I can't pay attention. Do I have ADHD?

Most people have difficulty with distraction at one or more times in their lives. Some degree of distraction is normal; especially in a world filled with so many wonderful distractions (excuse me while I check my iPhone).

Some people have difficulty being distracted or restless more often than not. For these people this can mean that they forget things, lose things, or are unable to focus on tasks that require sustained attention. Inattention and restlessness can be caused by many different things including: stress, depression, anxiety,  ADHD, head injury, learning problems, and even dementia. Many of these things can cause similar problems so it is important to be evaluated by a mental health professional to determine the cause of inattention. Many people see a psychologist to determine what the source of their inattention is. A psychologist can do a clinical interview and psychological testing to determine what the origins of the inattention are.

There are some indicators that psychologists use to differentiate between ADHD and other problems. A significant number of ADHD symptoms must begin before age 12 and the symptoms must cause problems in more than one area of life (school, home, work). For example, if you are in your 30's and have never had significant difficulty paying attention before but have become unable to focus at work for the last 2 months, there may be another explanation for your inattention than ADHD. Even those who have had longstanding inattention may be experiencing something like un-diagnosed anxiety or depression. This overlap in symptoms is the main reason why an evaluation by a mental health professional is so important. It can help you to obtain the correct diagnosis and decide on an appropriate course of treatment.

In my office I have seen many people who were misinformed about what ADHD testing involves. Many primary care doctors and/or psychiatrists will give parents a questionnaire that lists symptoms of ADHD like restlessness, inattention, or hyperactivity. While these are helpful in screening for ADHD they may not be conclusive measures of ADHD. ADHD testing may vary some from psychologist to psychologist but many times it will include intelligence and/or learning tests to make sure there are no intellectual or learning difficulties, a test of attention and processing, screenings for other disorders like depression, anxiety, and PTSD - in addition to a questionnaire like the one they use at the doctor's office. The benefits of psychological testing for ADHD may include:

• More accurate diagnosis
• Awareness of learning issues
• Awareness of strengths and weaknesses
• Awareness of possible other causes or contributing factors  

If you are concerned that you, a child, or another loved one may be having attention issues contact a psychologist today to ask about ADHD assessment. 

In Remembrance

The Psyowa blog is dedicated to public education and issues that are important to psychology in Iowa and in the rest of the world. This post is both about education and something that is very important to Iowa psychology. Recently, Iowa lost one of its most important psychologists. Michele Greiner of Fairfield, Iowa passed away in November of 2015. She was one of the most influential psychologists in Iowa, especially to early career psychologists. She was one of the most tireless and dedicated psychologists I know.

 When I met Dr. Greiner it was a little over 6 years ago. I had just returned to Iowa to complete my psychology training at a pre-doctoral internship at the Central Iowa VA Medical Center in Des Moines, Iowa. To give you some idea about  the rigor of psychology training for those of you who don’t know, psychologists complete 4-6 years of graduate schooling after their bachelor’s degree, then complete a one year supervised pre-doctoral internship, and a one year post-doctoral internship. I was looking for a post-doctoral internship in Iowa because that is where my family is from. The opportunities at the time were few. I feared I would have to move somewhere I really didn’t want to go just to complete my training. Someone suggested that I contact Dr. Greiner and I did. She welcomed me to psychology in Iowa with warmth that only Dr. Greiner could and offered as many possibilities for me to stay in Iowa as she could think of. With her help I was able to secure a position at the Poweshiek County Mental Health Center in Grinnell, Iowa.

Dr. Greiner headed an effort to create post-doctoral positions in Iowa to both serve communities in need of mental health care and early psychologists that needed training. Her work was instrumental in the creation and continuation of that vision. Because of the requirements of becoming a psychologist and the limited training opportunities in Iowa many new psychologists had been leaving the state. This is a terrible thing because Iowans lack access to mental health services. Of Iowa’s 99 counties, 89 are considered mental health professional shortage areas. Psychologists are an important part of the mental health workforce. Unfortunately, Iowa has a critical shortage of psychologists. Iowa ranks 46th in the nation in psychologists per capita. Iowa has approximately 19 psychologists for every 100,000 citizens which places it lower than the neighboring states of Nebraska, Missouri, Illinois, and Minnesota. Equally alarming is the fact that Iowa psychologists are the oldest of Iowa’s mental health professionals. Recent data shows that 53% of Iowa psychologists are age 55 or older.

The post-doctoral program has been a collaborative effort between the Iowa Department of Public Health (IDPH) and the Iowa Psychological Association (IPA), with support from the Iowa Psychological Foundation (IPF) since 2007. As of the fall of 2013, the program had trained 11 psychologists who remained in Iowa providing including myself. If each of those 11 only saw 25 people per week, those 11 psychologists could reach over 14,000 Iowans per year. This program has been instrumental in increasing access to mental health services and keeping psychologists in the state.

Over the six years after I met Dr. Greiner she mentored me through my early professional journey into becoming a fully licensed psychologist and post-doctoral supervisor myself. She helped me through the sudden closing of the mental health center where I worked and helped me as I continued to grow after I left there. I served with her on the Iowa Psychological Association training committee and worked with her on the very project that helped to keep me in Iowa to create post-docs. She set an excellent example for the type of psychologist I aspire to be. She embodied hard work, professionalism, integrity, and humanity. She tirelessly traveled the entire state promoting psychology, training, and mentorship. If it were not for her many young psychologists in Iowa may not be here serving the communities that we do. Her influence has likely touched thousands of lives if not more through her work in psychology.

I wanted to dedicate this Psyowa blog post to her and all of the ways in which her life touched others. I also wanted to send out my hope that we all continue on her mission to promote psychology training in Iowa and access to mental health care for everyone. I encourage all of those who are mental health care professionals to mentor and educate when you can and I encourage all of those of you who aren’t mental health care professionals to give back to the world in your own way. It is a reminder for everyone that there are some amazing people like Dr. Greiner working quietly behind the scenes to make this world a better place.