Saturday, March 03, 2007

ADHD Notes

ADHD Notes

0’s, the MRI, PET and spec scan emerged as great research tools demonstrating that the brains of ADHD persons are different. Alan Scentian published pet scan studies in which two groups of people with the use of radioactive glucose used by the brain for energy (scan shows brain activity in color) demonstrated that the frontal lobes of ADHD people are smaller, so we know that there are biological differences.

It is believed that ADHD people have reward deficiency syndrome: they have a more difficult time finding pleasure and are more likely to have addictions.

An aside: an audience member asked about Tom Hartman, who wrote about ADHD as

Hunters in a Farmer’s world, which posits that the ADHD brain is simply a genetic brain trait from an earlier time in history when men had to be hyper-vigilant, quick acting, liking action. Ned loves to hear him debate with the ADHD authority Russell Barkley.

Ned says the fear is the great learning disability. When we experience fear, we can’t learn anything.

Another aside: Ned says MRI etc should not be a tool of diagnosis, but rather research. The only way to diagnose is by history: the behavior of an individual as reported by family members, teachers etc.

Causation: clearly genetic, based on twin studies OR acquired by brain insult, trauma or a virus; lead poisoning or environmental toxins.

Are we seeing a rise in cases? No, just better dx and maybe an increase in environmental allergens.


Making the Diagnosis: Basic DSM: 2 clusters of 9 symptoms each-9 hyperactive; 9 impulsive.
Impaired functioning present in multiple settings.
No such thing as adult onset; just adult diagnosis

Most common symptoms is a sense of underachieving. No matter how well you are doing, always have a sense of missing a lot in work, school, jobs relationships. That’s what finally brings people in for dx and treatment.
Difficulty getting organized. Tend to pile up stuff or stack….big piles
Procrastination and a frenzy of action at deadline. Two times: NOW and NO NOW. The capacity to anticipate not present. Need external structure.
There is a tendency to have many projects—love the novelty, but lack follow-through.
Tendency to say whatever comes to mind. Genetically related to ADD is Tourette’s symdrome.
Tendency to search for high stimulation in order to feel focused. The high stimulus produces endorphins. People with ADD tend to worry a lot and create worry in order to provide a stimulus.
Intolerant of boredom.
Easily distracted-hypervigilent and hyperreceptive. Mind goes wherever and enchantment takes it. That occurs to all of us, but for ADD people is frequent and in all setting. BUS STORY
Tend to be mavericks—don’t follow instructions.
Tend to be creative, highly intelligent. Treatment should aim to find special talents.
Impatient—move it along; keep changing.
Sense of insecurity and mood swings…labile because they do not have mood controls.
Restlessness-drumming fingers, tapping feet, twirling hair. This is emotion in search of a cause.
Poor tolerance of frustration. Not knowing and can’t do it. ADD people heat up quickly; need to contain it.
Have problems with self esteem
Inaccurate self observation.
There is a family history.
Often hypersensitive to touch, itchy clothes.

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