Wednesday, October 21, 2009

About ADHD

If you’re waiting for your child to outgrow ADHD … don’t. Approximately 60 percent of children with the condition will carry it into adulthood. Early evaluation and treatment, when appropriate, can pre-empt years of more serious problems. As the ADHD child gets older, his symptoms — and his means of coping with those symptoms — can intensify. A 10-year study currently under way has already found that young adults are at high risk for “markedly elevated rates of antisocial, addictive, mood and anxiety disorders.”

Over treatment and misdiagnosis are still problem areas. Some bioethicists believe that pharmaceutical companies are pushing their drugs, leading to medical treatment in patients who don’t need it. At the same time, a true case of ADHD is a neurobiological condition — a medical problem, not just a psychological one — and does warrant the use of prescribed medicine.

A major part of the problem is that most primary-care physicians are simply not trained yet in diagnosing ADHD. The disorder was not formally recognized as a disability until 1998, and doctors are still catching up to the ongoing research and the efficacy of treatments. Seek physicians with experience in ADHD diagnosis, and educate yourself.

ADHD is most effectively treated with a combination of medication and therapy. Prescribed medicines are effective for approximately 50 percent of the patients who need them. But even in the patients who do respond, only about half of their symptoms are relieved. The drugs won’t necessarily treat problems with organizational skills, coping socially and the overwhelming emotions associated with underachievement and failure. Cognitive psychotherapy can reach where medication does not.

It is still undetermined whether ADHD can be beat. We don’t know yet whether adult patients can be free of the condition after stopping medication and therapy. (Children may have not carried the condition into adulthood.) While on a treatment program, people do learn to relieve impairments and decrease distress. But it is unknown whether patients can maintain long-term control over symptoms on their own when the course of meds is ended.

Half of all people with ADHD have other disorders as well. Depression and anxiety are the most common conditions that “co-travel” with ADHD. These co-travelers present a major problem because they mask ADHD; physicians will often recognize and treat the mood disorder, which they’re familiar with, but miss the ADHD completely.

As in children, adults with ADHD are also more likely to have asthma. Other co-travelers, so to speak, include smoking, drug or alcohol abuse, and obesity — all of which signal ways in which people try to cope or self-medicate.

It's very real. Sure -- many people in our generation or older can remember a time back when behaviors that mirror ADHD/ADD were punished since they looked like plain, old disobedience or out of control impulsiveness. You, as parent, know your child best. But also recognize when it's not only okay, but in your child's best interest, to seek the advice of experts -- your son or daughter likely isn't intentionally trying to forget homework assignments night after night, and treatment of a perhaps previously overlooked medical condition could make a world of difference to you all.

(Research by John Tesh)

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