July 20, 2004

• This is a fascinating article, mare, and I think it raises many interes - Oooh, a squirrel!
• ''As I sit here and talk to you in a relatively calm conversation,'' he said, ''there's an amusement park going on in my head.'' *runs screaming from the room* And yet, I'm not hyperactive at all. Uh. Not all the time at least. There are days when I can be sloooow.
• I must ask - why did the NYT feel the need to write such an extremely long article about A.D.D.? I got about a third of the way through ("How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?"; "How often do you have difficulty getting things in order when you have to do a task that requires organization?"; "How often do you have problems remembering appointments or obligations?"; "When you have a task that requires a lot of thought, how often do you avoid or delay getting started?"; "How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?"... er, all of them, all the time?), but then I thought I'd go and make a cup of tea, then watch that Transformers breakdancing video again. From what I read, it describes me almost as well as this did...
• Huh? What were we talking about? );
• The problem is that articles like this simply list the questions to such screeners out of context and do not explain how to properly use the scales, such as the one discussed in the article. See this site for more information and then read the forthcoming Psychological Medicine article (listed on the above site) once it is published to get a much better understanding of this screener.
• I was diagnosed as hyperactive when I was a kid. I don't believe they had the attention deficit diagnosis back then, so who knows. I'm sure I was probably ADHD. My mom claims I was on ritalin as a child, but I only remember pretending to swallow some pills and then spitting them out for a short period of time. In any event, I did terrible in school and almost flunked out, but then went on to graduate with honors near the top of my class in college. In college, I found myself able to concentrate quite well on taking notes and studying and did so fastidiously in a way I never did in high school. I find it hard to believe I had a complete metabolic reversal in the 9 months between high school graduation and my first quarter as a freshman. So what happened? I cared! I couldn't give a hoot about high school, but I wanted to do well in college. It mattered to me. I had to go to high school and had a limited choice of what classes to take, but I went to college by choice and had a vast choice of classes. Maybe I have a less severe form of ADHD than others. After all, its not black and white. However, I do think that 100% of the population could be diagnosed with one disorder or another. If its not ADHD, it's depression or social anxiety disorder or obsessive compulsive disorder or alcoholism or drug addiction or sex addiction... Of course, its in the drug companies' interests to create more diseased people so they can sell more drugs to treat them. Corporations need to create a society of emotionless drones that can work in the dehumanizing corporate environment to assure future corporate profits and hegemony. I sometimes wonder if drugs would help me, I really do. Then I have to remind myself that if it hadn't been for my 'disorder', I probably wouldn't have traveled to 41 countries and 47 states and lived on 3 continents. I would have gotten myself into some boring corporate job fresh out of college and be a vice-president for ACME corp by now. I have used my short attention span to constantly engage myself in new and exciting adventures. I can't sit still for too long before I go a bit crazy. That keeps my life interesting. God forbid it should be otherwise. If I really feel like I'm buggin' out, I turn to meditation. It never fails to help calm me down. Oddly enough, I wonder why I find it so easy to meditate at times if I'm truly ADHD. Has anyone ever done any studies on ADHD and meditation? I'd be curious to see what the results would be.
• PigAlien- there's a review in the Annals of the New York Academy of Science. reference: Ann N Y Acad Sci. 2001 Jun;931:310-41. The abstract gives a taste. Bottom line, lots of things look like working for some people. Alternative treatments for adults with attention-deficit hyperactivity disorder (ADHD). Arnold LE. Department of Psychiatry, Ohio State University, Columbus, Ohio 43210, USA. arnold.6@osu.edu A previous review of alternative treatments (Tx) of ADHD--those other than psychoactive medication and behavioral/psychosocial Tx--was supplemented with an additional literature search focused on adults with ADHD. Twenty-four alternative Tx were identified, ranging in scientific documentation from discrediting controlled studies through mere hypotheses to positive controlled double-blind clinical trials. Many of them are applicable only to a specific subgroup. Although oligoantigenic (few-foods) diets have convincing double-blind evidence of efficacy for a properly selected subgroup of children, they do not appear promising for adults. Enzyme-potentiated desensitization, relaxation/EMG biofeedback, and deleading also have controlled evidence of efficacy. Iron supplementation, magnesium supplementation, Chinese herbals, EEG biofeedback, massage, meditation, mirror feedback, channel-specific perceptual training, and vestibular stimulation all have promising prospective pilot data, many of these tests reasonably controlled. Single-vitamin megadosage has some intriguing pilot trial data. Zinc supplementation is hypothetically supported by systematic case-control data, but no systematic clinical trial. Laser acupuncture has promising unpublished pilot data and may be more applicable to adults than children. Essential fatty acid supplementation has promising systematic case-control data, but clinical trials are equivocal. RDA vitamin supplementation, non-Chinese herbals, homeopathic remedies, and antifungal therapy have no systematic data in ADHD. Megadose multivitamin combinations are probably ineffective for most patients and are possibly dangerous. Simple sugar restriction seems ineffective. Amino acid supplementation is mildly effective in the short term, but not beyond 2-3 months. Thyroid treatment is effective in the presence of documented thyroid abnormality. Some alternative Tx of ADHD are effective or probably effective, but mainly for certain patients. In some cases, they are the Tx of choice, and initial evaluation should consider the relevant etiologies. A few have failed to prove effective in controlled trials. Most need research to determine whether they are effective and/or to define the applicable subgroup. Some of them, although not safer than standard Tx, may be preferable for an etiologic subgroup.
• From the NYT article:In the January report, Sales was chided for missing a deadline for a student newspaper because of a computer problem; missing a meeting because she forgot, despite three e-mail reminders; and missing a day of work because she forgot to take her medication. She failed to straighten the library bulletin board where students post ''for sale'' and ''for rent'' notices. She yawned through an entire meeting, without covering her mouth, leading Harris to reprimand her for ''unprofessional behavior.'' Many, many people are good at their jobs, but no one is perfect. Mistakes happen, and perfection doesn't come in a pill. Yes, our employers pay us, but they hire human beings, not autobots. We're biologically geared to be running around outside hunting rabbits, not cooped up in stuffy offices in front of a goddamn computer all day. Has it occurred to anyone that ADHD might actually be "normal"?
• shinything: Being diagnosed with ADHD by a health care professional is much different. Think about friends who are "depressed" vs. those who are clinically depressed. The difference is substantial.
• brokevespa: I know, and I'm sorry for oversimplifying. Me brain often goes a bit too black and white in discussions. (And I should know better, because I'm one of those clinically depressed folk.) Though sometimes I wonder what, if anything, would improve if we apes in suits got outside to play more often. The Man is bringin' us down. Seriously, this is a fascinating topic and discussion.
• shinything: That's okay... I actually work with the screener that is discussed in the NYT article so I felt like I had to comment. And, related to depression and other mental health issues, you might find this interesting.
• I'm glad you did comment. And thanks for the JAMA piece. Very thought-provoking. [bananas]
• Though sometimes I wonder what, if anything, would improve if we apes in suits got outside to play more often I was on a bike trip with some 12 year old Scouts and one of the boys requires a daily Rx of Ritalin to help keep him under control. As it turns out by the end of this bike trip this boy tells me he forgot to take his medication today but feels fine. No hyperactivity, no uncontrollable actions just a hard working well balanced kid out for a 10Km bike ride in the mountains with friends. I wonder if, as shinything said, we encouraged our kids to get away from the X-box and go play your butt off outside, there would be less Rx's needed to keep them focused and under control. This comment brought to you by a kid supposedly diagnosed as "hyperactive" and "ADD" as a child and with a Mother who refused to medicate him and instead kept him busy working around the house and in the yard.
• squeak: While I do agree with your comments, one must always consider who is making these diagnoses or decisions to medicate. If it is the primary care physician, are they qualified?
• I'm the poster boy for Attention Deficit Disorder. I'm 45, so that means that as a child they didn't have a name for the "condition". I think that it is misnamed, misunderstood and (yes) over-diagnosed, but that makes it no less real. I don't believe that A.D.D. people can't concentrate. In fact I believe we are capable of hyperconcentration in which we don't even hear people talking to us. I also think that A.D.D. people APPEAR to be distractable because in conversation they will seemingly jump to other subjects. In my experience, that is because the A.D.D. person is capable of making connections between apparently unrelated subjects. The A.D.D. person will often leave out the transition thought and simply begin conversing on (what is to them) a related subject. This same quality is a component of creativity and even genius. Many A.D.D. people are quite gifted and bored in school because they get it the first time and need to occupy themselves while things are repeated for the "normal" kids. This is often misinterpreted behavior. I find it very interesting that much of the current biological research on A.D.D. centers on dopamine. Dopamine is also implicated in Dyslexia (which my father has) and Parkinson's Disease (which his mother had). I will not be surprised if in several years they find that a particular genetic combination results in getting one or more of these conditions. I have a theory that many addictions, such as the current meth craze, is fueled by A.D.D. people attempting to self-medicate. I don't think we should be surprised that this country is home to a higher percentage of A.D.D. sufferers. It was just those kind of impulsive "thinking outside the box" people to pack up, leave their homeland and sail to this country in the first place. If there is a genetic component to the disorder, I would EXPECT to find the most in North America.
• I probably have A.D.D. but I don't care. As mercurious points out. My creativity depends on me loosing track of whatever I was thinking about. Actually it's a fun excersise to try to trackback a long derailed train of tought. So... what was I saying?
• Zemat, you were saying something about the train you took yesterday to the neat haircut you got a few years ago by that girl you dated in high school and how she really didn't know how to use a socket wrench on a burned-out head gasket. Uh, what was I saying?
• I don't think i have ADD, but I know that connections thing, that is for sure.
• Oh no, another point for my "every group that can be defined, in any way, will convince itself it's better than anyone else; if their common thread is mental, they will convince themselves that they are the next step in human evolution" theory. I'm dysthymic. I'm not the next step in human evolution. I'm just really boring. That said, if the champions of ADD can lead the rest of us to a society that lets us outside during the day, I will follow your wildly skittering banner proudly.
• Sales was chided for missing a deadline for a student newspaper because of a computer problem; missing a meeting because she forgot, despite three e-mail reminders; and missing a day of work because she forgot to take her medication. She failed to straighten the library bulletin board where students post ''for sale'' and ''for rent'' notices. She yawned through an entire meeting, without covering her mouth, leading Harris to reprimand her for ''unprofessional behavior.'' Many, many people are good at their jobs, but no one is perfect. Mistakes happen, and perfection doesn't come in a pill. Shinything, are you saying that this type of behavior in the workplace should be considered normal? Sure, no one is perfect, but missing meetings after being reminded, not doing your job and acting unprofessionally - is that standard in today's workplace? It may not be ADHD, but I'd at least consider it abnormal and worthy of being reprimanded, and not just chalk it up to the fact that no one is "perfect."
• There was one who was famed for the number of things He forgot when he entered the ship: His umbrella, his watch, all his jewels and rings, And the clothes he had bought for the trip. He had forty-two boxes, all carefully packed, With his name painted clearly on each: But since he onitted to mention the fact They were all left behind on the beach. The loss of his clothes hardly mattered, because He had seven coats on when he came, With three pair of boots -- but the worst of it was He had wholly forgotten his name. --Lewis Carrol, The Hunting of the Snark, Fit the First
• Sooooz, you're right, I didn't phrase that well at all. If she hadn't requested accomodation, she would have lost her job. However once she made her request, the supervisor became so intertwined with her personal life and day to day routine that the final list of criticisms sounds (to my ears) minute and petty. I think there was more going on here than just this woman's ADD. Forgetting a meeting: I've seen lots of people caught up in deadlines who occasionally forget or are unable to attend internal meetings. Sometimes they even have to hand off a client meeting to a colleague. They're not fired for it. Because the article says she was reminded three times beforehand, it sounds like it was a Very Important Meeting. I agree, that's not good. Failed to straighten bulletin board: not enough information. According to the article this was one task out of many. Was the bulletin board consistently messy? Or was it forgotten once? Secretaries, office managers, etc., have lots of big and small tasks that come up each day. They're not fired if a small thing is put at the end of a big list of priorities. Missing a day of work: for the rest of us, missing one day of work is just a sick day, and the details are none of our employers' business. This woman missed one day and, because of her accomodation, she was forced to admit to her supervisor that she forgot to take her medication. Yes she should not have forgotten, but it was one day, not two, three, or several. Do other people get reprimanded because they get the flu or stay home with a sick kid? Yawning during a meeting: how many times do non-ADD people yawn in meetings? Are they reprimanded for it? Is it documented as a reason to terminate them? And how do we know that the yawning wasn't a side effect of her meds? It's a well-known side effect of many anti-depressants. Missed deadline due to computer problem: not enough info here. Did she not notify tech support in time? Were no other machines available? Was tech support unable or unwilling to help her in time? We don't know. As it's phrased in the article, it seems like a strange reason to fire someone. It sounds like the supervisor had already decided to fire her, but then was stuck once she requested accomodation. After the request was made, she was watched like a hawk. I'll say it again, the supervisor's criticisms seem petty to me, individually and as a whole. It would be good to get a "big picture" view of the situation from an unbiased source. Sure, probably this detail-oriented job wasn't right for her, but I wonder how things would have turned out if her supervisor had been slightly more understanding. This article reinforced my decision to never, ever inform an employer of my mental health status. Apologies for the lengthy reply.