What is ADHD

[Louisw]

This is a thread to discuss a very important issue.

What is ADHD?

No one, certainly me, is is disputing that there exists a problem or problems we have labeled ADHD.

My question is what is ADHD. Until you know what the problem is you are usually unable to solve it.

Edited by Louisw - 9/6/12 at 7:10pm

[bec]

I'll bite, for the moment.  My eldest has ADHD.  The way it was explained to me, there is no longer a classification of ADD, they all fall under the umbrella of ADHD, and then with a sub-category of either Inattention, hyperactivity, or impulsivity.  My eldest is mostly inattentive ADHD.  Due to some health concerns, and the possible side effects, we chose a non-stimulant medication for her with the help of her psychiatrist. 

My daughter is a fabulous human being, on or off medication.  She is creative, compassionate, kind, generous, and if the ways she is gifted aren't easily articulated, she has that spark.  Off medication, she simply is NOT able to follow a conversation among her peers.  Multiple step directions (like more than one) are extraordinarily challenging for her.  She was slipping away into a dreamland where she was becoming more and more disconnected from the real world.  We made the decision to medicate when this started to affect every aspect of her life, and her quality of life was diminishing.  I would save her that hurt, the pain of exclusion, the list goes on. 

We are not lazy parents.  Her teachers (with very few exceptions) are not lazy teachers.  She isn't disruptive, so it would be easy for a lazy teacher to write her off and shuffle her to the side with a bad grade.  This is not the case.  We worked with the school as a collaborative team to get her the help she needed.  She was on an IEP for years before we made the decision to pursue a diagnosis and medication.  We have many techniques at our disposal to help her in addition to the meds.  The meds are not a magic bullet.  They do not cure anything, do not change her personality, and are not perfect.  She still needs the reminders, the structure, the routine that set her up for success.  But the medication helps her to come back to the real world when she needs to be present.  It does not stifle her creativity, but lets her focus her energy as a conscious decision.  She composed a short song over the summer to play on her flute (she played in band last year and started private lessons over the summer.  Something that simply would not have been possible without medication).  She would never have been able to do that prior to medicating. 

I'm not going into it to defend my choices.  I know what is right for my daughter.  But, I am clarifying so make the point that for some kids, this makes the difference between success and failure.  And call it whatever you want.  There is something about the way her brain is wired that makes it extraordinarily difficult for her to succeed.  At home, at school, with friends.  I am not sure if you understand what it is like to have every.single.aspect of my child's life negatively impacted by this. 

[catnip]

To save myself some time, I copied and pasted a list of ADHD symptoms of of WebMD.

These are symptoms that I struggle with every day:

    easily distracted by irrelevant stimuli and frequently interrupting ongoing tasks to attend to trivial noises or events that are usually ignored by others
    inability to sustain attention on tasks or activities

    difficulty following, or inability to follow multi-step instructions

    difficulty finishing schoolwork or paperwork or performing tasks that require concentration
    frequent shifts from one uncompleted activity to another      
    failure to complete tasks such as homework or chores
    frequent shifts in conversation, not listening to others, not keeping one's mind on conversations, and not following details or rules of activities in social situations
    impatience
    difficulty delaying responses
    blurting out answers before questions have been completed
    difficulty awaiting one's turn
    frequently interrupting or intruding on others to the point of causing problems in social or work settings
    initiating conversations at inappropriate times
    fidgeting, squirming when seated
    often talking excessively

These are things that I used to have trouble with, and have very deliberately learned to     compensate for, to the point that they are no longer difficult for me:
    procrastination
    difficulty paying attention to details and tendency to make careless mistakes in school or other activities; producing work that is often messy and careless
    disorganized work habits
    forgetfulness in daily activities (for example, missing appointments, forgetting to bring lunch)

These are things that I never had major issues with:
    getting up frequently to walk or run around
    running or climbing excessively when it's inappropriate (in teens this may appear as restlessness)
    having difficulty playing quietly or engaging in quiet leisure activities
    being always on the go
 

I have the following common co-morbidities: anxiety, depression, weight issues, OCD, and insomnia. In addition, as a child, I had dyspraxia.

I was diagnosed at age 8, after a one-on-one Stanford-Binet IQ test placed me off the top of their charts. That got the adults in my life looking at why my school performance was so bad. We tried the Feingold Diet. It helped some, but not enough to allow me to function in a school environment. Then I took Ritalin for most of the next ten years. (I went off of it for about six months in seventh grade. I immediately became a profound behavioral disruption, and started failing every class but art).

I stopped taking Ritalin when I turned 18 because of a lapse in medical care once I aged out of the pediatric specialist I had been seeing. I managed a semester of college with passing grades, but then failed everything the next semester, dropped out and got a job. I tried taking Ritalin again for a few days at around 20, but the side effects were much more noticeable and I decided that I would have to learn to live without it.

I am now 38. I've never had trouble finding or keeping a job. My attempts at returning to finish college have been a disaster.

I do occasionally have trouble in interpersonal relationships due to ADHD. I can't keep secrets. I interrupt, eavesdrop and then start random conversations with strangers in the grocery store. I get bored and my mind wanders during sex. I forget to eat. I get wrapped up in something and tune out my daughter so she has to yell at me to get my attention. I wander out in front of moving vehicles. I'm a terrible driver. I pick fights for sensory stimulation.

I'm also a very creative person. I'm a terrific cook. I write and run live-action RPGs. I organize group activities. I organize and run a household. I keep a reasonably tidy house and get a fairly balanced meal on the table every night. I have a good-sized web of really amazing friendships that are a constant source of joy and challenge for me (interestingly, almost all of my closest friends also have ADHD or Asperger's). I have been married for 13 years. Money is sometimes tight, but we've kept the lights and phone on the whole time, and we can usually afford a vacation or two every year.

Things that seem to help me:

  an understanding spouse who knows what to expect from me

  coffee, tea, and kombucha

  regular chiropractic adjustments (I think this helps by removing the distractions of an imbalanced spine)

  DHA supplements

  avoiding concentrated red food dyes most of the time

  Motherwort for anxiety, scullcap for insomnia

  lists - lots and lots of compulsive lists. Breaking down EVERYTHING that starts to overwhelm me into a list

  splitting my attention - when I need to listen, doing something like crochet, embroidery or coloring to occupy my hands and eyes. When I need to focus on something like tidying, organizing, folding laundry, walking, or driving, audiobooks and podcasts.

  Google calendar and a smartphone with alarms and alerts

  Setting arbitrary deadlines to avoid procrastination, usually with a pad to allow for unexpected trouble

Edited by catnip - 9/6/12 at 6:44pm

[Louisw]

Originally Posted by bec 

I'm not going into it to defend my choices.  I know what is right for my daughter.  But, I am clarifying so make the point that for some kids, this makes the difference between success and failure.  And call it whatever you want.  There is something about the way her brain is wired that makes it extraordinarily difficult for her to succeed.  At home, at school, with friends.  I am not sure if you understand what it is like to have every.single.aspect of my child's life negatively impacted by this. 

Thanks.

To me this seems to be a key aspect in your situation. "There is something about the way her brain is wired that makes it extraordinarily difficult for her to succeed."

[melissa17s]

Originally Posted by Louisw 

Thanks.

To me this seems to be a key aspect in your situation. "There is something about the way her brain is wired that makes it extraordinarily difficult for her to succeed."

MRI imaging has been used to prove that different portions of the brain are used for tasks by individuals with adhd http://www.ucdmc.ucdavis.edu/welcome/features/20071128_mind_adhd/index.html and http://www.webmd.com/add-adhd/news/20111127/kids-with-adhd-have-distinct-brain-patterns .  Also, different brain waves register on eegs for particular tasks, so they can also be used to identify, but are not as commonly used for this diagnostic method http://www.sharpbrains.com/blog/2008/11/23/neurofeedback-quantitative-eeg-for-adhd-diagnosis/ .    

[Louisw]

Originally Posted by catnip 

These are things that I used to have trouble with, and have very deliberately learned to compensate for, to the point that they are no longer difficult for me:

    procrastination
    difficulty paying attention to details and tendency to make careless mistakes in school or other activities; producing work that is often messy and careless
    disorganized work habits
    forgetfulness in daily activities (for example, missing appointments, forgetting to bring lunch)

Thank you for your extensive history.

Would you say the above paragraph is a fair summary of your problems? If not how would you summarize?

[catnip]

What you quoted? No. Those are the things that I had problems with as a child, but have learned to compensate for, so they are no longer problems.

These are the things that are a problem for me most days, now, as an adult:

• easily distracted by irrelevant stimuli and frequently interrupting ongoing tasks to attend to trivial noises or events that are usually ignored by others
• inability to sustain attention on tasks or activities
• difficulty following, or inability to follow multi-step instructions
• difficulty finishing schoolwork or paperwork or performing tasks that require concentration
• frequent shifts from one uncompleted activity to another
• failure to complete tasks such as homework or chores
• frequent shifts in conversation, not listening to others, not keeping one's mind on conversations, and not following details or rules of activities in social situations
• impatience
• difficulty delaying responses
• blurting out answers before questions have been completed
• difficulty awaiting one's turn
• frequently interrupting or intruding on others to the point of causing problems in social or work settings
• initiating conversations at inappropriate times
• fidgeting, squirming when seated
• often talking excessively

A few examples of ways that my life is impacted are these:

   I have trouble in interpersonal relationships due to ADHD. I can't keep secrets. I interrupt, eavesdrop and then start random   

   conversations with strangers in the grocery store. I get bored and my mind wanders during sex. I forget to eat. I get wrapped up in

   something and tune out my daughter so she has to yell at me to get my attention. I wander out in front of moving vehicles. I'm a

   terrible driver. I pick fights for sensory stimulation.

These arejust a few examples. It's pervasive and often impacts me in ways I do not always recognize.  

[pek64]

My appologies (in advance) for sounding argumentative. I don't mean to imply that anyone's diagnosis is invalid. My questions are sincere. My comments show my reluctance to accept such a diagnosis, but I know from my food allergies that unless you've lived it, you don't understand it.


How many of the symptoms would a person need to have to be diagnosed with ADHD? How severe do those symptoms have to be to be a problem?

Edited to remove comments.

[heatherdeg]

Moving this to the Health & Healing forum since this particular thread doesn't specifically deal with parenting a specific type of child.

[catnip]

I don't have an answer for that. I had almost every common symptom as a child, exhibited in every environment.

The key thing about ADHD is that it is not a sometimes thing, it's not developmentally appropriate, and it's severe enough to cause a problem. For example, I literally cannot, at age 38, keep a gift a secret for a few weeks. Before it was pointed out to me that this was an ADHD behavior, I felt awful about it, and couldn't understand why it kept happening. No one would expect a five year old to do it , so that would not be an ADHD symptom in a young child.

I can tell you that knowing that there are other people that have the same challenges that I do helps me, in a couple of ways. First, it reminds me that when I screw up certain things, it isn't because I didn't try hard enough, but because it is harder. And I get extra satisfaction when I get it right. I'm not lazy. I'm not stupid. My brain is wired differently.

[cyclamen]

Originally Posted by catnip 
. For example, I literally cannot, at age 38, keep a gift a secret for a few weeks. Before it was pointed out to me that this was an ADHD behavior, I felt awful about it, and couldn't understand why it kept happening. No one would expect a five year old to do it , so that would not be an ADHD symptom in a young child.

What? This too?  LOL.  If I can keep a gift secret a few hours I am proud of myself.  I was not diagnosed until I was an adult and I am constantly finding facets of my personality which are apparently ADHD traits.  At first it was a relief and now sometimes it makes me laugh because of how extensive it is.

Unlike a PP, I was also tested as a kid and found to have "gifted" IQ.  But no one ever asked why I was doing poorly in school, as far as I know.  Instead, my teaches told me I was irresponsible and needed to shape up, and my mom beat me for being lazy, since it was clearly not an intellectual defect.   Over the years I've learned to compensate.  And once I received my diagnosis, I made huge strives in learning new coping skills.  I struggle much less with procrastination, completing tasks, and thinking about how I will perform a task before I actually begin.  I know that I have to write everything down if I want to remember it.  I still struggle with interrupting people, but I am able to manage that better if I carry a small notebook with me.  Interrupting, for me, is not related to impulsivity as much as it is fear that I won't remember what i want to say.   I was not able to develop these skills until I learned there was no moral deficiency in me, but that my brain had a different way of operating.

I don't know what ADHD is, but the mental health professional I saw said that she preferred to think of it as being a "difference" in my brain and not a dysfunction.  I liked that.  Our society isn't set up well to accomodate this processing difference because we tend to value and esteem some kinds of work over others.  And we are a very form oriented society.  She and I talked about how I am more comfortable working certain jobs than others (I tend to feel most comfortable and productive in service or labor oriented jobs over abstract or "white collar" jobs which I find too stressful, demoralizing, and confusing) due to the way my brain works, and that is ok.  If I had a desire to work in a job where I had to fill out a lot of forms, sit still constantly, or do lots of writing, with lots of abstract, rolling deadlines, medication might be something I would want to pursue.  Instead, I have chosen jobs where my ADHD traits and compensations help me do well; and I recognize that I love to work with my hands because then I'm not at war with my mind or my body.   When I do have to fill out forms (for instance), I seek help from friends or social workers.  Since I've learned to manage my ADHD, my anxiety has lessened tremendously.  Learning this about myself literally changed my life and my outlook.

Incidentally, my brother was diagnosed with ADHD in elementary school and my mom rejected the diagnosis.  And both my parents do have many classic symptoms of ADHD (hyperfocus, impulsivity off the top of my head - but there is a lot more).  Both my parents grew up in dangerous and traumatic environments and so did my brother and I.  Both of my parents are very smart people but struggled in school.  My dad left college to go to Vietnam partly for financial reasons and partly because he couldn't follow directions.  My mom had such difficult time in school as a young child in a culture that valued education highly that she actually tried to kill herself.  I don't know what all that means, I don't know if the ADHD is environmental or genetic, but there definitely seems to be a hereditary factor at work in my family.

[Louisw]

Originally Posted by catnip 

I'm not lazy. I'm not stupid. My brain is wired differently.

Well that is two so far.

What could cause a brain to become wired differently?

Edited by Louisw - 9/9/12 at 12:14pm

[catnip]

I was SO bloody lucky. I had a teacher's aide that had a niece with ADHD. She recognized the symptoms and suggested to my parents that they look into it. I got years of speech therapy to train me to stay on a topic long enough to complete a thought. I got adaptive PE that helped with the dyspraxia. On one hand, I might have been able to avoid medication if I had been homeschooled, on the other hand, I wouldn't have had the level of therapy that I got in public school.

One of my biggest traumas of my public school years was in third grade, before I was diagnosed. One of the math activities was doing basic fact flashcards. We needed to correctly answer 100 flashcards in under 3 minutes. When everyone completed this, the whole class got a major reward (field trip, pizza party, talent show, movie day, something big). The list was public. I was, by far, the last kid to be able to do the addition ones, and the teacher, in the end, had to give me an extra 30 seconds. I never managed the subtraction. Every kid in the class knew that I was the stupid dummy keeping them from their reward.

Interestingly enough, I had no problem with the mulltiplication and division, because those were broken down into 10 sets of 10 problems in 18 seconds each. I passed those both my first time through. I could maintain focus long enough to do 10 problems, just not through 100. It wasn't until very recently that I realized that if they had just stopped the timer and given me a break every x seconds, I'd have been fine! 

That experience still haunts me. I went to 42 weeks gestation with my daughter, and as induction was discussed, I regressed to the little 8 year-old who couldn't do the flashcards in time.

[catnip]

Louis, I really, truly, don't (bleeping) care. My grandfather had ADHD, he dropped out of school at age 14 to join the military. They didn't know what to call it then, beyond laziness, willfulness, and disobedience, and they tried to beat it out of him. My mother has ADHD. She was never diagnosed, people just thought she was 'flightly' and an 'airhead.'

I am not in this discussion to further your anti-vaccine agenda. I know non-vaxed kids who have ADHD. I know MANY MANY vaccinated kids who DON'T. If that is all you want to talk about, find another shill. I'm done here.

[Cyllya]

Originally Posted by pek64 

How many of the symptoms would a person need to have to be diagnosed with ADHD? How severe do those symptoms have to be to be a problem?

It's six or more, out of nine, per sub-type. Here is the DSM5 criteria. (DSM5 is not finalized yet, but I think what they've got so far is better than the DSM4, which you can see by clicking the blue "DSM-IV" tab on that page.)

As with many other mental illnesses, diagnosis depends on the level of "impairment," which is pretty subjective and could be different for the same person in different scenarios. Personally, I have all nine inattentive symptoms, and while I can look back and tell they were there during childhood, they weren't really a big problem at the time. I didn't even have trouble in college. But once I entered the work force and moved out of my mom's house, I crashed and burned. It took me a few years to be in a position to seek professional help, so I just started treatment yesterday. I was worried I wouldn't be able to remember all my symptoms/problems when the doctor asked, plus I don't fit the stereotypical ADHD case, so I spent a few days (because I kept getting distracted, heh) making a list of ways my attention problems impair me. It was over two pages.

[Louisw]

Originally Posted by Louisw 

What could cause a brain to become wired differently?

http://www.youtube.com/watch?v=4wnIU6Jr7VY&t=43m15s

When areas of your brain are destroyed as by mercury, stroke or trauma for example your brain will AUTOMATICALLY attempt to minimize the FUNCTIONAL damage by rewiring itself. Certain functions once accomplished by the damaged portions of your brain are rerouted to undamaged portions of your brain not fully designed to accomplish these functions as a PRIMARY function. With years of experience a person with the damaged portions will often learn to participate in this rerouting process. He will learn to live with ADHD; learn to live with his stroke, for example.

Your brain often accomplishes this with a good measure of success; sometimes not so successfully. In all cases it attempts.

[Louisw]

Originally Posted by catnip 

I am not in this discussion to further your anti-vaccine agenda.

Might you be if you were convinced "vaccines" often damage the brain resulting in Autism Spectrum Disease?

Come on don't leave the party just now we are making progress.

[catnip]

Here's the thing, Louis. You aren't bothering to read what I write, beyond scanning for your pet key phrases to make your point. I see no point in continuing to talk to you.

[AngieB]

My ds is ADHD. He is very smart, part of the GATE program at school. He was ADHD in the womb. My pregnancy with him was very different from my other 3 pregnancies. He moved around more and it was a different type of movement , I don't know how to describe it, more extreme, harder and more often. The day he was born everyone commented on how he never stopped moving, even in his sleep his body twitched and he made funny little faces. We would have to swaddle him with his arms wrapped up really tight and then hold him tightly to our chest to get him to sleep as a baby because his body never stopped moving. From about age one on I had him at doctors questioning why he was different from all the other kids. Ds is not ADHD because of vaccines, like all the other posters have said his brain is wired different. Has been since before birth. His brain is amazing, and he is going to do amazing things.

[Louisw]

Originally Posted by catnip 

I see no point in continuing to talk to you.

My dear lady you are taking to a FORUM.