In light of a discussion on a "possible solution to add", with everyone talking about how there is no such thing because it hasn't been formally documented or whatever, I just wanted to point out that add isn't a condition like how Parkinson's disease or color blindness or whatever is. Many of my friends say that everyone has add to a degree, and while that may be true in describing the general characteristic of add, having add is simply having a pronounced, worse condition of having the general symptoms of "forgetfullness" or " not paying attention at some given time". Some authority person said that add is just like having a low level case of alzheimers, and I believe that. Dr Amen has shown that certain brain parts act abnormally in adders.

The significance of what I said is that it is a pretty general condition, which is probably why so many people are misdiagnosed. I notice that on days where I get poor or inadequate sleep, my symptoms are way worse.

So don't treat it as if it is simply a condition with a rigid treatment solution, because it's not.

... having add is simply having a pronounced, worse condition of having the general symptoms of "forgetfullness" or " not paying attention at some given time"...

ADDers have less control over how long they are paying attention. ADDers are more likely to "blink" unintentionally in situations requiring prolonged attention (such as taking notes in meetings, reading, etc.) Many people don't believe in ADD because they do not understand what the problem is (as they do not experience certain problems, such as distractability and forgetfulness to the same degree).

I don't like the notion that ADD is compared to a low level of Alzhiemers. I happen to have an excellent long term memory, but a poor working memory. Sure, I may get up out of my seat, start walking, and forget what I was going to do, several times a day, but I can remember events from the past with good accuracy. Plus, if we forget to do something, is it always "forgetting"? One may forget to do something, but if reminded, they can remember what it is that is needed to be done. I would say part of the forgetfulness is lacking an internal scheduler.

The journal article entitled International Consensus 2002 is generally regarded as the single most definitive research paper on the existence of ADHD.

It is signed off on by over 80 of the world's leading scientist's and also contains the best operational definition of what constitues a "disorder."

I don't have my copy with me but I believe this will be very close to a direct qoute:

"ADHD has been recognized as a medical condition/disorder by the American Medical Association,American Psychiatric Association, American Academy of Pediatrics and the American Psychological Association." (p.89)

You can view the article at www.chadd.org and also at Russ Barkley's site.

P.S.

ADHD is among other things, a brain based disorder, as well as a neurobiological disorder. Complicating matters though is that it is also classified as a "dimensional disorder " in that most people do show the symptoms to a certain degree at some point in their lives.

However, what separates them from those of us with ADHD is "impairment in daily life activities" that create "harmful dysfunction."

In light of a discussion on a "possible solution to add", with everyone talking about how there is no such thing because it hasn't been formally documented or whatever, I just wanted to point out that add isn't a condition like how Parkinson's disease or color blindness or whatever is. Many of my friends say that everyone has add to a degree, and while that may be true in describing the general characteristic of add, having add is simply having a pronounced

You bring up several good points. Parkinson's, I believe is a disorder, and there is no blood test. There are many disorders which you can't do a blood test for. That would include Major Depression, BP, Schizophrenia, Autism, Tourettes, OCD, and the list could go on and on.

Do you ever feel depressed? Do your moods ever swing? Do you ever feel slightly crazy, tuned out, compulsive, or do you blurt something out which you didn't mean too.

Hmmm...so everyone has the above disorders also to a degree...yet we accept them as true disorders because the behaviour is extreme while ADHD behaviour is more normal.

I work with ADHD kids everyday, they are different. I believe that this just isn't an exaggerated or pronounced trait....just like BP isn't. I believe that there is something else going on here.

ADD is a lot of things to a lot of people. For some it is merely a personality quirk to others it has effectively destroyed their lives.

The incessant debate over what is or is not ADD whether it is "real" or not is detrimental to the lives of many myself included. It is irrelevant if it is termed ADD, ABC or QRX.

The fact that it is compromised of normal behavior that everyone exhibits detracts from the seriousness of the condition. These behaviors are "normal" what is not is the extent and severity of them and the negative impact they have.

Various behaviors both concious and autonomic are controlled by differant regions of the brain. I'm right handed but the left hemisphere of my brain controls the right hand and vice versa.

Speech and language are controlled by Broca's and Wernike's areas of the brain.

The frontal cortex is the repository for many of the behaviors that we need to function in a civilized society including planning, impulse control. organization. The ability to plan etc.

If for whatever reason a portion of the brain is not functioning properly it impacts the behavioral characteristics or autonomic functions associated with that area.

Their are a wide variety of ways that the basic functioning of the brain can be altered. Chemicals can alter our behavioral patterns. Both those ingested and those naturally occuring.

Unless someone lives in a void everyone has experienced altered behavioral patterns. If you have gotten drunk, drank too much coffee or have gotten an "adrenaline rush" due to a scary or intense experience.

People have suffered brain injuries in accidents and their entire personality has changed such as the famous case of Phineas Gage
http://www.deakin.edu.au/hbs/GAGEPAGE/

So ADD, ABC or QRX or whatever is a real condition. It's real for people like myself who has to deal with it. And it should be "real" to anyone who has a brain themselves and has the ability to reason.

All the theories, and uneducated opinions, and the scoffing and disbelief can be dispelled with a very simple equation

behavior=brain+brain not working properly="normal" behaviors affected=REAL CONDITION

So one last re-iteration for the edification of the cognitively impaired. The brain controls behavioral function, for some reason yet to be conclusivley proven people who have ADD have a dysfunction in a portion of their brain. The fact that these are normal behaviors and should be so easy to rectify makes it even more distressing.

The portion of their brain thus affected is probably the frontal cortex. Due to this they/I experience great dfficulty with seemingly normal mundane behavior. Such as:
1.Procrastination
2.Organization
3.Concept of time
4.Keeping Track of things
5.Attentiveness
6. Doing Paperwork
7. Planning
8. Forethought
9. Being Absentminded
10. Impulsiveness etc etc etc


The financial and emotional devastion that has been wrought by ADD is incalculable. The fact that they are seemingly benign behaviors make it harder to deal with because the mind tries to rationalize it. It can stretch a persons sanity to the breaking point, being your own worst enemy.

I think it is sad and rather unfortunate that a "condition", "disorder", "mental illness" such as ADD should be the subject of such ignorance, ridicule and scorn. Not only in society in general but in the medical community as well.

And I myself was just as guilty despite the fact that I could be the poster boy for it. In law if the facts of a case are so compelling it is known as a "prima facie" case. Prima facie is Latin for "first face". ADD is a prime example of a prima facie case. The evidence is clear and compelling "on it's face". Just the verdict as to the root cause or causes is not in.

Mike,

That was very well articulated. Thanks.

Phineas Gage is considered to be among the first documented examples of "acquired ADHD," however, there was a lot more going on that just that.

Russ Barkley described ADHD as a "devastating disorder" and I agree with that.

All you have to do is look at the documented risk factors for not treating ADHD (this refers specifically to the Hyperactive-Impulsive and the Combined types only ) and it becomes self -explanatory.

One research study that I've seen discussed before at 2 different workshops indicated that for non-medicated ADHD kids, only 22% graduate from high school.
Of that 22%, only 5-10% go on to complete their higher education (college, tech school, grad school, etc.)

I happen to be a part of the latter group as I wasn't diagnosed until age 22.

Sandra Rief's book The ADHD Book of Lists (2003) has a section devoted to the risk factors, followed by references .

I think to main reason to try and spell out what ADHD is and is not, is to help educate people .That can hopefully help empower them to become better advocates for themselves and their families.

Mike, I'm totally with you on this one. I can hardly even stand life anymore. As I'm a college student, I have to study a lot. But what happens when you can't comprehend what you read? That's what it's like for me. Ironic and incredibly frustrating. Without adderall, I'd be a zombie, but I hate having to depend on it. Is there anything else we can do for our deficit in frontal cortex ability? I suppose I'll start trying to look for any nutritional deficiencies, but the requirements seem terribly broad..

I appreciate the compliment. Especially as I am in the former group high school drop-out ninth grade education.

I expressed a wee bit of anger in that last post due to my own experiences. I fall in to the devasted category as well as the uneducated.

While the general disbelief in adult ADD can be somewhat disconcerting, I believe the main issue is the manner in which ADD is handled by the medical and mental health community.

I especially take issue with the diagnostic criteria as presented in the DSM. The rigid guidelines for diagnosis are in my estimation dangerously simplistic and naive. There is more than one way to bake a cake and their is more than one way to manifest the symptoms of ADD.

The "must have had exhibited these symptoms by age 7" is exemplary. Someone who reads that may dismiss the possibilty of having ADD. I also believe that many people don't receive the proper help. Many seek out the services of a therapist of the wrong discipline. Only to be treated to psychoanalytic hogwash promulgated by a man who was obsessed with sex and extolled the virtues of cocaine.

I wonder how many people are out there going to therapy talking about the puppy they had when they were 6. When the underlying cause of their misery is a neurological disorder.

I personally don't believe ADD is a mental illnes it a neurological disorder. As for the application of the term "normal" I believe having ADD doesn't warrant an automatic exclusion from the "normal" club. Especially in consideration that many who have ADD are cognizant of their behavior, distressed by it to a varying degree and try to change it.

Mike, I'm totally with you on this one. I can hardly even stand life anymore. As I'm a college student, I have to study a lot. But what happens when you can't comprehend what you read? That's what it's like for me. Ironic and incredibly frustrating. Without adderall, I'd be a zombie, but I hate having to depend on it. Is there anything else we can do for our deficit in frontal cortex ability? I suppose I'll start trying to look for any nutritional deficiencies, but the requirements seem terribly broad..I'm not in the advice department especially since I could use some myself. I can however draw from my own experiences and make some common sense inferences upon whats presented.

1. You would be suprised what you can handle in life.

2. Alot of college students without any underlying malady have a tough go of it.Maybe you have taken on to much. You could possibly drop a course or two.

As far as reading I'm a bookworm but If I am forced to read something I don't enjoy or at least find mildly stimulating my comprehension stinks too. Maybe you should adjust your curriculum to find topics more interesting.

And it never hurts to have a back-up plan. I was self employed in my early 20's. Being a disorganized procrastinator isn't exactly conducive to business success. A civil service job would have been a decent back-up. But being king procrastinator I never took any tests.

There are a wide variety of civil service positions that can provide you with a good living and a comfortable life and just as important structure and stability.

A trade is also another viable alternative. A lot of plumbers make more than lawyers. And a trade like plumbing can never be outsourced.

And last but not least don't despair life is in a constant state of flux. You may meet somebody decent who can have a positive effect on you. You may discover your true calling and find a job that your passionate about.

And as far as ADD I do not believe that it is static I believe the ability to deal with it can improve. The extant and severity of it is also dictated by the circumstances of your life. A lot of college students are stressed And being cognizant of it as you are is also a major plus.

I also believe that many people don't receive the proper help. Many seek out the services of a therapist of the wrong discipline. Only to be treated to psychoanalytic hogwash promulgated by a man who was obsessed with sex and extolled the virtues of cocaine.

I wonder how many people are out there going to therapy talking about the puppy they had when they were 6. When the underlying cause of their misery is a neurological disorder.Mike, I agree with you. I think there are a lot of AD/HD folks getting pretty useless therapy trying to fix what isn't wrong. After I took my first medication it was such an "Oh brother!" experience for me -- "You mean this is how the other 95% experience things. All the exploring supposed childhood issues that didn't happen and this was just a neurological thing all along." I made more progress (husband who has a very low opinion of therapist in general even agrees) in the first six weeks with an AD/HD trained therapist after I started meds than I did in years of prior counseling that tried to get at the "root" of the problem. Oh well, better late than never!

It also bugs me when people condemn medication who have never been in my shoes. Can they really make an informed opinion when they have no idea how hard it is to stay balanced emotionally, do all the everyday things people do, and try to appear normal and have no idea why it is so hard and what you're wrestling with? When they have no idea what a relief it is to feel your body finally relax as you turn down the internal and external constant assaults on it, so that you don't feel you have to swim so hard constantly just to avoid drowning in something you can't even see?

Scattered

ADDers have less control over how long they are paying attention. ADDers are more likely to "blink" unintentionally in situations requiring prolonged attention (such as taking notes in meetings, reading, etc.) Many people don't believe in ADD because they do not understand what the problem is (as they do not experience certain problems, such as distractability and forgetfulness to the same degree).

I don't like the notion that ADD is compared to a low level of Alzhiemers. I happen to have an excellent long term memory, but a poor working memory. Sure, I may get up out of my seat, start walking, and forget what I was going to do, several times a day, but I can remember events from the past with good accuracy. Plus, if we forget to do something, is it always "forgetting"? One may forget to do something, but if reminded, they can remember what it is that is needed to be done. I would say part of the forgetfulness is lacking an internal scheduler.that description was very good. yep that's it..i feel wierd today.

that description was very good. yep that's it..i feel wierd today.Sorry you feel weird today. The description is good. I really relate to that lack of an internal scheduler. It's like people will look at me like there's something I'm suppose to be doing, and I'll feel guilty but still be pretty clueless about what's suppose to be on the schedule now.:confused:

Scattered

I personally don't believe ADD is a mental illnes it a neurological disorder. As for the application of the term "normal" I believe having ADD doesn't warrant an automatic exclusion from the "normal" club. Especially in consideration that many who have ADD are cognizant of their behavior, distressed by it to a varying degree and try to change it.
Great stuff, Mike. I really enjoy reading your posts.

Diagnosing ADHD in adults is different in than in kids. With adults, you have to "age reference" the symptoms, as the oldest subject in the sample population was 16yrs old.

So for adults, "fidget and squirm" may translate to "workaholic." There are a number of other age reference examples at the office.

Also, the older the person becomes, the fewer the symptoms needed to substaniate the diagnosis.

Remember, you're comparing the person with their own developmental stage. You're also looking for "impairments in major life activities" that create harmful dysfunction.

For adults, as well as kids, "checklists trump tests." The best checklists are supported as being both valid and reliable measures of ADHD.

No test is perfect but the other types tests like IQ and neuropsych memory tests have not been shown to produce scores that carry over into real world (ecological validity), as actual measures of Executive Functions.

Having said that, if you'd please go to the now closed thread on .."Here's the Proof," not the one thats still open , you'll see one of my last few posts goes into some detail as to how the symptoms were empirically derived over time.

You may not like them but they are based on solid research that allows them to be used in the first place.

There are a number of shortfalls that I fully expect will be addressed whenever the next one comes out. The bottom line is they're all supported by research. If not, they wouldn't be in there.

When evaluating adults, the best checlist is the Conners ADHD Adult Rating Scale or the CAARS.

The difficulty is that research has shown that adults with ADHD actually under report their symptoms because they've lived with them for so long that they seem "normal."

Thats why the more people (family members, spouses/significant others ) you can get to also fill those out, the better.

In addition, its important to know about prenatal care, as even nicotine use has been sighted as being a potential high risk factor for childhood learning problems.

How a person did in school growing up is very important as well. For example, when I'm evaluating kids for ADHD, one of the first things I look for is the use of the word "always." That implies "from an early age."

Then you look for examples of impairments in major life activities.For example, did the person repeat a grade or did they drop out even tho they're bright?

How many jobs have they had over the course of their lives, as well as how many driving accidents or tickets/suspensions /revocations ?

People with ADHD have trouble holding a job (if untereated ) and will make less money over the course of a life time; again without treatment (meds).

Thats kind of a synopsis, but the bottom line is you want the evaluator to know what works and what doesn't.That means they're keeping up with the research, as that's the essence of an "evidenced based practice."


Ive got more info on this but Im getting tired and need to take a break. Hope that helps .

mctavish23 (Robert)

Ive got more info on this but Im getting tired and need to take a break. Hope that helps .

mctavish23 (Robert)Thanks once again, McTavish for taking the time to enlighten us. It is appreciated! Boy, I wish I could send my husband for an evaluation -- you just described him to a T. But getting him in for a AD/HD history and assessment will probably never happen, since he doesn't want to know. Bet you didn't know dyslexia could cause all those same symptoms:rolleyes: -- if you don't believe it just ask him!;)

Scattered

I had started to post this in the (now closed) other thread of the same name, but got sidetracked

These are the rest of Sandra Rief's references regarding the research findings and etiology of ADHD. I believe I already posted the first 2, so I'm just going to continue where I left off.

This is from Section 1-7 of The ADHD Book of Lists and encompasses pages 22-24.

Ellison, Anne Teeter. "Research Update: Recent Scientific Findings," CHADD:Attention,vol.8,no.4,February 2002,15. (attention@chadd.org)

Fine, Lisa." Research:Paying Attention," Education Week,May2001. (http://www.edweek.org/ew/ewstory)

Goldstein,Sam. "The Facts about ADHD: An Overview of Attention-Deficit Disorder Hyperactivity Disorder." (http://www.samgoldstein.com/articles/9907.html)

Harman, Patricia."One-on-One with Russell Barkley,CHADD:Attention,vol.6,no.4,March/April 2000,12-14. (attention@chadd.org)

Jensen,Peter S. "AD/HD: WHat's Up,What's Next? CHADD:Attention,vol.8,no.6,June 2001,24-27. (attnetion@chadd.org)

Lombroso,Paul,Larry Scahill and Matthew State. "The Genetics of Attention-Deficit,"CHADD:Attention,vol.5,no.1,Spring 1998, 25-30. (attention@chadd.org)

MTA Cooperative Group. "A 14-month Random Clinical Trial of Treatment Strategies for AD/HD,Archives of General Psychiatry,56:1073;1999.

Nadeau,Kathleen and Patricia Quinn. "Future Directions in Understanding Girls and Women with AD/HD," ADDvance,vol.5,no.3,February/March 2002.

National Institute of Mental Health ADHD reprint (http://www.nimh.nih.gov/publicat/adhd.ctm)

Ringeisen,Heather. "AD/HD and the National Institute of Mental Health:Where Are We Now and Where Are We Going?" CHADD:Attention,vol.7,no.3,November/December2000,10-13. (attention@chadd.org)


Now, those are the ones I promised to finish.They coincide with the now closed (other) "Heres The Proof" post from 9/1/05 in Adult ADD on page 5.


I believe that these references could fit into either the 2nd No Scientific Basis: Here's the Proof," or what add is.

Before going further, I'd like to comment on something that I've seen for years,both in ADD Support chat in Yahoo,as well as in here.

These are my own observations based on several years of (anectodal ) experience.

People who come in to criticize for the purpose of "debunking ADHD" almost always say the same thing about CHADD. They give this same lame mantra about refusing to recognize anything from Attention magazine or anything with their (CHADD) name on it because it's somehow not valid or biased in a way that distorts the information. The underlying implication is that its all lies and that the info can't be trusted.

Having said that, they then go from irrational to deliberately passive-aggressive by refusing to read any of the articles.

(Rational thought/behavior is grounded in scientific proof. Irrational thought/behavior isn't. It thrives on (unproven) assumptions, innuendos and myths).

That ultimately serves several different purposes: 1) it guarantees that they won't have to admit being proven wrong on their position(s) because they never read the material in the first place; 2) they can continue to take a "holier than thou" posture by not "lowering themselves "to the contaminated level of the biased info.

What that does is to create an "illuson of conspiracy," which, in turn, tries to cast a negative light on the science behind ADHD.

The articles I've read in Attention and the references given are primarily well known, highly respected ,mainstream researchers.

In many cases, Attention is simply reposting a journal article for parents to read;as they are not likely to read professional journals.

In other instances where researcher/authors have been asked to do articles or be interviewed, they're going to cover whatever their research interests are at the time. (None of which is inappropriate).

The (rational) reality is that this is about research.

I know that there have been criticism of the MTA study, as I've read it and the follow up study.

I believe the point Sanda Rief is trying to make here is to present an overview of the topic entitled : What The Research Is Revealing About ADHD.

These are my observations after multiple 'debates" and "discussions" with people who, for whatever reason, seem to be looking to discredit the science behind ADHD.

There are legitimate criticism to be sure and there ones with hidden agenda's. In most cases you don't really know which is which.Either way, it always comes down to the research.

I'll leave you with something Russ Barkley reported at the Medical College of Wisconsins 2003 Door County Summer Institue.

He mentioned either 2 or 3 (I don't have my notes so Im not positive) researchers who reportedly came forward and made complaints against the Church Of Scientology for allegedly threatening to cut their research funding if their findings didn't coincide with their (church's) beliefs. Apperently,these individuals reportedly did honest work and it didn't support the church's position.

The problem is you never hear about stuff like this.

Thanks for taking the time to read this.

take care

mctavish 23 (Robert)