Need advice about evaluation for my husband

As a result of my request, urging, pleading and tears in therapy, my husband has finally agreed to an ADHD evaluation. We called a very reputable psychologist in our area who conducts a 2 hour interview as part of the assessment.  The doctor would like for the spouse (me) to be present to be able to provide more information which will lead to a more accurate diagnosis. Originally, my husband was against me being part of the eval, but after further explanation from me has realized that my input could be beneficial. Can anyone offer insight about how to handle the eval from the non-ADD spouse's point of view? I have so many things that I want to bring up in the eval, but I don't want my husband to feel like he is being attacked.  I finally feel like I have some hope and if I don't prepare adequately for the evaluation, details may be overlooked.  Any thoughts from the community...

Try not to do a brain dump

Let the evaluator lead the conversation. You might be tempted to tell EVERYTHING you have ever seen and heard from your spouse. Select a few examples/stories of how you see ADHD affects his life. Stick with concrete, observable examples (e.g. spotty job history, inability to finish projects, computer addiction, whatever).  Unless directly asked, I wouldn't bring up some of the emotional/social/personality stuff that ADHD's tend to have. (e.g. he ignores you, doesn't consider your feelings). IMO, those are too easy to argue away. The point of the evaluation is to get diagnosis & a treatment plan. It's not therapy (that comes later).

My husband has taken part in an evaluation for me (depression) and I sat in an evaluation for him (ADHD). I remember the doctor would ask the patient a question and then seek clarification from the spouse. For example: "Do you think you play video games excessively?" Spouse: "No. There are lots of people who play way more than me." Same question to me: "He plays 60-80 hours a week." Then more follow-up questions and clarifications for both of us.

I may have been lucky, but our evaluators were thoughtful and skillful while evaluating our response. They had a way of making the patient talk more and not feel threatened. I think it is a good sign that your evaluation will take two hours. It tells me the evaluator takes his time.

Writing down major themes

Thank you doublej for your insight. It has prompted me to write a list down of things that have led us to where we are with the ADHD evaluation. It will be hard , but I will try to keep feelings out of it. Instead, I will focus on  concrete examples. I have written a list and putting them into categories (Distraction, Impulsiveness, Organization). I think it helps me to get this perspective. What is really ironic about this is that my husband has done absolutely NOTHING to prepare. I gave him an article to read and I doubt he has looked at it. I asked him yesterday how he was feeling about the appointment we have this Friday and he said it wasn't even "on his radar." At least he was honest.

Checklists

Hi Suda,  Here is a pretty exhaustive checklist/questionnaire that you might consider doing and even consider taking a copy with you (regardless of whether you can get your husband to even contemplate it, let alone do it).  Or you could compare this with your own notes:

http://www.drpaulschenk.com/forms/Amen_ADD_Questionnaire.pdf

doublej  is right about keeping it factual - if your husband feels attacked he is likely to try to turn the tables and blame you for your emotions (if he did it is possible the doctor would see right through it but it would be best not to let that happen).

You have probably already thought about it but you might make sure your husband knows that you will take some notes of your own with you just to help you remember things. Suddenly producing them in the appt would probably be A Bad Thing.

 

how do i get around his feelings about being attacked...

Thanks sunlight. I will make sure to let him know that I have taken some notes - turned out to be a three page document with bullet points. I am sure when I share this with him - he won't be happy. I hope he doesn't ask to see it.  I am digging up a lot of examples from our past that will probably make him furious because he likes to move forward and not look back. But they are still recurring themes and  therefore relevant to mention in an evaluation.  For example,  10 years ago, he quit his job one day and didn't tell me until I got home from work that he did it and going to start his own business.  After many long years, he has a viable business (now with a business partner), but I feel this is relevant example as part of his impulsiveness.  Is it ok to mention something from long ago that at the time was very impulsive and brought so much angst to our marriage, but in the end worked out ok? I just feel like it adds to the story and can give more insight.

As far as my husband's feelings, I don't know if it is even possible that he won't feel attacked, threatened, vulnerable in some way by this evaluation. Just having me in the evaluation is already threatening enough I am sure....

"Feeling Attacked" isn't necessarily a bad thing

Remember, hyper-sensitivity, extreme self-defensiveness, a quick temper, and excuse-making are all signs of ADHD. It if happens, it's good for the doc to see. Don't try to intentionally provoke your husband, of course. Stay calm and rational. When my husband went on a "rant" during his interview, I made eye-contact with the doc and gave sad, half-smiles (trying to convey that this behavior was typical).  Also, don't argue back or make sarcastic comments. Stay as silent as you can. My husband kept talking to fill dead air. The more he talked, the more he displayed his thought patterns to the doc. That helps diagnosis.

A couple of other tips:  1)There will be some "quantity" questions ("How often..."). Don't answer with "always" or "never." (You probably already know that.) Answer with "usually," "frequently," "seldom" or give percents ("He does that 80% of the time"). 2) If you can, make positive answers. For example, we were asked about household chores. I said (truthfully) "He mows the lawn and maintains our computers." My husband couldn't argue with that (it affirmed his contributions) and the doctor could infer all the chores he wasn't doing. (He made follow-up questions.)

Finally,yes, talk about your husband's business and historical trends in his behavior. I'm sure the doctor will ask about it. My husband's doc pointed out that my husband's work history had strong ADHD patterns (I never made the connection). He is entrepreneurial, works odd hours, doesn't like having a boss, feels smarter than everyone else, etc. He started a new job in January. It is the first time he has ever had a 9-5 job. (He is 42.) His job history isn't "negative" (he doesn't lose jobs and has always provided), but there is typical ADHD behavior governing his career path. There may be similarities in your husband's work situation that point to ADHD. (Does he work odd hours? Does the partner handle administrative/organizational duties? Does he hyper-focus on certain projects while neglecting other things? ) You can state all your observations (& be truly positive. Your husband probably has a brilliant business concept--ADHD's are typically very smart) while leaving out the emotional "angst" part unless directly asked.

Good luck. By your posts, I can tell your really love your husband. It may be hard, but you are doing this in your husband's best interest.  There is hope! My husband does very well with medication.  After a few months of being on meds, he said, "Why didn't you make me take this 20 years ago?" He feels much more successful now.

great insight and tips

doublej, thank you for your post. it gave me encouragement.  I am going to remain calm and supportive and try not to interject. Hopefully the doc will ask my opinion and as you suggested, I will try to remain factual and provide examples when possible.  My husband has not said much about it. I told him I was bringing notes and he said ok. I approached him though at the end of a long day when he was vegging out in front of the tv so I didn't really expect us to get into any detailed conversation about it.

To be honest, I will be very disappointed if the evaluation turns up nothing.  I just feel it in my gut that we are dealing with ADHD and we have a long road ahead of us.

How did it go?

Hi Suda,  I am in your same situation right now - actually we have already had our first of 3 assessment sessions, during which I was allowed to offer input.  I am worried about the next session which I will not be present for.  I am worried because his account and memory of events, and their frequency is so very distorted.  This must be a common symptom of ADHD, musn't it?  Surely I can have faith that this is accounted for with assessment procedures?  I would love to hear an update on how your husband's assessment went.

Yes, he was diagnosed with ADHD

Hi Clara,

We had one 2 hour assessment with a therapist who specializes in ADHD. It consisted of an open dialogue where the therapist would say "tell me about high school, or tell me about your college years" and it would be an open discussion where my husband would talk. The therapist might ask him to elaborate on something he said. When we discussed our relationship/marriage, the therapist spoke to both of us. My husband would say something and therapist would ask me if I felt the same way. I would get the chance to elaborate as well. I tried to not make it too much of an attack session. It was already awkward to begin with because my husband wanted no parts of this eval.

At the end of it, the therapist diagnosed him with ADHD and recommended he go on meds. It was not easy for my husband to hear this at all. We went home and don't think he talked to me about it for a week. Eventually he went back to therapist on his own and continues to see him weekly. He did go on meds too. Things are improving, but it will be a constant struggle in our marriage. However, I do have hope now..

I continue to learn/read more about ADHD.  Let me know if I can offer any additional insight

 

 

My husband refuses to agree to an assessment

Our 6 yr old son has recently been diagnosed as ADHD and aspergers and my husband displays all the symptoms of ADHD but refuses point blank to consider he may have ADHD he just won't even entertain it, I am completely exhausted from trying to fight my sons battles and having to deal with his teenage outbursts and general behaviours I am finding it extremely frustrating and am starting to resent him, I love my husband immensely and really want to work together to help my beautiful boy but feel that until he can be more balanced in himself I am fighting a losing battle any advise as to how I can get him to see sense would be gratefully read I am a desperate housewife wanting my husband back xx

Not sure you want to do what I did...

Dear mkMummy,

 But I basically lost it one night and just yelled.  I really don't recommend what I did because when you get angry the other person is not able to hear you. We have had many angry outbursts and still do, but I was at my breaking point. My anger went on for days because I wasn't going to let it rest. I was having trouble eating and sleeping. I normally have to get 8 hours of sleep, but my adrenaline was so high that I had trouble falling asleep. My husband stays up very late and I was trying to corner him into talking when normally he uses that time to veg out in front the computer. I guess it was 2 or 3 days of sheer persistance with the theme of asking him.." do you really want to live the rest of your life like this? Are you truly happy in our marriage?" I felt we were both unhappy and we needed to make some changes. After 3 days of arguing, he finally agreed to see someone, but put some condition of it within 30 days. I think he just said that to get me off his back. Anyways, we were seeing a couples therapist for years and during one of our visit, I lost it in our session because he gave me this 30 day deadline instead of calling the ADHD therapist that I had researched.  I think I cursed, yelled and cried all within our  50 minute session. I think he was taken a back by my outburst because I normally kept it together in front of others, but I just couldn't any more. I didn't want to go on like this when I was 95% sure that he had ADHD after I read Melissa's book. So, he finally agreed and called the next day for an eval.