“Living With ADHD”

“Organizing Life One Minute at A time”

An UncommonSense Health Newsletter

from drhuggiebear.com and Frank Barnhill, M.D.

Issue 6 Volume 1 June 2005

We sincerely trust you are having a great summer.

Dr. Frank

This UncommonSense Health Newsletter is dedicated to being your source for easy to read, up to date ADHD information on current and important medical issues for your growing family.

We really appreciate your subscription and respect your privacy! We never share, loan, sell or license our mailing lists. This free e-newsletter is sent only to those who have requested so through an opt-in confirmation subscription list.

Dr. Frank’s behavioral rule #1:

“ADHD is first a diagnosis of exclusion, then a diagnosis of inclusion!”

You must first exclude all the illnesses that mimic ADHD and then be sure the diagnosis fits ADHD traits.

This Month’s issue:

ADHD diagnosis

“Making the diagnosis of ADHD in adults”

Frank Barnhill, M.D.

It is likely that most adults diagnosed as ADHD by age 25 years, had symptoms
and signs of the disorder by the age of six years. In my experience in talking with
parents and spouses of ADHD adults, one can clearly believe that 90% of these same adults had ADHD before the age of nine and most were missed and therefore not treated.

A lot of doctors feel that ADHD doesn’t exist in adults, because there have been
few studies that actually showed signs and symptoms of ADHD that applied only to adults and even fewer studies indicating effective treatment outcomes. This is probably due to the fact that in the past, ADHD often went undiagnosed in children, and wasn’t even considered in adults until the past few years.

While it’s true that a lot of teens learn to cope with their ADHD by the time they’re on the verge of adulthood, some studies have shown that as high as 25% or even 40% of ADHDers will continue to have the traits of impulsivity and inattentiveness well into adult years.

If these adults are not identified and treated, they risk many emotional, social and economic disasters not experienced by non-ADHDers. Medical experience indicates these persons will fail to reach their fullest potential in personal and work related life.

Some of these risks include:

Divorce
Inability to form friendships
Inability to keep a job
Problems with the law or authorities
Spousal and child abuse
Drug and alcohol abuse
Depression
Anxiety
Risk for suicide

To help you identify possible ADHD adults, here is a list of questions I ask while screening those over age 20 for the disorder:

For inattention or easy distraction

Did you fail any classes that you didn’t finally pass during high school or college?
Have you lost a job or a position because you could not pay attention to the work?
Do you often fail to finish what you start or have multiple projects started, but unfinished?
Do you feel un-organized and just can’t seem to get started when assigned a task?
Is it hard for you to pay attention to someone who is speaking directly to you?
Do you avoid anything that seems to require a lot of thinking or attention?
Do you often lose things you need to do your work, chores or hobbies?
Do you find yourself daydreaming a lot when you should be paying attention as when driving or listening to an educational presentation?
Do you tend to forget the important things in your life, such as anniversaries and appointments?

For Impulsivity and hyperactivity

Do you tap your feet, drum your fingers, twist your hair, pick at acne or skin conditions, bite your nails, have trouble sitting still or fidget a lot?
Do you feel restless and have to be on the go all the time or get bored easily?
Do you have trouble relaxing when you are supposed to be off or having fun?
Do you talk excessively and offer long complex answers when asked a question?
Do you have trouble waiting in lines or for your turn in answering questions or participating in a discussion?
Do you interrupt other’s conversations before they are finished?
Have you gotten a ticket for speeding or running a stop sign in the past 6 months?
Have you been arrested for any type of violation?
Have you been divorced or separated or had multiple sexual relationships?

In order to make a clear cut diagnosis of ADHD, at least six or more of these signs and symptoms need to be present for six months or more in two different settings (home, work, or at recreation), some of these also should have been present by age 6 years, should cause some type of difficulty in family, work or social life and other diseases must not be the cause of the ADHD-like symptoms. For a more exhaustive discussion of diseases that can mimic ADHD, see www.drhuggiebear.com/ “When it’s not ADHD, what is it, a zebra?”

Currently, as in children, adult ADHD is best treated by skills and behavioral traits training and medications. Only the non-stimulant, Strattera, has been approved by the FDA for use in adults, but lots of doctors use the stimulant drugs such as Ritalin, Adderall, and Concerta with good success. So far, studies have shown that behavioral training alone is not sufficient to successfully treat ADHD.

Let me emphasize that:

ADHD is not curable and at best responds 85% of the time to drug therapy
ADHD medications are some of the most studied and safest drugs on the market when used properly
ADHD drugs do not change behavior. They allow a person to improve behavior and skills through improved use of executive brain functioning and concentration. This improved thinking ability allows one to decrease impulsivity and improve concentration by “taking a moment to reason and focus on a task”.
Our ultimate goal in treating ADHD should be to help the person reach their maximum potential in life as a happy, productive, adult with good self-esteem and the social skills needed to travel through life with the least pain.

Dr. Frank

Remember: Our goal in treating ADHD must be to use the most appropriate therapy to help your child develop the social and learning skills necessary to reach their fullest potential as a happy child and eventually an independent adult.

Dr. Frank’s Golden Rule:

“ADHD is first a diagnosis of exclusion, then a diagnosis of inclusion”.

Frank Barnhill, M.D.

No portion of this information is intended to be offered as medical advice for the individual. Your family doctor is still the best source of advice for you and your family and you should consult him or her if you have any medical concerns. If you wish to use this article as a parent handout or in your newsletter, please see http://www.drhuggiebear.com/ for our reprint policy . mailto:drfrank@drhuggiebear.com

drhuggiebear.com is your source for uncommonsense medical resources.

Let Dr. Frank’s years of experience help you find solutions for life’s little ups and downs. Our complimentary newsletters include timely information on ADHD, depression, work and personal stress, family health, and drugs.

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All articles are derived from published materials, educational sources and years of experience for each author. No portion of the above-contained information is offered as medical advice in any manner. In times of need, your family doctor or professional counselor is still the best source of advice for you and your family and you should consult him or her if you have any medical concerns. If you have comments or questions, please drop me a line at drfrank@drhuggiebear.com.

Frank Barnhill, M.D.

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