Gifted Issues Discussion homepage Forums Twice Exceptional Pearson presentation TODAY: outing ADHD fakers

In the work Dr. Amen has done with SPECT imagining of brains, he has found the blood flow to the pre-frontal cortex (home of executive function in the brain) diminishes significantly when those with ADD focus on an activity. This is the opposite of how a neuro-typical brain responds. I saw it in my son's scans.

My child in particular has a type of ADD brain pattern on SPECT scans (Amen calls it ring of fire) that looks identical to a Manic/Depressive brain pattern. The Hyperactivity and impulsivity can be Mania rather than ADHD and lack of focus and lethargy can be depressive symptoms. They were careful to tease out whether DS had any depressive symptoms or ideation. I was told what HowlerKarma was sharing about Bipolar when discussing appropriate treatment at my son's psychiatrist's clinic.

I've read a bit about the "outgrowing it" theories for ADD/ADHD. The most plausible thing to me is the proposition that adults have more freedom to work out their own environments. An adult can choose a job with constant movement or take a walk down the hall or even buy a treadmill desk (have you seen these?). I've heard it suggested that ER doc was the ideal career for someone with ADD.

My husband (ADD) is a phenomenal multi-tasker. He also raises the adrenaline level by managing multiple clients on the side while maintaining a fulltime job. There's always someone needing something. Focusing on ONE job is death to him. He can't stay awake or get it done. In college he had 12hrs of classes and 12hrs of independent study when we started dating. He's never been medicated and he does frequently leave the milk out overnight and is horrendous at home maintenance tasks. If he had a job that didn't allow flex scheduling, he would certainly be fired. But as it is, in the environments he has chosen, he's been a mostly high functioning individual.

My BIL chose a career as a gym teacher and both he and my FIL include time to run each day which allows them to sit and work as needed.

Nutrition is huge as has been stated. Changes there (including therapeutic levels of vitamins and minerals) and with aerobic exercise, including choosing flexible environments make coping with adult ADD more manageable.

So many of you touched on these things I had to chime in with experience with our extended ADD family. It's been fascinating to me to learn about it.

I read one of Amen's books and wish I could get both of my kids a SPECT scan. Is that what they are talking about now in the news when they say there's now a brain scan for ADHD?

Studies that state medication does not work for ADHD seem absurd to me in light of our experiences with DD. When she's not medicated, she does things like smear poop on the wall like a 2 year old. Draw on the walls, sneak things, destroy things for no reason, etc. If I take her out, I fear she will run out into the road like a toddler and get hit by a car. If I put her on the computer and have her practice her math facts, she would do horribly without the meds but all of a sudden medicated, she can remember then all? When she's on meds no one would ever guess she has a disorder. It's that extreme. I suspect that in extreme cases of ADHD, the meds unquestionably benefit most kids but they don't make nearly as much difference in those with mild ADHD (and it's probably not worth the risk to use them). The mild cases are also probably the kids that appear Ok after 3 years because they've "outgrown" it.

I was thinking about the routine or lack of it nowadays. When we were kids we got up at the same time every week day, we ate the same breakfast, biked or walked half a mile to school, had a school day that was mostly the same every day and when there were trips etc we knew in advance, we had classrooms where you worked quietly by yourself and exercise every day, then we biked or walked home had something to eat and played outside until teatime. We did no outside activities, we never went grocery shopping or on errands (it was done while we were at school). We went to bed the same time with the same routine every night except Saturday when were allowed to stay up until 8.30. We had no TV and no computer. My little brother was still on the hyper side but not in trouble just tiring at tines. My kids have such a different life.

puffin, that is the exact same thing that has occurred to me.

Just the level of noise input alone is phenomenally different.

Compared to my childhood (which was chaotic since I lived in a highly dysfunctional home), my daughter's life is a veritable CIRCUS of chaos from day to day. It must have seemed almost random to her until she was 10 or 11.

It is easy to think that these neurological disorders are caused by environment to a great extent; and some studies show that true deprivation does cause problems in brain development that look like ADHD.

However, this kind of claim often moves over imperceptibly but surely into blaming the parents for not providing a proper environment for the child. We were once told by a well-meaning psychologist that if we were doing time-outs properly, our DS would not have the difficulties he was having (not unlike all the docs in the 1950s who blamed autism on the "refrigerator mothers"). We were "doing them properly"; they were simply not what DS needed for learning.

Our household was quite calm in my children's early days, no TV, not a lot of hustle; and yet they became neurologically interesting. Ah, well. I'm probably doing it wrong some other way.

Not in my book, Dee Dee... what I mean is that we can only shield them from such radical changes in the larger world to quite a small degree, when you get right down to it.

As parents we only control so much of their environment.

I'm not sure of that. There have been a few who have found markers for ADD. I think some of the first work was done at Univ. of TN in Knoxville with EEGs. Amen mentioned this study inspiring him. He often says Psychiatrists are the only doctors who never look at the organ they treat.

What I most respect about Amen's work is that he was HIGHLY motivated to pursue better diagnostics and treatment because his wife and children suffered from it. He's lived it and is sympathetic. He is also not ANTI med. For some it is the best choice. He just doesn't START with drug trials. He starts with diagnostics like blood tests, computer testing, and SPECT scans in addition to extensive history. Those results determine the plan. Rather than try this drug, come back in a few weeks and we'll see how it goes. IF you can get the results you need through diet, exercise, biofeedback, vitamins, supplements, etc than certainly with the risks of medication it would be good to have that option available.

It is expensive to do the SPECT scans. I've seen them run about $1000 to $1200 each and insurance doesn't often cover it. For us, we thought we could easily spend that in psych bills trying to chase down solutions and diagnoses... My husband and I are considering saving for him to get his brain scanned as well. We know he has potential brain damage affecting him from a concussion as a teen. The full work up and follow up is about $3k plus we have to travel to get to one of the clinics. Knowing how helpful it was for my son it seems worth it to us.

I think the length and depth of this post is a testament to the passion and complexity of dealing with ADHD and its increasingly frequent diagnosis.

Our life feels chaotic to me, but particularly in term time our weeks are VERY consistent, DH travels a bit, but the kids have consistent sleep/wake, exact same morning routine every day (down to the same food), exact same chore / work expectations. School is predictable... We have after school activities mon-wed, but they are extremely consistent and generally only the child with the lesson goes out, the others play at home. They have more screen time than ideal. Could we be more perfect at discipline? Yep, sure could, I know I was spectacularly good at thinking before I spoke, carefully formulating consequences and absolute follow through when I had only one child and no health problems of my own. But still we have higher expectations and enforcement than much of what I see around us. And still we have a child with AS and one with ADHD.... Our biggest variability is endless Dr/psych/OT appts. And our chaos and struggles are almost always about just how hard it is to keep these kids organised and on time and looking "functional/normal" in their interactions with the world.

Oh and all the kids are on different, needs based, strictly controlled diets that help them enormously.

My youngest has the most variability in her days (two preschools, a nanny one day and ballet one day, every morning she asks "What am I doing today?"), she's my most NT child and LOVES this, she's always happy to be going somewhere (painfully extroverted) and is generally a happy easy child, she's well behaved, socially/emotionally delightful, gifted & funny - daycare and preschool LOVE her... And really she's received our "worst" parenting and most chaotic start to life. Despite my being less "on" as a parent she's my first child to make it to 3 without needing minor surgery for a facial injury, never has accident reports from daycare, doesn't throw herself into 6 feet of water for fun, or climb inappropriate things, break things, etc...it's astonishing how often you get those looks for being such a crap parent to a difficult-to-parent-child when in fact you work SO much harder for that child than the easy child... Noone blames my bad parenting and chaotic life for how friendly, happy, easy and delightful my third child is...

The presence of this item on the American Community Survey (ACS) of the Census Bureau may be reflective of ADHD as well?
Other questions ask about difficulty dressing or bathing... and for those 15+, doing errands alone such as visiting a doctor's office or shopping?

Indigo I think questions like that are aimed at any of a plethora of problems, sure ADHD is on the list, but probably low down compared to RA, MS, Dementia, severe panic disorders, etc. the adults I know with ADHD forget things, screw things up out of sync with intellect, take ages to get some things done (super speedy with others), etc. But they generally CAN do the grocery shopping, even if they are slower and less reliable than someone without ADHD. As compared to someone who physically can't push a trolley, drive a car, whatever...