Thursday, September 23, 2010

ADHD: Take 3, To Med or Not To Med

TO MED OR NOT TO MED?

I have heard a variety of opinions regarding ADHD and medications. I have heard the argument that medications, like Ritalin, have serious side effects, such as the potential for seizures. I have read research suggesting such medications can cause a person to lack creativity due to the effects on that part of the brain (I am guessing they mean the right side of the brain). I have also heard the other side, parents and doctors suggesting to anyone and everyone who is struggling with anything should “get on some good meds because there are great medications to help make everyone’s life easier. I find this conversation especially true with parents who are looking for some parental relief rather than seeking the best interests for their child.

I don’t know the best answer. I am glad I chose a profession that does not write up prescriptions. Please hear me! I stay mostly neutral on the subject of meds. I am uncomfortable with the idea of putting a child with ADHD on medication the second they are diagnosed. I am also uncomfortable seeing a child who is struggling to adapt and cope with anxiety and frustrations when some medication could potentially make a world of difference. I have seen both extremes.

As a licensed counselor, I believe we need to take a holistic approach to ADHD. According to research done by Dr. Daniel Amen, we should consider our child’s diet. Are they eating an over-abundance of sugar or caffeine? Are they getting enough vegetables and protein? We should also consider the amount of physical exercise our child is getting. Do they get out and walk, ride their bike, play games, swim, cross-country ski, or go on long hikes? Or, instead of exercising are they spending more than a half-hour playing video games? Also, we must consider vitamins, and other supplements like fish oil (omega 3), Multi-Vitamins, Vitamins B, C, and D. If your child is having difficulty sleeping at night, have you tried giving them three mg’s of Melatonin? It is not a medication, but a nutrient that provides a sleep hormone.

The problem with medications is too many people jump to medications without taking a holistic approach to see if there are other ways to cope with ADHD. I believe more often than not, people are lacking in exercise, adequate sleep and appropriate diet, which can make one’s ADHD more difficult to cope with. If the individual is sleeping well, exercising regularly and eating healthy and still struggle to pay attention and complete tasks, one might consider talking with a psychiatrist or doctor about getting on some medication. I will caution, if you talk with a family doctor about prescribing medication, get some consultation from a psychologist or licensed counselor regarding the type of medication and dosage. I have seen family doctors be very quick to prescribe medication without knowing anything about the psyche or emotional state of the patient.

I have very good friends in the mental health work who believe all ADHD medications have side effects that are not worth the risk. They are convinced if individuals with ADHD exercise and eat right they will cope well enough to adjust. However, when I was in high school I was in great physical shape. I played basketball, soccer and ran in a cross-country race one time because they needed an extra person. I still struggled to concentrate on school and life. I believe there are situations when a person will rule out all the other coping options and be at a place where they could use some medication.

Thursday, August 26, 2010

ADHD In The Classroom

I believe our western culture concentrates itself on academic success and excellence. Many schools will display the phrase, “Knowledge is Power” on their hallways and in their classrooms. They love the student who is compliant, sits still in class and scores high on exams and papers. The individual with ADHD typically does not excel academically. Some with ADHD have high IQ scores. I have heard parents say, “I just don’t understand. He took an IQ test and he scored extremely high, but he just doesn’t apply himself at school.”

I heard Dr. Tony Atwood describe life at school for a teenager with Asperger’s Syndrome. He said, “When they are at school, they are performing. They are not made to sit still, be quiet and listen for 7 hours.” I believe the same is true for those with ADHD. Our school classrooms are set up for the “gifted” student. (By gifted I mean those students who easily excel the academic system set up in our western culture schools. As I said, people with ADHD are also gifted, just differently.)

One important fact we need to remember is students with ADHD excel in more non-traditional settings. They often like noise in their studying environment rather than silence. It is not uncommon for them to prefer a chaotic mess in contrast to an overly clean and calm homework setting. Yet, they do need some structure and routines. They also learn more quickly when they experience learning. For example, my junior year of high school our class took a trip from Lansing, Michigan to Gettysburg, Pennsylvania. Being on the spot where the battlefield took place helped us to grasp what it looked like and how it all happened at the actual battle. Standing at the place where President Abraham Lincoln gave the Gettysburg Address brings more meaning to his speech than reading it in a textbook. As a teenager with ADHD would say, “Civil War textbooks got nothing on being at Gettysburg.”

When I have a client with ADHD who is failing school, I listen to their frustrations, and empathize with them. I tell them I understand how frustrating it is to have a teacher who expects you to think, behave and perform exactly as they do when they learn. I understand how frustrating it is to have to learn about different sciences or math problems you will never again in your life practice. However, I also explain it is necessary for them to go along with it for the time being. For those of us with ADHD, sometimes we have bigger mountains to climb than others. Is it fair? No! Yet, the consequences of blaming society, teachers and our school systems will not help us graduate and cut corners in life. We must sustain and learn the way others learn for now.

Thursday, June 24, 2010

"OH LOOK, A CHICKEN"

“OH LOOK, A CHICKEN!”

A friend gave me a t-shirt for my birthday one year that said, “People say I have ADD, but they just don’t understand…Oh…look, a chicken!” I was never without a comment whenever I wore that shirt. I remember standing in line for the Millennium Force ride at Cedar Point, watching the enjoyment of others as they endured comic relief in a two hour long line for a ride that lasted less than five minutes.

I don’t know what happened to my favorite t-shirt. The last time I remember wearing it was on a bike trip in the upper-peninsula of Michigan. I heard many of my bike team members tell me I better keep an eye on it, as they might snatch it from me when I was not looking. They loved my t-shirt as much as I did. It was in high demand. Why? I don’t know. Maybe their infatuation with my shirt had something to do with their ability to relate with it.

This begs me to ask the question, are there a large number of people with ADD/ADHD? Then I must ask myself another important question. Are there really that many people with ADD/ADHD or is there an over-diagnosis? Are people looking for a “quick medicated fix” for their children or do they really need some pharmaceutical assistance?

Over the next three weeks, I will attempt to address these questions. ADHD is a diagnosis in the DSM-IV, soon to be DSM-V. It describes the individual who has difficulty paying attention to details, sitting still and completing tasks, as well as many other challenges. Why is it a diagnosis? Maybe so counseling agencies can give a report on the progress a client with ADHD is making in therapy.

I am not so concerned with the diagnosis. I believe it is culturally biased. Am I saying there are no individuals who have ADHD? Not at all. People with ADHD should be seen as those who are gifted differently in a culture that loves systems, details, timeliness and anal-retentiveness. Truthfully, they are often the most compassionate people. I have worked with teenagers for over 20 years. I love them. They are energizing, interesting and unique. I often have more fun with teenagers than adults. They are some of the most misunderstood people in our western culture. I especially enjoy teenagers who have ADHD. I remember a time when I had broken a pair of sunglasses at a teenager event. One of the “extreme” ADHD boys in the group picked up my broken shades and said with great enthusiasm, “I can fix them. Really! Can I please?”

If I were to write a book about ADHD I would call it “Being ADHD in an Engineer’s World!” I live in Oakland County, Michigan, where many engineers reside. Engineers have transformed our society. Where would we be without the automobile, telecommunication and the opportunity to fly across the country for work, pleasure or to visit friends and family? Yet, if one ever spent time with an engineer, or tried to work with one, you have to be able to speak their language. Some are the epitome of anal-retentiveness. Some are addicted to structure and they have a mistress called “how do you get from point A to B to C?” Sometimes it seems like one can never have a normal conversation with them. There has to be a purpose. They do not have time for small talk.

People with ADHD have difficulty coping in a world that demands structure and does not allow “down time” or “free time” to let loose. I am often entertained by the conversations and conflicts between engineers and those with ADHD. They have to discipline themselves to even understand the other person. It is especially tough for those with ADHD because society and culture seem to value the engineer ahead of them. The engineer is not any more valuable than the individual with ADHD, nor is the ADHD person any more valuable than the engineer. Fortunately, for the engineer, society values their role in our culture. Not always does our culture value those with ADHD. How do I know this? Those with ADHD have been given a diagnosis, a label. They are treated as with a disorder when they should be treated as people who are gifted differently. Yet, they must cope with and learn to adjust to society rather than blame them.

Next week I will address ADHD in the classroom and the following week I will discuss ADHD medications.