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Everything ADHD - Symptoms to Treatment Options

Added Oct 10, 2018 •

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what we know as ADHD attention deficit hyperactivity disorder or some people still call it ATD attention. what disorder has been recognized by some doctors since way back in 1902 but from 1902 until 1980 it was all about little boys who couldn't sit still couldn't shut up or driving everybody it was just behavior problems the name of the disorder was change the number of times that are different formulations but it was all about behavior problems since 1980 which is when they first changed the name of the disorder to include the words of 10 deficit we realized that this is not so much a behavior problem but far more a problem with the brains management system it's executive functions and we also learned that there are many people who have ADHD never had any significant behavior problems have the attention problems that tend to make more trouble for people particular it got a little bit older and more is expected of them for being able to man some cells 1 things it's important to be clear about from the very beginning is that ADHD has nothing to do with how smart a person is there's some people have this or like super super super smart others High average middle average average slow I treat people for this right University professors and doctors and lawyers and big shots and business a lot of people who are regular folks some people have trouble doing the basics you can be anything along the IQ spectrum and still have ADHD has nothing to do with smart you are you don't seem to know is that this is a problem a set of problems that include a wide range of characteristics and what I'd like to do today is to describe for you some of the characters 6 of what we call ADHD give some examples of them and then talk a little bit about what we know about what's involved in the brain in the course of ADHD thing that's important is that people if you want to main things that people with ADHD complain about his a shuttle staying tuned that when they're listening or reading or working on something they get part of it but then it's sort of drifts off and then they're back and then I drift off and drifts off again and then their back they have difficulty to staying tuned it's similar in a way to the problem you have with a cell phone where you're in an area where you don't have good reception and get part of it and then the message keeps fading in and out the other thing is if they often have a problem with being distracted like anybody else they see and hear things that are going on around them they have thoughts going through their head but most people if they have something that got a focus I can put that stuff out of the way and focus on what you got to do people with ADD is real hard for me to do that you'll be sitting in the classroom trying to listen to what's going on or perhaps it'll be in a meeting or sitting down trying to read something or write something and somebody dropped a pencil NAFTA start a check and see where did the pencil go back on task again for a couple of minutes then I think about some TV show they saw the night before and they're back on task again for a minute to think about some conversation I had with somebody 2 hours ago and then they're back on task again for a few minutes and then they're looking out you know like anybody else will from time to time but they're likely to sit and watch the squirrel go up the tree a little longer than somebody else and be checking out the traffic in the cloud formation the guy was mowing the lawn and their back on task again for a few minutes nobody think about what they're going to do with this over and how soon is this thing going to be over in I've got things I've got to do with what I'm going to have for supper tonight and I wonder what's on TV tonight all these things are coming in all at one time is almost like you're trying to watch TV and got four different stations all coming into the same time at the same on one channel and it's kind of hard to separate the signal from the noise the things with puzzling about this that really makes it very difficult for people to understand is for people who have ADHD it's like that almost all the time but not always buddy I've ever seen was a TD and that's a lot of people has a few things they can do where they have no trouble paying attention no trouble focusing give me an example 16 year old boy I saw he was the goaltender schools ice hockey team it just happened that the day is parents brought him in to see me was the day after his TV just won the state championship in ice hockey so they're bragging a little bit of the beginning about how great he was in the tournament the day before apparently was a very good goalie isn't it playing hockey team is nothing he knew where the f*** was every second of fast game totally on top of the kind of goalie every team wants smart kid tested way high up in the superior range wanted to get good grades was hoping to go to medical school but he was always in trouble with his teachers once in awhile you'll say something that shows how smart you are we'll be talking about something you'll come in with some, this really very perceptive it's quite impressive but most the time you're out to lunch you're looking out the window you're staring at the ceiling and look like you're half asleep half the time you don't know Paige run and the question kept asking was if you can pay attention so well when you're playing hockey how come you can't pay attention you're sitting in class or is another example as parents are bringing kids for me to see in the state or the teacher says this kid can't pay attention for more than 5 minutes you know that's not true we have watched her play video games and she can sit and play those video games for 3 hours at a time and not move and a teacher said she is easily distracted when she's playing those games she's locked on the laser the only way you're going to get her attention to jump in her face turn off the TV so we can even do it here why can't you do it there that's not always sports or video games or some people if they do then I could have that stuff they might be the art they're sketching and drawing a really getting into it somebody else when they're little they're creating engineering Marvels with Lego blocks when they're older they're taking car engines apart and putting them back together or designing computer networks but everybody I've ever seen with ADHD has a few things they can do where they have no trouble paying attention even though everything else that got a lot of trouble paying attention ask what I say what's with this how come you can do it here and you can't do it here here and here you see what they'll say is it's easy if it's something I'm interested in I can pay attention if not I can't the most people here that they say yeah right that's true for anybody anybody going to pay attention better for something they're interested in them for something or not which is true but here's the difference people who don't have ADHD and they got something they've got to do and they know they've got to do it it's important they can usually make themselves it was pretty boring just because they know they have to do it people with ADD it is incredibly difficult for them to be able to make themselves pay attention unless the task is something that's really interesting to look at because somebody told them that oughta be interesting but you because use interesting to him for whatever reasons or if they feel like they have a gun to their head and something very unpleasant is going to be happening very fast if they don't take care of this right here right now under those two conditions no problem they can focus very well anything else it's really difficult for them to focus but the problem is this is not something is under voluntary control it makes it look like it's a problem with willpower if you can do it here why can't you do it here here and here but it's not a problem with willpower it's a problem with the way the brain is wired all the characteristics of ADHD which I'm going to be describing here I think everybody has trouble it's sometimes just people with ADD have a lot more trouble with it so in that sense ADHD is not an all-or-nothing deal I pregnancies are you are pregnant or you're not pregnant there's nothing in between it's more like depression where everybody gets a bump that once in awhile but just me because I'm unhappy for a couple of days doesn't mean we were diagnosed clinically depressed it's only when those depressive symptoms are persistent and pervasive and making a lot of trouble for me so yeah that's a depression we got to do something about it so all the characteristics of ADHD our problems everybody has sometimes it's just the people of 80 do they just have a lot more difficulty with it more the time in the problem is it is not under voluntary control it's not something you can do with willpower let me tell you about some of the other things in which we see with people with ADHD one is they often have trouble getting organized and getting started on things for many it's difficulty organizing their stuff that they're their desks their notebooks their filing system their living space bigger mess than most other people most of the time unless somebody else is helping to take care of it other people have no trouble at all with their stuff they have a lot of trouble with their time in their work and what they'll tell you is if I have a bunch of to do it one time it's really hard for me to look at and say okay that should be first that should be second that you be third what do you want to get your priorities straight which often doesn't happen they tend to have a lot of difficulty getting started another piece of it that you often. about from people with ADHD is they say they have a lot of difficulty regulating their sleep and their alertness and being able to keep up the effort to finish things in a reasonable time many complain that they have trouble getting to sleep and what they'll tell you is I don't stay up a lot later than I really want tore should because I found if I try to go to bed before I'm really really exhausted I just can't shut my hand off I just keep thinking of stuff and so I stay up late reading watching TV surfing the net or whatever so I'm just exhausted I fall asleep fine the problem man is I-10 asleep like a dead person and I have a hard time resurrecting myself in the morning if I don't have somebody around to help me get myself out of bed in the morning I'm very likely be late to whatever it is I'm supposed to do or possibly sleep through the whole day just keep hitting the snooze button or just turned block off all together during the day do you see all right as long as they're on their feet moving around or talking a lot just have to sit still for very long to listen or to redo paperwork that I would start getting kind of heavy another thing that often happens as a problem with people you hate with ADHD as they have trouble staying with a task that they may started reasonably well but they have a hard time and keeping up the effort to finish it in a reasonable time start from the University of Runner who came into my office one day and he said my mind is a great Sprinter that's a lousy distance Runner he said at the task I have to do is something to do in one quick chunky just go all out for when you're done with it but if it's something one quick trunk is a longer-term project to keep chipping away at a day after day that I have a more trouble with my Approach that is a hurry up slapdash get something done or when we decide and wait until becomes a little more of an emergency everybody has trouble with deadlines sometimes people with ADD it's almost like they can't get started until it's becoming an emergency another thing that often persons with ADHD have trouble with his writing penmanship now I'm talking about taking ideas and putting them into sentences and paragraphs because what what people say is off and I got a lot of ideas for what I should write for this essay I'm supposed to write her for this term paper but it takes me half a forever to be able to get the sentences and paragraphs put together so they make sense I'm either changing it or it's just disorganized they have difficulty organizing their thoughts and being able to get the words out in a reasonable way another piece of this it's not part of the official diagnostic criteria for ADHD but it's certainly something that a lot of people with ADHD are concerned about and complain about is that many times they have difficulty managing their emotions I need to give you a few exam because it's not the same for everybody salesman I saw one time came in and said you know I was in a diner yesterday late afternoon having a lunch I'm in a pretty good mood sitting there eating my sandwich behind me gets his sandwich you said there was something about that noise is driving me nuts it was as though a computer virus have gotten into my head and just gobble up all the space and that's all I could think about was that noise I'm sitting with my fist clenched seriously thinking about getting them out because he's chewing so obnoxiously loud do it I don't want to get arrested but if I've been home I wasn't yelling at somebody or some little frustration the kind of thing that most people on it frustration to say it goes from 0 to 10 for me said it could be like a surge of anger I feel like punching somebody or breaking some music they said it's not always that way today before that I'm at the office I'm walking down the hall a friend of mine or other departments coming around the corner he's walking toward me reading some papers as he's walking I haven't seen it for a long time so she approached each other I stopped and said hey what's up how you doing heading to lunch time I got nothing done for the rest of the day I spent all afternoon thinking to myself that I do something to annoy him or maybe I did something to offend somebody his department at all angry with me or maybe I'm just too kind of person nobody likes to tell me about if I couldn't get it out of my head other people it's not like that they got an idea on their head of something they want to do or something want to get her something want to buy don't send that wish takes on such strong urgency the feeling is I've got to have it now and it almost doesn't matter how expensive it is or how it could be it's going to be for them or for somebody else or weather using time and money now for this at they know they need for something else tomorrow that's more important there's just this Relentless pushing they will keep that up until they get it or they hit a brick wall forget it they're not that happy cuz you'll be fine then they're off on something else other people it's not like that but they were a lot like woman who talked about how she was driving down the expressway she's in the left lane she said I'm in the left lane at the jersey barrier to my left and 18 wheeler truck on my right cruising about 65 miles an hour in this truck starts to pull over a little bit you can get my lame you got me thinking about how big his truck was all small my car was and pretty soon I'm thinking to myself what might happen if he didn't see me he pulled over and push me against the jersey barrier thinking about him running in my head imagine exactly what it would look like if that truck came over and smashed into my car the car Sharpies the middle or sticking in me I'm bleeding to death cars getting dragged along the Jersey the truck jackknifes cars and trucks behind us are hitting repeatedly there's this massive traffic jam takes a long time to get the rescue squad out of how to cut me out of the car by that time I bled that that the call my family and tell him I'm dead and all this time I'm trying to drive the car 65 miles an hour down the road just shuts the fact that happens to me all the time little thing and I think this happened no it's not like anybody with ADD is all this stuff but many will have one some combination of a couple of but what they have in common is that computer virus in the head thing that the emotion whether it's the hard feelings or being annoyed about something or I've got to have it now or what would happen if comes into soda gobbles up all the space in their head this very difficult for the poison perspective to put in the back of their mind and get on with what they've got it to another thing that's very important for people with ADHD is there working memory if you have ADHD how's your memory I got the best memory of my family I can remember stuff nobody else can remember they give me some example about some movie they saw 10 years ago and I can tell you every detail the entire storyline of the movie or somebody else will say yeah I went to the Super Bowl 5 years ago I can still describe for you almost every play there and during that game or somebody else will say I've got 450 songs in my head all the music all the lyrics All the verses they were probably back in the seventies but even though they might be very good about remembering some things like that from a long time ago if you ask them about something that happened just a couple of minutes ago or yesterday off and I can't tell you the problem with memory with ADHD is not with long-term storage memory it was short-term working memory depend on when going to the other room to get something and you're standing there scratching your head and what in the world you came on in here for what are you working on a project of downstairs get something you need for the project see something else that's interesting or something else that needs doing soon you're up to your elbows in Project number have you totally forgotten your Davila project number one upstairs was kind of important to get it done students complaining be in class teacher asked a question a real estate and they've got to go to answer for a teacher calls on somebody else first have to wait while his other kids as her and the teacher comes back totally clueless not believe I forgot what I was going to say what was the question again order to read something understand it perfectly well at the moment today rated they read a few more pages stop for a second I realized her eyes upon all over every word they have got the or just really bothersome the study for a test tonight for the test don't go over in quisim they've got it they going to class the next day thinking they're going to get a good grade on this and all the sudden the big chunk of what they knew the night before is he read template I need it in a few hours a few days later something chives the memory is all back again it's not that they didn't have it is they couldn't retrieve it when they needed it to half an hour later you walk out the door you got one of them can't remember the Ford Escape where you have to hold one thing you're mine while you're doing something else that's the kind of memory problem that people with ADHD complain about another part of this is managing action and I was certainly true that there are some even as adults are very restless and Nancy it's like they always have to have some part of them in motion and there's some who are very quick to jump into things even as adults and certainly their many kids who have this sort of thing but the fact is ADHD have difficulty slowing down and they need to slow down and speeding up when I need to speed up off and I have difficulty in monitoring their actions if sometimes speak out of turn and not take into account what the effects are going to be at walking I'm saying what they're saying I don't jump into something without thinking about what's going to happen if I do this the only things I'm talking about the problems with memory the problems with difficulty in controlling actions the problems with regulating emotions problems with regulating alertness and sleep the problems with being able to focus and shift Focus we need to talk all these things constitute the range of difficulties that people with ADHD complain about her remember all of these with things everybody has Trump sometimes it's just the people that did he have a lot more trouble with so the question is not does it ever happened but how much does it happen how much does it interfere with the person being able to do the things they have to do in there. life know how does it happen why is it that some people have this so much more difficulty with these things than other people do the evidence shows that it seems to be mostly inherited for people diagnosed with ADHD one of them has a mom or dad who's got it whether they know it or not they never used to diagnose this very well even today it gets missed a lot the other three if they don't have a parent who has it they have a grandparent or and uncle and Audra Cosner Brothers one of the Roses to have it although office not recognized there's some people have this where you can see it from Early Childhood there's some others where you don't see it much in the early years of their schooling but then when they begin to move into middle school and they don't have that one teacher who can help to keep things organized for them now all of a sudden they've got to keep track of what's going on in several different classes and homework for different courses and moving around from one class to another they have a lot difficulty managing it there's some whose parents are so effective in building a scaffolding around them that you could don't even see the problem until they get up into high school where the parents are not that much aware of what they need to do more they may move out of the house and we'll be off to college or get involved in in some work for the parents can't help them in the begin to see them that they had a lot of trouble organizing themselves and doing what they need to do so we don't always see this an early childhood sometimes it doesn't really appear until adolescence early adulthood but the fact is that those are usually the hardest times that would say probably for most Middle School high school first couple of years of college or going out in the Work World those are the times when most people with ADHD have the most difficulty with it because those are the times when you have the widest range of tasks you have to do with the least opportunity to get escape from the ones you're not that good at lucky as you move on you can focus more on the things you're good at and let somebody else do the other stuff that you're not that good at and some people function quite well that way but the fact is these are problems that can cause a lot of difficulty not just in school but in the way people get along with other members of their family the way people manage their social relationships and the way they manage their jobs and what we need to do is to be able to design a way of helping them to work with their strengths and working around their difficulties but I think in order to be able to really appreciate this fully support understand what's going on in the brain that underlies these difficulties which I've just been describing news about 2 and 1/2 pounds Epic in there you got a hundred billion neurons are the cells that make up most of the brain tissue it's hard for most people to imagine a number as big as a hundred billion but here's a way you can do it think about pixels on a TV screen imagine of 17 in TV TV screen or monitor screen for your computer screen you have about 200,000 pixels now imagine if we then went to the Freedom Tower in New York almost a hundred floors high and take 17 inch monitor screens side-by-side bottom to top all the way up one side all the way around so this entire building is totally 17 inch TV sets Inter Milan and out of all those pixels on all those screens and then entire huge building you would then have enough pixels if you add in the mall together to show how many neurons one person has no this is neurons they're very tiny you have to look at them under a microscope but they come in different sizes and shapes but they all work out of branches and twigs system something like this if your eyes one of them it's fine that they're over 1,000 places where it's connecting and interacting with the ones around it but the thing that's amazing about it is the whole system works on low volt electrical impulses and it is not wired together for anybody that's true for those with ADHD is true for every one of the rest of us they are not directly connected let me show you what it looks like if you can imagine these tiny tiny connections that are so small you need a microscope to see them look like a couple of mushroom heads but it up against each other and then there's a space between them which is thinner than a piece of tissue paper so when there's something coming in from the brain electrical impulses traveling along here it has to jump this Gap like a spark plug and then there were receptor buttons on the other side here it has to connect with in it it comes in strong enough it goes on to the next connection and moves on from there to wherever it needs to go if it doesn't it just Fizzles here but the other thing we have here is there a little bubbles on the side this is where there come this is where the chemicals are manufactured the brain makes 50 different chemicals to help carry messages back and forth and their two of them the control most of the things that I've been describing an ADHD so what happening when an electrical impulse comes as it releases microdots of that chemical that's what crosses the gap it hits these receptors that works like a spark plug and then if it hits the right threshold it moves on and then on this side there's some little cells that work like little vacuum cleaners the Colts and back the chemicals and reload the system otherwise it would be just locked open all the time waste what happens with people who have ADHD is their brains make these chemicals the same way everybody else has brain does but they simply do not release and reload them effectively and the other thing we know is good for 8 out of 10 people who have ADHD if you give him the right amount of the right medicine the system can work better for some it's huge how much it helps for others substantial that it's not huge for others and helps a little but not that much into out of town it doesn't work at all but the fact is though this is indeed a chemical problem the medicines that we have for ADHD cure nothing it's not like you have a strep throat you take an antibiotic and knocks out the infection it's more like eyeglasses I have a problem with my eyes I can't see well if I'm looking at typewriter size print it just looks blurry to me if I put these on I can read it as well as anybody can take them off I'm right back where I started the Glass to not fix my eyes help me see when I've got them on and the same thing is true of the medicines we use for treating ADHD but it's also important to recognize that medication is just one aspect of the treatment this important for somebody with ADHD and there many ways in which we help people with ADHD by helping them to learn skills by helping them to you some technology and strategies to be able to deal with whatever they have to deal with it school or on the job or in their family and social relationships and its most effective to be able to first of all have a very good evaluation to understand exactly which problems with ADHD this particular person has and then to have the team of if it's a child of child in the parent and the doctor in consultation with the educators of teachers that are working with them to try to assess what are the ranks of this child that's our beginning Point what are the difficulties and what plan can we put together which will allow us to be able to build on those strengths and help the child or the learn about ways of dealing more effectively with their difficulties so that they can succeed and reach their full potential

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Everything ADHD - Symptoms to Treatment Options

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