1) Children are little adults. During adolescence, the brain changes rapidly. As a result, therapeutic benefits, potential adverse occurrences, and drug interactions can vary with age. Adolescents, in particular, have unique characteristics meaning inconsistent results and effects. For example, SSRIs are being prescribed less for adolescents because studies have identified increased suicide risk among adolescents taking them.

2) Children have no reason to develop depression or anxiety. Researchers estimate “2-6% of children and adolescents in the community suffer from depression.” In addition, a report prepared by Hankin, Abramson, and Siler indicate between the ages of 15 to 18, depression rises from 8% to 18%. There are significant risk factors for youth depression, including genetic predisposition, stress, negative thought processes, and overall environmental factors such as bad parenting.

3) Psychiatric disorders are the same across adults and children. Depression is depression, but the symptoms are not the same for adults and children. For example, clinicians categorize irritability in children and adolescents as a core symptom of depression, but the same is not true for adults. What’s more, adult measures are more static, and treatment follows suit. However, disorders can change with age for younger populations making the child’s disorder a moving target for physicians.

4) Children can be prescribed lower does of the same drug. There is currently not enough evidence to substantiate this claim. Body weight is a factor, age is not.

5) Drugs are successful at treating psychiatric disorders. Pharmacological treatments are not the only or necessary the best option for all conditions. For example, cognitive behavioral therapy (CBT) and parental training can help treat and prevent conduct disorders.

In today’s highly evolved world of psychiatry, research has proven mental illnesses can begin in childhood or early adulthood. There is no question treatment is necessary to combat this grave problem. However, debate is continuing to grow about the over-reliance of psychotropics. In my next post, I will identify three areas of research that can provide answers to this alarming issue.

References

Lakhan, S., & Hagger-Johnson, G. (2007). The impact of prescribed psychotropics on youth Clinical Practice and Epidemiology in Mental Health, 3 (1) DOI: 10.1186/1745-0179-3-21

Hankin, B., Abramson, L., & Siler, M. (2001). A prospective test of the hopelessness theory of depression in adolescence Cognitive Therapy and Research, 25 (5), 607-632 DOI: 10.1023/A:1005561616506

The authors of a recent study published in the journal Pediatrics evaluated 140 white male children with ADHD over a 10-year period. They assessed the relationship between treatment with stimulants in childhood and adolescence and the later development of psychiatric disorders, as well as grade level retention. The subjects with ADHD were compared to a group of 120 age- and gender-matched children without ADHD. At the beginning of the study, the children were between the ages of 6 and 18 years old; at the 10-year follow-up, the mean age was 22 years. Nearly three-fourths of the children with ADHD had been treated with stimulants sometime during the 10-year study period. The authors reported that these children were significantly less likely to develop anxiety and depressive disorders or exhibit disruptive behavior in young adulthood compared to ADHD children not treated with stimulants. These children were also less likely to repeat a grade level compared with untreated children. Overall, the authors conclude that stimulant treatment decreases the risk for the development of psychiatric disorders and academic failure in children with ADHD.

<Untreated ADHD is associated with the development of significant and potentially dangerous disorders: major depression, anxiety disorders, conduct disorders, oppositional-defiant disorders, and bipolar disorders. In the Pediatrics study, the only disorder for which the risk was not lowered with the use of stimulant medication was bipolar disorder. This is likely due to the fact that bipolar disorder has very different causes than the other ADHD-related conditions.

The same authors of the Pediatrics study published related findings in the American Journal of Psychiatry in 2008. Evaluating the same group of children, the authors reported that there was no statistically significant association between stimulant use in childhood or adolescence and later alcohol, drug, or nicotine abuse. Another study that examined the link between age at initiation of stimulant treatment and later substance abuse also concluded that early treatment with stimulant medication does not increase the risk of substance use disorders. Specifically, the study found that the later the stimulant was initiated, the greater the chance of developing a substance disorder. The hypothesis is that early use of stimulants may actually increase the white matter in the brain of ADHD children, which is often smaller than in children without ADHD, during a period of immense brain growth.

All of these studies, while positive for advocates of the use of stimulants, do not account for the effects of early ADHD diagnosis, referral, and treatment, independent of medication administration. Possibly, any treatment, whether with stimulant medication, non-stimulant medication, or behavioral therapy, contributes to the decreased risk of psychological disorders and academic failures later in life. Perhaps the conditions associated with ADHD are the result of untreated ADHD, and not the ADHD itself. For example, if untreated ADHD leads to failure at school and a loss of self-esteem and self-confidence, children and adolescents may develop depression and turn to drugs and alcohol in order to self-medicate.

Medicating young children, particularly with stimulants, will remain controversial. But, leaving ADHD untreated is also a contentious issue. The latest guidelines issued by the National Institute for Health and Clinical Excellence advises that psychotherapy should be first-line therapy for children with ADHD, causing concern among many health care providers. New information will at least arm parents with the knowledge that stimulants may not cause as much harm in children as once believed, and may actually do a lot of good. Parents, clinicians, and patients must evaluate the risks and benefits of any treatment for their own use.

References

Biederman, J., Monuteaux, M., Spencer, T., Wilens, T., MacPherson, H., & Faraone, S. (2008). Stimulant Therapy and Risk for Subsequent Substance Use Disorders in Male Adults With ADHD: A Naturalistic Controlled 10-Year Follow-Up Study American Journal of Psychiatry, 165 (5), 597-603 DOI: 10.1176/appi.ajp.2007.07091486

Mannuzza, S., Klein, R., Truong, N., Moulton, J., Roizen, E., Howell, K., & Castellanos, F. (2008). Age of Methylphenidate Treatment Initiation in Children With ADHD and Later Substance Abuse: Prospective Follow-Up Into Adulthood American Journal of Psychiatry, 165 (5), 604-609 DOI: 10.1176/appi.ajp.2008.07091465

Brimble MJ. Diagnosis and management of ADHD: a new way forward? Community Pract 2009;82(10):34-7.
Nair R, Moss SB. Management of attention-deficit hyperactivity disorder in adults: focus on methylphenidate hydrochloride. Neuropsychiatric disease and treatment 2009;5:421-32.

Biederman J, Monuteaux MC, Spencer T, Wilens TE, Faraone SV. Do stimulants protect against psychiatric disorders in youth with ADHD? A 10-year follow-up study. Pediatrics 2009;124(1):71-8.

The hippocampus, the amygdala and the frontal lobes of the brain are responsible for development of cognitive and emotional functions. Repeated exposure to stress triggers the activation of the hypothalamus-pituitary-adrenal (HPA) axis, resulting in production of glucocorticoids by the adrenal gland. Glucocorticoids are essential for normal brain maturation and its receptors are expressed throughout the brain. Skewed levels of glucocorticoid impair maturation and survival of different brain cells. Hence, expression of glucocorticoids can have long lasting effects on the regions of the brain that regulate their release.

Exposure to stress when these regions of the brain undergo changes may result in long time cognitive and behavioral defects. The effects of stress at different periods of life interact and may manifest after an incubation period.

Maternal depression, intrauterine under-growth and low birth weight are indices of prenatal stress. Low socio-economic status, maltreatment, sexual abuse and war are considered adverse events causing postnatal stress.

Negative effects of stress in the prenatal period may manifest during childhood in the form of behavioral, neurological and cognitive disturbances. These developmental disorders include unsocial and inconsiderate behavior, attention deficit hyperactivity disorder (ADHD), sleep disturbances as well as psychiatric disorders like depressive symptoms, excessive amygdala functioning (fear reaction) and mood and anxiety disorders. However, quality postnatal care often moderates these negative effects.

The hippocampus continues to develop till the age of two years, and so it is extremely vulnerable to the effects of chronic stress. It has been clearly demonstrated that in children who were physically healthy at birth, severe abuse in the early years of life is associated with reduced brain volume. This reduction in volume decreases with increasing age of onset and increases with increased duration of the maltreatment. Children suffering from long hours of neglect are at higher risk of behavioral problems such as novelty-seeking, addictive behaviors and chronic depression later in life.

The frontal cortex undergoes major development during adolescence. Adolescents exposed to early postnatal stress are at a higher risk of developing depression. Also stress during adolescence may result in various psychopathologies such as anxiety and depression.

In adulthood and old age the brain regions that undergo the most rapid decline as a result of aging are highly vulnerable to the effects of stress hormones. Higher stress results in increased glucocorticoid levels. This in turn affects the frontal lobe and hippocampal volume negatively resulting in cognitive impairments.

This research reiterates the importance of rehabilitation of children affected by war, strife and abuse. Better monitoring of state care or orphanages is also needed. Moreover, we require stricter social policies aimed at protecting the most vulnerable section of the society — the children — in the family home from the long term deleterious effects of stress on brain, behavior and cognition.

References

Lupien, S., McEwen, B., Gunnar, M., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition Nature Reviews Neuroscience, 10 (6), 434-445 DOI: 10.1038/nrn2639

McGowan, P., Sasaki, A., D’Alessio, A., Dymov, S., Labonté, B., Szyf, M., Turecki, G., & Meaney, M. (2009). Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse Nature Neuroscience, 12 (3), 342-348 DOI: 10.1038/nn.2270

Charmandari, E., Kino, T., Souvatzoglou, E., & Chrousos, G. (2003). Pediatric Stress: Hormonal Mediators and Human Development Hormone Research, 59 (4), 161-179 DOI: 10.1159/000069325

Remember, we review the latest blogs related to drugs — medicinal, recreational, interactional, personal, professional, or any other aspect. If you were left out in this round, just leave a comment with your blog entry. You can check out the archives for every edition of this carnival.

For future editions, please remember to submit your blog entries using the online submission form. We will do our best to review and include your entry! Enjoy your readings…

Bioblog writes Bring on the free radicals!:

The use of antioxidants has been promoted for years to prevent disease and slow inevitable decline. The problem is, recent accumulating data suggests that vitamin E does not protect against disease and sometimes might even promote it. Once again, our overly simplistic assessment of a compound’s function in the human body has led us to believe we can easily alter that function to our benefit.

Surprising Science writes Drugs’ Odd Side Effects:

Can’t remember what you did yesterday? Are you taking Mirapex for restless-legs syndrome? Or maybe a statin, such a Lipitor? Both have had reports of short-term memory loss as a side effect. The good news, though, is that the problem seems to go away when people stop taking the drugs.

Darwin’s Finance writes Will Resveratrol Benefits Create the Biggest Blockbuster Drug Ever?:

Undoubtedly, you’ll be seeing ads for Resveratrol supplements all over the internet, but with the supplement industry needing no actual data to back up their claims in this regard, and the lack of a proven formulation to actually deliver the compound in the concentration needed to derive any benefit, it is my opinion that you’re throwing money down a rat hole.

My Meditation Garden writes Meditation for Dealing with the Recession:

In the great video [here], listen to Dr. Sarina Grosswald speak about studies made on children and adults suffering from ADHD and the beneficial impact that the regular practice of transcendental meditation has had on them. She speaks about school models, the negative impact of medication on the child suffering from ADHD, and all the side effects!

Branches Of Health writes Help Keep Small Farms Alive!!:

It was recently brought to my attention that there are a few bills going through congress right now that could affect the way local farmers make their living. HR 875 and HR 759 are being addressed as “food safety” bills that, intentionally or not, are targeted at industrial-sized farms, but do not exclude just growing vegetables in your backyard.

Wall & Main writes A glimpse into the future IV – Cancer Research:

An international team of scientists from the Moores Cancer Center at the University of California, San Diego, the University of North Carolina and several institutions in China have explained how a gene alteration can lead to the development of certain types of brain tumors -– low grade gliomas and secondary glioblastomas, and they have identified a compound -– alpha-KG -– that could staunch the cancer’s growth. The researchers have shown that when a mutated enzyme fails to do its job, the development of tumor-feeding blood vessels increases, allowing more nutrients and oxygen to fuel cancer growth.

Malignant Mesothelioma writes Research Suggests Vitamin D Plays a Large Role in Preventing and Fighting Lung Cancer:

An interesting fact found from the study suggests that cancer patients who had high intake of vitamin D doses from sunshine in summer months and who had Surgery during this time were more likely to live 5 years more than people who had surgery during winter months. Michael Thun, chief epidemiologist at the American Cancer Society quotes, “This is a very interesting study. It’s a new trend — looking at dietary factors as they relate to survival, not just the risk of getting a certain cancer.”

Remember, we review the latest blogs related to the brain and mind that go beyond the basic sciences into a more human and multidimensional perspective. You can check our archive for past editions.

For future carnivals, please remember to submit your blog entries using the online submission form. We will do our best to review and include your entry! Enjoy your readings…

It’s All in the Mind…

iOrgPsych writes You don’t know how I feel!:

Can you understand how someone is feeling if you haven’t experienced it? I say that yes, as human beings, we come wired for that ability. But not everyone will use it. If someone can empathize, the reason is not because they have been through it, but because they developed the ability to identify with and understand the others’ situation, feelings, and/or motives.

The Primate Diaries writes The Bad Taste of Moral Turpitude:

Perhaps what’s most intriguing about this study is the implication that moral disgust “hitched a ride” on the more primitive reaction to poisonous or spoiled food. This process, known as exaptation, is where a trait or behavior that was adapted for one function is later co-opted and used for something entirely different (such as bird feathers adapted for use in thermoregulation and only later being useful for flight).

Kathryn Vercillo writes Eidetic Memory: Is It Real?:

What is interesting about those people who have traditionally been considered to be eidetekers (the strange name for those people who may possess a photographic memory) is that they do not necessarily have a memory which remembers all details completely. Instead, they have an eidetic memory specific to certain subject areas in life.

Higher Education and Career Blog writes The Mind Field:

Salerian found himself in a prison interview room near Washington, DC. Two guards brought in the patient: A man who converted his van into a militaristic killing machine, crashed through the gates of a corporate office park, and opened fire. Several people died; dozens more were injured.

Change Your Life Hacks writes If you can change your brain you can change your life:

The main reason why efforts to change your brain – change your life fail, according to experts is due to the “the false hope syndrome”. Usually people set high standards and have high expectations and the end result makes them think that they failed. For example, “I lost only 17 pounds, and I intended to lose 25, I failed.”

brain health hacks writes Do antidepressant work just because they make you hungry:

There appears now to be several papers that suggest that many antipsychotics and at least some antidepressants increase ghrelin levels – at least in the long term (though SSRI still open to debate in humans). It is argued that for antidepressants to be effective they have to be used for a considerable time. Are the potential anti-depressive effects of antidepressants at least partly mediated by an increase in ghrelin? What about antipsychotics?

Spirit Happy writes The Rise of Teen Cutting and Self Harm:

The cut is the outer expression of a deeper cut that is on the inside. The wound is on the inside. Now recognize that this problem crosses every economic level and nationality. This inner pain knows no limits and causes one to literally harm themselves. The cutter is not trying to kill themself but wants to harm themself. It can feel good to them and can be addictive.

FlawlessFitness writes Increase Your Brain Power:

You see, what most people forget is that their brain needs to be put through a workout just like the rest of your muscles, otherwise it will lose its effectiveness.

EmbraceLiving.Net writes Are You Sleepwalking Your Life Away?:

Up till 2 years ago, I was living my life as a sleepwalker. I was busy pursuing inculcated goals such as getting good results, earning money and becoming successful. I was caught in the paper chase, such as scoring in projects and exams, getting a high CAP (GPA) and being on the dean’s list. I was busy earning money from the side with my designing business and tuition. My life was single-mindedly focused on what would make me rich and successful.

Dr Shock MD PhD writes Were does Humor and Laughter Reside in the Brain?:

The perception of humor is dependent on certain faculties of the brain, such as attention, working memory, mental flexibility, emotional evaluation, verbal abstraction and the feeling of positive emotions. Given these involvements, theory dictates that (at least) those regions of the brain associated with these processes should be active in the perception of humor.

SharpBrains writes Learning about Learning: an Interview with Joshua Waitzkin:

In 1993, Paramount Pictures released Searching for Bobby Fischer, which depicts Joshua Waitzkin’s early chess success as he embarks on a journey to win his first National chesschampionship.

a mom’s view of ADHD writes Did anyone see pigs in the sky?:

Yes, you heard me right, my ADHD son received an academic achievement award! I had resolved myself to accept that this wouldn’t happen for him, except maybe if pigs were flying, but here we were. He was one of two students in his class to receive the Academic Growth Award. His teacher recognized how much he has improved so far this school year and, despite the fact that he’s not the best reader and his handwriting is still atrocious, selected him for an academic award. Can I say it again? My ADHD son received an academic award! Woo hoo!!!

Novice Counselor’s blog writes Treating a Client with Low Self-Esteem:

Among psychosocial resources, higher levels of self-esteem have been shown to predict fewer stressors over time. Self-esteem has been associated with the use of problem-focused and active coping, lesser use of avoidance coping, and greater persistence in the case of failure or setbacks. Self-esteem may inhibit stress proliferation indirectly through its effect on choice of coping strategy, in particular, the positive association with problem-focused coping and negative association with avoidance.

Oftentimes I felt frustration. I knew that these students needed some minor adjustments to be as successful as they so desperately wanted to be. Usually their parents cried out for help too; they didn’t want school work and organization skills to be a daily, nightly struggle. Like many things in education, I wasn’t quite sure why more advanced training wasn’t provided, why ADHD children didn’t receive more outside support, why these children and their parents weren’t better educated about this condition.

A recent BMJ article shed light on some of my frustrations. In Diagnosis and management of attention-deficit/hyperactivity disorder in children, young people, and adults: summary of NICE guidance, the authors summarized key findings and recommended strategies for dealing with both conditions. Considering that the number of children diagnosed with ADHD has substantially increased in both the US and UK, this article sought to clarify some issues surrounding the disorder.

There were many recommendations regarding the treatment and management of ADHD/ADD, but the section that grabbed my attention was suggestions for future research. It turns out there are basic (or at least what I consider to be basic) questions about these conditions that researchers still don’t have definitive answers to. See for yourself:

• The criteria for diagnosis of ADHD in adult life? (There are no clear conclusions about the level of ADHD symptoms in adults that should be considered as grounds for intervention.)
• The optimal duration of drug treatment? (Methylphenidate is often prescribed for years without good evidence on whether prolonged therapy is effective or safe.)
• The effectiveness of group based parent training and education programs compared with medication in children of school age? (The evidence they do have is primarily based on studies of younger children.)
• The effectiveness of non-pharmacological approaches for adults with ADHD? (There is insufficient evidence regarding this.)
• The effect of providing training in behavioral management of ADHD for teachers?

These are the exact recommendations suggested by NICE. I took for granted that conclusions had been drawn regarding many of these issues. I was wrong.

I imagine researchers lack significant evidence for most mental illnesses. Being aware of this can eliminate some frustrations related to living with, or directly being involved with someone who has, a mental illness. This can also help you make better decisions. After all, if the optimal duration of drug treatment is unknown, you may want to talk to your doctor about other options. If someone dismisses the idea that ADHD can be treated without medication, you can refute that based on a lack of substantial evidence. Keeping abreast of the latest information is a key component to managing any mental illness. After all, knowing what you don’t know is always half the battle.

Reference

T. Kendall, E. Taylor, A. Perez, C. Taylor (2008). Diagnosis and management of attention-deficit/hyperactivity disorder in children, young people, and adults: summary of NICE guidance BMJ, 337 (sep24 1) DOI: 10.1136/bmj.a1239

Remember, we review the latest blogs related to the brain and mind that go beyond the basic sciences into a more human and multidimensional perspective. If you were left out, just leave a comment with your blog entry. You can check our archive for every edition.

For future editions, please remember to submit your blog entries using the online submission form. We will do our best to review and include your entry! Enjoy your readings…

It’s All in the Mind…

Mind, Soul, and Body writes Man as an Island:

Asperger syndrome is the very high functioning end of the Austistic spectrum. By definition their intelligence is normal, usually even well above normal, but their capacity for reading nonverbal cues, socializing, and empathizing is severely impaired. We don’t understand the basis for this entirely and certain different theories abound, but it appears Asperger individuals lack the firing of what is known as the mirror neuron.

Fighting Fatigue writes Positive Relationship Between Sleep & Thalamic Size in ME/CFS:

Lack of sleep and sleep disorders is a major issue in ME/CFS that continues to frustrate patients and makes recovery and remission hard to obtain. The thalamus (a right and left pair of brain structures) is a key structure in sleep disorders and in certain cognitive functions previously shown to be impaired in ME/CFS patients.

Tic Toc Talk writes Grow New Brains – Through Plasticity: Guest post by Heather Johnson:

This “extraordinary discovery” of the brain (according to Canadian psychiatrist Norman Doidge) to change according to new learning and experience has been termed neuroplasticity or plasticity of the brain. On taking a closer look at how neuroplasticity works, we find that it’s involved at a major level when we’re infants and the brain matures as we transform into adults.

Were You Wondering writes Researchers Identified a Brain Region Implicated in OCD:

Researchers from the University of Cambridge in the U.K. have found a way to determine predisposition to Obsessive Compulsive Disorder by examining the lateral orbitalfrontal cortex. This area of the brain is responsible for habitual behavior, flexibility of thought and decision making.

Thomas J. West Music writes Visualization and Mental Rehearsal: The Power of the Movie Theater in Your Mind:

Any good music teacher and most accomplished music students will tell you that repetition is a key ingredient in mastering any musical instrument. Repetition of a physical skill makes that skill become automatic. Often with my students, I use the analogy that learning to play an instrument is like learning to tie your shoes.

Anand Dhillon’s Self-Help Blog writes Building High Self-Esteem:

The problem of low self esteem lies in the fact that many of us learn to equate who we are with the external position in the world. So when you are successful externally, you feel good about yourself. When you fail at something, you feel down. When someone finds you attractive or approves of you, you feel good. When someone finds you unattractive or disapproves, you feel bad.

Brain Fitness Blog writes Computerized Cognitive Assessments: opportunities and concerns:

I see these instruments as a critical part in the brain fitness puzzle. Neuroimaging techniques such as MRI and fMRI are very important to support clinical and research work, but are not mature/ scalable enough to help measure brain functions in millions of healthy individuals. Neuropsychological testing is still today often done with pen and paper, administered by a trained expert, and very resource-intensive.

ADHD College Blog writes Starting My Day the ADHD Way:

Attention Deficit Hyperactivity Disorder (ADHD) is not only a daily struggle, it’s a morning struggle. Especially for me, because I wait to take my meds until just before I leave for work so I can get the most use out of them during my nine-hour day. Getting out of bed, showered, dressed, and making it to work without forgetting something at home is almost a superhuman feat… more like a super-ADHD feat.

HypNLP writes Framing: Sentence Focus Shifting:

This is a really simple example of NLP framing your words differently to strike different chords within the listener/reader. One sentence can be said/rewritten in 3 different ways the receiver of the sentence will in turn focus on various parts of the sentence.

Phil for Humanity writes The Definition of Morality and Ethics:

Western philosophy has been debating ethics and morality for thousands of years and still has not formalized a definition for them, so how can anyone truly understand them? Furthermore, if the greatest philosophers throughout history have been debating ethics and morality, how can the common man truly understand it? Therefore, I don’t think we regular folks have a chance at truly understanding ethics and morals.

Dr. Deb writes Mapping Your Mind:

Neuromarketing is a controversial new field which uses functional Magnetic Resonance Imaging – a medical technology – to sell products. It’s akin to mapping one’s mind for likes and dislikes. I’m fascinated by this technology, but also skittish about the use of it.

Spiritual Inquiry writes Less thinking leads to better decisions:

How much thought should go into our decisions? How long should we wait? It is a commonly held belief that the more we think about something, the better our decision will get. Many of us will ponder a decision for hours or even days. However, as shown in research by Dijksterhuis et al, over-thinking a problem can actually result in a worse decision.

Mind Think Success writes Train Your Brain To Work For You, Not Against You:

Put your two palms together. Start by using your left hand so that you are pushing your right hand. Then use your right hand to resist by pushing your left hand back. When your right hand is resisting the left hand by trying to pushing it away, your right hand is moving towards the directions of the left hand? So by resisting it, it is actually giving the energy and attention to the left hand.

The Success Triangle writes Key Behaviors for Success:

Success is the end destination of a long journey. Different people measure success differently. As you keep achieving your goals in business, the definition of success will likely change. Along the way to success, you will have to unlearn certain behaviors that could derail you from your path and you will have to make an effort to learn new behaviors so that you can invite success.

The Winding Path writes Self-affirmation makes hard-to-swallow advice more palatable:

The results showed that feelings of love increased regardless of which value the person rated as important. In other words, out of everyone who rated social life as the most important value, those who wrote about why it was important to them (the experimental group) felt more loving than those who wrote about why a less important value might be important to others (the control group). The researchers reported that the same applied for all the other values.

BlogMotivation writes Discovering Your Life’s Purpose:

It’s all in the direction that we take. Where you are going determines where you will end up. The question is, are you heading in the right direction? Clearly, if you are stuck in a daily routine that makes you ask yourself if life has more to offer than this, you are not going in the right direction!

I Will Not Die writes A guide for increasing your creativity:

Creativity is defined many ways by many people. We each probably have our own understanding of what creativity is. Many people associate it with art, or music or other “right brain” or non-analytical activities, but that’s not always the case. Creativity is as much a part of almost any activity as it is part of the arts. Creativity finds its way into our jobs, our homes, our schools, and even our relationships just as often, if not much more often, than it finds its way onto the end of a paintbrush or pen.

Remember, we review the latest blogs related to the brain and mind that go beyond the basic sciences into a more human and multidimensional perspective. If you were left out, just leave a comment with your blog entry. You can check our archive for every edition.

For future editions, please remember to submit your blog entries using the online submission form. We will do our best to review and include your entry! Enjoy your readings…

It’s All in the Mind…

Adventures in Daily Living writes ADHD:

Did you know that most children diagnosed with ADHD are boys (10% males: 4% females?). Is this a problem with boys? Or a problem with expecting boys to be not-boys? (Or merely a problem with diagnoses?)

Anand Dhillon writes Cognitive Distortions:

Overgeneralization occurs when you form an arbitrary conclusion based on limited external evidence. You believe that since something occurred once, it will occur over and over. One failed relationship means you will always be lonely. One failed business means you are not cut out to be an entrepreneur. Fear of rejection is commonly the result of overgeneralization.

Brain Stimulant writes rTMS and Aspergers:

You can read an interesting first hand account of a person with aspergers undergoing an rTMS (rapid transcranial magnetic stimulation) treatment to stimulate a specific area of the brain. This is the first time I have heard about it being used for this disorder. It looks like it may potentially improve specific symptoms for this syndrome and can have a large impact on a person’s perceptual consciousness.

Providentia writes The Shattered Man:

The Battle of Smolensk was part of a two-month offensive in 1943 designed to drive Nazi invaders from the city that they had held for two years. Although the offensive was ultimately successful, it came at a terrible cost.with much of Smolensk being devastated.by the occupation and the battle to retake the city. Thousands were killed or seriously injured including one 23-year old lieutenant named Lev Zasetky.

A. E. Brain writes BiGender and the Brain:

Cross-Gendered (CG) somatic form due to pre-natal hormonal exposure is more strongly correlated with CG sexual orientation than with CG gender identity. It is thus more strongly correlated with CG behaviour. CG sexual orientation is rather more weakly correlated with CG somatic form and CG gender identity, and so all but a few who have CG sexual orientation have perfectly normal somatic form and gender identity. CG somatic form is more strongly correlated with CG gender identity (by a factor of 30), but still the majority (90%?) of physically intersexed people have normal gender identities.

Intensive Care for the Nurturer’s Soul writes Nirvana is Only a Thought Away:

In her own words, [neuroscientist Dr. Jill Bolte Taylor says in her book while suffering a stroke], “When the cells in my left brain became nonfunctional because they were swimming in a pool of blood, they lost their ability to inhibit the cells in my right hemisphere. In my right brain, I shifted into the consciousness of the present moment. I was in the right here, right now awareness, with no memories of my past and no perception of the future

Change Therapy writes Creativity: a way out of depression?:

For me personally, the worst part of depression is a significant change in e-motion – in my inner movement, as well as in the actions that are influenced by that movement. When in a depression, the decision of whether to wear black or white socks is overwhelming because my decision-making apparatus has slowed down to a tired old snail’s pace. Leaving the house, if I manage it, can take two hours because putting on a coat and finding my keys present almost impossible-to-overcome obstacles. Fright or flight don’t work anymore – there’s only freeze.

axel g writes Memory And Thought:

Our attention or focus is continuously split between various activities. Think about it, when you’re not paying much attention to what something tastes like, because your mind is more interested in reading breaking news, you won’t be that aware of the taste of the food. On the contrary, if you do nothing else but eat and pay close attention to every bite you take and every taste that arises in your mind, then you’re said to be mindful or one with the present moment. With mindfulness we can be well aware of the taste of the food.

I Will Not Die writes How to become what you want to become, in about two days:

Do you want to know what prevents most people from achieving their dreams? Them. One of the most frequent obstacles people face when they try to reach their dreams is actually not a full-fledged obstacle at all. It’s just the way they are viewing the problem in the first place. In other words, the way they view the problem becomes a bigger problem than the problem. In a nutshell, they view the problem as something “other” making their dream a distant object, one that must be arrived at from some distance.

SharpBrains writes Why Smart Brains Make Stupid Decisions:

We just secured an interview with Ori Brafman, co-author of Sway: The Irresistible Pull of Irrational Behavior (Doubleday Business, 2008), to discuss our Dark Side (well, he calls it “different hidden forces” and “psychological undercurrents”).

Dental Health and Dental Care Guide writes Danger Of Dental Amalgam Fillings With Mercury:

Consumer advocacy groups are pushing the U.S. Food and Drug Administration to ban mercury used in dental amalgam fillings. Although a ban doesn’t look likely, the government may issue restrictions on amalgam fillings by next year. A recent lawsuit forced the Food and Drug Administration (FDA) to warn people about the possible dangers of mercury in dental fillings for some people, especially pregnant women and young children.

Potential 2 Success writes Eat This Now! The 20 Healthiest Foods You Shouldn’t Live Without:

In a 2006 University of Florida study, the Acai berry destroyed cultured human cancer cells. Acai is increasing in popularity and can now be found in smoothies, juices, and other products. But in order to get the most from the berry, it is best to buy a product that has been freeze-dried and prepared naturally.

Now I’m not implying that this is actually any laughing matter. School is a huge part of most children’s life and having problems there means that these problems are now a huge part of their life. And it’s important to do this research along these lines. But as a former teacher and someone who has worked with children who have ADHD, I can tell you that this isn’t a surprise.

This study followed 370 adolescents who have ADHD as well as 740 controls. (There were two controls for each adolescent with ADHD.) The study examined reading achievement, grade retention, dropout rates , and attendance. And the conclusions were that ADHD students are absent more, have lower standardized reading scores, dropout of school at higher levels, and are held back more often.

I wish I had the answer to this problem because there is nothing good about watching a child struggle to sit still or frantically ruffle through their backpack looking for a 3-day-old homework assignment. And it’s not fun to watch an 8 year old get frustrated trying to do something that is easy for children who don’t have ADHD.

But I believe that in general, children with ADHD will continue to struggle until their care givers, teachers, and doctors realize just how much assistance they need. Although the schools are “supposed” to meet the needs of all children, they don’t; they can’t. This is as impossible as saying that the schools will make sure that “no child (is) left behind.” When a child has any sort of special needs, whether this need is due to a learning disability or being “gifted,” the schools can try to meet the needs of the child but it will take some major work and input from parents as well. And even more than this, it will take collaboration between the schools, parents, and doctors.

Raising a child is not easy, for anyone. But when your child has something like ADHD it becomes a little more difficult. Your child probably needs to learn some specific skills that you may not have experience teaching. Their motivation patterns may not be familiar to you. You may not understand how to help them. And if they have a teacher who doesn’t have a good understanding of ADHD, it’s that much harder.

I recall a conversation I had with a parent of a child with ADHD. They just didn’t understand why their child couldn’t clean their room. It took them many years before they realized that their child didn’t “see” the steps needed to clean their room like someone without ADHD would. So of course, it was hard for them to help their child.

In the end I think that this research points out something that many educators, doctors, and parents of ADHD/ADD children already know: we need to collaborate to find definitive strategies that will help these children be successful in school. These strategies need to be wide-spread, taught to teachers and parents alike. Because we know there’s a problem; we need to focus on finding a solution. Until then, parents of children who have ADHD and ADD will have to exhaust local resources and will need to research the subject extensively so they can even out the playing field for their child.

Reference

Sayal, K. (2008). Attention deficit hyperactivity disorder is associated with poorer academic performance. Evidence-Based Mental Health, 11(2), 41-41. DOI: 10.1136/ebmh.11.2.41

To review the latest clinical thinking in this field, Medscape’s Randall F. White, MD, spoke with Richard H. Weisler, MD. Dr. Weisler, a busy clinician and researcher, is adjunct professor of psychiatry at the University of North Carolina at Chapel Hill, and adjunct associate professor of psychiatry at Duke University Medical Center in Durham, North Carolina.

… so long as the “latest clinical thinking” gives short shrift to anything but medication.

… some in the general public worry that ADHD may be overdiagnosed. When you look at the diagnostic criteria, they require impairment in multiple areas, such as school or work, and also in relationships or at home. If significant impairment exists in these areas, I believe that treatment is indicated.

But we won’t address the fact that there are regions where ADD diagnosis is at extremely high levels, and how diagnostic and systemic biases cause this. And don’t get me started on how we have abandoned the educational system and it’s need for adequate integrated counseling and mental health staffing.

Medscape: In your opinion, who are the 10.9% of adults with ADHD receiving treatment, and why are they getting treatment whereas the others are not?

Dr. Weisler: Some selection bias exists related to resources that people have, such as insurance coverage and maybe access to care in some regions. Certain places have a shortage of mental health professionals, and although primary care physicians may be comfortable in making a diagnosis of major depression or generalized anxiety disorder, almost half feel uncomfortable making a diagnosis of adult ADHD. They likely will refer the person to a psychiatrist for evaluation, if possible.

So only 10.9% of adults have adequate insurance or income and access to a psychiatrist or other mental health professional who would guide them properly? That’s the explanation? What about the extreme drop out rate among those who get medication for ADD? How about actually thinking this through? No. That would spoil the bias!

Medscape: Once the diagnosis is established and a decision is made to proceed with treatment, how should the clinician and patient arrive at the treatment goals? And what’s the best way to monitor progress?

At this point in the article, something good happens. Dr. Weisler talks about tracking real-life symptoms in order to monitor progress, and talking to people in the person’s life to get a more balanced and realistic view of what’s going on.

But he mentions something akin to denial:

If a person has somehow managed for 15, 20, or 30 years, he or she thinks that’s just the way it is.

Sometimes, but sometimes they have a lifestyle that does not challenge them in their symptom areas, and they are functioning well enough that they would rather not take the risks that are involved in taking medication. All medical decisions are, after all, a tradeoff involving risk, even if it’s relatively small. Or, perhaps the person is in a safety-sensitive job, such as being a pilot, and they don’t want to destroy their careers after performing safely and effectively for years.

At this point, Weisler takes the position that you should treat affective symptoms of problems such as depression before ADHD, but leaves room for individuality and points out that control of ADHD symptoms can improve abstinence by increasing life stability.

Then he recognizes the world outside of his office, which I wish more clinicians would do. He says that, since the most impaired people with ADHD are also the least likely to comply with medication, that people in the person’s life should be involved in their treatment. It would be nice if he had emphasized what kind of problem solving and problems with the medication take place. When medication has good odds of working, I agree that spouses should ask, “Are you taking your medication today?” even though it sounds like an unbalanced relationship. Even if it is, it’s still a relationship. He also points out advantages to once-a-day versions of stimulant medication.

He comes to a naive conclusion about a study on compliance. He mentions a study in which a medication management system showed that persons with cocaine dependence tended to take out their stimulant medication just before coming in to see the doctor, and lie about it, saying that they took the medication. He makes it sound like they were just disorganized and need a helpful spouse to remind them. But if they’re lying and addicted to cocaine, they are probably selling. After all, you have to take special measures to offset the cost of cocaine! But let’s not think this though, it would spoil the bias!

Here’s where I have the biggest problem, verging on disgust. Catch this:

More directly relevant to ADHD is a study by Capone and colleagues that examined monthly persistence on medication. They found that even after just a few months, half the people weren’t taking their medication. Adherence dropped to 20% after a year or so. Unfortunately, it’s not all that different from what we see with bipolar disorder, depression, or other psychiatric disorders.

How does he address this critical issue? He wanders off, briefly, into how children’s stimulant use goes down in the summer, and then veers into the awful things that are likely to happen to people with ADHD, such as job loss, divorce, and traffic violations.

In other words, he doesn’t answer the question, and distracts us with some fear mongering intended to emphasize the importance of medication. No solution is in sight, other than the clinician becoming more strident with the patient.

Or, as Medscape puts it, without alluding to any direct evidence:

So poor adherence could have deadly consequences.

Could be. More likely, the greatest threats to well-being are from developmental issues that medication cannot treat in adults. At best, medication might make an adult more successful in treatment directed at those developmental issues. But, in this case, the medication would be adjunctive. But let’s stick with the illusion of things being more clear-cut, don’t spoil the bias!

Weisler also points out that regular treatment (he always says treatment instead of stimulant medication treatment, as you would say if you were acknowledging the importance of other treatment modalities) reduces the initial side effects that can reduce medication compliance. In my experience, people who complain about side effects, whether they are taking stimulant medication or have discontinued it, complain about enduring side effects. I rarely hear of complaints about the initial effects.

Medscape: Aside from extended-action medications, what other pharmacologic characteristics affect treatment adherence?

Dr. Weisler: With ADHD, just as with other diseases, people will have idiosyncrasies as to what effects are unacceptable.

They have “idiosyncrasies,” because calling them personal preferences (like being upset about losing their appetite or sleep difficulties) is too, well, personal!

Oh boy, now we’re going to hear about something besides medication!

Medscape: What role do psychotherapy or other psychosocial interventions play in treatment of adult ADHD and promoting medication adherence?

Dr. Weisler: I think that psychotherapy can play a significant role. If you’ve lived with undiagnosed ADHD for many years, your self-esteem is likely to be low. You may well have some depression or be anxious in certain situations because you are worried about what people think of you. I think that cognitive therapy can make a big difference for both depression and anxiety.

Why are some people so good at diminishing a topic down to a token, and sounding as though they’re really talking about it? And how about the value of having a more specialized approach? It that too managed care unfriendly?

Dr. Weisler: Patients can learn techniques that will help them cope with their limitations better. Professional coaches can assist people, and simple techniques such as wearing sound-canceling headphones while they’re trying to work in a noisy environment can make a difference.

Sure, ADD people just need a few simple techniques. They are vulnerable to deadly things like traffic accidents, drug use and fights (well, the article says so), but this is because of impulsiveness (well, the article says so), and that’s taken care of by the meds (well, the article says so), so a couple simple techniques from a coach, and some counseling for self esteem and mood will take care of the rest. I’m starting to like the Weisler Universe. It’s so much tidier and simpler than the one with developmental issues and numerous reasons for medication noncompliance (such as the serious limitations of the medications themselves) that you have to deal with in the Unprocessed Universe.

Dr. Weisler: In my experience, adherence is clearly improved with psychotherapy. It doesn’t necessarily get people better faster, but it makes them more likely to stick with treatment, and it’s another way of addressing difficult issues.

Ugh. No comment. I’m done.

1,606 words about meds, and 156 about everything else. That’s just under 10%. It doesn’t take Noam Chomsky to see the pattern at Medscape.

Mind you, I’m not anti-medication. I’m just anti-brainwashing.

Reference

Weisler, R.H., White, R.F. (2008). Managing Expectations and Individualizing Treatment for Adults With ADHD: An Expert Interview With Richard H. Weisler, MD. Medscape Psychiatry & Mental Health.

Please remember to submit your blog entries using the online submission form. We will do our best to review and include your entry! Enjoy your readings…

Disorders

Janis Bennett presents ADHD Symptoms posted at ADHD-Living.

Memory and Cognition

Paul Li presents Memory impairment in those over 70 posted at Lumosity Brain Health, saying, “more than 1 out of 3 people over the age of 70 have some degree of memory loss, excluding dementia.”

Alvaro Fernandez presents Social Connections for Cognitive Fitness posted at SharpBrains, covers a recent scientific study that showed how socializing is, in itself, excellent brain exercise.

Personal Stories

Lexi Sundell presents Are You Trapped in a Brain Closet? posted at Energies of Creation, saying, “Leave the preconceived ideas others have about you and walk away from those tight little brain closets!”

Self-Awareness

Alex Blackwell presents Seven Practical Personal Development Strategies posted at The Next 45 Years.

Gabriella Kortsch, Ph.D. presents Our Joys posted at Psychology, Transformation & Freedom Papers, saying, “Grieve not for what is past… our joys as winged dreams do fly…”

Marcus Hochstadt presents The Power Of Focus posted at Marcus Hochstadt.

State of Mind

Patrick A. Sizemore presents Condition Yourself for Success posted at College Information for Smart Students.

Treatments

Mike Wheeler presents Deep Transcranial Magnetic Stimulation posted at Brain Stimulant.

For Fun

Roger Dooley presents Sexy Pics Beat Ugly Spiders posted at Neuromarketing.

The Neurocritic presents two interesting pieces. First, he discusses how popular media is distorting the body image of young men. Second, he covers a story on how sex induces more financial risk taking behavior in men? Neuroanthropology must have sex on his mind too, for he also wrote a piece on the latter issue. However, he takes a “crap-tastic” viewpoint. My favorite sentence of agreement is

… much of the worst ‘evolutionary psychology’ is practiced by people who know very little about evolutionary science, psychology, or genetics.

The Brain Blogger offers an article on pseudo-scientific theories focusing on Bruno Bettelheim’s assertion that autism was caused by bad parenting. Yourell says it best with,

… we can thank Bettelheim for causing an extraordinary amount of suffering because of his unscientific… thinking. Countless mothers were blamed for their children’s autism. What a thing to live with!

Cognitive Daily addressed how babies learn where one word ends and the next one begins and discriminates the functions of consonants and vowels in the understanding of language.

Missives from the Frontal Lobe offers a cautionary article on oversimplifying brain functions, succeeds to a “complex multi-level integration of system, cell, molecule, and gene”, and labels our state of knowledge towards a working model of intelligence as not in its infancy, but rather “embryonic.” Harsh, but I fully concur.

SharpBrains is running high-school student essays on their blog. Thus far, they have written on Alzheimer’s disease and its prevention. What a pleasure to see students interested in science, medicine, literature, and popular media… I recommend other bloggers to take on such a project. Simply, team up with a high school teacher in a subject of your respective blog and make arrangements to have their student’s write potential blogs/essays — not only will they learn the discipline, but also how to effectively portray complex topics to a general public.

PsyBlog presents a series of articles related to the psychology of money. Among them, I most enjoyed reading “Money and Self-Control” — where the author connects simple life-situations to our spending habits.

If you don’t know what is ensemble encoding, I suggest you have a look at Pure Pedantry. Young takes a crack at answering a fundamental question in neuroscience: how does the brain encode sound? In another article, he discusses the limitations of studies that aim to link single-genes to human behavior — all in the context of a recent article “linking” the vasopressin receptor AVPR1a to ruthlessness. Though much of these arguments aren’t new, they must be retold.

Suggested Scholarly Reading

Dick, D., Rose, R., Kaprio, J. (2006). The Next Challenge for Psychiatric Genetics: Characterizing the Risk Associated with Identified Genes. Annals of Clinical Psychiatry, 18(4), 223-231. DOI: 10.1080/10401230600948407

Kendler, K.S., Greenspan, R.J. (2006). The Nature of Genetic Influences on Behavior: Lessons From “Simpler” Organisms. American Journal of Psychiatry, 163(10), 1683-1694. DOI: 10.1176/appi.ajp.163.10.1683

Contribute

I would like to thank the bloggers featured in this edition of the Encephalon. To submit your posts for the next edition scheduled for April 28th hosted by Cognitive Daily, email encephalon {dot} host [at] gmail {dot} com.

Please remember to submit your blog entries using the online submission form. We will do our best to review and include your entry! Enjoy your readings…

Disorders

Sprouts presents Impacts Of Dyslexia posted at Adult Dyslexia.

Frederic Premji presents Bipolar Disorder – Facts posted at BlogMotivation.com.

Memory and Cognition

Alvaro Fernandez presents Sleep, Tetris, Memory and the Brain posted at SharpBrains, saying, “Why sleep is so important for the brain, by Dr. Shannon Moffett.”

Theodore Pappas presents Who Have Better Memories: Men or Women? posted at Britannica Blog.

CJ presents Less thinking leads to better decisions posted at SpiritualInquiry.com, saying, “Thinking for longer does not necessarily improve our decisions.”

Self Awareness

Phil B. presents Why People Make Bad Decisions posted at Phil for Humanity, saying, “Imagine for a moment how stupid the average person is. Do you realize half of the world’s population is dumber than that?”

Doc presents Placebos and the mind-body connection posted at Mind, Soul, and Body.

Werner Boersch presents The Psycho Electronic Men posted at personal-development, saying, “The living matter seems governed by a QFT (Quantum fields Theory) that creates spontaneously a order when thermodynamic conditions permitting it.”

David B. Bohl presents It?s All In Your Head: Healing the Body Through the Mind posted at Slow Down Fast Today!, saying, “We’ve all heard the term “mind over matter.” Have you ever thought about how that applies to your health?”

Spirituality

Olga Rezo presents Signposts on the Way – Divine Laws posted at Metaphysical light rays meditation.

State of Mind

Wisdom presents Conscious Flex: Your Brain Does NOT Know the Difference! posted at Conscious Flex.

Lori Jewett presents Journey into the Brain – A New Take on Nirvana? posted at Between Us Girls, saying, “Are we hard-wired for inner peace?”

Stigmatization and Discrimination

Winston Smith presents Vincent’s Ghost posted at Coming Out of the Bipolar Closet, saying, “A true life bipolar bares his soul. Learn what it is like to be mentally ill without actually being.”

Studies

David Alm presents Can a Teen Cure Cancer? posted at Awearness: The Kenneth Cole Blog, saying, “A 17-year-old high school student in North Carolina may have found a new way to treat brain tumors”

Therapy

Anmol Mehta presents Kapalbhati Yoga Breathing Exercise for Optimum Health & Healing posted at Mastery of Meditation, Enlightenment & Kundalini Yoga, saying, “Excellent yoga breathing therapy to purge the system of all negative thoughts and unhealthy patterns.”

Tiffany Washko presents Natural Remedies for ADD and ADHD posted at Natural Family Living Blog.

Treatments

Jeremy presents Bibliography: Psychopharmacology posted at Advances in the History of Psychology, saying, “An annotated bibliography of peer-reviewed histories of psychopharmacology and pharmacopsychology.”

What does it mean if you say someone is mean, lazy, stupid, or crazy? It might mean that you did something that made me mad, so I called you a name. Or maybe I’m PC enough to call your behavior a name, as in, “Jeez, Carl, that was awful stupid. Clean that up.”

Since people use these words to define people, we need to clean something up right now.

If you are MLS or C, does that mean you do something MLS or C more often than the average person? And how much more often do you have to do it, in order for IT to be WHO you are? Is ten percent too much? Is ninety percent too little? Speaking of words used to define people, if you’re an asshole, are you also a knee?

What is it that makes people argue that they aren’t MLS or C? And why do people, when they feel like an MLS or C person, hate themselves so much? (As in, “GAWD, I’m so STUPID!” Etc., etc.)

Consider this. “GAWD, I’m so EARTH BOUND! I can’t fly worth a damn, no matter how hard I flap my arms! I’m worthless!”

Okay, I’ll get to the point.

MLS and C are very morally-charged words that got their charge from a great deal of history, and our fears of losing membership in the tribe or of being made into an example and losing status. There’s evolutionary psychology in this, given that our ancestors lived in very threatening circumstances with primitive moralistic “tools” for social control. No wonder these words are so charged. There’s a lot at stake, and there’s a lot of genetic and social history.

Since you can’t wipe out all the harsh moralism of the world, let’s take care of this problem in you right now, so you can get on with things.

First, you have done things that could be called MLS and C. Since calling you MLS or C is the misuse of a primitive tool, let’s go at it differently from now on. But let’s not change where you draw the line on what is MLS or C. Just leave your value judgement right where it is. That means you will sometimes do mean, lazy, stupid or crazy things. Some of my dear readers will do more than average, maybe a lot more than average.

Let’s go for the worst case scenario. Let’s say you’re someone who does MLS AND C a good bit more often than the average person. If you have fibromyalgia, are sleep deprived, and are not on the right medication for a mental illness, we could say that you are mean, lazy, stupid, and crazy a good bit more often than you’d like.

It isn’t the words that are so bad. It’s the purpose and spirit. Black was an insult, now it’s a race. Queer was unnatural, now it’s an orientation. Atheist was evil, now it’s the majority of the developed world.

So let’s retool MLS and C. Whatever deficiencies or disabilities you may have, imagine what it would be like to take the charge out of MLS and C. What would it be like to feel how these are just words. You’re still aware of the primitive way they are used by many people, but in your emotional makeup, they’re just words.

So mean becomes, “I’m having trouble being constructive in this situation.” Lazy becomes, “When I try to do that, I get really fatigued and apathetic, and I play tricks on myself to avoid it.” Stupid becomes, “That isn’t something I’m competent at. I wouldn’t apply for that job. By the way, I’m going to need help with this thing over here.” And crazy becomes, “I really have poor judgement when it comes to that.” Or, “My mental illness is really getting in the way of making friends right now, I’m going to have to get to my psychiatrist, pronto.” Or, “My dang sacroiliac AND my bipolar’s acting up. Must be a storm coming.” Or, “Can you believe I dated that person. Now that was crazy.”

Imagine all the energy and creativity this would free up if everyone focused on what to do about MLC and S instead of creating all this emotional, moralistic froth, avoidance, shame, denial, hatred, and bigotry that disrupts our problem solving. Imagine that you don’t need someone to convince you that you aren’t MLS or C, because you’re too busy with constructive solutions, plans, and accommodations to have time for the shame. Imagine being able to educate other people about what needs to happen, instead of having to work so hard at pushing those words away.

Further Reading

Kate and Peggy Ramunndo. You Mean I’m Not Lazy, Stupid Or Crazy? Kelly, Scribner Pub. (1993) ISBN 0684815311. — This book attempts to deal with the problem in it’s own way, and the authors have created workbooks. It’s intended for people with ADD/ADHD.

As for Thomas Szaz, he was a pioneer, but I think at this point his work is so old school and polarizing, that it’s more useful for historical understanding than current thought leadership.

Or, since everyone’s saying it, could it be true? The witch trials were hexed by science. The House on Unamerican Activities went up in indecent smoke. The false memory movement of the ’70’s was sued into oblivion. Maybe it’s time for a kinder, gentler movement. You have ADD and we want to help you.

The problem with this theory may be much like that of all the people that were being sacrificed by demonic cults — there weren’t enough people missing. In a recent study of over 3,000 kids (Froehlich, T.E., Lanphear, B. P., Epstein, J. N., Barbaresi, W. J., Katusic, S. K., Kahn, R. S., 2007), the kids carefully assessed as having ADD came in at 8.7%. Another 3.3% had been diagnosed with ADD, but probably didn’t (or didn’t quite) have it. Is that enough bodies to support the idea that society has turned ADD diagnosis into the latest viral wave of mind control?

Probably not. 8.7% may not be so large when you consider the many ways one can acquire the syndrome. Lead exposure, maternal smoking and other drug use, physical trauma, and genetics are major factors. A childhood disorder that skeptics won’t object to, childhood asthma, has a U.S. prevalence rate of 7.5%. (Centers for Disease Control, 2006)

But we have to ask a different question, because the statistics vary by practice, place, and demographic group. When researchers looked at the actual practice of diagnosing and prescribing, they found that one out of three white elementary-aged boys in southeastern Virginia had been diagnosed with ADD. Statistics like this are don’t show up in nationwide data. (LeFever, G. B., and Arcona, A. P. and Antonuccio, D. O., 2003) The authors point out that the U.S. Drug Enforcement Agency (DEA) statistics suggest that communities may vary in stimulant prescriptions by as much as 100 fold. For now, the DEA may provide our best window into actual prescribing, if the data is accurate enough.

But are there communities that have gone ADD crazy? Are there pockets of faddish overdiagnosis? If not, then there would have to be profound differences in the amount of ADD-causing factors from region to region. Research isn’t supporting a difference great enough to account for the differences found by LeFever’s group.

One more thing. Why, with a consensus reflected in the DSM (which contains widely-accepted diagnostic information) of a 3-5% prevalence rate, am I not saying the 8.7% rate from the Froehlich, et. al., study is suspicious? I will just say that our understanding and measurement of ADD is still fluid for a variety of reasons, and that estimates have varied far more than that. That topic is treated in depth by Nefsky (see references below).

References with Comments

Center for Disease Control. (2006) State of childhood asthma, United States: 1980-2005. Press release.

Froehlich, T.E., Lanphear, B. P., Epstein, J. N., Barbaresi, W. J., Katusic, S. K., Kahn, R. S. (2007) Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Archives of Pediatrics and Adolescent Medicine, 161:857-864

The study data was drawn from The National Health and Nutrition Examination Survey (NHANES), an annual multistage probability sample survey of the non-institutionalized US population.

LeFever, G. B., and Arcona, A. P. and Antonuccio, D. O. (2003) ADHD among American schoolchildren: evidence of overdiagnosis and overuse of medication. The Scientific Review of Mental Health Practice. 2:1.

Nefsky, C., (2004) A conceptual history of attention deficit and hyperactivity disorder. Unpublished paper.

This is a very well-written, detailed, lengthy study funded by the Geza Hetenyi Memorial Studentship for the History of Medicine administered by the University of Ottawa.