Attention Deficit Disorder – When It Doesn't ADD Up!I know we've all seen and heard the news coverage in recent months about kids receiving increasing amounts of medications for behavioral disturbances. Today let's talk about ADHD which stands for Attention-deficit Hyperactivity Disorder, a condition affecting from 3 to 5 percent of kids and boys about five times more frequently than girls.What is ADHD and how is this condition treated? Attention-deficit Hyperactivity Disorder is not very well understood and, as yet, there is no definitive test for confirming the diagnosis. But, when we see it in children and in many cases in adults who grow up with it the following symptoms are present: He or she has problems with attention and focus, and often: Can't attend to details Isn't able to stay on task Doesn't seem to be listening when you're talking Isn't able to follow directions Is poorly organized Avoids challenges to his or her attention span Loses things Is distracted by stimuli Forgets what he or she is supposed to be doing Besides that, some kids or adults have to deal with a Hyperactivity-Impulsiveness dimension that includes symptoms like: Constantly fidgeting and squirming Restlessness Loudness Always on the go Talking all the time, like a "motor mouth" Impatience Inability to wait their turn Always interrupting The current diagnostic practice is to specify whether the disorder involves a predominance of inattention or hyperactivity-impulsivity, or a combination of both. What are the consequences of this disorder - How does it affect people's lives? It can be pretty devastating. Kids with ADHD. often become the negative focus in their classroom. Adults with it have a hard time keeping their jobs and sustaining nurturing relationships with friends or spouses. They may seem lazy or uncaring because of their difficulties in regulating their activity level and in processing information, especially emotional and social cues that we all need to understand and to get along with each other. As a parent, I've seen children who are often out of control and as a professional I've met people who seemed to lack essential organizational and work skills and yet they seemed to be intelligent enough and even work hard at their jobs. What can be done to treat ADHD and help some of these people? Let's start with stressing that having some of the symptoms we're talking about doesn't mean someone has the diagnosis — we need to consult with professionals who observe these kids, interview parents and teachers and use medical and psychological tests to make their assessment. Once established, treatment can consist of medication, behavioral and cognitive therapy or working with a coach or sponsor. I know that there's a lot of controversy about "drugging the kids," but what I've observed is that some hyperactive and inattentive children seem to normalize a bit with the help of certain medications like methylphenidate, which is Ritalin and other stimulants, such as Cylert and Adderall. Some non-stimulants are also used, usually to treat symptoms like depression or anxiety, for example, that may accompany the ADHD disorder. What's the promise and what are the limitations to using these and other medications with ADHD? It seems that the "engine that runs the brain" sometimes runs too slow and that hyperactivity may be a compensatory move to jump-start the brain. By using stimulants in careful doses, the brain gets up to normal speed, so that the hyperactivity is no longer needed to compensate externally for the lack of activation internally. One downside is that medications can have side effects, such as sleeplessness, loss of appetite and weight, and headache and they need to be monitored carefully. The final downside is that medications often are not sufficient to enable an ADHD sufferer to return to normal functioning in many areas of their lives. What else can we do to help? The mainstay approach is to combine medications with psychosocial treatments. With children, the parents can be educated to help structure their kid's environments to manage stimulation and distraction and make challenge a positive experience. Parents need to know that they are not to blame for their child's excessive energy or their inability to pay attention and follow the rules. Behavioral and cognitive psychotherapy can be very helpful for children and adults. Knowing that ADHD is a disorder of central nervous system functioning and not a personality defect, brings a sense of relief, though there's still work to be done. One promising approach for helping with ADHD is "coaching." A coach can help by being a regular presence and a support for organization, planning and moving the ADHD person's game plan. Coaches might have contact on a daily basis, checking in on progress and keeping their client on track. Coaches can help by: Getting your room organized and helping with your filing system or your closets. Helping with scheduling and setting up your daily and weekly calendar. Constantly keeping focus on priorities and doing the next important thing Staying on the task at hand and completing one thing before shifting to another. Learning and applying time and stress management skills Planning for balancing activities such as work and play. What can we all do to deal with ADHD? Here's a summary of some things we can do to help: We can learn more about these conditions and bring some compassion to those people who really suffer their inability to focus and flow in their life. We can help others to seek diagnosis and treatment. One of the biggest public health issues is untreated mental illness. There are a lot of children and adults who go around suffering with ADHD and don't even know what or why. Therapy, especially cognitive and behavioral approaches that teach self-monitoring and self-regulation skills can help to control symptoms. Most parents are reluctant to put their kids on medications and so am I, but there are a number of medications that can be effective, if prescribed very carefully by a psychiatrist who is expert in this kind of care. Lastly and firstly, we've got to work with teachers and schools and employers so that they know our kids well give them what they need to succeed. We all need to work together to help these kids and adults get back control over their lives and their futures. |
