ADHD

October is ADHD awareness month. This is part one of a two part series. In this posting, I address what ADHD is, the choice of medicating, other treatments, choosing a doctor and how to get diagnosed. Next week’s post will be more personal and address stereotypes, how to get help and how awesome the ADHD brain is! Neurodiversity rocks!

According to the American Psychiatric Association, “Attention-deficit/hyperactivity disorder is one of the most common mental disorders affecting children. ADHD also affects many adults. Symptoms of ADHD include inattention (not being able to keep focus,) hyperactivity (excess movements that is not fitting to the setting) and impulsivity (hasty acts that occur in the moment without thought)

An estimated 8.4% of children and 2.5% of adults have ADHD. ADHD is often first identified in school-aged children when it leads to disruption in the classroom or problems with schoolwork. It is more common among boys than girls.” (A quick side note: I really, really dislike this definition. It doesn’t even remotely describe ADHD. And a mental disorder? Please! I’ll get into that in next week’s post.)

ADHD can only be diagnosed by a physician. Typically, it’s pretty easy to diagnose. There’s a simple questionnaire. For Ryan, he went through testing through the public school system, then we went to the doctor. The school is not allowed to diagnose, but they can make recommendations and say the student has certain tendencies. Once officially diagnosed, then the school can put it into their forms, for a plan and an IEP.

Ryan was diagnosed with ADHD when he was 5 and started meds when he was 6. But I knew when he was much younger. (Like when he was 2!) I went through a period of time before he was officially diagnosed, praying that he didn’t have it. And I really didn’t want to medicate him when he was diagnosed. It was so painful to go through. My husband and I did a lot of research, reading, and talking to other parents who were going through the same thing. But when it came down to making the decision, someone said to us, well, if you had diabetes, wouldn’t you take insulin? ADHD is a medical condition just like diabetes. Wouldn’t you want to help alleviate the symptoms and make your child’s life more manageable and give them whatever it takes to help them be successful?

When we started Ryan on meds, I couldn’t believe the difference it made. He was able to be much more attentive in class and at home he didn’t have as many out of control moments. However, it wasn’t a completely magical pill. The dosage had to be adjusted with every growth spurt. Some of the side effects weren’t so great. Initially his appetite was affected and when we increased it too much, his affect became flat. He was no longer the happy go lucky kid with a joie de vivre. Finding the right medication and the right dose wouldn’t last forever. Often a medication would work for 6 months and then it would stop being as effective as we would like, and we would go back to the drawing board with the doctors. Over the course of 12 years, we have tried all kinds of medication “cocktails” to get the best outcomes. It’s also important to know that again – medication isn’t the complete magic pill. Even with medications, Ryan still exhibits many of the symptoms of ADHD. The meds just help slow the brain down a bit. In the words of Ryan, “my brain is running laps around me and I’m trying to catch it.” The meds help his brain slow down a bit, so he can catch up with it.

Many parents still opt not to medicate their children, and that is their choice. There are dietary, herbal, vitamin and mineral supplements that although haven’t been medically proven to help, there is anecdotal evidence that they do.. We had discovered that blue food dye seemed to cause Ryan to behave even more hyperactively. (See my post “The Incident of the Blue Icee”) We also read that nitrates in foods (used mostly in cured meats like bacon, salami and lunch meats) could also cause hyperactivity. We chose early on to keep Ryan’s diet as clean as possible. Other supplements such as Omega 3’s can help boost brain function as well as DHA. We have tried all of this, and honestly those alone have not significantly helped Ryan’s brain hyperactivity. Using supplements, diet, and medication together have been the best option for him.

Speaking of doctors, we opted to see a Developmental Pediatrician for the management of Ryan’s medications and testing. In my experience, a regular pediatrician typically doesn’t have the knowledge, training, and experience to manage a child with ADHD. Many times a pediatrician will refer their patients with ADHD to a psychiatrist. But a psychiatrist, whether or not they are a Pediatric Psychiatrist or one who sees all ages, just manages medications, not the entire child. A Developmental Pediatrician is trained to treat children with all developmental issues and is able to manage the entire child. They can be difficult to find, and many do not accept insurance. Our doctor was invaluable, and I do not know what we would have done without her. Over the 12 years we spent seeing her, she became a part of our family. She knew Ryan well, and Ryan always looked forward to seeing her. She offered a safe place to be completely open and honest and always had an ear to listen. Her advice, and testing, and heartfelt guidance was always welcome.

ADHD is typically not a stand alone diagnosis. It comes with all kinds of other complex issues. Some of these issues are DSM-5 diagnoses, like ADHD. Others are what are called dysfunctions and don’t have full DSM-5 diagnoses. (DSM-5 is short for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). To clarify a bit, dysfunctions can also be seen as a “side effect” or a “sign and symptom” of ADHD. Some of these dysfunctions are what you might use to diagnose ADHD. Not all people with ADHD have these dysfunctions, but many people do.

So, what are the signs and symptoms of ADHD? The APA’s definition is very short and sweet, but it just doesn’t do it justice. Here are the general symptoms according to The Connor Scale:

Hyperactivity

Trouble paying attention

Problems keeping friends

Emotional problems

Problems eating or sleeping

Impulsiveness

Problems with math or language

Temper tantrums

Compulsiveness

Fears of being separated from loved ones.

(The Connor Scale, is almost exclusively used for diagnosing ADHD)

And here’s a word on adult diagnosis. I know adults who I believe have ADHD. I have close relatives that I believe have ADHD. I have seen them struggle their entire lives. What I can say to them is, get tested.. It takes very little effort. And what it can do for them is give them a reason as to why they are the way they are. It could even possibly open up a world of help. Maybe the help will be therapy, or medication, or both. It can quite possibly help their relationships with friends, family and spouses. One is never too old to get help. And for sure it isn’t shameful.