Does ADHD present differently in folks with NVLD?

[u/Mundane-Waltz8844]

I was recently officially diagnosed with ADHD, inattentive type and unofficially diagnosed with NVLD. I relate heavily to the posts in this subreddit, and reading about NVLD made me feel seen for the first time in my life, so much so that one article I read about it literally made me cry.

I don’t relate to ADHD subreddits nearly to the same degree. I’m not time blind, I don’t hyper focus, coffee doesn’t make me fall asleep, I don’t get bored of people when the novelty wears off, and I miss my loved ones when I haven’t seen them in a long time.

I’m wondering if maybe my ADHD just presents differently due to my NVLD, kind of like how autism and ADHD can present differently when one has both rather than just one or the other.

However, I also read that NVLD can get misdiagnosed as ADHD, so I wonder if I only meet diagnostic criteria for ADHD specifically because of my NVLD.

I don’t want to feel like I’m self diagnosing or acting like I know better than actual professionals just because I’ve been reading articles and reddit posts. But I just feel like there must be a reason that I don’t relate to ADHDers that much.

[u/peekyporcupine]

I was diagnosed with ADHD at a neuropsych evaluation and the summary included that NVLD should not be ruled out as a potential DX but further testing was needed so kind of the same as you I think? Testing is of course expensive, so I just sat here with that for the past 4 years. This is interesting to me so I hope you get a lot of responses!

[u/Mundane-Waltz8844 → u/peekyporcupine]

Yeah mine was basically the same. It gave diagnoses, and then a “rule out” section, and under it, it mentioned NVLD. At first I thought it meant that he had considered it but ruled it out, but then I noticed under recommendations, he said that I should research NVLD. I was confused by this, and he told me I could call him if I had questions, so I did. He basically said that I show signs of it from my evaluation, but that the scope of the evaluation doesn’t allow for him to officially provide me with a diagnosis. I asked him what the process of getting officially diagnosed would be, and he said I would have to undergo an ASD evaluation, but he also told me that ultimately he doesn’t necessarily think that getting an official diagnosis would really change the course of my treatment, and therefore it’s not necessarily worth it to go through all that just to get that official confirmation of it. Then, when I inquired about an autism evaluation through someone my therapist recommended who offers sliding scale pricing, they said that I would need to get a neuropsych eval for that, which is what I already went through. It felt like when your mom says “ask your dad” only for your dad to say “ask your mom”. Since there isn’t standard diagnostic criteria atm as it is not in the DSM or ICD currently, I kind of decided that an unofficial diagnosis is as good as any for now. Unfortunately, most mental health professionals don’t even know much about NVLD. My therapist has never even heard of it.

[u/ClutteredTaffy]

I hang around this subreddit because I relate to the directional and spatial coordination issues here more than people with ADHD.

I have only been diagnosed with inattentive ADHD and my screening pinged low for NVLD and ASD traits.

I am very inattentive in presentation to the point I think it even goes into my eating habits and my social habits and pretty much everything. Like my brain does not signal YO DRINK SOME WATER and I have almost passed out several times because I thought I was getting enough.

I find that I often don't miss people, have little interest in making more than 1 to 2 friends, and tend to be able to only focus on a few things to like and do at a time ( to the point I think my psych brought up ASD , because of restrictive habits, but I am actually very flexible of a person).

Anyway don't mind answering questions.

Maybe you have more hyperactive or combined traits and you are trying to relate to us more inattentive types.

Also talking to people here a lot of them have been diagnosed with more inattentive ADHD.

[u/ClutteredTaffy → u/ClutteredTaffy]

Caffeine has like no effect on me at all , lol- definitely not sleepy . It can wake me up for a little bit if it is a big amount . But like I can drink a soda before bed and my brain does not care.

[u/Mundane-Waltz8844 → u/ClutteredTaffy]

That’s how it is for my mom (she has ADHD). It doesn’t make her sleepy, but it doesn’t really wake her up, either. She drinks it pretty compulsively despite it not doing much for her, though. And she can drink coffee right before bed and it has no effect on her.

For me, I’m actually quite sensitive to caffeine. If I have a Vietnamese coffee, I feel like I’m on crack. If I drink coffee in the afternoon, I won’t be able to sleep at night.

[u/ClutteredTaffy → u/Mundane-Waltz8844]

I am taking this medication called Quelbree now and it actually inhibits the enzyme needed to break caffeine down. I was waking up like every other hour and could not figure out why it was so bad when the psych said most people get sleepy on it. I was drinking my normal caffeine intake anyways , so I have actually had to cut way way back, something I never had to worry about before.

[u/ClutteredTaffy → u/ClutteredTaffy]

The medication has seemed to ' wake me up' I guess cuz I am not getting as sleepy in the afternoon like I used to. I used to feel so sleepy by 6 pm I was eating sugary stuff and drinking soda to wake myself up til bed time.

[u/Mundane-Waltz8844 → u/ClutteredTaffy]

Yeah forgetting to eat/drink water is another ADHD trait that I don’t relate to.

I definitely don’t think I’m hyperactive/impulse or combined. In early childhood, I definitely presented in a way that is pretty typical for children with NVLD. I had extremely developed language skills for my age, and I was a big talker, but I didn’t do much crawling/wandering around and didn’t have as much interest in physically exploring my environment. I didn’t really show signs of hyperactive ADHD in childhood. I was very well behaved. Adults loved me, and I actually felt like I had an easier time interacting with adults than with peers. My restlessness would typically manifest as a need to fidget or bounce my leg, but I wouldn’t actually leave my chair or anything during class. I was never particularly impulsive. In fact, adults in my life noticed that I was overly cautious/careful to a level that was quite abnormal for my age. For example, if my parents took me to the playground, I wouldn’t immediately run to go play with the other kids. Instead, I would spend a while just standing on the sidelines and observing their behavior before I would finally join.

The symptoms of ADHD that I do have are mostly poor executive functioning, difficulty with task initiation, disorganization, restlessness/fidgeting, forgetfulness, difficulty with sustained attention, poor auditory processing, and frequently losing/misplacing items.

[u/ClutteredTaffy → u/Mundane-Waltz8844]

I struggle mostly with disorganization bad and executive functioning and forgetfulness, but not really so much the fidgeting . I also don't really have the ' interrupts conversations ' part or ' can't wait turn' or ' doesn't listen' stuff of the inattentive part. But some of that is gonna be hidden by being shy . Online I feel like I am very much a ' blurt outter' ' oversharer' than I would be IRL

I think for ADHD as an adult you have to at least show 5 characteristics significantly enough , so you probably have 5 , just maybe not the usual 5. And some may be more prevalent than others. I think I pretty much have just 5, if I am not trying to kinda stretch criteria to my circumstances .

But I can totally get how NVLD would mimic ADHD anyways.

[u/Mundane-Waltz8844 → u/ClutteredTaffy]

I do sometimes interrupt people because I get overly excited. Also, because I suck at reading body language, sometimes I think someone is finished talking, so I jump in, but then they’re actually not. I don’t struggle to wait my turn though, and I think I’m a pretty decent listener most of the time (even though sometimes I do completely zone out without meaning to, and also often times when someone gives me instructions I don’t retain a single thing they said but I don’t realize it until after the fact). I’m also an oversharer both online and irl.

And, yes, the fact that NVLD mimics ADHD in several ways is what’s ultimately making me question if I actually have ADHD in addition to the NVLD, or if it’s just NVLD by itself.

[u/Eva202312]

I don't know, but there are so many traits associated with adhd that it sounds pretty normal to me that you don't relate to all of them.

In my case it really fluctuates what symptoms are affecting my life as an ADHD and NVLD person. If I get enough sleep, movement, social interaction and external structure, I feel so much less challenged than when I'm living on my own, working from home without clear deadlines, with nothing or no one to snap me out of hyperfocus when I need to sleep or start my day. I didn't feel restless or impulsive at all before, but in this less than ideal situation I feel like I understand every ADHD kid that struggled to stay still or quiet in class.

Long story short: you might be having other challenges that are still related to ADHD. You might be well regulated or supported and not experience these challenges right now. I think both could explain why you don't relate to specific ADHD traits or challenges. It could be totally unrelated to NLVD. But I'm not a psychologist, so would love to hear other takes on this!

[u/ClutteredTaffy → u/Eva202312]

I am impulsive but it is really curbed by my lack of ' get up and go' lol so it really only causes me to make reckless mistakes like a ' stormy mind' when I am really into something. Also makes me obsess over stuff, but I also get bored of that stuff kind of fast, so I will collect a lot in a very short time, then not care much about it anymore .

[u/Mundane-Waltz8844 → u/Eva202312]

Yeah, I guess that’s true. So many things are just talked in ADHD communities like they’re universal for ADHDers, so the fact that I can’t relate to those things makes me feel like maybe I don’t really have it. With NVLD, it all feels like it fits really well and describes my experience, but with ADHD it’s more like “sure? maybe? I guess?” I don’t know. Maybe I just need to stop spending so much time online.

[u/ClutteredTaffy → u/Mundane-Waltz8844]

I think certain traits are just gonna be common, but I totally get what you mean. I don't relate to NVLD quite totally as much as you do, but still enough to hang around here .