Interesting Medication TidbitJun 25, 2014I came across a very interesting tidbit at my monthly CHADD meeting early in June. One of the parents had noticed over the months that her 9-year-old son was seemingly under-medicated. Her suspicion was that the change had happened when he switched to longer acting formulation of Methylphenidate (Ritalin.) She wasn't sure if it was that the dosing didn't translate or if he just wasn't responding as well. Despite the doctor's reluctance, she pushed to have her son put back on three times daily of short acting Methylphenidate. To the great surprise of many, this was much, much more effective. He seems like he is a whole new kid. (Of course the parents are doing a ton of behavioral stuff with him. But now that he's appropriately medicated, they are really seeing results.) Pharmacologically, there is no difference in the active ingredient in Ritalin, Methylphenidate (generic name and the actual ingredient,) Metadate, Ritalin LR, SR, ER, Concerta, Daytrana, and even Focalin. But most patients will tell you that they respond better to one or more than others. The conventional wisdom is that the longer lasting more sophisticated delivery systems are more beneficial. Clearly, as in this boy's case, that is not always true. I think the take away here is that it is important to think outside the box and not assume anything when it comes to trying stimulants. It really is trial and error. But, when we get it right, it can be life changing. More on meds coming up.
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Fighting "overwhelm"Jun 23, 2014When we get overwhelmed our functioning becomes radically diminished. I would imagine that is the same for most people. Maybe it is just that as ADHD'rs we are more prone to overwhelm? When I was going through coaching school I developed a coaching model about the many different causes of overwhelm. I think there were 12 or 13. However, my experience working with clients since then has taught me that there are three main causes. The first main cause is our lack of effective executive function as it relates to decision making. But that is a whole other post. More on that later. The second is anxiety which is usually rooted in negative thought patterns, projecting negative outcomes. I think I'll tackle that in another post too. The third, which I want to write about today it the idea of missing information. This is also a way in which our negative thought patterns can effect us. Often we become overwhelmed when we are missing a key piece of information that then doesn't allow us to proceed. Add in the fact that our tendency is to project the worst possible outcome when mentally filling in the blank, and we can become paralyzed and not even seek an answer to our question. For example, I have a client who is working toward getting in to a very specific grad school program for a specific career. She became overwhelmed by the process of getting accommodation for taking the GRE's. She expressed anxiety about getting a formal diagnosis, what would be accepted, how to find this out, does she even need to take the GRE's to get in to this specific program, will she be qualified to get into this program anyway... I think you get the picture. She had lots of blanks to fill in and very little real information to grab on to. I would suggest the best thing to do is to make a list, prioritize it, and start by answering one question at a time. In this case, if she doesn't need to take the GRE's to get in to this program, all the other questions are moot. If she does, that informs her on which of the next questions she needs to get answered next.
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The Sweet SpotJun 23, 2014I think that it's important to know that as ADHD'rs we need to live in what I call the "Sweet Spot" between being understimulated and overwhelmed. If we are bored or understimulated our brain doesn't produce the dopamine necessary to pay attention and we effectively shut down. If we are overwhelmed our brain becomes overstimulated, goes into panic mode... and we shut down in a different way. More on being overwhelmed in the next post.
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What to tell your kids about testing?Jun 3, 2014I had a question from a client today. She wanted to know what to tell her nine year old daughter about why she was going to neuropsych testing. My response was atypically brief, so I thought I would just post it too. I would point out that you know she is struggling with lots of stuff. The testing is to see if you she has ADHD just like mom and aunt –––. If she does, that's actually a good thing, because it can be dealt with and her life can get easier and less stressful.
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Daily scheduleMay 5, 2014
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Rock the radioApr 28, 2014Many of the mundane tasks of life bore us ADHDers to the point that we avoid them, rush through them, or hate them in a way that is totally out of proportion to how much of a bummer they should actually be. Listening to the radio is one thing that I have found really helps me get though those daily and weekly tasks. I guess it began in high school. I got one of those shower radios and listened to music mostly while I was getting ready in the morning. I found it easier to get out of bed and get in to the bathroom and get on with my day. I started doing it again at some point in my adult life. I listen to the radio, mostly sports now or NPR when I'm in the bathroom in the morning, or when I'm in the kitchen. Podcasts are also a great thing to take advantage of. I might not survive my hour or two in the kitchen every weekend without NPR podcasts, the Moth, and Risk. They are entertaining enough that I can get anything done without it seeming like a total chore.
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