Category Archives: ADHD

Understanding Hyperfocus in ADHD

From PsycCentral By Helen Nieves

A symptom of attention deficit hyperactivity disorder (ADHD) is the inability to focus at a task for a long period of time. Being distracted is also another common symptom of ADHD, where the individual finds difficulty in maintaining attention to a specific task.

However, when I work with children diagnosed with ADHD, I often hear the parents tell me that their child can play video games for hours and get immersed in the game without anyone breaking their attention. But when it comes to completing their homework, it takes them forever to complete one simple assignment.

Although many parents are aware of the symptoms of ADHD, they sometimes overlook a less common symptom, which is the child’s ability to absorb themselves and have an intense focus and concentration in tasks that are stimulating. This is called hyperfocus.

“ADHD is not necessarily a deficit of attention, but rather a problem with regulating one’s attention span,” wrote Eloise Porter in ADHD and Hyperfocus (www.healthline.com, 2012). Individuals who have ADHD find it difficult to focus on activities that are not stimulating or that are boring, but can spend hours focusing and concentrating on playing video games, sports, or activities that interest them.

Advantages and Disadvantages of Hyperfocus

Hyperfocus can have its advantages and disadvantages. I often explain to parents that being in a hyperfocused state can have its pros and cons. If not used properly, hyperfocus can lead to failure to take care of other commitments. Children may hyperfocus on unproductive tasks which can lead to setbacks and failure in school.

Usually, people go into a hyperfocused state when a stressful situation arises. This can happen when a child needs to prepare for a test or to write a paper. It is important for parents to realize and be aware when their child becomes hyperfocused in order to prevent this state from happening, and to use relaxation techniques to help them de-stress and help them set and finish their goals.

On the flip side, if used effectively, hyperfocus can be an advantage, such as when individuals set their mind on a goal they want to achieve and work until it is attained. I often tell parents about famous actors and artists diagnosed with ADHD, including Adam Levine, Albert Einstein, Leonardo da Vinci, Thomas Edison, and Olympic swimmer Michael Phelps, who directed their hyperfocus toward their craft which allowed them to perfect their talent. Besides, if it wasn’t for the ability of many scientists, writers, and artists diagnosed with ADHD to focus on what they’re doing for hours, we wouldn’t have some of technologies today.

How to Cope with Hyperfocus

Parents tell me that it is difficult to get their child out of a hyperfocused state. It takes a lot of awareness and forcing a child to get “unstuck.” Most children, however, are not aware of when they go into this state, and most will not rationalize or stop to de-stress themselves in order to break the pattern.

Here are some suggestions I tell parents to help their child cope with hyperfocus and to set their mind on a goal:

  1. Create a schedule for activities that you know your child will tend to hyperfocus on. If your child hyperfocuses while watching television or playing video games, do not allow them to engage in this activity before homework. Restrict time spent watching television or playing video games if you know your child will “zone” you and the world out.
  2. Help your child find activities that are built on social interaction and remove them from isolated time. If a child is isolated, they are more prone to find activities that they will hyperfocus on.
  3. Try using a signal to refocus their attention. Tapping them on the shoulder or using a bell can help to refocus their attention. Unless something or someone interrupts the child, hours can drift by.
  4. Use timers and alarms so your child is cognizant of how much time has passed since they started the activity.
  5. Help set breaks in between activities that your child may hyperfocus on. Set milestones on activities and have your child stop each time he reaches one. For example, if a child is playing a video game and wins a level, ask your child to stop the game and help you with a productive activity.
  6. Turn off the television or computer to get your child’s attention.
  7. Find ways to make your child’s homework more stimulating. If your child does not want to complete an assignment or study for a test, make it fun. Instead of memorizing information for a science test, have the child draw the information they need to learn, use hands on activities to convey the information that they need for the test, or make a game out of it.
  8. Use activities that your child enjoys as rewards for the tasks he does not find enjoyable. For example, if your child likes to draw, have him do five English questions, and then spend five minutes drawing (make sure you set a timer), and then do another five questions.
  9. If you see your child is stressing out, do some fun relaxation techniques to help them de-stress.

Hyperfocus can be a gift if used constructively on things we want our kids to focus on, such as schoolwork. Managing hyperfocus is important in managing ADHD, and learning the right tools and techniques to help them move in a positive direction is key.

 

 

A Look at Effects of Stimulant Treatment on ADHD

A Look at Effects of Stimulant Treatment on ADHD

Researchers are working to gain a better understanding of long-term impacts.
From psychology today

Medication is an effective approach to helping children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), but more research is needed to explore the long-term effects on the brain.

Most of us are aware of the fact that ADHD is often treated with stimulant medications. While there are well-documented, short-term benefits of this type of treatment, the long-term effects are still being studied. This post discusses how the medications act in the brain immediately, helping symptoms of ADHD, and then touches on some of the issues surrounding long-term effects on behavior and brain functioning.

ADHD can make it difficult for children to succeed in school and disrupt functioning in other areas of their everyday lives. About 6.4 million U.S. children have been diagnosed with ADHD (Centers for Disease Control and Prevention [CDC], 2011) and the most common treatment approach is stimulant medication (Barbaresi et al., 2006). Stimulant treatments for ADHD include Ritalin, Concerta, Focalin, Metadate and Adderall.

Stimulant treatment has been used to help reduce the two major symptoms of ADHD: 1) inattention and 2) hyperactivity and impulsivity (American Psychiatric Association, 2013). Some children display both symptoms, while others exhibit primarily only one symptom. Frequently recognized behaviors associated with ADHD include:

1. Inattention – behaviors such as forgetting to complete homework, having difficulty organizing or planning a task, or trouble following instructions.

2. Hyperactivity and impulsivity – behaviors such as difficulty remaining in a seat, speaking out of turn, or engaging in too many tasks at once (see http://www.cdc.gov/ncbddd/adhd/research.html).

These ADHD symptoms are thought to stem from improper levels of chemical messengers, or neurotransmitters, in the brain. Two critical neurotransmitters are dopamine and norepinephrine. Their action and signaling mechanisms within many brain regions are essential for the regulation of attention and behavior (http://www.adhdandyou.com/hcp/neurobehavioral-disorder.aspx).

For individuals with ADHD, stimulant treatment helps to maintain optimal levels of dopamine and norepinephrine in the frontal cortex and other critical brain regions. The proper levels of these neurotransmitters help to reduce hyperactivity, inattention, and impulsivity (Arnsten 2009 for review).

While a particular medication may not clinically benefit all individuals for all symptoms, there are substantial benefits for many individuals (Fredriksen et al., 2012; Parker et al., 2013). As each type of medication differs slightly, different children might respond better to one type of medication compared to another. Unfortunately, there is no perfect method of determining the ‘best’ medication; often this process consists of trial and error.

Americans have reported concerns about pharmacological approaches to treatment, including their effectiveness and side effects, such as sleep abnormalities, loss of appetite, and nervousness. (For more discussion, see http://www.cdc.gov/ncbddd/adhd/research.html). These effects are important to consider.

Another concern with treating children with stimulants for ADHD is the long-term effects on the developing brain. During the ages that many children and adolescents receive stimulant medication for ADHD, the brain is still changing and maturing (Andersen, 2005). It is important to understand the effects of these medications on the brain after months or years of treatment.

A recent research paper reviewed much of the available information on brain structures of children with ADHD. Overall, the authors found that some areas of the brain in children with ADHD were reduced in volume compared to children of similar ages without ADHD. Stimulant treatment “normalized” particular brain regions, such that they were similar to children not diagnosed with ADHD (Schweren et al, 2013).

However, it is very difficult to study long-term effects of stimulant treatment in human children. Every child enters a study with a different treatment background (e.g. Ritalin v. Adderall, 2 years v. 6 years of treatment) and it makes it difficult to determine the cause of changes to the brain.

Our laboratory and others have recently studied stimulant treatment in young rats during their “childhood” ages. The lifespan of rats (~2 years) is shorter than humans and all developmental stages are faster, although similar to humans (Andersen, 2005), which makes rats very useful for studying ADHD medication and the brain. Rats can be given Ritalin orally, similar to a child, either on a cookie or in drinking water each day during their childhood years, and then tested in adulthood.

Initial findings from our laboratory suggest that adult female rats perform better on learning and memory tasks when given Ritalin as young rats, compared to female rats given no treatment. Unexpectedly, male rats given Ritalin performed the same as untreated rats in the same learning task, suggesting that the differences in stimulant treatment might depend upon gender. We hope to determine where in the brain Ritalin facilitates the behavioral improvements in female rats seen months after the last treatment.

In conclusion, scientific understanding of the fast actions of stimulant medication in the brain is quite clear, such that stimulants change the neurotransmitter levels. But the long-term effects of childhood stimulant treatment on the brain are still being measured (Molina et al., 2009).

More research is helping us to understand whether there are treatment approaches for childhood ADHD that could result in enhanced learning and memory throughout a lifetime. Indeed, that would be an exciting possibility for those who suffer from the disorder.

Leslie Matuszewich is an associate professor of psychology at Northern Illinois University. She is in the neuroscience and behavior program and teaches courses in biopsychology, research methods and psychopharmacology. Her research interests include the effects of chronic stress on brain function and behaviors, sex differences in motivated behaviors, and long-term effects of early stimulant exposure.

Mercedes McWaters is a graduate student in the Neuroscience and Behavior psychology program at Northern Illinois University. Her research interests include the long-term effects of early stimulant exposure, motivation, and the effects of stress on the brain and behavior.

What is Executive Function?

What is Executive Function?

National Resource Center on ADHD

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Executive Function (EF) refers to brain functions that activate, organize, integrate and manage other functions. It enables individuals to account for short and long term consequences of their actions and to plan for those results. It also allows individuals to make real time evaluations of their actions, and make necessary adjustments if those actions are not achieving the desired result.

There are differing models of executive function put forth by different researchers, but the above statements cover the basics that are common to most. Two of the major ADHD researchers involved in studying EF are Russell Barkley, PhD, and Tom Brown, PhD.

  • Barkley breaks executive functions down into four areas:
  • Nonverbal working memory
  • Internalization of Speech (verbal working memory)
  • Self-regulation of affect/motivation/arousal
  • Reconstitution (planning and generativity)

Barkley’s model is based on the idea that inabilities to self-regulate lie at the root of many challenges faced by individuals with ADHD. He puts forth that they are unable to delay responses, thus acting impulsively, and without adequate consideration of future consequences — beneficial or negative.1

Brown breaks executive functions down into six different “clusters.”

Organizing, prioritizing and activating for tasks
Focusing, sustaining and shifting attention to task
Regulating alertness, sustaining effort and processing speed
Managing frustration and modulating emotions
Utilizing working memory and accessing recall
Monitoring and self-regulating action
According to Brown, these clusters operate in an integrated way, and people with ADHD tend to suffer impairments in at least some aspects of each cluster. Because these impairments seem to show up together much of the time, Brown believes they are clinically related.

Under Brown’s model, difficulties in these clusters lead to attentional deficits, as individuals have difficulty organizing tasks, getting started, remaining engaged, remaining alert, maintaining a level emotional state, applying working memory and recall, and self-monitoring and regulating actions.2

It is clear that executive function impairments have an adverse effect on an individual’s ability to begin, work on and complete tasks. It is also commonly thought that deficits in executive functions are highly interrelated to symptoms associated with ADHD.

_______________________________________________________

1. Barkley, Russell A., Murphy, Kevin R., Fischer, Mariellen (2008). ADHD in Adults: What the Science Says (pp 171 – 175). New York, Guilford Press.

2. Brown, Thomas E. (2005). Attention Deficit Disorder: The Unfocused Mind in Children and Adults (pp 20 – 58). New Haven, CT, Yale University Press Health and Wellness.

Last Updated July, 2009

ADHD Is Different for Women

By Maria Yagoda

When you live in total squalor—cookies in your pants drawer, pants in your cookies drawer, and nickels, dresses, old New Yorkers, and apple seeds in your bed—it’s hard to know where to look when you lose your keys. The other day, after two weeks of fruitless searching, I found my keys in the refrigerator on top of the roasted garlic hummus. I can’t say I was surprised. I was surprised when my psychiatrist diagnosed me with ADHD two years ago, when I was a junior at Yale.

In editorials and in waiting rooms, concerns of too-liberal diagnoses and over-medication dominate our discussions of attention deficit hyperactivity disorder, or ADHD. The New York Times , with great alarm, the findings of a new Centers for Disease Control and Prevention study: 11 percent of school-age children have received an ADHD diagnosis, a 16 percent increase since 2007. And rising diagnoses mean rising treatments—drugs like Adderall and Ritalin are more accessible than ever, whether prescribed by a physician or purchased in a library. The consequences of misuse and abuse of these drugs are dangerous, sometimes fatal.

Read Article From Atlantic

 

5 Facts that Crush ADD/ADHD Stigma

5 Facts that Crush ADD/ADHD Stigma –

http://www.amenclinics.com/blog/5-facts-crush-addadhd-stigma/

Are you tired of hearing people say that ADD/ADHD isn’t real, and that people with it just need to try harder? As you probably know, that’s just not true. ADD is real—we can see it in the brain!

Read and share my 5 FACTS that crush ADD/ADHD stigma:

ADD has been described in the medical literature for about one hundred years. In 1902, pediatrician George Still described a group of children who were hyperactive, impulsive and inattentive.

ADD is found in every country where it has been studied. I once had a patient from Ethiopia who had been expelled from his tribe for being easily distracted and impulsive.

Many people with ADD are never hyperactive. The non-hyperactive or ”inattentive” ADD folks are often ignored because they do not bring enough negative attention to themselves. Many of these children, teenagers, or adults earn unjust labels: ”willful,” ”lazy,” ”unmotivated” or ”not that smart.” Females, in our experience, tend to have Type 2, Inattentive ADD, and it often devastates their lives.

The harder many people with ADD try, the worst things get for them. Brain-imaging studies show that when people with ADD try to concentrate, the parts of their brains involved with concentration, focus and follow-through (prefrontal cortex and cerebellum) actually shuts down—just when they need them to turn on.

Ineffective parents or teachers cannot cause a child’s ADD. However, ADD behaviors can make even the most skilled parents and teachers appear stressed and inept.

If you suspect that you or your child might have ADD, don’t wait to get help. Effective treatment does not make those with ADD different people: It removes the barriers hindering them from being the people they already are and allows them to reach their potential.

We like to think of effective treatment for ADD like glasses for people who have trouble seeing. The glasses do not change the person; they just make the person’s vision more effective!

Harnessing ADHD

As a followup to my ADD article, this explains how you can make ADHD work for you.

Harnessing ADHD from the The ReThink ADHD Blog

By Jeff Emmerson

I search for “Famous people in history with ADHD,” and some pretty cool lists come up on the internet. I don’t have proof that they all had it, or that this is all even provable, but I know damn-well that the more ADHD’ers I meet online, the more of a pattern I see! It isn’t always pretty, since the down-side is the anxiety, depression and other co-occuring disorders that exist for many. However, it is what it is, and as mentioned in other recent blog posts, therapists I know have come to the same conclusion: There IS a pattern of innovative, intuitive minds that are very passionate, outside the box thinkers and feelers. I call it a “super-power” due to my own life experience. Sure – I’ve screwed up a lot in my life, but my passion, my ability to see the big-picture, uncover new ways to overcome challenges, and my innate ability to carve my own path via entrepreneurship is a pattern that countless people with ADHD share.

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