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Thoughts on ADHD
James Brody · 1/1/99 at 5:52 PM ET
You don't want me to stop and think before I explode; if I stop and think, it means that I'm scheming. Manic/ADHD junior high student. ADHD is rarely alone; it occurs (often about 40% of the time) with depression, anxiety, oppositional behavior, and conduct disorder. Tourettes, allergies, early ear infections, and various physical oddities are often associated with ADHD. One of its fraternal twins -- "mania" -- will be discussed for most of this essay. Barkley has suggested ADHD be renamed "behavior inhibition disorder" because he theorizes that problems with response inhibition lead to both hyperactivity as well as to the array of memory, planning, emotionality, and problem solving dilemmas that occur regularly in ADHD children and adults. He's wrong about hyperactivity -- it's often a blessing when the rest of the mind is sound. He's probably very correct about the other features of ADHD. The following paragraphs make a distinction between "mania" and ADHD as two disorders and that many children and adults probably have both disorders. (A longer paper, now under review for publication, is available.) Mania is associated with liveliness, a keen awareness of social alliances, striving for power (telephone, curfew, automobile, better toys, more allowance), heightened word flow, and slightly higher I.Q. than average. Mania has to do with becoming dominant, with getting more goodies and the best mates. We see it in our executives, military officers, construction superintendents, and politicians. Mania has to do with "winning" and is as old perhaps as multicellular life. ------------- ADHD, however, seems to reflect an impairment rather than an excess, an impairment of recent and working memory, word retrieval, sequencing events correctly, estimating time, making plans, sharing plans, analyzing problems, and inventing ways to solve them. ADHD means that we lose access to the past 200,000 years of evolutionary tuning, of access to whatever genes allowed us to solve problems in our minds instead of on the spot. Combine mania with ADHD and you have a person with tremendous determination but poor targeting ability. The manic traits -- the fights over power and dominance are usually the ones that bug teachers and parents. "Teacher is unfair" often translates into "Teacher won't let me win" or "Come get the teacher off of my back." I suspect -- but cannot prove -- that manic features are as significant a contribution to the Connors ratings scales as ADHD and perhaps a more frequent motivation for teachers to complain. I also suspect that mania accounts for the sleep disturbances frequently seen in "ADHD" children. ----------- ADHD without mania sometimes describes a fairly popular individual -- accepted but not trusted with the car keys. Mania without ADHD describes our stars who know when to push and when to keep quiet in order to achieve long term goals. Mania with ADHD describes a mess! The will to power is obvious, timing is poor, and social manipulations are obvious for everyone to notice and evade. Treatments for ADHD: - Immediate consequences - Clear signals - Lively teaching styles - Let the child fidget; work and read while standing or walking - Parent and teacher training - Stimulant medication I suspect that other tactics to increase blood flow -- although Barkley doesn't endorse a "blood flow" explanation of ADHD -- will also help. Research may yet show us that exercise, hot peppers, nicotine, and ginkho biloba will be effective for many inattentive people, the ones who once out of school are diagnosed by their quart of coffee each morning from the mini mart. Treatments for Mania: - Find arenas consistent with talents, arenas where drive and energy are targeted correctly and achieve outrageous success - Use the Rules for Determined Kids (Stubborn People) on another page - Certain antidepressants for irritability and rage, for extreme lack of cooperation. - Mood stabilizers - Find a mentor with comparable energy and talent but good social skills.
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ADHD (Attention Deficit Hyperactivity Disorder) has been explained and re-explained in many books, articles, and professional meetings. Russ Barkley described it as one psychological disorder where popular demands have led the research team instead of the reverse arrangement. Children and Adults with Attention Deficit Disorder had approximately 35,000 members when I last checked.
The "trinity" of impulsiveness, inattention, and hyperactivity is threadbare at this time as is the earlier notion that ADHD disappeared by age 16 or that girls didn't experience it.
"I can't plan, I never know what's going to happen." ADHD teenaged girl
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"I tell them to let the train hit me; I can stop it at the last minute with a wave of my hand" Manic/ADHD teen.
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