“I have a patient with 2 PhD’s and a Master’s Degree, about 55 years old [two degrees in physics, and the other in another field of science] – he simply can’t think when the variables become unpredictable and, in the context of time, too abundant to manage in a give time frame. He is wonderful in the context of mathematics, but simply can’t take the responsibility of working socially with the unpredictable variables present in management with a team.
“In math he can think, in the team he freezes.
“Do you know anyone that has been overlooked like this… just think for a moment.”
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So writes Dr. Charles Parker this week in his excellently informative CorePsychblog (Brain & Body Connections: Core Science Findings for Everyday Psych Problems).
A less-than-astute clinician might diagnose this beleaguered scientist with Social Anxiety Disorder — and wonder why treatment doesn’t take hold. But ADHD? It will never been seen as a possibility. Why? Because the public, and even mental-health professionals, have a hard time letting go of some dangerous fallacies:
- You can’t have an advanced degree and have ADHD.
- You can’t hold a high-level job and have ADHD.
- People with ADHD are always spontaneous, life-of-the-party people.
Tags: Adult ADHD, advanced degrees, corepsychblog, Diagnosis, Dr. Charles Parker, Misdiagnosis
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Gina,
Thanks so much for your comments and understanding… you will be interested to see that even with this blog discussion some still didn’t get it – so I did another post just after to explain the concept of reality and context!Thanks for your notes over here… so interesting to see what we have learned from SPECT imaging. When you see the brain in action, and compare it to the Conner’s results, the testing context becomes more apparent.
If a person masters the context of video games they can simply beat the computer test. All this is so remarkable in the context of the regular reliance on computerized testing for ADD. Everyone wants testing to make the diagnosis, as they don’t know how to chase down the clinical presentation when we have only descriptive labels as a standard.
Thanks again Gina, it’s great seeing how your book has been so well received – and to hear the great comments from patients in the office who do now get it.
Chuck
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Hi Dr. Parker,
We depend on clinicians such as you to keep us informed on these nuances and new discoveries that can make such a difference.
In fact, I was just at the dentist’s office, where I picked up a copy of “Neurology Now” (or something like that). The current cover story is on Normal Pressure Hydrocephalus (NPH); it’s estimated that at least 10 percent of patients diagnosed with Parkinson’s or Alzheimer’s instead have NPH.
And of course I remembered your article several weeks ago on this very topic.
http://www.corepsychblog.com/2008/09/spect-brain-nph.html
Thanks for stressing the importance of examining the myriad causative factors for ADHD-like symptoms and other neurocognitive deficits. Patients are desperate for this kind of big-picture, critical thinking.
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” you will be interested to see that even with this blog discussion some still didn’t get it – so I did another post just after to explain the concept of reality and context!”
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Yes, Dr. P., I’m not surprised that some people don’t get it. It’s so counter-intuitive. And there is so much black-and-white thinking about ADHD (i.e. assuming that someone with ADHD lacks intelligence or couldn’t complete college, much less have an advanced degree).We erroneously assume that if someone is “smart” in one area, those smarts should translate to another area. And when it doesn’t, it’s confusing and sometimes maddening. For example, when your partner is a brilliant architect/scientist/fill-in-the-blank at work, it’s pretty annoying to never see that brilliance at home. It feels like it’s intentional or a matter of caring, not a matter of context.
To make a small tangent: Having socialized with many scientists over the past decade, I’ve also observed that some even have better social skills when they are with their peers than with the general public. There is just a higher comfort level, it seems, even when they are not talking about scientific things. Take some people out of that context, and they are rather socially challenged, somehow losing their ability to make small talk, etc.
As you say, context is important!
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