Pre-schoolers and ADHD medication – scary? Not so much…

When the Guardian writes a piece about preschoolers and ADHD, as they do here , we don’t expect it to scaremonger or to conform to prejudices around this complex neurodevelopmental disorder. We expect some breast beating from the Daily Mail or the Telegraph, but we hope for sense from the Guardian. However, while medicating preschoolers is controversial, ADHD medication (please don’t call it drugs – this not pushing recreational ecstasy tablets or making toddlers smoke joints) is immediately written off as a Bad Thing – without any explanation for what type of medication it is. Continue reading “Pre-schoolers and ADHD medication – scary? Not so much…”

ADHD and Exercise – When will schools get it?

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I’ve just been in to meet with my son Michael’s head of year, two teachers and Special Needs co-ordinator. None of them seemed to think that excluding my ADHDer from sport yesterday was not the best way forward when they also wanted to talk about his challenging behaviour in class. As they went on and on about how he liked to “challenge the rules”, and his mis-behavioural points, I wanted to say that – like a Golden Retriever dog that always brings back the ball – he wasn’t going to change. And I couldn’t help thinking – “well you have the power, if you don’t want to argue the toss over the rules with him – just don’t engage’.

More worryingly for me, is that he doesn’t have the choice to challenge his exclusion once again from extra-curricular activities. Last term he was made to sit in a library while others were outside playing games, because he was deemed a “risk” (to himself? to others?). Despite the fact that he had a giant black eye from a friend hitting him in the face during hockey after school (we are used to Michael being accident prone and didn’t complain) this time Michael was the culprit. Except Michael was excluded from hockey club for hitting another boy with the hockey stick.

Arrrrrgggghh. Why can’t teachers get it? Exercise is the best medication for ADHD? Continue reading “ADHD and Exercise – When will schools get it?”

Now Dr Saul wades in with ADHD doesn’t exist

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Doctors are getting themselves in a right twist. In response to the previous post on the New York Times piece, Behavioural Neurologist Dr Richard Saul in Chicago has waded in, puffing his provocatively titled book called “ADHD does not Exist” (ironically reviewed by Belinda Luscombe on the same site as one of the Top Ten ADHD books here ). Dr Saul’s stance argued on the Time Magazine’s website here has a particular beef with the new diagnostic manual for mental health (DSM V), which awards ADHD to anyone displaying a minimum of five out of 18 possible symptoms.

His views will no doubt curry favour with Daily Mail readers, who do see this massive upsurge in ADHD diagnosis and medication as a problem, and also with those who feel that taking medication for ADHD is in some way “cheating” in life – whether offering extra focus at school or in the workplace (something that is shown to be not the case in the more level-headed recent Time Magazine piece by Denise Foley in another piece . Foley points out that even with meds, the attention of an ADHD child is still below the par of a “normal” child in school).

Without blamming the reader with any more Time Mag pieces to read, what Dr Saul does not to address in his piece, Continue reading “Now Dr Saul wades in with ADHD doesn’t exist”

Is ADHD a disease? And are novelty-seeking jobs really a cure?

From the NY Times article
From the NY Times article

When a piece like this comes out in the NY Times  it doesn’t always help the cause of seeing ADHD as a real issue, that people struggle with daily, and that those that are affected by it do deserve help. We don’t tell the short-sighted to try and manage without glasses, so why assume that the ADHDer has to settle down to difficult daily tasks without medication (or drugs, as the piece annoyingly calls them)?

First, is the author, a professor of Clinical Psychiatry Richard A. Friedman right to call it a disease? Not really. It confuses what it is, and it is already confusing enough – as disorders go. Disease is something one contracts, or that one gets over or rid of – like malaria or typhoid. Because ADHD is neurodevelopmental, ie the brain can develop and grow out of it, or at least many of the symptoms can be helped, it is better seen as a bundle of traits or a different brain wiring than a disease. You can’t give ADHD to anyone else after all, only your offspring because of the genetic link.

Secondly, are novelty-seeking jobs really a natural cure? Or small classes in school? Not really, not when inattention means that that adult or child will underachieve in any environment, unless some accommodation can be made to assist them to keep on task and pay attention – medication, coaching, teacher’s tricks. They aren’t going to learn or perform well in any environment, if they can’t stay focussed.

Finally – the jump in diagnoses does seem scary when you put it into percentages, but it is obvious really. Neuroscience is new science – a generation ago, people were just told to shape up,  mental health was seen as a shameful area of the medical profession, people were stuck in psychiatric institutions and the key was thrown away.

Given the genetic component of the condition, if a child has a positive diagnosis – it doesn’t take very long until one of the parents looks back at the difficulties in their life, and realises that they may have ADHD, too, ad that it’s just they were branded naughty, wrong, undisciplined, or are reading this in jail (expert Dr Ned Hallowell estimates that 20% of the US prison population have it – much of it undiagnosed). This then leads them to seek a diagnosis and medication (some of which is not apparently that different from caffeine – another Dr Ned observation) which then leads to what the author calls an “epidemic”.

Remember, in the UK, up until 2006, after the age of 18 it wasn’t even possible to get further medication for ADHD because it was deemed to have disappeared overnight, and adult ADHD did not even exist. Of course, if you take this as the base point, statistics and percentages are going to go off the Richter scale as people come forward to ask for help.

So, before suggesting that all ADHDers find a natural “cure” by following the path of our most famous UK ADHDer Sir Richard Branson, and become entrepreneurs ( hopefully without too much of the novelty-seeking risk taking associated with the condition, complete with pilots dying in test runs to space), let’s look at what the  new brain science is teaching us about this complex condition first. The more we learn about it, and the better we treat it and support those that have it (think of those unnecessarily locked up prisoners, who might have take a different course if not branded “wrong”, disobedient or dangerous at an early age) the better we might harness their human potential.

Only then will we have something approaching a natural “cure”.

 

 

Mastering ADHD for adults – Dr Hallowell’s Game-changing Workshop in London on 30 September

adhdcartoonAnyone who has been touched by ADHD considers US-based Dr Hallowell as something of a guru. And, on the eve of ADHD Awareness month, the Crossley Family managed to persuade him across the pond to talk to those affected by ADHD in the UK. An author of 20 books, a self-professed ADHDer himself, with dyslexia, and a father to two ADHD boys – Ned Hallowell also runs a psychiatry practice in New York, and advocates what he calls a “strength-based” or positive approach to the condition.

At 64, he has some 25 years of experience under his belt, he refuses to see the complex neurological “disorder” as a disability – instead insisting that if he had a choice to have ADHD or not have it, then he’d keep it. Despite dishing out scripts for medication Continue reading “Mastering ADHD for adults – Dr Hallowell’s Game-changing Workshop in London on 30 September”

Dr Ned Hallowell – says it Oh So Simply

UnknownEvery now and then, someone comes along and sums up this complicated condition in such a neat way. Dr Ned Hallowell, author of many books on ADHD, talking more in Additude online magazine this week about Girls and why they often go undiagnosed. In his short video here , he ends by saying something so simple – basically, if your child is underachieving then go and get them tested.

I am sure it may be woefully obvious to an outsider, but to a parent – it is a Very Big Thing, getting your child or teenager tested for a neurobiological disability. Nobody wants to think there is something wrong with their kid, and you don’t want your kid to think  there is something wrong with them either. Especially if – in my case – they are now a teenager and fast growing up. But just as they grow up, so the stakes get higher, with grades and exams counting for more and more, and with their threat of slipping further and further behind.

So Dr Ned has a point – don’t complicate it. If your child presents – as so many ADHDers do (who can seem to effortlessly excel in professions like acting and stand up comedy, where their bundle of traits become a positive rather than a negative) as an articulate, engaged, and entertaining person- and yet woefully underachieves at school – get them tested.

It’s not complicated. It’s just about UnderAchievement. It’s something only a parent or a caring teacher can tell. That’s the only starting point you need for the journey. And if they don’t test positive for ADHD, then back to the drawing board.

Girls with ADHD, underdiagnosed and misunderstood

I knew there were some gender differences between boys with ADHD and girls with it, but I didn’t realised they were so pronounced. This research that appeared in the American organisation CHAD’s newsletter – Attention – gives some idea of how different. Teaching teenage mothers to cook, I often pick up on some of the Learning Difficulties that some of them have, and at least one was ADHD. Teenage pregnancy in young undiagnosed female adhders is often one of the consequences as this article here explains.

Prison, ADHD, and The Mental Health Scandal…

Untreated ADHD for teenagers that don’t have much support (or even a diagnosis) often ends in teen pregnancy for girls, and juvenile delinquency for boys. Undiagnosed, these young kids often seek thrills and danger, and go off the rails, attracted to the mad, bad and dangerous, ending up in prison.

The Guardian piece this weekend documents how the failure of mental health services to identify or deal with the problem early  on is leading to bedlam in prisons, as more and more young offenders are ending up inside without support for their mental health issues. Around 10% of prisoners, 8,000 offenders, are in the nick with serious mental problems, with around 20 per cent having ADHD, depression, bipolar disorder, schizophrenia or autism. All of these conditions are treatable, with medication and behavioural support, and all it takes is a little bit of energy and focus on the individual.

The younger they are treated, the more responsive they are. However, up until 2006, ADHD wasn’t even recognised by the NHS as existing in adults, once children with the condition reached 18 all support vanished. While ADHD in adults is now being slowly recognised, it still takes expert psychiatrists to adjust medication and treat this complex neurological disability.

While the Guardian piece concentrates on the really extreme mental health cases, with inmates who turn to suicide, or murdering their fellow inmates, you can’t help feeling that the headline grabbing cases are just the tip of the iceberg. How many of these bored, frustrated, young offenders shouldn’t be in there at all?

Two charities I am supporting with a bit of time, rather than money is Key4Life and Fine Cell Work . The former is a new charity, which gives young offenders on the outside some intense support to rebuild their life and find work, adopting positive strategies away from the gang culture. The other provides inmates with a sense of purpose and something to do when they are banged up for 18 hours, fingers twitching over the needlework, some of them going on to stitch their way to earning thousands of pounds and saving the money for the outside.

I hope that by the time my teenage ADHDer reaches my age, we will see mental health for what it is. Something that needs support, not punishment.

Until then, we languish in the Victorian era, and as the Guardian headline says: “We are recreating Bedlam”.

Why is Negative So Much More Attractive than Being Positive?

ImageWhy is Negative So Much More Attractive than Being Positive?

I’ve written on this blog before about Kevin Roberts being the poster boy for ADHD and now have completed his rather good book – Movers, Dreamers and Risk-Takers, Unlocking the Power of ADHD. I like it, ironically, because he is so positive about the whole ADHD issue, something that the Neuroscientists like Russell Barklay are not (“It’s a Neurodisability, why dress it up as anything else?”)

One of the more fascinating nuggets to emerge from this book is that ADHDers create negative dynamics in many areas of their lives because “negative information and stimulation weigh more heavily on the brain than positive information and stimulation, thus creating brain activity”*.

As Roberts writes: “I have come to the inescapable conclusion that I feel more alive when I am being negative. Opposing something gives me more juice than supporting it. We ADHDers create negative dynamics in many areas of our lives… Continue reading “Why is Negative So Much More Attractive than Being Positive?”