How we need to re-think how we perceive A.D.D.
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Thursday, July 19, 2007
Newest Research on Ritalin
From New Study Suggests Pediatric Ritalin Use May Affect Developing Brain
"The findings, specially highlighted in the Journal of Neuroscience suggest that doctors must be very careful in their diagnosis of ADHD before prescribing Ritalin. That's because the brain changes noted in the study might be helpful in battling the disorder but harmful if given to youngsters with healthy brain chemistry, Dr. Milner says."
Clearly this is an important part of the process. There has to be a multi-step diagnosis process in place to identify children with ACE over those with other issues. We simply can't be medicating any child with a behavioral challenge because "most" of his/her ways can be categorized by ACE. I strongly encourage anyone going down this path to make sure that you or your child are being thoroughly evaluated before beginning any type of medication regimen. Only until YOU are comfortable with the diagnosis should you even consider this type of treatment.
And further in the article...
"That's encouraging, and supports the notion that this drug therapy may be best used over a relatively short period of time, to be replaced or supplemented with behavioral therapy," Dr. Milner says. "We're concerned about longer-term use. It's unclear from this study whether Ritalin might leave more lasting changes, especially if treatment were to continue for years. In that case, it is possible that chronic use of the drug would alter brain chemistry and behavior well into adulthood."
Now I realize that this blog is mainly a discussion of adult ADD, but I find this research and this article interesting because...tooting my own horn...I have always advocated a limited use of medication in children and adults until such time that behaviors are learned and practiced on a daily basis.
Medications are not a long term solution in my opinion. There are strong arguments on both sides of this equation, but I prefer to take the middle ground. Initially, therapy without medication is akin to learning to ride a bike with no wheels. You'll go nowhere. If conquering the struggles that ACE's have to deal with were simply a matter of "doing better" or "trying harder" or "learning new skills", we would have accomplished this long ago.
The fact of the matter is, however, that for most ACE's, especially children who do not yet have the mental controls, medication is a necessary crutch that can probably be disposed of once they have ingrained the coping skills required.
"The findings, specially highlighted in the Journal of Neuroscience suggest that doctors must be very careful in their diagnosis of ADHD before prescribing Ritalin. That's because the brain changes noted in the study might be helpful in battling the disorder but harmful if given to youngsters with healthy brain chemistry, Dr. Milner says."
Clearly this is an important part of the process. There has to be a multi-step diagnosis process in place to identify children with ACE over those with other issues. We simply can't be medicating any child with a behavioral challenge because "most" of his/her ways can be categorized by ACE. I strongly encourage anyone going down this path to make sure that you or your child are being thoroughly evaluated before beginning any type of medication regimen. Only until YOU are comfortable with the diagnosis should you even consider this type of treatment.
And further in the article...
"That's encouraging, and supports the notion that this drug therapy may be best used over a relatively short period of time, to be replaced or supplemented with behavioral therapy," Dr. Milner says. "We're concerned about longer-term use. It's unclear from this study whether Ritalin might leave more lasting changes, especially if treatment were to continue for years. In that case, it is possible that chronic use of the drug would alter brain chemistry and behavior well into adulthood."
Now I realize that this blog is mainly a discussion of adult ADD, but I find this research and this article interesting because...tooting my own horn...I have always advocated a limited use of medication in children and adults until such time that behaviors are learned and practiced on a daily basis.
Medications are not a long term solution in my opinion. There are strong arguments on both sides of this equation, but I prefer to take the middle ground. Initially, therapy without medication is akin to learning to ride a bike with no wheels. You'll go nowhere. If conquering the struggles that ACE's have to deal with were simply a matter of "doing better" or "trying harder" or "learning new skills", we would have accomplished this long ago.
The fact of the matter is, however, that for most ACE's, especially children who do not yet have the mental controls, medication is a necessary crutch that can probably be disposed of once they have ingrained the coping skills required.
Sunday, July 1, 2007
Abundant Creativity Effect and Ultrasensitivity
I've had the great fortune of late to discuss what it 'feels' like to be an ACE with a variety of people from all walks of life. These people have opened up to me, and I to them because of our similarities in emotions, mental states and desires for understanding. All of us have a need to feel that someone 'gets us'; that someone truly understands what it's like to live in our skin. While no one person can truly live 'in' the life of another, commonalities can provide a certain degree of kinship or 'kindred-ship'.
One of the most common elements running through the ACE's I've talked to is a feeling of ultra-sensitivity. We, as a group tend to be sensitive to a whole host of external stimuli. Whether it be a rude sales clerk, slight variations in temperature, or our new underwear.
Emotional Sensitivity.
ACE's have a tendency to take everything very personally. Any slight or criticism is taken to heart. In part, I believe, this is physiological, but in essence I believe that this comes from our own self-esteem and self-criticisms growing up with the feeling that we are 'less-than' somehow. We see others doing things with ease that we struggle with. We ask ourselves why we are so stupid and lazy.
It is only natural then, to assume that others feel the same about us as we do. Since we view ourselves as inferior and without skill, then we are very willing to allow others to validate that feeling through their comments.
Physical Sensitivity.
Many ACE's that I've talked to prefer cotton to silk; denim to wool; sweats to suits. This is due in large part to our physical sensitivity to touch. Many ACE's cut the tags out of their clothes because the very presence of these annoying little tabs of cloth or paper can distract us all day with their tiny little pokes and scratches. (The person who came up with tagless clothes is a genius and should have a statue erected). Clothes that are too tight or too loose, or just feel 'wrong' are a constant source of irritation to be endured as well.
Physical sensitivity doesn't limit itself to clothing. We may be sensitive to the touch of another person as well. People sitting too close to us on the bus can put our nerves at high alert. A handshake can leave an impression on our skin that stays with us for hours, distracting us from the business at hand. (Sorry, bad pun)
Mental Sensitivity.
This one is easy. The abundance of external stimuli we face on a daily basis can drive us to exhaustion and dis-ease. The smells, sights, sounds, tastes and feelings we take in at any one moment are like an avalanche of information in our brains. Because we have very limited filtering capabilities, all of this stimuli is processed and our brains are working overtime to get it all tucked away in the right compartments.
No wonder we are susceptible to 'zone out' moments. It's a wonder we are able to function at all.
Spiritual Sensitivity.
This one may or may not be ACE related, but I include it here to ponder. I feel, as many of my friends do, that just as we are sensitive to the material world, we are sensitive to the spiritual nature of the world and its inhabitants. This could be due in large part to the fact that we are constantly taking in the world as a whole, and for the spiritual, this would mean too, the 'essence' of the world as well.
Generally, I can feel the intent of a person I meet. That's not to say I can read their mind. What I mean is that I can intuitively feel their basic spiritual nature. I'm not claiming to be a medium or psychic or anything like that. I just think that being as sensitive as we are, we can feel their emotional/spiritual/mental state although we may not be able to assimilate what we feel into language or thought. We just get an impression, and in most cases we're pretty accurate.
So what?
So, we're sensitive. What do we do about it? I say we do absolutely nothing. Recognize your sensitivities. Understand where they come from, and trust in them. Rest when you can, re-energize yourself by doing something that makes you feel comfortable and at ease. Trust your instincts when it comes to other people. Above all, give yourself a break, and understand that others do not see you as poorly as you see yourself. Take the compliments when given, and take the criticisms at face value.
One of the most common elements running through the ACE's I've talked to is a feeling of ultra-sensitivity. We, as a group tend to be sensitive to a whole host of external stimuli. Whether it be a rude sales clerk, slight variations in temperature, or our new underwear.
Emotional Sensitivity.
ACE's have a tendency to take everything very personally. Any slight or criticism is taken to heart. In part, I believe, this is physiological, but in essence I believe that this comes from our own self-esteem and self-criticisms growing up with the feeling that we are 'less-than' somehow. We see others doing things with ease that we struggle with. We ask ourselves why we are so stupid and lazy.
It is only natural then, to assume that others feel the same about us as we do. Since we view ourselves as inferior and without skill, then we are very willing to allow others to validate that feeling through their comments.
Physical Sensitivity.
Many ACE's that I've talked to prefer cotton to silk; denim to wool; sweats to suits. This is due in large part to our physical sensitivity to touch. Many ACE's cut the tags out of their clothes because the very presence of these annoying little tabs of cloth or paper can distract us all day with their tiny little pokes and scratches. (The person who came up with tagless clothes is a genius and should have a statue erected). Clothes that are too tight or too loose, or just feel 'wrong' are a constant source of irritation to be endured as well.
Physical sensitivity doesn't limit itself to clothing. We may be sensitive to the touch of another person as well. People sitting too close to us on the bus can put our nerves at high alert. A handshake can leave an impression on our skin that stays with us for hours, distracting us from the business at hand. (Sorry, bad pun)
Mental Sensitivity.
This one is easy. The abundance of external stimuli we face on a daily basis can drive us to exhaustion and dis-ease. The smells, sights, sounds, tastes and feelings we take in at any one moment are like an avalanche of information in our brains. Because we have very limited filtering capabilities, all of this stimuli is processed and our brains are working overtime to get it all tucked away in the right compartments.
No wonder we are susceptible to 'zone out' moments. It's a wonder we are able to function at all.
Spiritual Sensitivity.
This one may or may not be ACE related, but I include it here to ponder. I feel, as many of my friends do, that just as we are sensitive to the material world, we are sensitive to the spiritual nature of the world and its inhabitants. This could be due in large part to the fact that we are constantly taking in the world as a whole, and for the spiritual, this would mean too, the 'essence' of the world as well.
Generally, I can feel the intent of a person I meet. That's not to say I can read their mind. What I mean is that I can intuitively feel their basic spiritual nature. I'm not claiming to be a medium or psychic or anything like that. I just think that being as sensitive as we are, we can feel their emotional/spiritual/mental state although we may not be able to assimilate what we feel into language or thought. We just get an impression, and in most cases we're pretty accurate.
So what?
So, we're sensitive. What do we do about it? I say we do absolutely nothing. Recognize your sensitivities. Understand where they come from, and trust in them. Rest when you can, re-energize yourself by doing something that makes you feel comfortable and at ease. Trust your instincts when it comes to other people. Above all, give yourself a break, and understand that others do not see you as poorly as you see yourself. Take the compliments when given, and take the criticisms at face value.
Monday, June 11, 2007
I Am Encouraged By This Research
From http://ajp.psychiatryonline.org/cgi/content/full/164/6/856 The American Journal of Psychiatry's article: Why Does the Worldwide Prevalence of Childhood Attention Deficit Hyperactivity Disorder Matter? by Terrie E. Moffitt, Ph.D. and Maria Melchior, Sc.D.
Exerpt: The finding of Polanczyk and colleagues of a uniform prevalence rate worldwide attests that ADHD is probably not caused by the avarice of the American psychiatric profession or by permissive Western culture and that reducing our avarice and permissiveness will not make ADHD disappear. A uniform prevalence rate worldwide also suggests, disappointingly, that geographical variation will not provide fresh clues to the causation of ADHD. Because there is no causal biomarker with which to diagnose ADHD, the diagnosis remains syndrome-based. Thus, becoming an identified ADHD patient is partly a function of the gap between a child’s behavior and the expectations of the adults in his or her world about how children ought to behave. This gap is encoded differently in DSM-IV, which identifies more children with ADHD, versus ICD-10, which identifies fewer. The question is whether DSM-IV overidentifies ADHD or ICD-10 underidentifies ADHD. The answer matters. Excess medical costs per ADHD patient, relative to same-age children, have been estimated at near $1,000 per child per year for hospitalization, primary care office visits, outpatient mental health visits, and medications. Thus, even a small shift in the population prevalence of diagnosed ADHD could have important fiscal implications for institutions involved in the treatment of ADHD. Nosologists are working toward a more unified approach between DSM-V and ICD-11; there is much good work to be done.
Finally we may be able to stop making lame accusations and assumptions and move onto research into the real causes of ADD/ADHD (ACE) and real solutions.
Exerpt: The finding of Polanczyk and colleagues of a uniform prevalence rate worldwide attests that ADHD is probably not caused by the avarice of the American psychiatric profession or by permissive Western culture and that reducing our avarice and permissiveness will not make ADHD disappear. A uniform prevalence rate worldwide also suggests, disappointingly, that geographical variation will not provide fresh clues to the causation of ADHD. Because there is no causal biomarker with which to diagnose ADHD, the diagnosis remains syndrome-based. Thus, becoming an identified ADHD patient is partly a function of the gap between a child’s behavior and the expectations of the adults in his or her world about how children ought to behave. This gap is encoded differently in DSM-IV, which identifies more children with ADHD, versus ICD-10, which identifies fewer. The question is whether DSM-IV overidentifies ADHD or ICD-10 underidentifies ADHD. The answer matters. Excess medical costs per ADHD patient, relative to same-age children, have been estimated at near $1,000 per child per year for hospitalization, primary care office visits, outpatient mental health visits, and medications. Thus, even a small shift in the population prevalence of diagnosed ADHD could have important fiscal implications for institutions involved in the treatment of ADHD. Nosologists are working toward a more unified approach between DSM-V and ICD-11; there is much good work to be done.
Finally we may be able to stop making lame accusations and assumptions and move onto research into the real causes of ADD/ADHD (ACE) and real solutions.
This Is What I'm Talking About
I read this news article today. http://www.tv3.co.nz/News/NewsDisplay/tabid/209/articleID/28320/Default.aspx It talks about a Canadian researcher who has shown that children from broken marriages are twice as likely to be prescribed Ritalin than those in intact families. It continues to state that further research needs to be undertaken to find out why. I consider myself to be somewhat articulate, but I have to admit that my first response is...'Duh!'
This is what I've been talking about. There is so much misunderstanding about ADD that even researchers don't have a clue. Has anyone bothered to think that the reason so many children from broken families are prescribed Ritalin is because they come from ADD families?
Relationships are difficult enough without ADD thrown into the mix. Of course the divorce rate amongst this population will be much higher than couples who do not have ADD. The logical conclusion therefore, since ADD is genetic, is that one or more children of these couples will have ADD. Even if they were not on medication prior to the breakdown of the marriage, the emotional and psychological strain of this traumatic event may be the catalyst for behaviors warranting at least a temporary respite from ADD by way of medication.
Stop worrying about whether or not we should medicate our kids. Medications that are supervised by a doctor have been proven time and again to be safe. Let's worry, instead about how to recognie ADD in adults so that treatment can begin and possibly save a relationship before another 'study' has to be undertaken.
This is what I've been talking about. There is so much misunderstanding about ADD that even researchers don't have a clue. Has anyone bothered to think that the reason so many children from broken families are prescribed Ritalin is because they come from ADD families?
Relationships are difficult enough without ADD thrown into the mix. Of course the divorce rate amongst this population will be much higher than couples who do not have ADD. The logical conclusion therefore, since ADD is genetic, is that one or more children of these couples will have ADD. Even if they were not on medication prior to the breakdown of the marriage, the emotional and psychological strain of this traumatic event may be the catalyst for behaviors warranting at least a temporary respite from ADD by way of medication.
Stop worrying about whether or not we should medicate our kids. Medications that are supervised by a doctor have been proven time and again to be safe. Let's worry, instead about how to recognie ADD in adults so that treatment can begin and possibly save a relationship before another 'study' has to be undertaken.
Thursday, June 7, 2007
The Guilt of ADD
I was watching the news today, and saw some stories about the tragedies in Africa, the war in Iraq, and the devastation of cancer, and I realized something. I realized why adults with ACE are reluctant to stand up for themselves and ask for help. We feel guilty.
I know personally, that it is difficult for me to see these types of things and want help for myself. I think that I am not as worthy of assistance as the people affected by disease, poverty and war. I have been inundated with media stories about ACE being an excuse to medicate our children, as an excuse for laziness, and as a 'pretend' disorder concocted by the pharmaceutical companies. I have been made to feel ashamed, and made to question the validity of my ACE.
I recognize that ACE is not life threatening, at least in the sense that the condition itself won't kill me. I would like to know, however, how many people who have committed suicide had undiagnosed, or even diagnosed ACE. I know, however that ACE has affected my life and the lives of those I love. I know that the state of my finances, for instance are a direct result of my ACE.
I also know that I have much to contribute to my life, my family and my community. If only...
If only I could get my finances under control.
If only I could get my household under control.
If only I could get my schedule under control.
If only I could get work under control.
If only I could get school under control.
If only I could get my kids under control.
How will we ever get the help we truly need and deserve if we are too ashamed and guilt ridden to stand up and educate the world on what ACE REALLY is and how it affects day to day living? We have to stop worrying about how others will view us. It is going to be hard. People are going to say terrible things. But we have to know in our hearts and minds that this is the right thing to do. We need to establish some kind of organization that can help us with our day to day living, and not make us feel like failures in the process.
I know personally, that it is difficult for me to see these types of things and want help for myself. I think that I am not as worthy of assistance as the people affected by disease, poverty and war. I have been inundated with media stories about ACE being an excuse to medicate our children, as an excuse for laziness, and as a 'pretend' disorder concocted by the pharmaceutical companies. I have been made to feel ashamed, and made to question the validity of my ACE.
I recognize that ACE is not life threatening, at least in the sense that the condition itself won't kill me. I would like to know, however, how many people who have committed suicide had undiagnosed, or even diagnosed ACE. I know, however that ACE has affected my life and the lives of those I love. I know that the state of my finances, for instance are a direct result of my ACE.
I also know that I have much to contribute to my life, my family and my community. If only...
If only I could get my finances under control.
If only I could get my household under control.
If only I could get my schedule under control.
If only I could get work under control.
If only I could get school under control.
If only I could get my kids under control.
How will we ever get the help we truly need and deserve if we are too ashamed and guilt ridden to stand up and educate the world on what ACE REALLY is and how it affects day to day living? We have to stop worrying about how others will view us. It is going to be hard. People are going to say terrible things. But we have to know in our hearts and minds that this is the right thing to do. We need to establish some kind of organization that can help us with our day to day living, and not make us feel like failures in the process.
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