ADHD A Short History

     Various impairments that are seen with Attention deficit hyperactivity disorder, ADHD, have been noted for most of the twenty first century and perhaps even earlier. According to Dr. Russell Barkley (2006), the first scientists to have given “serious clinical attention” to the behavior associated with ADHD are George Still and Alfred Tredgold.  In 1902 Still wrote a series of papers regarding 43 patients that he had that displayed serious problems with “sustained attention.” (Barkley 2006 Page 4).  In these papers he described behavior and theorized that the behavior demonstrated a “defect in moral control.” (Barkley, 2006 ).  Tredgold used the terms early, mild and undetected to label a set of behavioral and learning deficiencies.  Both believed that there was perhaps a genetic link but more likely a post-natal injury causing this lack of morality.
Later the behavioral issues that are components of ADHD were associated with an outbreak of encephalitis.  This epidemic was most pronounced in 1917 and 1918 (Barkley, 2006).   This is a brain disease and the survivors showed behavior consistent with ADHD.  That is that the children were “impaired in their attention, regulation of activity and impulsivity as well as other cognitive abilities including memory.  They were often noted to be socially disruptive as well.” (Barkley, 2006)  Throughout the decades there were numerous studies done on children displaying the behavioral tendencies noted above.  Many of the studies were born from doctors who were involved with children that had diseases or evidence of brain damage.  However, there were some cases where these behaviors existed where there were no signs of brain damage.  A couple of doctors made the statement that “psychological disturbances alone were de facto evidence of brain injury.” (Strauss and Lehtinen, 1947).  Thus the idea of the brain injured child was born.  So was a new acronym.  Minimal Brain Dysfunction, MBD (Barkley 2006).  During this period prevailing theories existed on causes of MBD that mostly had to do with brain injury.  These injuries occur either pre or post natal or could be linked to some type of disease like encephalitis.  .
A study was done in 1876 with monkeys that had frontal lobe lesions.  These lesions were known to result in excessive restlessness, poor ability to sustain interest in activities, excessive appetite among other behavioral changes. (Barkley 2006).  Over ninety years later continued frontal lobe studies continued to show a path towards a reason for behavioral differences and some meaningful treatment for ADHD.  Early studies were conducted on children that had autism and retardation.  Some theorized that the absence of brain injury must lead to the conclusion that these behaviors were due to “spoiled child syndrome” (Barkley 2007).  It was much later in time that children that had no brain injury but displayed the triad of behavior were segmented out and studied on their own entirely.  Throughout the 1950s and 1960s research continued.  By the end of the decade of the seventies over 2000 studies on the subject were published. (Baker 2006).
Until the seventies almost all research of ADHD was concentrated on children.  In the 1970s Hans Hussey and Paul Wender observed that while some children seemed to grow out of ADHD it was not always the case. (Hallowell and Ratey, 2006).  Their observations led to many studies that concluded that anywhere between sixty to seventy percent of children with ADHD continue to have ADHD in to adulthood.
As far back as 1937 stimulants have been used to treat patients that exhibited these behaviors.  A very frustrated doctor was attempting to save some boys from being beaten in reform school.  He had read a study showing stimulant medication having the affect of altering the mood of some adults.  In desperation he thought this might help the boys.  He prescribed the stimulants to the boys and noticed a marked difference in their behavior. (Halowell and Ratey 2006)
     According to Ballard, Burton et al. The neuro-transmitters known as dopamine and serotonin are involved with attentional systems.  These chemicals are catecholamine which are used throughout the neuroanatomical structure (Ballard, Burton et al. 1997).  The neuro-transmitters relay messages across pathways that control behavior associated with ADHD.  These pathways control attentiveness, motor activity, restlessness and responsivity. (Ballard, Burton et al. 1997) ADHD medication, which is primarily stimulant, is used in order to stimulate the release of catecholamine in the brain in order to maintain control over these behaviors (Ballard, Burton et al. 1997).
Ballard, S., Bolan, M., Burton, M., Snyder, S., Pasterczyk-Seabolt, C., & Martin, D. (1997). The neurological basis of attention deficit
      hyperactivity disorder. Adolescence, 32(128),855. Retrieved from Academic Search Premier database.
Barkley, Russell Dr. (2006). Attention-Deficit Hyperactivity Disorder, Guilford publicationsHallowell, Edward Dr. and Ratey, John Dr.  (2006) Delivered from Distraction, Ballantine Boston MA

Strauss, A. and Lehtinen, L. (1947)  Psychopathology and education of the brain-injured child,  Grune and Sratton

Acceptance

One cracked pot to another

An elderly Chinese woman had two large pots,

each hung on the ends of a pole which she carried across her neck.
One of the pots had a crack in it while the other pot was perfect and always delivered a full portion of water.
At the end of the long walks from the stream to the house, the cracked pot arrived only half full.

For a full two years this went on daily, with the woman bringing home only one and a half pots of water.
Of course, the perfect pot was proud of its accomplishments.
But the poor cracked pot was ashamed of its own imperfection, and miserable that it could only do half of what it had been made to do.

After two years of what it perceived to be bitter failure, it spoke to the woman one day by the stream.

‘I am ashamed of myself, because this crack in my side causes water to leak out all the way back to your house.’

The old woman smiled, ‘Did you notice that there are flowers on your side of the path, but not on the other pot’s side?’

‘That’s because I have always known about your flaw, so I planted flower seeds on your side of the path, and every day while we walk back, you water them.’

For two years I have been able to pick these beautiful flowers to decorate the table.

Without you being just the way you are, there would not be this beauty to grace the house.’

Each of us has our own unique flaw. But it’s the cracks and flaws we each have that make our lives together so very interesting and rewarding.

You’ve just got to take each person for what they are and look for the good in them.

So, to all of my cracked pot friends, have a great day and remember to smell the flowers on your side of the path!

The Church and Mental Illness (ADHD)

Please take time to read this article. The Catholic church is a wonderful, holy and compassionate body. The Church is actively reaching out and understanding the impact of mental disorders. I found this article to be very enlightening. It does not specifically mention ADHD however there is nothing to suggest that ADHD is not included in the desire to accept mental disorder/illness in a way that includes grace and acceptance of a need for proper treatment including the use of pharmaceuticals. Click anywhere on the excerpt to be taken to the entire article.

Here is an excerpt.

Her mood disorder left her furious at God. Because she was a nun, she kept going to daily Mass and regular prayers, but, she says, “I would sit in the back of the church and glare at the cross. I couldn’t believe for a year that God existed.”
The only way Hermes could pray was to read the second half of the Book of Isaiah, the Book of Consolation. “I read those promises of God,” she says. “I didn’t believe it, and I couldn’t find any joy in it.”

Responsibility

Catholic ADHD Coach I was recently in a discussion group that was asked about responsibility for actions. This group happened to be a group of young mental health students. Their responses regarding responsibility were chilling as they seemed to understand that one is responsible for his actions but they could not understand how mental illness impairs the ability to judge. This was my response.

What do you think?

After reading the responses submitted here I am scared. I am a practitioner in the mental health field. I am an ADHD coach. Furthermore I have been diagnosed with ADHD and use a multi-modal approach for treatment. This includes pharmacology, exercise, yoga, prayer, massage and coaching. I am not always responsible for my behavior. What could that mean? If I drink and drive did I choose to get behind the wheel? Of course. However my choice was affected by a lack of filtering through the normal executive functions located in the pre-frontal cortex.

Thank God I have never made that choice but I have clients that have. If there is guilt it’s in not treating the ADHD. As a rule people with ADHD like to take risks. They like to start fights with their spouses. They like to drive fast. All of these are due to a need to increase the amount of hormone in their PFC. When we are super stimulated we feel normal. We can focus and concentrate because our PFC is on. This is what my meds. do for me. I don’t have to chase stimulus all day, every day in order feel like my brain is working.

One client I have has a child with ODD as a co-morbid disorder with his ADHD. He is in the 2nd grade and whenever he is slightly provoked he will lash out. Children or adult it does not matter. When in line with another child he may have his toe stepped on and then bam he will hit the kid. Is he choosing to do this? I don’t believe so. I believe that this very bright child has a neurological disorder that meds and other therapeutic means will help to control. At some point he may have control or not but one can not say that he is choosing the wrath that comes upon him when he reacts.

A very famous study shows that when leaving a child in a room with a marshmallow and giving instructions to leave it alone a child with ADHD will respond differently. When leaving the room the adult states that if you leave the marshmallow alone that you will receive more upon my return. Non ADHD children are very successful at waiting as they grasp the point and can control themselves to wait to receive the bigger prize. Children with ADHD were almost wholly unsuccessful at waiting and immediately ate the marshmallow. They consistently understood the benefit of waiting but they could not.

Finally ADHD is about 40% hereditary. That is to say that about 40% of kids with ADHD have a parent with ADHD. That is much higher than most disorders. To immediately suggest that these children are completely responsible for all of their actions is to not understand the nature of mental illness. None of us volunteer to end up with the negative aspects that befall us based on our maladaptive behavior. However we do look to the mental health community to understandingly assist us in getting to normal. That is helping us to achieve all that we can.

Interesting Discussions

some interesting chat from facebook.

Where is this motivation? When does it come? Lord says be patient but it is HARD. My son has been battling ADD since he was 4! Luckily his preschool caught it and he’s had all the right tests. Now at 13 we still can’t find what motivates him. He can create a reason for anything so no punishment sticks. Sitting at a table or desk for hours is no problem. Staring into space with a list of chores in front of him is apparently a content way of life. But God bless him – he loves the Lord and is compassionate towards EVERYONE but seems to leave care for himself behind as some sort of extreme example of the Bible’s definition of humility. No longer can I get angry because it only hurts me. I strive to see the positive and continue to pray pray pray wait wait wait. He is in the PERFECT Christian school with a program for kids like him till 12th grade. Just please Lord tell me he won’t be legally old enough to buy the beer at senior prom!

Answer; Catholic ADHD Coach Wow, I will pray with you. For me it’s music. I play the drums and I have since 9. When all else failed I could be motivated with music. God brought me back to The Church on three occasions using music. As a child the punishment most feared was not being able to pursue it. Watch out here comes the ADHD trap. EVEN WHEN WE LOVE SOMETHING we avoid the repetitious nature. We stim chase because we need the rush. Meds. work because they bring chemical balance that we seek. Therefore even though the drums are the most important thing in the world with ADHD I avoid starting to practice. Once practicing I will become hyperfocused but it may take an act of God to get me started. Apply this thinking to being married or long term friend relationships and one begins to see why ADHD becomes a back breaking disorder to have as an adult.

Keep praying and be sure to stay in constant communication at this age. This is a generalization but puberty is sure to bring on many motivators that can get out of control in a hurry.

A nice thought

I read a very wonderful quote this morning that as ADHDers give an interesting perspective. >”I am who I am in the eyes of God. Nothing more, nothing less.” (Rohr, R) Have a blessed day.

Rohr, R. Fr. Retrieved 09/27/2010 www.cacradicalgrace.org

Are we responsible?

I was recently in a discussion group that was asked about responsibility for actions. This group happened to be a group of young mental health students. Their responses regarding responsibility were chilling as they seemed to understand that one is responsible for his actions but they could not understand how mental illness impairs the ability to judge. This was my response.

What do you think?

After reading the responses submitted here I am scared. I am a practitioner in the mental health field. I am an ADHD coach. Furthermore I have been diagnosed with ADHD and use a multi-modal approach for treatment. This includes pharmacology, exercise, yoga, prayer, massage and coaching. I am not always responsible for my behavior. What could that mean? If I drink and drive did I choose to get behind the wheel? Of course. However my choice was affected by a lack of filtering through the normal executive functions located in the pre-frontal cortex.

Thank God I have never made that choice but I have clients that have. If there is guilt it’s in not treating the ADHD. As a rule people with ADHD like to take risks. They like to start fights with their spouses. They like to drive fast. All of these are due to a need to increase the amount of hormone in their PFC. When we are super stimulated we feel normal. We can focus and concentrate because our PFC is on. This is what my meds. do for me. I don’t have to chase stimulus all day, every day in order feel like my brain is working.

One client I have has a child with ODD as a co-morbid disorder with his ADHD. He is in the 2nd grade and whenever he is slightly provoked he will lash out. Children or adult it does not matter. When in line with another child he may have his toe stepped on and then bam he will hit the kid. Is he choosing to do this? I don’t believe so. I believe that this very bright child has a neurological disorder that meds and other therapeutic means will help to control. At some point he may have control or not but one can not say that he is choosing the wrath that comes upon him when he reacts.

A very famous study shows that when leaving a child in a room with a marshmallow and giving instructions to leave it alone a child with ADHD will respond differently. When leaving the room the adult states that if you leave the marshmallow alone that you will receive more upon my return. Non ADHD children are very successful at waiting as they grasp the point and can control themselves to wait to receive the bigger prize. Children with ADHD were almost wholly unsuccessful at waiting and immediately ate the marshmallow. They consistently understood the benefit of waiting but they could not.

Finally ADHD is about 40% hereditary. That is to say that about 40% of kids with ADHD have a parent with ADHD. That is much higher than most disorders. To immediately suggest that these children are completely responsible for all of their actions is to not understand the nature of mental illness. None of us volunteer to end up with the negative aspects that befall us based on our maladaptive behavior. However we do look to the mental health community to understandingly assist us in getting to normal. That is helping us to achieve all that we can.

St. Anthony

As and ADHDer I have a lot of experience with looking for lost things. In fact when I read Delivered from Distraction by Hallowell and Ratey I was blown away by one of their suggestions for those with ADHD. On page 308 item 3 from the top tips chapter, Keep a basket by the door for things you need when you leave. Like, keys, wallet , cell phone and the like. I was reading a blog and came across the following article regarding St. Anthony the patron saint of lost things. I asked the author if I could reprint the article and she agreed. So reprinted with permission from Peggy Bowes is the article in it’s entirety.

“Where on earth did I put that refund check?” I mumble to myself as I search through a stack of papers on the desk. My daughter cheerfully replies, “Ask St. Anthony. He never fails us.” She joins in the search, and moments later the check almost miraculously appears, stuck to the back of a letter in the pile we’d gone through three times.

Like many Catholics, I have come to depend on the intercession of St. Anthony of Padua. St. Anthony is a Doctor of the Church and an eloquent Franciscan preacher who lived in the early 13th century. He is often depicted holding the infant Jesus and a Bible based on a vision of Baby Jesus lovingly caressing his cheek as he read over the Scriptures he knew and lovedso well.

St. Anthony came to be the patron of lost things based on a legend of a missing psalter. A novice had coveted the saint’s valuable book of Psalms and took it for himself when he left the order after becoming weary of the structured life of a Franciscan. St. Anthony prayed fervently for its return, and the novice received an alarming vision. He not only immediately returned the psalter but hastily rejoined the order with renewed fervor.

Over the years, St. Anthony has located many lost items for my family and friends, often in rather creative ways. Yet there are some things that are never found.

My son saved his money for many months to buy an MP3 player, but lost it in a car we rented on vacation. We all prayed fervently to St. Anthony for its return. The rental car agent kindly called the new renter who gamely combed the car but never found the player. I was secretly relieved that it didn’t turn up as I was not fond of my son’s latest preferences for music. I foolishly allowed him to listen to songs that I didn’t approve of rather than pointing out how the lyrics did not enforce the values I had taught him. Fortunately, St. Anthony knew better.

Recently, I searched high and low for a prayer card with a devotion I wanted to share with my family during Holy Week. I prayed to St. Anthony, feeling confident that he would help me find an item that would bring us closer to the Suffering Servant during the closing days of Lent. I finally gave up and tried to find the prayers online, only to come across a site discouraging the devotion for several very valid and convincing reasons.

As my daughter wisely stated, “St. Anthony never fails us.” He finds what we need but also knows when some things should just stay lost.

St. Anthony died near Padua, Italy, on June 13, 1231, at the age of thirty-six. He was proclaimed a saint by Pope Gregory IX one year later, and his feast day is celebrated on June 13th.

I thank her for sharing. You can read more from her on her blog at http://www.rosaryinfo.blogspot.com/ She also has a great website that incorporates our ADHD need to exercise.
www.rosaryworkout.com

Thank you Lord

In Philippians 1:13-14 Paul reminds us that even in our times of suffering we can be and should be grateful to our Lord. He was imprisoned in a jail that would make any of today’s jails look like a country club. While there he thanks the Lord and is rejoicing that his imprisonment is causing a surge in preaching of the gospel fearlessly. I bring this up as a topic here because sometimes it’s easy to get caught up in the negative aspects of AD/HD. This is a type of prison and if not caught early can lead to long spiritual imprisonment. There is strength in remembering that God has a plan and that with faith I can trust in God in all things. He was there when I found my coach. He was there when I started my meds. and he is here now helping me to coach those that are ready to deal with AD/HD.

There are many wonderful blessings to be thankful for. When I find myself wanting to kick myself for forgetting an appointment or arriving late to a gig, I stop and thank the Lord for the blessings I have before me. There are many instances that God has used me through my issues. Being late caused a colleague to have to go on a T.V. show solo. In the end his show drastically improved because he had the confidence to lead the show no matter who the guest was and whether or not they showed up. Of course that is God using a negative aspect of AD/HD. He uses the positive everyday. We with AD/HD know how creative a mind that God has given us. On a routine basis I think of out of the box ways to evangelize. I also am prone to getting hyper-focused and when that concentration is on doing something in the name of the Lord, it is always great. Thank you Lord Jesus my God for gifting me with a wonderful and quirky way of being.