Doctor: ADHD Does Not Exist

first_imgTime 14 March 2014Over the course of my career, I have found more than 20 conditions that can lead to symptoms of ADHD, each of which requires its own approach to treatment. Raising a generation of children — and now adults — who can’t live without stimulants is no solutionThis Wednesday, an article in the New York Times reported that from 2008 to 2012 the number of adults taking medications for ADHD increased by 53% and that among young American adults, it nearly doubled. While this is a staggering statistic and points to younger generations becoming frequently reliant on stimulants, frankly, I’m not too surprised. Over my 50-year career in behavioral neurology and treating patients with ADHD, it has been in the past decade that I have seen these diagnoses truly skyrocket. Every day my colleagues and I see more and more people coming in claiming they have trouble paying attention at school or work and diagnosing themselves with ADHD.And why shouldn’t they?If someone finds it difficult to pay attention or feels somewhat hyperactive, attention-deficit/hyperactivity disorder has those symptoms right there in its name. It’s an easy catchall phrase that saves time for doctors to boot. But can we really lump all these people together? What if there are other things causing people to feel distracted? I don’t deny that we, as a population, are more distracted today than we ever were before. And I don’t deny that some of these patients who are distracted and impulsive need help. What I do deny is the generally accepted definition of ADHD, which is long overdue for an update. In short, I’ve come to believe based on decades of treating patients that ADHD — as currently defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and as understood in the public imagination — does not exist.Allow me to explain what I mean.Ever since 1937, when Dr. Charles Bradley discovered that children who displayed symptoms of attention deficit and hyperactivity responded well to Benzedrine, a stimulant, we have been thinking about this “disorder” in almost the same way. Soon after Bradley’s discovery, the medical community began labeling children with these symptoms as having minimal brain dysfunction, or MBD, and treating them with the stimulants Ritalin and Cylert. In the intervening years, the DSM changed the label numerous times, from hyperkinetic reaction of childhood (it wasn’t until 1980 that the DSM-III introduced a classification for adults with the condition) to the current label, ADHD. But regardless of the label, we have been giving patients different variants of stimulant medication to cover up the symptoms. You’d think that after decades of advancements in neuroscience, we would shift our thinking.Today, the fifth edition of the DSM only requires one to exhibit five of 18 possible symptoms to qualify for an ADHD diagnosis. If you haven’t seen the list, look it up. It will probably bother you. How many of us can claim that we have difficulty with organization or a tendency to lose things; that we are frequently forgetful or distracted or fail to pay close attention to details? Under these subjective criteria, the entire U.S. population could potentially qualify. We’ve all had these moments, and in moderate amounts they’re a normal part of the human condition.However, there are some instances in which attention symptoms are severe enough that patients truly need help. Over the course of my career, I have found more than 20 conditions that can lead to symptoms of ADHD, each of which requires its own approach to treatment. Among these are sleep disorders, undiagnosed vision and hearing problems, substance abuse (marijuana and alcohol in particular), iron deficiency, allergies (especially airborne and gluten intolerance), bipolar and major depressive disorder, obsessive-compulsive disorder and even learning disabilities like dyslexia, to name a few. Anyone with these issues will fit the ADHD criteria outlined by the DSM, but stimulants are not the way to treat them.What’s so bad about stimulants? you might wonder. They seem to help a lot of people, don’t they? The article in the Times mentions that the “drugs can temper hallmark symptoms like severe inattention and hyperactivity but also carry risks like sleep deprivation, appetite suppression and, more rarely, addiction and hallucinations.” But this is only part of the picture.First, addiction to stimulant medication is not rare; it is common. The drugs’ addictive qualities are obvious. We only need to observe the many patients who are forced to periodically increase their dosage if they want to concentrate. This is because the body stops producing the appropriate levels of neurotransmitters that ADHD meds replace — a trademark of addictive substances. I worry that a generation of Americans won’t be able to concentrate without this medication; Big Pharma is understandably not as concerned.Second, there are many side effects to ADHD medication that most people are not aware of: increased anxiety, irritable or depressed mood, severe weight loss due to appetite suppression, and even potential for suicide. But there are also consequences that are even less well known. For example, many patients on stimulants report having erectile dysfunction when they are on the medication.Third, stimulants work for many people in the short term, but for those with an underlying condition causing them to feel distracted, the drugs serve as Band-Aids at best, masking and sometimes exacerbating the source of the problem.In my view, there are two types of people who are diagnosed with ADHD: those who exhibit a normal level of distraction and impulsiveness, and those who have another condition or disorder that requires individual treatment.For my patients who are in the first category, I recommend that they eat right, exercise more often, get eight hours of quality sleep a night, minimize caffeine intake in the afternoon, monitor their cell-phone use while they’re working and, most important, do something they’re passionate about. Like many children who act out because they are not challenged enough in the classroom, adults whose jobs or class work are not personally fulfilling or who don’t engage in a meaningful hobby will understandably become bored, depressed and distracted. In addition, today’s rising standards are pressuring children and adults to perform better and longer at school and at work. I too often see patients who hope to excel on four hours of sleep a night with help from stimulants, but this is a dangerous, unhealthy and unsustainable way of living over the long term.For my second group of patients with severe attention issues, I require a full evaluation to find the source of the problem. Usually, once the original condition is found and treated, the ADHD symptoms go away.It’s time to rethink our understanding of this condition, offer more thorough diagnostic work and help people get the right treatment for attention deficit and hyperactivity.Dr. Richard Saul is a behavioral neurologist practicing in the Chicago area. His book, ADHD Does Not Exist, is published by HarperCollins. read more

Antigua Puts on a Good Show

first_imgJohnny Alfred.Last night at the Lindo Park in first game of the invitational basketball tournament between Dominica National Basketball team and the Big Banana Express of Antigua gave the fans the opportunity to see the Dominica Team in Action. While being overmatch in size and manpower the Express team put on a show that anyone would be proud off, the game remain close . Every time the Dominica team would take a 10 point lead Express came roaring back with some great 3 point shooting by Antigua national team player Marlon Charles. But the experience play of Johnny Alfred on the inside kept Dominica in the lead.Final scores was Dominica 75 points to Big Banana Express 62 points. See below for score board,DominicaBernard Mills – 5 rebounds, 5 steals and 6 assistDavidson Toulon – 9 pointsJunior Isles – 9 points, 13 rebounds, 1 steal and 3 blocksJohnny Alfred – 19 points, 13 rebounds, 2 steals and 2 blocksGarth Joseph – 11 points and 4 reboundsAntiguaMarlon Charles – 27 points, 11 rebounds, 3 assist, 5 steals and 1 blockKareem Blair – 12 points, 13 rebounds, 2 assist and 1 stealBarry Hodge – 9 points, 3 rebounds, 6 assist and 1 stealStellan Braithwaite – 4 points, 7 rebounds, 2 assist, 1 steal and 2 blocks.Games will continue at the Massacre Hardcourt on Saturday from 8.30 pmBy: Mickey Joseph Dominica Amateur Basketball Association 33 Views   no discussions Sharing is caring! Share Tweetcenter_img NewsSports Antigua Puts on a Good Show by: – September 2, 2011 Share Sharelast_img read more

L.A. council must say no to DWP rate-hike grab

first_imgThe Los Angeles City Council should do more than just delay the Department of Water and Power’s planned rate hikes. It should flatly say no. DWP officials say they need the extra cash to increase staff and replace aging, beat-up equipment. DWP officials don’t say why the equipment is so beat up and worn, and if that’s indeed the case. Also, they don’t say why there’s a sudden staffing crunch. Yet still they are asking the L.A. City Council and taxpayers to approve double-digit rake hikes over the next two years on their assertion that there’s a looming power crisis. That’s simply not enough to go on. In the past, power companies have massaged, manipulated and blatantly distorted energy needs, supply and costs to get rate increases. A near-textbook example of that is the rate-hike grab by San Diego Gas and Electric for 2008. The Division of Ratepayer Advocates, an independent arm of the state Public Utilities Commission that represents consumers, found that SDG&E wildly inflated salary projections, employee benefits, cost of customer-service operations, and the price of equipment maintenance by tens of millions. The cost fudging was more than 30percent above the industry average. But it’s a straw-man question. Even if DWP officials could give such a guarantee – and that’s highly questionable – that should not be the basis for the council’s granting the rate hike. The hike should be based solely on need and proven performance. The DWP hasn’t made a firm case for either. But that’s never stopped city officials from rubber-stamping fee and tax hikes before, or approving overblown salary increases for city officials – especially themselves. Los Angeles is in a serious budget crisis, and city leaders are asking taxpayers – as always – to bail the city out of that crisis. That’s bad enough, but don’t make it worse by asking taxpayers to bail the DWP out of a crisis that isn’t a crisis. The council must say no to the DWP’s rate-hike grab. Earl Ofari Hutchinson, an author and political analyst, is a frequent contributor to the Daily News. He blogs at local news?Sign up for the Localist and stay informed Something went wrong. Please try again.subscribeCongratulations! You’re all set! AD Quality Auto 360p 720p 1080p Top articles1/5READ MOREWhicker: Clemson demonstrates that it’s tough to knock out the champEach time, the energy and utility companies swear that the increases will be the last they’ll demand in the foreseeable future. Of course, that’s never true. If the DWP really has equipment and staffing problems, it’s certainly not because of a lack of money. The DWP has one of the highest operating budgets of any city agency. But the money the DWP shells out to its top officials and its employees is nothing short of scandalous. David Nahai, the new DWP chief, will bank more than $300,000 in salary. And DWP workers are on average the runaway highest-paid city employees. In fact, their pay tops that of many of their private-sector utility counterparts. L.A. residents are plainly fed up with the City Council and Mayor Antonio Villaraigosa’s incessant demands for more and higher fees and taxes without any clear explanation of why the money is needed, let alone assurances that the money will markedly increase the level and quality of services to residents. With the resistance to the tax and fee increases mounting, city officials know that sooner or later taxpayer fury could easily translate into voter fury at them. That’s probably why some City Council members say they want assurances from the DWP that the proposed rate hikes will put an end to summer brownouts and power shortages that thousands in the San Fernando Valley and other parts of the city sweltered through last summer. last_img read more