Surge in women taking drugs for ADHD

Surge in women taking drugs for ADHD
What’s behind this?

From Newsday: http://www.newsday.com/news/health/surge-in-women-taking-drugs-for-adhd-1.7372481

“The number of Americans taking attention deficit hyperactivity disorder medicines rose 36% in 2012 from 2008, led by a surge among women, according to drug-benefits manager Express Scripts Holding Co.

Use of the medications grew 85 percent in 2012 from 2008 for women ages 26 to 34, and women 19 and over now outnumber men in use of the medicines, according to the report released yesterday. Boys 12 to 18 years old are the most heavily prescribed, with about 9.3 percent on ADHD drugs in 2012.

Almost 4.8 million privately insured people were on ADHD medicines in 2012, the report said. Those with the disorder have problems paying attention, the U.S. Centers for Disease Control and Prevention says.”

How does one explain the incredible increase in ADHD medication use especially among women ages 26 to 34? Is it due to increased stress? The demands of home and work? Better marketing among these women? Can a pill fix these problems?

Your opinions are welcome.

Play Attention, Parkinson’s, & Alzheimer’s

Play Attention, Parkinson’s, & Alzheimer’s

When I first met George two years ago, he was unable to find his way out of his living room in his house. He had been diagnosed six years earlier with Parkinson’s disease and early dementia caused by exposure to Agent Orange during the Vietnam War.

George had been president of his own engineering company, was an avid golfer, and loved being outdoors. Unfortunately he had to sell his company, give up golf, and was fairly confined to the indoors. He could no longer read or write and was very depressed.

I’ve been using Play Attention with George two or three times a week for two years. Now he can identify and go to any room in his house, practice golf on the Wii, read or listen to short stories, and answer comprehension questions. We go outside for long walks to enjoy nature. He and his wife can go out to dinner, go to the movies, and participate in a bible study group.

Although I use several therapies with George, his favorite is Play Attention! I believe this is because Play Attention gives him back a sense of control over his mind, and by extension, over his life. Even while Parkinson’s disease slowly robs him of body control, Play Attention allows him to retain his mind and memory control. This is crucial for his psychological and emotional well being.

George scores between 70% and 90% on the Play Attention games. He has moved through the beginner, intermediate, and advanced levels. I put Velcro on the space bar so he can re-establish his finger position if the tremors interfere with his hand. On games where the mouse is needed, I move the mouse while he focuses. George loves Play Attention and takes great pride in his success.

For most people with neurodegenerative disorders, (i.e. Parkinson’s, Alzheimer’s, etc.), their greatest fear is increasing loss of independence and control of their lives. This can lead to loss of hope and severe depression.

I have seen the difference Play Attention can make in the lives of both PD and AD clients. While Play Attention can’t cure such diseases, I’ve seen it certainly slow the progression and restore quality of life. They feel a return of confidence, self control and self esteem. Play Attention gives them hope and a more positive attitude with which to live their lives.

Submitted by Nancy Thomas
Brain Fitness Center
Raleigh, NC

ADHD Isn’t Real

ADHD Isn’t Real
Pediatric neurologist claims ADHD is a sham

Read More: http://www.examiner.com/article/pediatric-neurologist-richard-saul-claims-adhd-does-not-exist-upcoming-book,
A controversial upcoming book by Pediatric Neurologist, Dr. Richard Saul, is titled, “ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactivity Disorder.”

ADD was first appeared in the Diagnostic and Statistical Manual(“DSM”) in 1980. Its name was changed to ADHD in 1987 and diagnoses have skyrocketed to reach all time highs. Dr. Saul claims that ADHD shouldn’t even be in the DSM.

“ADHD makes a great excuse,” Saul notes. “The diagnosis can be an easy-to-reach-for crutch. Moreover, there’s an attractive element to an ADHD diagnosis, especially in adults — it can be exciting to think of oneself as involved in many things at once, rather than stuck in a boring rut.”

Dr. Saul bases his conclusions on his many years of treating patients. He concludes that ADHD is nothing more than a collection of symptoms and not a disease. ADHD is often called a ‘garbage pail’ diagnosis as many different symptoms are often dumped together to make the diagnosis.

Dr. Saul sought out different causes for his patients’ symptoms. He found that by searching deeper into his patients’ specific situations, he could make a proper diagnosis and resolve their problems. For example, Dr. Saul treated a young girl who was unruly in school, but it turned out to be that she couldn’t see the blackboard and only needed glasses. Another example he cites was a 36-year-old man who thought he had ADHD was simply drinking too much coffee and not getting enough sleep.

Dr. Saul lists other causes that are associated with what he considers a wrongful ADHD diagnosis:

Tourette’s
OCD
Fragile X Syndrome (a genetic mutation linked to mental retardation)
Autism
Fetal Alcohol Syndrome
Learning disabilities
Substance abuse
Poor hearing

Not every case needs to be diagnosed concludes Dr. Saul. For example, Saul treated a female adult who was convinced she had ADHD and who had been prescribed stimulants. Saul realized she was not coping with her life because she was greatly overwhelmed. He simply advised her to return to regular exercise and cut back on her work schedule.

Your opinions are welcomed.

ADHD’s Genetic Link

What causes attention-deficit hyperactivity disorder – ADHD? Research in the English medical journal, The Lancet, says it’s not too much sugar, bad diet, or poor parenting. Professor Anita Thapar, lead author of the study, says it’s likely genetic.

Thapar and her group of scientists at Cardiff University in Wales compared 366 children with ADHD to 1,047 kids without ADHD. In particular, the researchers examined differences in the children’s DNA. They found that kids with ADHD were more likely to have small segments of DNA that were duplicates or missing (copy number variants or CNVs — either a deletion or duplication of genetic material).

"We hope that these findings will help overcome the stigma associated with ADHD," Professor Anita Thapar, the study’s lead author, said in a written statement. "Too often, people dismiss ADHD as being down to bad parenting or poor diet. As a clinician, it was clear to me that this was unlikely to be the case. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children."

While being media friendly, Thapar’s last statement is a stretch in relation to her research. People and the media love statements that provide seemingly conclusive answers.

Let’s go beyond the media hype that says this research concludes there is a definite genetic link. The researchers really only say there seems to be a possible “genetic link.”  However, their research did not conclude that it is purely or even primarily genetic. What they truly are saying is that this study is evidence that ADHD is not purely social.

The authors conclude:

    “Our findings provide genetic evidence of an increased rate of large CNVs in individuals with ADHD and suggest that ADHD is not purely a social construct.”

This is logical because only 15% of the research subjects with ADHD demonstrated increased CNVs. So is it safe to conclude that genetic makeup may contribute, at least in some particular cases, to ADHD? Yes, but to be clear,  this research did not conclude that it is entirely genetically based and was only partially genetically based in a small segment of their study population. This is very similar to other genetic research.

Why is it, if ADHD is genetically based, at least in part, that 30% don’t have it as adults when diagnosed as a child? What happened? Where did it go? This is what is most  important to parents and professionals.

Epigenetic theory, now being widely embraced by the scientific community, maintains that human development  includes both genetic origins of behavior and the direct influence that environmental forces have on the expression of those genes (nature/nurture). Epigenetic theory regards human development as a dynamic interaction between these two influences.

Simply put, how our genes express themselves is greatly impacted by environment. This is likely why, over time, 30% of children don’t display symptoms as adults. The brain changes, rewires, or (a radical version of epigenetic theory) their genes change.

Do tools exist to do this? Yes. See support.playattention.net.

If I may quote Dr. Theodore Dalrymple, “What seems to have happened is that parents have lost the awareness that they had for decades – if not for centuries – that concentration and self-discipline do not come naturally to children, and have to be taught (as well, sometimes, as enforced).”

Meditation & ADHD

Sunset & Sky 098 Researchers, Dr. Zylowska, et al from the University of California-Los Angeles conducted a feasibility study of an 8-week mindfulness training program for adults and adolescents with ADHD. Their report was published in The Journal of Attention Disorders (2008 May;11(6):737-46. Epub 2007 Nov 19).

The researchers sought to inquire whether mindfulness meditation could improve attention, reduce stress, and improve mood. The researchers recruited 34 adults and 8 adolescents. Study participants were given a weekly training session. They were also required to practice daily starting with 5 minutes of meditation per day and gradually increasing to 15 minutes per day.

The majority of participants (after dropouts) reported improvements in self-reported ADHD symptoms. Independent tests on tasks measuring attention and cognitive inhibition also indicated improved symptom outcomes. Improvements in anxiety and depressive symptoms were also observed.

In yet another pilot study conducted by Sarina J. Grosswald, Ed.D., a George Washington University-trained cognitive learning specialist, a group of middle school students with ADHD were required to meditate twice a day in school. After three months, researchers found over 50 percent reduction in stress and anxiety and improvements in ADHD symptoms.

"The effect was much greater than we expected," said Sarina J. Grosswald, Ed.D., a George Washington University-trained cognitive learning specialist and lead researcher on the study. "The children also showed improvements in attention, working memory, organization, and behavior regulation."

Due to the neuroplasticity of the brain, better attention can be attained through meditation. Buddhist monks have been doing it for centuries. This seems to be true of ADHD persons as well. However, it is quite apparent that attention difficulties are just the tip of the ADHD iceberg. Other skills including organization, filtering out distractions, memory, time on-task, motor skills, visual tracking, etc, are typically diminished in ADHD persons. A complete program like Play Attention is required to teach these skills.

As for meditation, it is likely a good supplement to training in the aforementioned skill areas, but given the nature of the cited studies, a controlled clinical study is warranted.

Shire Launches Nationwide Adult ADHD Mobile Awareness Tour

The worldwide adult ADHD market holds a potential for billions of dollars for the pharmaceutical industry. In a brilliant marketing effort guised as a benevolent informational/screening initiative, Shire pharmaceuticals, the makers of Adderall for ADHD, launched a “screening initiative” in Atlanta. Shire’s press release states that they “…expect up to 20,000 adults to self-screen for ADHD in 13 cities” over 90 days.

Shire’s press release further states that:

The screening initiative, launched in Atlanta, GA, is designed to help raise awareness that ADHD is not just a childhood disorder. Research shows it is estimated that up to 65 percent of children with ADHD will continue to exhibit symptoms into adulthood. Adults who think they may have ADHD can take the first step toward recognizing the symptoms of the disorder by answering the 6-question World Health Organization (W.H.O.) adult ADHD screener. The screening initiative, known as the "RoADHD Trip," is housed, transported and anchored by the RoADHD Trip Tractor Trailer which expands into a tented area housing eight self-screening stations.

“Shire developed this mobile screening initiative as a forum to educate the public about ADHD in adults and provide information and resources to individuals about this disorder," said Gerardo Torres, M.D., Vice President and Scientific Lead, of Shire’s ADHD Business Unit. "This program demonstrates Shire’s on-going commitment to providing information for those who may be struggling with the symptoms of ADHD."

In each of the 13 cities, Shire is partnering with the Attention Deficit Disorder Association (ADDA), a leading adult ADHD patient advocacy organization, in an effort to assist up to 20,000 adults to self-screen for this disorder. Volunteers from ADDA will also be on-site to answer questions about ADHD in adults and to provide information about their organization. The W.H.O. adult ADHD screener, a questionnaire that is used to help recognize the symptoms of ADHD, will be available via on-site computers to help facilitate self evaluations. The W.H.O. screener is not designed to provide a diagnosis of ADHD but may provide information to participants regarding the symptoms of ADHD. Participants should discuss any questions they have regarding the W.H.O. screener results and other concerns about ADHD with their physician.

"Seeking information and speaking to qualified health care professionals are critical steps to diagnosis and management of ADHD," further explained Dr. Torres. "This initiative is an important first step to encourage that dialogue between patients and their physicians."

This should leave Shire’s competitors slapping their foreheads saying, “Why didn’t I think of this!”

Do ADHD Adults Really Lose 3 Weeks of Work Each Year?

Do ADHD Adults Really Lose 3 Weeks of Work Each Year?

A new study claims they do.

It’s estimated that approximately 70% to 80% of all children will carry their attention problems into adulthood. According to the new study, this could present problems for their employers. The study, published in the Journal of Occupational and Environmental Medicine, found that ADHD adults worked 22.1 days less than other workers each year. Furthermore, the study found that they were unable to carry out normal work activities an average of 8.4 days per year, 21.7 days of reduced work quantity and 13.6 days of reduced work quality.

The study of 7,075 workers in ten countries was performed by the World Health Organization (“WHO”) research consortium at Harvard Medical School in Boston Medicine and partially subsidized by pharmaceutical giant, Eli Lilly. The WHO claims that an average of 3.5 per cent had ADHD.

Strangely enough, adult ADHD workers in the Netherlands actually showed improved job performance – exactly contradictory to all other trends in the study. The researchers explained this as an aberration. Historically, the Netherlands medicates persons for ADHD far less than other countries and has a particularly different perspective on attention problems.

This study tends to corroborate Dr. Joseph Biederman’s work (oddly enough, he’s with Harvard University too) that indicates ADHD adults collectively lose $77 billion each year due to workplace failure.

Adult ADHD and Job Performance

As I reported earlier (Do ADHD Adults Really Lose 3 Weeks of Work Each Year?), a study published in the journal Occupational and Environmental Medicine, found that ADHD adults worked 22.1 days less than other workers each year. Furthermore, the study found that they were unable to carry out normal work activities an average of 8.4 days per year, 21.7 days of reduced work quantity and 13.6 days of reduced work quality.

However the study actually begs the question of what is adult ADHD. If you’ve found that it’s difficult to concentrate because you may be hyperactive, have trouble remembering appointments or finishing a project once the challenge is gone, are easily distracted, or avoid tasks that require concentration the World Health Organization (“WHO”) says that you may have adult ADHD! The WHO also thinks that many adults do not know they have the condition.

Who (no pun) hasn’t felt easily distracted or avoids boring tasks? I wonder if the shaky diagnosis of adult ADHD – which by the way, is totally subjective – is being exaggerated so that more people can be ‘treated’ i.e. prescribed medication.

The researchers (World Health Organization (“WHO”) research consortium at Harvard Medical School in Boston Medicine) formed their conclusions by evaluating data from 7,075 adult workers in several countries. The workers ranged in ages from 18 to 44 and were screened for ADHD as part of the World Health Organization World Mental Health Survey Initiative. The researchers surveyed the workers about their performance at work in the last month.

Both the media and the pharmaceutical industries have helped spur the diagnosis of ADHD by clinicians. However it will remain a controversial diagnosis shrouded by concerns about context; we are now required to sit and perform focused and organizational tasks more now than ever before in history. This has changed greatly from work at standard manual labor and assembly lines of the past. Is it natural for us to become distracted at tedious or boring jobs? Do we need medication to improve our work? For whose benefit? Furthermore, an ADHD diagnosis can be symptomatic of personal learning problems or family dysfunction among many other scenarios that comprise the human situation.

Adult ADHD is caught in the midst of a tug-of-war between pharmaceutical marketing, changes in the workplace, and a very loose, subjective diagnosis. Buyer beware.

Max Gail and ADHD

I sat down with veteran actor, Max Gail a short time ago to discuss Max’s attention problems and how they relate to his family and acting career.

Q: Do people still recognize you from Barney Miller?

A: Probably most people would connect me up as an actor or I get recognized for the work I’ve done as an actor because it’s a real visible kind of work. People say where do I know you from, which I hear a lot, or gee you look familiar to me or something or haven’t I seen you in the movies or something. I start with Barney Miller because it’s a TV show that was on for, we shot for seven and a half seasons and then went immediately into reruns and were on twice a night for another 8 years in most cities and it’s still playing some places.

We had critical success and we had a lot of fun doing it. I did a show, and we did half a season, and they showed it on ABC called Sons and Daughters.

Q: You told me that your son, Max, Jr. has attention problems. How have the two of you coped with them?

A: My son Max, really really bright kid was having some difficulties with certain aspects of school and I saw that they were the same difficulties I had although when I was in school it was easier to slide around those things and most of the solution that were being offered had to do with drugs and I had some intuitive issues with that. At a different time if they would have been diagnosed with ADD or ADHD or maybe Asperger’s [syndrome] or any of these things, you know, I could have made the cut. I have to say [I’m] a person who resonates with this, personally, both in what my life has been, where my strengths and weaknesses have been, in everything I’ve tried to do.

Q: Is that what spurred your interest in finding a solution?

A: I met you, Peter, at the disabilities conference in Los Angeles. I’m concerned about helping my son and spreading what I find into the community at large. Watching my son in particular but really all my kids in some ways struggle with these things and then to see that there really is a way to use some technology and some understandings and some relationships to deal with those issues in a way to create a since of having some kind of powerless confused sort of feeling that makes you want to deny it or run away from it or get angry about it or blame somebody. It’s just a really wonderful thing

Q. What do you think about Play Attention?

A: I love the name Play Attention. I love that there’s something behind it very meaningful that comes from people who have worked with kids and care about kids and care about these kinds of problems and identifying that there are solutions.

Play Attention with the technology and the coaching components of it really creates a way that there can be that guide in a practice of working to develop those kinds of skills and strengths that are missing. Play Attention puts that focus on play state which is really how we learn. Play Attention provides a practice that’s meaningful and can be fun to do and this is kind of special technology even though it’s made up of stuff that’s around.

It’s kind of new to get it out to people. It’s new for people to hear about it so that process is mostly families or people that are at their wits end that finally find out about Play Attention and they call and get connected and try it and it works and then they’re really thankful. They’re having a lot of recurring pain and lack of success or confusion or just problems in their lives that can really be helped or something that can be done about it.

ADHD and Social Distancing

As I’ve discussed in previous blogs, ADHD children and adults have difficulty recognizing social cues or regulating impulse control and therefore frequently cannot maintain friendships or adapt well socially.

A recent study published in the Journal of Health and Social Behavior, (48, 50-67) examines the other side of this issue; it examines the attitudes of adults toward persons with depression or AD/HD. The study indicates that many adults would personally prefer not to interact or have their child not interact (social distancing) with an AD/HD child. The study also reveals factors that contribute to the desire for social distancing. Participants in the study consisted of 1393 adults from across the US.

Participants were read a randomly selected vignette that provided a brief behavioral description of 1 of 4 different children. While no diagnoses were provided, the vignettes depicted behaviors characteristic of a child with a medical condition (asthma), a child with depression, a child with ADHD, and a child that presented what the authors described as “normal troubles.”

After listening to the vignette, researchers asked a series of questions to learn about the participants’ thoughts and emotions regarding the child depicted in the vignette. To more deeply delve into the reasoning behind social distancing, the researchers also examined participants’ beliefs about the suspected causes of behavior displayed by the child in the vignette. These included whether the participants believed the child had a mental illness, “bad character”, or “chemical imbalance in the brain.” Participants were also queried whether they believed the child depicted was a danger to self or others.

CONCLUSIONS

Interestingly, percentages of adults who were more likely to not engage with a child or child’s family, if that family was described as having symptoms characteristic of AD/HD or depression, were 2-3 times higher than when a child with “normal troubles” or asthma was depicted.

Some clear trends were also established: male participants were more likely to desire distance than females and older children desired distancing more frequently than younger (8 yrs.) children.

Furthermore, preference for distance increased if participants believed that the depicted child’s problems were caused by poor parental discipline.

When participants believed the depicted child’s problems were caused naturally, e.g. from food allergies or “normal ups and downs” their preference for distance decreased.

Attributing the child’s problems to a mental illness increased the preference for distance. Related to this, believing that the child posed a danger to himself or to others increased the preference for distance.

SUMMARY

The researchers cite that “… a substantial minority of American adults are reluctant to interact, or to have their children interact, with children described in ways consistent with ADHD and depression. Specifically, about 1 in 5 adults was unwilling to have these children living next door, in his or her child’s class, or as his or her child’s friend.”

It is a myth that poor parenting causes AD/HD. However it is evident that social distancing is desired if parents deem the offending child’s behavior to be caused by poor parenting.

By middle school, I would suggest a majority of AD/HD children feel socially outcast. Social acceptance of AD/HD children by their peers may be influenced by the parental attitudes either explicitly conveyed or indirectly communicated. Regardless, it’s evident that despite continued public education, barriers toward social acceptance exist albeit on a minor scale as about 4 out of 5 adults did not report these biases.

I think the greatly varying attitudes toward AD/HD reflect a general confusion regarding the subject. It’s regarded a brain disorder, not as a learning disability which is where I would prefer to see it. The brain disorder lends a certain stigma to AD/HD which is unfortunate. If it were considered a simple lack of certain skills (which is what it actually is) then not only could it be better understood by the general populace, but it would force the medical community to broaden their utterly narrow perspective on treatment benefiting all concerned.

Kids with mental illness often rejected socially

March 19, 2007

NEW YORK (Reuters Health) – Research suggests that a “substantial minority” of American adults are reluctant to let their children interact with children who suffer from depression or attention deficit hyperactivity disorder.

About one out of five parents would not want these children as neighbors, in their child’s classroom, or as their child’s friend, report Jack K. Martin and colleagues from Indiana University in the Journal of Health and Social Behavior.

Older children and boys with mental conditions are most likely to be rejected.

This troubling pattern, the investigators report, appears to result from perceptions that a mentally ill child may be “dangerous.”

“If, as it seems, the ‘mental illness’ of either children or adults signals danger to the public, this barrier must be addressed by future political, legal, and research agendas,” according to Martin and colleagues.

The research stems from interviews with more than 1,100 adults as part of the General Social Survey administered by the National Opinion Research Center. The interviewees were given descriptions of children of various ages with asthma, attention deficit hyperactivity disorder, depression or “normal” ups and downs of childhood.

Levels of rejection for children with depression and ADHD were two to three times higher than those reported for children with asthma or “normal” childhood troubles.

The results showed that almost 30 percent of parents said they would not like their child to become friends with a child who was depressed and more than 18 percent wouldn’t want to live next door to a family with a depressed child.

Roughly 23 percent of parents said they preferred that their child not make friends with a child with behaviors consistent with ADHD and 22 percent wouldn’t want to live next door to a family with a child with ADHD.

“In line with the 1999 Surgeon General’s report on mental illness, our analyses point to continuing barriers to public acceptance,” note the report’s authors. “While not as significant an obstacle as the rejection of adults, social distance does reflect stigma surrounding children’s mental health problems.”

They hope a greater understanding of the roots of this stigma will lead to effective efforts to confront the persistent lack of social acceptance of the mentally ill.

SOURCE: Journal of Health and Social Behavior, March 2007.