Taking "the road less traveled" in treating ADHD
February 18, 2009 11:35 PM   Subscribe

If you don't see any patterns in your data, yet day-to-day fluctuations persist, he is reacting to something you aren't tracking. Look elsewhere. A heartrending (and long) online log of one father's 10-year struggle to make sense of his child's ADHD and find a way to treat it without medication.
posted by Deathalicious (60 comments total) 9 users marked this as a favorite
As someone with pretty severe ADHD as a child, whose parents tried everything under the sun to cure me, before eventually trying (and having success with) medication, I found this story painful on a number of levels. Now that I am about to get married, the prospect of having to deal with this one day myself as a parent is equally scary.
posted by Deathalicious at 11:40 PM on February 18, 2009 [2 favorites]

A review of the literature I read concludes that no matter what therapies you pursue, teaching kids with ADHD coping strategies is more effective than any other strategy.
posted by Peach at 12:18 AM on February 19, 2009 [4 favorites]

And why is it that all my mom's friends who believed in ADD-diet links and so on had names like Gaia WildOne?
posted by dunkadunc at 12:34 AM on February 19, 2009

Mein eyes! The goggles do nothing!
posted by Pope Guilty at 12:40 AM on February 19, 2009

Yeah, I have trouble taking any website with such horrible layout, colors, and fonts seriously.
posted by dunkadunc at 1:02 AM on February 19, 2009

I read all of this, and it was long (the actual story is readable black-on-white text) and I am generally skeptical, but it was compelling - he tries so hard to observe and experiment to figure out what works for his children, and it doesn't work out perfectly, but he seems to do the best he can.
posted by dreamyshade at 1:23 AM on February 19, 2009 [1 favorite]

Props to the guy for trying. I confess I would not have gone about it the way he did though, which makes me think about my way and his way.

What about other inputs - specifcally tv, videos, toys etc?

Life is complicated and the various ways life has been so thoroughly commodified it's hard to separate the wheat from the chaff. 'Wheat' being stuff you need and/or that is amusing and augments life and 'chaff' is stuff that diminishes the wheat even if it seems harmless in small amounts.

MY point is his "Look elsewhere" seemed to have a huge blind spot in it. A blind spot that kind of broke my heart.

I think this commodification is despicable but most tellingly, it is damn hard to parse what is comodification and what is just 'stuff.' (I mean, how much 'Winnie the Pooh' branded spoons, pillows, toothbrushes, slippers do you need to have? What is the point where cute becomes too much/pathological? As long as they can keep that line blurry, people's appetites will lead them towards excess. I speak from my own experience.)

We're raising our kids in a spare white room with four toys each. The toys are actually just sticks. What, you think that's too many sticks?

posted by From Bklyn at 2:42 AM on February 19, 2009 [3 favorites]

I meant to just skim read his story, but it really did draw me in. There's a lot of denial in there, which he admits and then backslides on, then admits again, etc.

I think all the sneaking of foods could have been headed off at the pass if he'd been stricter about the diets at the beginning - by the time your kid is old enough to buy snacks for themselves, it's a bit late to be trying to eliminate snacks. If you're going to try a restrictive diet, then do it completely and do it early.

As he points out but doesn't really address properly, his own and his wife's eating habits were not a good model for his kids. Why were there so many packets of biscuits and tubs of icecream in the house when you're a family of two overweight adults and three kids with dietary issues? He avoided that issue for a long time.

But his sincerity and love for these kids is plainly obvious. And I teared up at the time when the kid offered to spraypaint a sorry message on the lawn for his mum. I hope all five of them go on to be happier and healthier in the future.

Oh, and the formatting/colours aren't that bad, but damn, run a spellchecker over the page!
posted by harriet vane at 2:49 AM on February 19, 2009 [1 favorite]

What is the point where cute becomes too much/pathological?

posted by benzenedream at 3:25 AM on February 19, 2009

These children break your heart. As a teacher in an after-school sports program, I encounter dozens of them every year. Some of the parents know what's going on, some still deny that their children are outside the norm. Sometimes the staff will joke among themselves-- "whoah, time to adjust the medication"-- but after reading this article I think I need to stop that. I see two types of these children (to oversimplify)-- the ones who understand that there is something wrong; their heartbreaking confusion when everyone else knows what to do, is very frustrating. They aren't trying to be bad, they often literally do not understand that you can stand still and listen, process the language, and know what to do. They cannot do it-- that someone is imparting useful information via language is incomprehensible. Not the language itself, but the act of teaching.

The other ones have parents who have laser-focused on them in an effort to get and hold their attention. These kids are on their way to be ruined. They have been spoiled for good and loving reasons (not just simple overindulgence), but the effect is blind egoism; if you are not focused on them and only them they will disrupt the class, sometimes violently (I have been, and have observed others, hit, pushed, screamed out, or the simple expedient of causing yourself an injury, which is easy do to on the ice).

Anyway, dealing with these kids equitably is probably the hardest part of my job, and the easiest to complain about or refuse to deal with because "whoah time to adjust the medication".

Thanks so much deathalicious for an eye opener of an article. I hope the insights will make me a better teacher.
posted by nax at 3:26 AM on February 19, 2009 [12 favorites]

What happens to kids like this when they become adults?
posted by dydecker at 3:39 AM on February 19, 2009

Really. Wow. I feel for him. I really do. I don't know if I would have done this the same way, but...

Reading over this, I wonder how much our generation's oh-so-over-diagnosed ADHD is similar to the way we diagnose schizophrenia; a common grouping of symptoms with many possible causes is easy to group together into one 'disorder.' I've worked with children who were (and should have been) diagnosed as ADHD, and I have known many people who claimed to have been diagnosed with the same.

Reading this leads me to wonder how many symptoms overlap with mild autism/aspergers/sheer boredom/whatever, and the implications for what that means about what children latch onto as 'important' stimuli in the environment they are raised in. For instance, if you were to test my responses to flashing advertisements after a few years surfing the web, from the perspective of someone looking for a response to adverts, I think I might be considered a little sub-par in noticing these things. Does that mean I am attention deficit for flashing ads? What if I were over stimulated for X during childhood? Or if I didn't come to associate that stimuli with something socially/emotionally/vitally important?

Anyway, insert the blah-blah-society-is-doing-it-all-wrong comment here, and I really would appreciate any input. I really would.
posted by Avelwood at 3:41 AM on February 19, 2009

I mean not to spoil the ending or anything, but after all those years or effort on his diet, the kid doesn't end up massively different. From last year:

"He is doing much better." reports the social worker. "He's still failing 4 out of 6 classes, but he doesn't refer to his teachers as stupid whores, and he's not calling his aid a f**king bitch any more."

That's pretty depressing, and you'd have to imagine a teenager with an attitude like that will end up as an adult in prison in a few years.
posted by dydecker at 3:46 AM on February 19, 2009

Mein eyes! The goggles do nothing!

Yeah, I have trouble taking any website with such horrible layout, colors, and fonts seriously.

Dude's blind, give him a break.
posted by plant at 4:15 AM on February 19, 2009

What happens to kids like this when they become adults?

posted by loquacious at 4:47 AM on February 19, 2009 [3 favorites]

And why is it that all my mom's friends who believed in ADD-diet links and so on had names like Gaia WildOne?

Because a data set of N="People I Know" is not very scientific?
posted by absalom at 5:08 AM on February 19, 2009 [3 favorites]

This guy is 100% right. It might be too late for his kid, sure, there might be permanent damage, but addressing diet -- insofar as it works -- is way more benign than drugging the kid into submission, and probably helps. Our kids aren't ADHD (they just have Crohn's and kidney disease respectively) but dietary therapy is doing OK. Once you start down that path, it's amazing how well it can work.

You can always scoff and say only idiots reject the Big Pharma paradigm that more drugs has to mean more control and thus only woolly-headed fools would look for less harmful ways to save their children. God knows we've heard that one enough. But if you have a child with a serious chronic illness, you actually have to make that decision yourself. And let me tell you, it is not a trivial one.

harriet vane, the road to figuring out just how serious you have to be to make real dietary changes is not quite so simple as you seem to believe. In American society, it is damn difficult to realize that "just a little snack" really can destroy three weeks of salads. My daughter is the one with Crohn's, which is after all a disease directly of the digestive system and so it's much easier to believe prima facie in a dietary cure, but after our first real success with her it turned out, about a year ago, that her friends at school were giving her chocolate bars. She had enjoyed the bad-girl rep (so to speak) of eating whatever people gave her.

OK? She's not stupid. She represented Puerto Rico at the national MathCounts competition that same year, she speaks three languages, she worked through geometry in five weeks, entirely on her own, after her teacher gave her the book -- and got an A on the final. She's really not stupid. But she was thirteen years old, and peer pressure is amazing at that age.

When she realized that these minute amounts of sweets were actually making her worse again -- and I do consider internal bleeding to be a significant indicator of "worse"; Crohn's is just all-around a more noticeable illness than the behavioral changes in ADHD -- she realized what she was doing. She stopped eating sweets. And hasn't had symptoms for the last year -- so in her case, despite all professional claims to the contrary (by which I mean, we had to stop going to the gastroenterologist because he still claims that improvement after dietary change is entirely random chance), dietary changes work.

But even with easily measurable symptoms, it was very difficult to learn what's what, and even harder to take it seriously enough to really and fundamentally change our diet. If behavioral symptoms were our only guide, I'm not sure we would have done as well as this guy.

From Bklyn, it might very well be that our psychological environment contributes to ADHD -- certainly the incessant din of television and commercialism has to be the psychological equivalent of high-fructose corn syrup -- but once you start reading the literature, these digestive problems influence everything. And our society is just so incredibly blasé about the notion that there could be anything at all wrong with eating pure sugar after evolving as half-starved hunter-gatherers with a richly omnivorous diet. And then there is just the fact that everybody's kids watch television and they're not ADHD (OK, they all eat the same crap, too -- but it's just easier to believe in genetic variation in digestion, I suppose, than in wide genetic variation in psyche.)

One thing's sure, though -- when something threatens your kids, you'll react in one of two ways. Either you'll go into denial, or you'll go entirely rabidly obsessed about whatever theory you're currently pursuing. Personally, I tend towards denial and my wife locks onto rabid obsession.

It is not my denial which is saving our children. It is not my denial that has allowed our daughter to avoid getting her intestines cut out in what passes for therapy, and it is not my denial that has allowed my son to keep his functional kidneys. Maybe it's blind luck -- certainly the doctors think so, usually (sometimes you get a glimmer of insight from one of them, but it's a scary thing to have the legal responsibilities of a doctor) -- but you know? Rabid obsession gets things done.

Good post, Deathalicious.
posted by Michael Roberts at 5:32 AM on February 19, 2009 [6 favorites]

This child has been in an endless cycle of diet-changing and "okay, here's the new set of rules we're going to try; everything in the last month is void, I'm totally restructuring your environment" switcheroo. He's been overmonitored by someone who demands exactly consistent output, without fluctuation. "Why did John react to a restaurant meal one night and not another? It was exactly the same meal, prepared the same way, as far as we could tell. " Any fluctuation is a Big Problem. I call that treating people like software, and dad's occupation came as no surprise to me. Look at this guy's diction: "Feingold compliant" is a great example. "Unauthorized toaster breakfast treat," "elimination trials," and so forth.

You know, it's not hard to stumble across the data showing that you can actually see ADHD show up on a PET scan. It's there, in the brain, frontal and possibly pre-frontal lobes. Once you know that, trying to solve the problem via diet for ten freakin' years is insane. I might as well fix my gallstones via a foot massage and some aromatherapy — all that air I'm inhaling ends up in my organs somehow, right? Now, after all the research this guy has done, he has probably read about PET scans and ... what, dismissed it? PET scans don't have a magic chip that automatically bias the results in favor of Big Pharma. No, dad had made up his mind early on:
"We are going to manage his symptoms with diet." I declared flatly. — 1999
If this were IBS, or Crohn's, or juvenile diabetes, this would make sense. If the child had phenylketonuria, this would make sense. This, though, does not. I'm surprised dad hasn't put the child on a raw food diet (although it looks like he's getting close to it) and used an e-meter to check the color of his eyes. Over and over again, he becomes certain: "The conclusion was clear - John is highly sensitive to amines." And then something will defeat the hypothesis du jour and he'll be back to "It just doesn't make sense. None of it makes any sense." "I am faced with nothing but contradictions." That's probably a good sign that your overall approach is wrong, but, hey, let's burn this kid's entire learning experience growing up all so you can prove "it's the diet, stupid!"

Dad's a well-meaning crazy person whose ideology, ego, and obsession are systematically destroying any sense of stability, resilience, and initiative in this child's life. Ten years this kid could have been on a good, not perfect, medication, carefully titrated every six months or so, instead of a complete rollercoaster during which his childhood and chance to grow have been wasted. What's the biggest lesson this kid has learned? I'm a defective, bad boy who has to be controlled and can't even pick what I put in my mouth, and I cannot understand why what I can and cannot eat keeps changing. What are the chances that John is going to have absolutely no sense of permanence, respect for authority, or belief in himself by the time he's an adult?

It is a heartrending account ... for the kid.
posted by adipocere at 5:59 AM on February 19, 2009 [48 favorites]

This guy is trying to decipher this to obtain a diet to relieve a neurological condition.

"John's disorder produces ketones, and lots of them! "

False, the ultra low-carb diet you have him on produces ketones.

"The smoke, in this case ketones, spill into your brain and make you crazy. "

Ketones can be used by the brain in the absence of glucose. The presence of ketones in his brain is induced by the low-carb diet. Your kid's brain is not consuming its preferred source of energy, due to the diet you put him on, and you are attributing the "crazy" to the evil ketones which you, being in so deep you cant even imagine, don't realize you are responsible for.

"Pyruvate carboxylase (for example) could always underperform in a new, undocumented way. I can think of at least 6 reasons why the Krebb's cycle might skip a beat at this step."

Thank you for isolating Pyruvate Carboxylase (its in square F5 of the chart linked above) as the enzyme that is causing your son's ADHD. I would love to hear his "at least 6 reasons" why the TCA cycle might err at this particular enzyme.

... yada yada yada and I'm really tired of pointing out the mistakes in logic here.

I do not understand why he is treating this as a metabolic disorder. The only way I can see to obtain an effect even remotely close to that of Ritalin through dietary means would be to make sure that the kid is ingesting enough Tyrosine, a precursor of dopamine, the neurotransmitter that Ritalin supposedly keeps from dissociating from its receptor. This really is amateur hour nutrition and the most shoddy biochemical analysis I've ever come across.

The guy is experimentally inducing various dietary disorders on his kid and then is surprised that nothing seems to help his ADHD. He is trying to fit the proverbial dietary square into the neurological round hole and it simply is not going to work. I feel bad for the kid, if his metabolism wasn't fucked up before, it likely is now.
posted by clearly at 6:02 AM on February 19, 2009 [18 favorites]

When we brought John home in August he already had imipromine in his blood stream ... Although the drug suppressed some of his activity and aggression It did not lengthen his attention span or reduce his impulsivity.

OK! So we have a severe behavioral issue that was responding well to medicine - get that kid to a therapist specializing in children's psychology to keep up the good work, and chalk up the impulsivity and daydreaming to, you know, being a kid.

Instead we go on a years long trek in futility and failure. The shrink who took the kid off of the anti-depressant and put him on ritalin was wrong. Worse than prescribing antibiotics for a head-cold.

It may have been the time - in the 90's, psychology was in the final stages of shaking off the notion that children could not suffer from depression or anxiety disorders, and an ADHD diagnosis was a pretty potent tool in identifying and treating kids with persistent learning issues. To the point where it was over-used, a catch-all bin child psychologists who should have known better tossed lots of different issues into. Also in the 90's the industry seemed taken with "wonder drugs" - pop a pill for your troubles. Prozac, xanax for mommy and daddy, ritalin for junior - just get a script from the family doctor or specialist. This is a recipe for failure, as the talking cure works better without drugs than drugs work without therapy, and the combination works better than either alone for severe cases. It requires hard work to get it right - careful monitoring, tinkering with the dosages and types of medicine, weekly therapy sessions, especially at the beginning - which is why a lot of people don't get it right.

But, what really did the kid in, was his father's inability to recognize his own mental illness, and his wife's enabling. That journal is terrifying - flourine? Drunken Man's disease? Tyson Chicken? The Maillard reaction? The paranoia and obsession was way the hell out of hand. Absolutely heart-breaking.
posted by Slap*Happy at 6:04 AM on February 19, 2009 [7 favorites]

You can, indeed, modify your brain chemistry through diet. Eating foods with a lower glycemic index will help your concentration; too much glucose has been shown to interfere with concentration and clear thinking.

For those of you who don't know my post history, I'm an upper-level undergraduate neurobiology student who is on track to go to graduate school and get a PhD in neuroscience. Please run all this information past people who already are where I will be in a few years.

Adderall and Ritalin are stimulants. ADHD is not a well understood condition; if we in neuroscience don't know a whole lot about it, neither does anyone else. Ritalin is a dopamine and norepinephrine reuptake inhibitor (yes, it works similarly to SNRI antidepressants), which means it increases the amount of dopamine and norepinephrine that gets across a synapse (if a neurotransmitter is unabsorbed for too long, it will get reabsorbed, which is meant by the word 'reuptake' in the phrase 'selective neurotransmitter reuptake inhibitor'). This gives it a higher chance of being absorbed by the postsynaptic neuron. Adderall works slightly differently - it is an agonist, rather than an antagonist, and it also serves to get more dopamine and norepinephrine in your synapses.

Yes, there are side effects to any medication, but you need to investigate the risks of these versus the benefits. It's part of being an informed consumer and being a good advocate for your child's healthcare.

Michael Roberts, as for your case, the best I can recommend is that you read medical research thoroughly and understand it or get help understanding it. Know how these systems work normally and know what mechanisms screw up in your children's diseases. One of the more subtle benefits of scientific literacy - besides its obvious benefits of being able to know more about the world you live in and the principles by which the universe, Earth, and life operate - is that it helps immensely in maintaining your health, because your body does very specific things to keep itself alive and your body can fuck up on a macroscopic scale or a microscopic scale!
posted by kldickson at 6:15 AM on February 19, 2009 [1 favorite]

I reckon I had ADHD or something similar. I was a real little annoying shit at school, couldn't shut up, used to wander around the back during class, sit on my desk... but thankfully had above average smarts, was in all the advanced streams, took all the hard subjects, and was - if I do say so myself - a loveable rogue, not a "fuck you, teach!" type. So I was generally well liked and got away with a lot.

But thankfully mum+dad were anti game consoles, anti TV, anti sitting on my ass. I had v.bad asthma so they got me right into swimming from about age 5, and right into sport full stop. Plus I had a huge back yard because back then everyone had huge back yards.

A not-unusual day might have consisted of:
• Rise at 5am.
• Swimming training for 75 minutes or so. Hard swimming "squad" training, 3 - 4 kms.
• Ride bicycle to school 4km.
• Get to school AS EARLY AS POSSIBLE to play silly buggers with my mates before school. Start school dripping with sweat.
• Recess. Run amok.
• Lunch. Absolutely run amok. Cricket. Footy. British bulldog. Brandy. Whatever. Back to class absolutely dripping with sweat.
• Ride bicycle home. Find someone to play with. Maybe another 2 - 3 kms swim.
• Homework for 1 - 5 hours, depending on my age. Crank out some bicep curls and 50 pushups and 100 situps before bed.

Exercise, and loving parents who organised all that stuff and took an interest, saved me. I have absolutely no doubt. Looking back, I can't *believe* how active I was, and yet I still couldn't sit still in class.

I wonder how much lack of exercise helps with bad behaviour?

[I've just recently noticed, to my acute embarrassment, that every freakin' post I make is an anecdotal post about me or something I saw. Me me me me! Unlike, say a Malor or a pastabagel. Ah well.]
posted by uncanny hengeman at 6:19 AM on February 19, 2009 [5 favorites]

The kids would have been much better off if he had put them on the medicine right away. He could still do all the other things. It's not like the medicine solves all the problems. Instead of failing classes and swearing at teachers perhaps the kids would have passed the classes and at least gotten along passably with the teachers, and probably better with the other kids as well. What this father did was rob the kids of some of the better aspects of childhood.
posted by caddis at 6:29 AM on February 19, 2009

You know, it's not hard to stumble across the data showing that you can actually see ADHD show up on a PET scan. Once you know that, trying to solve the problem via diet for ten freakin' years is insane.

I am not a doctor, just an interested amateur, but it strikes me that the truth is the other way around. We know so little about the mind and brain that expecting a simple photograph of the organ to reveal explanations about a complex psychological disorder is insane, the 21st century version of the Rorschach test. I'd say trying to attack the problem through diet is quite rational, comparatively speaking.
posted by dydecker at 6:31 AM on February 19, 2009 [2 favorites]

Michael Roberts, I didn't mean to imply that it was simple to just figure out that too many snacks was a problem. I certainly wouldn't expect any kid, no matter how bright, to figure it out for themselves. They're kids, and every experience is new to them. I'd even suggest that it's a little *more* difficult for the bright kids, who are better at justifying their decisions to adults, and figuring out things ahead of their ability to make grown-up decisions.

I just noticed that the father kept edging around the subject - touching on it, withdrawing from it, ignoring obvious implications then diving into them and retreating again. I was thinking that it's the same reason I eat a chocolate from the vending machine after lunch two or three times a week, and drink a few too many glasses of wine each weekend, even though I know perfectly well that it makes me put on weight, and that I don't like that effect. I just do a bad job of giving the proper emphasis to long-term benefits vs short-term benefits. Food and the human brain have an extremely complicated relationship compared to food and the human body, which is complicated enough to start with.

I think this guy really wanted to do the right thing. And he didn't manage it, in my completely non-expert opinion. But it wasn't for lack of trying, or lack of love.
posted by harriet vane at 6:32 AM on February 19, 2009

@uncanny hengeman: posting about your own experiences makes this site what it is, don't knock it. Browse the sidebar sometime.
posted by RikiTikiTavi at 6:35 AM on February 19, 2009

Wow, kldickson, why didn't I think of that? I should be following research!

Thanks, I do that. It's very difficult to organize clinical trials for diet, essentially because (a) everybody lies about how much cake they eat anyway, (b) it takes insane concentration to be aware of everything you eat, much less to document it, and (c) there's really not much money in food. But mostly (b).

The metabolic reductionism route is pretty close to futile, as some of the vitriol above indicates (not that I'm pointing fingers at the three posts after mine above, but ... OK, I'm pointing fingers at the three posts after mine above). The sad fact of the matter is that we just don't know much about what goes on in the body at that level.

And yeah, there's stress involved in changing theories every few weeks. Let me assure you, there is stress involved. Perhaps we're crazy people, too. God knows every year that goes by without my wife being able to have a career based on her doctorate in theoretical physics because she's too busy reading more about, well, medical research, is another year of frustration and pain.

But anybody who actually has a child with a problem of this nature, and interacts with the sometimes well-meaning medical community, knows that they're shooting in the dark as much as Karl Dahlke, or me and my wife. With the added benefit that physicians are authoritarians and, as a rule, not very intelligent except in the very narrow sense rewarded by the medical school system.

At this point, I'm going to bow out of this thread, because I can definitely feel that good ol' flamage coming on. (Huh -- Firefox spell checking likes "flamage". That's kinda cool.) As I said above, you can respond with either denial or with rabid obsession to threats to your kids. I know that diet is working with my kids, even though many of our conclusions and logic are tenuous at best, and I see no reason to believe that ADHD isn't just another organic expression of the same fundamental dietary disorders I see here at home.
posted by Michael Roberts at 6:47 AM on February 19, 2009 [1 favorite]

Argh. Apologies, kldickson -- I should have had the flamage detector on earlier in the post, as well. You're right. Following medical research is a good thing. I'm going now.
posted by Michael Roberts at 6:50 AM on February 19, 2009

What happens to kids like this when they become adults?

They spend $175/hour every week to try to reconcile the adult minds interpretation of irrational childhood emotions and the associated psychic pain these internal conflicts create.

This dad is a motherfucking cock ass motherfucker. Where did I put my fucking adderall...
posted by Jeremy at 6:57 AM on February 19, 2009

DHA, good sleep, and avoiding foods I know I'm allergic to have helped me quite a bit. I'll take an amphetamine on bad days.
posted by mecran01 at 6:58 AM on February 19, 2009

I have a child diagnosed ADHD that is extremely difficult to control, and we've tried (are still trying) diet modification, although not to this degree.

It's difficult to explain to someone who hasn't lived through just how difficult this is to live with. You've got a child who is constantly disruptive. He has difficulty having friends because of his behavior (the day my 5 year old son came home and told me "they told me they don't want to be friends with me anymore") is one of my saddest on memory. His behavior problems (constantly seeking stimulation) end up having us having to separate him constantly from his siblings so they don't get hurt. It is a major strain on the marriage. We can't go out anywhere, including things like birthday parties, because of the problems that invariably result.

Wherever we go, we are often labeled as "bad parents." I'd grin and bear it if it could somehow help my son, but it's really frustrating that the same techniques that work with our other children, and are recommended by books and counselors, just plain don't work with him. We end up being extremely strict, actually, and keeping him under very close control because of his tendency to lose control. If he is unmonitored he will get more and more out of control until someone gets hurt. He doesn't watch TV, only a movie a week or so (for good behavior), because his behavior gets really bad after TV (more so network programming than movies).

Now, about diet. We're willing to try practically everything. I totally understand this guy. In our case, medication has been ineffective. The latest meds don't do much to change his behavior besides make him sleepy all the time and have to take a nap in the middle of the day. Stimulant meds make him more aggressive--and more focused--but I'm really less worried about school than I am about his social development. I'd rather have him likable than less distractable, if I am forced to make that choice. Foods, though--I don't have to go to the doctor ($$) and get a medication ($$) just for something that has little to deleterious effect on the little guy. He does get obviously worse if he's hungry (low blood sugar), so it is not entirely far-fetched to consider the effects of diet. Add to this the fact that the psychiatrist sees him about 5 minutes a month, and is making decisions off of that, and that I can't even *find* a new one for a second opinion because none of them return calls for an initial appointment--I just don't see where the drug approach is working all that well.

Yes, I know--it's unlikely that we've exhausted the pharmaceutical route. There are undoubtedly other ones to try. Believe me, although we'd prefer not to have to medicate if there was a pill that made it all better we'd be doing that, both for his sake and for the sake of the entire family that is stressed by this behavior.

I have nothing but empathy for someone who is trying to help with any tool at his disposal.
posted by RikiTikiTavi at 6:59 AM on February 19, 2009 [3 favorites]

nax: They aren't trying to be bad, they often literally do not understand that you can stand still and listen, process the language, and know what to do.

This. This this this this this this this.

uncanny, sounds like you might have just been hyper, not necessarily affected by ADD. Although it's true that I was not plunged into sports as a kid, I don't think I ever noticed (nor did my parents) any improvements in concentration after exercising or running around. For kids with severe ADHD, this is what your childhood is like: everyone seems angry or upset with you, and you don't know why. No matter how loving your parents are, your day to day interactions with others will lead convince you that you are a very bad person. You know that you are supposed to behave a certain way, but find yourself unable to do so and don't know why. The fact that you could do even an hour's worth of homework suggest, to me, that you probably did not have ADHD, just excess energy.

Personally, I think diet just might work for some kids with ADHD. The problem is that it doesn't look like there is one specific trigger or cause, so different kids will respond to different diets. There are arguments that kids with ADHD need to get a much higher level of B vitamins and omega 3 oils, for example.

The other problem is that in my experience ADHD can often exhibit the Hawthorne effect: go to an energy healer, start eating carrots, march around in circles, and for a few days you may notice a marked improvement. It doesn't last. And ADHD can respond positively for stressors ("You were able to be on time for the dress rehearsal, something you really cared about, why can't you be on time for x...is it because you don't give a crap about us?" or "You were able to sit still and be quiet at the funeral.1 Why can't you be that way more of the time?") so it's often hard to determine whether specific behavior was successful because of the behavior, or because of the context of the situation. That's part of what makes the story so heart-rending. Not just that he thinks he can establish a reliable pattern, but that he blames himself for not finding it yet.

My feeling is that if you can get a diet to work successfully for your kid after 2 or 3 tries, then congratulations and keep doing what you're doing. But if you can't make a change after a few months, you probably should look at medication unless there's a specific medical reason (as in, "my son will get very very sick if he takes Ritalin") not to.

Slap*Happy: and chalk up the impulsivity and daydreaming to, you know, being a kid Maybe. But inattention and impulsivity, more so than hyperactivity, are strong markers for ADHD. I have known people whose children had ADHD and were aggressive and acted out. For them, Ritalin (in relatively high doses) worked to both address behavioral issues and to enable them to focus.

1. Actually, my dad once had to lean in and whisper, "Use your funeral voice!" at a funeral.

posted by Deathalicious at 7:18 AM on February 19, 2009 [2 favorites]

I see no reason to believe that ADHD isn't just another organic expression of the same fundamental dietary disorders I see here at home.

Apples and Oranges. Hell, Apples and Neil Armstrong.

I have nothing but empathy for someone who is trying to help with any tool at his disposal.

This bugs me. The father in the article is pretty obviously running makeshift dietary experiments on his child. You can almost predict what the next epiphany is going to be because the father is actually inducing these conditions on his kid through extreme dietary conditions. By the time the child has abnormal bacteriological cultures in his digestive tract, it has been years of abnormal diets that change with every new WebMD article the father reads. There is no mention of exercise or psychological surroundings, only an intense extremely varying and uninformed manipulation of the child's dietary intake.

The father has a subsection called "mirrors", I'd suggest he'd find the problem by looking at one.
posted by clearly at 7:29 AM on February 19, 2009

To better illustrate my point that the father is on a wild goose chase around metabolic pathways:

"During one of his terrible episodes we rushed him to the doctor. "What's that smell?" she asked. He didn't have to breathe in her face; it was apparent from across the room ... She wrote a script and we ran off to the hospital for a blood test. A few days later the results came back. The PH is low, and the smell is butyric acid. Not a ketone, not a mercaptan, but an organic acid. Course there may be other odoriferous, volatile compounds that they weren't screening for, but butyric acid is definitely one of them."

So the father finds out that the smell is from butyric acid, and immediately dismisses the notion that it could be a ketone. There are three ketone bodies produced as a result of fatty acid catabolism: Acetone, Acetoacetate, and get this! B-hydroxybutyric acid. Since he is absolutely positive that it is not a ketone, he searches for bacteria that produce butyric acid in his child's GI tract.

Father: "And what does the GI specialist have to say? Same old crap."
GI specialist: "I've seen many people use diet to affect behavior. It usually doesn't work"

This is the kicker:

"We cut back on carbs, holding at about 75 per day"

The child has breath that you can smell across the room. The results point directly to a ketone, produced when fatty acid catabolism is the source of the body's energy due to a lack of carbohydrates and the father's solution is to cut back on carbohydrates.

The brain operates on glucose, and can use ketones as a secondary source of fuel when glucose stores have been depleted. Ketones are not the desired fuel for the brain and do not allow it to operate at maximum efficiency.

I'll extrapolate and say that any positive behavioral effects i.e. not punching his door in were a direct result of the child's body and brain being deprived of its most readily usable form of energy.

Really, the father's solution is essentially starvation, but we can excuse that because it is a good faith effort to help his child. A completely misguided, uneducated, altogether clusterfucked good faith effort to help his child.
posted by clearly at 8:05 AM on February 19, 2009 [7 favorites]

I read a journal a while back of a woman who had grow up in a macrobiotic refined-sugar-free household. The passage I recall most was (paraphrased)

"There's a picture of me at my 6th birthday, with friends gathered around an apple, with a candle stuck in it. You can tell me -- I'm the one that's crying."

I'm against keeping cookies & soda pops in the house, but for god's sake, a little cake now and then is part of fucking childhood, ADD or no.

I didn't read much, but I'm figuring Helicopter Parent EXTREME version™.
posted by Devils Rancher at 8:43 AM on February 19, 2009

chalk up the impulsivity and daydreaming to, you know, being a kid

This is so true. Again, because I come in contact with so many kids (teaching after school skating, 70 to 100 kids per week, and about 50% new kids every 10 weeks), I see an enormous range of behavior. I consider ALL of it normal except the extreme disruptive ends. Parents need to take a step back sometimes and ask themselves if they are judging their child against some educator's or doctor's definition of an idealized norm, or if in fact, human beings have a broad broad range of behaviors, some nature some nurture, for interacting with their world.

You child's deviation from this norm is not deviate unless he is actively harming himself or others, by which I mean real physical or emotional threat. Treating kids' normal range of behavior as pathology is so misguided.
posted by nax at 8:47 AM on February 19, 2009

A couple years ago, I made a little youtube primer on ADHD.

The most challenging aspect as a child growing up with the condition is being chronically misunderstood. But with the right nurturing environment, they'll come around. Just be patient (and forgiving).

A review of the literature I read concludes that no matter what therapies you pursue, teaching kids with ADHD coping strategies is more effective than any other strategy.

Natch. Meds, while effective to a degree, turned me into a zombie, sapped my creativity, and rendered me high-strung. What worked far better was taking a break every 10-15 mins of studying, channeling all my excess energies into extra-curricular activities, and using little heuristic devices to watch what I say in conversation.
posted by Christ, what an asshole at 8:48 AM on February 19, 2009

clearly: Fair enough. Road to hell paved with good intentions and all that. My own attempts at diet modification (nowhere near this extreme) are partially motivated by the face that it's something I can do without having to track down a psychiatrist. A low glycemic diet does help.

Devils Rancher: I don't know what to think of that, honestly. On the one hand--live a little! On the other--is it really going to damage someone going through childhood eating extremely healthy food? I mean, we're not exactly talking child abuse here. Personally, my parents were pretty limiting when it came to sweets, and I don't really fault them for it nor feel particularly deprived. I did tend to binge on candy in high school, but now I generally prefer healthier stuff. I'm sure the former was due to not eating as much sweets as a kid, but as to the latter, who knows?
posted by RikiTikiTavi at 8:55 AM on February 19, 2009

uncanny: I wonder how much lack of exercise helps with bad behaviour . I'm not sure that lack of excercise would have anything to do with ADD or ADHD, but I will tell you it's a huge source of discipline problems in my field. These kids have been sitting sitting sitting for hours; many schools have only intermittent recess for younger children and I think most schools get rid of it somewhere between 3rd and 5th grade now. They get into these after school programs and they are so twitchy and constratined that they pretty much ALL go crazy. This just exacerbates the problem for the truly ADHD kids, who can't process the social signals that say "stop now."

Wherever we go, we are often labeled as "bad parents." rikitikitavi, I think random strangers in stores and other parents may (but may not) make this assumption, but I just want to reassure you that those of us in educational fields understand that it isn't you. Here's a hug().
posted by nax at 8:57 AM on February 19, 2009 [2 favorites]

aargh. constrained.
posted by nax at 8:58 AM on February 19, 2009

What worked far better was taking a break every 10-15 mins of studying, channeling all my excess energies into extra-curricular activities, and using little heuristic devices to watch what I say in conversation.

It's harder to get younger kids to use coping strategies, as they tend to just blow off the intended task and spend all the time on the breaks (assuming they're stimulating enough). At least, this is my experience. It is clear to me as has been mentioned that coping strategies are going to be crucial and we're continually trying to make a habit of them. It's a long process, though.
posted by RikiTikiTavi at 8:59 AM on February 19, 2009

nax: Thanks, I appreciate that. And:

I'm not sure that lack of excercise would have anything to do with ADD or ADHD, but I will tell you it's a huge source of discipline problems in my field.

Interestingly, we've gotten a lot of advice to "just get him more exercise" but he generally comes back from the challenge just as hyper as before. Sometimes more so, as the behavior worsens if he hasn't had enough sleep (he generally sleeps well, though). Don't doubt that lack of a recess is a big problem in general for most kids. The trend is one reason we homeschool. Another is the behavior problems--I'm not sure if we're more worried about the effects of a school environment on him or on the other children around him.

...ADHD kids, who can't process the social signals that say "stop now."

Well put.
posted by RikiTikiTavi at 9:06 AM on February 19, 2009

I couldn't use coping strategies until I started taking medication. Without medication, I just wasn't a reliable observer of my own behavior, so I couldn't see what I was doing wrong and change.
posted by Deathalicious at 9:49 AM on February 19, 2009

...I should add that now that I have been able to learn these strategies, because of the medication I took earlier, I am now able to cope if I realize I've forgotten to take it that day.
posted by Deathalicious at 9:49 AM on February 19, 2009

It seems like a pretty big step to even say these kids have ADHD or that it's diet-based at all. You could just as well diagnose those kids as having fetal alcohol syndrome which isn't going to be fixed by anything.
posted by GuyZero at 10:14 AM on February 19, 2009

I didn't get far into the article before I became angry and depressed ... too close to home for me. I very strongly disagree with that person and what he is doing. That being said, I also feel very sympathetic ... sigh.
posted by lesChaps at 10:19 AM on February 19, 2009

RikiTikiTavi -

You may be putting the cart before the horse. There could be another issue that's causing your kid to act out, apart and aside from ADHD (or worse, acting in conjunction with it.) Are you seeing a psychologist or counselor specializing in children with behavior disorders? They need to be the ones sending you to see the psychiatrist for a tune-up (or in my case, a nurse practitioner specializing in mental health) as they're spending a half-hour per week talking with you and with your kid. Clinical depression and anxiety aren't always expressed as feeling sad or scared... unhappiness expresses itself differently from person to person, especially if it's a biological thing.

I'm an adult, but my depression and ADD was diagnosed by a counselor, who then recommended a specialist who's job it was to pick a medicine and dosage. It took a few visits to get it right, but working with the counselor helped me tell the pill-pusher what I needed and how to monkey with the dosages. Even after the medicine started to work, keeping up with the therapy helped fix a lot of unpleasant things I had developed because of living with untreated depression.

I don't know if this is standard practice industry-wide, but it damn well should be if it isn't. Too many people self-diagnose and ask for a lexapro script from the GP during their physical - I'm appalled at how many doctors are OK giving them one. Ditto ritalin.
posted by Slap*Happy at 10:21 AM on February 19, 2009

It's harder to get younger kids to use coping strategies, as they tend to just blow off the intended task and spend all the time on the breaks (assuming they're stimulating enough). At least, this is my experience. It is clear to me as has been mentioned that coping strategies are going to be crucial and we're continually trying to make a habit of them. It's a long process, though.

True. It all happened late in the game for me. I didn't really develop a self-awareness until I was about 17-18, and didn't really solidify who I was until about 20-21. But it was at that point that I began taking more firm control over what I was doing.

...ADHD kids, who can't process the social signals that say "stop now."

Well put.

Also true. On the bright side, at least anecdotally, when that self-awareness kicked in, so too did a knack for picking up social cues, to the point that it's now a hyper-vigilance/awareness. I can now walk into a room and unconsciously pick up on things immediately.

Best of luck. I know I was a nightmare to my parents.
posted by Christ, what an asshole at 10:33 AM on February 19, 2009

I need to leave, but want to leave one thought here about diet and ADHD. In addition to diet, when I was younger, my mom helped me control my ADHD through diet. I drank a bottle of Mountain Dew almost every weekend morning, as I did not take my ritalin on weekends. I also drank caffeine containing soda before sports matches that happened after after my meds wore off. It worked. Not as a permanent solution, of course. But loading me up with sugar, yellow number 5 and most importantly caffeine (actually the caffeine was really all that mattered) made me into a more functional human being.

It's how my uncle got his PhD. Of course he now drinks over a pot a day of coffee, but he's a tenured professor. When I read the title of this page, my first instinct was to swear loudly. I've started reading it, but unfortunately don't have time to finish it. I do believe that diet can help ADHD, I know there are promising studies about Omega-3 oils out there (no, they don't do anything for you freaks with normal brains, just us weirdos with ADHD). But most of the rest of this, I have real trouble buying. As has been mentioned up thread, ADHD can be seen in PET scans. The frontal and pre-frontal lobes don't activate as much in kids with ADHD as everyone else. Getting that brain activity up is really all that matters, at least initially.

I suppose part of my frustration is seeing kids going through what I went through. I was diagnosed at 6 and went on ritalin at 9. We spent 3 years trying everything in the book before putting me on meds. I don't fault my parents for this in the slightest. I don't remember most of the attempted treatments, although I wonder now if the lack of chocolate in the house for quite some time was part of a diet modification idea. But they didn't work. What worked was putting me on a stimulant medication so that I could pay attention for long enough to learn coping mechanisms. And those 3 years were pure hell. When most people reflect back on how idealistic their childhood was, I have very few good memories. They get a lot better once I reached middle school.

And Rikitiki, sleep is crucial. My ADD (I still call it that, as it's what I was diagnosed with, I didn't get that fancy H) is worse if I don't sleep enough. I don't have hyperactivity problems anymore, but that lack of sleep will not cut his energy. I fidget more when I sleep less. From what I've read (and remember) from studies, exercise helps ADHD in the short run, for a couple of hours, but it isn't long term effective as it is for depression. Of course, I could be misremembering, so don't just take my word for it.

On preview, I have the same thing with social cues that Christ, what an asshole does. To the point that I've had to teach myself not to read them too much.

And despite needing to leave 20 minutes ago, I end up writing three paragraphs. That's hyperfocusing for you- if you can get your child to figure out how to do that, school work becomes a great deal easier. Of course, it took me to college to do that.
posted by Hactar at 11:50 AM on February 19, 2009 [1 favorite]

Wow. I was misdiagnosed with ADD as a kid. I'm fine now, but I think that for most kids... Oh! KITTY!
posted by fuq at 12:07 PM on February 19, 2009

Flagged as fucking wacked.

Amines. Like -NH3 amines? Like every third thing in every peptide chain and I'm sticking them onto a carbonyl group in my kidneys right now amines? Those amines?

No wonder I need the concerta.
posted by Kid Charlemagne at 3:32 PM on February 19, 2009 [1 favorite]

I read this for a while last night, and the more I did the more fascinating it became. This guy must the complete opposite of the deadbeat dad- almost to the point of obsessiveness. Interesting little asides as well- like Rumsfeld and Aspartame.
posted by mattoxic at 4:03 PM on February 19, 2009

There's also a whole subset of kids who look like ADD but are really suffering PTSD. Let's say you're being abused at home or have suffered some trauma. What will you focus on? Not the stuff the teacher is saying, but the noises at the door, the expressions on people's faces (is he going to hit me?), etc. This hypervigilance can look like inattentiveness.

The other key childhood response to trauma is dissociation-- ie, spacing out, daydreaming, not being "there." That, of course, also looks like ADD.

Medication isn't going to do anything for a kid who is watching Dad beat mom every night at home or who has been in ten foster homes but many doctors don't take the child's history, they just see the behavior and write the prescriptions.
posted by Maias at 4:10 PM on February 19, 2009 [3 favorites]

What happens to kids like this when they become adults?

posted by loquacious

Sometimes they become published writers, or prize-winning painters, or they get Ph.D's, they turn into competitive athletes, they become teachers, and they get sucked into being school administrators. Someone asked me how it was I got so much done in so many different fields, and I said "Inability to focus." She thought I was joking. They didn't have the medications when I was a kid, but I learned to self-medicate with caffeine. The only problem is if I have too much of it I get anxious.

A few years before my mom died, she took one of those online tests for ADHD, using my symptoms to answer the question. "You were telling the truth about having ADHD," she announced to me the next time I saw her. Well, damn, Mom. She apparently thought I did all of that on purpose. Including setting fires, shoplifting, insulting teachers, blurting, fidgeting, twitching, never handing in homework, stealing food, drinking alcohol, and never doing whatever it was I was supposed to be doing at the time. I'm lucky I became an alcoholic and had to recover, because it gave me something to blame :)

My adult daughter is all too aware of the ways in which I still am prey to hyperfocus on the absolute wrong thing in the midst of the conversation. Unlike my husband, she knows I'm only able to listen to part of what she's saying. The rest of my attention is on that car, that token machine, the texture of the sidewalk, the title of the book in the window, and that hand she's holding up in my field of vision while she twiddles the fingers and goes "Blug-a-blug-a-blug-a!" and laughs at me. I'm fooling everyone else, though.
posted by Peach at 4:45 PM on February 19, 2009 [1 favorite]

Avelwood mentioned above that he thinks of ADHD as being similar to schizophrenia in that it's a whole bunch of similar symptoms that could all have different etiologies but get grouped into one syndrome. He also noticed that ADHD symptoms can overlap with those of autism and maybe other problems. He's hit the nail on the head, and I think that eventually we'll be able to target our treatments for not-so-single conditions like ADHD, autism, and schizophrenia much more specifically by separating them out by causes, whether those be genetic, environmental, or both.

We are finally beginning to realize that for a wide variety of medical issues, the dividing line between mind and body is as tenuous as vapor (or a "leaky gut"). I don't know so much about schizophrenia, but there is a growing body of tentative research out there that links the spectrum of ADHD and autism to genetic predispositions combined with potential environmental triggers, in some cases possibly including immunological ones, and of those, possibly including dietary ones. Similar webs are being explored for clinical major depression and gut disorders like irritable bowel syndrome. There are definitely parents out there who see distinct improvements in their children's behavior and ability to learn after a round of dietary elimination trials and changes.

One of the main problems right now is that most of the public and much of the medical profession continues to treat these disorders as single conditions with a limited range of one-size-might-fit-might-not treatments. (Let's ignore for now those who believe that a given condition doesn't exist or is synonymous with "spoiled brat" or "woman making up pain and symptoms.") It's not necessarily their fault, as the true wellspring of the problem is largely a dearth of information that's intimidating by the standards of other fields; we understand very little about the body, hardly anything about the brain, and when we start to figure something out, the concomitant indications for treatment are very slow to filter out into standards of practice. As perhaps they should be. But this is a really, really tough thing to swallow if you're a parent watching your child suffer or wreak suffering.

The medications for ADHD don't effect cures (well, mostly), they just treat symptoms, and most of them have side effects that can range from undesirable to potentially deadly. We only sort of understand how some of them work. They are crude, weak medicine. They are our era's equivalent of chewing willow bark to temporarily ease the misery of a broken ankle.

Parents know this. Patients know this. So why shouldn't they go looking for other ways of easing the symptoms that seem less harsh on the mind and body, and that might offer permanent relief? And why shouldn't there be a few, afflicted with tunnel vision and suspicious of their own views of the periphery, who eschew all forms of temporary symptom relief that don't also carry the weights of safety and permanence? Doesn't that seem like the ideal? Wouldn't you relentlessly strip gluten from your child's diet and bathe her in Epsom salts if you thought it would spare her from a frightening chemical that has been linked to cerebral hemorrhage? And wouldn't you barrel down this path alone, leaping fences and sneaking shortcuts, unable to conceive or admit to yourself that you might be going the wrong way, if you were convinced of your purest intentions to exorcise your child of the demons destroying her life from the inside out? Wouldn't you blanch, believing that a step away from the path is a step over the cliff, knowing that the sickness of seeing your child ruined or realizing that your most sacred efforts of heart and ego ended in eventual failure would be its own destruction?

You wouldn't, maybe. I wouldn't. We know that, like the willow bark for the broken ankle, the modern pills can work for long enough that the original wounds can heal or allow us to adapt to them; they don't harm most people much; at times, they work to degrees that seem miraculous. We're too sensible. Too informed. Too grounded.

But yes, we would — and I say "we" because that semi-religious state I characterized is not a predicament of "them," it's a predicament of being human — we do chase magic, and we'll keep seeking new shamans as long as our own bodies and minds remain as desperately mystical and shadowed to us as the rest of the world seemed back when we chewed bark to ward off pain.

So I can't be too critical of anyone who sees one shaman with willow bark, another with an amulet, knows the willow bark might sometimes burn the gut, and . . . picks the amulet.

Disclosure: I have ADHD, regulated with diet, exercise, and the occasional use of medications as needed.
posted by jeeves at 6:43 PM on February 19, 2009 [1 favorite]

[This is a comment from an anonymous commenter.]

There's also a whole subset of kids who look like ADD but are really suffering PTSD

Yes, yes, and yes. As a child I didn't know when or who would be punishing me for what, so I was always on the lookout for signs that meant I was in for it. It wasn't so much physical abuse as it was emotional and psychological. This wasn't something that people recognized as 'abuse' back then, so I had nothing to complain about.

This continued into adulthood, where I would find myself in the same kinds of relationships, either at home or at work. Emotional and psychological abuse - except I didn't recognize it as abuse. I found myself unable to concentrate, unable to "keep it together", all of these things that seemed to match ADD symptoms perfectly.

I joined some ADD groups and used the coping mechanisms, which did help, actually. What really helped though, was getting into real therapy, coupled with an anti depressant. That finally let me see what I'd been wasting half my brain on - avoiding "punishment" from the abusers around me.
posted by cortex (staff) at 7:57 PM on February 19, 2009 [3 favorites]

OK, now that I have more time I'm going to tell you all a secret from deep in the bowels of big pharma.

There is no such thing as ADD or ADHD.

There. I said it.

There are neuro-normal, mentally healthy people like myself and there are people who are predisposed to ending up as saber toothed cat shit. The thing is after a while there weren't as many saber toothed cats as their used to be, so the vital skill of noticing them went by the wayside. And while we were watching out for your ass, you were all off reproducing and watching rocks or whatever the hell it is you do that bores us out of our skulls.

And then you have the nerve to complain about us not sitting still.

Next time some part of the environment that you didn't notice comes up and takes a bite out of you, remember, you have no one to blame but yourselves!
posted by Kid Charlemagne at 9:35 PM on February 19, 2009 [1 favorite]

There are neuro-normal, mentally healthy people like myself and there are people who are predisposed to ending up as saber toothed cat shit. The thing is after a while there weren't as many saber toothed cats as their used to be, so the vital skill of noticing them went by the wayside. And while we were watching out for your ass, you were all off reproducing and watching rocks or whatever the hell it is you do that bores us out of our skulls.

Hi, I have ADD/ADHD, and if a saber tooth tiger ran up to me, waved his hands in my face, roared in my ears, and waited 10 seconds, he still might have a good chance of eating me. Especially if I'm reading a book.

I appreciate the farmer-hunter analogy that has been applied to an examination of ADD/ADHD, but I think it really is a bit oversimplistic and doesn't take into account all forms of ADD.

There are many people with ADHD who are highly functioning without medication and have found a niche that is compatible with the way their brain functions. I personally had a very difficult time interacting socially with others well into my teens, which had little or nothing to do with whether I wanted to be running around like a crazy person, and far more with the problem of having a barrier that stood between me and normal interactions with others. That barrier was my ADD.

You. You were, and maybe are, hyperactive. You're the one people point to when they say there's no such thing as ADHD. You're the one that people use as the poster boy when they say that people just need to let kids run around a bit more.

Compare with

Me. I was, and certainly am, someone whose life is affected and, in my opinion, worsened by ADD/ADHD. I'm the one people got angry at, hurt by, and fed up with. Until I was 10, I was not "here". Until I was well into my teens, I could rarely successfully engage in a balanced conversation with more than one other person, and that improved as soon as I started taking medication. I'm the one that people use as a poster boy when they say that all that kids or adults with ADHD need is a bit of medication.

This is the secret: there is no one ADD/ADHD. Some people (and especially kids) are diagnosed as ADHD when they are really mostly H. They may show signs of impulsivity, and can't sit still, but after that they function normally and can do things like read people's faces, engage in balanced conversation, and be functionally aware of their surroundings. There are the withdrawn ADD kids who almost never get diagnosed. They don't move around and are often able to hyperfocus on educational settings (in class, while reading a book) so they appear to be model kids. Sure, they seem a bit spacey sometimes, and they don't seem to have many friends, but this is mostly attributed to "shyness". This group is most likely to discover that they have ADD and have always had it, when they are an adult and realize they can never manage their lives. There are tons of other kinds, but I was a third kind: impulsive, hyperactive while at the same time hyperfocused when reading or in class (I always did fairly well in school and unlike many who did well in school because they were really really brilliant, I was never really bored), but relatively withdrawn in social situations or hyperactive and not really interacting with other people. Basically, the only thing I did well was read and pay attention in classes I cared about. At all other times, I was effectively non-functioning. So, when I wasn't running around and annoying people, I was watching rocks with total and complete captivation.

Also, if reproducing bores you out of your skull, you are doing it wrong.
posted by Deathalicious at 8:05 AM on February 20, 2009 [1 favorite]

There's also a whole subset of kids who look like ADD but are really suffering PTSD

PTSD?! I'm a thirty year-old boy?
posted by Avelwood at 2:45 AM on February 24, 2009

You can have PTSD at any age-- but the likelihood of adult PTSD being misdiagnosed as ADD is relatively low as adults can typically verbalize their trauma-related symptoms. With kids, things like being placed in foster care once (let alone multiple placements) should be considered traumatic -- but often, the traumatic events are either not discovered because there's no medical history taken or not considered because adults think kids are "resilient" and that any attention symptoms are ADD.
posted by Maias at 3:05 AM on February 24, 2009

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