Posts Tagged: Treatment

ADHD — 2 Comments
28
Jan 10

ADHD Coping Mechanisms Blaming Yourself or Them

adhd-coping-mechanism-study-school-graphic One of the things that I have consistently found most fascinating since discovering my ADD and the science of ADHD in general, is the concept of coping mechanisms.

All human beings, whether they have attention deficit disorder or not, develop over the course of their lifetime, a set of skills (for lack of a better term) that allows them to get by in life. These skills range from the most basic, like tying your shoe, to much more complicated ones, like initiating and developing a romantic relationship with another person. Coping mechanisms are a specific subset of these life skills. A coping mechanism is a skill or habit that develops in order to compensate for something, whether it is a some sort of shortcoming, some form of emotional discomfort, or simply to take the edge off of life’s many potential disappointments. One common coping mechanism is emotional eating, where a person eats either certain foods, or large amounts of food, in an effort to make themselves feel better.

Common ADD Coping Mechanisms

For adults with ADHD, recognizing and understanding coping mechanisms is an important component of non-medication attention deficit hyperactivity disorder treatment. True coping mechanisms are mental or behavioral in nature, as opposed to functional. In other words, the constant adjustments and refinements we make everyday are not coping mechanism. The habits, skills, and emotional responses we develop over long periods of time are coping mechanisms.

For example, always placing your keys in the same place is a method of doing something, not necessarily a coping mechanism. That is simply an attempt at perfecting the flow of your current lifestyle.  However, being someone who is always compulsive about keeping everything in its assigned location, is a coping mechanism.

Like everyone, people with ADHD have good coping mechanisms, and bad coping mechanisms. Recognizing the good ones provides a starting point for developing new coping techniques or expanding upon already useful coping methods. Recognizing the negative coping mechanisms provides a starting point for lifestyle adjustments that hopefully, lead to the eventual disappearance of said habit. Detecting and adjusting the mental attitude that often accompanies negative coping responses is also a good place to start when it comes to therapy or ADHD coaching.

Blaming Yourself For ADHD or Blame Others?

One of the most intriguing things about common ADHD coping mechanisms is how they may or may not apply to any one person. Even more interesting is how the same mechanism can be flipped upside in some people that have ADHD.

One of the very common coping mechanisms for adults with ADHD is to blame supposed character or personality flaws for certain things. For example, a woman with ADD who can’t seem to do any job beyond answering phones because she is never organized enough for anything more advanced, may eventually take the edge off of such disappointments by laughingly noting that she is, “just a space cadet sometimes.” Unfortunately, this all too common side effect of ADHD, is not only surprisingly effective at blunting the hurt of disappointment, but also at making one resigned to never striving for anything else.

Reading about this coping method, or its variations, in book after book left me skipping chapters and writing off certain advice, because it never really seemed to apply to me. I’ve always been very confident in my abilities, often getting jobs, projects, and responsibilities beyond my current skill level. Fortunately, I’m also quick to learn with either the interest or immediately looming threat of disaster is strong enough. But, I thought, I’ve never really blamed myself.

Ironically, it turns out that I use the blame coping mechanism just as much (or more) than most people with ADHD, the only difference is that I blame other people.

Many ADHD books, including the oft mentioned, Hallowell books, Driven To Distraction and Delivered From Distraction are written by successful individuals who claim to have ADD themselves. In one of the books, Hallowell, who is a successful doctor, describes his thriving medical practice and his extensive work with ADD patients before saying that he, himself, also suffers from ADHD.

As I read that passage soon after being diagnosed with adult ADHD, I couldn’t help rolling my eyes. Hallowell, I figured, was lying in order to boost his credibility in the area of ADD. After all, I thought, he went to medical school, graduated, became a doctor and developed a successful medical practice, just how bad could his ADHD be? Oh, my gosh! Did he have to use sticky notes to keep track of assignments? Oh, the horror!

The truth is, that I despised Hallowell and his success as a doctor and subsequently an author. The reason is that instead of blaming myself, I blame others. When Hallowell, and his “I barely have ADD” colleagues go out and build these big, successful careers, fat bank accounts, and speaking tours, I reasoned, it hurts those of us who REALLY have ADHD.

I’ve thought that way my whole life.

“I’m the smart one. The only reason he is doing better in school is because he studies EVERY NIGHT.”

“I could have started up an Internet business, but I didn’t want to spend every single day working in my basement.”

The tragedy is that until recognizing what I was doing, I took much of it as a badge of honor.

I graduated from High School near the top of my class. I got all A’s except in English where I got B’s. I could have gotten A’s in English, but I never did homework. Literally, NEVER. I did my schoolwork during the class before the class it was due in. So, I did my Algebra homework for second period during my History class at first period. The one thing I couldn’t quite get done like that were long essays. So, every time an English paper was due, I would start it during the class before it was due, but I wouldn’t finish it. I’d have to wrap it up the next day. It was still an A paper, but with the one letter grade penalty for being late, it became a B.

I was proud of that as I left high school. You see, grades or no grades, I was faster, smarter, and better than everyone else. Those kids who left with a 4.0 where the chumps, not me. They were the ones who wasted their free time actually doing homework.

Unfortunately, not recognizing the truth cost me a lot in college where I not only continued the same pattern, but actually expanded it. In high school, attendance was required. Between parents, teachers, and administrators, the path of least resistance was going to class. Coming up with an excuse, sneaking out the door, and then trying to keep my parents from getting a phone call or note about my absence was way more work than just going to classes, so I went.

At college, that was no longer the case. In college, no one called my parents, most professors didn’t know whether you were there or not. The path of least resistance became not going to classes, and I didn’t go. My new pattern became:

  1. Go to class one or two times and get syllabus.
  2. Use syllabus to find exam dates and due dates of essays or projects.
  3. Stop going to class.
  4. Go to the class the day before the exam to get review sheets and any changes about what would be covered.
  5. Hurriedly read through the textbook chapters that would be on the exam.
  6. Take test.
  7. Surf the curve to a B or C.
  8. Start any essay or project the night before it was due. Work on it until it was “good enough.” Surf curve to C.

During my Junior year, I literally attended my Geography class 5 times the entire semester. I got an A.

The only exceptions were the classes where the professor actually took attendance and docked your grade if you missed classes. In every one of those classes, I got an A, because I actually went. Ironically, I seldom paid much attention while I was in the class. I read the student newspaper, worked on other classes’ homework, or just daydreamed. But, looking up at the board and hearing a paragraph here and there was enough to let some of the information sink in. More importantly, it was enough to give me an idea of what the professor felt was important.

For years after graduating, I proudly told anyone who asked that I graduated with a 2.14 GPA, but, I added, I never really went to class or did any of homework. I don’t know if anyone was ever impressed by that. Not that it matters.

The true tragedy is that I didn’t do anything else. There would be some redeeming value in how I spent my 4 years on campus if I had gotten in a 100 day ski season, or spent sunny days hiking, biking, or doing ANYTHING. Instead, I mostly slept in, napped, and messed around on my computer. The only good to come out of it was that in those days, the Internet was a text based Unix system. There were no web browsers, just FTP, vi editor, GREP, UUENCODE, and so on. In the end, I knew a lot about how to use computers, which meant I didn’t have to figure out how to get a job in Chemistry with no professor recommendation (none of them would have recognized me), no summer lab work, and no internships. Instead, I got a job as a computer administrator and quickly became certified in numerous technologies just as the technology bubble started ramping up.

Of course, the blaming cope strategy didn’t go away. I always felt that I should be the project manager or the startup millionaire or whatever, but I never was. The reason was simple, I could have been, but they just worked harder, tried harder, or refused to give up. Not me. Those suckers.

*******************

These days, I try not to blame others for their success, nor assume that I would be twice as successful under the “slightly different” circumstances of me actually busting my butt to make something happen. But, like most attitudes developed over decades, it can be hard to keep up, and even harder to see when it is happening.

ADD Medication — 4 Comments
9
May 09

Non-Prescription ADD Treatment Options – St. John's Wart

My recent post on avoiding medical scams in the name of non-prescription ADD / ADHD treatment options, drew a heavy response, including a lot of people who were interested in what the non-prescription vitamin and supplement choices were that I referenced.

There are literally hundreds of vitamins or supplements that various people purport to have a positive affect on ADD behavior.  However, none of these treatments have received the kind of scientific study required to actually say that they do or do not work.  That isn’t surprising since there is no money in finding out that Vitamin X treats ADD symptoms better than Ritalin in children, getting funding for such research can be difficult.

(Incidentally, if you are a non-profit organization or scientific researcher or group that does ADD/ADHD research, and you would like some grant writing help, please feel free to contact me.  I’m a professional writer and I would love to help out by doing SOME pro bono work if it would bring some funding to your research. — Note: I’ve had one bad experience with a group in the past who thought that my offer to help gave them a free full-time grant writer.  I am willing to help, but I also have a family and a business to run, so please contact me with the right expectations in mind.  I will work hard to help get grants to fund this important research, but I can only do so with the flexibility my schedule allows.)

Some treatments only seem to have ADD benefits in children, while others only seem to work in adults.  And, most concerning of all, is the lack of data on side affects or other drug interactions.  So, make sure you do your own research and investigate all of the details.

I have done my best to list sources when I can remember them or re-find them.

St. John’s Wort For ADD / ADHD

St. John’s Wort is actually most commonly indicated for the treatment of low-grade depression. As such, it seems to help with certain ADD symptoms in some individuals, most likely because it treats some of the depression-like symptoms that occasionally manifest with certain types of ADHD. That being said, it does have a widespread following of ADDers who insist that it provides some relief for their symptoms.

St. John’s Wort has been shown to inhibit the reuptake of serotonin, dopamine, and norepinephrine.  This allows these neurotransmitters to build up to greater levels in the brain.  Depression is thought to be caused by low levels of these chemicals and that is why St. John’s Wort is effective in helping treat certain kinds of depression, according to research.

Theoretically, the same kind of mechanism may have something to do with ADD.  However, the research on that is still out.

What is known is that a large number of people with ADD/ADHD also show certain symptoms of depression.  Whether there is a correlation at a physical, biological, level, or if this there is just a correlation due to the lifelong burdens carried by some ADDers isn’t known.  However, if children, teens, and adults with ADHD do have some sort of depression in association with their ADD, then St. John’s Wort would help with the depression, which would provide an improved mental state overall, which could be misinterpreted as helping the ADD part of the issue.

Indeed, recent research from the National Institute of Health showed no improvement in ADD symptoms over a placebo in children and adolescents.

However, this was a very small study over a very small period of time.  Ironically, this is exactly the kind of research that gets dismissed by the medical establishment as non-conclusive when the study makes conclusions the other way around.  That is, if this study had found vast improvement, you could be sure that the researchers would conclude by saying that this was only a small sample and that further research was needed.  The fact that they don’t say that here, is disturbing to those of us who want to think that medical research gets a level playing field regardless of the outcome and whose profits might be hurt.

The study in question was 54 children aged 6 to 17 who were otherwise healthy and taking no other medications.  In standard scientific methodology half were giving St. Johns Wort and the other half were giving a placebo.  The two groups were generated randomly from the participants.  Then monitored for changes to inattentiveness and hyperactivity at 1, 2, 4, 6, and 8 weeks.

In other words, 27 children were tested to see how they responded to St. Johns Wort. The good news is that the study lasted 8 weeks, because the research on St. Johns Wort suggests that it takes several weeks to become effective.  But, the bad news is that at weeks 1 and 2, and maybe even week 4, there should not be any expected benefit.

The other bad news is that this study used the older weaker form of St. Johns Wort commonly sold in grocery stores and health food stores.  The newer form, called High Hyperforin contains 3% – 5% of hyperforin, versus the 0.14% used in the study.  However, since that form is relatively new and people have been claiming benefits since before it became available, this is still good research.

The really weird part of the study is that symptom improvement was noted to IMPROVE in BOTH groups!  While that lets the scientists conclude that there is no benefit of the supplement over the placebo, it raises an interesting question for those of us who actually care about those with ADD, namely, why did the symptoms improve for everyone?

Was it just that actually having some attention paid to their condition provided some help?  Was it that a new an interesting environment (where the observation took place) was enough to stimulate the minds of these children to help with symptoms?

Is The Criteria Too High?

Another interesting factor is that the researchers actively expected this outcome. They anticipated a 5-point reduction on the ADHD RS-IV total score in the placebo group!

Further, it was determined that in order to count as a “meaningful” improvement, the St. John’s Wort group would require a 13-point improvement on the same scale.

The ADHD RS-IV scale has 18 items. Each item is ranked from 0 to 3 with 0 being never or seldom, 1 being sometimes, 2 being often, and 3 being very often. In other words, the lowest possible score is 0 and the highest possible score is 54. So, for a meaningful result to be obtained, subjects needed to show a minimum of a 24% improvement! Considering that most people with ADD/ADHD aren’t necessarily looking for a result that would give a zero, and would be very happy to move down to a one on their major symptoms, this seems to be a very large requirement.

Obviously, more study is needed and there are interesting facts that should be looked at.

Should You Try St. Johns Wort for Your ADD?

Obviously, everyone has to make their own health decisions, and I am not a doctor, nor do I have any other certification or qualification, so take this a general knowledge only.

St. John’s Wort has been subjected to extensive study around the world, mostly in Europe.  During those studies no major immediate side effects have been reported. Indicating that St. John’s Wort can’t hurt, even if it doesn’t help.  This makes it a perfect treatment to try out and see if it can help you, even if it doesn’t meet the scientific criteria set out for clinical trials.

There is one area that is a concern and that is that St. John’s Wort does interact extensively with a wide array of medications.  In other words, St. John’s Worth is NOT the treatment for you to try if you currently take any prescription medication!

Talk to your doctor first to fully understand what affect St. John’s Wort might have on your medications BEFORE you try anything out.

Also, St. Jons Wort can be very stimulating to the brain.  That means that it can make it difficult for some people to sleep.  If you are taking St. Johns Wort, do it first thing in the morning. If you develop trouble sleeping, or it feels like your brain is “buzzing” then, cut back the dose or stop altogether.  You’ll be way better off with your usual ADD symptoms than you will be with long-term sleep deprivation.

Otherwise, if you are going to try alternative therapies, you could do a lot worse than St. John’s Wort.  Be careful, and listen to your body.  If it doesn’t feel right or you seem to have problems flare up, stop.

Also, remember that St. Johns Wort is not an instant-on treatment.  Depression patients report that it takes WEEKS for the herbal supplement to provide any noticeable improvement.  This is because inhibiting the re-uptake of neurotransmitters doesn’t mean you get the full smash right away, so if you are going to try it, don’t just take it for a week and decide it doesn’t work.

Pay attention to what you are buying.  Shifty supplement manufacturers and retailers want to capture your dollars no matter what, and they know that some people won’t pay certain prices.  That means that the lower concentration St. Johns will sell right next to the higher concentration supplements and no one will make that clear on the front facing label.  Turn the bottle around and make sure that you are getting the right amount that you have decided to start taking.  You’ll need a lot more of the 0.14% kind than you will of the 3% or 5% kind (and vice versa).

Good luck, and let me know how it goes for you by posting a comment or shooting me an email.

, , ADD/ADHD, Non-Prescription Treatment, ADD Mediction,

P.S.  If you noticed a couple of mispellings of key words like “Wort”, that is to allow those who search for information with mispelled words can still find this page.  That is also why I actively alternate between ADD, ADHD, and ADD/ADHD.