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ADHD
The Invisible Disorder
Or the
TOO MUCH ATTENTION EVERYWHERE DISORDER
Attention Deficit is not actually a deficit of attention, but too much attention everywhere. It is rather like being in a hypervigilant state found in PTSD, responding constantly to the least little input. This occurs even when sleeping. The ADHD mind is more easily distracted by environmental sounds (barking dog, street traffic, people talking, various noises) and that can partially arouse the individual, reducing the quality of sleep, even though the individual does not fully wake up and may not be aware of the disrupted sleep.
Due to devoting too much attention everywhere, the ADHD mind works too hard. Research estimates that the ADHD mind works 2 to 8 times as hard to accomplish anything as a non-ADHD mind. As a result, the ADHD mind often feels overwhelmed by things others take in stride, making the individual feel anxious, constantly worn out, and inadequate. A byproduct of the mind being overworked 24/7/365 is feeling constantly overloaded even on days where not much is going on, accompanied by ever escalating anxiety.
Too much attention everywhere can cause sensory overload. Individuals with ADHD often have difficulty with sensory overload, unable to screen out background noise well, and may be highly sensitive to reflected light. This is because not focusing means not filtering properly. For instance, if I want to purchase a female, black and white Australian Shepherd with strong herding instincts, and I type DOG in google, I get millions of hits. My search is not “focused” adequately; therefore, I am not filtering out unnecessary data swamping the mind.
DETOUR:
This Interstate is Closed
Neurologically, there are many areas of the mind that are affected besides attention and focus. Another aspect of the ADHD mind, is that large neurons in the white matter of the brain, are having difficulty. These large neurons are supposed to transport information from region to region of the brain, but may not be fully engaged. This aspect has been found to be on a continuum (spectrum) with Autism and OCD. The large neurons are like interstate highways compared to streets and country roads. With dysfunction in this area, information may be detoured through millions of tiny neurons (streets/country roads) in the grey matter, rather than on neuron “interstates”.
Additionally, the timing mechanism of the ADHD mind, which is governed by brain waves and neurons interacting, is also impaired, impacting the ability to accurately estimate time of tasks, priorities, and even categorization.
THE MANY POORLY KNOWN SYMPTOMS
A New Study Reveals Why Some People Have ADHD
The ADHD Survival Advantage
Indeed, modern-day nomadic populations, such as the Ariaal tribe in Africa, have been shown to have higher levels of certain genetic mutations associated with ADHD, according to a 2008 study.
Together, this information suggests that the evolution of ADHD may have helped our ancestors survive through exploratory foraging behavior. ​​The researchers put the ADHD advantage down to their tendency to move on to the next patch—that is, go exploring—sooner than those who screened negative, who tended to spend longer focusing on a single patch.
While many people today consider ADHD to be a condition that needs treating, it may have actually given our ancestors a survival advantage. The evolution of ADHD helped our ancient ancestors survive as hunter-gatherers, according to a new study. ​​
Foraging requires balancing the trade-off between exploiting known food sources and searching for new ones. While many hunter-gatherers may have chosen to stick to their known food patches, individuals with ADHD may have been more likely to engage in more exploratory behaviors.
ADHD Medications
ADHD medication activates the various areas of the mind that are supposed to give an individual control over focus and attention, and subsequently filtering. In the ADHD mind, these areas appear to be under active rather than missing or underdeveloped. Thus, when medication activates these underactive areas, the mind works in a way that feels normal not drugged, and not like a zombie.
Non-Stimulant Medications
Strattera (Generic form - Atomoxetine):
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24-hour effect
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non-addictive
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not controlled
• Best dosage is gradual: 25 mg – 3 weeks, then 40 mg next 4 weeks, then 60 mg for another 4 weeks then evaluate
- Recently some providers are starting clients out with 10 mg twice a day instead of 25 mg.
• This gradual schedule tends to drastically reduce risk of uncomfortable side effects that typically occur in the first two weeks
• Most common side effects are headaches and upset stomach. Doing these things helps also
1. Eat something when taking it,
2. Don’t skip doses
3. Take first thing when getting up
Qelbree (great new medication – no generic form):
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24-hour effect
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non-addictive
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not controlled
• This medication seems to have less side effects, but is very expensive unless insurance covers it
o There is a discount card that can provide the medication for as little as $20 a month, typically for a year
o https://www.qelbree.com/adults/adhd-support-and-savings/download-sign-up
• Eating something before taking it is helpful with this medication which should also be taken in the morning and at the same time as much as feasible
Stimulant Medications
Note: Many doctors and other medical prescribers may strongly encourage patients to take stimulants such as extended-release Adderall. They will explain that stimulant medication is more effective because:
Adderall, Ritalin, Concerta, Vyvanse, Focalin, and others
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6 – 12 hours
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Negative sleep impact
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Addictive
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Severely controlled,
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other health risks to some people
• Stimulants address two neurotransmitter problems that occur with ADHD
o Norepinephrine and Dopamine
• Non-stimulants address only one neurotransmitter (usually Norepinephrine). So technically, the stimulant is “better”.
• However, practically speaking, stimulants are not actually as effective in an adult’s life,
o The stimulant runs out before the end of the working day
o The stimulant does not work at night.
o An adult’s life with responsibilities does not stop at the end of a working day
o Adults have less time available to make up for poor sleep
Dual Approach
On some occasions, some individuals need a dual approach. The non-stimulants are prescribed for continuous and stable 24-hour coverage to improve the overall effectiveness of the patient’s daily and weekly routines without the variability that stimulants cause.
Daily: Non-Stimulant plus low dose stimulant
PRN: Daily Non-Stimulant and low dose stimulant as needed for certain events or tasks
Then a lower dose of a stimulant is prescribed to be taken
• Daily - at the peak of the patient’s day, for optimal performance of focus intensive tasks
• As needed – when only some days of the week have focus intensive tasks
EFFECTIVENESS OF NON-STIMULANTS
A New Person
A therapist who has begun seeing the advantages of the use of non-stimulants such as Strattera (generic Atomoxetine) described her experience with a client who started Strattera:
- My client started Strattera at a micro-dose of 10 mg after demanding it from the NP who wanted to merely prescribe another ineffective antidepressant after the failure of three others. Due to the positive results, the client intends to have the dose increased on her next visit.
- I have no idea who this person is in my office. The person I had been seeing was depressed, anxious, unmotivated with intrusive, self-deprecating thoughts daily. This is a new person.
ADHD Myth #1
ADHD isn’t a real medical disorder.
ADHD has been recognized as a legitimate diagnosis by major medical, psychological, and educational organizations, including the National Institutes of Health and the U.S. Department of Education. The American Psychiatric Association recognizes ADHD as a medical disorder in its Diagnostic and Statistical Manual of Mental Disorders — the official mental health “bible” used by psychologists and psychiatrists.
Attention deficit hyperactivity disorder (formerly known as just attention deficit disorder) is biologically based. Research shows that it’s a result of an imbalance of chemical messengers, or neurotransmitters, within the brain. Its primary symptoms are inattention, impulsiveness, and, sometimes, hyperactivity.
ADHD Myth #2
f you go back a century in medical literature, you’ll see descriptions of children who look very much like children with ADHD. A century ago, that specific diagnosis didn’t exist, but physicians described children that were hyperactive, impulsive, inattentive, all the things that we would put together to make an ADHD diagnosis today. Some of the earliest reports date back all the way to the 1700s.
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In the 1800s, the German physician Heinrich Hoffman wrote poems and drew illustrations to describe the children he saw in practice. One great example is Fidgety Phil, who he describes as, “Let me see if Philip can be a little gentleman. Let me see if he is able to sit still for once at the table. But Fidgety Phil won’t sit still. He wriggles, he giggles, and then I declare, swings backwards, and forwards and tilts up his chair.”
ADHD Myth #3
ADHD is the result of bad parenting
The problem is rooted in brain chemistry, not discipline. When a child with ADHD blurts things out or gets out of his seat in class, it’s not because he hasn’t been taught that these behaviors are wrong. It’s because he cannot control his impulses.
In fact, overly strict parenting — which may involve punishing a child for things he can’t control — can actually make ADHD symptoms worse. Professional interventions, such as drug therapy, psychotherapy, and behavior modification therapy, are usually required.
ADHD Myth #4
Girls are just as likely to have ADHD as are boys, and gender makes no difference in the symptoms caused by the disorder. But because this myth persists, boys are more likely to be diagnosed than girls.
ADHD Myth #5
A kid who can play video games for hours couldn’t possibly have ADHD.
It is quite common for a child with ADHD to be very distractible in one setting, but highly, highly focused in other settings.
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It is quite common for a child with ADHD to be very distractible in one setting, but highly, highly focused in other settings.
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Why is this? Because ADHD does not mean no attention. Really, ADHD means dysregulated attention. Environments or activities that are highly stimulating can actually lead to hyperfocus. It’s in the more mundane and less stimulating settings where you see the distractibility really come to the surface.
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ADHD Myth #6
More than 70% of the individuals who have ADHD in childhood continue to have it in adolescence. Up to 50% will continue to have it in adulthood.
Although it’s been estimated that 6% of the adult population has ADHD, the majority of those adults remain undiagnosed, and only one in four of them seek treatment.
Yet, without help, adults with ADHD are highly vulnerable to mood disorders, anxiety, and substance abuse. They often experience career difficulties, legal and financial problems, and troubled personal relationships.
ADHD Myth #7
05.
Children who take ADHD medication are more likely to abuse drugs.
Actually, it’s just the opposite. Having untreated ADHD increases the risk that an individual will abuse drugs or alcohol. Appropriate treatment reduces this risk.
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ADHD Myth #8
ctually, children with ADHD are at a distinct disadvantage, and school policies, accommodations, and education legislation concerning disabilities seeks to decrease this disadvantage as much as possible.
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ADHD is a real and meaningful diagnosis. Longitudinal studies tell us unequivocally that the diagnosis of ADHD confers risk for a host of negative outcomes, including not completing high school, dropping out of college, teen pregnancies, car accidents, and a whole wide range of negative outcomes.
ADHD Myth #9
Many well-known, high-achieving individuals from the past are thought to have had ADHD, including Mozart, Benjamin Franklin, Abraham Lincoln, George Bernard Shaw, and Salvador Dali. The list of high-achieving people with ADHD in business today includes top executives such as Richard Branson of Virgin, David Neeleman, founder of JetBlue Airways, and Paul Orfalea, founder of Kinko’s.