I'm just back from a wedding, which prevented me from catching Real Time with Bill Maher until today. And I have to say that I'm delighted that I didn't watch it Friday night because I would have been too riled up to sleep. Bill Maher and his guest Arianna Huffington were talking about ADHD (ADD) like experts when clearly they're not.
The subject arose when Maher raised the topic of over-medicated America -- a fair point. Huffington used this as an opening to raise the topic of ADHD. She disclosed that teachers in her children's school had wanted her kids to take ADHD medication, which she linked to the propensity to over-medicate in America. In many well-to-do communities, this certainly occurs, but this is not the whole story. A far larger problem than the over-diagnosis of ADHD is under-diagnosis. As a result, many children and adults with ADHD never get the help that they need, including medication.
As someone who has the disorder and benefits from taking Vyvanse, I feel an obligation to point out that equating a genetically-caused mental health disorder like ADHD with an avoidable excess (over-medication) cheapens the discussion of both. In fairness, most people only know ADHD by reputation, so I thought that I'd share something of the reality. Hopefully, it will explain why medication is so very important to so many people with the condition.
One, the ADHD brain develops in an atypical fashion when compared to the population at large. Those of with the condition are literally wired differently. As a result, many things which most people take for granted are difficult for us.
Two, everyone experiences ADHD symptoms -- e.g., impulse control, inattention and organizational deficits -- at least some of the time. The different for those of us with ADHD is the frequency, duration and depth of these states. In our case, the symptoms are very likely to disrupt our ability to succeed in rather important arenas like school, work and long-term personal relationships.
Three, discipline and routine can help people to control the symptoms of ADHD but are not always sufficient. That's why Vyvanse (similar to Adderall) was such a revelation to me: it has helped me to achieve the capacity to focus that most people take for granted. That's why I take it daily.
Four, ADHD is subtle and therefore easy to dismiss. This is because: there's no single, clear-cut test for ADHD; it's popularly regarded as a childhood disorder; and it's over-diagnosed.
Unfortunately, none of this changes the fact that over 10 million adults have ADHD or the reality that medication can help many of them to lead happier, more fulfilled lives. Of course, if you don't have ADHD, it's hard to imagine what a difference the right medication makes.
Mr. Maher and Ms. Huffington, please continue to discuss ADHD, but first consider using your prodigious and powerful network of experts to get the facts right first. So much focus on abuse can obscure the reality that ADHD medication can help many people lead happier, fuller lives.
Follow Michael B. Laskoff on Twitter: www.twitter.com/mlaskoff
I've been treated for depression for 20 years. Fifteen years of therapy worked wonders. However, I continued to have issues with moods and energy - mostly flat moods and no energy. My gp and I have tried all sorts of different anti-depressants, as well as trying no antidepressants.
Finally, I read Talbot's article about neuroenhancing drugs -- and asked my doctor about Provigil -- he laughed and said that it was for narcolepsy - and I said - let's think this through more. We tried it – terrible reaction.
I went back the next week -- and we talked some more. All of a sudden, a little light went off for him, and my doctor said, maybe you have ADD?? No, no, you can't have that - you have a Ph.D. and are a full professor -- BUT -- you have problems focusing??
Indeed, I said. MY doctor said let's try amphetamines. I said no way - diet pills scared me to death - and we'd never gone there -- in spite of the fact that I am obese.
HE said - no - these are not diet pills - and suggested Dexedrine.
I took one the next day and woke up. It's been about a month now --
Thank you so much for writing such a great blog post. We need more people out there like you to stand up and speak out about ADHD.
Tara McGillicuddy
www.taramcgillicuddy.com
Thanks for stepping up and clarifying the real issues and the issue of speaking out of turn without actual knowledge of which is spoken!
Bryan Hutchinson
www.adderworld.com
It's good to hear, however, that you demonstrated the necessary tenacity to find practical treatment options. For many people, as you exmemplify, behavioral therapy has remarkably positive outcomes on its own.
It has become my passion to spread awareness about ADHD. The pain I suffered undiagnosed is beyond the scope of a comment here; however, I am doing well today thanks to a loving wife who recommended I seek psychiatric therapy (which has a negative connotation on its own). We divorced long before ADHD was finally diagnosed – she became overly critical of my behavior and I felt parented and, yes, ashamed.
I was treated with Cognitive Behavior Therapy. It is important though, to mention that not all therapists are equal. When in therapy many personal secrets and supposed shames come out. It is necessary to feel comfortable with one’s therapist. Additionally, not all therapists are qualified to treat individuals with ADHD. Too many people with ADHD complain about the therapy they have received to ignore this, suffice it to say if a therapist is not trained to treat ADHD, then they should be upfront about that.
I take major issue with wrong information, along with scare tactics about medication, drugging etc… partially because there are incalculable numbers of adults with ADHD that are still going undiagnosed. Too many do not realize that undiagnosed people with ADHD are probably suffering from a life of untold struggles and shame, underachieving. With false or erroneous information spreading, it is possible that many of these people will not allow themselves to be properly diagnosed for their underlying condition of ADHD.
Thank you,
Bryan
www.adderworld.com
As Mr. Laskoff states, it's most likely a genetic trait passed among families.
As a former elementary school principal, I am quite aware that attention difficulties are just the tip of the iceberg. ADHD children can't filter out distractions, finish tasks on-time, use their memory optimally, etc. A pill doesn't teach these skills.
My wife and I opted to use cognitive training for our son, Alex. We used Play Attention (www.playattention.com) and ADHD Nanny (www.adhdnanny.com). We've been very successful with these approaches. We also changed our parenting skills with great success.
It's just important to know that medicine teaches nothing. Parents and teachers must actively participate to help change a child's life.
And, technically, ADHD is not considered a mental illness; it's a developmental disability. Yet, about 75% of adults with late-diagnosis ADHD have co-existing conditions (anxiety, depression, OCD, substance use disorders, etc.); partly, this is attributed to neurogenetic underpinnings but partly it is from the stress of living with undiagnosed ADHD.
Today's children are lucky to have a wealth of strategies that their parents can take advantage of. Mostly, they can grow up knowing how they are "wired" and not have their problems compounded with shame and stigma.
It's great that you are finding strategies that work for your child. But please keep in mind, the jury won't be in on your success rate until your child is an adult and you can see how well these strategies took root. Many parents will provide super-structure for their children with ADHD, eschewing medication, but when their children leave the nest they find they have no internal structure. Then they look back and regret their decision.
And, I must correct you that "medicine teaches nothing." It is shocking to hear from someone who says he is a former elementary school principal. For many children and adults, the medication gives them the ability to focus, learn, integrate, prioritize, and manage their attention. Without medication, they often have to repeat and repeat and repeat -- and still sometimes never learn.
Over-medication is a real problem, but it shouldn't be allowed to obscure the help offered by medication.
As to the disparaging remarks, I can only say that so long as you don't as you don't use ADHD as an excuse, you should hold your head up high. You've got enough enough on your plate without losing sleep over how the uninformed perceive you.
When they finally get a formal diagnosis, which can be done by a psychologist and is very expensive ($1000 plus), they still struggle with the stigma created by people who focus too much of the over-medication or who see it as a mental disorder. As a result, many are afraid to ask for help at work, there some very simple tools and strategies could make a world of difference. There have been 1000s of research studies that prove beyond a shadow of a doubt that ADHD exist and can be helped with medication, along with self-management skills to learn to live their life as ADHDer. Their brain wiring is different, it's normal that their strategies for doing things will be different. We know that while pills don't give skills, like glasses when you suffer from myopia, it will help you "see" better so that you can begin to improve your life dramatically.
When I went to school, parents new how to discipline their children; schools new how to insist on attention, and parents didn't interfere. How easy to prescribe mind altering pills to children who could change their brain pathways through behaviour modification.
Wired differently, you say. Recent research on neuroplasticity has shown that no one is hardwired. Brain pathways are created by behaviour and can be changed.
Thankfully, so far doctors don't reach for prescription pads to prescribe alcohol and street drugs, yet they calm people down too -- just as your prescription calms you down. It's all too easy, Mr. Laskoff, to excuse scattered behaviour patterns by wrapping them in an invented disorder to be treated with dangerous drugs -- the easy way out.
Anecdotal demonstration of my point is as simple as the results shown on that show, "The Nanny." Badly behaved ADHD headed children changed by firm, yet not abusive, discipline almost overnight.
Ten million people in the US with ADHD, a disorder that did not even exist a few decades ago. A shameful scandal.
Thank you for the constructive response. I only wish that I had answered as well.
MBL
(1) ADHD has been acknowledged as a condition for close to a century, albeit under different, less complimentary names.
(2) You must have gone to a very special or small school if not one student showed any symptoms of ADHD. (Is it possible that you simply were not sufficiently aware of the symptoms?)
(3) Neuroplasticity is not infinite. The brain can adapt marvelously but that doesn't always make for permanent change in ways that we'd like. That's why stroke victims don't always recover fully.
(4) Amphetamines are many things, but they are neither mind altering nor comparable to street drugs.
(5) "The Nanny" is entertainment, not science.
You have a right to your opinion, but your beliefs and fact are not necessarily the same thing.
Pot works great because when I'm high I don't care wether I am unfocused, undisciplined, and unproductive.
To be clear, Vyvanse does not work for everyone, which is why a skilled pschopharmacologist is essential when it comes to finding the best treatment option. Unfortunately, not many people have access to such professionals, which is why so many people end up taking medication that does not have the intended result. That's tragic because there are currently lots of options that can be tried.
I'm not moralizing. As far as I'm concerned, you should stick with the weed for entertainment. That said, don't confuse feeling fuzzy with treating your ADHD.
I work in psychiatry and I know for sure that ADHD is under-recognized and under-treated by most psychiatrists. When I was in school, it was discussed only very briefly as a childhood disorder.
To Sandy, I'm sorry about your son. 30 years ago, serious treatment for ADHD was just getting started and the available medications were short acting. Prescribers recommended stopping and starting medication and giving medication for school only. For many young people, it's outside school that they need the most help learning to manage and organize themselves.
And, dextroamphetamine is NOT the same thing as methamphetamine. That's like saying a cantaloupe and a watermelon are the same.
To learn more about ADHD as a disorder of executive function, I recommend that you read the work of Thomas E. Brown, PhD at drthomasebrown.com. Arianna and Bill, I recommend that you read it too.
Thank you for the kind words and for pointing out that the product of meth labs and FDA approved pharmaceutical plants are not one and the same. To your suggestion, I would also add that "Delivered from Distraction by Hallowell and Ratey is a great starter source of information.
I did not mean to insinuate that adderol is not helpful. Yes it can be, but not everyone who has this ADHD problem are able to cope as well as you. My son and others I know simply overdid it, like they did everything else. His other addictions were gambling and motorcycles. I am glad that it worked for you.
NO, Adderall is not methamphetamine. That is like comparing a pea-shooter to an elephant gun. But many people who need ADHD medication instead resort to methamphetamine, and it is a tragedy.
If you could have tried harder and didn't, perhaps you have ADHD as well. I don't mean this to be insulting but to point out that it takes a very focused parent to best help a child with ADHD. And the genetics are such that a child with ADHD has 24 times greater odds of having a mother with ADHD than do chidlren who don't have ADHD. I don't have the figures on fathers. But it's also high.
ADHD is a family-wide problem, and it takes careful attention to treat adequately, not one pill.
Gina Pera, author
is It You, Me, or Adult A.D.D.?
http://www.ADHDRollerCoaster.org
Just wanted you to know so you would not think I was pulling a Tom Cruise on you. I know that medication is invaluable but in my son's case, it was not the answer. Everyone has to choose what is best for them.
I knew a young woman whose two sons were diagnosed with ADHD, and their doctor told her that she herself was probably ADHD. She was medicated, and her life changed completely. Those times of disorientation were controlled; she could plan things, complete projects, and best of all cope with her sons.