Before reaching a tipping point, people often are able to balance known or unknown ADHD challenges with strategies they may not have even realized they were using. They had been able to adapt and cope well with their symptoms. Their symptoms may not have interfered with their functioning, so that they avoided an official ADHD diagnosis.

But for some reason a life change — a job promotion, relationship change, school change, or myriad other things — renders the current strategies ineffective. Over time there is a sense that things are no longer going well and in fact, life seems to be falling apart in a big way.

Here are some life situations that could be possible tipping points::

1. New problems at school.

Often, when higher elementary or middle school hits, students begin unraveling. They experience more responsibility in juggling multiple classrooms, more homework and larger classes. Suddenly it seems like nothing is working anymore. They can’t get things done that they want to get done, everything becomes chaotic, things start to come undone. Their schoolwork starts to suffer; they may have trouble concentrating in class, forget to hand in homework or start to experience difficulties with old friendships.

Often, no one recognizes these warning signs as being ADHD-related because the students previously had managed or were able to compensate for their challenges. Parents and educators start to feel helpless when a previously successful student seems to become unmotivated. Students are told they just need to try harder. Everyone is unsure how to get the child back on track and the students begin to feel stupid, lazy and incapable.

2. Inability to cope after significant life changes.

Some people with ADHD experience their first tipping point after a significant life change, even a positive one such as getting married or moving into a new home. These major life celebrations are anticipated with great joy, but often may be a change that tips the balance. Perhaps you’ve been able to balance your own life and your own schedule and where you put things up until now. But then you get married and now your spouse has a different way of doing things or expectations of the way things should be organized that differ from your views. That’s not to mention having to deal with the extra stuff in your space.

Slowly you notice that things are not working as well as they had before, and because this is supposed to be the happiest time of your life, you think there must be something wrong with you — right? Wrong! Significant life changes such as getting married, having another child or moving homes often can upset an unknown balance.

3. Unable to transition successfully into a new role at work.

Up until your “tipping point” you have been performing really well in your job — so well, in fact, that you are promoted. Slowly you may start to notice that you are not doing this new job as well as everyone expected, and you begin to isolate yourself, dread going to work and may eventually get fired.

What happened? You reached your tipping point. Not because you didn’t deserve the job, but because changes in work often come with changes of staff, support, work space, etc. that throw you off.

4. Change in family dynamics.

If you find yourself with new responsibilities and changes in your family, such as taking in an elderly parent, adding members to your family, or getting a new roommate, the additional responsibilities, change in routine and stress can gradually sink in and leave you overwhelmed and unable to cope as you have previously. It is so easy to begin to think you are a terrible mom, unfit for the responsibilities of a family or that you may be destined to live alone.

It’s not you. You were thrown off-balance, and your ability to compensate for your ADHD with your old routine, structures or systems is no longer working. But instead of seeing the truth, that it isn’t anything you’ve done wrong, or knowing that you can fix this, you’re filled with undeserved guilt and shame.

5. Physical injury.

People often experience their tipping point when an ADHD-management strategy such as exercise decreases or activity level changes. Unbeknownst to many people with ADHD, participation in sports or daily exercise provides some additional dopamine to our brain and helps to create structure and routine in our lives that help to better manage ADHD symptoms.

Tipping points are common for high school athletes who have earned success not only in their sports but academically, only to go off to college and experience failure for the first time. Without the rigorous physical training and structure of high school, they begin slowly to fall apart. Another common tipping point for people with ADHD is when they have experienced an injury and have to decrease their activity or exercise level. This change in routine and absence of daily dopamine boosts can challenge previous steadiness, energy levels and ability to focus. Life begins to wobble.

As you can see, there are many reasons, often beyond your control, that might lead you to your tipping point. A tipping point means that you are at a crossroads. You have a choice which way you will react. You can continue down that path to chaos and overwhelm, or you can get restructured and relearn ways to to cope and get back on track.

Food allergies or intolerances can have a great effect on your mood. For example, if you have gluten allergy or intolerance, consumption of gluten (found largely in wheat products) can leave you feeling sluggish or even depressed. Dietary changes have been suggested for children with ADHD or autism. This suggests there is a strong link between food, mood and behaviors.

Fluctuations in blood sugar also can change your mood. High blood sugar often can lead to irritability, while low blood sugar can bring about feelings of anxiety, depression and lethargy.

Research also suggests that low levels of vitamins, mineral deficiencies, and low intake of fatty acids and omega-3s can contribute to altered moods and mimic various mental health issues. Some believe that these deficiencies actually cause mental health issues. Insufficient levels of vitamin D, in particular, can lead to mood swings, depression and fatigue. If you have any deficiencies, your mood may be improved simply by adding supplements.

If you are interested in exploring how food may be affecting your moods, keep a food diary for at least two weeks. Record everything you eat and drink and your moods before and after. It may sound tedious, but it is beneficial. If you notice a pattern, you may wish to seek a nutritionist or experienced health care provider to assist you in making the necessary changes. Since diets should be individualized, you will want to make sure the changes you are making are appropriate and healthy for you.

Many people feel that it is difficult to eat healthy or to change their eating habits. It’s really simple if you keep it simple. Start slow and make changes over time. Using the all-or-nothing approach to cutting out certain foods typically leads to failure.

You can also make changes by slowly substituting bad foods with good ones. Experiment with different grains, fruits, and vegetables. Get online and find exciting new recipes, and you just may fall in love with a good food you never imagined you would eat.

Remember every change you make matters. If you fall off the wagon, just get back up. It’s about making changes to improve your emotional health. Don’t get discouraged or depressed if you slip up. Consider that day as a misstep and make healthier choices in the future. Here’s to a healthier you!

Kevin Roberts, in his book Movers, Dreamers, and Risk-Takers: Unlocking the Power of ADHD, posits that this negative attitude toward people he affectionately calls “ADHD-ers” is part of the problem. He believes that changing the way society, educators, and parents approach ADHD would go a long way to help ensure ADHD-affected kids do better in school and in life. He points out that people with this disability tend to be considerably more creative, goal-oriented, and out-going than those of us without ADHD. And he recommends how those affected by the disorder can adapt to it on a daily basis.

As a writer, Roberts is engaging; as a comedian, he is able to laugh at himself and keep the book light-hearted and upbeat. As a life coach, ADHD counselor, and ADHD patient, he demonstrates that he has the professional and personal experience to speak from a position of authority on the subject. This combination of personal and professional experience, positivity, and humor makes his book an irresistible read.

Roberts begins by giving his and his family’s history of ADHD. The book is interspersed with his personal story, stories of his clients, and techniques he has used to help kids better manage their schedules and homework. He cites several studies to back up some of his claims about the roots of ADHD and its attributes. But what seems to me most refreshing about the book is that Roberts chooses to look at the positive side of ADHD. 

The author maintains that people with ADHD are not “unteachable” or “difficult.” They simply think differently—and this difference needs to be accounted for. Personally, I find that this makes complete sense. No one would expect a physically disabled child to move just like other kids or work exactly like his or her able-bodied classmates. So why in the world are we expecting kids and adults with learning disabilities to think like everyone else?

To drive home his point about how “ADHD-ers” think differently, Roberts offers examples from his clients. He gives a synopsis of each client’s issue and illustrates how he helped them overcome their “road block” in that area. In another section, he gives several study, work, and organization tips tailored to people with ADHD. One of them is to “get physical.” Move around when studying, typing a work report, or doing another work or school-related activity, he suggests. This, he says, will avert boredom and help an ADHD-er stay focused.

Due to Roberts’s light-hearted and positive approach, his book is an easy, fun, and interesting read. I suspect it will help many people who have ADHD themselves, love someone who has it, or work in education.

Movers, Dreamers, and Risk-Takers: Unlocking the Power of ADHD
Hazelden, June, 2012
Paperback, 250 pages
$14.95 

It’s normal for parents to feel helpless and confused about the best ways to handle their child in these situations. Because kids with ADHD do not purposely decide to act up or not pay attention, traditional discipline — like spanking, yelling at, or calmly trying to reason with your son or daughter — usually doesn’t work. Fortunately there are treatment options that can help alleviate the symptoms of ADHD and arm families with the tools needed to better handle problem behaviors when they arise.

These interventions include:

• Medication
• Psychotherapy
• Or a combination of these two approaches

Medications

Used properly, medicines such as methylphenidate hydrochloride (Ritalin) and other stimulants help suppress and regulate impulsive behavior. They squelch hyperactivity, improve social interactions and help people with ADHD concentrate, enabling them to perform better in school and at work.

These medications also may help children with co-existing disorders control destructive behaviors. When used with proper medical supervision, they are considered generally safe and free of major unwanted side effects. (Some children may experience insomnia, stomachache or headache.) They rarely make children feel “high” or, on the flip side, overly sleepy or “out of it.” Although not known to be a significant problem, height and weight should be monitored with long term use of these medications. These medications are not considered addictive in children. However, they should be carefully monitored in teenagers and adults because they can be misused.

It is important to understand that these medications are not a cure-all, but they can be highly effective when used appropriately in the right dosage for each individual. In fact, as many as nine out of 10 children do better when they are taking one of the most commonly used stimulants. However, in combination with other techniques such as behavior modification or counseling, symptoms may improve even more. Researchers are currently evaluating the effectiveness of medications in combination with these other approaches to determine the best route to take.

Individuals taking any of the medications listed below should see their doctor regularly for a check-up to review the types and timing of ADHD symptoms. The benefits and potential risks of using these medications also should be discussed before the first prescription is filled.

The most commonly used stimulants are:

• methylphenidate hydrochloride (Ritalin, Ritalin SR, and Ritalin LA)
• dextroamphetamine sulfate (Dexedrine or Dextrostat)
• a dextroamphetamine/amphetamine formulation (Adderall)
• methylphenidate (Concerta)
• atomoxetine (Strattera, marketed as a “non-stimulant,” although its mechanism of action and potential side effects are essentially equivalent to the “psychostimulant” medications)

When these “front-line” medications are not effective, physicians sometimes opt to use one of the following:

• buproprion hydrochloride (Wellbutrin) — an antidepressant that has been shown to decrease hyperactivity, aggression and conduct problems.
• imipramine (Tofranil) or nortriptyline (Pamelor) — these antidepressants can improve hyperactivity and inattentiveness. They can be especially helpful in children experiencing depression or anxiety.
• clonidine hydrochloride (Catapress) — used to treat high blood pressure, clonidine also can help manage ADHD and treat conduct disorder, sleep disturbances or a tic disorder. Research has shown it decreases hyperactivity, impulsivity and distractibility, and improves interactions with peers and adults.
• guanfacine (Tenex, Inuniv) — this antihypertensive decreases fidgeting and restlessness and increases attention and a child’s ability to tolerate frustration. Tenex is the short-term preparation, while Inuniv is the long-term preparation.

Duration of treatment

On the one hand, health professionals know that attention deficit hyperactivity disorder is a chronic condition that lasts for years and sometimes for a lifetime. On the other hand, the risks and benefits of medications can change over time, so typically the treating physician and the family need to regularly re-evaluate medication use.

Unlike a short course of antibiotics, ADHD medications are intended to be taken for a longer period of time. Parents should anticipate that, for example, if the child begins taking a medication at the start of the school year, then they are generally going to be committed to working with that medication for the rest of the school year. A child’s situation may improve to where other interventions and accommodations kick in and the child can function pretty well without the medication.

Because children change as they grow — and their environments and the demands they face evolve as well — it is important for families and the treating physician to maintain an open line of communication. Problems can be encountered when a family discontinues a medication without discussing their concerns with the practitioner first.

Adults with ADHD also respond well to similar interventions, including stimulant medications. When making treatment choices, practitioners should consider the individual’s lifestyle. While these medicines can be very beneficial, side effects can occur and should be monitored. Non-stimulant medications, including the antidepressant buproprion hydrochloride (Wellbutrin), have been used. Newer reports show other antidepressants such as venlafaxine (Effexor) may be beneficial in adults as well.

Psychotherapy

Research has shown that medication alone is not always sufficient. For more than two decades, psychosocial interventions such as parent training and behavioral modifications have been used for children with ADHD. A key goal is to teach parents and educators methods that equip them to better handle problems when they arise. In this approach they learn how to reward a child for positive behaviors and how to discourage negative behaviors. This therapy also seeks to teach a child techniques that can be used to control inattention and impulsive behaviors.

Preliminary research has shown that behavior modification is also effective for children with severe oppositional problems. Such an approach may lower the number or severity of oppositional behaviors, although the underlying condition — ADHD — remains.

Some people with ADHD benefit from emotional counseling or psychotherapy. In this approach, counselors help patients deal with their emotions and learn ways to cope with their thoughts and feelings in a more general sense.

Group therapy and parenting education can help many children and their families master valuable skills or new behaviors. The goal is to help parents learn about the particular problems their children with ADHD have, and give them ways to handle those problems when they arise. Likewise, children can be taught social skills and gain exposure to the same techniques the parents are learning, easing the way for those methods to be incorporated at home.

Support groups link families or adults who share similar concerns.

Treatments to Avoid

These therapies that have not been scientifically proven to be helpful in the treatment of ADHD:

• herbal products
• restrictive or supplemental diets
• allergy treatments
• supplements
• megavitamins
• chiropractic adjustment
• perceptual motor training
• medications for inner ear problems
• yeast infection treatments
• pet therapy
• eye training
• colored glasses

What type of professionals should be sought

Most parents consult with their child’s pediatrician or family physician first. If the child mainly has symptoms of hyperactivity, impulsivity or attention problems, then these doctors are in a position to address those concerns. If the child has associated other difficulties, including anxiety, fears, depression, or motor tics, then they should be seen by a mental health specialist, such as a child psychiatrist or school psychologist. Neurologists, whose field focuses on the brain and nervous system, also diagnose ADHD.

It is important to involve the child’s teacher. Educators can lend valuable insight that helps health professionals arrive at an accurate diagnosis and plan the best treatments for that child. Teachers can convey how the child is behaving in school and help review the child’s academic progress.

Prognosis

Even though most people will never completely outgrow ADHD, a thorough assessment and treatment catered to the individual’s particular set of challenges can help them master their symptoms and lead productive, achievement-filled lives. Many believe the disorder’s characteristic behaviors can actually give these individuals a unique creative edge. People with ADHD have gone on to have successful careers in an array of occupations.

Prevention

Because researchers do not yet fully understand what causes ADHD, there are no documented strategies for preventing the disorder. However, some recent studies have indicated that smoking during pregnancy appears to be associated with an increased risk for ADHD.

Most of us recognize these as some of the symptoms of ADD or Attention Deficit Disorder. (OMG – maybe we all have ADD.)

But these struggles are not the exclusive domain of ADD. Difficulty getting things done and falling prey to distraction, a wandering mind and temptation is a reality for most of us at times. And, of course, it’s all compounded by the constant lure of digital distractions.

With ADD, however, overcoming these obstacles is not simply a matter of choice, Here, lack of capacity can trump the best intentions to use willpower and self-discipline to stay on track, Further, ADD deficits often cause longstanding effects on career and relationships, leading to underachievement, and a chronic sense of frustration, shame, and failure.

ADD is a neurobiological syndrome beginning in childhood that is chronic, pervasive, and hard-wired, with a strong genetic component (Barkley, 2010, Hallowell, 2005). Research indicates that about four percent of adults in the U.S. have ADD (Hallowell, 2005). ADD symptoms also include forgetfulness, impulsivity and difficulties with organization, time management, staying on task, and shifting attention — being able to unglue oneself from a task or knowing when to stop (Barkley, 2010).

ADD symptoms are essentially executive function deficits, interfering with the ability to follow through on conscious intentions and sustain future- or goal-directed activity. Researchers have called ADD a condition of “nearsightedness” (Barkley, 2006, p. 56) with regard to time. ADD creates a blind spot for the future, often leading to short-sighted decisions and procrastination (Barkley, 2006).

Seventy-five percent of people with ADD have at least one other co-existing condition, usually anxiety, depression, or substance abuse. Although medicine helps 80 percent of people with ADD, lack of response or worsening of symptoms may occur when untreated co-existing conditions are mistakenly attributed to ADD (Hallowell, 2005).

For example: Jenny held a high-status academic position. In her struggle with ADD, she was most affected by distractability and procrastination, often surfing the web for interesting political news instead of doing her work.

Jenny was raised by a very critical father who shamed her when she didn’t meet his expectations, or when she asked a question he thought was stupid. Although ADD was an aspect of Jenny’s problem, even with structure and medication, it did not remit until she addressed the psychological issues driving her avoidance.

Jenny internalized the perfectionism imposed on her by her dad, along with a sense of inadequacy, shame, and fear of disapproval. She was easily triggered into a flood of anxiety around her work, fearing she’d be exposed as an imposter. This led to cycles of inertia, shame and further avoidance. When Jenny could recognize and change the inner critical voice in her head modeled after her dad, she lowered the stakes she set for her performance, and could make use of strategies to treat her ADD.

Structural and biochemical differences in ADD brains limit the capacity to regulate oneself, or have self-control. It makes it difficult to initiate, persevere, or stop behavior so that actions are in line with one’s future goals, rather than immediate impulses. Further, depletion of dopamine, a neurotransmitter involved in the experience of pleasure and reward, creates difficulty sustaining a feeling of vitality, contributing to a pull toward behaviors that provide stimulation or an adrenaline rush.

Some researchers have found that the secret to harnessing the energy of the ADD mind is finding a naturally compelling creative outlet where focus comes easily. Successful adaptation involves compensation for deficits, for example, by finding environments compatible with the strengths of the ADD brain. Such environments are often fast-paced, intellectually or physically stimulating, or structured, perhaps with regular deadlines paced at short intervals.

Work that requires intense energy, here-and-now attention, independent thinking, imagination and tenacity may also capitalize on ADD assets. Most important, educating ourselves and our loved ones about ADD is essential to prevent needless judgment, shaming, and self-blame that are common with this condition. Then, instead, we will be in a position to harness the unique, inspired energy of the ADD mind.

References

Barkley, R.A. (2010). Taking charge of adult ADHD (1st ed.). New York, NY:The Guilford Press.

Barkley, R.A. & K. R. Murphy (2006). Attention deficit hyperactivity disorder: A clinical workbook (3rd ed.). New York: Guilford Publications.

Hallowell, E.M. (2005) Delivered from distraction. New York: Ballantine Bks, Random House Publishing Group.

Burge, who has a B.A. in Psychology and an M.A. in Organizational Development, is also an ADHD coach and mother to two sons diagnosed with ADHD.  It is not unreasonable to assume that The ADD Myth is the product of both her professional and educational backgrounds as well as a quest for knowledge in support of her sons. 

As a result, you are going to be exposed to a unique way of looking at a condition that has been diagnosed at an alarmingly increasing rate since its definition was changed in the DSM-IV to allow for inattentiveness without the hyperactivity or impulsivity.  ADHD, the name by which ADD is now known, may not be something that requires a diagnosis at all. 

It may instead only require a willingness and daring to look at it as purely a personality trait whose name is intensity rather than a disorder called ADHD.  Shaping this new view is a blending and extrapolation of two concepts in particular; the work of Dr. Kazimierz Dabrowski (positive disintegration) and Dr. Candace Pert (neuropeptides).

Dabrowski’s five areas of “super-stimulatibility” are reinterpreted in The ADD Myth as “intensity.”  Burge’s take on them – sensual, psychomotor, intellectual, creative (Dabrowski’s was imaginational), and emotional – results in the acronym SPICE, supporting her belief that “intensities are the spice of life.”  Throughout the book, 16 meditative-type practices are presented to develop these intensities so they are manageable.  If “instead of the intense person having a deficit, they have a brain that intensifies stimuli,” these practices would seem to help dial down the intensity of those stimuli when mastered.

Dr. Candace Pert’s discovery of particular molecules (neuropeptides) in the body that were thought only to be present in the brain resulted in her conclusion that our bodies also have an “emotional brain,” and it is the unconscious mind.  Using that premise, the author infers that sensory input makes its way into the subconscious mind which then acts as a “gatekeeper” to the conscious mind.  It is at this gate that information is evaluated and then allowed to continue on its path to consciousness (the brain) or stopped dead in its tracks.  Whether or not it gets past the gatekeeper depends on if the information is determined to be one of three things:  dangerous, important, or something that the conscious mind has said to be on the lookout for.

Regardless if there is a diagnosis of ADHD or not, it would seem that an “internal map of reality” can be a very telling way to look at how we all navigate everyday life and its myriad interactions.  Remember “truth is defined by your map”?  Containing your “beliefs, opinions, values, attitudes, and many other forms of understanding the meaning of what you encounter in the real reality,” it is not something we consciously create, but is “given to us primarily by our family, culture, and early experiences.” 

In intense persons, the author likens this map to the Internet in that thought is nonlinear, and intuition is utilized when analyzing incoming information.  In those who are non-intense, the internal map is simply a highway system, “with roads leading to other roads.”  That analogy would seem to speak volumes of the challenges an intense person faces.  The search returns millions of hits for every piece of information presented to them and then they are tasked with having to sift through them all to select the one that best serves the purpose at hand.  Intense?  You bet.  ADHD?  Maybe not.

Perhaps the best reason for the theory of intensity is with regard to children and the way in which they learn. 

“Schools are designed to teach the non-intense type of brain, the linear thinking style.  They use practice and repetition to create the pathways in order to store the information.  The non-intense child is well adapted to this approach for learning.  The intense child is only frustrated by it.  When a math teacher insists on seeing the ‘work’ behind the answer to a question, he is looking for evidence that the child has built and traveled the correct roads in order to store the information.  For the intense child, the road is not nearly as concrete.  They may intuitively know answers and not be able to ‘show’ their work because there wasn’t any.”

The ADD Myth is written in an easy-to-read style that conveys the author’s conviction that intensity is more descriptive and helpful than a diagnosis that requires medication to control.  She offers a way to put that control back into the hands of the one whose life it is that is being affected.  In that regard, it would seem that a prescription for partnership rather than medication is in order.  As Burge states, “For ADHD professionals, know that intense people are becoming self-aware.”

The ADD Myth
Martha Burge
Conari Press, Sept. 2012
Paperback, 256 pages

Jessica Johansson of Orebro University in Sweden and her team set out to investigate whether children with ADHD show differences in the transport of the proteins tryptophan, tyrosine and alanine, since these amino acids are the precursors for brain chemicals which have already been implicated in the development of ADHD.

They analyzed connective tissue cells called fibroblasts from 14 boys ages 6 to 12, each of whom had ADHD. It turned out that the cells’ ability to transport tryptophan is lower in boys with ADHD than in other boys.

The finding could suggest greater biochemical disturbances in the brains of people with ADHD than previously realized, Ms. Johansson said. She commented, “This indicates that several signal substances are implicated in ADHD, and in the future this could pave the way for other drugs than those in use today.”

She explained that her work focuses on analyzing important signaling substances in the brain. Excessively low levels of these substances may lie behind the development of conditions such as ADHD.

The findings “probably mean that the brain produces less serotonin,” she said. “Thus far the focus has mainly been on the signal substances dopamine and noradrenaline in the medical treatment of ADHD. But if low levels of serotonin are also a contributing factor, other drugs may be necessary for successful treatment.”

Low serotonin could contribute to greater impulsivity, she added, which is a core symptom of ADHD. More investigation into serotonin in people with ADHD and disruptive behavior disorders is urgently needed, she believes.

The children in the ADHD group also had increased transport of the amino acid alanine in their fibroblast cells. It is unclear how this affects ADHD, the experts say, but they suggest it might influence the transport of other amino acids important for normal brain activity.

Interestingly, increased transport of alanine has also been found in children with autism. In a study of nine boys and two girls with autism, fibroblast samples showed significantly increased transport capacity for alanine. This increased transport of alanine across the cell membrane “may influence the transport of several other amino acids across the blood-brain barrier,” said the researchers, adding that, “the significance of the findings has to be further explored.”

No differences were seen in the action of the amino acid tyrosine in the samples from boys with ADHD, which the experts say “is difficult to explain,” given that tryptophan activity was different to that in boys without ADHD. However, they think it means that the change in tryptophan “could be linked to a more general alteration in cell membrane function in ADHD.” Similar changes in cell membranes have been seen in other psychiatric disorders such as schizophrenia and bipolar disorder.

Team leader Dr. Nikolaos Venizelos points out that dramatically reduced levels of the acetylcholine receptor were also seen in the boys with ADHD. This lack could cause problems with concentration and learning.

Drugs that improve acetylcholine levels already are available and currently are used in treating Alzheimer’s disease. Full details of the study appear in the journal Behavioral and Brain Functions.

Dr. Venizelos added, “I’m doing research on mental diseases and functional impairments at the cellular level. Many of these are assumed to be the consequence of excessively low levels of important signal substances in the brain, so cell biochemical analyses help us understand the processes that cause the changes.”

This study was limited by a small patient group which included only boys. But the team conclude, “Children with ADHD may have a decreased access of tryptophan and an elevated access of alanine in the brain.

“The decreased tryptophan availability in the brain might cause disturbances in the serotonergic neurotransmitter system, which secondarily might lead to changes in the catecholaminergic system [which covers dopamine activity].”

In this way, the new discoveries fit with previous findings that the genes identified as linked to ADHD include several that are linked with the catecholaminergic system.

Finally, the experts call for “a further and extended exploration concerning the disturbance of amino acid transport in children with ADHD.”

References

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191351/?tool=pubmed

Fernell, E. et al. Aberrant amino acid transport in fibroblasts from children with autism. Neuroscience Letters, March 12 2007, doi:10.1016/j.neulet.2007.03.004

Johansson, J. et al. Altered tryptophan and alanine transport in fibroblasts from boys with attention-deficit/hyperactivity disorder (ADHD): an in vitro study. Behavioral and Brain Functions, September 24 2011, doi:10.1186/1744-9081-7-40

I homeschooled our son until he started college at age 16. But mentally, I wasn’t done homeschooling. So I wrote a series of math books, showing how I taught my son, and began tutoring kids who were struggling in math. Of all the kids I tutored, there were two that struck me as oddly similar. Just looking at them you wouldn’t see any similarities, but when it came to learning, they were identical.

They were both smart, but neither one of them knew it. They both had the ability to learn, but they were so easily distracted that they had a hard time concentrating. They both paid so much attention to every detail that even the slightest change in scenery would bring about a whole host of questions. Every foreign object would be questioned. Every sound would need an explanation. For them, holding still and listening was as hard as learning math.

These two kids wanted to learn, but it was as if there was something constantly pulling their attention away. Imagine yourself having a conversation with the most boring person you’ve ever met. You are looking at the person and you can hear him, but you are actually paying more attention to the interesting conversation going on behind you. You have the ability to follow this conversation, but your attention is being pulled behind you. That’s how these two kids seemed to me. I couldn’t hold their attention long enough to get through a whole lesson. There was always something else in the room that got their attention before I did.

My husband overheard us and he bluntly told me, “You need to discipline those kids. They need to sit still, stop playing with stuff, and pay attention.” I agreed with him, but when I tried to be stern with one of the boys and make him sit still and pay attention, it was as if he started melting. In fact, he almost fell asleep. I could actually see his eyes rolling back as he slowly blinked. That wasn’t working for me.

The next day, the boy happened to discover a little piece of foam, some leftover packaging material. This piece of foam immediately became his main focus. He picked it up and fidgeted with it while I tried getting through a few math problems. However, his fidgeting quickly developed into throwing this piece of foam and catching it as it banked off the couch.

I started getting a little agitated with his behavior, so I reached out to take away the piece of foam. But just then I stopped and said, “Throw it here.” He quickly threw the foam to me. I asked him, “What is seven plus seven?” As I threw the foam back to him, he thought for a second, answered “Fourteen,” and then threw the foam back to me. I asked him another math question and continued the game of catch.

At that moment I had a breakthrough. I realized that if I mildly entertained the part of his brain that was curious and fidgety, his intellectual side was ready to receive knowledge.

About that time, my husband walked by again. He couldn’t believe we were playing catch when we were supposed to be learning math. He was appalled that I was letting him get away with that kind of behavior. But then he stopped and listened. He heard the boy solving math problems with enthusiasm. He was amazed: The boy was answering math problem after math problem.

I couldn’t believe it. Once his hands and eyes were occupied, I was left with an intelligent brain waiting for information. He was a very smart boy, but when he was told to sit still and listen, he nearly had an internal meltdown. He didn’t seem to have an “off button” for his curious, fidgety side, so trying to suppress that behavior became his main focus. He couldn’t receive new information because on the inside he was in the middle of a war.

I tried this same technique with a young girl. When she showed up for class the next day, she quickly spotted a Mr. Potato Head game in the corner of the room. This became her main focus. She was not going to be able to listen to me until she had had a chance to play with the toy, so I let her spill out all the pieces. As she plugged in the different eyes and ears, I used that opportunity to explain the Slope Formula to her. If you aren’t familiar with the Slope Formula, it looks extremely complicated and confuses a lot of math students, but I have a very simple method to teach it. Within minutes, she learned the Slope Formula and said, “That was easy.” The whole time she was building a Mr. Potato Head face.

Oftentimes these kids are told they have a learning disability, such as ADD or ADHD. I say they are extremely observant people with a unique learning style that has the potential to make them highly knowledgeable. I would like to see this learning style get a new name, because when you give a young person a label that ends in the word “disorder” or “disability,” you tear down their self-esteem instantly. I prefer the term “active ntellects.”

I hope this helps you understand that you are teaching a wise, energetic person who is fully capable of learning. Embrace your child’s gift. Realize that he has the ability to multi-task. Recognize that once his hands and eyes are mildly entertained, his brain is a sponge waiting to soak up knowledge. “The heart of the prudent getteth knowledge; and the ear of the wise seeketh knowledge.” (Proverbs 18:15)

Copyright 2012, used with permission. All rights reserved by author. Originally appeared in the January 2012 issue of The Old Schoolhouse® Magazine, the trade magazine for homeschool families. Read the magazine free at www.TOSMagazine.com or read it on the go and download the free apps at www.TOSApps.com to read the magazine on your mobile devices.

While the book goes into more detail about different aspects of anxiety, the workbook includes enough background information to function by itself.  Since the workbook also contains worksheets for each technique, if you were to purchase just one of the two books, you would probably find that the workbook meets your needs.

Wehrenberg says that the first step is to assess the type of disorder you suffer from.  To help you do this, Wehrenberg provides checklists and assessments which she says “are based on situations I have observed over the years in my practice.  As such they are not validated tests but rather represent questions I ask my clients and the circumstances they describe to me.”  Some of the assessments are specifically designed for adolescents.  In spite of not being validated, when I compared a few of the assessments with scientifically validated versions, they produced comparable results.

The workbook focuses on panic disorder, generalized anxiety disorder, and social anxiety disorder. It is divided into three sections:  managing the anxious body, managing the anxious mind, and managing anxious behavior.  In the section on managing the anxious body, chapters focus on the impact of food and drink on anxiety, and on breathing, mindfulness, and physical relaxation.  Each chapter presents techniques which may be valuable for all types of anxiety, then describes how a technique can be applied to each of the anxiety disorders.  The book includes a CD with guided exercises for breathing, practicing mindfulness, and physical relaxation.  The CD is well-produced, with exercises read by the author, who has a pleasant voice.

Techniques vary from strategies you can use when you only have as little as two minutes to strategies for developing productive new habits.  Most chapters end with a S.I.M.P.L.E plan that you create for specific problems.  Each letter stands for a different element of the plan which includes “S” for describing the symptoms of your problem, “M” for the method you’re going to try, and “E” for evaluating the results.

The book includes detailed and useful information about how to perform diaphragmatic breathing, as well as teaching how to practice mindfulness and relaxation.  It contains detailed and less useful information about how to stop catastrophizing and on thought stopping and replacement.  Even though some of the advice may seem obvious, if you suffer from anxiety you are likely to find a strategy that could help you.  One interesting idea is that when we’re anxious, we need to seek the “right reassurance.”  If you ask for reassurance from others, you may feel better only temporarily.  Wehrenberg says that “the right reassurance is reassurance that you are competent to handle problems.”  She says that you’ll continue to worry unless “you remind yourself that even if the worst does happen, you will be able to deal with it.”

One of my quibbles with the book is that the author has an annoying habit of personifying the brain, as when she says “Your brain does not like it when you have a physical sensation without an observable reason, so it decides, ‘If I feel this bad, there must be something wrong!’”  She also makes strange assertions such as “If your energy supply is not burned off through physical exertion, such as when sitting in front of a computer 12 hours a day . . . you have a release of energy that never gets used.  This is a major reason people put fat on in their middles when under stress.”  She implies that sedentary jobs lead to anxiety because of this “release of energy that never gets used;” and also that stress is the deciding factor in whether we get fat when we have a sedentary job, leaving out the importance of dietary intake and exercise.  She also recommends questionable techniques such as the use of affirmations, even though research does not validate their use.

Strangest of all is her invention of the term “too much activity” (TMA), which she describes as though it is a scientific diagnosis.  Someone with TMA suffers from a “high drive” and sufferers are unable to “hold still,” causing their feelings of anxiety to increase.  Her diagnostic assessment for TMA includes statements such as “getting unexpected free time can raise my anxiety, especially if I have no warning” and “I become very impatient when something slows down my progress.”  TMA also includes perfectionism, which she says some people use to control their anxiety.   The strategies she describes for dealing with TMA include life/work balance, planning for free time, and learning to have fun.  You may find her treatment information useful, but I question creating a new diagnosis for what might otherwise be called a “Type A” personality.

Should you purchase this workbook if you suffer from social anxiety, generalized anxiety disorder, or panic disorder?  You will find a great deal of useful information, along with worksheets and tools to help you try new strategies and evaluate your progress.  In spite of my reservations about a few areas that she writes about, overall, a sufferer from anxiety will probably find it and the accompanying CD useful.

The Ten Best-Ever Anxiety Management Techniques Workbook
By Margaret Wehrenberg
W. W. Norton & Company: March 19, 2012
Paperback, 240 pages
$19.95

The authors — an assistant professor of psychiatry at Harvard’s Medical School and assistant psychiatrist at Massachusetts General Hospital’s Department of Psychiatry and “Coach Meg,” the founder and CEO of a leading corporation which focuses on building international standards for professional health and wellness coaches — offer a very holistic approach to decreasing the frenzy that so many of us encounter in our daily lives.  They complement each other wonderfully. Dr. Hammerness (the professor) usually approaches the reader head-on, lobbing out new tidbits of scientific research and trying to get the reader up to speed on the ever-evolving field of neuroscience.  Coach Meg, on the other hand, greets us at the end of each chapter in a more “nitty-gritty” manner, giving us practical steps to take on our journey toward less chaos.

Each chapter walks the reader through a clear and concise look at one “Rule of Order,” as the authors term these guidelines to gaining control and order in our every day.  They typically illustrate where so many of us go wrong and help us pinpoint the moment or moments that lead to disarray.  Many of the cases highlight individuals who have made it into adulthood with varying levels of ADD or ADHD, often through acquisition of coping skills that unfortunately have their limits.  When these people or those coping skills have met their limits, Dr. Hammerness conveys to the reader, he often sees them in his office, eager for their first appointment.

As a younger professional in the sciences who has been diagnosed with ADHD, I can easily empathize and readily understand these individuals. Throughout the book, we see myriad cases in which people struggle to keep their heads afloat in a world that seems to never stop picking up the pace around them.  The authors relay tales of mothers who allow themselves to obsessively get roped into cleaning a garage, while the rest of the world spins out of control, and contractors who forget pertinent details needed to keep business booming in a subpar economy.

Within this book we gradually move with the authors through the all of the Rules of Order: “Taming the Frenzy;” “Sustaining Attention;” “Applying the Brakes;” “Molding Information;” “Shift Setting” and “Connecting the Dots” (where we learn to put together each one of these valuable tenets to form a practical design with which to newly approach our lives).  If ever, during the course of the narrative, we doubt the real need for adjusting our turbulent lifestyles, the authors rein us back in with new understandings in neuroscience and another example of someone burning the proverbial candle at both ends.

At one point the authors even lure us into a few examples of people “multi-tasking,” goading us into momentarily believing that those people who seem adept in this supposedly coveted ability to handle more than one task at a time are superior.  But quickly we see that multitasking is akin to seeing a snapshot of a juggler with a dozen balls in the air.  We don’t see the juggler drop all of the balls in the next snapshot, so don’t truly have an accurate depiction of the ability or limitations of the juggler. 

Similarly, when we see the person in the office next door texting, typing and listening in on a conference call, we should understand that each of those tasks will be of poor quality and many likely will not be completed at all.  There are, Dr. Hammerness assures us, limitations with any human brain.

For anyone who has sought this title out in a bookstore, there will likely be no disappointment with the content.  Organize Your Mind, Organize Your Life is an extremely well-constructed and astutely interesting mix of science and recipe book, arming the modern-day person with countless tasks consistently scheduled, a more productive and less stressful manner with which to approach life.  By the end of the last chapter the authors seem like two dear friends with whom we have learned invaluable skills, like stepping back from each situation and assessing before acting.  With them we learn to welcome an interruption and flex with the changing nature of the world around us.  Surely if we follow these two recommendations alone, we can thank both authors for a few added years!

As the book claimed from the beginning, Coach Meg and Dr. Hammerness offer us tools with which “to tap into our embedded organizational skills, improve focus and attention and better structure our life.”  As someone who has at times struggled with the challenges of ADHD, I practice mindfulness meditation, engage in regular physical activity (which the authors strongly urge) and attempt to eat well.  This book is a priceless addition to my library in terms of very tangible life skills that will certainly improve my ability to organize and manage my hectic schedule.

In addition, I look forward to pursuing some of the websites and citations found within this gem.  For these two gifted authors to utilize them, it will certainly be worth my time and effort to follow up on all extraneous information offered.  I cannot recommend Organize Your Mind, Organize Your Life enough, as it truly does just what it sets out to do:  educates and empowers the reader to “train your brain to get more done in less time.”  It would hard to begin to put a cost on that.

Organize Your Mind, Organize Your Life: Train Your Brain to Get More Done in Less Time
By Paul Hammerness, MD and Margaret Moore
Harlequin: December 27, 2011
Paperback, 272 pages
$16.95

Complications of Diagnosing ADHD in Adults

• Adult symptoms vary and are harder to diagnose than those present in children.
• It is less well known that adults can have ADHD. Those who suspect they have it may be reluctant to seek help or be unaware that they should.
• General practitioners often attribute ADHD symptoms to more commonly diagnosed disorders such as depression, bipolar disorder, anxiety disorders or common negative lifestyle issues such as poor diet. Improper diagnosis ensures that ADHD remains untreated.
• Adults with ADHD may adapt to symptoms over time. In fact, some may enjoy or feel a benefit from the energy that can define the hyperactivity part of this disorder. Those who have lived with the illness, undiagnosed, for a long time—often since childhood—may not even be aware of their own erratic behavior.

Adults with undiagnosed ADHD also exhibit a much more frequent incidence of addictive behavior than those who do not suffer from the disorder. Reasons vary, but substance abuse often is connected to a need to self-medicate untreated ADHD symptoms.

The Prevalence of Addiction in Adults with Undiagnosed ADHD

Oxford University Press, on behalf of the Medical Council on Alcohol, published an investigative research paper focusing on ADHD patients and nicotine and alcohol dependence. The findings reported, “Several studies have shown that attention-deficit/hyperactivity disorder (ADHD) represents a significant risk factor for the onset and development of addiction” (Ohlmeier et al., 2007).

Although this research focused primarily on nicotine and alcohol addiction, the rate of addiction for all substance abuse, specifically drugs with stimulant properties, is much higher for ADHD sufferers than in the general populace. Carl Sherman, PhD, explains, “A recent survey found that more than 15 percent of adults with the disorder had abused or were dependent upon alcohol or drugs during the previous year. That’s nearly triple the rate for adults without ADHD” (2007).

Often, those abusing any form of negative or illicit substances are not properly treated for the disorder or the resulting addiction — because they are unaware that they have ADHD and treatment for it is available.

Living with Undiagnosed Adult ADHD

I was not diagnosed with ADHD until age 24, so I have firsthand knowledge of the pain and difficulty that adults with ADHD face. I began to abuse stimulant drugs when I realized that they were able to slow me down — a paradoxical effect. For example, while cocaine speeds most people up, adults with undiagnosed, untreated ADHD often are slowed down. Illegal drugs affect the brain in a way similar to the medication commonly prescribed for ADHD — it is no wonder those unaware of their condition often turn to self-medication.

I abused alcohol for the same reason. It was a vicious cycle: My untreated disorder led to impulsive behavior (abusing drugs and alcohol). The relief they brought encouraged me to continue my substance abuse. This is far too common a problem among adults living with undiagnosed ADHD.

Why Is Addiction Such an Issue for Adults with Undiagnosed ADHD?

In his insightful article, “Addiction and ADHD Adults,” Carl Sherman quotes a study by Timothy Milens, MD: “In our study…only 30 percent [of participants] said they used substances to get high… Seventy percent are doing it to improve their mood, to sleep better, or for other reasons” (2007). Sherman goes on to elaborate that abuse of substances, when connected to adult ADHD, often is based on a need to self-medicate the symptoms: “…This kind of ‘self-medication’ seems especially common among individuals whose ADHD remains undiagnosed or who have been diagnosed but have never gotten treatment” (2007).

Stimulant drugs such as cocaine can provide temporary relief. Alcohol has a similar effect on the central nervous system. The medication used to treat ADHD has stimulant properties and affects the same area of the brain as stimulant drugs, though to a lesser degree. Primarily because of this, the potential for abuse among those being treated with adult ADHD, especially those who have a history of substance abuse, is difficult and requires a comprehensive approach.

Treating Adult ADHD When There is a History of Substance Abuse

Before I was prescribed medication for ADHD, I had to remain sober for a year—a reasonable amount of time. Once I was prescribed the proper medication (Concerta, a slow-release variety of Ritalin), I appreciated the ability to focus, and I found that recovering from addiction was easier, primarily because my impulsivity was lessened. Dr. Sherman also elaborated on the importance of this approach: “What’s the right way to get help? Recent studies suggest that it’s best to optimize the treatment for ADHD only after the individual has been sober for six weeks to a few months” (2007).

All stimulant-based drugs have the potential to cause addiction. For this reason, many doctors initially choose to prescribe non-stimulant medications. “Which ADHD medication is best for someone who has already battled substance abuse? For many doctors, the first choice is non-stimulant. These drugs may not be as effective as stimulants for treating certain symptoms… Other doctors choose to prescribe a stimulant…an extended-release formulation… These slow-acting meds are less likely to be abused” (Sherman, 2007).

Adults living with undiagnosed ADHD may engage in addictive behavior simply because they are medicating the primary diagnosis, which may be inaccurate. If they receive a proper diagnosis and proper treatment, they will be less likely to turn to drugs or alcohol and less likely to succumb to addiction.

Treating adult ADHD is difficult both for the primary caregiver and the patient. Because the incidence of addiction is so high among this population, treating the disorder with stimulant treatment regimens must be properly and thoroughly evaluated.

References

Ohlmeier, M.D., et al. (August 31, 2007). Nicotine and alcohol dependence in patients with comorbid attention-deficit/hyperactivity disorder (ADHD). Alcohol & Alcoholism, 42(6). Retrieved from http://alcalc.oxfordjournals.org/content/42/6/539.full.pdf

Sherman, C. Addiction and ADHD adults. ADDitude, February/March 2007. Retrieved from http://www.additudemag.com/adhd/article/print/1868.html

Throughout the book, Kaye fluctuates between the past and present to tell her story. She begins her narrative with some insight into the possible early warning signs of Ben’s illness:

It all started, or so I thought, with marijuana. Or did the trouble really begin when Ben dropped out of high school, with plans to travel cross-country, search for his father, and knock on doors to ask for work if he needed money?

Maybe I should have recognized schizophrenia when Ben was fifteen, the night he broke down in sobs after a huge fight with me and said, “What’s wrong with me, Mom? Please, please, find me someone to talk to. I don’t know what’s happening. I used to be so happy.”

The consistent theme throughout Kaye’s book is that “there must be a reasonable explanation” for her son’s maladaptive behavior. She carries the reader along and we, in turn, can feel her pain to find the answers to her son’s issues and problems. She begins some of her chapters with excerpts from Ben’s writings, which provide the reader some insight into his perspective on his struggles:

I am most of my voices

Many different selves

I don’t need to give in to what I fear

Just give in to the fact that I’m afraid.  

~ Ben, c. 2001

As a helpful resource, Kaye includes ‘chapter guideposts’ which clarify some of the various issues and terms related to loving someone with schizophrenia. She also offers tips and resources to assist in the management of the disorder. One guidepost she provides in chapter 19 is entitled “some reasons for medication noncompliance” For example, the individual may have a “lack of insight into the illness (biological — the brain is impaired),” “they don’t like the side effects (weight gain, sexual performances, sedated feeling)”  and “fear of becoming medication dependent.” Kaye also offers suggestions for what loved ones can do about this problem, including watching for the return of symptomatic behavior and increasing supervision of medication.

Ben was diagnosed with ADHD in high school. Kaye notes that during the following years, “he was to pass through the hands of four psychiatrists, several therapists, and several diagnoses and prescriptions.” He was also subject to five psychiatric hospitalizations in 2003 alone, then two more at a later date. Those eventually led to his current recovery. Kaye described the weight of Ben’s illness on her life: the “family feels isolated, stigmatized, and often very alone.”

It is remarkable that Kaye remained optimistic about her son’s recovery even as she trudged through all the years of hardship and anguish. Her dedication to her son is reflected in a statement made in her introduction: “Ben has never lost us; the love of his family has been part of his recovery.“ Currently, Ben is in recovery as he adheres to a medication regimen and lives in a group home. Kaye is hopeful that her son “can one day attend college, hold a job and eventually live on his own.”

It is unfortunate that Kaye and her family had to go through so much before Ben received the correct diagnosis of schizophrenia. From this psychotherapist’s perspective, it seemed obvious from early in the book that Ben was struggling with more than just typical ADHD-related issues. Therefore, I found myself feeling frustrated by the various mental health professionals that Kaye consulted and why they could not see what was the core diagnosis underlying his maladaptive and tormented behavior. On the other hand, the book also reminds me that schizophrenia does not make up a person’s complete identity. These individuals are more than just their voices and symptoms; they are human beings that require love, compassion, dignity and respect. 

Overall, Ben Behind His Voices is a book I would recommend for those individuals diagnosed with schizophrenia as well as those who love them. Kaye shares her own personal pain and frustration in understanding the illness as well as provides suggestions to readers on how to best cope with it. It also offers hope to those families who may be on the verge of giving up on their loved one and further reminds mental health professionals to remain compassionate in their treatment of persons afflicted with this tragic disorder.

Ben Behind His Voices: One Family’s Journey from the Chaos of Schizophrenia to Hope
By Randye Kaye
Rowan & Littlefield Publishers: August 16, 2011
Hardcover, 320 pages
$26.95

Kennedy and Banks are mothers, as well as professionals who previously collaborated on the book The ADHD-Autism Connection, and each has multiple children who are twice exceptional.  “Twice exceptional” is a term that they address in the beginning of their book. They write that it is “a relatively recent term that refers to children who have dual ‘exceptionalities’—that is, exceptional gifts (creative, academic, intellectual, or physical abilities) along with a learning or developmental disability.”

Temple Grandin is perhaps one of the world’s most successful people with autism. She has her PhD in animal science and is both a professor and an author.

As they did with the term “twice exceptional,” the authors begin with a lot of contextual information to help explain the terms, intentions, and needs for writing this book. They go on to implore, as does Temple Grandin in the preface, that changes be made.  These twice exceptional (or 2e, as Kennedy and Banks come to say) children are falling through the cracks because their disabilities are being granted power over their abilities.

The book is organized into three sections. All three are equally important in helping a child with 2e: ‘Who They Are,’ ‘Why They’re Stuck,’ and finally, ‘How to Help Them.’ Since Kennedy and Banks are both mothers, they take care to explain that this is a book meant to help parents in a variety of ways.  This book is not just an offering of support and resources, but it also breaks down the issues of why these children are “stuck” in the first place.

Temple Grandin, as you may have already known from the HBO movie based on her life, has had great success cultivating her abilities despite having autism.  Kennedy and Banks mention that she is a perfect example of being “bright and not broken,” a goal they have for all children, 2e or not.  They believe that the success of each child will greatly help the world because these children can then feel good about what they can contribute, instead of being stuck on what they can’t do.Temple Grandin brings attention to how some children with autism introduce themselves, saying that they tell her their disorder first—showing that they define themselves by their limitations.

The authors give some context to these disorders by explaining that 2e kids today are tomorrow’s “Albert Einstein, John Couch Adams, Thomas Edison, Sir Isaac Newton,” and the list continues.  Many of these classic figures had symptoms that today may have been diagnosed as ADHD or autism. For example, Einstein didn’t speak until he was 3 and Gregor Mendel, who gave us the foundation for modern genetics, couldn’t pass the exam to qualify to teach high school.  Had these men been labeled with a disability, they may never have achieved their greatness, because they may have also defined themselves by limitations.

Kennedy and Banks also break down ways to help teachers and parents identify their child’s gifts.  They explain these disorders in a refocused way by giving supportive and caring definitions that require a deep understanding.  These new definitions were created by combining a parent’s care and understanding and the experienced intelligence of a professional in the field.

As mentioned, all the sections of this book are important for understanding the entire issue at hand, but the section on ‘Why They’re Stuck’ is extremely informative and explains exactly how and why the current system is not doing these children justice.  Particularly, they explain how important it is for parents to know the different debates in standardized testing.  This way, they can avoid falling into the trap of defining their child by these flawed systems of measurement.  I found this section to be the most intriguing because after you read it, it will be nearly impossible for you not to want to change the system.  Kennedy and Banks have certainly done their research, but they also show how to apply it in a practical way, making this book a great help to parents and professionals alike.

Finally, they talk about diagnosing and educating the whole child instead of just labeling one aspect of them.  This new type of diagnosis and education factors in all their needs and gifts, showing how to adapt it to individual children because, after all, we all have individual needs.  Most importantly, Kennedy and Banks keep reminding their readers that 2e children have so much so offer the world and they want to make that happen.  Also, if you want to do more exploration, they end with a long list of helpful additional resources.

Personally, they have convinced me that in an attempt to help people with disabilities, we have hurt them by labeling them.  This label can hurt them because if focuses all the attention on what they cannot do, instead of also exploring what they can do.  This book is truly inspiring and it shows that by simply changing our perception of these children, and then the testing and education that stems from that perception, we can help them become successful, contributing adults.  Perhaps they could even make history.

Bright Not Broken: Gifted Kids, ADHD, and Autism
By Diane M. Kennedy and Rebecca S. Banks
Jossey-Bass: September 13, 2011
Hardcover, 320 pages
$24.95

But this isn’t an oversight on your part. An inability to focus is a prominent symptom of ADHD. While you can’t fully control your capability to pay attention, you can find strategies that help you sustain it. Here are 15 tips to try.

1. Focus your energy on problem solving. It’s common for people with ADHD to get frustrated with their focus troubles and blame themselves. But gently remind yourself that this is a symptom of ADHD. Instead of being self-critical or judgmental, use diminishing attention as a reminder that it’s time to try one of your focus-fueling tools, said Lucy Jo Palladino, Ph.D, clinical psychologist and author of Find Your Focus Zone: An Effective New Plan to Defeat Distraction and Overload.

2. Employ some background noise. Having background noise helps drive out distractions, according to Stephanie Sarkis, Ph.D, a psychotherapist and author of 10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction & Accomplish Your Goals. When you’re studying or working, she suggested turning on your ceiling fan, a white noise machine or music on low volume.

3. Clear your workspace. “Visual clutter can impair focus,” Sarkis said. So to pay better attention, clear the disarray from your desk before sitting down to work, she said.

4. Dissect tasks and projects. It’s hard to focus when you’re overwhelmed by a big project and iffy on everything it entails. “Chunk your goal into manageable sub-goals,” Palladino said. She gave the following example: “Divide ‘Start writing this paper’ into ‘Outline 3 main points,’ ‘Plan intro,’ ‘Write first page of rough draft.’”

5. Get support from loved ones. According to Palladino, relying on people who are rooting for you can help. She suggested remembering your cheerleaders — who might be your parent, partner, child or coach — and keeping their photo close by. A 2003 University of Wisconsin study found that flashing the names of certain friends and family helped students work longer on concentration-heavy tasks.

6. Use an accountability partner. Another way to ask for support is by having an accountability partner. This could be your friend or an ADHD coach. “Make a deal with them that you will text or email them with your tasks that day, and then text or email that person as soon as you finish each task,” Sarkis said.

7. Paraphrase conversations. Paraphrasing what a person said helps you digest the conversation, ensure you understand them and formulate a response, according to Sarkis.

8. Use a “concentrated distraction.” For instance, when you’re sitting in a meeting or lecture, fiddle with a mini-Koosh ball under your desk, Sarkis said.

9. Have visual reminders of your goals. For both short-term and long-term goals, have a tangible touchstone that connects you to your objectives, Palladino said. For instance, you might keep a piece of paper with your graduation date, a photo of the car you’re saving for or the amount of money you’ll earn after finishing a project, she said.

10. Move while you work. Constantly moving can help you focus better on the task at hand, Sarkis said. One way to incorporate movement is to sit on a large exercise ball by your desk.

11. Encourage yourself along the way. Use positive self-talk to help you pay attention, Palladino said. For instance, you might remind yourself of your past successes, such as “Last term, I finished my 20-page history paper on time,” she said. Positive self-talk is helpful when it’s simple and direct, such as “I can do this,” she added.

12. Concentrate on certain words. According to Palladino, repeating anchor words like “focus” can block distractions. Another option is to create a mantra based on your task, such as “Expense report; expense report; expense report,” she said.

13. Write down everything. “If someone tells you they need you to complete some tasks, either ask for it in an email or in writing, or tell them to hold on while you get paper and a pen, or your digital device,” Sarkis said.

14. Practice healthy habits. As Palladino noted, engaging in healthy habits helps improve attention long-term. This includes: “regular sleep, physical exercise, good nutrition, limited caffeine intake, reasonable planning and — to the extent possible in today’s world — a distraction-free work environment,” she said.

15. Get a proper diagnosis. If you haven’t been diagnosed with ADHD, but you’re noticing difficulty with paying attention and these other symptoms, see an ADHD specialist for an accurate assessment. If you have ADHD, medication is a huge help. “ADHD is a neurobiological disorder, and medication can help your brain work more effectively,” Sarkis said.

Q: What is ADD?

A: The letters ADD stand for “attention deficit disorder.” Having attention deficit disorder is like needing to wear glasses. It means you have trouble seeing life clearly. You have trouble paying attention. You may like to move around a lot, and this also makes it hard to pay attention to what is going on. Just as it can be annoying for people who wear glasses to have to put on their glasses, it can be annoying to have ADD. But there is nothing wrong with it. It doesn’t mean you are stupid or dumb. Not at all. In fact, lots of really smart kids have ADD, just as lots of really smart kids wear glasses.

Q: Does ADD mean you’re stupid?

A: No. Absolutely not. Lots of very smart people have ADD. The man who invented the light bulb, Thomas Edison, had ADD. He invented many other amazing things besides the light bulb. He’s the greatest inventor in American history.

Q: My friend said if you have ADD, you’re a retard. Is he right?

A: No, he is not right. Having ADD has nothing to do with being smart or stupid. Many very smart people have ADD. Your mom or dad may have ADD. Your teacher may have ADD. The principal of your school may have ADD. Both people who wrote this book have ADD (and one of them has dyslexia, too). Your doctor may have ADD. So may a fireman or a police officer or the person who brings the mail or an airplane pilot or an astronaut. Anyone may have ADD.

Q: I have a friend who takes Ritalin and I don’t like him. If I take Ritalin, will I become just like him?

A: No. Ritalin will not change the basic way you already are. It’s like if you take an aspirin, you don’t necessarily become just like everyone else who has ever taken an aspirin. I’ll bet, in fact, that you and the friend you don’t like have both taken an aspirin at some time. The aspirin didn’t turn you into someone like him, did it? Neither will the Ritalin.

Q: I don’t want to take the medicine. Why do I have to?

A: I don’t think you should have to take it. I think you and your mom and dad and your doctor should talk to each other until you reach some kind of agreement so nobody is doing anything against their will. Tell your mom the medicine will work better if you take it without being forced to.

But just because I don’t think you should have to take the medicine doesn’t mean I don’t think the medicine can’t help you. Lots of kids have been helped by medicine for ADD. It is very safe, and when it works, it really helps a lot.

Q: What good does the medicine do?

A: When it works, the medicine helps you pay attention better than you can now. It helps you focus better, like a pair of eyeglasses. It can make it easier for you to pay attention in school and at home. It can make reading easier. It can make homework go better. It can make school less boring. It can make it easier to get along with your brother or sister, if you have one. It can help you remember things. This is the good the medicine does when it works. If it doesn’t work, you just stop taking it.

Q: Does the medicine do bad things?

A: Sometimes, but the bad things are not very bad, and they go away as soon as you stop taking the medicine.
Sometimes the medicine takes away your appetite, so you have to be careful to eat plenty. Sometimes the medicine makes it hard to sleep, so you have to be sure not to take it too close to bedtime. Sometimes the medicine just makes you feel funny. If that happens, you simply stop taking it, and the funny feeling goes away.

Once in a great while (that means almost never), the medicine slows down your growth. This scares many kids. But they do not need to be scared. If the medicine slows your growth, you just stop taking the medicine and you grow as big as you would have grown if you’d never taken the medicine.

Most of the time the medicine does not do anything bad, and it does a lot that is good.

Q: Will taking the medicine mean I’m crazy?

A: No, not at all. No more than taking an aspirin for a headache means you’re crazy.

Q: My friend says I should be able to do OK on my own without taking medicine and if I take medicine it means I’m a wimp. Is he right?

A: No. He is not right. I’ll bet he’s had shots to keep him from getting serious illnesses. Does that mean he’s a wimp to have had those shots? Of course not. And I’ll bet if your friend had blurry vision he’d wear glasses. That wouldn’t mean he was a wimp, just that he needed glasses. And it does not mean you are a wimp to get treatment for your ADD, anymore than wearing glasses means you’re a wimp or taking vitamins means you’re a wimp.

Q: If I take the medicine, how long do I have to take it?

A: We don’t know. What your doctor will do is tell you to stop taking it once or twice a year to see if you still need it. Sometimes kids take it for years. Sometimes just for months. The only way to find out is to stop it now and then and see if you still need it.

Q: I just found out I have ADD. How can I keep this secret from my brother?

A: It is a hard secret to keep. If you really want to, you probably can, with your parents’ help, but it will take a lot of work. Instead, why don’t you and your mom and dad figure out a way for you to tell your brother. I understand the problem is to figure out a way to tell him so he won’t tease you and use it against you and make you feel dumb. But I’ll bet your parents can help you with this. Life will be a lot easier if your brother knows. Believe it or not, he might even help you out.

Q: I heard ADD means you’re weird. Is that right?

A: No. That is not right. ADD does not mean you are weird any more than needing to wear glasses means you are weird.
Also, I’d be careful of that word “weird.” Lots of really nice people get called “weird” just because they are a little different from somebody else who doesn’t like them. Being called “weird” really hurts their feelings. Nobody likes being called “weird,” so why hurt people’s feelings?

Q: Is it true that if you have ADD you can think faster than other people?

A: Sometimes. And sometimes you think slower. It probably evens out in the long run. But it’s true that sometimes people with ADD think really fast. So fast they lose track of their own thoughts. It’s sort of like watching a train go by so fast that you can’t see the individual cars, just a blur.

Q: Sometimes I want to take the medicine, and sometimes I don’t. Is that OK?

A: It is usually better to take the medicine regularly than once in a while. If you find you want to take it sometimes, but don’t others, why don’t you talk to your parents or your doctor about it? Maybe you have some questions that need to be answered about the medicine. Or maybe the dose is wrong or the time you take it is wrong.

Q: Is there anything bad the medicine will do to me that they don’t know about now?

A: The answer is almost a definite no.

Ritalin, which is the main medicine we use to treat ADD, has been around for a long time. We have found it to be very safe. Can I tell you absolutely, 100 percent for sure, without a doubt, that there is no problem? No, I can’t. But pretty close.

Q: Why does the school nurse have to give me my medication instead of me taking it myself in school?

A: Because that is the school rule. Why is that the school rule? So you’ll remember to take the pill. So the school will know you took it, in case you forget whether you did or not. So you won’t lose it and some other kid pick it up and take it. So if you get sick the nurse will know what medicine you’re taking. These are all good reasons.

Q: Will the medicine make me smarter?

A: No. But it might make you get better grades because you might be able to pay attention better and do homework better. But the medicine won’t make you any smarter, just better able to use the brain you’ve got.

Reprinted with permission from the book, Answers to Distraction by Edward M. Hallowell, M.D. and John J. Ratey, M.D.