New York Times best selling author and psychiatrist Dr. Daniel Amen, known for his brain imaging approach to treating disorders of the brain, say many people unknowingly may have the controversial condition ADD, which is associated with behavioral problems in kids. That our disorganization or lack of concentration may be a symptom of ADD and that we could be feeling a lot better if it was being treated properly. In his PBS special Healing A.D.D. Dr. Amen and his wife, nurse and best selling author Tana Amen help us to determine if we may actually be suffering from ADD ourselves and dispel some popular myths surrounding ADD. We also learn of the different types of ADD and the importance of targeting treatments to each specific type. They give an overview of the Amen Clinic’s approach to treating these individual types of ADD.
So, How do you know if you have ADD (Attention Deficit Disorder)?
- Do you have a short attention span?
- Are you easily distracted?
- Do you struggle with organization?
- Do you tend to procrastinate?
- Do you get into trouble for saying and doing stupid things usually by impulse?
If you have answered yes to three or more and the symptoms interfere in your life you may have ADD.
Don’t Distress. Some very successful and famous people have been associated with ADD. Thomas Jefferson is thought to have had ADD. Olympian Michael Phelps was formally diagnosed with ADD. Hall of Famer Terry Bradshaw and Grammy Winner Justin Timberlake have said they have ADD.
Many people with ADD are known to be highly intelligent, creative and spontaneous and many tend to chose professions that are very stimulating such as ER doctors and firefighters.
But they may have to put extra effort in coping with these symptoms of ADD.
Short Attention Span – is the hallmark symptom of ADD but not short attention span for everything! It is usually short attention span for routine, every day and regular activities such as homework, paperwork and chores. One clue is “How long does it take to do a typically one half hour of homework or a typical chore!” If it’s longer than an hour think ADD. People with ADD usually can pay attention to things that are new, novel, highly interesting, stimulating or frightening. Researchers have found that people with ADD have low levels of the stress hormone adrenaline. That is why stimulants seem to work and are typically prescribed as a treatment. Without treatment people with ADD tend to find ways to stimulate themselves which can result in bad behavior such as in the classroom.
Distractibility – this is when people are very sensitive to things going on around them. A typical brain has the amazing ability to block out distractions. A person with ADD tends to notice everything around them. They see too much or feel too much or hear too much. Even their clothes tends to bother them to the point where they sometimes prefer to be naked.
Disorganization – people with ADD tend to have trouble being on time and with time management. Their personal space such as their bedrooms and their desks and offices tend to be messy and disorganized. Many people with ADD tend to not get ready to go until they are late because they need that additional adrenaline rush of “Oh No, I’m late!” to get them up and moving.
Procrastination and follow through – they will do something only as long as there is an intense interest. Even though they may know about term papers or deadlines for months, they often won’t start until the last minute.
Impulse control – people with ADD often do things without thinking of the consequences. They may speak out of turn too quickly and regret it later, spend money they don’t have, eat too much food, flirt and have affairs when they should not.
Medication use for treatment is one of the many controversial issues and myths surrounding A.D.D. ( Attention Deficient Disorder) also sometimes referred to as A.D.H.D.(Attention Deficient Hyperactivity Disorder).
Dr. Amen with his 23 years of experience through research and knowledge gained from clinical work with brain imaging studies called SPECT which looks at blood flow and brain activity, gives us his take on those controversies and myths.
- It is a fad! Many people feel that way but the condition has been described for over 100 years.
- ADD versus ADHD. In 1987 the American Psychiatric Association voted to change the name from ADD to ADHD which highlighted the hyperactivity component. But Dr. Amen thinks it was a big mistake because clearly one half of the people ADD are never hyperactive.
- ADD is over diagnosed. That may be true in some cases. But it is also under diagnosed especially in females because they are usually not hyperactive. Also ADD may be under diagnosed in introverted males because they are usually quieter and not causing obvious problems.
- Just try harder! If you try harder you will do better! But Amen Clinic SPECT brain scans have found evidence that the harder a person with ADD tries, brain function actually decreases. That is why stimulant medications tend to work. They prevent brain shutdown from occurring.
- Everyone will outgrow ADD by age 12 or 13. But researchers have shown that half of children diagnosed with ADD will continue to have symptoms into adult hood. They tend to outgrow the physical hyperactivity but not the symptoms of restlessness and attention issues.
Types of ADD and why it is important to know your type.
Dr. Amen explains that in 1991 when he started his brain imaging work, he thought ADD would have one pattern in the brain. Since then they have discovered seven relevant types of ADD. This is important because it explains why some people did well on one treatment and others did not. Treatment needs to be tailored to each specific brain type not to a cluster of symptoms. And each individual can even have more than one type of ADD.
To understand the types of ADD and their different treatments, Tana Amen explains a little about….
Three common neurotransmitters that are relevant to ADD and its treatment
- Dopamine – affects focus and motivation and getting things done.
- Serotonin – affects mood, sleep, shifting attention and flexibility. It’s the ‘Don’t Worry Be Happy’ chemical.
- GABA – this helps to calm the brain.
Seven Types of ADD and Treatment Strategies
- Classic – typically what most people call ADHD. These patients tend to have the hallmark of ADD symptoms.
- low dopamine levels
- short attention span
- poor impulse control
- restless and hyperactive. They have trouble sitting still even as adults and tend to be pretty impulsive.
- Treatment-respond to measures that boost dopamine such as stimulating supplements or medications. EPA type Omega-3 fatty acids. Exercise and diet is also helpful.
- have trouble focusing
- tend to be introverted
- more common in girls and the diagnosis is often missed because they have fewer behavioral problems.
- not hyperactive or overly impulsive
- Treatment– measures that will boost dopamine levels. Diet higher in protein. Stimulating supplements and medications.
- Over focused
- most of the classic ADD symptoms but….
- they have trouble shifting attention
- get stuck in loops of thinking – In order to focus you have to be able to continually shift your attention from thought to thought. If you get stuck on one thought, it is impossible to follow the next thought because your attention is stuck on that one thought. Tana Amen gave the example, that if your husband says something that irritates you and you think about it over and over, it is impossible to hear or focus on anything else because your attention is still stuck on what your husband said.
- low serotonin and dopamine levels
- excessive activity in the anterior cingulate gyrus area of the brain which is considered the brain gear shifter. It helps you go from task to task, move from idea to idea, be flexible and go with the flow. It is also involved in error detection or knowing when something is not right. When the the anterior cingulate gyrus works too much, people tend to get stuck.
- worry and hold grudges.
- tend to get upset if things don’t go their way.
- can be argumentative and oppositional and tend to see too many errors.
- on the surface they may seem selfish but what is really going on is that their brains are inflexible
- Treatment-they do best on medications or supplements that boost serotonin and dopamine levels. They do not do well on a higher protein diet. Once you get their diet right these people can feel warm, focused and less worried.
- Temporal lobe – exhibit hallmark ADD symptoms plus
- temporal lobe symptoms such as problems with learning, memory, and temper outbursts.
- Treatment– a. supplements or medications to boost GABA and stabilize the temporal lobe. b. something to boost dopamine to help focus. – This treatment needs to be in this particular order. If you get the order wrong you can hurt the patient. Healthy fats and a higher protein diet can also help.
- Limbic – exhibit hallmark ADD symptoms plus
- they tend to be sad, negative and see the glass as half empty
- poor appetite
- feel socially isolated
- the limbic or emotional part of the brain works too hard
- Treatment – stimulating supplements or medications that boost the brain and enhance mood so you can feel happy and more focused.
- Ring of fire
- tend to be moody
- easily distracted
- have too many thoughts
- overly sensitive to lights and sounds
- the brain is so active that it looks like a ‘ring of fire’ on the brain scan
- it is possible that this type of ADD can be related to bipolar disorder which used to be called manic-depressive, or can be caused by allergies or inflammation of the brain
- Treatment – A big problem with people who are diagnosed with ADD is that they are immediately put on stimulants. But stimulants usually make this type of ADD worse. This type of ADD needs a brain calming regime. a. special diet b. group of natural supplements to calm the brain c. GABA and serotonin boosting measures… and in that order!
- Anxious – exhibit hallmark ADD symptoms plus
- tend to get anxious nervous and tense
- normally don’t like to speak in public
- freeze on timed tests
- have physical ailments such as headaches and stomachaches
- too much activity in areas of the brain associated with anxiety
- Treatment -need to produce a relaxed and calm the state. Stimulants alone can make it worse. Practice deep relaxation techniques. Supplements or medication that balance the brain. Substances that boost GABA and dopamine
To learn more about Dr. Amen’s approach to treatments for ADD, see Dr. Amen’s PBS Special Healing A.D.D. Check your local TV listings or contact your local Public Broadcasting Stations. They may also offer a Donor Combo Package of information which may include such items as DVDs of the program, books, and tools and other information concerning The Amen Clinics and their brain imaging work. Visit their website Amen Clinics.
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