All posts by larry

ADHD Medication Bias

I am receiving more calls from distraught folks complaining about the difficulty in finding a provider here in Portland OR. to assess and or treat their suspected or already diagnosed ADHD or ADD. The callers report contacting many practitioners and are told “sorry we don’t prescribe ADHD medication” and told to go elsewhere.

One reason for this difficulty might lie in the callers age 18-35 where there are some “bad apples” that are seeking ADHD medication for illegal purposes (selling, trading, bartering, etc). Stimulant medication, like benzodiazepines (anti-anxiety medication), and pain mediction (opiates) are three of the most sought after prescription medication sometimes because they have “street value”. This leads many providers to avoid the prescribing of these classes of medication for any long term time period. Unfortunately, stimulants have been shown to be most effective when seeking a medication option to treat ADHD symptoms, hence the angst patients are feeling when they can not find a local Portland provider to assess and treat them.

This problem is especially difficult for new arrivals to Portland from other cities and states that have already been diagnosed and are successfully treated with ADHD medication and can not find a new provider here in Portland (OR.) Oregon to take over their medication management.

The only solution to this problem is a combination of patience, assertiveness in making calls, and a willingness to find a true ADHD specialist who understands ADHD and treats each person as a unique individual. Additionally we need to be more proactive in raising the awareness of what ADHD is and debunk those who feel that ADHD/ADD is either non existent or over diagnosed.

Once again, thank you to all those who call, write and e-mail. I welcome all your questions, thoughts, recommendations and positive feedback.

ADHD and ADD Medication in Portland Oregon (OR)

It’s fall and the calls have picked up from students returning back to college. Many of the calls are from frantic voices indicating that they are from other parts of the country who have move here and are having great difficulties finding a prescriber to take over their ADHD medication management. Some indicate that they’ve contacted over twenty doctors, psychiatrists and other prescribers and were told that they do not work with ADHD or that they do not dispense certain kinds of ADHD medications. The students are also told by some schools that they must undergo rigorous mental health testing that in some cases is not covered by their insurance plans and costs hundreds/thousands of dollars.

The students are wondering why is this necessary especially if they have a history of previous ADHD diagnosis and previous successful medication management? Why do many doctors refuse to treat ADHD or refuse to dispense certain kinds of ADHD medications? The answers are not simplistic, rather they are multi leveled. One possible reason is that hardly a week goes by when there isn’t some article that claims ADHD is not a real diagnosis or can be explained by some other explanation. The most recent one I read indicated that ADHD is really a need for someone to have challenging change of scenery and when a person isn’t challenged they can become bored and easily distracted. While there is some validity to many ADHD folks being easily distracted and finding some repetitive tasks boring, it may be wishful thinking to proffer that all one has to do is change the scenery and the ADHD disappears.

Another problem to this ADHD medication issue in Portland Oregon is that there are far too few specialists here and in the country that have extensive knowledge about ADHD. I’ve been rather fortunate to have worked with thousands of ADHD clients and understand how beneficial it can be to find someone who both understands ADHD and doesn’t demonize those who are simply wanting to be treated with dignity and respect. The reality is that there are a few “bad apples” who seek ADHD medications for illicit means usually to divert it to others or use it on occasions to enhance performance. This is the rare exception and prescribers need to be especially diligent to weed these individuals out but at the same time, not punish those who legitimately have ADHD issues. This could also be said of those with legitimate pain or anxiety issues as well.

The challenge in all of this is to find an ADHD medication specialist in Portland who you feel you can work with. Please feel free to contact me at (503) 492-2200 to discuss your situation.

As always, I welcome your notes, feedback and suggestions for future topics.

ADHD Testing

I get numerous calls inquiring about ADHD testing here in Portland OR. Many will ask if there is a definitive test that can prove they have ADHD or ADD. Like many diagnosis in mental health, much of what we utilize to make a definitive diagnosis includes self report data. Such things as: Do you have problems with focus, attention or concentration? Do you have problems with organization? Are you easily distracted? Do you have trouble listening in conversations? Do you have issues with procrastinating? Do you have problems either starting or completing tasks? Do you have difficulties with time such as being frequently late? Do you lose or misplace things? If you answered yes to many of these questions, you may have ADD or Attention Deficit Disorder also known as ADHD or Attention Deficit Hyperactive Disorder Predominantly Inattentive Type. Many adults have this type of ADHD but may have had hyperactive symptoms as young children. Some indication of the hyperactive form of ADHD include: restlessness or hyperactivity, trouble sitting still, being fidgety or in constant motion, being noisy or having a hard time being quiet, problems arising from felling like you act as if you are being driven by a motor, you talk excessively, you have difficulty with being impulsive, difficulties awaiting your turn, or you interrupt or intrude on others. If you feel that these apply to you, then you may have ADHD Predominantly Hyperactive-Impulsive Type. There is also the combination of inattentive and hyperactive-impulsive type and this is known simply as ADHD Combined Type.

Some non believers in ADHD or ADD will say that many folks have one or more of the above symptoms but they don’t have ADHD or ADD. What is important in distinguishing this is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development.

Many people who have undiagnosed ADHD or ADD have known for many years that they were different than their peers. Many have heard things like “you’re quite bright but you aren’t working up to your potential” or “you’re not trying hard enough”. Yet, it seems that no matter how much effort they utilize, they can’t get traction and find themselves operating at a deficit compared to their peers.

If you believe that any of these ADHD symptoms apply to you, find a local practitioner who specializes in ADHD diagnosis and ADHD treatment and inquire about ADHD testing. If you live in the greater Portland OR area and want adult ADHD testing, feel free to contact me.

As always, I appreciate all your questions, concerns and suggestions.

ADHD & The Media Part 2

I am often asked if ADHD is being over diagnosed because it is slowly getting more well known. I wonder about the nature of that question and so I ask the person why they are asking the question, and many times they will say they read an article or heard some commentator or possibly went online and read the report of someone that feels all medications are harmful, especially some medications that treat ADHD. I ask them if they know anyone who has ADHD or ADD and many times they say no, but they are curious. I’m glad that they are inquiring and if they’re are open minded, I’m only too happy to share my experiences with them having worked with and treated thousands of men, women and children with ADHD or ADD.

While some estimates place the number of Americans with ADHD/ADD at 6%, others feel that it is more like 10-14%. If we do the math at 6% it is 19 million and at 14% it is 44 million, so for a mid-range lets make it around 31 million Americans have ADHD or ADD. That means approximately 1 out of 10 so at your next workplace meeting, or classroom, or religious group or any larger meeting, one out of every ten persons more than likely has ADHD. Some are undiagnosed and still struggling with their symptoms. When asked why they waited, many will say because they heard or read that ADHD is not a real diagnosis, or that it is being over diagnosed or that medications used to treat ADHD/ADD are being over prescribed.

To that effect, I was contacted recently by one of the major networks here in Portland Oregon (OR) and asked to be interviewed by a noteworthy reporter on ADHD. They indicated that my name came up as being knowledgeable in the treatment of ADHD and they wanted to get my professional opinion. I was interviewed for approximately 20 minutes and the bulk of the questions were on only two main subjects; was ADHD being over diagnosed and was medications used to treat ADHD/ADD being over prescribed. Many times the conversation was redirected back to those two points so that I wondered if there was a hidden agenda to find “the smoking gun”. I was told that the story would run in the next few weeks in prime time but then received a notice that the station decided not to run the piece after all. I was curious why that was and wonder if after all the digging they couldn’t find the evidence to fit the supposition?

I also noticed that there is a national reporter in a major US paper who periodically runs a story that highlights one or two people that had a negative experience with either the diagnosis or the medication and then uses that to support the aforementioned two beliefs. I do strongly feel that we are in the relative infancy stage of knowing the reasons why some folks have ADHD or what are the definitive causes. There is so much we don’t know about the brain but we are making headway. I also feel that we need to know more but am weary of perhaps well meaning people that start their research with a belief and then want to find all the evidence that supports that position while omitting facts that are contrary to the belief.

ADHD and ADD are very real. Those who do not have those symptoms perhaps do not understand how debilitating it can be especially when you hear messages that tell you its not real and some of the tools used to manage it, are being over utilized.

If you want more information on ADHD symptoms, treatment, diagnosis, or medication, and are in the greater Portland Oregon (OR) area, please contact me at (503) 492-2200. As always, I welcome your feedback, your questions, comments and suggestions for other topics.

ADD/ADHD & Shame

Hardly a day goes by when I don’t get multiple calls and e-mails from new prospective folks inquiring about coming in to get evaluated for possible ADD or ADHD.

I get to hear their stories about difficulties in life as it manifests in employment, academics, personal and professional arenas.

Too often they tell a tale of not being good enough. Of hearing over and over again that they are lazy or absent minded.

They hear how bright they are, but aren’t living up to their potential. They hear others tell them that while they are sorry, they have to let them go in one capacity or another whether it’s in a job, or being asked to leave college, or failed love relationships.

One must wonder what this does to the average psyche to be told that no matter how hard you work on being more organized, paying better attention, “trying” to finish tasks, not leaving things to the last minute, finding the items that you just had but can’t find, etc, you can’t succeed.

They say that even steel breaks at a certain point if pushed beyond its limits. So it is with this situation where the individual begins to internalize that something is seriously wrong with them as a person and shame develops.

Shame is about who we are as a person where one begins to feel embarrassed, unworthy and disgraced. It is no wonder that this situation oftentimes can bring forth a sense of heightened anxiety and depression.

Luckily, we understand more today than ever about the brain and brain chemistry. No longer does one have to suffer the ill effects of shame related to their cognitive deficits due to ADD or ADHD.

If any of these words apply to you, or a friend, colleague or loved one, encourage them to seek a professional who specializes in ADD and ADHD.

If you live in the greater Portland Oregon (OR.) area and have questions about ADHD therapy near Portland Oregon, ADHD psychiatrist Portland, ADHD therapy Portland Oregon, ADHD diagnosis Portland, ADHD counseling near Portland Oregon, ADHD assessment Portland Oregon, or ADHD professionals Portland OR, feel free to contact me to discuss your needs.

Many thanks for all the positive feedback to this blog. If you have any questions, comments, or suggestions don’t hesitate to contact me.

Going to College with ADD/ADHD

Lately I’ve been receiving more contacts from college students indicating that they are having significant difficulties now that they are in college. Many indicate that while these difficulties started in their early formative years, they’ve somehow managed to persevere until now. Some report having attended college before, only to receive poor grades, be placed on academic probation, or in some cases, asked to leave the college.

That leads some to question, why now? What is it about going to college that makes things for the ADHD/ADD college student more problematic?
Many individuals with ADHD/ADD have grown use to using brains, willpower and pluck to compensate for their inability to stay on track, focus, concentrate, stay organized, procrastinate and many of the other ADHD/ADD symptoms. While this might work in middle school and high school, when the students transition to college that approach is insufficient.

College brings more independence and more responsibilities. Students oftentimes have classed that have several hundred students and are also expected to sit for longer hours. They are also expected to find classrooms across a much larger campus and have much less individual contact and support from their teachers. Additionally college students are expected to manage their own financial affairs which might include rent, food, tuition, books, social activities, transportation etc, many for the first time. All these increased responsibilities with less parental and educator support, leads some students with ADHD/ADD to drop out of college and wonder if they can function in a college environment.

Luckily, for many, the answer is yes. Today, we have more understanding and awareness of what ADHD and ADD are about. There is no need to suffer needlessly and if you or a loved one, someone you know can identify with any of these symptoms, please seek out an ADHD/ADD specialist and discuss your situation. If you live in or near the greater Portland Oregon (OR) area feel free to give me a call at (503)492-2200.

As always, I welcome your questions, concerns, and suggestions.