The Truth About ADHD

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The Truth about ADHD

   Carrington M. Nye

  University of Phoenix
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                                          Abstract

Speaking to someone with ADHD about their disorder seemed the best approach to take
when undertaking this particular assignment. Therefore, I undertook the task of
interviewing my husband‟s sister, Colleen, who is now an adult, but who, while in middle
school was finally diagnosed and treated for ADHD. This will be but one part of the paper,
which will also cover the myths of ADHD, the difficulties diagnosing the disorder, and
finally the different treatments available. Perhaps it should be noted that I chose this
disorder because I have always been a firm believer that this is not a “real” disability, but a
crutch of sorts or an excuse. Learning more about the disorder and the facts from a research
standpoint (hopefully) will quell any illusions I have personally about the disorder.
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         Colleen Nye Dunlap is a very real individual. With her permission, she will be

featured in this paper about ADHD (Attention Deficit Hyperactivity Disorder) and she will

tell us how as a child her behavior was prior to being diagnosed, how she was diagnosed,

what steps she had to take for her treatment, and how she still struggles in her daily life as

an adult living with ADHD.


Question: How old were you when you were first thought to have ADHD?


Answer: It was as early as fourth grade, but everyone just wrote it off as regular childhood

hyperactivity. By the time I was in middle school, my teachers were hollering that I needed

to be tested and put on medication for (the disorder). My mom flat refused medication

though.


Question: When you say that the teachers were saying those things, how did they say

them; in a parent/teacher conference or in letters home?


Answer: All of the above. I was getting into trouble all the time for not paying attention,

for not sitting still, for not hearing what my teachers said to me during class. It was so

frustrating, but I was just bored to tears and could not focus on one thing at a time. I still

can‟t.


Question: How did you finally get diagnosed to everyone‟s satisfaction?
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Answer: Mom took me to my doctor who knew of this woman at the University of

Tennessee who was getting ready to start a case study on ADD and ADHD. He contacted

her and we were in – I went to see her (her name was Sheryl Brim) soon thereafter and that

is when I was finally diagnosed.


Question: How were you diagnosed?


Answer: There was a questionnaire, an interview with Ms. Brim, and some activities that I

had to do. It is hard to recall everything but I do remember that much.


Question: And the treatment?


Answer: Like I said, Mom said no to any medication, she didn‟t want me to be zoned out

and to act differently, and that was what was so good about this case study, I was taught

how to cope with my disorder. When other kids were heading to the pool in the summer I

got to go to U.T. and sit around learning all day!


Question: Do you still have it?


Answer: Yes, but I now know how to cope, how to bring myself back to the present. My

Professors still get grouchy when I am doing homework for another class in their classes,

but they don‟t say anything because I am getting A‟s and B‟s in their classes. But if I

cannot focus, that is what I do, multitask.


           Motivation and Students with Attention Deficit Hyperactivity
           Disorder by
           Sheryl A. Brim, PhD.; Diane P. Whitaker.
           http://www.informaworld.com/smpp/content~db=all~content=a9207
           77049

           
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       Next, let us explore some of the more popular myths surrounding Attention Deficit

Hyperactivity Disorder. One of the most common myths of all is that ADHD is not a real

disorder. Some people have even gone so far as to state that this disorder was created by

the psychiatric community in contusion with pharmaceutical companies to increase drug

company profits. This may seem a bit far fetched, but there are those out there that truly felt

that this „conspiracy theory‟ was and is true. (National Institute of Health)


       According to the National Institutes of Health, the Surgeon General of the United

States, and an international community of clinical researchers, psychiatrists and physicians,

there is general consensus that AD/HD is a valid disorder with severe, lifelong

consequences (NIH, 2000; U.S. Surgeon General's Report, 2001). Studies over the past 100

years demonstrate that AD/HD is a chronic disorder that has a negative impact on virtually

every aspect of daily social, emotional, academic and work functioning (Barkley, 1998).

Studies show that children with AD/HD have higher rates of other psychiatric disorders,

higher frequency of hospitalizations, emergency room visits and total medical costs

compared to individuals without AD/HD (Liebson et al., 2001).


       Another popular myth is “ADHD is over diagnosed”. And if you have been even

remotely aware in the past decade, it did seem that ADHD was as much a fashion as

Tommy Hilfiger and Abercrombie and Fitch. ADHD was everywhere; the news, talk

shows, in magazines, and at the doctor‟s office.
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          Despite these claims, it is difficult to find evidence that AD/HD is over-diagnosed

or that stimulant medications are over-prescribed (Jensen et al., 1999). Changes in special

education legislation in the early 1990s increased general awareness of AD/HD as a

handicapping condition and provided the legal basis for the diagnosis and treatment of

AD/HD in the school setting. These legal mandates have increased the number of school-

based services available to children with AD/HD and may have inadvertently led some to

conclude that AD/HD is a new disorder that is over-diagnosed. (National Institute of

Health)


          Taking a look deeper, to understand how a child has ADHD, we go up, to the brain.

The answers as to why there are many mental disorders are there – if you know what to

look for; ADHD is no exception. The frontal lobe, or the “manager” of the brain, is the area

of the brain that:


    1. Decision-making and planning of new situations

    2. Error detection and correction and developing plans for trouble-shooting

    3. Technically difficult or new situations with demand for new solutions

    4. Resisting temptations and habitual responses

    5. Impulse control and dealing with frustrations

    As you can see from the list above, the frontal lobe, if not working properly, can have a

    huge impact; one consequence of this impact could very well be ADHD.

    (web4help.info)
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    The diagnostics of testing for ADHD, and to meet the diagnostic requirement

according to the DSM-IV (Diagnostic and statistical Manual of psychiatric disorders)

must be met:

Six (or more) of either 1) Inattention, or 2) Hyperactivity/Impulsivity Symptoms must

have persisted for at least 6 months to a degree that is maladaptive and inconsistent

with developmental level:

1) Inattention

   often fails to give close attention to details or makes careless mistakes in

    homework, work, or other activities

   often has difficulties sustaining attention in tasks or play activities

   often does not seem to listen when spoken to directly

   often does not follow through instructions and fails to finish schoolwork, chores, or

    duties in the workplace (not due to oppositional behavior or failure to understand

    instructions)

   often has difficulties organizing tasks and activities

   often avoids, dislikes or is reluctant to engage in tasks that require sustained mental

    efforts

   often loses things necessary for tasks or activities (e.g. toys, school assignments,

    pencils, books)

   is often easily distracted by extraneous stimuli

   is often forgetful in daily activities
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2) Hyperactivity/Impulsivity

Hyperactivity

   often fidgets with hands or feet or squirms in seat

   often leaves seat in classroom or in other situations in which remaining seated is

    expected

   often runs about or climbs excessively in situations in which it is inappropriate (in

    adolescents or adults, may be limited to subjective feelings of restlessness)

   often has difficulty playing or engaging in leisure activities quietly

   is often "on the go" or often acts as if "driven by a motor"

   often talks excessively

Impulsivity

   often blurts out answers before questions have been completed

   often has difficulty awaiting turn

   often interrupt or intrudes on others (e.g. butts into conversations or games)

B) Some symptoms causing impairment were present before age 7

C) Some impairment from the symptoms is present in two or more settings (e.g. at

school and at home)

D) There must be clear evidence of clinically significant impairment in social,

academic or occupational functioning

E) Occurrence is not exclusively during the course of a Pervasive Developmental

Disorder, Schizophrenia or other Psychotic Disorder. (web4health.info)
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Where in the brain does ADHD come from?


ADHD in children is caused by low levels of Dopamine, a chemical in the brain that is

considered the neurotransmitter of focus and attending. Low levels impair the ability to

focus or to “lock on” to a task, an activity, or conversations. (Joseph M. Carver, PhD.)


What are some of the treatment options for those with ADHD?


Pharmacotherapy is one option of a multimodal treatment approach of ADHD. While

stimulants (methylphenidate, amphetamine, dexamphetamine) are the treatment of choice

some antidepressant medication has also positive effects for the treatment of ADHD.


Methylphenidate is the name of the most commonly used medication for the

psychopharmacotherapy of ADHD. Brandnames of drugs with Methylphenidate are

Ritalin, , Ritalina, Ritaline, Ritalin-SR, Ritalin LA, Concerta, Attenta, Penid, Rubifen,

Focalin, Daytrana and Metadate. There are also some generic medications with

Methylphenidate (Equasym, Medikinet). Methylphenidate is a central nervous system

stimulant, or a CNS stimulant.


To achieve positive effects for ADHD patients the main target of the medication is the

dopamine system of the brain. The most relevant neurobiological problem of ADHD can be

explained as a malfunction of the dopamine transporter system. These transporters are

responsible for the reuptake of dopamine from the synaptic gap into the nerve cells. If the

activity (or number of transporters) is too high, the available dopamine is too low.
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The other option (without drugs) is psychotherapy. Behavioral Therapy is a very well tried

way to change certain habits and behavior by increasing the frequency of acceptable

(wanted) behavior and decrease the frequency of unacceptable behavior.


Behavior Modification is a term that describes this approach with certain programs that

have been developed for children, adolescents or adults with ADHD. The bases of

behavioral modification are rewards and consequence structure. Positive feedback

(appraisal or any kind of immediate reward) are given for "good" behavior. So the child

will try to increase this behavior to please the parents (or get the reward). (web4health.info)


What are some symptoms of ADHD?


Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood

disorders and can continue through adolescence and adulthood. Symptoms include

difficulty staying focused and paying attention, difficulty controlling behavior, and

hyperactivity (over-activity).


What causes ADHD, or how do some people have skewed Dopamine levels?


Scientists are not sure what causes ADHD, although many studies suggest that genes play a

large role. Like many other illnesses, ADHD probably results from a combination of

factors. In addition to genetics, researchers are looking at possible environmental factors,

and are studying how brain injuries, nutrition, and the social environment might contribute

to ADHD.
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                                     References:


Information about ADHD retrieved from the National Institute of Mental Health,
2010 at http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-
disorder/complete-index.shtml


ADHD - Behavioral Modification, Copyright 2003-2008, retrieved 2010 from
http://web4health.info/en/answers/adhd-behav-modif.htm

Carver, Joseph M. PhD; Living With Mental Illness, Monday, 16 February 2009, retrieved
from http://www.mental-health-
matters.com/index.php?option=com_content&view=article&id=759&limitstart=2