Mary is open to debate on whether SCT is a true "disorder" but can attest to its cluster of traits challenging day-to-day functioning
Little-known but life-affecting, SCT needs more study
We all suffer from "brain fog" from time to time, but imagine living 24/7 in a cogntive haze, wondering how others can think, plan, act and react so darned quickly. That's life for kids and adults with a syndrome researchers are calling Sluggish Cognitive Tempo.
People with Sluggish Cognitive Tempo are daydreamy and spacy much of the time, with staring spells. They tend to be underactive and lethargic, moving slowly. They process information more slowly than others, too. As part of their overall mental fogginess, they can be easily confused and error prone. Socially, they tend to be reticient or withdrawn.
While it looks as though SCT did not make it into the new Diagnostic and Statistical Manual of Mental Disorders (released in May 2013), it may someday be categorized at a distinct disorder, separate from the inattentive ADHD it often "lives with" in the same individuals. Here, a look at what is known, or at least believed, about Sluggish Cognitive Tempo.
Sluggish Cognitive Tempo vs. "Type i" ADHD
What's the difference?
According to Russell Barkley, PhD, one of what seems to be a very small pool of ADHD researchers looking seriously at this condition, Sluggish Cognitive Tempo is present in 30 to 50% of those who have the inattentive subtype of ADHD. (For what it's worth, Barkley publicly implored 7 years ago for a name change from Sluggish Cognitive Tempo to the perhaps less demoralizing Concentration Deficit Disorder.) So not all those with inattentive ADHD will have SCT. Nor will all those with SCT meet the criteria for inattentive ADHD. To confuse things even more, at least one study has found that SCT correlates with overall inattentiveness in kids, regardless of the ADHD subtype they are diagnosed with (e.g., predominantly hyperactive-impusive, predominantly inattentive, or combined type).
Experts have gone back and forth on whether SCT is a subtype of ADHD type I (in other words, a subtype of a subtype) or its own disorder. But it seems reasonable to speculate that both of these could be true. SCT is really just a descriptive phrase for a certain set of day-to-day symptoms or challenges.
Here are some differences that researchers like Barkley have found to date:
~ Information processing with SCT is slower and can be more error prone than with inattentive ADHD without SCT.
~ SCT correlates with a higher risk of anxiety problems than with inattentive ADHD without SCT, and possibly a higher risk of depression.
~ ADHD stimulant medications tend to be less effective for those with SCT, but behavioral therapies possibly more effective.
~ Those with SCT can get along with others but are often socially withdrawn.
~ High levels of SCT are found in kids diagnosed with both ADHD and an anxiety disorder.
To delve much more deeply into the debate over whether SCT deserves its own designation, check out this article that extensively quotes Barkley and some clinicians who rather vocally disagree with him.
What's up with the SCT brain?
In one YouTube clip, a self-diagnosed SCT sufferer explains that his trouble, cognitively, is not so much distractibility as exhaustion: mentally, getting "too exhausted to go through anything hard."
Researcher Adele Diamond has argued that the inattentive ADHD/ SCT mind is chronically underaroused and gets very easily bored. On the other hand, a 2021 study (albeit very technical in nature) on how SCT vs ADHD manifests in terms of "early and late selective attention" seems to suggest that while the ADHD mind gets quickly bored and wanders off, the SCT mind gets quickly overwhelmed and shuts down -- going so far as to suggest that effective academic accommodations might be different for these two cohorts; e.g., simplified fonts and summaries for students with SCT but visually busier, more colorful materials for those ADHD.
It's important to note that the foggy, sluggish qualities characteristic of SCT can sometimes stem from a completely different problem. For instance:
~ Thyroid problems: An underactive thyroid gland can absolutely cause chronic mental fogginess and lethargy. A blood test can rule this out.
~ Seizures: The staring that is common with SCT can actually be a symptom of absence (or petit mal) seizures. Doctors conduct EEGs to detect these.
~ Sleep problems: Chronic poor sleep (because of getting to bed too late, trouble falling asleep, trouble staying asleep, restless sleep or sleep apnea) can produce many of the same effects as SCT. A sleep physician can diagnose an actual sleep disorder and help create a treatment plan that could improve sleep-related inattention, but often this is just a matter of turning off the electronics & hitting the hay -- every night. Or getting more exercise during the day. Or cutting out the caffeine.
~ Depression: SCT and depression can sometimes coexist, or the SCT can be a symptom of depression (confusing, I know). "Slowed thinking, speaking or body movements" can be a symptom of depression, as can "trouble thinking, concentrating, making decisions and remembering things." If these go hand in hand with issues like a loss of interest in activities previously enjoyed, chronic sadness, and irritability over even small matters, a psychiatrist should evaluate for depression.
How is Sluggish Cognitive Tempo treated?
Just as the genetic basis of SCT and which neurotransmitters are involved are still big question marks, little is known at this point about how to treat SCT effectively.
Russell Barkley has said it may respond well to behavioral interventions and cognitive behavioral therapy, but admits there are very few studies on this.
He also has seen a less "clinically impressive" response to stimulant medications than with ADHD sufferers in general. Barkley estimates that 65% of SCT patients experience some improvement with these medications, but only 20% have a strong clinical response. Some stimulants may work better than others for both SCT and inattentive ADHD--sometimes at lower doses than normally prescribed for other ADHD subtypes--and non-stimulant medications such as atomoxetine can improve SCT problems for some. Medication management is both a science and an art, so it's important to consult a doctor who is experienced in treating these conditions.
Neurofeedback treatment to counteract excessive theta (daydreaming) brainwaves holds promise, but it's expensive, time consuming and not clinically proven.
A helpful video, with advice from Ellen Braaten PhD
Does SCT get better over time?
As parent of a bright, loveable young adult with SCT and inattentive ADHD, I can endorse Dr. Braaten's advice, in the above video, to embrace an "acceptance, accommodation, advocacy" strategy that includes nurturing an ability to self-advocate in developmentally appropriate ways over time. It does help. On the other hand, it's probably no accident that the video features a young man, not a young boy, explaining "I don't multitask mentally." This is often a long-term situation that needs to be managed long term -- as evidenced by the fact that the young man's mom is still talking about lending him a bit of her brain.
I've researched long-term prognosis for the Sluggish Cognitive Tempo cluster of symptoms but have come up mostly emptyhanded. The SCT profile really started to be defined only 20-30 years ago, which in medical research time is not long at all, and of course is still controversial.
Experts have long held that about 50% of childhood ADHD remits by adulthood, but new research suggests that in reality, that figure could be much lower and that a whopping 90% "continue to experience residual symptoms into young adulthood."
A 2018 study specifically on SCT looked at kids 6 to 18 to compare SCT symptoms at different ages within this range, finding that daydreaming and processing-speed problems become slightly less problematic with age, but "internalizing symptoms" like anxiety and depression remained constant.
An interesting and, I think important, side note is whether the Sluggish Cognitive Tempo (or Concentration Deficit Disorder) cluster of traits is more/less culturally compatible in different parts of the world -- i.e., it could be less maladaptive in some areas than others, potentially causing much less stress for the person with these traits. Stephen P Becker, PhD, has called for a global inquiry on SCT to assess this, among other aspects.
For my own SCT kid, an IEP at school with accommodations such as extended time for exams (which routinely take him 1.5 to 3x as long as his peers) was essential. He had to severely limit extracurriculars to finish his homework (which takes him at least twice as long as typical classmates), and was sustained by a couple of good friends and some creative outlets that offset the mental fatigue he fought every day. Navigating college never got easy for this talented but speed-challenged guy (I'm almost glad I didn't read, before he started, that researchers in 2016 found SCT symptoms may be twice as prevalent in the college student than overall adult population and have a negative impact on academic functioning, household chores, money management, social demands and more, "even after controlling for symptoms of ADHD, depression and anxiety"). But with a ton of effort and careful course planning -- including taking a community college course each summer for transfer credit to his main school -- he did finish in four years. Afterward, he did a lot of service work around the country to figure out what kinds of tasks he's best suited for and how to avoid burnout -- a learning process he's continuing as part of the regular workforce.
~~ parenting an SCT kid? ~~
Are you living with Sluggish Cognitive Tempo? Do you know someone who is? Or do you, like most of the commenters on this Guardian article from a few years back, believe this is a trumped-up condition, ripe for use as one more excuse to medicate kids? Please share your experiences, what people should know about this condition, and what (if anything) has helped. Even if there are no "answers" yet, comparing experiences with others in a similar boat can help.
Mary (author) from Chicago area on July 30, 2014:
@aurora27: Hmm, have not heard of it per se, but it sounds like the "Raising a Spirited Child" book I read many years ago. My son with SCT was not our spirited child, though -- that was one of his brothers, in his toddler/preschool years...went rather beyond the norms for that age in terms of the intensity of his responses to a whole variety of things.So how do you think HSP ties in with SCT? They seem kind of opposite - but I would really love to hear your take, given that you've got the firsthand HSP experience!
aurora27 on July 14, 2014:
@anonymous: Have you heard of HSP? I have that (Highly Sensitive Personality) - where you don't necessarily hear noises more loudly (according to tests) than others but process it more extremely and are affected more so... not just by sounds, but stimuli in general... there's a Squidoo article on it! Very helpful!
Kmzikas on October 08, 2013:
I too am extremely worried about how my eighth-grade daughter with SCT will survive the work load of high school and how she will fare in the college admission process. Nowadays, it's not good enough to just get good grades, you need extracurriculars and service projects too. I have no idea how she will keep up.
Worrying aside, I did find that exercise helps. She plays soccer twice a week and rock climbs (combined with conditioning training) twice a week.
She also has trouble sleeping although she always complains about being tired. Is there anyone else who experiences that issue?
Mary (author) from Chicago area on August 26, 2013:
@anonymous: Hi Kara -- actually anxiety can cause all the symptoms of SCT; has your son been diagnosed with something like generalized anxiety disorder?
Homeschooling could be a great plan, esp. if you keep up with the extracurriculars (for social interaction & learning from other adults -- coaches etc. -- besides mom) and the exercise. You definitely will be able to cover the curriculum quicker, and what you might want to do is try to get your son a bit ahead, academically, over the next year, and then try to reintegrate him to school -- if that feels like a good move -- so that he can focus on learning as part of a group and social/emotional growth.
Best of luck, and please do keep us updated!
anonymous on August 19, 2013:
My 8 year old son was diagnosed with SCT last year. He is very smart but has a hard time keeping up with his class. He would still be writing his name when they are on number 5. He has high anxiety and being at school for 7 hours a day seems to be to much for him. The pychologist said at first that he couldn't find anything wrong and that I just has a "pokey" kid lol. But then it hit him and he realized that a lot of his symtoms are SCT.
I also wonder if this a processing issue since he is also extremely sensitive to loud sounds and has since he was a baby. I tried telling the doctor this and they just tested his hearing and said nothing was wrong. But at the same time, I told the teacher my thoughts. Since his class was being timed with math problems and he was only getting 2-4 done within 2 min. The teacher listened to me and put him in a quiet room for these test and he started getting A's on them.
He does get help with reading during school which seems to help but I don't think tutoring after school would help at all since part of the problem is going all day is mentally stressful for him so I don't want to add to it.
His anxiety is something that really bothers me and I feel that school makes it worse since he has to try fo hard to keep up, so he always tells me he is stupid.
I would like to homeschool him. We could get done in three hours what he does in 7 at school (not counting if he has to get a tutor and his homework.) I could exercise him in the morning and he could work at his own pace. I will keep him in the extracurriculer activities so he still gets to see other kids. I think that this would help huge with his anxiety and help him catch up better.
I would appreciate the opinions of those of you who have been diagnosed with this if u think this would of helped you at a younger age.
Mary (author) from Chicago area on July 31, 2013:
@anonymous: My son has a soft voice, too -- very challenging in restaurants and other noisy venues. You are right that there could be environmental factors playing on genetics here. Thanks for the reminder on how much of a struggle "to be normal" this is, and I'm really glad the Concerta is helping. For this condition, I think 70% symptom relief is pretty darned good. Thanks also for the tip on naps -- had not thought of that for my son, but maybe a quick nap after school, pre-homework would be good. Either that or a quick round of walking or jogging. Basically the same basic things that are healthy for all people are especially good, and important, for people with SCT...
anonymous on July 23, 2013:
51 here and have been (mostly successfully) taking Concerta for 5 years, which managed to sharpen me dramatically and honestly changed my life. I knew there was something amiss in my brain since high school and had experimented with a lot of different things- combined caffeine tablets with ginkgo, tried choline, DMAE, fish oils, and other "brain supplements"... anything to get my brain to work faster and pull me out of the fog. Naps helped in the short term and I was able to sleep just about anywhere- my car, closed offices, park benches. Exercise helped- helped a lot. But the Concerta- for me- made a remarkable difference, especially in my career. I am successful in my career now. Very successful.
That's not to say that the difference is 100%. More like 70%, which is a much better place than I was. Some questions for the rest of you-
Does your body often feel massively stressed? Fatigue is one thing, but it sometimes feels like every cell in my body is under assault. It's difficult to be around people when like that- it's a struggle to be normal.
Do any of you have voice problems? A very weak, thin, tired voice where people are constantly asking you "what? what?" This is very clearly linked for me with the cognitive issues- and the sometimes massive amount of energy that social situations can demand, but drives me mad because there's no faking that something less than good is going on.
Also, I'm convinced that my brother has this condition, but far worse than me. Yet the rest of our family - uncles, aunts, cousins, parents - are plenty quick. I'm wondering if there's something environmental at the core of it. Like, as kids, did we get hold of some lead paint?
Mary (author) from Chicago area on June 13, 2013:
@anonymous: Well, I worry about self-medicating with anything but exercise (which for some can be as powerful as medication). Smoking weed would be about the last thing my SCT son needs -- he would go from being deeply spacy to comotose. I thought your line "This is a prosessing disorder evey bit as limiting as Autism but it does not efect our social abilities in the same way" was intriguing, and somehow that does ring true! Also the parts about art & music ability (yep, that's my son too) and the need for this to be treated (and supported) as a legitimate developmental disability. Something like an arts-oriented cooperative for people with SCT, but with coaching and support from non-SCT people who have business sense but also integrity, could be good. I would love something like that for my son. I am so happy to hear you had a good college experience, with accommodations. If you don't mind sharing, where did you go to college? (ok if you don't want to share)
Thanks for posting, stay strong, and best of luck.
anonymous on June 13, 2013:
I have had extensive testing done. Results correlate with SCT. Not ADHD. My life has gone nowhere until I began to use my extreem gifts in music.If you have this, you MUST go with your gifts. Low dose Dexodrine is the only med that I have found that helps my SCT. I also have a dianosis of Cronic Fatigue, but that came about from a neroligist trying to figue out where my MS or Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) like symptoms were coming from. These symptoms came aboul latter in my life. The SCT has been with me all my life. I expect that the Neroligist was getting the to disorders confused. I can suffer from stymulas overload to the point of even affecting mobility and ballence This is a prosessing disorder evey bit as limiting as Autism but it does not efect our social abilities in the same way. Dexidrene will help clear the fog. Stress and overload brings on the Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) like symptoms. â¢tingling or other abnormal sensations,weekness, muscle spasms, pain from nerve inflammation, Are helped with the right strains of medical marijuana. I found out by accedent that the right strains even help with SCT.Very Small amounts again. To much to often will just make the SCT worse. It is very useful to help with the creative aspects of music and the arts. Like songwriting,painting etc. Don't use it to get high, rather use it in moderation to help the creative process to flow. Not if you have to drive.
The government describes ADHD,inattentive ADD as being a developmental dissability. SCT should be looked at in this way also and those of us with it need the same protections because we can be taken advantage of easily by those with little or no ethics and con artists.The every man for himself greed driven business world of the USA will over run and take advantage of people with SCT. They will use your gifts and ideas but not give us the recognition or compensation we are due. They use our low self esteem and manipulate us. Like other developmental disabilities, SCTers need the social programs from the government to help level the playing field for us. Many of us could benefit from supported self employment in the arts and music. I did well in College oce my disability was understood and accomidated.
Mary (author) from Chicago area on June 03, 2013:
@anonymous: Well, menopause/permenopause can mess with sleep quality -- have you been having any night waking or night sweats? That could cause daytime fatigue, for sure. The No-Doz and espresso could definitely mess up sleep too! Combine those 2 things with what sounds like a high-ish dose of thyroid medication, and I'm actually a little worried for your heart .... am not a doctor (!!!), so no advice on that, but you should definitely tell your doctor about all of this self-medicating with stimulants.
You shouldn't pursue ADHD medications unless you get a proper diagnosis, which would take into account the severity of your ADHD symptoms and when in your life they started. If you did not have clinically impairing ADHD symptoms before age 12 (DSM used to say age 7, but they've increased it to 12), a good dr. will probably not dx you with ADHD. If you do get dx'd with ADHD and begin taking stimulant medications, you absolutely must tell the prescribing dr. first about the caffeine intake (pills, drinks) and thyroid (and any other) medications, or you could get a dangerous multiplier effect from all this stuff. Your primary doc should refer you to a good psychiatrist for evaluation and possible dx, but keep all docs in the loop about everything you're taking/ingesting.
Sorry for what you're going through, and I hope you get some answers soon. Hang in there!
anonymous on June 03, 2013:
I'm wondering if I might have this. I found this lens while researching my own problems (yet unknown exactly what they are). I am hypothyroid and have been on medication for over 10 years. Until recently, my main problems were weight gain and incredible fatigue (before thyroid problems I had energy and was of normal weight). Within the past year I've also become (I'm pretty sure) peri-menopausal. Anyway, I've always been daydreamy and had problems with procrastination, but still managed to get good grades in everything except math. I've also always done very well with written work. I even managed to get a graduate degree and write a thesis before the thyroid problem started.
Now, I'm at my wit's end. A little over a year ago, after being unemployed and unable to find another job, I became an online content writer. Things were going well until recently, when I found out that I'm apparently slow. That is, I'm taking too long to write articles for one of the companies with which I'm employed. There were no quality problems with my articles (ratings from the editors were usually very good), until recently. Long story short, I'm spending ever-increasing amounts of time working off the clock to make it look like I'm working much more quickly than I really am. Even worse, I'm starting to make stupid mistakes that I don't even see, and getting lower ratings even though I'm working at a snail's pace and proofreading and spell-checking my stuff several times before turning it in.
I'm currently seeing an endocrinologist and had my thyroid medication dosage increased, but the doctor has told me that if he increases it anymore it will be dangerous for my heart. I'm having also having problems remembering little things and focusing on tasks, I'm so sleepy and foggy I'm washing down No-Doz with espresso shots to be able to stay awake and do any of my work (after 8 hours of sleep). My primary care physician has mentioned the possibility of trying ADHD medication. Do you think this would help me? The last time I felt completely awake and "normal" was when I was on prescription diet pills (phentermine) for a few months several years ago. That was also the last time I was able to lose more than five pounds despite dieting, going to the gym five days a week and forcing myself to work out even though I'm exhausted. I worry about becoming addicted to ADHD drugs, but I'm starting to feel like the way things are heading, I'll have to apply for disability if I can't get straightened out enough to work competently at a reasonable pace and stay awake.
Mary (author) from Chicago area on May 29, 2013:
@anonymous: Well, unfinished projects are a hallmark of ADD, which could be your situation. I am not a doctor (!!!), but to me a lot of what you're describing does sound like depression. It's hard to know whether you may have become depressed through struggling so long with attention/cognitive issues, or whether depression was the original problem. That is, theoretically, why we pay doctors the big bucks -- so they can tease all of that apart.
This may sound way too basic, but given all your trouble with medications, how are your sleep and exercise habits? Did you know that regular exercise has a proven medicinal effect for mild to moderate depression? (Numerous studies on this.) Getting enough sleep at night is also important and can have huge effects on mood & brain function. I think it's really hard for any meds to work without a foundation of decent health through exercise, sleep & decent diet (doesn't have to be perfect, but make sure you get some protein in the morning, enough water, some fruits & veggies, etc.)
I have to disagree about IQ. IQ and academic performance doesn't rule out a problem like SCT or ADHD, or most disorders. People who do well on IQ tests and in school can still struggle a lot in life -- again, there are many studies on this.
"I want to be like everyone else" -- I know what you mean (really), but remember, everyone else does have problems, too. We all have different problems, but nobody's life is a cakewalk all the time. Pretty much everybody reading this page understands what you're dealing with, and so do many others. Put your health first, and treat yourself as well as you can. Break big goals down into small steps, and celebrate the small stuff that might seem trivial to others (e.g., maybe they can run 7 errands in an afternoon, but you have to pat yourself on the back for getting 1 done ... that's ok; it's a start!). Try to change the way you talk to yourself (it's hard; I know). Hang in there. You're definitely not alone.
anonymous on May 24, 2013:
i hate all these people who get diagnosed with disorders when they have above average iq's and a lot higher than that, if it's a disorder, than your iq shouldn't be any higher than average, its stupid how so many people these days are labeled with disorders even though they have no difficultites really doing basic general every day tasks as most people, a disorder should only be labeled if the person is unsuccesful, lazy, not creative, or gifted in any sort of way and is depressed, it doesn't seem like most people with adhd are like this, every person i know that says or has the disorder seems very optimistic to me (which it shouldn't be like that, it should be the opposite), they are not lazy, ( i know lots of people with adhd but are very successful and get very good grades, perform better than most people). im saying this because i haven't met one person that's in the same shoes as me, ive met one or two people in my lifetime that ACT exactly like me, they have that weird straring at the distant view where you can't really see their eyes because they always are somewhat avoiding it or squinting (i can't describe it), and they stand the same, walk the same, and give the same expressions. again, only 2-3 people ive noticed in my life have almost the same facial expressions as me and act.
to sum it up, i graduated high school with a gpa of like 2.3 or something like that, i took a few local community college general ed courses, failed a few, barely passed a few, its been 3 years now and 75-100 percent of my friends, people i know are way ahead of me, even people who came from out of the state who barely spoke english at first are still a lot more succesfful that me, but here i am, lazy, depressed, avoiding life in general, frustrated, and sitting at home all day expecting things to get better, seen a psychologist for over a year, hasn't helped me at all, psychiatrist prescribed me pills, none of which worked, i took bipolar meds, adhd meds, anti-depressants, welbutrin didn't do anything, ritalin made me more anxious and depressed, vyvanse made me throw up very badly and made me feel like shit for days, anxious and my whole body almost paralyzed, cymbalta and cymbiax were garbage too and didn't help, made me dizzy, and eyesight worse.
basically its a wild goose chase for me, i want to fix myself and be happy and to do this i want to be like everyone else but in reality you can't change your personality which is what i want to do, and the whole medication thing is frustrating because i have no other option to feel better and want to take something but at the same time i don't want to take something that will damage my body when i didn't need in the first place, even if it helps supposedly...
if they have a disorder for this, i would love to know what my condition closely resembles -
. thinking im always stupid
. but at the same time thinking others are stupid
. im not creative
. im not gifted
. life is predetermined, you can't change deeper problems,
. im clumsy
. i tell others i will try but i never do
. i envy almost everyone
. or maybe i just hate humans, which means you hate yourself and clearly i do
. im always emotional
. i avoid stress and problems
. life is predetermined (my life has been like crap, will always remain like crap, example - making me life worse/harder but others lives easier, actual example, when i buy used motorzied scooters, i make them brand new because i want the best of something and later on sell them for a lot less than i should losing a huge amount of money and giving other people good deals, but then i go buy expensive stuff from other people and rip myself off because im too impatient)
. buying a computer part on ebay and never using it because i wanted to do something with it but then i changed my mind and end up not being able to sell it because no one would buy it unless i put it for literally a bargain price ( i do this a lot, my projects never go finished and waste tons of money, my hobbies are staying at home all day playing computer games, working on my scooter, and rarely going out with my bro to a party that which isn't fun nor boring, because since i don't do anything, i just sit there like a statue, its like im going there for no reason..
Mary (author) from Chicago area on May 16, 2013:
@anonymous: I think a sort of cycle can kick in when falling behind -- it causes stress, which slows thinking more, which causes one to fall further behind ... and on and on. Probably positive self-talk can help -- just reminding yourself "yes, things take me longer; that's just how I am, and others need to deal with it, just like I deal with others' issues..."
It's tough the way speed is considered such a virtue, and extreme multitasking the sign of a productive and capable person. I happen to think there are very capable, productive people who function best doing one thing at a time, but tell that to the larger society...
Sounds like you know yourself pretty well, and that's actually a big part of managing this condition and maximizing your potential. Best of luck, and thanks for sharing here!
anonymous on May 16, 2013:
Hello! I've been diagnosed with inattentive ADD - but had not yet heard the term sluggish cognitive tempo - but that sounds SO very much like me!! I'm 43, have a high IQ, but I've had such similar experiences to the police officer from the UK: I just feel like it takes me 10 times as long to "get" things that everyone else seems to understand instantly. I always feel lost and clueless and left behind. I get anxious whenever I do something new that involves remembering several steps: whether it's a new recipe or traveling to a new place. I will be constantly checking the recipe or the map, holding my finger on the spot where I need to remember that particular bit of info, until I'm sure I've completed it, then I'll move on.
I'm mostly commenting to say thanks for the article and offering something new. It seems so often when I visit forums or blogs about ADD/ADHD it's just the same stuff rehashed a thousand times over and I get discouraged that I've plateaued -- that I've improved as much as I can since my diagnosis about 13 years ago. I will definitely have to do more research on Sluggish Cognitive Tempo!
Mary (author) from Chicago area on May 14, 2013:
@anonymous: I think you've done very, very well, and the fact that you're now managing your condition with a combination of (what sounds like) appropriate medication and CBT is a very good sign. Those 2 things can work well in partnership. The truth is, you may always feel somewhat "foggy" and have to try harder than others to keep pace (just like a diabetic will always need to watch diet and monitor blood sugar), but you seem to be doing many things right.
I'm so sorry about your experience as a teen. Sounds like anxiety has been a problem almost your whole life (I get it, believe me). Doctors have explained to me that anxiety can sometimes actually be the cause of chronic inattention - have you discussed that with your dr.? Or people with ADD can develop anxiety over time because of the struggle to keep up and avoid/handle negative feedback from others. The latter scenario is especially common with folks like you who were diagnosed late. You had to work hard for a long time to compensate, without any targeted support, for your anxiety, your ADD, or both. That is really tough. The good news is you are clearly a strong person, or you wouldn't have come as far as you have.
My 2 cents on social media is that it can be awful for people with attention problems. You may want to use a small timer when you're online, or your real-life priorities, responsibilities, and relationships can suffer. That's true for us all, really, but with ADD it is extra hazardous.
You were probably "self medicating" with the drugs for ADD and with alcohol for the anxiety. This unfortunately is not uncommon for people who didn't get the appropriate diagnosis & help growing up. Do you have better control over those things now with the combination of Concerta & CBT? I hope so. If not, please do talk to your dr., and be honest about substance use.
One more thing & I'll shut up -- There's nothing wrong with being a natural introvert. My son with SCT and inattentive type ADHD is the same way. Extroverts draw energy from others and use that to get them through alone time, while introverts draw energy from alone time and use that to get them through time with others. Neither one is "better" than the other, but extroverts tend to be more valued socially. Don't let that get you down. Just a couple of good friends/relationships can go a long way. And if you aren't allergic, I'd recommend a pet, too :)
Best of luck, and do keep us posted, ok? There's not a whole lot written about SCT, so it does really help to share experiences.
anonymous on May 14, 2013:
I am a 36 year old man from the UK who was diagnosed with ADHD-I in March 2011, albeit with some uncertainty due to a lack of definitive evidence from my childhood. I present as a high achiever but this does not sit well with my own self-perception other than I recognise I am an intelligent person.
I obtained good grades at school, although maths was a struggle for me, especially at 'A'-Level where one of my teachers told me I had a number phobia. I very nearly dropped out of my bachelors degree at university in the second year but stuck with it and completed the course. In every job I have held I have always felt like it is the best job in the world at the start but within months felt bogged down in detail and confused about what I am doing or where I am going with it. This occasionally leads to such frustration that I just become depressed and moody. I joined the police in 2003 and throughout my career I have wondered why I have struggled to 'get it' - seeing both colleagues less intelligent and equally/more intelligent than me who seem to grasp what it is all about. Meantime my head is full of worry and confusion about all the law and procedure that exists. Slow time I seem to make good decisions but fast-time I just get confused and hesitant. And yet, everyone around me treats me as though I'm on some higher plane. I can be fairly certain that when it comes to real incidents others nearly always take the lead and this is something that I beat myself up over.
I was a shy child and have recollections that my mother in particular would get annoyed with my slow responses. I had friends but not many and I didn't enjoy socialising, preferring my own company. I would spend hours sitting around or lying on the floor listening to music to see if the 'fog' would lift. Interestingly, though I have an appalling ability to match songs with artists or even remember lyrics; it is another thing that undermines my self-confidence in social situations. I was pretty rubbish at sport, which on reflection may have something to do with being too slow to follow the ball! I was anxious as a child and this got to the point when I was about 16 that I self-harmed. I was subsequently put on anti-depressants and that led onto many years of anxiety medication and counselling.
When my relationship broke down in 2007 I found things very difficult and ultimately ended up getting into recreational drugs of various sorts. I had always been prone to binge drinking; even at school one of the teachers nicknamed me 'temperance' in irony at my lack of self-restraint. On looking back I got annoyed that my teachers didn't do anything to help me; presumably because I came from a 'stable' family. In 2009 I started a masters degree at the point at which I had turned to my employer for help and was able to stop the drugs. But the study was so difficult and I was failing. It was then that I got the ADHD-I diagnosis and things improved significantly. I started getting some coaching and, alongside the medication (Concerta 36mg) I finally found I could put into practice the CBT training I'd had before.
Somehow, though I still don't feel quite right. I do feel that I struggle to process information quickly and often spend hours getting stuck on pieces of work. My writing skills are very good but I will tend to make mistakes with getting words mixed up; I do the same quite often in speech. I was interested by KristenSM's mention of getting work as a proofreader, I love doing that! I often feel a mental block to access memory. I have had a lot of anxiety and find this creeps back on the Concerta so take regular medication 'holidays'. If my diet, sleep and exercise haven't been right then I might as well not take the medication at all as it doesn't seem to do anything. I still remain socially withdrawn and am usually the quietest in a social group, unless I have been drinking.
And social media has to be one of the worst (or best!) distractions ever!
I only found out about this SCT thing last week when I was feeling down. I'll probably bring it up at my next ADHD review but if my experiences help anyone then that's a result. I've actually turned things around a lot but it's the niggle that there is something still holding me back. Let's hope the research in this area continues.
Mary (author) from Chicago area on May 06, 2013:
@anonymous: Well, first of all, you should feel very very proud of having gotten through school with very few accommodations. That must have been very stressful and difficult.
I don't know about the eye issue. I do think multiple head injuries could exacerbate your SCT. Hope none of them was too serious.
I am never sure what "sensory problem" really means -- can be so broad that almost any neuro challenge could, one could argue, be related to that.
the pacing difference between you and your husband illustrates what is so frustrating about the ADD/ADHD literature out there .... 99% of it relates to people like your hubby who, when they manage to focus, can get things done very quickly. only 1% relates to people like my son who cannot hurry to save their lives. there is so little info and help for the latter category.
"studying in bars" is a completely alien concept to me! can't imagine how you got anything done!
anonymous on May 06, 2013:
I am a 36-year-old woman with SCT. I was diagnosed with ADHD--inattentive type when I was 20 years old. My whole childhood, I was ridiculed and called stupid by my peers and some adults because I was so spacey and out of it. I was tested for ADD as a child, but it was ruled out, I think because I wasn't hyperactive. They determined I was just daydreamy and that I was a holistic learner. I drifted through life, never causing any trouble but never excelling. I fought depression for many years, because I started to believe all the terrible things people said about me. I had few friends and was painfully shy, though I started to open up and make more friends once I started college.
It wasn't until my second year of college that I was diagnosed with ADD and started taking Adderall. Before my diagnosis, I struggled in school. I tested above average in intelligence, but my GPA in high school was just 2.75. I struggled in college too, but once I started the Adderall, my grades went up and I gained a lot of confidence. After graduating, I managed to survive for three years working in the publishing industry before I was accepted into graduate school. I was so nervous about going to grad school that I did a bunch of psycho-educational testing in order to get extra time for tests, because in college, I'd always been the last person in the room finishing a test and I often had to turn in tests before I got a chance to complete them. I also just needed to be reassured that I was capable of handling the course load. I did great in grad school--straight As--but I wouldn't have done so well if I hadn't insisted on only having an extremely part-time job. I took out a ton of loan money because I knew I wasn't going to be able to handle balancing work and school.
After grad school, I took to working in publishing again, first as a proofreader. I loved proofreading, because it allowed me to hyperfocus and tapped into my strong language skills. Also, I could listen to music or podcasts while proofreading, which meant I could flood my brain with information, so that I wouldn't get bored and my mind wouldn't wander away from the task at hand. After a few years, my department was eliminated, and I was offered a really boring position, which I took, but I hated it and I wasn't very good at it either. My self esteem plummeted.
Then I hit my head, and everything got much much worse. I developed PCS--post concussion syndrome--but I wasn't diagnosed at first, because it just seemed like a worsening of my existing SCT symptoms. I had three more head injuries, which made my PCS symptoms even worse, but after a two and a half year struggle, I am about 85 to 90% better. My remaining PCS symptoms are lethargy, photosensitivity, eye strain, lack of stamina, and depression.
Now that I am getting better, I want to learn more about SCT and how I might improve my symptoms. I believe that SCT truly is separate from ADHD. My husband has ADHD but is high functioning (always has been) and we are totally different. He is so fast, and I am so so so slow. He literally can do everything 5 times faster than I can. We used to get in fights because he would end up doing more of the housework, but now he understands that I just can't do as much as he can in a set amount of time. He is also always on the go, whereas I'm lethargic. I had a hard time accepting his ADHD diagnosis because how could two people with the same disorder be so incredibly different. When I read about SCT, it all started to make sense!
So I also have a theory I want to share. Since many of my PCS symptoms were due to concussion-related vision problems, I've done sensory integration therapy (which cured my severe vertigo) and am now doing vision therapy. It occurred to me when reviewing my medical records that my eye strain and light sensitivity began before I ever hit my head. My job as a proofreader was very hard on my eyes, but I just figured it was dry eyes and allergies causing my terrible eye strain. After talking with my neuro-optomitrist, I realize I probably already had some eye problems before I hit my head--in particular, convergence insufficiency. Could that be part of the SCT puzzle? Is that a contributing factor to the far-off stare of people with SCT? Also during all the testing my neuro-op put me through, it was determined that I had a much lower registration of external stimuli than most people, meaning that I just don't notice things that other people notice. I know I've been this way my whole life, caught in a haze I can't quite penetrate, unable to perceive the nuances that other people notice. Strangely, I always liked studying in bars or crowded coffee shops rather than in the library. I almost need to be flooded with outside stimulation to be able to pay attention to the task at hand, which is I think the opposite of what most people with ADHD would need. Is SCT a sensory problem? Does it have to do with how we process the world around us and are there existing therapies that could help? I plan to talk to my neuro-op about it and see what he thinks. I feel like I could be onto something. What do you guys think?
anonymous on May 06, 2013:
@anonymous: Dina, have you ever bumped your head and/or had a concussion? What you are describing sounds a lot like Post Concussion Syndrome (PCS), and since SCT is something you have for most of your life, it may not be what you are experiencing. Unfortunately, I have both, which is not fun, but my PCS is getting better with rest, physical therapy, and vision therapy. PCS is terrible, but at least there is the hope of getting better, so I hope you have that and not SCT!
PCS would NOT show up on a CT scan or an MRI. Some people who have it had major head trauma and some (like me) just bumped their noggin. That was all it took for my first symptoms to manifest. Since then, I've had several more mild concussions, none of which caused a loss of consciousness, but which caused a worsening of my symptoms, That said, my cognitive symptoms lifted after 6 months of being on disability. I still have more to do before I'm back to my normal SCT self, but I am about 85 to 90% better now.
I may be way off-base, but I had to post something just in case. I went a year and a half after my first concussion before I was diagnosed with PCS, and in the meantime, my fragile self esteem was destroyed. I'm trying to rebuild myself and my life now. I don't want other people to suffer needlessly without a diagnosis if I can point them in the right direction. Good luck to you!
Mary (author) from Chicago area on March 01, 2013:
@anonymous: thanks Dina! so sorry to hear this seems to have gotten worse with age (though of course you're still very young!). I think there have actually been trials of Alzeheimers type meds on kids or adolescents with inattentive-type ADd, but I'm not sure how that ever panned out. interesting to hear about yoru food experiences, and it's a bit of a lightbulb for me, because although my son does eat wheat products, he gravitates toward veggies, fruits and nuts. maybe a form of "self therapy"? were it not for the nuts, he would be really underweight.
anonymous on March 01, 2013:
I am an adult (23) and this "SCT" matches exactly what I have been dealing with for a few years now..maybe even longer, but it has gotten worse as I've gotten older. It feels like there is always a fog in my brain, and I feel pressure in my head at all times. "Slow" is a good way to describe it, as it seems like time is passing by faster than my brain can process what's going on around me. I've had a CT scan of my brain thinking it was a possible tumor or brain cancer, but they found nothing. I am beginning to think it could be possibly caused by undetected brain damage. Or perhaps an unknown virus or bacterial infection? I strongly suspect it is not just a mental disorder but a medical disorder, or caused by unknown medical problems. Eating a healthy diet does improve my brain function somewhat. This symptom could be related to a food allergy or intolerance, such as gluten intolerance, gluten sensitivity or celiac disease. I have noticed that consuming wheat and sugar really inhibits my brain function, and avoiding it seems to help me think more clearly. I try to eat mostly very basic, simple foods, such as vegetables, fruits, nuts, etc.
anonymous on February 25, 2013:
@anonymous: Which medication are you using now? My son also has CAPD and possibly SCT, so I am wondering if meds would give him a boost.
Mary (author) from Chicago area on February 25, 2013:
@anonymous: don't cry! medication may not always work (though you should be sure to ask your dr. about different ones -- there may be something you haven't tried yet that could help), but good sleep habits, exercise, nutrition (especially protein in the morning), and someone to talk to (be that a partner/spouse, friend, colleague...) can make a big difference.
as the economy improves -- let's hope! -- you might also want to think about whether you're in the right line of work or workplace, if coworkers frustrate you to that degree. are you in a field that plays on your strengths? (for instance, my son with SCT is slow paced but very patient and persistent) certainly many are "stuck" right now due to the difficulty in finding a good job -- or, in some cases, any job. over time I think we'll learn more about SCT and how to treat it -- but for now, try to pay attention to the the 'basics," which can make a bigger difference than you might think.
anonymous on February 24, 2013:
This honestly makes me want to cry. This thing I have is never going to get better. I was diagnosed with ADHD three years ago (I was 30) and put on stimulants which only made me lose weight and increased my anxiety. I am incredibly intelligent, but a constant underachiever stuck in a job with incredibly dense coworkers. This makes me depressed, which apparently only exasperates the problem, and according to the article there are no studies to indicate treatment even works. I'm 33 and can't imagine another 40-50 years of living like this. I feel like I'm sleeping my way through life.
Mary (author) from Chicago area on February 18, 2013:
@anonymous: so glad you have found a way to keep healthy!! thanks for posting!
Mary (author) from Chicago area on February 18, 2013:
@anonymous: at 15, my son already experiences that "putting more of a workload" on others problem - such as in science lab at school. he does deliver high-quality work, but it takes him longer. he gets frustrated at the quality of other students' work sometimes (in group projects), but I know they get frustrated with his pace. so hard!
anonymous on February 18, 2013:
@anonymous: You just described my life RJ. I couldn't relate any better. I guess we are doomed for the rest of our lives.
anonymous on February 11, 2013:
I often feel "stupid". That doesn't correlate with knowing I am intelligent. People see me as calm and quiet, but they don't realize inside my thoughts and ideas are racing. It takes me a long time to get together a response because I am slow to process. An example is hearing. As a child I tuned out, was spacy in order to cope. At 60 I was diagnosed with Central Auditory Processing Disorder. I hear OK, but am slow to process, filter, organize to make sense of what I hear. So I guess a lot if I can't figure out what I heard quickly. While I am processing to make sense of what I think I heard, I miss what is going on. My memory records what I process but there are big gaps when I am not attentive to what is going on because I am focusing on processing what I just heard. Iam not stupid, just slow.
Now at 71, a small amount of a medication enables me to manage good sleep, diet, exercise and meditation, yoga and Tai Chi. I can make decisions, organize, respond and feel better about myself.
anonymous on February 07, 2013:
I'm 59 years old and finally I've read something that makes sense. Whatever I have, I've had it all my life. It's very hard to explain to other people that it takes me twice as long or longer to accomplish any task. I'm smart enough, just very, very slow. It's always been a problem at work because it puts more of a work load on others. I hope more research is done on this. Just having other people understand this condition would be helpful to those that suffer from SCT.
Mary (author) from Chicago area on November 08, 2012:
@anonymous: "kind of helpful but still not even close to normal" is about what my son (15) gets from Vyvanse too. dependency shouldn't be a concern with that med when it's addressing legitimate focus problems. if you were using it recreationally or for an academic "boost" without real problems, that would be another story.
you are obviously very bright, and working hard to sort all this out. remember that (assuming you are in the U.S.) you're part of a culture that heavily favors extroverts & considers introverts somehow lacking .... never mind that introverts have produced some of the best art, music, scientific & other inventions... to feel better, maybe check out Susan Cain's Quiet: The Power of Introverts in a World That Can't Stop Talking. you are right though that a total passivity re. your struggles wouldn't be super healthy, so it's a good sign you're caring more, even getting appropriately ticked off sometimes. if you find yourself feeling angry all the time, of course, you'll want to share that w/ your psych.
brain science tells us now that the brain does a lot of maturing at 18-25, and that is also a stressful time for many: http://online.wsj.com/article/SB100008723963904437... -- you may feel like nobody quite gets it re. your unique combo of issues, but rest assured you aren't the only young adult struggling. stay strong -- you'll find your way.
anonymous on November 06, 2012:
@anonymous: Same thing here. I keep (somewhat) joking that at the rate I'm going I'm going to take 10 years to finish undergrad. My mom most recently said to that "I took about 12 years.." --"that's encouraging." And she laughs... that's a big issue for me, actually, I'm very quick with being sarcastic. It's usually taken the wrong way (too lightly, or too heavily/dark/offensively), but I don't know how else to talk to people lol... I mean as far as having to actually try to address an emotional concern or something or explain what I'm thinking. It feels forced/fabricated to me.. like I'm a lying robot most of the time. haha. "Normal" socializing (which is very rare because usually it's too much 'work' for me to bother with people.. and like most of my emotions, being 'friendly' feels.. unnatural and faked lol) is usually much easier. But like I said it's rare I can even find that. When it happens I'm thinking "don't lose this one too.." --which is generally how I am with any sudden impulse/emotional arousal. Then I get frustrated because it goes away in like a second or less most of the time. Or when the meds wear off (which SUCKS b/c I also work much better at night!) :(
I was on antidepressants for basically 14 years until a few months back. I felt like I almost had to beg and plead (fakely?) to go off them, b/c I'm so obviously suffering from depression according to most doctors (and my parents.) --Communication issues again! The same problems that very likely got me onto antidepressants and gave me a very extensive mental health (er.. illness haha) history to follow me around most of my life, is also what has made it so difficult to "convince" anyone I had to stop them because they were making me more sluggish and apathetic. "Oh but the last time..." yeah, I don't care. lol...I tried to go off them twice before and had severe, pretty debilitating anxiety attacks, they seemed almost constant, also since childhood had a vomiting phobia that led to all kinds of fun-ness in psych. hospitals and with more shrinks and therapists to talk to and stuff :D (probably also b/c I never really brought it up with people and/or I did to a social worker and not long after was simply given zoloft to "help my mood". and I clearly recall wondering why I needed a pill for that, didn't think I had a mood issue.. "oh must've been cuz I mentioned the vomit thing so they all think I'm a weirdo...probably shouldn't do that next time...") :-/ my introversion has been labeled "social anxiety" probably to the point I actually suffered from it for a period of time--until I realized there were too many exceptional circumstances where it didn't apply...("what is the point of having male friends? Guys are so boring at my age.." "from what I understand girls are not supposed to be this easy to talk to. maybe I am gay and my entire sexuality is as faked as anything else..." lol...) and that apathy is kind of..the opposite of 'anxiety.' but the emotional blunting/apathy/lethargy-- chicken/egg thing by now.
I need to be running on adrenaline to get anything productive done. I also take Vyvanse every day--or at least when people aren't telling me I need a break to avoid dependency issues--clearly this was a nonissue in the >a decade on/off antidepressants :P usually I also need coffee to contribute to the "kind of helpful but still not even close to normal" that I get from Vyvanse.
And I'm on a lower dose of it since I stopped taking Effexor (~10yrs.). I'm also typically at half the daily caffeine (which I basically abused in at least the past year before discontinuing, while my grades plummeted anyway! --I might ask my psych. for a note next time to address this academically-- or I might not, it depends how able-to-speak-clearly I am at the time.) Also I can hardly sleep in double digits anymore... used to be 10-12 hours+, otherwise I couldn't even get out of bed--or I would take vyvanse and it'd backfire. Or I'd go 12-14 hours and then feel groggy the entire day... until it got dark LOL.
Couldn't win. Still can't for the most part now, it seems. Although being able to be actually "concerned" about my "lack of concern" for once is a plus... anger/resentment esp. towards any of this stuff, are also very empowering (if there's enough of it) because nothing else motivates me! lol
MyBabyBoo on September 26, 2012:
Excellent lens, well done!
anonymous on August 24, 2012:
@verymary: Yes, I have had a full physical. I almost wished it was my thyroid, at least that would be a more straight forward diagnosis and without this trial and error way of finding what works. I read somewhere that Vyvance is most effective for females between the age of 20 and 29. If only I could have a do over!
Mary (author) from Chicago area on August 24, 2012:
@anonymous: my son (15) takes Vyvanse and has been helped by it somewhat, but not as much as he needs. good luck with this -- have you had your thyroid checked? probably so, but thought I'd ask...
anonymous on August 23, 2012:
I am a 52 year old woman. I was recently diagnosed with adhd inattentive type. I've been prescribed Vyvance partly because Shire Pharmacuticles pays for it. I just discovered info on sct and I feel this fits me to a t. I brought it up to my prescribing nurse but she didn't have much to say about it. It seems that for me anyway that the main difference between the inattentive type and sct is that I'm not so much distracted by external stimuli but rather internal mental distractions. My thinking is frequently muddled ,disjointed and slow. I've been this way my whole life and I've had a lot of problems in school, work and socially due to sct. Vyvance so far is not working very well for me. I started out at 30mg for the 1st month. It did seem to work o.k at first mostly for energy but not that much for memory or focus. My dosage was increasd to 40mg for 2 weeks with pretty much the same results. Then it was increased to 50mg for another 2 weeks, no better. I'll be taking 70mg starting tomorrow for 2 weeks. I'm not really expecting better results but I'll know soon.
Mary (author) from Chicago area on June 14, 2012:
@anonymous: very sorry to hear that :( - hope things look up for you soon.
anonymous on June 11, 2012:
Mine is getting worse over time. I am too tired to look for or keep a job. I have not found anything to help the debilitating fatigue. I look normal so there is no empathy or understanding from the general public nor the medical professionals I've tried to seek help with.