In one of my first ADHD: from A to Zoë blog posts, I tried, unsuccessfully, to find a definitive statement about what ADHD is.
It turns out, we ADHDers are not the only ones who have a difficult time understanding what defines ADHD.
For most of us, our family doctors are the front-line person whom we approach first when we’re looking into a diagnosis. Unfortunately, many family physicians are as in the dark about it as we are.
The grocery list of ADHD traits
Anyone who’s read a book on adult ADHD, or who’s taken an online ADHD screening questionnaire, is familiar with the grocery list of symptoms that are said to comprise the typical traits that exemplify ADD.
If you’re like me, you’ve shared some of these characteristics with friends, family members, and others, only to have them say, “Bad memory? I’ve got that!” Or, “Distraction? Tell me about it!”
I never quite know how to take these responses. Punching someone in the face for minimizing my situation doesn’t feel like an option to me. Comments like this seem either cavalier, or a denial of the lifetime of losses that I’ve suffered as a result of undiagnosed ADHD. Or, they seem like ill-founded attempts at commiserating with me, trying to make me feel that they understand, and that it’s okay, I’m just like everybody else. This belies the fact that my life’s journey is anything BUT the same as the experience of a non-ADHDer.
This is one of the fundamental problems with a list of symptoms or character traits: it’s all too easy for every human being on the planet to identify with at least one, or more likely, many of them. It’s not a far jump from there, to concluding that either, 1) adult ADHD doesn’t exist; or 2) adult ADHD does exist, and everybody has it – or at least a little of it – or at least have it some of the time.
I mentioned in my blog post, Zoë Kessler: Double Agent, that I’d interviewed Dr. Timothy S. Bilkey, an adult psychiatrist specializing in adolescent and adult ADHD, at his ADHD Clinic in Barrie, Ontario, Canada.
According to Dr. Bilkey, you can’t have “a little bit of ADHD.” That’s like being “a little bit pregnant,” says Bilkey. “You either have it, or you don’t.”
Bilkey has developed a relatively new approach to the adult ADHD diagnosis to enable Canadian family doctors to identify ADHD in adult patients, without having to resort to a shopping list of symptoms.
This program highlights typical patient presentations and has been nationally accredited for the past 2 years through the Canadian College of Family Physicians for clinical use by Canadian family doctors. It is based on clinical studies and research from some of the foremost experts in the field, and Bilkey’s private clinical practice and research.
Are You On the “Top 10” List?
Bilkey’s approach to ADHD diagnosis, a unique and innovative one as far as I’m aware, is comprised of 10 profiles which typify the various presentations of an adult with ADHD.
When Dr. Bilkey first told me about these profiles, I was dubious that they would represent the full range of adult ADHDers. Being the drama queen that I am, I was insulted that someone would suggest that we adult ADHDers could so easily be pinned down into just 10 simple categories. “We’re much more complicated than that,” I thought, defensively.
I kept asking questions. I kept an open mind. I listened (incredible, I know, but I’m learning to do that!).
By the end of our interview, Bilkey had alleviated my doubts, assuaged my tender ego, and convinced me of the merits of his approach. For one, Bilkey’s diagnosed over 3,000 adult ADHDers, and no matter how much research and interviewing I’ve done to date, there’s no way I can compete with that!
He also explained that it would be far more likely that a clinician would pick out an adult with ADHD if he used these profiles then if he or she referred to a dry list of symptoms.
As I think we’d all agree, family doctors on both sides of the North American border are swamped. As Bilkey explained it, a general practitioner has to diagnose so many different conditions on a daily basis, that this two-page patient presentation screen is far more likely to yield a diagnosis, given the real-life experiences of adult ADHDers. It’s either that or pulling huge tomes of reference books from their shelves and referring to bloodless, clinical descriptions.
Another thing I didn’t consider
Bilkey emphasizes that ADHD is a context-driven condition. This means that our symptoms can be exacerbated under stress, and can be brought out in certain situations, while we function fairly well or very well in other contexts. Bilkey emphasizes that, for a diagnosis, our symptoms must exist in the context of everyday life (work, academics, relationships, etc.); they must be long-standing challenges; the patient has to give real-life examples of their symptoms; and someone who knows the patient well would be helpful in confirming the patient’s input and providing additional information.
On the second page of this two-page screening instrument, the 10 patient profiles are summarized.
In Dr. Timothy S. Bilkey, ADHD Psychiatrist and…Storyteller? – Part II, I’ll outline the 10 profiles. Maybe you’ll see yourself in one, or several, of them.