Question: My son is a Junior in high school and he is not doing well academically. He was not hyperactive as a small child so we never suspected that he had ADD but he has never done well in school and this year his guidance counselor suggested we get him tested for ADD without hyperactivity and he did have this. This really explained a lot about his behaviors and helped us not feel so frustrated with him for his inability to organize his life at all. His guidance counselor has suggested we get in touch with a local therapist who she says has helped other students quite a lot. The therapist uses Neuro-Linguistic Programming. This type of therapy sounds very strange to me. Do you think it is worthwhile for a teenager with ADD?

Jan Falk Says...:

I would be very hesitant to label or seek any kind of treatment based on anyone elses opinion. These days any student who is : smart, quirky, talented, bored, artistic, athletic, active....you get the idea, gets labeled with ADD or ADHD. If you see it at home, maybe there is some merit, but if your student is able to focus when doing something he likes to do, it is most likely a problem with the educational instruction. What does he say? He is a Junior in High School, which is the most stressful and difficult year, I would tread lightly on backseat quarterback diagnostics.

Question: What do you think about the Dr. Daniel Amen method for adult ADHD? I have heard some really amazing things about the progress one of my friends’ sons made and my son is 24 and really directionless and unemployed. He is a creative genius and amazing artist. If he could stay focused on completing a series of paintings he already has preapproval for a show at a major gallery. The problem is he can’t get it done and this is so frustrating to him and to all of us. We have tried every ADHD medication out there and they only help a small amount so he is not sure they are worth the side effects and since they don’t help I wonder if his ADHD diagnosis is not 100% accurate. This is why the idea of really comprehensive brain scans to find out what is going on in there sounds like exactly what we need to do.

Loren Gelberg-Goff Says...:

Excellent question, and I certainly admire and appreciate Dr. Amen's work and the way in which he can really get to the root of one's problems... I agree that your son may need to be fully evaluated and assessed to see what is really going on for him. As is often the case, individuals who may have had ADD/ADHD growing up and didn't have really good outcomes with whatever medications or treatment modalities were used, carry negative beliefs about themselves as they mature. These negative self-images do a lot to sabotage &/or undermine their successes in their adult lives. So, while having your son evaluated is a great idea, I'd also explore having him work with a good therapist who can help him get to the emotional source of his sabotage and inability to complete what he starts. 

Please look into Emotional Freedom Therapy (EFT)  This has been shown to be very beneficial for breaking through internal barriers. If you haven't already done neurofeedback, then I would STRONGLY recommend that your son do neurofeedback. It's an extraordinary therapy that truly benefits people with ADD/ADHD, problems with focusing, etc.  

I understand your concern and frustration for your son, and it is important that he be engaged in this process as well. Since many people are so used to feeling stuck because that has been their pattern, they often just shut down to new ideas and possibilities, leaving you to be the one who is pushing, cajoling, and begging. How engaged is your son in wanting to do something different in his life? There are many factors here that both you and he can explore together, but he needs to be at least as engaged in this process as you are to have the success you are looking for and that he deserves.

I hope that these few suggestions and recommendations are helpful as places to start. Dr. Amen is certainly an awesome resource, and you have other possibilities as well... Please feel free to contact me should you have any other questions or concerns and I'll do my best to provide you with further guidance. Wishing you and your son all the best.

Question: Is my ADHD the reason why I am addicted to food? It’s weird because most people that have ADHD are all fidgety and skinny but I am fidgety and really heavy. If I take Adderall is this going to help me to lose weight even if I am a food addict?

Penny Bell Says...:

ADHD and food addiction are two separate issues that may or may not be related. Because I don’t know anything about your addiction history – when it began, what triggered it, what you have done to manage it up to now – I’m not sure of the answer to your first question.

Nevertheless, I can say this: addictive behaviours most often occur in response to emotional stress or pain. People with ADHD have a higher prevalence of addictions than is found in the general population, and it is thought the reason for this is that the addictive substance or activity is being used to self-medicate the stress of having ADHD symptoms. We self-medicate to change the way we feel, and in your case, food has become your “drug of dependency”.

I am assuming you have been diagnosed with ADHD but as yet you have not embarked on a treatment to ease your symptoms. There are several different drugs that can be prescribed for treating ADHD, one of which is Adderall. By helping you with your impulsivity, distractability, disorganisation, avoidance and other stressful symptoms, and improving focus and concentration, you may find that medication will help to ease your addiction to food by mitigating your stress levels.

If Adderall, which is a stimulant, is prescribed for you, it is also possible that your appetite will be decreased, but this is not necessarily so. Some people experience this as a side-effect and some do not. It would be a good idea to discuss your concerns about your weight, food addiction and ADHD medication with your doctor. If you decide to embark on a trial of using Adderall, and find that you are still struggling with food, your next step should be to seek help specifically for your addiction.

Other treatments for ADHD, which can be used alone or in conjunction with medication, are cognitive and behavioural therapies, relaxation training and stress management, life coaching and family therapy. All of these can help you acquire skills for living life to the full with a healthy self-esteem, manageable levels of stress, as well as giving you strategies for controlling your eating behaviours.

I hope this has helped you to move toward a decision for action for taking ownership of your health. Taking action will empower you to be more in control of your physical, psychological and spiritual health, leading to improvements in all these areas. We are at the beginning of a new year, and this is an excellent time to embark on something new and different that will enhance your life. I wish you all the best for your health and future!

Question: Since all ADHD treatments are basically psychostimulants will all psychostimulants basically work as ADHD medications? Specifically, would caffeine in moderately high doses help to control ADHD symptoms, assuming the side effects were tolerable?...red bulls…ephedrine?

Rob Danzman Says...:

Many adults with ADHD believe that caffeine boosts their attention, but research results are less clear. Some studies find better performance on memory tasks; others find that caffeine aids concentration but impairs short-term memory. There is also anecdotal research that caffeine makes people more anxious and hinders sleep. Caffeine withdrawal may trigger headache, fatigue, irritability and nervousness.

Since it is a stimulant, caffeine has definitely been investigated as a potential treatment for attention deficit disorder. Its use as a therapy is not widespread because it was found in research studies to be less efficient than other stimulants. What this means is that caffeine could be effect for treatment except for the significant amount necessary to reduce ADHD symptoms as much as traditional stimulants. Also - researchers suggest the doses were too low to have a consistent effect. They say that if caffeine proves useful, it “would represent a qualitative increment over the traditional repeated use of psychostimulants, which can have severe side effects if repeatedly used in children.” Basically, it would be awesome to use coffee (or Red Bull, etc.) instead of Adderall but you would need to consume such a concentrated amount that the side effects would make this unsustainable.

Anecdotal evidence suggests that many individuals are already using caffeine to self-medicate ADHD in themselves or their children. Not surprisingly, many with ADHD find it has the opposite effect (just like prescription stimulants) than it does in other people: instead of making them more active and stimulated, it actually has more of a calming effect and encourages sleep. Seems as helpful as a self-assessment tool for ADHD.

Ultimately, talk with your psychiatrist (not regular physician) about how to mitigate symptoms related to ADHD. Research also supports the use of Cognitive Behavioral Therapy, exercise, and Meditation. These have been found over and over again to be as effective as prescription stimulants without the weird side-effects.

Question: I have ADD. I am 16. I was tested by a psychiatrist last year. I have a prescription for ritalin and I am supposed to take it before breakfast and lunch. I have been using it for almost a year. I don’t think it helps me at all. Does this mean I don’t have ADD? Does taking this medicine harm my brain if I don’t have ADD? My parents say I should take it but I am not sure.

Loren Gelberg-Goff Says...:

Great question... just because Ritalin doesn't work for you, it doesn't mean you don't have ADD... There are many facets to ADD and therefore many ways to address the symptoms.  If you find that Ritalin isn't working for you, there are other options as far as medications go that can be helpful.  Sometimes it's a matter of finding the right medication for you based on how your body responds.

Alternatively, you can explore other treatment modalities that are helpful, beneficial and effective in treating ADD

1. Neurofeedback: shown to be very helpful in increasing focus, attention span, reducing agitation, etc.

2. Meditation: Increases your abilities to be relaxed, calm, centered, focused and relaxed.

3. Biofeedback... teaches you internal control strategies and helps you to learn how to monitor your own reactions and responses to situations that trigger certain ADD behaviors. 

4. Nutritional counseling Often many symptoms of ADD have roots in nutrition and food choices.  Definitely worth looking into to see how you may be reacting/allergic to certain foods that can trigger ADD symptoms and behaviors.

5. Organization and time management strategies... it's always beneficial to change certain behaviors that keep you stuck in sabotaging behaviors so that you can confidently move forward... these are new coping skills so that your ADD doesn't control your life.

The advantage of neurofeedback over the other modalities is that you show up for sessions and do not have to "practice" anything in between sessions.  Since both meditation and biofeedback require ongoing practice (and they are definitely worthwhile practices) and it may not be something you are ready for, neurofeedback provides an internal shift during the sessions that are cumulative.  You simply need to show up regularly for your appointments. Additionally, while organizational counseling with someone who specializes in working with people with ADD  and nutrition counseling(with a nutritionist or naturopath who is experienced in dealing with ADD) is also truly worthwhile you and your parents need to choose what you are willing to participate in that will move you forward in a positive way in your life. 

Please contact me if you have any additional questions.  I can make referrals for professionals in the above areas if you are in NJ, but google, and recommendations from your dr. chiropractor, school counselor will also be helpful resources.  All the best, Loren

Question: I just got dumped again. I do not have a good track record with relationships. My brother in law says he thinks I have ADD. I am always drifting off and not staying focused on what people are saying so it always seems like I don’t care about other people even though I do. I am also hopeless about remembering important stuff, like birthdays and anniversaryes. I am 34 and I always thought I would just figure things out when I grew up but maybe that’s not going to happen. I am not sure what to do?

Penny Bell Says...:

Attention Deficit
Disorder, or ADD, affects around 5 percent of children and it is now quite well
established that it continues into adulthood. 
Symptoms begin in childhood, and some of these are poor concentration,
inattentiveness, being easily bored, easily distracted, and impulsive.  If hyperactivity is also present, there is restlessness
and an inability to relax.

Adult ADD can look a
little different from childhood ADD. 
Rather than repeatedly leaving the seat in the classroom, running, and
excessive climbing (part of the childhood criteria) and so causing difficulties
at home and at school, there can be problems at work, in relationships and even
with the law.  The latest thinking is
that at the core of the disorder is impaired inhibition – the ability to
deliberately suppress a thought (or impulse) in order to achieve a later goal -
and this “disinhibition” drives other regulatory problems in the individual.

If you are suspicious that
you actually do have this disorder, it’s important that you have an assessment
so that you can take the next steps in learning how to manage it.  If it turns out that you don’t have it, my
advice is to seek counselling to help you explore your “bad track record” with
relationships and discover some new ways of connecting and staying connected.

Question: My son has ADHD and he has a lot of trouble with impulse control and with dealing with frustration. When he was little we taught him to hit a pillow when he was angry because this was better than having him smash things or hit people. Now he is 15 and he is 6 foot 2 and he is getting to a size that when he starts hitting pillows and yelling and cursing he is starting to scare people around that do not know him. He needs to learn a new way to handle frustration but he does not learn new things easily and he has a lot of trouble handling his impulses. I do not want to make him stop with something that works unless he can learn something better first. What should we do and is there someone that can help us with this?

Cynthia Klatte Says...:

Dear anonymous,

Impulse control problems are common struggles for adolescent boys with ADHD. ADHD is an inherited disorder that has been associated with lower activity in the front part of the brain, called the prefrontal cortex or PFC. Low activity in the PFC is associated with reduced impulse control (Rheba Estante, Attention Deficit Disorders Association). And the coping skill you taught him served him well as a child, but now that he is older and larger, he will be needing to learn additional skills to cope with feelings of anger and frustration. And yes, there is help out there for you and your son.

There are many types of treatment for ADHD and treatment is usually multimodal, or consisting of a combination of types of assistance. Treatment can include stimulant medication, specialized educational programs or supports, coaching for parents in the use of behavior modification and management techniques, and education and counseling for the adolescent in ways to manage the symptoms. There are also many other types of treatment that have been used that are alternatives to traditional treatment.

A good resource for families is the National Resource Center on ADHD at http://www.help4adhd.org. Here you can find helpful information regarding ADHD diagnosis, treatment, issues for parents, educational issues, and more. You can consult with the center online or by phone at 800-233-4050 to get connected with help for your son.

In terms of your concern about him stopping using his coping skill before learning a new one, he will likely need to use the tools he has until he can be taught others, but perhaps he can use that skill in a more private way to not frighten others who don't understand. By pairing it with the skill of walking away, he can go somewhere private to hit a pillow or other safe target. In addition, getting him involved with sports or some form of physical activity can help give him a healthy outlet for feelings of anger and frustration.

You and your son don't need to go through this alone. There are a lot of resources out there to help your family and thank you for your question.

Best,

Cynthia Klatte, LCSW, ACSW

Question: I am sure I have ADD but I do not remember and my parents have confirmed this, that my restlessness and inattention did not begin until I was in my mid teens. According to my doctor this means that I could not have ADHD now. She did not suggest what else I could have. I have read a lot on the symptoms of adult ADHD and it is like every article is writing about me personally. Is it at all possible to have ADHD that doesn’t start until adolescence?

Cynthia Klatte Says...:

Dear Anonymous,

ADHD, by definition, is a disorder that begins in childhood. Per Kevin R Krull, PhD, in his article Attention deficit hyperactivity disorder in children and adolescents: Clinical features and evaluation, hyperactivity in ADHD typically begins by age 4. It tends to peak by age 7 or 8 and declines steadily, being barely noticeable by adolescence. Therefore, whatever you are experiencing is not likely to be ADHD.

There are many conditions that can mimic symptoms of ADHD. The bipolar spectrum disorders can sometimes be mistaken for ADHD and have their onset either in childhood, adolescence or early adulthood. Per recent studies, another condition commonly misdiagnosed as ADHD is sleep apnea. Other similar conditions are anxiety, depression, traumatic brain injury and learning disabilities.

Typically, when someone is experiencing difficulties with attention, concentration, and restlessness or excessive energy, they consult with their primary care physician, a psychiatrist or a mental health clinician. If the situation is complex, it may be recommended that the individual undergo neuropsychological testing, which is conducted by a psychologist or neuropsychologist. Testing will help with the process of accurate diagnosis and with the development of a treatment plan.

Cynthia Klatte, LCSW, ACSW

Question: My brother passed away 2 years ago. My sister in law has what seems to be a pretty clearly an out of control ADHD son, who is 7. She very natural and homeopathic and she just will not consider getting him diagnosed because she doesn’t believe in conventional medicine and medications and anything that comes from a big corporation (it's all evil). My nephew is obviously struggling at school and none of the other kids in the family really want to play with him because he is so out of control. To my mind he needs some good medications, but since that’s not going to happen, are there any very ‘alternative’ therapies that my very alternative sister in law would possible go for or that could help my nephew fit in a little better with friends and God forbid, possibly learn something in class?

Penny Bell Says...:

I am sorry to hear of the loss of
your brother.  It must be very difficult
for your sister-in-law to be bringing up her children on her own.  I can see you are feeling for her seven year
old, who sounds as if he is larger than life and overly energetic!   

There is evidence that symptoms of
childhood trauma can mimic those of ADHD, and as your nephew lost his father
two years ago, and this may have impacted upon him emotionally to the extent
that he is not coping with everyday life or himself. 

Assuming however that he indeed
does have ADHD, here is some information that may be of help to you:

ADHD is a neurodevelopmental
disorder identified by symptoms of inattentiveness, hyperactivity and impulsivity,
and it is estimated to affect 3–12% of school-aged children. Conventional
treatments for ADHD include stimulant medication and/or behavioural therapy,
which have both been scientifically proven effective. Although widely accepted
as the most compelling ‘evidence-based treatments,’ not all children respond well
to these treatments, and some parents are unwilling to medicate their children,
and are unable to access counselling for behaviour modification.

This then opens the door to the
less conventional or alternative treatments, and studies show that
a large percentage of children with ADHD are treated with one or more complementary
and alternative medicine (CAM) therapies. 

These include restrictive diets
such as the Feingold diet, food colouring elimination, sugar elimination,
nutritional supplements, essential fatty acid supplements, mind body therapies
such as exercise, yoga, meditation, neurofeedback, Cogmed (a commercially
available working memory training computer program), and certain occupational
therapy techniques. 

There have been many studies
trialling alternative therapies but unfortunately none are held as solid
evidence for the efficacy of these therapies due to methodological flaws in the
studies, and so the American Academy of Paediatrics does not recommend any CAM
therapies for ADHD. 
This does not necessarily mean that it would be a waste of time and
money to trial any of them yourself, but it would be wise to choose a treatment
that has some good anecdotal evidence at least. 
One of the above named treatments, essential fatty acid
supplementation, was found to be modestly effective, so may be a good place to
begin.

Question: I have adhd and I dropped out of high school 3 years ago, got into drugs and drinking and haven’t really had a good job ever in my life. I am not good looking and I am fat. I still live at home with my mom and dad. I am trying to stay off drugs but it is hard. I go to a group meeting with some other people twice a week. I have to go by the court. They say I have low self esteem and that is why I use drugs. I think this is true. How can I raise my self esteem? Especially when I think I have very good reasons to have low self esteem, like not being very smart or pretty or anything very good.

Loren Gelberg-Goff Says...:

OK... first things first... you do have the ability to change your attitude toward yourself... You have the ability to see yourself through a different lens.  I hear you whining about your life, and that never gets anyone anywhere except deeper in a hole.  So, the good news is you decided to write in for some assistance... that's step 1... the next step is you deciding to act on the advice you are given.  That's within your control. 

While staying clean and off drugs feels hard, please give yourself kudos for staying off drugs!  Excellent!

Saying you're fat and ugly is certainly a good way of undermining your self-esteem... I want you to look within yourself and find 5 things that are beautiful about you... it might be your sense of humor, your willingness to listen to friends, your strength to stay off drugs, your willingness to ask for help, being a loving daughter, etc... Look for your inner qualities that you have (and yes, even without meeting you, I am sure you have them...) that are beautiful...

What are you looking for?  What are your goals?  It's hard to move forward in your life if you haven't crystallized your goals and desires...

I would strongly recommend therapy, and not just therapy for addictions, but therapy to help you understand how to cope with your ADHD, self-image issues and what your coping skills are in your life so that you can make them more effective and positive...Your message sounds like you are also depressed, and this needs to be addressed in therapy as well.

You say that you are fat... You can get up and take walks everyday... do something physical to at least get you moving and out of the apparent slump that you are in...

I don't know where you live, but finding a good therapist is easier these days with the help of the Internet... after all, you found this site and are reaching out here. 

I have a practice in Northern NJ, and will be starting a virtual group later this summer focusing on self-esteem...

You might also look into doing neurofeedback, which has been shown to be very helpful in dealing with ADHD... (If you are not familiar with it, you can get info on it at www.eeginfo.com ) 

While you have a number of issues that you feel are holding you back, they no longer have to hold sway over your life... You can take back your power and live knowing you really are well within...Know that you are are worth fighting for...

I hope that this gives you some food for thought and some ideas for direction you can take to change your life.  Please let me know if I can be of further assistance... Loren M. Gelberg-Goff, LCSW  (www.beingwellwithin.com)