Physicians who have ADHD

[Anonymous]

I’m a psychiatrist diagnosed after some twenty years in practice who has been wondering about the role that this gift/stigma/disability/ability plays in the larger culture.

A year or so ago I answered a page from a medical student who was helping to care for a patient of mine. I was explaining the patient’s medication regimen which included a seemingly robust dose of psychostimulant for his daytime sleepiness and ADHD. This patient was a distinguished professor in retirement, whose ADHD was only recently diagnosed in his late seventies after being in treatment with me in a formal psychotherapy off and on for some ten years. My teaching point was about why it took so long to diagnose him.

The student was taking all this in stride. So after concluding my presentation I announced that it was his turn to teach me. He began by stating it was his belief that the condition was more or less a necessary requirement for getting into med school, enduring the training and surviving practice. He reached this conclusion after polling many other med students he had come across over the preceding few years. “That seems to be the consensus,” he said.

Of course, I knew he was right. And at this point I’m largely over the idea that ADHD is necessarily a legitimate mental disorder. My own psychiatrist opines that it is a “variant survival strategy.” To my mind the diagnosis is really more of a disorder of civilization, a consequence of the industrial revolution whose entire purpose is to profit via the enforced conformity of its workforce. Standardization, scheduling, coordinating, efficiency…time is money.

So if I have this disorder, which confers such substantial intellectual, financial and prestige advantages, what’s a disorder? When I talk to patients about this condition I often make the point that if you have the right job you might not get diagnosed. You might otherwise be referred to as a doctor, teacher, artist, CEO, etc.

When I started my practice I was doing psychotherapies all day. I sometimes would make an interpretation which would include a near verbatim recitation of a dream the patient had presented to me a few years previously. Startled, they would ask how was it possible to remember such detail and context about them? “My training,” I would say. Sometimes I would write a quote down in my notes five to ten minutes before the patient said it or I might say a detailed statement out loud the patient had not yet made because I couldn’t wait for them to get to it. ESP? Nope, ADD. I have the right job.

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[Anonymous]

I have the exact opposite view. I am a nurse practitioner and I am really struggling. I have compensated for many years. I have always gotten very high grades and been a high achiever. However, I have had to use very significant chucks of time. I have very few other responsibilities than school and devote 100% to it. However, the medical field is extremely fast-paced and I no longer was able to compensate by throwing more time at the problem. I am so rushed all the time that I save all my work and charting for the end of the day and have turned 6 hour shifts into 11 hour shifts. I am taking stimulants for the first time in my life, desperate for some relief before I lose this job. I don’t understand how one could function better with a mind which is constantly distracted and will waste time by forgetting things, remembering things at inopportune times, and having difficulty with time management and thought organization. Maybe it is because my main problem is inattentiveness? I am personally suspicious that med students are ‘neuroenhancing’ with stimulants, meaning that they do not have actual ADHD, but use the medication for an extra edge.

something to think about. I love that I am unique and creative, but this is an impairment in certain ways.

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[Wgreen]

Alrighty—a mental-health clinician adding some voltage to the conversation!

The theory that ADD is a disorder of the Industrial Revolution is not new. Many have argued that human beings are not neurologically hardwired for a sedentary lifestyle. Indeed, a vigorous exercise regime seems to mitigate the symptoms in many sufferers, ¿no?

Too, I’ve heard it said that many people with extremely high IQs often present ADD symptoms—the ditzy professor syndrome. Happily, IQ often trumps the other issues.

I have the disorder, and I also managed to have a career that conferred considerable “intellectual, financial, and prestige advantages.” Still, the damage to other aspects of my life has been devastating. I don’t think I’m alone. Then there are the countless others who make Willy Loman look like Donald Trump, the ones who never make it out of the gate. I’m glad you think your ADD gave you a leg up. Congratulations on finding your vocation.

As a psychiatrist and therefore official “smart person,” you might find James Trilling’s American Scholar article about his family and ADD illuminating (Trilling is the son of famous New York critic Lionel Trilling). I’ve cited it before: http://www.highbeam.com/doc/1G1-54756983.html

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[Anonymous]

Great gifts and great terror. The turning point for me was when I decided to consider my diagnosis as another identity along with all my other identities. Doc, patient, guy, jerk and a half, son, mystic, scientist, lover, victim, oppressor, subversive, citizen, yogi, minister, infidel are a few of the others lurking in my consciousness somewhere. All of my known and unknown identities are vying for dominance at any given time and although I can influence the mix consciously my unconscious mind is always way ahead laying down traps, ambushes, pleasures and unpleasures.

The “smart person” identity is both pleasure and pain and maybe the most dynamic of the clan. It’s my prodigal son: proud, disobedient,

cursed and cherished.

Surrendering to my needs of being dependent and taken care of as a patient allowed me to spend more of my time and energy as a mad scientist, mystic and rocker. Now, I can at least suppress the brilliant psychiatrist physician part of me which is usually overwhelmingly in charge and spend more time with the asshole from New York side who loves to say “fuck you” to all the other kindred assholes I meet. My bliss.

Psychostimulants and psychiatrists are great to have on my team. They are necessary and indispensable, coaches who call in the desired plays to me. But I like to call my own audibles because I’m smarter than anybody on the field and the coaches are idiots anyway! But I fumble more when I ignore them and must then hang down my head in all due shame. The roar of the crowd is worth it until I go back to the bench and the coach says, “hey asshole, what the hell was that stunt anyway?”

“It’s called ‘My way’ and I won the game”, I arrogantly reply. And then I sit out a game or two in total regret, until they need the angel of vengeance yet once again. And then I glory in both the cheers of encouragement and the howls of execration.

But on Monday I go back to work to heal the sick and bury the dead…and desperately try to catch up on my charts.

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[Anonymous]

careful with that “I’m smarter than anyone on the field”…sounds like a bit of grandiosity .

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[Anonymous]

I was recently diagnosed with ADD in Nov 2011. This is 25 years after I was in graduate school

Prior to the ADD diagnosis I was treated for everything from depression to bipolar illness to sleep apnea over a

20 year period. My inattentiveness and impulsivity have been there since early childhood. I wasn’t able to articulate

the symptoms and so the rest is history.

My diagnosis came as a result of a personal crisis in my life. I have been married to an alcoholic

who was a heavy drinker for the better part of 20 years. She crashed and burned. I ended up

going to Alanon recently (better late than never) and because the focus is on me I started to

do something about my physical and mental problems

I actually watched some TV show that had the clinician who started the clinic where I sought help.

Needless to say I have responded well to stimulants and am working on changing behaviors that

have caused so many professional and personal relationship problems.

For most of my career I have worked in the healthcare industry including the dark side (Big Pharma)

I must say it has been an overwhelming ride for the last 3 months (positive and negative)

Shrinkrap,

Your 8 month old post provided some much needed perspective for me.

You are very funny as well.

Wgreen

I have had a reasonable level of success and like you some devastating life experiences

My next steps in my career I am looking for more success and a much better work/life balance

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[Anonymous]

I, too, am a psychiatrist and was just diagnosed in my 40s. Being an ADHDer, I did not find my way to medical school until I was in my 30s. I finally figured out what was going on with me AFTER residency. Of course I procrastinated actually getting a diagnosis and have just started taking Ritalin. I am not sure how it will affect me, it doesn’t seem to be doing much other than make me a little sleepy at a pretty good dose of IR. My doctor suggested I read Delivered from Distraction and I read a lot of things that I have also experienced. It was nice validation. I am on my third job since I got done with residency in 2008 and currently work out of my house in telemedicine. Originally I got this job because I thought it would be less distracting than my previous job, and I would have time for various “projects” when I had no-shows. Also to be more available for my kids. However, I have come to realize this job is high stress, low stimulation and, being an employee, I have very little control over my schedule, etc. I am really gettting burned out and bored and have been practicing for less than 4 years! What I need is low stress/high stimulation, but where can that be found in psychiatry?!? Anyone have any ideas?

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[Anonymous]

Wow ShrinkRap……….another one! Me too……wonderful life…… success up the yin yang……love my ADD brain and all it brings to my table…….I read you post…..and said thank-you….. thank-you……..thank-you…I knew there were more out there!!!!

“I often make the point that if you have the right job you might not get diagnosed. You might otherwise be referred to as a doctor, teacher, artist, CEO, etc.”………………yes!!!!!

Thank-you again…..

Toofat

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[Anonymous]

Psyched/Shrinkrap, I was wondering if you guys woudn’t mind giving me some advice, in the forum I just created since you’re a mental health expert. Thanks!

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