ADHD OCD Anxiety Diagnosis? Brain Function Beyond Labels

[lambymorreale]

Dr, Parker--thank you so much for your video blogs. Between this one here and the "avoidance" video, you have explained my issues precisely. It's been difficult to find a doctor who sees this with me, primarily because i am not physically jittery, and I can answer their questions quickly, but they're not exactly the "right" answers, the "truth", for me. So they push anti-depressants/anti-anxiety meds, I politely decline, and leave frustrated and depressed. I wish I lived closer to your office...

[DrCharlesParker]

@lambymorreale These two subsets are, without doubt, the most frequently missed ADHD subsets, the most frequently overlooked executive function disorders on the planet. You are in big numbers company, as those two subsets are the ones I routinely see on "complex" second opinions. - Not so complex if you can see the path.

[JackMack02660]

Thanks Dr. Parker, You nailed it with your descriptions ,AND what responses and behaviors are associated with an ocd/add/adhd/anxiety condition. I had been diagnosed bi-polar couple years ago... i knew that wasn't right, because of that mental ocd aspect that had manifested to mask an extreme fluctuation in mood . So yes,thought patterns ,behaviors and the huge anxiety factor..so i guess i gotta own it now, and at 44, the regrets..cpippling..

[DrCharlesParker]

@JackMack02660 Hey Jack, just remember this less complicated point: You have but one life - think of the thousands that have completely passed in years gone by with never a twit of recognition that their challenges were correctable. They died thinking they were stupid, bad, guilty, and irresponsible - you have a new life and speaking from my aging perspective, you are a young guy with many miles to go before you sleep. Carry on!

[JackMack02660]

@DrCharlesParker Thanks for response..! ya now i'm in sub-acute care and at peace with it for the most part..The brain saturation became a 5 hour replay on one single thought,,This sharp acute increase of ocd dwelling, locked in that crap..it was kind of needed..Thanks for the words, i get it, pos.reinforcement. If you wanna respond ,that would be awesome--(.5 klonopin x2, seroquel(sleep)75-100mg 10 pm..clonodine.05 am ,.10 pm effexor 150 am adderall 20xr am. 10 ir 2-3 pm..ty

[JackMack02660]

@DrCharlesParker .I tend to ramble-just threw those spript numbers up there..if that seems reasonable just your input if you wanna..thanks...Checks in the mail.,lol.thanks again, take care!!! Anyone ever say you kind of,(mannerisms,way of speaking) remind them of younger pres Bush???.Thx again!!!!!

[DrCharlesParker]

@JackMack02660 Never heard the comparison to Pres Bush - certainly can't hurt being

compared to the Pres, unless I get caught not remembering what I am talking about!

[NyraLunaEXE]

Is it typical for an ADHD/OCD sufferer to constantly "mental check"? You're not exactly focussed on the task at hand, but instead fretting if tasks or objects etc. trigger a thought or image?

[DrCharlesParker]

@NyraLunaEXE The mental checking is quite typical of the cognitive abundance - almost anything can trigger this phenomenon - it irritates me that so many raise the poor choice of humor about flashy objects when in fact anything not nailed sufficiently down may stimulate more efforts at understanding and control.

[NyraLunaEXE]

@DrCharlesParker @DrCharlesParker Ah! That makes more sense! I have a bit of OCD with ADHD, so I constantly mental check or mental track to see if the objects, tasks etc. trigger thoughts or images. I am having a lot of trouble breaking those habits. Yes, that seems to be the stereotypical "ADHD" person nowadays. :/

[NyraLunaEXE]

@DrCharlesParker Also, is it typical for thoughts to be exaggerated and overwhelming?

[anitar7111]

Dr. Parker, If you have ADHD and social anxiety, what medicines should you be on?  Please help.

[DrCharlesParker]

@anitar7111 If meds need mixing to cover both presentations, need to be careful with drug-drug interactions, specifically prozac/paxil and the amphetamines. Otherwise it will fall to your doc and you regarding their/your choices of the best combo-

[roDinski584]

I was wondering if you could give me some input on the basis that these anxiety disorders stem from serotonin and or dopamine concentration issues. I was diagonised with OCD and since the use of the medication I experienced EPS, serotonin syndrome, hypervigialance, hyperthermia, deliriumn, and a few other symptoms the psychologist was unable to answer for. The "hit and miss" tactic employed by these medications don't really show a proper understand at the core issue. What is your input?

[DrCharlesParker]

@roDinski584 Generally speaking whilst translating neurotransmitter data over to clinical appearances the serotonin issues relate to deeper brain structures often associated with affective, feeling nervous or anxiety. Dopamine often is associated, as described in detail in my book on ADHD Medication Rules, is associated with cognitive, thinking, cortical anxiety arising from issues with working memory in the prefrontal cortex. To top it off the level of one can modify the other neurotransmitter.

[roDinski584]

@DrCharlesParker Thanks for the response and info

Since there isn't any blood tests that I know of that would directly state which is the governing issue towards the disorder (dopamine/serotonin levels), could there be a different contributor to why these symptoms be problematic? Since dopamine is also associated with the cognitive activities, would the root cause be the dopamine levels or is there other issues, being either the wiring of the brain, that is causing these levels to be off?

[roDinski584]

Like, for example, although the dopamine levels are triggering these behaviors there is another issue, such as a certain thought or event or a problem with non-associative lobes addressing other lobes not associated with be causing these levels to go out of whack?

Why would I experience such severe symptoms if the real cause is a serotonin/dopamine levels between either the synapse or just in the negative feedback loop? Would it be safe to assume that my real issue is not be based on [ ]?

[roDinski584]

By the way, I like this point: "My point on this: Many are treated for thinking problems - without specific thinking about the thinking process." I think it is really in the right direction towards diagnosing these disorders. Thanks for sharing and I hope it goes far.

[DrCharlesParker]

@roDinski584 and thanks for your kind remarks on the thinking with ADHD and OCD

[tlie03]

I desperately want to address Cognitive Anxiety w/ my psychiatrist but have questions:  (1) Is Cognitive Anxiety a sub-category of ADHD, or a completely separate condition? (2) Assuming it's diagnosed, how should it be addressed medically? With an ADDITIONAL prescription (1 for ADHD, 1 for Cogntive Anxiety) or should I REPLACE my ADHD presciption with one for Cognitive Anxiety?

[DrCharlesParker]

@tlie03 Cog Anx is not even in the books yet, only in my book... all other references chunk it under OCD and take concerned practitioners down the SSRI path. The cog part of the problem usually responds well to a stim, the affective side an appropriate SSRI ... all this is assuming that your *background noise,* your metabolic medium is already balanced. Start slowly, learn what you can, and with a workable grid in place, with clearer targets it will all be much less amorphous.

[IncelTreatment]

Great video is there anywhere I can find out more about this?

[DrCharlesParker]

@IncelTreatment Both the CorePsych Blog and this link will take you to many more details: Log in for Predictable Solutions a complimentary special report there in the upper rt hand corner - cp

[butiamnotcrazy]

I'm a college student with ADHD as well as some Anxiety features. I had a lot of success of Adderall and took it all through high school, and freshman year of college, but lost insurance and had to quit. I went about a year and half with out meds (bad idea) and began taking Ritalin a couple months ago. My ADHD is improved some but my focus is still off, and my anxiety has really gotten worse because of this. Any tips?

[DrCharlesParker]

@butiamnotcrazy Best you can do if no insurance is the generic Adderall, about the same price as Rit I am told, but honestly haven't shopped it up. See my other video on DOE for specific dosing instructions. I have all the ADHD videos together on a YouTube player as an ADHD med tutorial at CorePsych Blog... just *Search* "Tutorial"

[juuliuuz]

Hey, very interesting video. I was put on SSRI (Lexapro) for my GAD two years ago my anxiety comes back when I become busy. I started to think that really something is wrong with me and its not just anxiety.I started to GOOGLE, GOOGLE & GOOGLE (My GP said its wrong to do googling its just anxiety,but it is not) Went to psychiatrist she said to do diary and come back in 2 months. Its getting worse and worse and I cant multitask.. I'm so sad, anxious, scared, depressed. I think I have OCD too

[DrCharlesParker]

@juuliuuz Yeah, this is often the hallmark of ADHD, failure of the SSRI with even more anxiety and impulsivity!

[dannyland1]

I can see why I do well with structure, I'm not even sure if this was the video addressing that, uhh well anyways I suffer from some pretty extreme ADHD, I have all symptoms you talk about in your videos, I was wondering if being attracted to all forms of really intense sports, tv, video games, music is also a trait for ADHD, basically, I'm thinking my brain needs constant stimulus. is this an accurate assumption? If its not mental stimulus i need to move around when not on my meds.

[DrCharlesParker]

Take a look at my other video on ADHD Context which also adds to the current dialogue about diagnosis and the reality in which symptoms occur. Thanks hope it's helpful!

[DrCharlesParker]

@dannyland1 the stimulus keeps the focus, the structure and the diminished variables do exactly that: take away distractions. The biggest problem, the most overlooked problem with ADHD sufferers is the 'unmanageable cognitive abundance' out lined carefully in *ADHD Medication Rules.*

[reddorothy]

Do you find that bupropion works? Its not an SSRI.

[DrCharlesParker]

@reddorothy Wellbutrin helps just a bit, often not as significantly as stimulant meds - DA and NE both effect PFC function... but patients prefer to have the best correction with a stimulant dialed in accurately based upon their personal metabolic presentation.

[DrCharlesParker]

@reddorothy - not as well as DA or NE, but can be helpful.

[chillidogdupree]

So what's the solution for patients with OCD and ADD? An SSRI w/ a stimulant? I've tried this route before and it worked for several years. The problem I had with this combo, however, was insomnia and hypomanic episodes from the SSRI. So then Lamictal was added but this caused aphasia and memory problems. Bipolar, ADD and OCD--how would you treat this combo on a hypothetical John Doe? Also, is it dangerous to start Lamictal out at 100 mg? And thank you for the great videos!

[DrCharlesParker]

@chillidogdupree

Yes, often the answer, after determining the underlying problem ruling out ADHD, is most often comorbid challenges with serotonin... but that doesn't leave out all the other neurotransmitters relevant to ADHD: NE, PEA, Glutamate... measurement of the neurotransmitter biomarkers is the key to that mystery door.

cp

[DrCharlesParker]

Juliette6478 - read my book on *ADHD Meds,* that will help them understand what you are saying and how to establish more effective treatment targets.. the last chapter is on how to work with your doc and how to find the right one.

cp

[juliette6478]

what a life saver a description of me but this still wont help me get a diagnosis from ignorent doctors 

[steelD0wnage]

Could you maybe make a video about Aspergers syndrome if you might have just as much, or also alot, knowledge about that?

I would really appriciate that :)

[docparker1]

@steelD0wnage I've been working on my new book, but will be happy to record a video on the interface between ADHD and Asperger's - we often see Avoidant ADHD or Thinking ADHD mislabeled as Asperger's - and is so often so easily treatable with properly dosed meds or specific neurotransmitter precursors: See this page: /neuroscience at CorePsych Blog

[beingther]

i never kow that anziady has to do with my add

[codsteb]

Yes, yes, yes! I tried to explain this to people so many times and NO ONE got it.  Thank you, very much, for seeing this distinction between affective anxiety and cognitive snxiety.

[ADHDRollerCoaster]

Great overview of an important and mostly misunderstood topic, Dr. Parker!

Gina Pera, author

Is It You, Me, or Adult A.D.D.?

[DrCharlesParker]

Thanks Gina, means a great deal coming from a journalist and ADHD reporter with your experience! Readers should drop by Gina's site for some super additional ADHD info-