@Alex-bo5cp unhinged, conspiratorial comment

[@Zinnia2023]

Hello, I am 54 and menopausal. I feel I have some symptoms of ADHD but how would I know if it’s declining estrogen and not ADHD?

[@PsychiatrySimplified]

Estrogen is closely linked to cognition and can exacerbate Sx of ADHD. An assessment by a psychiatrist would help clarify. Sometimes both may coexist. To diagnose ADHD, childhood or adolescent Sx are usually required.

[@circuscyaneus3709]

Hi, Paris. Dr. Thomas E. Brown has written that it's not uncommon for women to develop symptoms of ADHD or even become diagnosable during menopause. This may be due to the fact that estrogen plays a role in enabling the release of dopamine in female brains. The following is an excerpt from Dr. Browns book "Smart but Stuck: Emotions in Teens and Adults with ADHD" [pages 111-113]: "In 2000, I published my initial observations about this phenomenon of perimenopausal and menopausal women with midlife onset of a constellation of cognitive impairments similar to what is commonly found in ADHD.8 In that brief report, I noted that a possible mechanism for this midlife onset of chronic cognitive difficulties in women might be the menopausal decline of estrogen, a hormone that is a facilitator for the release of dopamine in the female brain. Dopamine is a neurotransmitter chemical manufactured in the brain. It plays a critical role in facilitating communication in neural networks that service executive functions of the brain. Basic research in neuroscience suggests that in the female brain, estrogen facilitates and modulates the release of dopamine, especially in brain areas associatedwith EF [executive functions], in a variety of complicated ways.9 If this is so, significant reductions or inconsistency in estrogen levels such as occurs in a woman’s body during perimenopause and beyond may contribute substantially toworsening ADHD symptoms in women with ADHD and may even produce midlife onset of ADHD-like symptoms in some women who have not previously manifested ADHD symptoms in any significant way. Estrogen’s impact on cognitive functioning had already been demonstrated in earlier controlled studies of verbal memory in women. Researchers in one study read two stories, each just a couple of paragraphs, to women before their estrogen level was reduced by surgery or chemical suppression; their recall of comparable stories was then tested after their estrogen level had been suppressed. Results showed that the women had much more limited recall of details in those stories after their estrogen level was reduced than they had in the testing prior to estrogen suppression. It was also shown that administration of additional estrogen after suppression tended to improve story recall significantly. "Another study used fMRI to show that administration of estrogen to postmenopausal women increased activation in specific brain regions during verbal and nonverbal working memory tasks.11 Subsequent to my brief report in 2000, a number of studies have elaborated on cognitive impairments suffered bymany women during perimenopause and on the impact of estrogen on these impairments. Much of the research literature is contradictory, but indications are that there may be a critical period for effectiveness of estrogen augmentation. Estrogen replacement therapy may be helpful in alleviating cognitive impairments of perimenopausal women, but such treatment is reported to be less effective for some women, and perhaps even harmful for older postmenopausal women.12 Given these ambiguous findings and the fact that some women and their doctors are apprehensive about estrogen augmentation, it would be helpful to identify alternative treatments to alleviate cognitive impairments in peri- and postmenopausal women. Medications used for treatment of ADHD may be an option to be considered. Over the past ten years, the impact of estrogen on cognitive functioning has also been studied in women who have undergone chemotherapy for breast cancer or lymphoma. Many, though not all, women who undergo treatment with estrogen-suppressing drugs report and demonstrate that such chemotherapy produces “chemofog,” substantial impairments in their cognitive functioning, particularly their working memory, executive functioning, and processing speed.13 There is evidence that genetic factors may render some women more likely to experience such impairments.14 Apreliminary study has shown that dexmethylphenidate, a stimulant medication used to treat ADHD, may be useful in alleviating some of these cognitive impairments in women undergoing chemotherapy."

[@PsychiatrySimplified]

@@circuscyaneus3709 absolutely - thanks for your comment. covered this in the article on gender differences. psychscenehub.com/psychinsights/attention-deficit-hyperactivity-disorder-in-females/

[@dawidlon613]

Are there biomarkers for adhd?

[@PsychiatrySimplified]

Good question! No validated bio markers as of yet. Many of the imaging studies have shown abnormalities but lots of heterogeneity in ADHD ; hence the need for a comprehensive evaluation. Many conditions can affect frontal lobe functioning that can ‘appear like’ ADHD. Here is an article on neurobiology of ADHD where we cover this in more detail. psychscenehub.com/psychinsights/neurobiology-of-adhd/

[@A_blue_Sky]

Sir, I love your work but I was 30 seconds in your vid and I was already contemplating putting the speed on 75x, instead I skipped 50 seconds in, got distracted by a comment, decided to write a comment and remembered mid-writing that I was going to put the speed on 75x and all the while I'm reading what I'm writing while thinking that I might have just written this long ass paragraph and gotten all it wrong because I didn't wait to finish your video

[@PsychiatrySimplified]

😁

[@moganpalm9387]

Get psilocybin shrooms products 🍄 💊 cus that's the only remedy from👇.

[@moganpalm9387]

*Willi_capps,*

[@moganpalm9387]

ON IN STA GRAM,

[@ProfBoggs]

So if ADHD is a diagnosis of exclusion, is it fair to say it is a residual category? Or is a diagnosis of exclusion a common diagnostic approach in psychiatry? I found this video quite clear. It also helped me better understand the logic behind the diagnostic procedures I underwent. Thank you.

[@PsychiatrySimplified]

All medicine is based on bayesian inductive reasoning. Especially psychiatry where we are dealing with uncertainty ; so probabilistic thinking is important. We gather facts and then make hypotheses and then test those hypotheses. So for example let's say we have 5 patients presenting with hyperactivity, inattention/ concentration issues and impulsivity. All 5 could attract a diagnosis of ADHD - we saw 5 people with criteria = ADHD. But there is an issue with this approach. These symptoms can be etiologically underpinned by - Obstructive sleep apnea, depression, severe insomnia due to other mood disorder, neurocognitive impairment or thyroid issues. So what a psychiatrist has to do is to ensure other aspects aren't a primary etiological factor / and or isn't a major contributor. So sure some may have ADHD - but if I don't treat the OSA properly they won't get the maximum benefit from the treatment of ADHD. So a hierarchy offers a structured approach to ensure a comprehensive assessment and therefore comprehensive management. In other words we are trying to exclude other conditions as if other conditions are identified - treatment of those many actually threat the condition. E.g severe iron deficiency or hypothyroidism etc Hope this helps. Thanks for your comment.

[@PsychiatrySimplified]

Here is a video where we go into more detail about formulation using the hierarchy kzbin.info/www/bejne/h6KWg3-Aos6NhJo

[@PsychiatrySimplified]

And here - a shorter one kzbin.info/www/bejne/jniXlaKqr6l2m7c

[@ProfBoggs]

@@PsychiatrySimplified Thank you. I hadn't considered the link between Bayesian approaches and medicine. Nifty!

[@PsychiatrySimplified]

@@ProfBoggs you might like these videos on our channel on pattern recognition by Prof Parker kzbin.info/www/bejne/b52Qm2Cpqc97nqc

[@theoriginalSkooby]

The intro and exit music are way too loud. People with noise sensitivity are a highly likely customer considering the topic

[@PsychiatrySimplified]

Thank you for your feedback. We are making changes to the intro and outro for further new videos.

[@user-yx7qx7hu4g]

Hum.. i got distracted after 4 minutes and i dont remember what i was just thinking about does this mean i have add?

[@PsychiatrySimplified]

Happens to a lot of people! Video viewing is not an easy thing to do. Attention spans are generally shorter when viewing videos

[@marcellepretorius7744]

Can you please be my doctor. How can a specialist ask a few questions and say ok it's ADHD and there you go

[@hard_top]

Is there any pathology used to diagnose this?

[@PsychiatrySimplified]

There are no pathology markers for ADHD. It is a clinical diagnosis. Medical conditions, however will be ruled out that need blood tests

[@PsychiatrySimplified]

We covered the diagnosis in this video in more detail Attention Deficit Hyperactivity Disorder(ADHD) Simplified | How to Diagnose ADHD | How to Treat ADHD kzbin.info/www/bejne/d6qxfId-rLJmnJI

[@hard_top]

@@PsychiatrySimplified So a clinical diagnosis is subjective versus the objective results of pathology? Isn't an illness something that is detected through the use of pathology, like cancer or diabetes etc. Seems a bit vague using clinical diagnosis.

[@PsychiatrySimplified]

@@hard_top adhd is a syndrome. Many psychiatric disorders are. It is a diagnosis based on a set of symptoms and ruling out things that mimic it. Unfortunately, the brain is complex, and we don't have a single test or a blood marker to diagnose psychiatric illness as of yet. There is also significant variation amongst individuals. Some tests like QEEG may assist in diagnosis but aren't diagnostic. So ADHD aetiology has several possible hypotheses but no diagnostic marker.

[@delishme2]

I think chronic fatigue and fibromyalgia, depression and anxiety, self medicating are symptoms of undiagnosed ADHD, not causes. I'm in the opposite camp. 50, undiagnosed, misdiagnosed with other things such as anxiety depression, chronic fatigue etc which are symptoms not the cause. I know this because I have no emotional baggage/ triggers and SSRI's and anxiety medication had little to no effect. I've been chasing the emotional, behavioural, medical trails for 30 years, with little relief on overcoming my symptoms. And as such have effectively lost 20 years of my life to despair, stress, creative coping strategies that have simply detoured me AWAY from the issue. With the recent increase in misdiagnosed adults, I would assume the statistics would be stacked against getting the diagnosis correct in the first place.

[@PsychiatrySimplified]

Adhd is comorbid with chronic fatigue and fibromyalgia, along with depression, anxiety, sleep disorders, eating disorders etc. Chronic fatigue syndrome and fibromyalgia are common associations with ADHD in females. Cognitive aspects of chronic fatigue is very similar to adhd presentations. We have covered ADHD in females and CFS on the psychscenehub in detail.

[@PsychiatrySimplified]

Here is ADHD in females - psychscenehub.com/psychinsights/attention-deficit-hyperactivity-disorder-in-females/

[@EyeLickChildren]

In my case, starting in my mid 20's (I'm 31 now), I started seeking therapeutic and psychiatric help for depression and anxiety. No medication worked, I don't remember there even being any side effects with any antidepressant, benzo or mood stabilizer, and between me and the doctors, we couldn't pin down any real cause or reason for my depression. I always just approached them with "I can't function and my life is going to hell because I'm depressed." Got diagnosed with MDD, general anxiety, melancholic depression, distyimia, and bipolar 2. Bipolar 2 was the most common. They'd hear me talking about depression and difficulties, but witness me drumming on things and speaking fast, and just conclude it was a manic phase. No one ever listed to me that I was alwats moving, always speaking fast, and that in always have. I felt like they were always telling me what my symptoms or behaviors must be instead of listening to me, especially considering all the personal history I'd give them that should have pointed a big red arrow at ADHD for them. I missed that arrow, because I was only very vaguely aware of ADHD. I had no idea what it was of what it entailed. I eventually had to deep dive on researching every condition or disorder I could find before I considered ADHD. It checked all the boxes for me, both in reading the literature and other people's experiences, and after several months of researching just ADHD, I decided that was my best bet, that I wasn't struggling to function because of depression, but was depressed because I struggled to function and all the consequences that came with that, went back to my GP and psychistrist better equipped to describe myself, and very quickly got a diagnosis and some cool new pills. The kicker here though is that after doing those months of research and securing a diagnosis, I was on a phone call with my mom, dumping all this information on her, and she told me my biological father was diagnosed with ADHD as an adult. Fuck. That would have helped had I known. I was always told I was just like him, minus the alcoholism. "He was so smart, probably a genius. He could do anythung he put his mind to, he just had to want to do it first. Always in his own little world, doing or making all these great, wonderful things, but he just couldn't get his life together and drank so he wouldn't have to deal with it." Yeah, that's me (minus the alcohol). I'll neglect everything else in my life to churn out endless lines of c++ just because I thought of a concept I want to explore and grow it into a year long project, or play my guitars and write music until my knuckles can't take the fretting anymore, but I can't finish my community college English comp week 2 assignments or remember to pay my rent. My dad died from cirrhosis (from drinking) when I was 19, fresh out of marine corps boot camp. I always thought and was told he was just a selfish jerk who couldn't be bothered to think about anything but himself and fixing cars (such a good mechanic that he had NASCAR connections that lead to my aunt marrying Kevin Harvicks crew chief). Functionally, I guess the effects were the same, but rather now I believe he was probably just a really smart guy, passionate about his interests, but his brain made it difficult for him to focus on "life," and at some point just got tired of the failures and frustrations and gave up. If his experience was like mine, he was probably always recognised for what he wasn't, instead of what he was, and wasn't allowed to operate in ways that would work for him. No idea what his diagnosis meant to him or how it inpacted his life. Based on what I do remember of him, he probably just reacted with a "no shit, Sherlock." I really forgot where I was trying to go here, but life story and fond memories out of the way, I'll pull a conclusion out of my ass. Just based on my own experience, and what I've learned and read over the last year and some change, I think the only people placing enough emphasis on a lot of comorbidities being results of the ADHD experience rather than "a part of the package" are the people with ADHD who experience it. Years of depression, seeking help and misdiagnosis seems to be pretty common. Developing anxieties in response to repeated negative experiences is common. Irregular sleep patterns seem to come with the package often enough, but are also exacerbated or created by typical ADHD behaviors like indulging an interest way passed a reasonable time. Emotional trauma and C-PTSD from mistreatment because we "don't act right" hogging the stage and hiding the ADHD. All these different things that are the result of consequence of ADHD behavior, that also mimic or exacerbate the behaviors. They get treatment, symptoms are mitigated to whatever degree, so it's decided that "I couldn't function because of depression and anxiety" and the ADHD is missed while the focus remains on the symptoms, not the cause. Granted, one of the first points made in the video is that ADHD is diagnosed through exclusion. We don't have an accurate, widely available method of diagnosing ADHD "on its own merit", for lack of a better term, when other symptoms or conditions are present.

[@PsychiatrySimplified]

@@EyeLickChildren thank you so much for sharing your experience. I'm sorry for the challenges you faced. You have described your journey in an amazing manner ; amongst the best descriptions of how adhd can be missed ; the family history, the hyper focus; etc. I hope this helps others. Thank you for sharing.

[@faisalazamkhan3240]

Can it be treated at any age ? Even if 30s

[@PsychiatrySimplified]

Yes ofcourse. Adult ADHD is treatable

[@faisalazamkhan3240]

Any contact for consultation?

[@Bceva]

I just looked through the comments and realized I can't remember the last sentence he said. ksksksn.

[@Rundark-]

Comments are turned off for your desoxyn video, just FYI.

[@PsychiatrySimplified]

This is very strange - it's the second time it's happened and we haven't turned it off? Any ideas. Strangest thing. Thank you for letting me know

[@Rundark-]

@@PsychiatrySimplified I figured as much since you were asking to leave comments. YT is screwing with you, this was happening to another content creator and he explained what he had to do to turn them back on in his channel settings. This platform has become an unfriendly place for the free exchange of information and ideas. And you are very welcome, I'm glad I could help.

[@tonijones2564]

Am I the only one that had to speed this up by 2x?

[@emmasommer9348]

No🤚🏻🙂english isn't my mother tongue and I don't even live in an english speaking country but still, 2× speed just helps me understand more

[@PsychiatrySimplified]

Many people report needing to speed up videos to follow.

[@vidyapaul8231]

Have you come across a patient who’s hunger increases on methylphenidate?

[@PsychiatrySimplified]

Generally not as part of adhd . But in context of depression yes as if appetite has been low then after improvement appetite can increase .also it can occur as part of side effect of a ‘hypomanic switch or mild activation”

[@justalittlesquish4749]

me: already diagnosed with adhd as an adult also me: hmm, interesting

[@Mohammad-xl7cg]

😀

[@kimberlyhoskins5929]

I will always thank you for giving me a new life,thanks to dr udoka on KZbin am cured adhd

[@Mohammad-xl7cg]

@@kimberlyhoskins5929 god bless you ☺

[@kimberlyhoskins5929]

@@Mohammad-xl7cg no problem

[@sushimmukherjee8579]

Sir, Is adult ADHD CURABLE.....?

[@scarred10]

No ADHD is curable, you are born with it but medications help a lot as does therapy for the symptoms.

[@bishgroundwork3089]

Ive got ADD I cant sit through this

[@PsychiatrySimplified]

Try to break it into small parts?

[@dianaaredia4202]

What I do is watching KZbin (well, Netflix as well) setting the speed x2

[@kirkmo1666]

I'm overwhelmed now and very discouraged but I'm sure you feel good about yourself.

[@sherillaidasumiro6541]

ADD

[@Azzy_Mazzy]

my shitty and awful doctor didn't even attempt half of this and refused to do a full ADHD assessment even though i had nearly all of the symptom

[@PsychiatrySimplified]

Sorry to hear. Hope you can get a complete evaluation.

[@Azzy_Mazzy]

@@PsychiatrySimplified i did! By two different doctors even but still I can’t get any medication because only the government hospitals provide them and there i have to deal shitty doctors. Hopefully you videos spread more and we can get better and science based evaluations.

[@Priy1nka00]

Chai

[@Mat_Sedano]

hey! a boring video for people who distract easily! yay! 😃

[@terryhorne3247]

For someone researching whether or not they have adhd, this video is far too long.

[@PsychiatrySimplified]

Thanks for the feedback. It's probably why Tik Tok is one of the reasons outlined for the increase in requests for adhd assessments. 😁. On a serious note the aim of the video us to provide a practical evaluation of adhd. Want to make sure the video conveys the clinical aspects which often take several appointments over several hours.

[@Priy1nka00]

Gu jasto video 🤣🤣

[@johnacord6224]

Way to tap dance around the issue and keep the poor patient coming back and make a few extra bucks. Bla, bla, bla, I'm not buying it.

[@PsychiatrySimplified]

Thanks for your comment. However lost patients with ADHD once stable in 3-6 months are usually solely managed by their GP - so no they don't keep coming back. There are a lot of bases against psychiatry & what psychiatric treatment entails. Which sometimes prevents individuals from getting help even when they need it