And, with all due respect, those who gget the best results with drugs or therapy are also those who predominately are doing prettty well to begin with. That is, the "diagnostic requirement" of impact in personal, work or school, etc, concurrently is somewhat a stretch.

Though clearly ADHD, a person who is employed successfully in say, counseling, having attained an advanced degree and survived starting one's own business or getting appropriately hired, is NOT an example of severe dysfunction in ANY of those things. Add married with children, and the "areas of demonstrated dysfunction" are vastly reduced.

Simply, if these people are helped by drugs or therapy, how would one know? the change from incompetent to conduct a successful social life, sexual relations (in a marriage relationsship), work, are already in the succesful range before starting!

Show me failures who are turned into successes! then THAT I will beleive is a treatment that "works."

quote:Originally posted by tudorose
I also don't agree with the medication argument. If I was not on drugs I would not be able to function. I don't mean that lightly either. I would not be able to work. I would not be able to function in any capacity as a wife or mother and my life would be crap.

Subjectively I don't challenge your impression of the significance and imprtance of the medications in your life. What I was challenging was objective SIMPLE measures changes or the lack thereof.

I have to suspect that I am missing something in my understanding of this rebuttle.

Is it the premise, the conclusion, the test, or the counter example or the argument that you take issue with, or all of them?

Originally posted by Wheel1975

Show me failures who are turned into successes! then THAT I will beleive is a treatment that "works."



Matthew - Age 9. Diagnosis - Autism & ADHD -
medication - toffranil - dexamphetamine

Failure to success

Matthew could not understand let alone express his emotions. Holding a coherent reciprocal conversation with him was not possible. Learning was difficult for him. He was overwhelmed at the slightest triggers.

Now he can hold such good conversations that people who don't know him don't even know he's autistic. He can understand and express his emotions better and he can tolerate more stimuli than before.

Before if I compared Matt to other autistic kids he seemed to not be as advanced. Now he is more advanced than most of the autistic kids that I meet.

Originally posted by Wheel1975
And, with all due respect, those who gget the best results with drugs or therapy are also those who predominately are doing prettty well to begin with.

Though clearly ADHD, a person who is employed successfully in say, counseling, having attained an advanced degree and survived starting one's own business or getting appropriately hired, is NOT an example of severe dysfunction in ANY of those things. Simply, if these people are helped by drugs or therapy, how would one know? the change from incompetent to conduct a successful social life, sexual relations (in a marriage relationsship), work, are already in the succesful range before starting!

Show me failures who are turned into successes! then THAT I will beleive is a treatment that "works."

quote:Originally posted by tudorose
I also don't agree with the medication argument. If I was not on drugs I would not be able to function. I don't mean that lightly either. I would not be able to work. I would not be able to function in any capacity as a wife or mother and my life would be crap.



David: This is just a guess -- but am I correct to conclude from these statements..and others you've made in these forums....that you believe that in order to get "well" from ADD and whatever meds one is on -- that one has to almost be "well" to begin with? And that unless they are already on the "successful" path before starting meds -- then they cannot get "well"?

In my opinion this type of thinking is almost a "setup" for failure before one has begun. It implies that the "cure" must be there before meds are taken....that one must have have it "all together" before they start.

I believe anyone seeking treatment has to start SOMEWHERE....And at the bottom is okay.....And at the bottom IS a good place to start for many.....Before they've achieved any level of "success" in their lives.....What happens is that they find the right combo of meds....that "works".....they start taking them....and start to "feel" better...and little by little they start taking "actions" to allow the "other successful stuff" to start happening.....

But the successful stuff was not there first. I just don't agree with the premise that people who do well on meds -- were doing well anyway before they started. It's very defeatist to think this way....in my opinion. One tends to stay "stuck" with this type of thinking....The thinking says "well my life sucks now so why bother"?

Now granted people will seek other types of "help" while on meds...and I've heard many professionals suggest getting a therapist while on psychiatric meds...and I think it's a great idea....The meds do not magically make the changes in the person's life....they just enable the changes to be made....A therapist, in combo....can help the patient along as he makes the changes....

What is your definition of success David? Where do you think YOU have to be before you believe meds will work for you? I'm curious what YOUR thinking is tell you. And what would you like to see happen in your life....in terms of success and change?

Originally posted by tudorose


Matthew - Age 9. Diagnosis - Autism & ADHD -
medication - toffranil - dexamphetamine

Failure to success

Matthew could not understand let alone express his emotions. Holding a coherent reciprocal conversation with him was not possible. Learning was difficult for him. He was overwhelmed at the slightest triggers.

Now he can hold such good conversations that people who don't know him don't even know he's autistic. He can understand and express his emotions better and he can tolerate more stimuli than before.

Before if I compared Matt to other autistic kids he seemed to not be as advanced. Now he is more advanced than most of the autistic kids that I meet.

My intention was to question, in objective terms, objective measures for improvements of ADHD, and perhaps even more specifically, hyperactive or combined type only.

In my view, autism is a very different creature, and I would not make the same or similar assertions about the efficacy of drugs in those cases, primarily because of my lack of experience with the situation.

Not sure I understand!?!

You said that if meds worked that there was probably not much of a problem to start with. I took that to mean that you thought that people didn't really need medication because it didn't make much difference. Maybe I didn't understand you properly?

****

Well, I didn't really mean "there wasn't much of a problem" OR that meds didn't "help."

It is a characterization of how meds DO help and how they DON'T help that I was trying to get at.

Let me try to illustrate that distinction in my response to Joan...

Originally posted by joanrdtobe


David: This is just a guess -- but am I correct to conclude from these statements..and others you've made in these forums....that you believe that in order to get "well" from ADD and whatever meds one is on -- that one has to almost be "well" to begin with?



Not exactly perhaps. I see this as a differnt kind of thing....


.......... better .............
+
+
not well ++++++ well
+
+
........... worse .............

I see meds working on a "better and worse" axis, and not well vs. well being on a different axis, independent, technically.

We've all seen people who are very "weird" probably the result of one form or another of mental illness or other mental problems, who none the less "meet the marks" of everyday life with aplomb, perhaps even performing with distinction and excelling in a field of interest or ability.

Others have relatively little wrong with them, and fail to function virtually at all.

The measure of such funcionality is independent of the severity of their difficulty(or impairment), in the noteworthy examples we might find.

Again, At CHADD in Florida (2001 or 2?) the hot topic was the finding that drugs or no drugs did not coreleate with measures of "success in life outcomes" in later life. That drugs made these people tangibly easier to be around, for themselves and for others, and even may have contributed or been responsible for better grades in school, arguable providing "better" opportunities than would have been otherwise available, the end statistical results were unimpacted.

On the other hand, people who had a single, memerable, unifying "Ah ha" moment concerning themselves and what to do, had such improvements in life outcomes.

the argument isn't that drugs have no effect. Clearly for many people they have some positive effect. the question is concerning the nature of that effect, and the "real" value of that nature.

Originally posted by joanrdtobe

And that unless they are already on the "successful" path before starting meds -- then they cannot get "well"?


I would not care to limit the unpredicatability of the future that way. I don't think these things constrain the answer either.

Originally posted by joanrdtobe


In my opinion this type of thinking is almost a "setup" for failure before one has begun. It implies that the "cure" must be there before meds are taken....that one must have have it "all together" before they start.

I believe anyone seeking treatment has to start SOMEWHERE....And at the bottom is okay.....And at the bottom IS a good place to start for many.....Before they've achieved any level of "success" in their lives.....What happens is that they find the right combo of meds....that "works".....they start taking them....and start to "feel" better...and little by little they start taking "actions" to allow the "other successful stuff" to start happening.....


before or after is not an issue for me.

And one must always start where s/he is. IMHO

Originally posted by joanrdtobe


But the successful stuff was not there first. I just don't agree with the premise that people who do well on meds -- were doing well anyway before they started.


In every example I have seen in real life, this has been the case, especially in the context of the evidnce from my first secion abve..

Originally posted by joanrdtobe


It's very defeatist to think this way....in my opinion.


Or it could be a discernment...

A recognition of two separate things sometimes seen as one and the same... : )

Originally posted by joanrdtobe


One tends to stay "stuck" with this type of thinking....The thinking says "well my life sucks now so why bother"?

Now granted people will seek other types of "help" while on meds...and I've heard many professionals suggest getting a therapist while on psychiatric meds...and I think it's a great idea....


I think "staying stuck" implies the existance of a way out not yet taken. Being stuck describes a current state not yet accessing any "way out."

I'm l for "combining treatments" especially when they all come from different "angles" on the problem, or utilize different methods from each other. But that is an entirely different issue from either efficacy, or efficacy with respect to what, in particular.

Originally posted by joanrdtobe


The meds do not magically make the changes in the person's life....they just enable the changes to be made....A therapist, in combo....can help the patient along as he makes the changes....


I've spouted the same "enabling" verbage myself, and believed it from my subjective sense. But objectively, whether it participated in those things that change "life outcomes" I've never been sure, in fact. Palpably things are more comfortable, convienient or less contentious than without drugs.

It is becoming evident in research that this is nice, but does not alter the statistics of "life outcomes" perhaps decades later.

Originally posted by joanrdtobe


What is your definition of success David?

I think that is the topic for an entirely different thread. I don't mind getting personal, but here, "life outcomes" is a measure devised by others whom i am willing to allow stand as they have defined it, without additional comment, at this time.

Originally posted by joanrdtobe


Where do you think YOU have to be before you believe meds will work for you?


The evidence may be that I would have to be on the other side of a life changing experience for the effect to which you refer to come into evidence, independent of drugs. I'd avail myself of the drugs in any case, for what they Do do, but it is perhaps specifically my contention that they don't and can't "work" specifically in the manner that your question supposes.

Originally posted by joanrdtobe

I'm curious what YOUR thinking is tell you.


no doubt, < grin > partially in view of my recent "glum" outlook from my port hole to the world.

I don't think that the validity or lack of validity of an arguement or point of view is defined by the optomism or pessimism of the current proponent of the arguement.

Originally posted by joanrdtobe

And what would you like to see happen in your life....in terms of success and change?

My this has traveled a long way round Robin's Red Barn!

For the baby shark, success is struggling free of the sac that insured its life, and now, if it does not leave it, insures its imminent death as well.

Success for "David" consists of success in roles in which David participates. Daily living skills, procreation of the species, right conduct and treatment of self and others, proper stewardship of gifts, and on and on.

The answer to that question is the map of life itself. And though perhaps unintended by you, requires some regard of "success in death" and "success by the time of death" as well.

Much too large a question for this thread on the measure of success for drugs in ADHD.

< tired smile >

Much too large a question...

Maybe it should be smaller...

maybe a Saturday night on the couch in fron of the tely is reward enough for a week's worth of struggle... Maybe having a couch and a t.v. is reward enough for a decade's worth of struggle... Maybe, a wife that "tolerates" (likely a mistaken impression) you being "not well accept by your kids" (ditto) is reward enough for a lifetime of struggle...

In view of the vastness of all possible outcomes for a chance meeting of a sperm and egg... maybe the ability to engage in stimulating discourse about the measurement of success in a virtual world like this forum is very much on the "success" side of that spectrum of possibilities and the rest is just splitting hairs.

This is written in the spirit of friendship and kindness, as much directed at the author as the reader.

Originally posted by why


Maybe it should be smaller...

maybe the ability to engage in stimulating discourse about the measurement of success in a virtual world like this forum is very much on the "success" side of that spectrum of possibilities and the rest is just splitting hairs.

This is written in the spirit of friendship and kindness, as much directed at the author as the reader.

Truely. appreciated and accepted in content and presentation as intended.

At the same time, I am a person of surprising conflicts. (If i say it, people argue with me. If I stay quiet, they say it like I don't know yet! : ) )

Where I apparently excell, is in splitting hairs. That it is not all there is to life is clear. That it isn't even a sustaining function is clear. That others are well advised to go do one of the things they do better than splitting hairs is true.

But, protestations aside, if I put my greatest strength aside, i have very little else to offer. Perhaps seeking to be paid for my greatest strength, even one of ilrepute (critisism), may be an error.

But contribuing from my strenght rather than conforming to others expectations and contributing from my weakness is still, I think, the better course for me.

Splitting the hair of effect vs. common characterization of effect, or improvement vs. change of a different significance, is not an "optional" course for me while I breathe.

I need to find more traction, not "get back to business." I am not competent at "business." I am, at least from time to time, a frustratingly or even infuriatingly good hair splitter. Where others are well advised to turn away, I must turn into or cease to turn at all.

Every chemical step in metabolism consists "splitting the drop of energy" between two other chemicals, in yet a smaller step. this proves to make life look different from a candle flame, ... though both are beautiful, the "hair splitting" offers higher complexity to the result, even if both the candle and life exhale water, CO2 and heat.

What to do? what to do? Hmm. Not always clear.

Though less often, even dogs sometimes are at a loss for what to do next. But they get over it pretty quickly, or take a nap.

: )

Hair splitting has its place.

I have often been very frustrated with people who didn't care enough to get something right.

Ahhh...but a good nap, at the right time, in the right place is magical experience lost on far too many... therein is real sadness of this world - not in the great tragedies, but in the smallest ones.

Perhaps in a similar way, I see the greatest courage in the smallest courages it takes to do the small things... reach out, fess up, etc.
Large courage is a no-brainer.

David, You are a very logical thinker, much more linear than I will ever be. Aren't you a programmer for your occupation? That profession seems to require a lot of logic. You sound a little like a friend of mine, 38 years old, he often says "I am trying to find out what I want to be when I grow up." In saying that I am not trying to say you're immature, but saying that sometimes it takes a person a long time to fall into a niche that fully utilizes their talents, gifts, and strengths. We are all works in progress.


As a side note on the debate of Drugs in the treatment of ADD, on another site that I used to belong to I say the debate on drugs as very very devisive. People had their STRONG opinions on them or not using them. I would encourage ALL who participate in this debate to relax and not be too intense about it all. I left that other ADD site because it was too negative, bitter, and seemed like one big fight ALL THE TIME.

BE CAREFUL IN THE TONE OF THE DEBATE :)

Originally posted by jimmmaaa
David, You are a very logical thinker,

In saying that I am not trying to say you're immature,

But it is true...! How did you know?!!

but saying that sometimes it takes a person a long time to fall into a niche that fully utilizes their talents, gifts, and strengths. We are all works in progress.

Though I think my standing distress is the impression that I am a work not in progress.


[B]As a side note on the debate of Drugs in the treatment of ADD, on another site that I used to belong to I say the debate on drugs as very very devisive. People had their STRONG opinions on them or not using them. I would encourage ALL who participate in this debate to relax and not be too intense about it all. I left that other ADD site because it was too negative, bitter, and seemed like one big fight ALL THE TIME.

BE CAREFUL IN THE TONE OF THE DEBATE :)

I hope the inquiry into What drugs help is distinct from whether drugs help.

And though I personally welcome energetic expressions of positions, and the relating of personal experience, I have to hope that no one here would wish to force others' actions, or do so by acrimony.

I really like this site. It IS encouraging, supportive and friendly. I don't think anyone has forced their views on anyone, I just know that people can get heated regarding Drugs for treatment vs No Drugs. I am all for lively debate. We have a good thing going on and I want it to stay that way :)

So jimmmaaa, do you have anything to share concerning specifics of what drugs, in your case, or in the case of those you have observed, have and have not done?

I had a friend taking Strattera. He kept saying "I'm so much more productive and focused!" And I kept asking him, "What have you done?" Several months later he quit the drug, because "I had to get something done!" It had created single focus in him, but that was not, as I had observered from the outside, the same as being productive, objectively.

Will you play on topic? : )

Wellllll, I have not specific experience with any ADD drugs. In fact I am self-diagnosed. I have not been to a Doctor, but on reading have come to the conclusion that I have ADD. So I guess, I don't have much to offer to the debate. I have been thinking about going to my doctor to be tested, but have not done that yet. But I fit the symptoms, so I am in the 90s percentage that I do have it. Also, my son was recently diagnose wiht Aspergers Syndrome and I believe my daughter may be an ADD person. My wife is actually going to a checkup for my daughter this afternoon and is going to talk to the doctor about what we have observed.
So, I am not sure how much my "Play" will add to the discussion.

Oops.. David removes foot from mouth... :))

I take it that so far you have no friends diagnosed who have let you in on their drug lives... fair enough! : )

I suppose I have killed off the interest in this topic, or I was the most interested in it in the first place. ;)

choa

I think there might be something wrong (with me) as I can't seem to understand the posts - at least in the right context.

Maybe as a simplistic thing - if such a thing exists. Whether meds work or don't work or help slightly is an individual thing. Maybe someone who is severe might benefit greatly from drugs while someone who is mild might not. Maybe someone who is mild might get a huge benefit and someone who is severe might not.
Maybe it's to do with other factors like self discipline, diet, environment, past history that factor in whether meds are effective. Maybe it's that each person reacts differently to different things. You can't assume who meds will not work for and you can't say that if meds work than you're only a mild sufferer. It is not a measurable response. The measure of success is purely subjective and so are the measuring standards. I will see it as a success if both my kids can live independantly. Others might not see this as a success. Maybe their idea of success is academic acheivements.

The thing that I have learned is not to judge myself by the standard that others set. I am the way I am and my measures of success are the only way I can survive with any self esteem. I will see it as a success if I can make it through this weekend without crying. That is my measure for today. Will meds help me achieve this - maybe / maybe not.

I think the thing we need to do is not come up with wild sweeping theories as that tends to not be constructive. I think that each individual has their own path to take and their own standards to meet and their own expectations of life. Sometimes reading things here may bring enlightenment but mostly, the answers are within.

Well Said Turdose!

David,
You didn't put your foot in your mouth. You just didn't know that I am self-diagnosed. I am sort of neutral toward drugs. I think they either work or they don't. I used to take Prozac for depression, but after taking it for a few years I didn't like how I felt. I researched an herbal called St. John's Wort and have been taking it now for about 4 years or so, it has the same effect, without the side effects. But I am not necessarily an a granola and tofu person, I just read about it and tried it out.

Originally posted by tudorose
I think there might be something wrong (with me) as I can't seem to understand the posts - at least in the right context.

The measure of success is purely subjective and so are the measuring standards.

I will see it as a success if both my kids can live independantly.

Others might not see this as a success. Maybe their idea of success is academic acheivements.

Actually, what you are discussing here is the context I wished to focus on!

Drugs seem to improve grades, and a number of other thigns, like the tollerability of having ADHD kids in class rooms, but there seems to be evidence that this does NOT improve "life outcomes" over being drug free.

That is, specifically, no improvement in "living on ones' own." This is also important to me, both as an adult with ADHD combined, and a parent of one or more children with the symptoms.


The thing that I have learned is not to judge myself by the standard that others set.

Here I would agree with you, though you might not agree with me.

I think the thing we need to do is not come up with wild sweeping theories as that tends to not be constructive.

Indeed not wild, nor sweeping. but let us follow the evidence WHEREEVER it may lead. There certainly are examples of people who clearly have had, or have ADHD and succeed by anyone's definiton.

Why? How? These people with ADHD who none-the-less also succeed in the world as it is do so by some means. By what means is it?

I think that each individual has their own path to take and their own standards to meet and their own expectations of life.

Sometimes reading things here may bring enlightenment but mostly, the answers are within.

Perhaps. i certainly have looked there alot (within) but I suspect that were I to follow the examples of those similarly situated as I am myself, who none-the-less acheive results I would prefer to those I produce myself, that I would be the better off.

Discerning what part of their example is the operative portion, I think might benefit from the combined observations of many, rather than just my own (genius) efforts. but seriously. I really beleive in the process of concensous making by revealing dissent and dealing with it, rather than majority force of will over minority observations, opinions, and experiences. Indeed, it may be that a minority of people with ADHD sucessfully meet the challenges of normal independent life. If so, the minority is where my hope lives.

So I see my hope in the disparate and diverse contradictory impressions of many, distilled slowly perhaps over some "great" time, to reveal what remains from the confusing mixture of everything that is ADHD in real people... revealing at least how some are ADHD, perhaps with or without drugs, and do well enough that I would wish to emulate their adjustment to the world, if not acheive their specific results and rewards in it.

Life outcomes talk from an expert in the field:

Sam Goldstein

http://www.samgoldstein.com/articles/9907.html


"It is increasingly recognized that ADHD treatments are effective in reducing the immediate, symptomatic problems experienced by individuals with ADHD. The long-term outcome research, however, for children with ADHD, has led researchers to conclude that symptom relief alone is likely not synonymous with significantly impacting long-term outcome. Thus, it has become increasingly recognized that the factors predicting positive life outcome for all children are critically important in predicting life outcome for children experiencing problems caused by disorders such as ADHD. There has been an increasing recognition of the importance of "balancing the scales" for individuals with ADHD. Thus, treatments for ADHD are provided to relieve symptoms while efforts are also made to assist the ADHD individual in building life success. The motto "make tasks interesting and payoffs valuable" appears critically important for individuals with ADHD. "

Hmm... interesting discussion. I don't even know if I really am AD/HD yet, and there's an element of autism thrown in as well, but I do know that I would give meds a shot if they were recommended to me.

To me, my satisfaction with myself and thus my happiness is directly related to how much I manage to get done and how calm I feel on any given day, so if I could take something that takes away that internal unrest and helps me focus my energy creatively, I know it wouldn't magically solve my problems (most of my everyday problems and worries are down to growing up the way I am), but it would more likely than not help me put my life back together and regain some self confidence.

Personally, I know the theory behind keeping my life in order and being great at my job and having a semi-decent social life, it's the practicalities, the follow-through and the effort I need help with.

I think arranging to get things done, using others as well as self, is a practical key for the ADHD.

I think the key defects in ADHD are sure to include: time, orientation in (time, space, flow, process, or social net,) unsynchronized sleepy brain, failure of triggered remembering abilities, short term memory to longer term memory failures, emotional overwhelm, singleness of consideration per task combined with multiples tasks instead of one task with multple considerations within it, (the missed significance that results from the preceding), misapprehension of attributions by self and others concerning "responsibility", transfer failure from thinking to doing, and the neccesary but unrecognized ramifications of uncultivated coping strattegies for the above difficulties.

Drugs, I expect, can affect only a limited number of these primary and secondary issues.

Though Sam Goldstein refers to research that deals with life outcomes, I have not tracked that down.

Has anyone else?

Originally posted by Wheel1975
Though Sam Goldstein refers to research that deals with life outcomes, I have not tracked that down.

Has anyone else?

No I haven't.....but thanks for the Sam Goldstein website....He seems to know what he's talking about with regard to ADD. He calls it a "biopsychosocial" disorder.....sounds about right....:)

I have several of his books.

IMHO he is right about what he thinks is important being important.

He is wrong that other things are not important. IMHO.

Wow.. quite the thread.. I'm new as you all no doubt have figured out..
I'm grateful to have found this board and this thread.

I have just begun my trials with Methylphenidate and Dexedrine. This week will be a full course of Dexedrine.. I'm hoping it's smoother than the Meth.. I find it a bit course.

After reading this entire thread almost word for word I don't see any indication that anyone has gone through any testing to prove one way or the other that the problems of consentration and focus are indeed addressed with the meds. Or is this not a goal? Or am I blind? heh

After my diagnosis I was stunned to find the gaps in my preformace after reviewing the test results. I had function levels as low as the third percentile in some areas and then some others were very high but the information came as a bit of a shock to me regardless.

Now I'm in about my forth week of meds and I'm beginning to wonder if I have any increased ability for rational thought.. I have tremendous trouble with what I like to call my shortage of "RAM" to use a computer analogy. I'm always feeling as if I am a very powerful computer running on about 8 megs of RAM. I hope that analogy speaks clearly enough to make my point of concern clear.

My goal in taking the meds was to try and help some of the gaps close up some. One point of interest was focus and I think that has been addressed wonderfully through the use of these stimulants.

I'm curious as to whether any one here has gone through the initial diagnosis testing for adhd to view the results before and after medication. I'm tempted to do just that in the spring after settling on one course of medication or another. I am certainly convinced that I'm better off with the meds.. I feel like I can contribute much more to those around me and have a much greater sense of self worth generally because of my increased productivity.

Well.. that's enough rambling from this first time poster. I'm glad to have all your earnest comments to help guide me.. I like the tone of this board, it's commendable.

I'm choked I can't use my avatars of choice until my tenth post.. ;P.. I hope I can hang in for at least that duration..

Cheers!

Cool. Welcome. good luck with "productivity." i'm a biologist at heart, always looking for the behavioral metrics... number and size produced before, number and size produced now.

Not that subjective "feeling" more productive isn't an important thing... I've just found it hard to get hard chartable numbers for "focus" and "productivity" even in things that proport to be "research."

Hope you make it until you can post your avatar!

Gracias.. you Unicycle Rider you..heh

I'm not actually interested in real numbers on this. I would doubt the validity of the sources and haven't the drive to do the research on said sources.. above and beyond what I have already found, but...

I am certainly wide open to any subjective observations you or others might have regarding my commnets.

I suspect after my short trials, that I have no better ability to reason. My ability to remain doing one thing for an extended period seems improved somewhat. However I have acknowledged that meds are not going to "fix" me. There have been drastic improvements across the board and I'll have to be patient as I adapt the skill set I have, to the new variables I'm confronted with while medicated. I was also hoping I might be able to focus long enough to remember the lyrics to some of the songs I've been singing for years.. at least through the duration of the song without getting distracted and forgetting my place... but this may be just too much to ask! hehe or at least I wish I could laugh about it.. ;^)

Two months ago I was shutting down my meagre business. I actually put in a full weeks work last week.. so productivity is something to celebrate right now.. as I have not quit working.

"Hope you make it until you can post your avatar!"

All this from a "Guru" who posts no avatar? heh.. I feel at home here already and I'm sure to make my minimum posting requirements for custom avatar status..

So.. if I read you correctly you have found nothing or little to support the use of meds for increased "focus" and "productivity"? hmmm too bad. I have not found much of substance either.

I'll have to rely on the month end statements.. <g>

Cheers!

Hey 1 hour south of winterpeg

Just jumped in on this thread and havent read them all

So.. if I read you correctly you have found nothing or little to support the use of meds for increased "focus" and "productivity"? hmmm too bad. I have not found much of substance either.

I am using dexadrine myself and it is like day and night when I take my meds as to my ability to focus on a single task.

I only take them when I feel foggy brained or want to focus deeply on something but I absulutly love my med.

Actully too much as it could be come quite addictive if you so let it as I find it does allow me to focus very clearly but if I take to much I get an extreame body stone and dont want to do anything but sit and think " very clearly" but I physically dont want to move from my chair.

To bad Im not rich as it would be great to be a leagaly stoned clear thinker

Grin

Originally posted by itschaotic
Gracias.. you Unicycle Rider you..heh

I'm not actually interested in real numbers on this. I would doubt the validity of the sources and haven't the drive to do the research on said sources.. above and beyond what I have already found, but...

So.. if I read you correctly you have found nothing or little to support the use of meds for increased "focus" and "productivity"? hmmm too bad. I have not found much of substance either.

I'll have to rely on the month end statements.. <g>

Cheers!

Well, I think it HAS been established that drugs can make a significant and measurable difference in reduction of disruptiveness in class, and perhaps some aspects of the school experience, though it is the "life outcomes" failure to respond to drugs that commands my current attention.

I left a question on Sam Goldsteins site... we will se what he cites as evidence and research on life out comes vs. drugs.

I got an email back from his site that he will be posting answers on Dec 1... : )

Gary.. is "Clinton" in southern Ontario or are you a bit closer to me in the northern part? It's a whopping big province yours is.. heh

I am really enjoying the dexadrine as well. I have the overwhelming feeling of getting superb traction on all wheels. <g> I have no requirements to sit down for long.. unless of course it's to do something on the computer. <vbg> My links page is:
http://clocker.hypermart.net/ at least for now. I'm trying to finish up a rebuild to my main site.

Wheel1975 your avenue of investigation warrents some reading.. I'm sure you'll keep us posted. Do you have your original note to Goldstein's site posted somewhere?

Cheers! Ian

Originally posted by itschaotic

Wheel1975 your avenue of investigation warrents some reading.. I'm sure you'll keep us posted. Do you have your original note to Goldstein's site posted somewhere?

Cheers! Ian

Life outcomes talk from an expert in the field:

Sam Goldstein

http://www.samgoldstein.com/articles/9907.html

"It is increasingly recognized that ADHD treatments are effective in reducing the immediate, symptomatic problems experienced by individuals with ADHD.

The long-term outcome research, however, for children with ADHD, has led researchers to conclude that symptom relief alone is likely not synonymous with significantly impacting long-term outcome."

I think those are the most relevant parts.

Or perhaps you meant:

On Monday, November 24, 2003, at 09:45 AM, Sam Goldstein wrote:

Dr. Goldstein is out of the office until Monday, December 1st at which time
he will respond to your email.

----- Original Message -----

To: <info@samgoldstein.com>
Sent: Sunday, November 23, 2003 4:27 PM
Subject: SamGoldstein.com Contact Form


On 2003-11-23 at 16:27:00,
The following information was submitted:
From Host: 68.

first_name = David
Interested_in_Speaking =
Interested_in_Evaluation =
comments = An article here posted refers to "life outcomes" research, but
does not identify any specifically. Could you direct me to the list of such
things that call into question the efficacy of drugs with respect to "life
outcomes?"

Wheel1975 I was actually trying to access "your" questions of this article... but I'll have a good review of this now and pick it up later..
gracias.. Ian.

David, You are definately a good researcher!

Sheesh.. you guys have so many posts it's intimidating.. heh

Thank-you for your clarification Wheel1975.

re: "An article here posted refers to ""life outcomes"" research, but
does not identify any specifically. Could you direct me to the list of such
things that call into question the efficacy of drugs with respect to "life
outcomes?"

I await the December reply with interest. I'm glad I asked the question.

http://www.samgoldstein.com/articles/9907.html
On this site the resource list seems to contradict his statement about " New ground is broken daily" with some very old material quoted. Is Dr. Goldstein the generally accepted leader in the field?

Cheers! Ian.

The leader (while we wait for some on target information Dec 1?...)

Some of his stuff is older... though, if you walk away from drugs, you also walk away from drug comany funding, which makes things hard.

He is one.

Actually, I think I am pretty well read as far as the core popular press folks go. There are many people doing related, to some degree, research who get quoted.

I think Sam Goldstein, Barkley, et al., have their strong points. I think I see the elephant and they see the tail, the nose, the leg, the side, the ear flap....

doesn't matter... i don't have the press agent, practice, or hutzspa...

You sound just like an objective independant observer... heh my favourite! I have much to learn.

Glad to have the benefit of your experience.
Ian.

Thank you. However, let me suggest that you take more stock in several other peoples' posts... there are too many to list, but they are the heavy posters as well as some who have seemed "called" to post only a very few times.

There is real wisdom on this board. I think, at best, I represent a force for bringing up important angles, but I frequently like OTHER peoples' conclusions and considerations better than my own.

So it is without false humility that I recommend to you some of the very people who are obviously BIASED as well as others who are also very objective, as deserving objects of your considerate attention.

Godspeed.

Wheel1975
I have been browsing my way through the board and I tend to agree that the talent pool is deep. I am thrilled to have found my way here.
Ian

Some drink at the fountain of knowledge...others just gargle

I can't wait mindlessly for Dec 1 to arrive!

Dr. Sam Goldstein has responded.

...In so much detail that I have felt the need to request that he clarify what use I might make of the materials he forwarded to me with respect to this forum.

Chapter 2 of "that appears in my co-authored book, Clinician's Guide to Adult ADHD (Academic Press, 2002, Goldstein and Teeter Ellison).* The chapter authored by me provides an overview of life outcome issues.* I believe these will address your questions."

So far, it reads as a very well documented book.

I'll refrain from further comment until I hear from him regarding his personal and legal preferences.

It seems that Chapter Six concerns what to do for adults...

Shall we have a voluntary "book club" and get this book and read and report,,, (in that other section?)

I've been in such a slump for so long that the work is piled up too high for me to be taking anything else on until I clear the deck.. Too bad though.. I really like your line of questioning..
Cheers.. Ian

computer memory issues are keeping me off line.. new main board is struggling... me too!

On reason that I spend as much time as possible on my Mac....

Zero "Wasted time" from updates, hardware problems, software conflicts...

Granted, there are updates, but they are relatively silent and painless.

Ah... but even my beloved Linux can't escape the blown main board I toasted on Friday..heheh Now the ram seems to be an issue..

Cheers! Ian...


Linux: because I want to get there today. Without rebooting.

Sam Goldstein (rather than drugs in childhood, these factors seem important to better long term outcomes...)

...Thus, living in an intact household, above the poverty level, with parents free of serious psychiatric problems, consistent in their parenting style and available to their children appear to be among the most powerful variables at predicting good outcome (for review see Goldstein and Goldstein, 1998).

…
Beginning with Chapter Six the contributing authors provide readers with a framework for developing a multi-modal treatment program for adults with ADHD.

...

Current theory for the etiology of ADHD is consistent with a lifetime presentation, reflecting developmental rather than a pathological difference between affected individuals and the general population.

The consequences of living with the burden of a significantly disabling condition reflecting limited self-control results in demonstrated problems for adults with ADHD.

The condition serves as a risk factor, limiting their potential for academic and vocational achievement, as well as acting as a catalyst for comorbid psychiatric and life problems.

+++

Thus sayeth Sam Goldstein

hmmm.. not quite up to the advance billing.. no?

My wife brought home "Taking Charge of ADHD" (revised edition) by Russell Barkley tonight and I had a poke around for ideas about coaching. I remembered this thread though and landed on this statement from page 275.

"Given these gains, several years of medication may very well leave the child with more academic knowledge than she would have had without medication, but unfortunately no studies have examined this issue beyone 14 to 18 months of medication use. We simply don't know about the long-term benefits to academic knowledge or skills from continued use of medication over several years or more of schooling."

So I expect we are ultimately responsible for our own healthy direction on this. What's your spin Wheel? Do you suspect there is no significant long term benefit to medicating for adhd? I'm certainly wondering about these things.

I do think it a worthy point that the increased self esteem I get from a more coherent work day will have greater spin offs than just to produce more income.

One time poor juggler.. Ian

I think those five sentences say an awful lot, for a NON-ADHD person to say.

Give them another look...

drugs aren't the answer for long term results, they help short term.

Some things DO help long term... look at what they are...

there are specific consequences to being ADHD. they are inevitable and real.

It is a start.

It is also a selection of 5 sentences out of an entire chapter, only one chapter of an entire book.

Page 96 to page 103 are full of citations of studies... that constitutes scores of studies for this chapter alone.

chapter 6 is the "what to do for ADHD in adults" chapter. this just put an authoritative point on the issue of the efficacy of drugs and long term outcomes.

What were you expecting? (Not retorical!) What would you have expected to live up to the billing?

Wheel.
I think I'm getting lost here and need some clarification.

What point are you making?

I'm not sure what you are trying to tell me but I think I see some frustration rising. Hopefully with some encouragement I can pick up the pace a bit and reduce the frustration.. but who knows.. I'll do my best.

My point is that the dope seems to have allowed me a window out of a very bleak period where all seemed lost. Obviously there is little to no evidence that there are long term dividends to taking this medication. Although as I have stated..
"I do think it a worthy point that the increased self esteem I get from a more coherent work day will have greater spin offs than just to produce more income."

So I'm not opposed to it's use, at least so far. I would hope to find some healing happening that will be of long term benefit and might be made possible not by the meds directly but by the patterns and habits established while medicated. Then again maybe not. However I'm going to try to make that happen with limited expectations. Otherwise why bother with the dope at all other than for crisis management? This is probably too broad a statement so please take it with a grain of salt so to speak.

If you have points that I am missing here and you'd take the time to point them out I'd be grateful. ;^)

Sometimes it's tough for me to display the emotions I am trying to convey and this is why I try and use emoticons where I can. I apologise if I've been slow to pick up on some of the direction of this thread.

It would be my thesis, that for my personal needs, my primary source for keeping a closed gate on the roller coaster ride of emotions and behaviour is a good coach to help maintain a structured day and develop and track my goals, and of course to maintain all those elements of prov-en long term benefit that you have stated.

My comment about "advance billing" was just a cynical way of saying "I wanted him to say more" I'd have liked to have his prognostications for the future.

I think that the five statements you point out are relevant to any healing and or healthy growth, regardless of the damage. The basic criteria for growing up are embraced quite clearly within them. Having many of those bases covered, and still looking for lasting effects I resorted to chemicals in the absence of having a coach in place to field the odd curve ball that inevitably comes my way. Summer for instance is tough for me to maintain structured days, as the whole family is home and distractions abound! <g>

Please forgive my shortcomings
Easy does it. Ian.

Chaotic, I like your Lava Lamp.

hehe.. I'm a sucker for images of all kinds.. ;^) Glad you enjoyed it.

Originally posted by itschaotic
Wheel.
I think I'm getting lost here and need some clarification.

Just don't forget you are asking for clarification from a white guy that gets "Say What?" as the response to the majority of his communication attempts, when the response isn't down right hostile! I'll try!

What point are you making?

Close to the same ones you do:

My point is that the dope seems to have allowed me a window out of a very bleak period where all seemed lost. Obviously there is little to no evidence that there are long term dividends to taking this medication.

This has not been obvious to everyone, or even most people up to this point. Most folks have tacitly considered that medications were a "good solution" to the most signiicant part of ADHD, not just the most obvious.

"I do think it a worthy point that the increased self esteem I get from a more coherent work day will have greater spin offs than just to produce more income."

Nice hope, but not supported by the data for children becoming adults, at least.

I would hope to find some healing happening that will be of long term benefit and might be made possible not by the meds directly but by the patterns and habits established while medicated. Then again maybe not.

Exactly. The evidence leans far over to the "Then again maybe not" side now.

Otherwise why bother with the dope at all other than for crisis management?

Very appropriate question, in my view, but not one many people are eager to consider or discuss or make plans or actions around!

This is probably too broad a statement so please take it with a grain of salt so to speak.

And what if it isn't too broad?

It would be my thesis, that for my personal needs, my primary source for keeping a closed gate on the roller coaster ride of emotions and behaviour is a good coach

Ever SO EXACTLY. A babysitter. A keeper. Not a micro-manager, but certainly another human engaged in REAL managment!

to help maintain a structured day and develop and track my goals, and of course to maintain all those elements of prov-en long term benefit that you have stated.

My comment about "advance billing" was just a cynical way of saying

#1 "I wanted him to say more"
#2 I'd have liked to have his prognostications for the future.

Of course, in an entire book he did say more!

But prognostications for the future outside the lack of efficacy of drugs for long term IS off topic for the question of "how effective are drugs at improving long term outcomes vs. no drugs?"

Even so, he highlighted an INCREASED need for good, standard, parenting, and some other overhead issues. This is not a sexy answer, and does little good for those of us who are already grown, except to help us understand the nature and root of our difficulty more clearly, and understand the significant difference of importance of "external organization", etc., to us (ADHD) vs. other people who "like it too."


I think that the five statements you point out are relevant to any healing and or healthy growth, regardless of the damage.

Which is the scariest part to me. If these are the most strongly correlated factors, how can those of us who cannot meet the requirements assist our children?

This at least redirects our attention from finding better doctors and better drugs, to looking inside the home, the school, and the work place, for things that can be "arranged."


The basic criteria for growing up are embraced quite clearly within them. Having many of those bases covered, and still looking for lasting effects I resorted to chemicals in the absence of having a coach in place

Which may be shown rather than to be an adequate substitute to rather be another version of "something good to do" but not addressing anything "long term."

to field the odd curve ball that inevitably comes my way.

Summer for instance is tough for me to maintain structured days, as the whole family is home and distractions abound!

So doesn't this take the mystery out of it and also avoid going down the "wrong path" of thinking that a "magic drug" will take care of the problem, when the problem is in fact, exactly as you described, and NOT a drug balance or flaw?

Doesn't this allow you to focus, instead of on "effective" but irrelevant affects available from drugs, on things, procedures, roles, that need to be filled by living , breathing , people?

david


< g >

Please forgive my shortcomings
Easy does it. Ian.

Emoticons involving < and > and some others do not show at all with no spaces. FYI

One of the major, in my mind, findings of Sam's review is that ADHD people do not consistently apply successful methods to know problems.

Not a real shock to any of us.

But NOT something we are likely to sanely expect a PILL to fix!


(I HAVE that lava lamp. Thanks to my wife! In red, which is my personal favorite.)


+++ Sam Goldstein, et al., as above.

Holdnack, et al., demonstrated that adults with ADHD exhibited slow reaction time to target stimuli. Their psychomotor speed was slower relative to controls.

These authors also demonstrated inconsistent application of a semantic clustering strategy for those with ADHD memory tasks.

Individuals with ADHD appeared susceptible to retroactive interference, and item recall inconsistency. In sum, adults with ADHD appear to experience a selective pattern of deficits, revealing slow cognitive processing and significant problems with list learning.


Post Script: I once worked with tree snakes; they move slowly to catch birds that move quickly.

(You can tease one and easily move out of the way before ( as) they strike. In fact, they strike mid-air where you were, not able to track your faster movements!)

If Hartman is right about us being hunters, we are more like the tree snake than the Cobra!

We may be the fisherman who is lucky enough to have the fish jump INTO the boat!

Your "say what" comment made me howl in laughter.. man can I relate! I'll try and get back to this later tonight..
Grateful. Ian. < duh > < / duh >

I think the information in this thread (must I say not mine but Sam Goldstein's which he got from others?) is very significant and requires the careful consideration of most who visit this forum in order to assist in "on target" activities that can really help, and to avoid wasted time and effort in activities that simply do not provide the results that some of us expected that drugs would provide!

71 words in one sentence. Does it parse correctly?

Hartmann seemed to reiterate some sobering assessments of the value of using drugs for ADHD, even in academic settings.

According to the studies to which he referred, even grades are not related to drug use, only the "acceptability" of the students behavior in teacher evaluations.

This seems quite an indictment to me.

I am apparently alone in my impression that the best "treatment" for ADHD is:

1) Setting and
2) Companionship
3) External cues and controls

better than drugs, better than therapy.

My "access" to Sam has been closed by his request... small wonder eh? That is a different issue.

No I don't think you are alone Wheel.. It's just not available to everyone in all circumstances. I found myself in a spot 10 months ago where just those elements you mentioned had changed my entire life for the better. It was the result of two years work. Many of those troubles that got addressed had been outstanding since I was a kid. The progress was remarkable to anyone who knows me and many commented.

I just came to a point where it seemed as if "not" using crutches when the leg is broken wasn't helping the healing process. If you can follow the analogy...

I'm with you on this point. I discovered my adhd via the universal healing principles you describe as:

1) Setting and
2) Companionship
3) External cues and controls

I came at the chemical intervention around the back side when I lost some of the key elements that had produced the good results, namely my coach/companion.

I believe that the fundamentals you mention help best over the long term and this has been prov-en in situation without a doubt. Recognising the key elements required to maintain and grow a better way of coping is something I'd like to have more skills with. A list published here and comments regarding key elements of coaching for example have been slim after much begging on my part.

It's possible that many aren't as cerebral as myself. (duh) eheh I would love to have a list compiled of elements that others have found important to initiating change for the better. I'm not the guy for the job unfortunately. I feel most days like a winduhs XP machine running on 8 megs of ram. < g >

Flushing out the details of "setting", "companionship" and "external cues and controls" would be of some help to me. How about publishing a "nutshell" version in reply David? I'll try and make some notes in the near future regarding these things.

Cheers! Ian.

nice picture.

1) listen to the characterizations flug at you when people aren't not as controlled and kind as they otherwise would like to be... in those moments they frequently state the obvious in unvarnished terms... and what they state is not "changable" ie, any "dealing with it" involves not "personal growth" but "good environmental planning."

A leopard does not change his spots!

IMHO

2) The list for one person is completely wrong for the next. that is because the cracks appear where the stress is... the specific weaknesses are different not only for each person, but even for a person in different situations, etc. A persons list is derived, in a custom manner, by listening as in step one. IMHO

Originally posted by itschaotic
No I don't think you are alone Wheel.. It's just not available to everyone in all circumstances. I found myself in a spot 10 months ago where just those elements you mentioned had changed my entire life for the better. It was the result of two years work. Many of those troubles that got addressed had been outstanding since I was a kid. The progress was remarkable to anyone who knows me and many commented.


can you say more about this expicitly?

I just came to a point where it seemed as if "not" using crutches when the leg is broken wasn't helping the healing process. If you can follow the analogy...

I'm with you on this point. I discovered my adhd via the universal healing principles you describe as:

1) Setting and
2) Companionship
3) External cues and controls

I came at the chemical intervention around the back side when I lost some of the key elements that had produced the good results, namely my coach/companion.

I believe that the fundamentals you mention help best over the long term and this has been prov-en in situation without a doubt. Recognising the key elements required to maintain and grow a better way of coping is something I'd like to have more skills with. A list published here and comments regarding key elements of coaching for example have been slim after much begging on my part.

It's possible that many aren't as cerebral as myself. (duh) eheh I would love to have a list compiled of elements that others have found important to initiating change for the better. I'm not the guy for the job unfortunately. I feel most days like a winduhs XP machine running on 8 megs of ram. < g >

Flushing out the details of "setting", "companionship" and "external cues and controls" would be of some help to me. How about publishing a "nutshell" version in reply David? I'll try and make some notes in the near future regarding these things.

Cheers! Ian.

Setting... a situation in which the flow of activity "naturally" externally refocuses one's attention on the adaptive thing (productive?) thing that should be done.

EMS workpresents a set of needs in strak contrast to the back ground of life, and the setting even "excludes" distractions from the larger world that are not pertinent to the situation.

Work as a therapist is very "setting guided..." once the therapist is at his or her own office, the work comes to them and leaves on 45 minute or hourly points... the Setting regulates the interaction, requiring less of tht to be done internally by the person.

It isn't a readers digest version , but it is a start...

Is that helping?

quote:Originally posted by itschaotic
No I don't think you are alone Wheel.. It's just not available to everyone in all circumstances. I found myself in a spot 10 months ago where just those elements you mentioned had changed my entire life for the better. It was the result of two years work. Many of those troubles that got addressed had been outstanding since I was a kid. The progress was remarkable to anyone who knows me and many commented.


your quote: can you say more about this explicitly?

Hmm.. I suppose I could but I don't think I will. If you ask single pointed questions I'll try to answer them. Your request is too general and would begin the writing of a book I fear.. < g > But it's not that I don't want to engage on this point. It's just a question of the logistics of my life and time available.

your quote: Setting... a situation in which the flow of activity "naturally" externally refocuses one's attention on the adaptive thing (productive?) thing that should be done.

In an ideal world this would be certainly the ideal. However I live in a house with two teens and a slightly ODD ten year old. We contain our lives to the 465 square feet indoors when the weather is nasty..heh it's a bit "close" to have much control over the "setting". Besides.. I tend to the "egocentric" and it seems to be good on all fronts to consider "internal" changes. This said, I have recently built a small 200 sq/ft clean shop for my machining and horological interests that is a haven for control. It's lovely.. < VBG >

I do believe the leopard can change his spots. I don't think it's common and may be rare but it happens. Some of the fundamental things I hated about myself are gone or in remission. Like some of my blunt and inappropriate social skills. I know they have changed by the way my life has changed socially. I get asked to do things that never were available to me before. The local 4-H club mistakes me for a reliable member of the community regularly. A friend among friends?.. I'm working on it. These points only move for me if I'm able to "let go" and by doing so something "else" happens.

What is "EMS"?

your quote: Work as a therapist is very "setting guided..." once the therapist is at his or her own office, the work comes to them and leaves on 45 minute or hourly points... the Setting regulates the interaction, requiring less of tht to be done internally by the person.

I'm not sure I understand what point you are making here. Work with a therapist is what it is, or at least what I make of it. If it's got merit I use it. If not I leave... but not at the first sign of challenge.. I specifically choose people who are not intimidated by my constant questions and inferences to their possibly thin knowledge or skill. Some of the social graces go out the window when my defence is required. Trust is something that is built over the long haul. I'm quite sensitive to manipulation. I am a skill manipulator myself... another leopard spot on the wane.. We work together in many formats that include phone, snail mail, face to face and fax... now if I could somehow talk their office into the digital age.. ehh

People are starting to rear their heads from a short night in bed.. I best look like Mr. French toast for a while.. Sorry I'm a little slow on the uptake on this one David. Please be patient with me.. I'm not used to such pointed attention... I like it but I'm pretty much an air head when it comes to rational arguments or so I've come to believe. I hope I haven't missed your line of thought entirely.

your quote: Is this helping?

what are you looking to help? Helping what exactly.. I'm thick sometimes.. maybe it's the four hours sleep.. yup.. possibly.. < g >

Cheers! Ian.

I think that that efficacy and self control are not the same.

I think ideas are too often under specified...

self control of self. vs. circumstantial control of self. vs. prior planning and external encumberment to effect control of one's self, etc.

ie, effective control of one's self need not utilize any self control at all.

yup