Posted by mtdewcmu on July 2, 2011, at 22:27:48
Hi, all. I haven't been posting lately. I think I have finally found a disorder that accounts for all my symptoms. It wasn't easy to find, because it is largely absent from the current version of the DSM, and it is only really described in the psychiatric literature. There is a good chance it will appear in the upcoming DSM-V, though.
In the DSM-IV nomenclature, it's a sub-subtype of ADHD, Predominantly Inattentive Type in which hyperactivity and impulsivity are completely absent, and in fact, there is hypoactivity and excessive hesitation. It's called Sluggish Cognitive Tempo (SCT). It's so different from traditional ADHD that some researchers believe it is a separate disorder (and I agree). It has a pretty good wikipedia entry: http://en.wikipedia.org/wiki/Sluggish_cognitive_tempo
SCT is fundamentally unlike what most people (and probably even most doctors) think of as ADHD, because it is the opposite of hyperactive. Personally, I have come across people with typical kinds of ADHD, and I do not relate to them at all. This is why it was so hard for me, and evidently my doctors, to properly diagnose. But I have read several academic papers on SCT over the past few days, and I fit the description perfectly. Needless to say, I have never found such an exact description of my symptoms in MH literature before.
I think that the psychiatric community has done a disservice to people with the SCT type of ADHD by systematically marginalizing and ignoring the SCT symptoms, even though there have been descriptions in the literature at least as far back as 1990. The wikipedia entry goes into some of the reasons it was excluded from the DSM-IV. It differs so much from the hyperactive kind of ADHD that there is a really strong case for it being a separate disorder. It's speculated that a bit less than half of ADHD Predominantly Inattentive Type is made up of people with prominent SCT symptoms, and the rest is made up of people with activity levels that are normal or above normal, and whose symptoms resemble ADHD Combined Type, but have hyperactivity that either resolved in childhood or doesn't meet all the criteria for inclusion in ADHD-CT. Hypoactive ADHD would probably be better excluded from ADHD and assigned to a new disorder. Having hyperactivity in the name of the disorder is counter-intuitive to say the least, and probably results in underdiagnosis. It's as if major depression was considered a subtype of bipolar, "Bipolar Disorder Predominantly Depressive." Or if all anxiety disorders were considered subtypes of a single disorder, GAPPD ("Generalized Anxiety Panic Phobia Disorder"). Why should there be only one kind of attention disorder?
Contact a doctor for medical advice. My advice is for entertainment only.
40mg citalopram, 30mg d-amphetamine, 15mg mirtazapine, 300mg bupropion
dx: ADHD (inattentive subtype), depression
poster:mtdewcmu
thread:990027
URL: http://www.dr-bob.org/babble/20110630/msgs/990027.html