The issue of attention as part of what gets broadly partitioned into 'frontal' and executive functioning is an important one, and I think the description you have given will resonate with a lot of people. There have been a few avenues of investigation into this, and I would avoid thinking of it as adult ADD and rather a general issue of attention, and in particular the amount of stimulus required to maintain concentration.

Psychiatry creates diagnosis categories based upon the outcome and what medication is prescribed, therefore often where there are heterogenous groups, if the treatment option is the same, then the differences tend to he glossed over. You see this with terms such as depression, where there are actually clinically different presentations, but the drugs are the same so the guidelines in most health services are not to bother with specific diagnoses such as atypical or melancholic depression. I raise this point in reference to ADD, as the area which has been the focus of research in attentional disorders and the focus of research from pharmaceutical companies has been attention deficits with hyperactivity in children. There are in fact the related diganoses of attentional deficits without hyperactivity (which is what you were referring to), but also alternative suggestions such as the unfriendly sounding 'Sluggish Cognitive Tempo' (SCT, worth googling from what you described).

What is believed to be at the centre of the symptoms you describe is the idea that much like those with ADHD, your threshold in terms of the level of stimulation in your environment fully engaging your attention is higher than most. It may be that you tend to also 'hyperfocus' when something really challenging does grab your attention. The difficulties that can occur socially arise from people finding you detached and distant, which some intrepret as rudeness when it's actually due to your attention and activation. In some ways this can present as a very mild autistic presentation, and there are some similarities.

The impact on work can also be profound, it may be that it takes a crisis or the adrenaline of a very close deadline before you are able to fully concentrate (i.e hyper focus) on a task. This all or nothing approach naturally can lead to anxiety, and a difficult lifestyle alternating between drifting and extreme stress.

The good news is that there are a lot of options out there to help with this kind of presentation. The medical/psychiatric route will naturally go towards the same medication as for ADHD, and this may be helpful in terms of concentration. However, if you have lived with an executive/frontal issue for a number of years there is likely to not only have been an impact on your self esteem, but also on your learned behaviours, habits, and coping behaviours. As such, practical guidance regarding yor cognition in the form of CBT or similar may be particularly helpful, as in many ways its about generating insight into behaviours and learning how to change your thoughts and actions to bring about those changes.

I'm a practicing Clinical Psychologist and Neuropsychologist, I work with older adults both in the diagnosis of dementia and in adjustment and support for those with cognitive changes due to ageing, whether dementia related or not. As a result I work with people who have developed attentional difficulties for a variety of reasons. I am also however someone who experienced a lot of what you described myself, and I spent periods of time in deep social withdrawal as a result of my problems engaging with people and tasks, and ultimately spent a significant period of time in a psychiatric ward as a patient myself. Change is possible, and I have now developed skills and awareness, but also changed my beliefs about myself which were formed through the negative reactions to my attentional state.

Mindfulness would be my no.1 suggestion to look into - in many ways attentional difficulties lead us to be 'mindless' of our surroundings and of others. So from day one, learning how to take time to be aware of oneself and to stop our minds disappearing into the clouds can be key. Lots of free stuff on the Internet to read about this, and also psychology is integrating mindfulness into practice through approaches as mindfulness based cognitive behavioural therapy.

You've already done in many ways the hardest thing, which is to develop insight into why you may feel the way you do, and you have made the brave decision to discuss it with others. Discussing it with your doctor makes sense as the next step; don't be thrown if he doesn't neccessarily understand the topic, just ask for a referral to someone else who might. I wish you the best of luck from here on out.

 

I think I have a similar thing. I have a very difficult time concentrating on anything unless it is very intriguing to me. I often find myself drifting off or fiddling with my phone at my boring office job.

I am very opposed to taking psychiatric medication in situations such as this.

I have long thought that I needed to get more involved with meditation. I have meditated on occasion and have found that my ability to concentrate has improved afterward.

Unfortunately, I also suffer from sever procrastination so I keep putting it off and end up never doing it.

 

That was amazing info and thank you for giving it.....however am I the only one that finds humor in using a wall of text to communicate with someone suffering from ADHD?

 

Just to clarify, he isn't describing ADHD, which is a diagnosis based on the presence of a hyperactive response to an attentional issue which is very much about the output, but rather a general attentional condition based more on how his cognitive system deals with input. In simpler terms, the mind struggles to concentrate unless the stimulus is either flagged as really important, or the stimulus is very strong (and multi-modal, for example). As such, having bravely posted about this issue in an outreach forum I'm banking on it being significantly important enough for attention to be maintained.

Sorry that was a rather sober answer to a light hearted question :)

 

Just be aware that some (not saying Daben) are too lazy to distinguish between ADHD and some of the things in this link. People just arent aware of things like Hyothyroidism which carries similar symptoms: http://www.healthcentral.com/adhd/related-conditions-40570-5.html and http://health.nytimes.com/health/gu...dhd/other-disorders-associated-with-adhd.html

I was once misdiagnosed with ADHD. Turns out what I really had was an iron deficiency and Oppositional-Defiant Disorder which gave off a lot of similar symptoms.

 

A lot of people being misdiagnosed with ADD these days. It's a pretty serious disorder, and the fact you are married leads me to guess that you may not have it. I would try mindfulness as Daben mentioned. Meditation will really help your concentration. I would avoid medication until you have exhausted all other options.

 

I very rarely post in this forum as it isn't possible to give accurate advice without going through a proper clinical process, which is never going to happen in this format. I posted this time mainly because of the request for those with personal experience to offer what they could and that was really the main part as what i was describing was really my own experience, the info part was very much just 'maybe' and 'could have'. The next step is to see a doctor who can look at the big picture/differential diagnosis if help is wanted. The important thing that can be achieved on a forum is fostering hope, in that we aren't alone in our problems and that change can happen if you really work at it.

 

I was diagnosed with ADD about six years ago but was prescribed Strattera and it helped greatly even so it was expensive as all hell, $220 a month. I have no insurance for the last couple years so was paying it out of pocket, about a couple months ago my doctor wanted me to come in for a visit before refilling my order, problem was I could not get to him and I was forced to stop using it and then decided to see if I could cope without it and the results ain't been pretty, my biggest problem is I use to take it first thing in the morning with my big cup of java so my day would start off sharp, the mornings this past couple months has been nothing but foggy for me leaving the house, I keep forgetting the stuff I need and have made repeated trips back home, frustrating to say the least. I also notice other areas I have problems with but I am leaving the world of freelancing and getting a 9-5 job at Merck starting next week and one of the first things I have going to do with my new health insurance is get back on Strattera.

A good thing about Strattera is unlike the other ADD meds like Adderall its not a narcotic so its not addicting and I never seemed to lose any tolerance for it.

 

Pretty much every diagnostic category in this field exists as a way of guiding medical doctors towards a particular medication and treatment path, rather than actually representing an identifiable organic condition. Whilst many people appreciate the clarity of a specific diagnosis, whether a particular issue reaches a set level of significance at which it qualifies for a specific diagnosis isn't necessary for it to be an area in which an individual can develop insight and understanding leading to positive change. I would always promote people focussing on what their own experiences and feelings actually are, rather than trying to fit them into a specific diagnosis.

 

Have you ruled out Asperger's by any chance?

 

I too feel like I have this similar issue, really effected me in school with studying, I could never just sit down and study, my mind would create a whole bunch of scenarios in my head, I would start day dreaming. I can't sit still, I am easily distracted. I am pretty positive I have ADD but I never been tested

 

It also effects my sleeping. It is 2:11 here and I am still up, I have a hard time going to bed. I usually take a melatonin to go to sleep but I am all out lately and I keeps me up till 4 am.

 

When I was younger I was having some problems in...OH! Hey! Look at that bird!

 

I thought I might bump this thread with my own stuff for anybody looking around.

I may be the poster boy for undiagnosed ADHD. I'm a bizarre mix of high function and just complete inability to perform. For example, I was valedictorian of my high school class, attended what is easily a top-25 state college in their honors program, and I failed out within 3 semesters.

My performance is very clearly related to my stress level. I am a constant fidgeter. Caffeine has no discernible impact on me, but Benadryl doesn't make me drowsy. On the LSAT, I was doing exceptionally well until the last 10 questions when I quite literally remember being distracted by a squirrel outside the window (yet even missing 10 in a row I did quite well). Antidepressants have been prescribed for me in the past, and they also had negligible impact on me. As I understand it, these are together quite highly predictive of ADHD.

Some of my prior stuff particularly with college was sleep apnea. When my CPAP machine broke down last year, I decided to not only get that fixed but also to bring up my ADHD concerns and push my doctor to give me a trial run on Strattera. I have been unwilling to try any controlled substances for this issue because I deal with people who are strung out on them all the time -- I barely even used the narcotic pain medication I got after a surgery. I preferred to hit it with NSAIDs and cope.

So far I have moved from 40 mg to 80 mg and see progressively better results. I think I'll be talking to my doctor at my 6 month check up from 80 mg to try 100, which is the maximum recommended dose. The odd thing is that the drug makes me drowsy, so I actually take it about an hour before bed. I don't feel the drug wearing off at all, and everybody I know sees a subtle but nice difference. Tasks that I used to avoid due to the frustration I felt in doing them are so much easier to handle. I don't think it deals with 100% of my ADHD-ness, but I'll take it.