Comments on: ADHD Myth #2: An Excuse for Irresponsibility

By: Isiah Palanza

Isiah Palanza — Thu, 15 Sep 2011 07:52:15 +0000

a proper good see of ADHD Roller Coaster: “Is It You, Me, or Adult A.D.D.?” · ADHD Myth #2: An Excuse for Irresponsibility Comfy love it

By: Jaelle n'ha Gilla

Jaelle n'ha Gilla — Mon, 02 Mar 2009 10:51:07 +0000

Gina, I’m glad you included that sentence “Yes, it’s true that some adults with ADHD use the diagnosis as an excuse”. I think actually everybody uses one or the other excuse to behave in a way they would not want to see in others. I include myself into that equation. Haven’t we all been more bitchy because we were sick that day, and rationalized later “Oh, but that was because I was sick”?
I don’t like the generalization much that this is a “myth”. It’s not. It’s human behavior and some people use it more, some less, and some have to work harder than others if they want to avoid it. I’m not saying it is always avoidable. All I’m saying is that it is there all the time.

I get the idea though, that ADD patients have other mechanisms of running decisions.

By: Gina Pera

Gina Pera — Thu, 19 Feb 2009 21:43:28 +0000

Thanks for the kind words.

Readers of your blog learn a lot, too!
http://www.beforeyoutakethatpill.com/

By: Gina Pera

Gina Pera — Thu, 19 Feb 2009 21:25:42 +0000

Dr. B — Don’t we use the rat model because rats are so similar to humans?

Re: the impaired appetite. Decreased appetite was just one of the common problems with IR Ritalin (and other IR stimulants), which is why the current thinking advises long-acting, gradually released medications like Concerta, Vyvanse, Daytrana, etc.

Anecdotally speaking, I don’t hear that complaint from parents as much as I used to. And there are workarounds. I’m no expert in this, but I see the same kind of poor medication protocols with kids as I see with adults: often too high a dosage (or not high enough) on IR stimulants, which just cause more problems for most people; no way around it. So, it’s hard to know, from these studies, what’s the result from poor clinical practices or best clinical practices.

As for the growth suppression, I think the latest word on that is covered by Dr. James Swanson, on Web MD: http://www.webmd.com/add-adhd/news/20070720/adhd-drug-does-stunt-growth

By: Gina Pera

Gina Pera — Thu, 19 Feb 2009 21:13:30 +0000

That’s a great story, Monica — and a prime example of how adults with ADHD often have to “self-advocate.”

By: Doug Bremner

Doug Bremner — Thu, 19 Feb 2009 21:12:00 +0000

But you have a lot of good stuff here. I am learning a lot of new stuff and I am a shrink!

By: Doug Bremner

Doug Bremner — Thu, 19 Feb 2009 21:11:32 +0000

Yes indeed. Sacrificing themselves for science, poor little things. I used to do research until I had a dream about a giant rat knocking on my door. Anyhoo impaired appetite with ritalin is a big deal for moms trying to get their boys to eat and grow. The whole kids and meds thing is a big guilt trip no matter what you do. From what I remember the growth thing amounts to about an inch over the lifetime and your point that the negative effects of the disorder is a good one.

By: Gina Pera

Gina Pera — Thu, 19 Feb 2009 20:45:57 +0000

P.S. As far as long-term effects on brain function — rat or human — I’ll have to get back to you. As far as I’m aware, no research has demonstrated negative effects on brain function, and the impact on height, etc. seems to be miniscule at best. But I’m not remembering the latest research on this.

But, as ADHD experts such as Yale psychologist Tom Brown like to point out, we do know the risks of untreated ADHD are significant and severe.

I had to look up the ACNP (American College of NeuroPsychopharmacology). I’m betting many rats gave their lives for those poster sessions, bless their little rat hearts.

By: Gina Pera

Gina Pera — Thu, 19 Feb 2009 20:23:16 +0000

Yes, stimulants have been shown to help with these other manifestations, but with adults that’s mostly from clinical observation and from the adults themselves (and their loved ones, bosses, friends, etc.). It would be difficult to measure improvements in financial management, cooperation, etc. But we do have studies showing the increased rates of bankruptcy, divorce, physical altercations, encounters with the criminal justice system, more lost time on the job, more on-the-job accidents, etc. with adults who have untreated ADHD.

There is a significant body of research on adult ADHD driving skills and medication, though. Driving safety is markedly improved with the use of stimulant medication.

But for late-diagnosis adults, who have a 75% chance of having a comorbidity, treatment is more complicated; it’s seldom a simple matter of taking a stimulant.

Sometimes they carry a lifetime of accumulated sleep debt (ADHD can adversely impact sleep, too), so that needs to be addressed. Sometimes they are depressed and anxious, from the lifetime’s pileup of frustrations and negative feedback.

And, with women, they often aren’t diagnosed until they hit peri-menopause or menopause, when fluctuating hormones wreak havoc with neurotransmitters, pushing them into worse cognitive function. So, sometimes thyroid and other metabolic issues are involved. So are chronic deficiencies in certain vitamins and minerals (particularly Bs, magnesium, calcium, potassium, etc.).

Finding a physician who can carefully address all these issues is tough! It’s tough even to find a physician who knows that, for some people, the AMP medications will push them into irritability and anger. I really like Dr. Charles Parker’s blog because it covers all the bases: http://www.corepsychblog.com

By: Doug Bremner

Doug Bremner — Thu, 19 Feb 2009 20:07:50 +0000

Yes, that is informative. So do stimulants help with these other manifestations of ADHD? And what is your read of the literature on long term effects on brain function and growth from rats and (if there is any data) in humans? I remember seeing a rat poster once when I was wandering around the poster session at the ACNPee pee. meeting (little joke, har har)