Tag Archives: ADD

Science People!

Science People!

I’ve been getting a lot of attention on Twitter for the last couple of posts, and that’s given me a lot of articles to read, blogs to keep up with, and Twitter users to follow. Some people got a little testy, and I don’t blame them, because they know more than I do. I get it.

Let me tell you something right now. I am not a professional scientist. I got my Bachelor’s degree in Spanish Language and Literature back in the early 80s, and distanced myself from science since I had to take my only B-track class in all of High School in Biology. I didn’t get it, I didn’t see the point, I put no effort in, and I sucked at it.

That’s ADHD.

But then I started reading books about the brain, and that struck a chord with me because my brain is not the nice neurotypical model. I started reading blogs and websites about the brain, and medicine, and genetics. I learned how to read published research (and occasionally got friends who would sneak me links to full text articles) and would search in the middle of searches when I found terms I didn’t understand or biological processes or mechanisms that were new to me but essential to understanding what I was reading.

This obsessive pursuit of information is also ADHD, BTW.

This means that there are gaps in my knowledge. I am not ashamed to admit that you know more than I do. Please don’t get angry with me when I’m wrong – explain to me why I’m wrong and then tell me how to understand it the right way. I don’t want to be right to win arguments or lord it over people, I want to be right because I have the correct information. You can help me with that.

Thing is, one thing I know I’m really good at is teaching other people things. I take my mistakes, the process by which I figured something out, and the way it works at the most basic level, and try to use that to explain what I know in a way so that other people can “get it.” There are several college students out there pursuing degrees in science because I got them all excited about it. They’re getting the chance I missed out on.

So, you want more minions? (MUHAHAHAHA!!) Give me comments. Help me understand. Because if you help me understand, I can help other people understand. I’m an intelligent woman, I’ll get it pretty quickly, and when I don’t, I’m not in the least ashamed to admit that I was wrong. We can have a mutually supportive and respectful interchange, and I’ll do my part to explain things in an accessible way, using the tools you give me.

Really. Comment. email. Bring it on. I love you guys!

ADHD and Pharmaceutical Fearmongering.

ADHD and Pharmaceutical Fearmongering.

It’s never difficult to find articles about how ADHD is some trumped-up condition made up to excuse poor behavior and/or line the pockets of the medical industry. Whether the writer assumes one or both of these, it’s necessarily bound together with denial, ignorance, and hyperbolic claims. Sometimes all you can do is get angry, but other times the writer gives you a chance to deconstruct his points. The Price of ADHD Business is that second kind.

He opens with this blockbuster:

Over 12 million children and young adults consume ADHD stimulant and psychiatric medications in the United States. Pharmaceutical corporations generated near 9 billion dollars in 2012 for ADHD stimulant drug sales, representing 5x the 1.7 billion in sales ten years ago.

Shocking, isn’t it? Except that in the US, the Pharmaceutical Industry makes about $345 billion a year. That means that psychiatric medications make up a whopping 2.6% of the bottom line. Hardly one of their biggest players, compared to drugs for cholesterol, pain management, and cancer treatment, which are much better performers when it comes to percentage of business. Also, notice the subtle slide from “ADHD stimulant and psychiatric medications” to “ADHD stimulant drug sales,” because this will be important.

More alarming, this rate of consumption represents 3x the world’s children combined, according to data collected by Scientific American. The business model of behaviorally assessing and prematurely medicating young school age children with powerful stimulant and psychoactive drug therapy for over 40 years is now under fire. The Government Accountability Office (GAO) Child Foster Care Drug Audit Report uncovered dangerous and unethical prescribing practices. Widespread abuses of overmedicating young foster care children with ADHD stimulant as well as psychiatric medications prior to ruling out nutritional, physiological, and environmental risk factors were uncovered by the largest child foster care prescription drug audit in American history.

Of course, being a first-world country, it’s more likely that we have 3x the children being treated for, say, cancer or juvenile diabetes, or any number of other childhood diseases, so there’s something of a leap from claiming that 3x the children being treated means that something is being treated too much – or “prematurely.” I notice also that the source of the alarmist rhetoric comes from a study of children in foster care. Well, this is a problem with foster care, not with all children. Foster care children are more likely to have disabilities, both physical and mental, meaning they’re more likely to actually need treatment. They’re also covered by state medical programs that make it pretty easy to get treatment that a self-payer parent might not be able to obtain. There’s more, but if a mere scratch on the surface can reveal that we’re comparing apples to oranges, there’s not much need to go even deeper.

In today’s America parents, educators, and prominent healthcare professionals challenge the 40-year ADHD business model, as the ADHD diagnosis rate surpasses epidemic status in 2014. The symptoms of ADHD are real and in many cases can be debilitating to children as well as adults. Especially in the young child population, the ADHD business model of assessment and treatment requires immediate reform. Children have a right to receive comprehensive bio-assessments as well as behavioral assessments to determine cause of their symptoms prior to powerful stimulant and psychoactive drug therapy.

Yes, we have a serious epidemic of about 5-8% of the population. That’s massive. Not. Notice how he snuck in the disclaimer (like, some of my best friends have ADHD!!!) but still calls the diagnosis and treatment of ADHD a “Business Model.” I sense a broken irony meter. Also, have you ever taken any of these medications? The stimulants are among the least powerful ones out there, with the most immediate effect (no two-month waiting period) and little to no withdrawal problems. Lumping them in with all psychoactive medications is disingenuous, especially for someone banking on his rep as a Pharmacist.

The Diagnostic and Statistical Manual for Mental disorders (DSM) lists ADHD as a mental disorder. The DSM diagnosing criteria, created by psychiatrists, involves a subjective behavioral assessment process which forces children primarily into premature drug therapy. Although seven out of ten children may exhibit an initial positive behavioral response to stimulant drug therapy for focus and attention, the long term side effects are now known.

Yes, they are, and they’re not terribly scary. Children who start using methylphenidate or dextroamphetamine medications may grow up to be as much as one centimeter shorter than their peers. Of course, they’ll also grow up happier and more successful and less likely to abuse drugs than their non-medicated ADHD peers, but that runs counter to the narrative here.

The Johns Hopkins Child Center Study results of 2013 prove that stimulant drug therapy should not be the primary intervention in young children. This study followed four year old preschool children who were diagnosed by their physicians for ADHD and medicated with stimulant drug therapy for a six year period. When the ADHD assessments were reviewed at age ten, over ninety percent of the children were worse off in their condition. Long term side effects of ADHD stimulants may include anxiety, minor depression, as well as aggressive behavior. Additionally, the Hopkins study determined that ADHD causes an economic burden to the US exceeding 45 billion dollars, annually.

To the first sentence I say, “Well, duh.” The primary intervention should be behavioral, with medications added to supplement as needed. This is not news, and it does not run counter to what any Medical Association is recommending, even the American Psychiatric Association, which says “Behavioral therapy and medication can improve the symptoms ofADHD. Studies have found that a combination of behavioral therapy and medication works best for most patients.” Add to this yet another lie, because what the Johns Hopkins study revealed was (prepare to be shocked) that ADHD doesn’t go away, and medications don’t cure it, just relieve the symptoms while they are in effect. And the economic burden he’s talking about? That relates to the consequences of untreated ADHD – people in jail, people who are substance abusers, people who are unable to work, people who have other health issues that are related to ADHD.

Many parents are not aware that a diagnosis of ADHD for their child is a diagnosis for mental disease in accordance to the DSM. Once a young child is placed on ADHD stimulants including Adderall or Ritalin prior to ruling out causative risk factors, there is an increased health risk. Additional medications for the treatment of long term side effects may be required due to the development of other behavioral symptoms.

Actually, parents know this, because lots of the evaluations are related to getting assessments for school. And it’s not the stimulants that increase the risk of further diagnoses and additional medications as much as the fact that ADHD is usually not alone, and the co-morbid conditions are discovered because the children are being observed and treated by doctors. The medications don’t produce these problems.

For example, the GAO drug audit uncovered a 2,200 percent increase in drug expenditures for atypical antipsychotic medication reimbursement to the state of Michigan during an eight year period from 2000 to 2008. Children in foster care, as the report states, were abusively prescribed powerful antipsychotic medications including Abilify, Zyprexa, Seroquel, Geodon and Risperdal. The Michigan Medicaid system was billed an increase of 40 million dollars during an eight year period just for this one class of medications in foster care children. US Senator Thomas Carper, requestor of the GAO drug audit and chairman of the Homeland Security & Government Affairs Committee, stated “I was almost despondent to believe that the kids under the age of one, babies under age one, were receiving this kind of medication”.

Remember what I said about the creep from the “all psychiatric medications” to “ADHD stimulant medications”? Here we go with another false equivalency. Antipsychotic medications are the last resort, used for treating not just ADHD, but ADHD with serious comorbids that would make the children a danger to themselves or others. Also, remember that this is the foster children, not all children with ADHD as a whole. AND keep in mind that several of these antipsychotics are essential for the treatment of schizophrenia and seizure disorders, which are probably too legitimate to mention in the context of this article. So the figures on antipsychotics for foster children in one state is cherry-picked data that in no way reflects that there is an epidemic of children with ADHD receiving inappropriate medications.

Should ADHD be labeled a mental disease especially in young children who have not been given the right to find the cause of their symptoms prior to stimulant drug therapy? Or, should ADHD be classified as a symptom of condition with underlying causative nutritional, physiological, and environmental risk factors?

Um, yeah, it should. Get inside our heads, mister – it’s definitely a mental disease. It’s certainly not something we can choose or turn off at will. And the cause of their symptoms is mental – the other “causative” factors have been thoroughly debunked as “causes” in study after study. So this is a giant flaming strawman.

The German magazine, Der Spiegel, quoted a prominent American ADHD psychiatrist in their February 2, 2012 issue. Dr. Leon Eisenberg, who coined the term ADHD over forty years ago, stated “ADHD is a prime example of a fictitious disease.” At age 87, this was Dr. Eisenberg’s last interview prior to his death. During the last forty years, he was involved in pharmaceutical trials, research, teaching, as well as the development of social policy pertaining to child psychiatry. He was a recipient of the Ruane Prize for Child and Adolescent Psychiatry Research. Currently, over fifty percent of psychiatrists on the DSM panel responsible for ADHD diagnosing and treatment protocols have direct business ties to drug manufacturing corporations.

All that education, and Mr. Granett doesn’t know how to check snopes. How sad. As to that second claim, well, a link would be nice, but I’m not surprised it’s absent, since the actual ties would be openly disclosed and not as incriminating as the author would like them to be.

Dr. Thomas Insel, Director of National Institute of Mental Health, stated on April 29, 2013 “patients with behavioral conditions deserve better… the current assessment process lacks validity.” He supports research that better treats and may even prevent the development of behavioral symptoms in children.”

Again with a diversionary link. Psych Central has some validity, but “The Verge”? Really? Why not link to the NIH’s Research Domain Criteria which explains that what this means is that the NIH wants to have research focused on multidimensional approaches to research, and research that is targeted towards evaluation of symptoms and behaviors rather than whole conditions, because we now know that there’s a lot of crossover and and a narrower approach will produce more successful and useful research. Oh, but that would not support the POV of the author. That’s OK, now you can see what Insel was really talking about. You’re welcome.

ADHD symptoms can be reversed through a process of differential diagnosing. The elimination of nutritional, physiological and environmental risk factors prior to premature drug therapy is the new ADHD Business Model for helping children and adults reclaim their behavioral and mental health. The Action Plan for Childhood Behavioral Conditions discussed in the book Over Medicating Our Youth as well as the upcoming 2nd edition T he American Epidemic: Solutions for Over Medicating Our Youth provides critical bio-assessment information to find the cause of ADHD symptoms. This action plan provides an informational template to unite parents, teachers as well as all healthcare professionals for the purpose of helping children win the battle against behavioral challenges.

Many assessments help determine the cause of ADHD symptoms. Learn how bio-assessments for reactive hypoglycemia, diabetes, the brain-gut connection, cervical spinal alignment, exercise, whole food nutrition, brainwave optimization, and nutritional enzyme supplementation may reverse ADHD symptoms.

And now, ladies and gentlemen, we begin our final descent into woo. ADHD symptoms cannot be reversed by any of these things, and. . .OMG, this whole thing is an advertisement for. . .wait for it. . .a book co-authored by Frank J. Granett! It’s so good that he had to cite himself! And real medical terms weren’t sufficient, so we have to make up some that sound really sciency, like “differential diagnosing,” and “reclaim their behavioral and mental health,” and “bio-assesment” so we can sell ineffective treatments to gullible patients. Blood sugar problems can be diagnosed and treated without ADHD medications. The “brain-gut connection” has no supportive research except in patients with full-blown Celiac Disease. Cervical Spinal Alignment is Chiropractic’s uglier younger brother, even less useful than regular Chiropractic for treating anything, much less neurological conditions. “Brainwave Optimization,” don’t even get me started. As for the rest, we already touched on how none of these things are causative, so they are not going to be curative.

But this is what it usually comes down to, isn’t it? The voices that protest the loudest that ADHD is a fake disease created to make money by the pharmaceutical industries tend to end up thinking that it’s real enough to be treated by whatever they themselves are selling. If only there were an all-natural cure for hypocrisy. . .

Treating the Symptoms, and the Placebo Effect

Treating the Symptoms, and the Placebo Effect

Proponents of various forms of alternative medicine regularly rally under the claim that medicine treats only the symptoms, while their favored modality “treats the whole person.” I’ve long known that this is wrong, and I could enumerate all the reasons why, but only now did it occur to me that there’s an even deeper level to this inaccurate claim that I haven’t seen addressed elsewhere – irony.

I’m not going to try to get into so much detail that it obscures the point (for a change) so I’ll stick to the examples that directly apply to my inspiration. Doctors and scientists who blog cover the overt falsehoods that are relative to their specialties with far greater specificity than I ever could. They can even tell you how each individual CAM treatment doesn’t work and why. I don’t think I need to do that, because I could never attain that level without the education, experience, and dedication that these science-based medicine bloggers have.

Instead, I’m going to draw from my own experience at a forum in which we discuss mental disorders – ADHD in particular, but also its other delightful companions and complications – where alternative treatments are accorded an undeserved level of respect and science-based medicine is treated with derision. In this place, since we are dealing with conditions that are complex in origin and difficult to reproduce and test in animal models, speculation is going to be a given. However, much of the speculation involves disregarding or even discarding the huge volume of information we already have from research.

There is absolutely no question that each condition being discussed is brain-based. There is absolutely no question that any effective treatment for these conditions is going to have to be a treatment of the brain. And there is absolutely no question that all the current approaches are aimed at relieving symptoms, whether through medication or other therapies, because research on the cause of symptoms yields results much more quickly than research looking at the most complex organ of the human body will yield information on causes. Science is churning away at brain research; new tools and knowledge are helping it to advance more quickly than it did in the past, and the findings from these are being used to develop even better tools and knowledge. Still, because there are practical and ethical limits on researching living human brains, results will not come as fast as they do for other diseases and conditions that involve other organs with simpler functions than the brain has.

Now that the introduction is out of the way. . .
Read the rest of this entry

ADHD Diagnoses up 24 percent. . .

ADHD Diagnoses up 24 percent. . .

among patients served by Kaiser Permanente who were seeking diagnosis.

This article by Stephanie O’Neill, via Southern California Public Radio, shows a common problem with science and medical reporting. This article, at least, includes a link to the study, full text, so you can see the methodology and results instead of just the abstract.

You don’t really need to read the whole thing to see the giant flaw, though. It’s right here in the second paragraph of the article:

The study of nearly 850,000 patients ages five to 11, who were seen at Kaiser’s Southern California hospitals, found a 24 percent jump in the number of children diagnosed with ADHD fro 2001 to 2010.

Not random, not controlled, not blinded in any way at all. Of course rates are going to look like they’ve jumped dramatically if your population for the study includes only people who came in requesting diagnoses for things. There’s some decent generic information in the study, there are some population concentrations that might be interesting to look at in a better-designed piece of research, but that’s not showing up in the headlines.

No, everyone in the media and on the internet is clutching their pearls about this dramatic increase. Cue the storm of conspiracy theorists insisting that this is proof that ADHD is an imaginary problem created by Big Pharma. Watch the comments of people saying it’s reflective of our horrible society that doesn’t discipline children properly and/or lets them watch too much TV and play too many video games. Note the absence in any of these reports of the obvious flaw in the methods, or even the mathematical acumen to figure out that this “dramatic jump” actually means 1-2 more children out of every hundred.

*sigh*

How to Not Fall Asleep.

How to Not Fall Asleep.

I am so tired of not sleeping. I’m so tired of seeing information on the internet about fixing sleep problems – it’s so simplistic, and doesn’t apply to me at all. I’m really tired of sleep medications that end up costing me even more sleep than I’ve already lost.

I’m trembling all over, feeling woozy, hung over, flu-ish. I hurt myself this afternoon because the exhaustion has made me so uncoordinated. Knocked a container off the refrigerator shelf because my hand missed what I was reaching for, slammed my other hand into the refrigerator door trying to catch it and missing broadly. The obvious solution is a nap, so I set aside an hour and a half. It went much the way my nighttime sleep did, and in my frustration, I decided to write a little chronicle.

I’m trying a little relaxation/meditation technique that involves picturing yourself as a hollow vessel, slowly filling with a warm orange liquid from toes up to head, then slowly draining back down. Very effective, according to sleep experts.

Slowly, the warm liquid fills up the toes of your feet. The big toes, the smaller toes, and then you feel the balls of your feet, then the arches, slowly filling you with warmth and calm.

I think the high pitched buzz in my head is a C. Maybe one day I’ll check to see.

Feel the warmth in your feet as the liquid fills your heels, then your ankles.

God, I hate this pounding and whooshing of my pulse in the right side of my neck and head. Whoosh/pound – whoosh/pound – whoosh/pound. . .why only on the right? Why did it start up again? It’s not the sleep meds, because it started two days ago. Maybe the feeling like someone’s plunging a sharp pencil into my right ear is from the sleep meds, though.

Feel the warmth in your feet – wait, did that. The liquid begins to fill your calves. It rises slowly, inch by inch. You feel warm and calm and peaceful.

I’m thinking of a song that was playing on the radio in Physical Therapy. Do I own that CD? The CDs are organized, the books used to be, but now I’m taking them down so we can move the shelves. Audrey’s going to the library tonight, maybe this time I’ll finally go and drop off some books for donation there. That room is such a mess.

The warm liquid rises up into your knees. Feel them relax, and then feel it begin to fill your thighs.

Hot flash. Throw off the covers. Damn dog is clanking her collar on the wood floor. Why can’t the damn dog sleep on a rug? Why does the damn dog have to sleep right in the doorway whenever I’m trying to nap? Why don’t I ever remember to take the damn dog’s collar off when I lie down for a nap? Now I’m cold. Bundle up again.

Where was I? Crap. Feel the warm liquid fill your. . .ankles? Oh, knees. Knees. Now feel it begin to fill your thighs. Feel the calming warmth spreading through your body.

Am I ever going to have the energy to finish that room? I haven’t even hemmed the curtains, now I need to take them down so I can paint. All the fabric to hang so I can start sewing again. I wonder which bag has the polar fleece? I’m hearing a Jonathan Coulton song now. I should download a few more of his tracks. But I never finished learning to play Skullcrusher Mountain, even after I transposed it into A.

The warm liquid begins to fill your pelvis. Feel the warmth entering your abdomen, filling you with peace and relaxation. . .

I have to remember to read last month’s minutes before Thursday. I should finish filling out the voucher, too, and I never did make up those forms and reports in Access. The leftover supplies are in a bag in the kitchen next to the stuff I want to Freecycle. I should do that and get them out of the way. Once they’re gone, it’ll be easier to wash the floor. This stupid medication didn’t help me sleep, I’m so tired. I could get all this stuff done if I weren’t such a zombie.

Feel the warm liquid rise up past your navel, up towards your ribs. . .

Time to get up!!!

Body Work

Body Work

I wasn’t going to say anything, but I’m sitting here in the middle of another annoying hot flash. They’re becoming fewer, and the intensity is diminishing, but the only good thing I can say about this is thank goodness I’ll be dealing with this for months rather than years. I have nothing bad to say about having a hysterectomy, and the hot flashes would have come anyway. I can predict some of them. . .every time I wake up, every time I lie down in bed. If I get up in the middle of the night, that’s a twofer. I’m finding that three layers are good, if cumbersome. Two shirts and a sweater for the normal cold house temperature. Sweater comes off for a mild one. Sweater and one shirt for a bad one. If nobody’s home, sometimes that last shirt comes off for a minute or two. 😉 I’m sure that by the time I’m almost completely done, I’ll remember to take my coat off before I drive, because I’m always getting pissy when a hot flash comes on and I can’t un-layer. It’s worse even than getting an itch on the bottom of your foot when you’re wearing boots and driving. WAY worse!

You know, though, I wish I’d been able to convince a doctor to do this years and years ago. I don’t have to worry about confining myself to the house in case my periods are too heavy for the most superest-plusest feminine protection. No more feeling like I have a bag of rocks in my abdomen. No more ovulation pain and cyst-busting pain. And the best is that I’m off antidepressants. That wasn’t part of the original plan, but unrelated circumstances led to weaning off, and when they were out of my system, I felt fine.

Well, fine as in before clinical depression. I do miss my Adderall, because ADD doesn’t switch on and off with hormones. I’d like to sleep, I’d like to focus, but I’d also like to see what I can accomplish without chemical intervention. And really, I’m better at focusing on one thing at a time, so right now it’s going to be losing all the extra weight. And I’m saying that here so that it’s out there to keep me honest.

South Beach, Phase 1 vegetarian. Short term this summer worked well, but then came band season (and cookie season, and grabbing something at the concession stand because you had no time to eat because you were packing and unpacking the band truck season. . .) and I lost track. So that’s where my head is right now. Remind me of that in case I forget! My blood sugar is on the high end, SB worked well for my mom on both the weight and blood sugar fronts, so we’re giving it another shot. Wish me luck.

Once I like what I see in the mirror and enjoy clothes again, I’ll decide what to tackle next.

ADD – I’m a Human, Not a Magpie

ADD – I’m a Human, Not a Magpie

So I was scouring around a couple of places for some new bumper stickers. Now that I have more than three (I don’t know if this is a real rule, or I just made it up) I can keep going to as many as I want. Heh. So I’m not certain what exactly to add besides maybe this:
sticker.jpg

So I decided “Gee, maybe someone’s made a good ADD sticker out there.” I don’t know where this came from, because my brain was all over the place yesterday. Oh, wait, that’s where it came from. I was all frustrated from the whirlwind, pointless meanderings of my unmedicated mind. There ya go. Which reminded me of a bumper sticker proclaiming that ADD is a myth, which pissed me off enough that I would have talked with the driver if he hadn’t been, well, driving. The search did not make me feel any better.

There were thousands upon thousands of variations of this (no link ‘cuz I don’t like it):
squirrelsticker.jpg

and this (same deal):
shinysticker.jpg

You know, it’s such a misguided, simplistic view of ADD, no wonder people think it’s made up. Sheesh. Yeah, ADD makes you easily distracted, but not usually by just any old thing. If I’m distracted by something moving or shiny or whatever, it’s because it sparks my imagination. I’ll see a color I want to use in fabric or clay or painting, and that might catch my attention for a moment. I might even interrupt a conversation or stop in the middle of a sentence to point it out, but it’s not going to stop me from picking right back up where I left off. The real problem is getting distracted by things that will take up large amounts of your time, because you’re reminded of something on your to-do list, or one of the many tasks you started but didn’t finish, or a sudden creative inspiration that must be attended to right away before you forget it.

ADD doesn’t make you stupid like that. (Often, it’s just the opposite. It makes you think outside the box, helps you make connections others don’t see, and inspires unique creativity.) You’re not carrying on with something important and just lose it because something caught your eye. Heck, if it’s really important, you’re probably hyperfocusing and can’t be distracted by a darned thing. This characterization of ADDers as people who can be stopped in their tracks by the sight of a small animal or a shiny object is just as offensive as the assumption that we’re making it all up.

Many of the others carried a more positive message, but were overly wordy, or angry. With one exception, my bumper stickers are short and sweet. I might go for something a little peevish, but I would never put something on my car that would incite someone else to anger. So I guess I have to come up with something on my own. Thank goodness for cafepress. Let’s see if something comes to me as I go off to run more errands. . .