Most people still believe that Attention Deficit Hyperactivity Disorder is a disease of childhood affecting only children and adolescents. In the past two decades however, scientists are convinced that ADHD is not “outgrown” with age… instead the symptoms persist but the individual copes with the resultant problems differently as he or she adapts to adulthood. For example a child’s “temper tantrum” or inability to hand in homework may be paralleled by the ADHD adult’s outburst (temper sounds like such a button pusher as we get older) at his/her family and failure or inability to pay household bills on time. There are several examples of paralleling symptoms persisting into adulthood without diminution, but let’s talk about treatments and the impact of the untreated individual and their family members.
How important is ADHD Treatment?
It is well documented that the untreated child with ADHD leads to academic failure, an increased risk of co-occurring conduct disorder, alcohol or substance abuse/dependence, and legal issues. In the adult, if treatment is discontinued or he/she escapes the mental health/legal system if never treated, they continue to experience academic failures, disrupted careers and relationships ultimately leading to feelings of failure, inadequacy and depression secondary to never “reaching their full potential”. In addition, it was noted in a study comparing the cerebellum (plays a major role in coordination and balance i.e. walking, running, writing, dressing and eating among other motor skills) to those diagnosed with ADHD to those without, that the volume of the cerebellum was significantly smaller in 57 boys with ADHD compared with 55 boys without. (Berquin, P.C. et al. Neurology, vol. 50, 1998. Pp. 1087-1093.)
Controversy over ADD/ADHD
Among the medical community, controversy over the diagnosis and treatment of ADD/ADHD as a child as well as over one’s lifespan is an understatement. ADHD is a syndrome, a cluster of symptoms, rather than a disease state with a specific etiology. Instead, it is a subset of a larger set of symptoms that persist, therefore there is nearly an infinite variety of presentations of syndromatic, psychiatric or medical diagnosis that unfortunately do not have a simple lab test or CAT scan to easily verify the “disease”. For example, depression – which I’ll repeat costs this country more than all cancers combined – is a perfect example of a syndrome-where like ADD/ADHD 2 people can suffer from, or carry the same diagnosis, and have no objective (outward) symptoms that overlap. This may be very confusing for some medical providers, which in turn may be one of the factors that contribute to the under-treatment of these diagnoses.
Contemporary medicine would never use a monothetic definition (applying to one theme or aspect) to describe a human condition as they would if they were describing an isosceles triangle, which is a triangle with 2 equal sides. Otherwise, man/woman monothetically would be described as a Featherless Biped – a two-legged animal lol (Paul H, Wender MD). Remember every person deserves to reach their fullest potential in their lifetime. On an ethical level, every health care provider has a responsibility to provide treatment to an individual that suffers from any illness. In regards to “Adult” ADD/ADHD, to refuse to acknowledge and treat it leads to physical and emotional human suffering and loss of productivity within society. In modern psychiatric terminology, the polythetic method (applying to multiple themes or aspects) of categorizing or classifying a ‘syndrome’ is common with the ultimate goal of diagnosing and treating a disorder without a specific etiology. Presently there have been advances in medicine identifying genes/genetic links to several psychiatric and substance dependence disorders.
Treatments for ADHD
There are some different medical treatments for ADHD which are involved in the regulation of specific neurotransmitters i.e. SNRI’s (Selective Norepinephrine Re-uptake Inhibitors) which boost the neurotransmitters such as norepinephrine/noradrenalin and dopamine; Amphetamines- which enhance norepinephrine and dopamine activity by blocking their re-uptake and facilitating their release in certain brain regions; Selective anti-hypertensives, ie: Guanfacine….. although the mechanism of action is unknown, it is thought to selectively stimulate alpha-2A adrenoreceptors in the prefrontal cortex, all of which can strengthen memory, reduce distractibility, improve attention and behavioral inhibition, and enhance impulse control. WOW, and if you were able to read that you probably don’t have ADD!! As you know, FOOD MATTERS and it has been demonstrated that individuals with ADD/ADHD have lower dopamine levels than those who do not. So eat plenty of tyrosine foods like almonds, bananas, avocados, lima beans, pumpkin (seeds) and sesame seeds….ENJOY!
