Tag Archives: ADHD

Believing in a cure for ADD, ADHD, and depression

This isn’t a post to deny that depression, ADD, and ADHD exist. They do and many people have a terrible time dealing with them, but that doesn’t mean they are permanently debilitating. It is possible to live with them, indeed thrive with them, and not need drugs or any special treatments.

Now, before, I pontificate any further let me say I am not a doctor, nor an expert. I’m just a person with a decent amount of experience with both.

I want to talk about this because I’ve noticed a trend over the last decade to marginalize any cure for either problem. The majority of help is focused on how to cope in the moment. To fix the issue for a day or get through the week. Everything has become about those moments of panic.

Which is very strange. The moments of panic do offer the most acute pain and suffering, but they don’t offer any solution. It is the moments after and before where the learning occurs. Those off-days when you can focus on the cure, overcoming any problems the conditions create for you.

There is no specific solution for this, rather it is a building process. It starts with being aware when the condition manifests itself. Am I starting to feel down? Has this problem troubled me in the past? Am I feeling distracted or unable to stay seated?

I used to be a public school teacher with tons of restless students. Without knowing if they were ADD or ADHD, I would ask them to try to stay focused for an extra minute each time it happened.  Also, to let me know when they were done. This was extremely effective because it taught them to become aware of when it was happening.

It also created an idea in their minds that this can be controlled. When I noticed they were starting to understand that I would approach them with the next step. I called it strengths and weaknesses. This involves pairing the problem with something the person likes, usually a hobby. The hobby serves as the strength and place of safety to rely upon during the moments of panic. It also frames the problem as a weakness to improve upon, instead of a permanent problem to accept.

For an attention example, one student loved reading skateboarding magazines. While every other teacher banned them in the classroom, I told the  student to keep one handy at all times. Whenever the symptoms came on (weakness) he was to pull out the magazine and read (strength). At first, he struggled a bit with it, often getting this dazed look in his eye. He continued to make progress and eventually was able to master his focus. He even became adept at reading the magazine while paying attention. I wasn’t sure this was possible until he answered questions correctly, completed homework, and all that. I think it even turned his weakness into a strength.

For a depression example, I knew someone who would feel slightly down before major episodes. He was aware that these slightly down moments were happening (weakness) and so I asked him to write down (strength) whatever was on his mind. He liked the idea of a diary, though, at first, was a little ashamed to write down his depressed thoughts. Then the depression would hit, he would recover, and be left with those writings. He soon became aware that a lot of what was troubling him in those writings were real issues. He then had a pre-written set of issues to work through on the good days. Nothing happened overnight, but gradually his depression has been lessening and maybe, one day, he will turn it into normal sad/down days.

The one thing you will notice in each of these examples is something I call a “trusted friend”. This is the last step, finding someone to help you through these issues. The strange thing is that most people with ADD, ADHD, and depression aren’t aware they have these problems. This is just the way they are and when it happens there is no alarm sounded. The role of the trusted friend is to identify for the person when it is happening. Sometimes they can give advice, like in the examples above, but most of the time all they have to do is alert the person.

One thing to be aware of with depression, there is something about the down attitude that hates being told it is down. There is also a high level of shame attached to it. This doesn’t mean the person should not be aware of what’s happening, it just means to be much more cautious and patient when dealing with it. Give them some time to get used to it.

There you have my theory (non-expert, non-medical) on how to help people work toward a cure for ADD, ADHD, and depression. I understand that many, more qualified than I, consider these to be lifelong problems and offering a cure is just false hope. It may be true, but these experiences I pass along have worked in every situation. Perhaps, becoming self-aware, building on one’s strengths and weaknesses, and having a trusted friend are just great ways to build character. If so, I am still happy to pass them along as one quiet voice for a cure in a sea of  “survive the panic” writings.

 

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For ADHD drugs it's dependence vs abuse, not addiction vs dependence

Amy and I had a strong debate today about the difference between addiction and dependence. Both of us were using different explanations, so we resorted to the official definitions in the DSM-IV, the American Psychiatric Associations big book of disorders and definitions.

As you will read below their is no mention of addiction in the manual. They purposely excluded that term in favor of more descriptive ones. Which means that addiction is now classified as dependence or abuse.

Substance Dependence

The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological, symptoms indicating that the individual continues use of the substance despite significant substance-related problems.

There is a pattern of self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine.

Substance Abuse

The essential feature of Substance Abuse is a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances.

Unlike the criteria for Substance Dependence, the criteria for Substance Abuse do not include tolerance, withdrawal, or a pattern of compulsive use and instead include only the harmful consequences of repeated use.

Addiction vs Dependence/Abuse

The DSM views abuse and dependency as a continuum, meaning addiction is not, in their eyes, an on-or-off proposition, but a disorder with degrees of affliction. The distinction is important when compared to 12-step programs, which preach that one is either addicted or not, and if you are, you are powerless over such addiction.

via Powerless No Longer

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For ADHD drugs it’s dependence vs abuse, not addiction vs dependence

Amy and I had a strong debate today about the difference between addiction and dependence. Both of us were using different explanations, so we resorted to the official definitions in the DSM-IV, the American Psychiatric Associations big book of disorders and definitions.

As you will read below their is no mention of addiction in the manual. They purposely excluded that term in favor of more descriptive ones. Which means that addiction is now classified as dependence or abuse.

Substance Dependence

The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological, symptoms indicating that the individual continues use of the substance despite significant substance-related problems.

There is a pattern of self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine.

Substance Abuse

The essential feature of Substance Abuse is a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances.

Unlike the criteria for Substance Dependence, the criteria for Substance Abuse do not include tolerance, withdrawal, or a pattern of compulsive use and instead include only the harmful consequences of repeated use.

Addiction vs Dependence/Abuse

The DSM views abuse and dependency as a continuum, meaning addiction is not, in their eyes, an on-or-off proposition, but a disorder with degrees of affliction. The distinction is important when compared to 12-step programs, which preach that one is either addicted or not, and if you are, you are powerless over such addiction.

via Powerless No Longer

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Do you have ADD or ADHD? Test yourself against the official criteria from the DSM-IV

The following is excerpted from the DSM-IV, the medical manual used by the American Psychiatric Association to define mental disorders. These definitions are then broadly accepted in the entire health profession.

Go ahead and give yourself the test.
 

Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder

A. Satisfy Either (1) or (2):

1. Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Inattention

  • (a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
  • (b) often has difficulty sustaining attention in tasks or play activities
  • (c) often does not seem to listen when spoken to directly
  • (d) often does not follow through on instructions and fails to finish schoolwork. Chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
  • (e) often has difficulty organizing tasks and activities
  • (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
  • (g) often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books, or tools)
  • (h) is often easily distracted by extraneous stimuli
  • (i) is often forgetful in daily activities

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Got Adderall? The Great D.E.A. Versus F.D.A. Duke-Out

Maybe you heard about The Great Adderall Shortage of 2011 that impacted “millions of children and adults” who rely on the pills to help stay focused and calm? Maybe you haven’t.

In terms of national crises, like joblessness and obesity, I wouldn’t rank it at the top of the list (although a country producing drug-addicted college graduates should be a concern), and yet it’s become very much a crisis for people dependent, or more accurately, addicted to the drug.

At the heart of the shortage is an ever-growing struggle between the F.D.A., who recently included several attention-deficit disorder drugs on its official shortages list, and the D.E.A. who is trying to minimize abuse by people, many of them college students who use the medication as a study aid.

It’s become so much of a problem in academia that colleges like Duke University have issued new policies to address misuse, qualifying it as cheating:

The unauthorized use of prescription medication to enhance academic performance has been added to the definition of Cheating.

The D.E.A., who authorizes a certain amount the core ingredient of Adderall — mixed amphetamine salts — to be released to drugmakers each year based on what the agency considers to be the country’s legitimate medical need, finds itself embroiled in a growing epidemic.

In 2010, more than 18 million prescriptions were written for Adderall, up 13.4 percent from 2009, according to IMS Health, which tracks prescription data.

As someone who has been on, and gotten off Adderall, I’m steadfastly in the D.E.A.’s corner. It is a highly addictive drug with serious side effects, especially after continued use, and can create more problems than it solves. Go to any ADHD forum/message board and read the testimonials of folks dealing with its impacts.

Can I Be Your Trusted Friend?

The following is an un-edited letter I sent to a friend, similar to the one on Processed Foods. It represents a set of personal beliefs developed through experience, failure, and success. While I believe much of this to be dead-on there is much to disagree with. I welcome an open debate:)

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For thousands of years humans lived easily without ADD and ADHD “diseases.” It’s not that these symptoms didn’t exist rather it is that our lifestyles have changed. There is an increasing focus of daily life on controlled seated conditions for an ever increasing amount of people. This is a relatively new environment for humans and our culture has not yet learned how to function in it.

There are basic skills one can learn to alleviate the symptoms of ADD and ADHD, that if not taught by adulthood lead to destructive habits. The foundation of these skills is helping the individual to become self aware. Creating a sense of when things are normal and when they are not. Once that recognition can happen a series of coping mechanisms can be put into play. More on that later, but first some more background.

ADD as a problem (and not a disease) has been studied and worked on for decades in the field of education. The Montessori school system has developed a method of teaching that they believe is superior to public education, while also helping to alleviate the problems of ADHD. Of course their schools are only as effective as the parents allow it to be. Parents are a major problem in education because they often endured harsh conditions without learning these skills and expect their children to endure as well, though for much longer (college and graduate school).

The real battle in our public schools is not over testing but over new teaching styles. To improve the quality of our education we need to teach our students better. School testing is only a measure of how effective these new styles are. The most effective styles to date ironically focus on alleviating the root causes of ADHD, things like group work, outdoor activities, large projects with structured tasks, etc.

Understanding this history in American education helps explain some key issues involved with ADHD, namely culture, environment, and adults. For a child we can help to control all three and make the process of dealing with ADHD easier. For an adult the process is like hardened cement, only making progress through blasting old concrete and recasting new pieces.

Back to the original “cure.” The first step is to become self aware. Doing this often requires a trusted friend. One who can tell the person that they are exhibiting the behavior. It is hard on both parties to develop this routine since ADHD manifests itself in many ways, through boredom, anxiety, depression, over-excitement, and most importantly the individual is unaware of their own behavior. With practice and experience this becomes easily explained and noticed.

The second step is to develop a range of support tactics to employ when suffering an attack. This involves the individual being self aware of the issue and then selecting the right tactic, or trying several until one helps. The tactics can be anything from taking a long walk to reading a magazine. They are entirely situational and often require a fair amount of practice. They act like a bridge where one side is normal and the other side is normal. ADHD acts like the river in the middle always ready to sidetrack and take you away through panic, anxiety, or whatever. Having a bridge allows one to cope during the attack, let it subside, and then safely arrive at normal again.

ADHD is not the scourge of the modern world. It is a problem in our society that only a few truly understand, the rest suffer from it. To fix it requires a simple yet focused set of skills applied over time with another trusted individual. For children this trusted individual is often the parents or a teacher. For an adult it is a boyfriend, friend, or coworker. For those without any of these people it is a drug addiction.