What is ADD?

What is ADHD?

 ADHD is…

a highly genetic, brain-based syndrome that has to do with the regulation of a particular set of brain functions and related behaviors.

These brain operations are collectively referred to as “executive functioning skills” and include important functions such as…

  • attention
  • concentration
  • memory
  • motivation
  •  effort
  • learning from mistakes
  • impulsivity
  • hyperactivity
  • organization social skills.  

There are various contributing factors that play a role in these challenges including chemicaland structural differences in the brain as well as genetics

.

  • Difficulty paying attention or focusing, such as when reading or listening to others.
  • “Zoning out” without realizing it, even in the middle of a conversation.
  • Struggling to complete tasks, even ones that seem simple.
  • A tendency to overlook details, leading to errors or incomplete work.
  • Poor listening skills.
  • Have a hard time remembering conversations and following directions.
  • Extreme distractibility OR hyperfocus.
  • Wandering attention, or overfocusing; both can make it hard to stay on track.

ADHD was the first disorder found to be the result of a deficiency of a specific neurotransmitter — in this case, norepinephrine — and the first disorder found to respond to medications to correct this underlying deficiency.

Like all neurotransmitters, norepinephrine is synthesized within the brain. The basic building block of each norepinephrine molecule is dopa; this tiny molecule is converted into dopamine, which, in turn, is converted into norepinephrine. *from www.attitudemag.com*

 

What are the treatment options?

Stimulants.

The most common type of medication used for treating ADHD is called a “stimulant.” Although it may seem unusual to treat ADHD with a medication that is considered a stimulant, it works because it increases the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention.

Non-stimulants. A few other ADHD medications are non-stimulants. These medications take longer to start working than stimulants, but can also improve focus, attention, and impulsivity in a person with ADHD. Doctors may prescribe a non-stimulant: when a person has bothersome side effects from stimulants; when a stimulant was not effective; or in combination with a stimulant to increase effectiveness.

Although not approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of ADHD, some antidepressants are sometimes used alone or in combination with a stimulant to treat ADHD. Antidepressants may help all of the symptoms of ADHD and can be prescribed if a patient has bothersome side effects from stimulants. Antidepressants can be helpful in combination with stimulants if a patient also has another condition, such as an anxiety disorder, depression, or another mood disorder.

Adding psychotherapy to treat ADHD can help patients and their families to better cope with everyday problems.

Behavioral therapy is a type of psychotherapy that aims to help a person change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioral therapy also teaches a person how to:

  • monitor his or her own behavior
  • give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting

Parents, teachers, and family members also can give positive or negative feedback for certain behaviors and help establish clear rules, chore lists, and other structured routines to help a person control his or her behavior. Therapists may also teach children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing. Learning to read facial expressions and the tone of voice in others, and how to respond appropriately can also be part of social skills training.

Cognitive behavioral therapy can also teach a person mindfulness techniques, or meditation. A person learns how to be aware and accepting of one’s own thoughts and feelings to improve focus and concentration. The therapist also encourages the person with ADHD to adjust to the life changes that come with treatment, such as thinking before acting, or resisting the urge to take unnecessary risks.

Further reading:

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The Science of ADHD

Real Science Defines ADHD as Real Disorder

Some of the most prestigious scientific-based organizations in the world conclude that ADHD is a real disorder with potentially devastating consequences when not properly identified, diagnosed and treated. Causes and Brain Chemistry Research has demonstrated that ADHD has a very strong neurobiological basis. Although precise causes have not yet been identified, there is little question that heredity makes the largest contribution to the expression of the disorder in the population.

In instances where heredity does not seem to be a factor, difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, significantly low birth weight, excessively high body lead levels, and postnatal injury to the prefrontal regions of the brain have all been found to contribute to the risk for ADHD to varying degrees.

Research does not support the popularly held views that ADHD arises from excessive sugar intake, excessive television viewing, poor child management by parents, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might aggravate symptoms, especially in certain individuals. But the evidence for such individual aggravating circumstances is not strong enough to conclude that they are primary causes of ADHD. A related problem that has some accumulating evidence is sensitivity to food or additives such as colorings and preservatives. Several controlled double-blind studies suggest that these might be important for a minority of children with ADHD, and a couple of controlled studies suggest a small effect on all children whether or not they have ADHD. Further research on this connection is warranted.

Neurochemistry

Structural and functional imaging research on the neurochemistry of ADHD implicates the catecholamine-rich frontal-subcortical systems in the pathophysiology of ADHD. The effectiveness of stimulant medication, along with animal models of hyperactivity, also point to catecholamine disruption as at least one source of ADHD brain dysfunction.

A 10-year study by National Institute of Mental Health found that brains of children and adolescents with ADHD are 3-4% smaller than those of children who don’t have the disorder and that medication treatment is not the cause (Brain Imaging in Children with ADHD).

Basic neuroimaging research is being conducted to further delineate the pathophysiology of ADHD, determine diagnostic utility of neuroimaging, and elucidate the physiological effects of treatment. However, the research is not definitive enough for practical application of neuroimaging.

Executive Function

Many of the symptoms classified as ADHD symptoms of inattention are actually symptoms of executive function impairments. Executive function refers to a wide range of central control processes in the brain that activate, integrate, and manage other brain functions. Best put, Thomas E. Brown, Ph.D., of Yale University compares executive function to the conductor of an orchestra. The conductor organizes, activates, focuses, integrates, and directs the musicians as they play, enabling the orchestra to produce complex music. Similarly, the brain’s executive functions organize, activate, focus, integrate and direct, allowing the brain to perform both routine and creative work.

The components of executive functioning that impact school or work:

  • working memory and recall (holding facts in mind while manipulating information;
  • accessing facts stored in long-term memory)
  • activation, arousal and effort (getting started; paying attention; completing work)
  • emotion control (tolerating frustration; thinking before acting or speaking)
  • internalizing language (using self-talk to control one’s behavior and direct future actions)
  • complex problem solving (taking an issue apart, analyzing the pieces, reconstituting and organizing them into new ideas) –

See more at: http://www.chadd.org/Understanding-ADHD/About-ADHD/The-Science-of-ADHD.aspx#sthash.0NOJMkIU.dpuf

Benefits of ADHD

You’ve cleared the afternoon to write the speech for your best friend’s wedding.

As soon as you sit down, your mind wanders to the street outside your window; the sound of the faucet dripping in the sink; the empty refrigerator. You were supposed to buy groceries. You get up and check the fridge. A glistening bottle of seltzer water in the back makes you realize you’re thirsty. You pour yourself a glass. While sipping, your mind wanders back to the speech.

You sit back down, determined to focus this time.

If you have ADHD, or attention-deficit hyperactivity disorder, this might seem like a familiar scenario: You’re used to having relatively simple tasks feel excruciatingly difficult.

But while most of us tend to focus on the negatives of ADHD, some of the characteristics we associate with the disorder, from impulsivity to an inability to follow directions, can have some surprising benefits too.

1. Being Perceptive

Okay, so your short attention span could mean that wedding speech will never get written. But being incapable of zeroing in on a single thing might also help you pick up on changes in your surroundings that others might not notice. This could come in especially handy when your job — or even your life — depends on noticing such a change. Say you and some friends are camping, for example. While most of the gang is busy roasting marshmallows, you notice a bear heading straight toward your campground. Your inability to focus on making s’mores just saved your life. Recent research suggests that this kind of behavior may have played a role in how we evolved: Some of our nomadic ancestors had ADHD-like characteristics, too. These people would have been quick to notice changes to their natural environment — such as a stream drying up or an approaching predator — and alerted their family members in time for them to find new sources of water or plan an escape. Thank you, easily-distracted nomads.

2. Thinking Creatively

 Most bosses, teachers, and parents agree: Having an employee, student, or child who can’t follow directions can be infuriating. But an inability to do what one is told might also enable someone with ADHD to come up with creative solutions to problems that others would never dream of. Recent research backs up that idea. In two studies (one of children and one of adults), participants with ADHD came up with more novel ideas than those without the disorder. In one test of children who were tasked with coming up with new toy designs, those with ADHD came up with a far more diverse array of different types of toys than those without ADHD. Similarly, in another test of adults who were asked to think of as many uses as possible for a common object, such as a cup or a brick, those with ADHD outperformed those without it. However, when the adults were given other tasks to test creativity, such as one in which they had to find something in common amongst three seemingly unrelated items (such as the words mines, lick, and sprinkle) those with ADHD performed worse than those without it.

3. Expressing Emotion

Many people with ADHD also have a hard time controlling their emotions. Researchers aren’t sure yet whether this experience is part of ADHD or a separate condition. If you have what’s known as emotional dysregulation, you rarely feel apathetic. Whether you’re sad, upset, or elated, your emotions tend to be strong and straightforward. While some people might label you emotional, others — especially close friends — might appreciate your tendency to share how you’re feeling. And recent research suggests that allowing ourselves to feel emotions as they happen helps us process them and prepare for the future. People with emotional dysregulation also tend to have a hard time recognizing others’ emotions and sometimes misinterpret them as a result. While this could certainly be a challenge to forming healthy relationships, research suggests that people can compensate for it with clear communication.

4. Tackling Specialized Jobs

Overall, these characteristics might make people with ADHD better suited than the rest of us for jobs that take advantage of their flexibility and impatience. “In the right environment, these traits are not a disability, and can be a real asset,” Weill Cornell Medical College clinical psychiatry professor Richard A. Friedman suggested in a recent op-ed for The New York Times. Jobs that require frequent travel, such as journalism and photography, or positions that require frequently switching from one type of task to another, could be well suited to people who have many of the characteristics associated with ADHD. One of Friedman’s patients, he writes, saw a decline in his ADHD symptoms after he switched from a desk job to a position in a start-up where his work environment was constantly changing.

Erin Brodwin, Business Insider


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