Dyspraxic Adults

Been to see the occupational therapist today to talk about executive functions. She went through a lot of questions, asked me all sorts of stuff - talked about how I was as a child, a teenager, now.

She wrote a lot of stuff down and said that she is absolutely positive now that I have problems with executive function, which she called "Dysexecutive Syndrome". She says I have problems in all the areas of executive functions, so this is fairly unambiguous.
http://en.wikipedia.org/wiki/Dysexecuti ... e_syndrome

She believes I need more support than what the occupational therapy team are able to provide, so she is referring me to - well, she said it was like a community mental health team, so I guess similar to that but not quite the same. They have support workery type people.

She really understands my frustration, which is very nice. :-) She's really sympathetic to being in the position of having intelligence and intellectually being able to think about things (I should do this thing because it's important, I should not do this thing because it's not nice) and yet not be able to take those logical thoughts through to action or inhibition. But only sometimes. Sometimes I can do those things, which just increases the frustration - why can I do it on Monday but not on Tuesday? I told her I felt really crap about it, lazy and useless and rubbish and STUPID that everyone else could do these things fine and I just.... couldn't. She said I shouldn't feel this way and it wasn't my fault. I almost burst into tears of combined stress, frustration and happiness, but I managed to keep hold of myself.

She says there are things that can be attempted to try to help me to learn to function better. She says it's not possible to know how I will respond to them until they are tried, but there are things to try.

I asked her about medication. She said she didn't know whether medication would help me - it might do nothing at all. She's going to take her report on my executive functions back to Dr Duffey to see if he can draw any further conclusions. I envision Duffey as a spider in the middle of a web, drawing all the strings towards him and seeing if any of them meet in an interesting way. She's going to speak with Duffey about medication. I fully expect him to say that he doesn't want me to have medication - or possibly follow up on the psychiatrist referral that he recommended, in order to see what a psychiatrist would say.

I had to look it up to see what it meant. Sounds familar. How did you get on?

Well. The occupational therapist (OT) referred me to the neuropsychology team as she thought i would benefit from a neuropsychological evalution. The neuropsychology team said, "Nope, no can do, not our jurisdiction". They won't take anybody without a diagnosis. And I don't technically have a diagnosis right now - although the OT believes I have an executive function problem, she is not a doctor, so cannot technically make a diagnosis.

So she said "ARGH!" and referred me to the community mental health team. They have psychiatrists, and psychologists, and mental health nurses, and biscuits, and all manner of wonderful things which she thought could be helpful. They said, "Nope, no can do, not our jurisdiction". They will not take anybody who isn't suffering from a "severe and enduring" mental health condition. Sadly, my depression just isn't awesome enough, nor are my weird habits (pulling my toenails off and pulling my hair out being two of them) - althouh they aren't normal, they wouldn't meet the diagnosis for impulse control disorders, though they are mild versions of them.

[Fun fact: of the behaviours on this list I have not experienced pathological gambling, pyromania or intermittent explosive disorder. As usual with me, even my weirdnesses are weird - none of these habits are compulsive for me. Normally, people feel a need. I don't usually feel a need, I mostly just do the behaviour, aside from the stealing - that was quite compulsive.]

So she said "WTF, PEOPLE?" and wrote to a local mental health charity called Our Celebration, who welcomed me with open arms. It isn't what we hoped for, but it is something. She also wrote to the neurologist who I saw originally. He was quite infuriated with the lack of Giving A Damn from the aforementioned teams and suggested that if a diagnosis was needed for neuropsychology he could MAKE ONE UP.

I love this man.

So, where am I now - I'm starting a computer course at Our Celebration. Most of it I will already know, but the qualification will be good, and my OT just wants to de-hermit me, get me out of my flat. I think I probably will end up being able to see neuropsychology at some time in the future. I'm also going to try to persuade the neurologist to let me try stimulants. From what I have been reading, it is incredibly common for executive dysfunction to be misdiagnosed as ADHD-inattentive type. Seven out of the nine discriptors for that type of ADHD are to do with the executive functions. Furthermore, I don't have problems with every single one of my executive functions AND I also meet the final two descriptors.

I figure that, while much less common since ADHD is more well known, it would also be entirely possible for ADHD-inattative type (or any type, in fact) to be misdiagnosed as executive dysfunction, since executive dysfunction goes with the territory of ADHD. I'm not splitting hairs here - this makes a difference in terms of treating it. If i have ADHD, stimulants might help. If I have executive dysfunction without ADHD, they probably won't. I reckon that the only way to know if stimulants would help is to try them.

I know some doctors are reluctant to try people on stimulants. Some doctors are also completely averse to the notion of ADHD in adults. My neurologist's wife is a psychiatrist, and he says she doesn't accept that adults have ADHD in the same profoundly affecting way that children do. Well... knackers, frankly. Also, I don't see stimulants as being any worse than anti-depressants, and GPs freely hand them out like sweeties.

That's my argument, anyway. I hope it works.

If it doesn't work, well. I'll just buy some Ritalin from my friendly neighborhood dealer and try them anyway. Or some other stimulant - I would need to research that. If it works, I'll then confess to my doctor and plead with them to not let me be a criminal - ie, to prescribe it. Hooray for being manipulative.

Sounds terribly complicated altogeher