Friday, May 2, 2014

ADHD...or, basically welcome to my world...

May, among other things, is ADHD awareness month. I have to wonder a bit about when all these awareness month things came to be, and whether they really were invented to serve the purpose of awareness.

Like cancer awareness, for instance. Are there people who don't know what cancer is? I highly doubt that there are.

Maybe a better term for this particular awareness month would be ADHD education month or ADHD symptoms month or ADHD coping tips month.

Just a suggestion, universe.

Anyhow, I wanted to talk a little bit about ADHD and share some of my personal experiences and observations about it, mostly because its a bit misunderstood even still today, but even more so because I spent much of the day yesterday dealing with how it affects our family.

The diagnosis rate of ADHD has increased dramatically in the past few decades, as has the tendency to medicate kids with the condition. The ever increasing demands placed on students in school to achieve at higher and higher levels and this constant nagging focus on outputs and test scores creates an environment where any child who struggles to pay attention will suffer, almost by definition.

There are two predominate types of ADHD, and a third type which combines the two. The first is hyperactive, which is exactly what it sounds like. People with this form of ADHD have significantly higher activity levels than people without it. In kids, it often looks like they are going, going, going all the time. They may struggle to sit still or sit at all. They need to keep moving almost constantly in one way or another. When told to sit, they may fidget. They can appear to be restless, running or climbing when it isn't allowed. They can have difficulty playing quietly or alone and may talk excessively.

The other main form of ADHD is inattentive. These people have difficulty concentrating on most activities, but can develop hyper-focus in others. They may struggle to stay on task and may have problems completing assignments or projects. They have very short attention spans and move from one (usually uncompleted) task to another. They are prone to procrastination and are easily distracted. They struggle to pay attention to details, may be messy and disorganized. Problems can surface in interpersonal relationships because of their inability to focus on conversations, follow instructions and more.

The combination type occurs in people who exhibit symptoms of both subtypes.

Generally to be diagnosed, children have to exhibit a set number of symptoms in more than one environment (school, sports, friends, home, etc) for a length of time in such a manner that it affects their daily life. There are forms and numbers that are set to determine actual diagnostic criteria, which in some ways is ironic considering all the forms are filled out by people with subjective assessments. Personally, I think that if it is affecting their daily life, the number on the form shouldn't hold too much relevance.

Many children who struggle with ADHD will continue to deal with it as adults. Likewise, many adults were never diagnosed as children and only begin to seek help when they realize they might have it as a grown up, often when it becomes obvious that things have "always been this way".

In children, one of the criteria often used for a diagnosis is that the symptoms have to be present before the age of 7, but again, I tend to wonder about the validity of any arbitrary cutoff with a condition like this one.

In my life, I am surrounded by ADHD, in just about every form.

This. So much this.
I almost certainly have inattentive type, though when we were kids they didn't diagnose things like this. I was intelligent enough to compensate for all the things I couldn't do - mostly, I couldn't focus for extended periods of time. I have always been easily distracted and I procrastinate more than anyone I know. On the flip side, I can totally get obsessed about things and develop the hyper-focus. I haven't sought out a diagnosis as an adult because I manage to live with it. I know my propensity to become distracted, so I tend to schedule my days ahead of time and try to set firm goals. I am a visual person, I LOVE lists, if only so that I can cross things off as I accomplish them.

I have kids with ADHD...kids of the female variety. People are often unfamiliar with ADHD in girls and it is diagnosed far less frequently in girls. One of my daughters has been compared to the boys her age for her entire life because her activity level was always closer to them than it ever was to her female classmates.

Parenting the hyperactive child
I have one child with hyperactive type. She has always worked very hard to control it at school, mostly because of the social consequences of her hyperactivity. Even your best friends will pick on you if you spill things all the time in the cafeteria, as she learned the hard way. So she works very, very hard to control it. For years, she couldn't sit in a chair. She still can't, though it is better than it used to be. We say that she doesn't sit so much as she perches on chairs, almost constantly changing position.

For that child, her ADHD has never negatively affected her school work. She has never been medicated, though we long ago eliminated almost all processed food from her diet, as well as high fructose corn syrup and dyes. The actively suppressing her activity levels during the day comes with a price, though. For a very long time, she would fly out of control after school. She needed to run and run and run. She would rage if she couldn't get it out of her system fast enough. She would become volatile and emotional.

It was as though she had spent all day bottling it up, and then it suddenly exploded. Usually in my general direction. I've, quite literally, had to sit on her. I often have to get down to her level, hold her face in my hands, have her look into my eyes and breathe...even now.

As she has gotten older, either her symptoms have lessened or she has just gotten better at managing them. She is a very active child and needs physical activity if there is any hope of her listening or getting homework done. So, we keep her busy. When she isn't listening, I literally throw her outside. Go jump on the trampoline, go ride your bike, just go run around. Just go.

One of my biggest frustrations with the focus on academics 24/7 in this education environment now is that recess and physical education has been cut significantly. For a kid like her, it will harm her performance in school. I can promise you that. These kids need more activity, not less.

Parenting the inattentive child
I have another child with ADHD, though hers is predominately inattentive type. She does have many symptoms of hyperactivity as well. Her situation is so different than her sister that it is like night and day. I didn't even realize that what she had was ADHD until one day, after years of struggling to read and falling further and further behind, I stopped watching what she was reading and started watching her.

Her eyes darted everywhere. She literally couldn't get through a sentence without her focus being pulled somewhere else. Even in quiet rooms. Even without other students around. She just couldn't focus, and suddenly it all made sense. She had done so well masking the rest of the symptoms that we missed the biggest one.

I kick myself for that still.

Once we went through the formal evaluation and diagnosis process, we pretty quickly determined that a course of medication was necessary. We'd already done all the diet alterations. She'd already been screened for allergies and all sorts of other issues. She was behind in school and rapidly falling further and further behind. She was almost done with second grade at the time, and we knew that the curriculum would get more demanding for reading both in reading itself and in math the following year.

The first day she took the medication, it was obvious that it was exactly what she needed. She made a ton of progress in a short period of time. Unfortunately, the side effects forced us to pull her off of it though. Most ADHD medications suppress appetite, but some of them can cause emotional disturbances in kids too.

For a while, we experimented with caffeine. It worked magnificently. Unlike the effect caffeine has on non-ADHD sufferers, in those with ADHD caffeine helps focus. It does not cause hyperactivity in kids (or adults for that matter) with ADHD. All the benefits of the medication, none of the side effects. The problem was that it required her cooperation for it to keep working, and she grew tired of drinking tea. It became more of a fight, she became more frustrated, and she asked if there was anything else we could do. I told her, point blank, that it was her body, she knew her body better than anyone, and that if she wanted to try a different medication, we would do that.

So we are. She actually just started it today. There are a multitude of medication options on the market and they all affect the patients a little differently. We're crossing our fingers that it helps without the side effects.

She wasn't in a good place with it all yesterday. She felt like her body was letting her down, like there was something wrong with her brain. I told her that there's nothing wrong with her, that she's just different...and that different is a good thing. I told her that I have it. Several other members of the family have it. Lots of famous people have it.

She still wasn't convinced.

Until this morning, when this article came across my interner browser. In it, a few of her favorite people in the world who happen to have ADHD just like she does.

Michael Phelps, Adam Levine, Justin Timberlake, will.i.am.

Suddenly, it was okay.

And it is okay. Millions of people live with this condition every single day. I'm one of them.

So are my girls.

We are creative. We invent things. We build things. We start companies. We think outside of the box. We brainstorm. We see the world a little different than everyone else does...and all of it is okay.

ADHD isn't who I am. It isn't who my girls are either. It's just a part of who we are.

You might need to be a little patient with us, but I promise...we're worth it.

1 comment:

  1. I think I have the inattentive type, as well, though like you, have never sought a professional opinion. In all likelihood, I won't. N has been diagnosed with all the testing and that whole process which is still beyond frustrating to me. We finally have a great therapist, who really helps N with coping skills, and with me. She tells me if I am being too 'soft', making excuses for him. I needed that, from an objective outsider. Objective outsider being the key. She also helps Z understand why things aren't always 'fair'; fair being the catchphrase they hear constantly, and I am doing my best to teach them that everyone may be equal, but everyone is not the same, and different does not mean unequal. That concept has not come easily. I, personally think that N has a combination of both subtypes, I see behaviors of both everyday and some are just him. He's N. I get so frustrated when asked about behaviors and reactions, being asked to label them. He is just himself.
    We, too, see a huge benefit in the meds, for a short time though. Because, within a few weeks come the side effects. I've tried a couple meds and both had side effects that were worse than his behaviors. The rage that explodes and the pent up energy, I so know exactly what you mean. Caffeine, yes. I gave him the same choice. He is choosing at this time to not be medicated, and I don't blame him. And if/when he decides he would like to try something else, that will be his choice, and I will do everything in my power to help him. Some people in our lives get frustrated with how I 'deal' with his ADHD. He is 10, but it is STILL his body, and ultimately his choice. I can't possibly know how the meds affect him and his moods and his thoughts; I just know that when he is on them, he is different. He doesn't like that, and I don't either. As far as I am concerned, I would rather him be himself and hyper or have to redirect him more than other children, than medicated to accommodate people who want 'normal'. Normal is a fallacy. Easier is what they want, and I'm just not willing to impose on my son for that.

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