Source: Connect with Kids

New research published in the Archives of General Psychiatry shows that children with ADHD are at an increased risk for depression and suicidal thoughts — and very well may need treatment for both. This reinforces the belief that parents and educators of even young children with ADHD should pay close attention to their child’s behavior.

Twenty-year-old Ariel has been living both with anxiety and depression since the eighth grade. She says, “It got so bad where I just slept all day, I didn’t get out of bed, I didn’t do anything.”

That is in addition to attention deficit disorder. Ariel says, “I was already upset and depressed about the fact that I had ADD and had to take medications for that. When I found out I had two more things, I was like, ‘Oh my God! What’s going on?’”

Research from Harvard University shows girls with attention deficit are 19 times more likely to be depressed…and 15 times more likely to have bi-polar disorder than other girls.

Dr. Richard Winer, an Atlanta-area psychiatrist, says, “There is a very high likelihood that there will be something else besides ADHD going on, probably at least a 70 percent chance if not more.”

Why is one person so likely to have several disorders? Researchers say the conditions are genetically linked…and tend to aggravate each other.

Ariel says, “I try to do something, but I can’t because of the ADD, and it frustrates me. Then that makes me very nervous and anxious and that goes to the anxiety. And then when I get like that, I’ll go ‘Oh my god! I can’t do anything! I can’t do anything!’ And that leads to the depression.”

Experts say girls like Ariel often need one medication for ADHD and another for depression.

Dr. Winer says, “I generally will try to treat ADHD first if I think there is also mild to moderate depression alongside. If the depression appears to be extremely severe in nature, then that takes precedence over treating ADHD in terms of what do you treat first.”

Ariel often skips her medication. She says it’s a crutch, but it does work. Her mom Arlene says, “She started taking some anti-depressants, and all of a sudden she was back to the way she had been six months earlier.”

Another study out of Harvard University shows boys with ADHD are also at risk for having another mental health problem, but the statistics are slightly less dramatic than they are for girls.

What We Need To Know

Many parents seem to be ignoring medical advice when it comes to treating their child’s attention deficit hyperactivity disorder (ADHD). A study conducted at New York University reveals that of 500 parents whose children have ADHD, 45 percent say behavioral therapy has been recommended, but less than one-quarter (21 percent) say that their child actually participates in it. In addition, 89 percent of parents with an ADHD child say medication has been prescribed for their child to help manage symptoms, but only 55 percent report their child is taking medication.

The study also included the following findings:

• More than twice as many parents of children with ADHD (43 percent) than parents of children without ADHD (18 percent) believe their child is likely to be picked on at school.
• Nearly half (49 percent) of parents of ADHD children say their child is likely to have difficulty getting along with other neighborhood children (compared to 18 percent of parents of children without ADHD).
• Seventy-two percent of parents of ADHD children report their child has trouble getting along with siblings or other family members, compared to 53 percent of parents of children without ADHD.
• Less than half (48 percent) of parents of children with ADHD say their child adapts easily to new situations, compared to 84 percent of parents of children without ADHD.
• According to their parents, children with ADHD are half as likely to have many good friends (18 percent vs. 36 percent) and are less likely to play with a group of friends (38 percent vs. 50 percent), compared to children without ADHD.

If you believe your child may have ADHD, keep an eye out for the following symptoms listed by the American Academy of Child and Adolescent Psychiatry:

• Has trouble paying attention
• Shows no attention to details and makes careless mistakes
• Easily distracted
• Loses school supplies and forgets to turn in homework
• Has trouble finishing class work and homework
• Has trouble listening
• Has trouble following multiple adult commands
• Blurts out answers
• Demonstrates impatience
• Fidgets or squirms
• Leaves seat and runs about or climbs excessively
• Seems “on the go”
• Talks too much and has difficulty playing quietly
• Interrupts or intrudes on others

Depression is not limited to kids with ADHD, although having ADHD may lead to depression in some cases. According to the Mental Health America, depression among teenagers is increasing at “an alarming rate.” Experts say as many as one in five teens suffers from clinical depression at some time during their teenage years. Depression can take several forms, including bipolar disorder (formerly known as manic depression). Depression can be difficult to diagnose in teens because adults often expect teens to be moody, and they often are. But depression is more than typical moodiness.

The following symptoms may indicate depression, particularly when they last for more than two weeks:

• Poor performance in school
• Withdrawal from friends and activities
• Sadness and hopelessness
• Lack of enthusiasm, energy or motivation
• Anger and rage
• Overreaction to criticism
• Feelings of being unable to satisfy ideals
• Poor self-esteem or guilt
• Indecision, lack of concentration or forgetfulness
• Restlessness and agitation
• Changes in eating or sleeping patterns
• Substance abuse
• Problems with authority
• Suicidal thoughts or actions

It is extremely important that depressed teens receive prompt, professional treatment. Depression is serious and, if left untreated, can worsen to the point of becoming life threatening. If depressed teens refuse treatment, it may be necessary for family members or other concerned adults to seek professional advice. Contact your local mental health association or a school counselor for suggestions on treatment.

Some of the most common and effective ways to treat depression in adolescents are:

• Cognitive-behavioral therapy – Helps teens change negative patterns of thinking and behaving; several studies support the effectiveness of this treatment
• Psychotherapy – Provides teens an opportunity to explore events and feelings that are painful or troubling to them; psychotherapy also teaches them coping skills
• Interpersonal therapy – Focuses on how to develop healthier relationships at home and at school
• Medication – Relieves some symptoms of depression and is often prescribed along with therapy

Resources

• Children with ADHD at Increased Risk for Depression
• New York University
• ADHD Facts from the American Academy of Child and Adolescent Psychiatry
• Mental Health America ADHD and Kids

10 Common Myths About ADHD

Attention Deficit Hyperactivity Disorder (ADHD) has been the subject of scrutiny in recent years due to the perception that it’s a faux-disorder. A patient isn’t diagnosed after an X-ray or blood test, but rather with a behavioral evaluation that considers his or her unique situation. The lack physical evidence fuels the skeptics despite the fact that many of them lack experience in dealing with the disorder. Just ask a parent of a child or an adult who suffers from ADHD, and they’ll tell you that it’s more than just the occasional loss of concentration — it hinders their ability to function to their potential, in school and social situations. The following myths have been perpetuated by people who don’t understand ADHD but have been debunked by doctors, mental health professionals and people who live with the disorder.

1. ADHD isn’t a real problem: It’s a common opinion that disorders like ADHD were devised by drug companies in order to make a few extra bucks, but that couldn’t be further from the truth. In fact, it’s a recognized disorder by the American Psychiatric Association (APA), Centers for Disease Control (CDC), American Medical Association (AMA), National Institutes of Health (NIH) and a majority of national psychiatric and psychological organizations. Acknowledgment of ADHD is almost unanimous by mental health professionals and researchers who have studied it.
2. ADHD is an excuse: As previously mentioned, ADHD is a legitimate disorder, and one that can hinder a person’s ability to reach their full academic and personal potential. Symptoms include: difficulty focusing on one thing, difficulty learning something new or completing a task, listening problems, general confusion and disorganization, the inability to sit still, the constant desire to be in motion, excessive talking, the inability to remain quiet for even short periods of time, and poor impulse control. A comprehensive list of symptoms is available by clicking the link.
3. Strict discipline can solve childhood ADHD-caused problems: Many people claim that strict discipline can solve a child’s behavioral problems caused by ADHD. Some skeptics tend to view it as a generational problem, asserting that children are spoiled and need to be more harshly punished for their actions. The truth of the matter is that children with ADHD lack sufficient impulse control and excessive punishment can prove damaging to their mental health. And while it’s important to set clear expectations and establish structure, it’s also essential that parents remain patient with their children.
4. All ADHD sufferers are hyperactive: Although constant hyperactivity is the primary problem associated with ADHD, it’s not the only symptom. Inattentive-type ADHD, or ADHD without the “H,” has become more recognized by the medical community in recent years. A person can control their impulses while being inattentive, which can lead to substandard academic performance. Even shyness is characteristic of inattentive-type ADHD sufferers; children with the disorder require positive attention, as low self-esteem may become an issue.
5. ADHD indicates a lack of intelligence: A Yale report published in 2009 showed that about three of four people with ADHD and an IQ score of more than 120 experienced difficulties with memory and cognitive tests. On the other hand, people without ADHD with similar IQ scores didn’t have as many problems. ADHD doesn’t discriminate based on IQ score. People of all intelligence levels have it; many just need assistance in harnessing their capabilities.
6. ADHD medication causes a drugged feeling: A doctor or mental health specialist will determine the appropriate treatment for ADHD based on the unique needs of the patient. Side effects are closely monitored and if a medication has an adverse effect, the dosage will be lowered or it will be changed to something more suitable. The stimulant that’s typically prescribed comes in different forms, including capsule, pill, patch and liquid. Some have short-term effects while others have long-term effects. In short, there’s not one treatment that’s applied to everyone.
7. ADHD can be diagnosed through a medication trial: Psychostimulants have the same effect on people without ADHD as they do on people with ADHD, so a noticeable difference in behavior subsequent to taking a medication isn’t a true indicator that a person has the disorder. A person who thinks they may have ADHD should consult a doctor or mental health specialist, and he or she will make an assessment with the assistance of diagnostic criteria established by the American Psychiatric Association, or the American Academy of Pediatrics if a child is being examined.
8. ADHD diagnoses have become too common: According to the CDC, just three to seven percent of school-aged children had ADHD in 2006. Between 1997 and 2006, diagnoses of ADHD increased by an average of just three percent each year. A 2005 report by the CDC indicated that 4.4 million children aged four to 17 were diagnosed with the disorder, and just 2.5 million of them were prescribed medication. What’s more, many medical professionals and researchers assert that girls and minorities are underdiagnosed.
9. ADHD is limited to children: Many children who endure ADHD still battle it well into adulthood, and many adults will be diagnosed for the first time years after they’ve entered the real word. Instead of forgetting homework assignments, failing to complete in-class assignments and inefficiently studying, they may forget an appointment, produce at a slower rate than their peers, and exhibit a general lack of preparation. In many cases, the result is job instability and a lack of career fulfillment, which can affect their overall quality of life. Adults who think they may have ADHD shouldn’t hesitate to visit a doctor or mental health specialist.
10. People with ADHD can’t succeed: The lengthy list of talented people who have ADHD includes 14-time gold medalist Michael Phelps, four-time Super Bowl champion Terry Bradshaw, Kinko’s founder Paul Orfalea, and Virgin Group founder and billionaire Richard Branson. Additionally, great innovators, thinkers and leaders from the past are said to have shown symptoms of the disorder, like Albert Einstein, Beethoven, Charles Schwab and John Lennon. Given the sheer amount of people who have overcome ADHD to achieve their dreams, it’s clear that it doesn’t have to be an impediment to success.

1. What were some of the assumptions you started with when you began writing this book?

I assumed that children were being grossly overdiagnosed and overmedicated. I assumed that society’s neuroses were being turned into pathologies in children; that what was being diagnosed as disorders in them was everything that was wrong in the competitive, high performance, driven, anxiety-filled world of childhood and family life in America today. The basic assumption was that those disorders, which no one seemed to have had when I was a kid – weren’t real, or were at least being diagnosed far more frequently than they ought to have been. How I knew this, I don’t know. Mixed in with the thought that the diagnoses were bogus was the idea that the medications used to treat children didn’t work; that they were a palliative for parents; and that parents were searching for an easy way out of their kids’ problems rather than looking at themselves, their families or society in general. And all of that rested on a basic disbelief in the direction that modern psychiatry was taking and a basic disrespect for parents who seemed to me to be willing to sacrifice their kids to their own ambitions and laziness. It was easy to have all these views. They were, and still are—although perhaps to a slightly lesser degree—the basic lens through which a lot of children’s mental health issues continue to be viewed. (For example, there’s still a lot of disbelief out there that things like ADHD or bipolar disorder are real. A lot of people still believe these problems are being grossly exaggerated and over-treated and think this is happening because parents want to “perfect” their kids).

2. What happened as you started working on the book, trying to report the various pieces of it?

As I started working on the book, I very quickly ran into problems. When I tried to back up the idea that what these kids had wrong with them wasn’t real, it became impossible to prove. I contacted experts – prominent psychologists and psychiatrists I’d seen quoted in the media indicating that kids were being overdiagnosed or overmedicated, people whose beliefs, I thought, paralleled my assumptions – and they didn’t actually believe that the mental disorders I was asking about weren’t real. And those who did believe that disorders like ADHD were socially constructed forms of disease tended to be people who were out on the fringe. The websites where I was finding articles agreeing with my point of view often were linking back to Scientology sites or other hard-core antipsychiatry groups and staking out ideological positions. I increasingly began to wonder about some of the things I thought were obvious and true. And when I talked to parents of children with mental health issues about my assumptions I encountered real hostility. One friend in particular just looked at me when I told her that I thought kids with nothing wrong with them were being overdiagnosed and that medication didn’t work. She forcefully asked, “How do you know that?” I would later learn that her son, who was ultimately diagnosed with Asperger’s Disorder, had seriously contemplated suicide at age six, had violent outbursts and paranoid episodes by age eight, and had begun holding the family hostage to his destructive rages by his early teens, and that my friend had gone through an ordeal of her own in trying to get him the best possible treatment.  Something wasn’t right. I just couldn’t find answers to prove that I knew what I thought I knew.

The notion of these kids being symptoms of something wrong in society, “canaries in the coal mine,” as it’s often said, worked as an intellectual construct, but it broke down whenever I talked to a parent of a child with mental health issues. Once I listened to parents’ stories, the intellectual construct fell apart.

3. Millions of parents struggle each year with how to help their children suffering from disorders like autism, Asperger’s, attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, obsessive-compulsive disorder, and the like.  What sort of challenges do these parents face as they try to make the right decisions about their children’s health?

These parents not only have to struggle with understanding their children’s disorders and finding the right treatments, but they also have to contend with enormous self-doubt and, often, skepticism and even condemnation from people around them who believe they’re exaggerating their children’s problems and pathologizing them. It is very difficult for them to find their way, particularly since it’s so hard to find doctors who can really take the time to explain treatment options to them and so hard to find institutions they can trust for good information.

4. One of the central ideas of this book is that there’s a real dividing line, a gulf of experience and understanding that separates these parents from those whose kids are untouched by these disorders.  What is it that people need to know about this gulf of experience?  And why is it so significant?

It is very difficult to understand what it is to have a child with mental health issues, because when a child has a real disorder it isn’t just a question of having symptoms that everyone has at one time or another. Everyone is sad sometimes; that doesn’t mean everyone is depressed. Everyone is anxious sometimes; that doesn’t mean we all have anxiety disorders. Everyone these days gets distracted, but that doesn’t mean we all have ADHD. Not all kids are suicidal. Not all kids have panic attacks. Not all kids struggle to keep their minds focused for a single math problem. These are not variations on normal child behavior. The differences of degree are real and significant. Not acknowledging the reality of children’s problems, minimizing what are real and often really difficult conditions, denies children the possibility of getting better.

5. A lot of what you’ve written in this book goes against received wisdom.  You’re not a doctor.  What do you say to those who question your standing to make the arguments you’re making?

I’m not a doctor but I interviewed a lot of doctors and I did what I know how to do as a journalist, which is to talk to experts, listen very carefully, read a lot of information, and pull it all together.  One of the reasons the book’s notes section is so long is that I wanted to show that I had done my homework, that I had been careful, that I had been accurate, and that I had read everything I could get my hands on.  There was a certain amount of anecdotal data I collected from parents, but I was determined, above all, to let the facts lead me in whatever direction they would.

6.  Some people feel very strongly there’s an epidemic of “legal drugging” of our kids going on.  They might see this book as formal justification for drug companies, or for physician practices or health plans that promote prescribing medication in a void, without comprehensive care.  What’s your reaction?

I’m not defending drug companies, nor am I saying meds are the answer to every problem.  And I’m certainly not in the position to be issuing medical opinions. What I am trying to do is approach this, and write about it, as a journalist. I’m describing a social phenomenon and how we ought to talk about it.  Needless to say, the issues you’re mentioning here are all nightmare issues for parents who end up in situations where they’re considering putting their kids on meds. When you talk to doctors about it they’ll talk about levels of risk, and the risk of not treating—which carries a risk of its own—compared to the risk of treating. Doctors have an ability to think abstractly and dispassionately about these issues. They can think in terms of whether, for example, the risk of taking ADHD meds is less than the risk of getting in a car crash because you don’t take ADHD meds.

I say throughout the book that children are not getting sufficient comprehensive care. Too often they’re getting meds without proper therapy or follow-up. Parents aren’t getting enough time to sit with doctors to talk about options. It’s all too expensive. And there are not enough specialists. We really need to be thinking in the direction of providing more and better options so that kids can get more comprehensive care. I also go on at length about drug companies and their practices and why they’ve completely lost the public’s trust. But I do think it’s a mistake to conflate entirely the negative activities of the pharmaceutical industry and what’s going on with child psychiatry today. It’s understandable, given how many psychiatrists are in the pay of Big Pharma, but it’s just too simple to say it’s all about drug companies pushing their products.

7. You spent a lot of time talking to as many parents as you could about how their children came to be diagnosed, and how they came to agree to give their kids medications (if medications were called for).  What did you learn?

Time and again I heard the same story. Nobody was rushing to have their kids diagnosed. They all hated giving their children medications. It became more and more important to me to tell that story, to change people’s perceptions, to cut through perceived wisdom and the shrugging-off of those parents and their kids. I also came to understand that while there’s a lot of good that can be done for children and that children can get very good help, most of them don’t get the mental health care they need. And even when they do get mental health care, it’s rarely top-quality care. They get what their parents’ health insurance will provide, or what they can afford, which isn’t much. We’re at a moment in time where there’s the potential to do a lot of good for kids with mental health issues, and instead a lot of bad things are being done.  That’s not going to change unless we start asking some big, important questions. But those questions have to spring from a place of compassion, not judgment and blame.

8. How many kids in this country have mental health issues?

The estimates range from 5 to 20 percent. There’s a wide variation because the numbers depends on the degree of severity.  There’s the 5 percent who have severe mental issues.  Then there’s the 20 percent whose mental health issues affect their abilities in some ways but who are still able to go about life the way other kids do.

When talking about children’s mental health issues, you’ll sometimes hear people dismissively say, “Well, they’ve all got something now.” One thing that was important to me was to try to determine exactly what “all” represented.  Clearly, the biggest number—20 percent—is a sizeable minority, but it’s far from “all.”

9. Why is there so much resistance to the idea that a fair number of children require psychiatric treatment and medication?  We’re willing to believe that something like diabetes has a genetic component—that it shows up in childhood and should be treated as early as possible.  Why don’t we accept that the same could be true of mental health disorders?

I think in part it’s because the idea is so new to us. When we were kids we didn’t know other kids with these problems, or at least we thought we didn’t. We all went to schools with boys who were constantly in the principal’s office, or getting into fights on the playground. We all knew kids who got into drugs in high school or were always getting into trouble. But we didn’t use terms like “depressed.” We didn’t think those kids might have a problem, let alone something like ADHD. They were just “bad.” If you don’t have the vocabulary for a concept, it doesn’t exist.

We’re also sort of primed to believe there’s something wrong with children, with childhood, and with family life today. We live in an insanely competitive and pressured time. A lot of us don’t like the parenting that goes on in our time.  We just assume that the hypercompetitive, overbearing parenting we see so often these days is going to lead to problems in our kids.  These are all naïve assumptions as to why children actually develop mental health disorders..

But they make sense to us – they seem logical. We tend to create and believe in narratives to explain what’s happening when things go wrong with kids. But what if not every problem has a cause that makes sense to us within this kind of narrative framework? What if some kids are just born with brains that work a bit differently? What if what we do as parents isn’t all-determinative? These are upsetting notions, because they undermine our sense of causality and control. Contemporary psychiatry, which is so biologically focused, simply goes against the grain of how we think about ourselves as people.

10. Your book laments the missed opportunities there are these days for putting science to its best possible use in treating children with mental health issues and also looks at ways that the benefits of scientific progress have been squandered – notably in the ways that the pharmaceutical industry and some psychiatrists have betrayed and lost the trust of parents. But you also point to stories of progress. What sort of progress has been made?

There are more medications now to help children than ever before, and forms of therapy that have been proven effective. Kids with mental health issues can get better and are able to participate more broadly in life than ever before. They’re not facing the same stigma they once did, nor are their parents as isolated as they once were. If you place the experience of the mentally ill child at the center rather than on the sidelines of the debate—in other words, if you keep in mind this is about children suffering rather than simply being symbols of the ills of contemporary life—then the developments of the past few decades truly become a story of progress.

11. One of the big questions that so often pops up in discussions about kids with mental health disorders is “Are there really more of them today, or are we merely seeing and counting them differently?” You say supposition is all we really have to go on in trying to find an answer. Why doesn’t good data exist?

If you go back beyond 1980, the nomenclature for various psychiatric disorders was completely different. Before the 1970s it wasn’t believed that children suffered from depression. The same can be said of bipolar disorder before the 1990s. The diagnosis for autism, as it’s formulated now, didn’t exist until 1980 and the publication of DSM-III (the third revision of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders).  There was also no diagnosis called ADHD prior to that year.  As for Asperger’s, its diagnosis didn’t exist until 1994. There’s simply no way to quantify disorders that didn’t exist and weren’t defined as such in the past.

12.  Why is there such a huge difference between what outside observers assume when thinking about the kids being diagnosed with mental health issues and what the parents of these kids are seeing and living through?

Many outside observers assume that what these kids are going through is normal and trivial, and that with better parenting, or at least more realistic expectations from parents, the problems will just go away. But for the parents of kids with mental health disorders it’s not a question of their kids getting B’s instead of A’s. It’s not about their kid having a temper tantrum like all kids do, or simply behaving badly. And it’s certainly not about their kids failing to live up to their expectations. It’s about kids who threaten suicide, or a girl who spends two hours every night locking and unlocking the front door. It’s about the son who makes a fuss about wearing the same shoes every day because he’s sure that if he doesn’t his mother will die. These are not the normal vicissitudes of childhood. This isn’t “normal stuff.” It’s a different level of experience, a different degree. And that’s what’s often missing in how these issues are discussed and framed.

13.  In the chapter on the use of psychotropic medications in kids you mention the dizzying array of damning numbers that have been making headlines over the past ten years.  Why do you say the numbers don’t really tell much of a story?

Because the story isn’t clear. Some numbers—like the often alleged 600 percent increase in Ritalin use in the 1990s, and the frequently reported “fact” that up to a fifth of white fifth grade boys are on ADHD meds—have turned out, upon examination, to be just plain wrong. Others lend themselves too easily to distorted meanings, unless you put them into context. For example, how meaningful is it to know that in the 1990s antidepressant use tripled if you don’t know that prior to the 1990s—i.e., before the age of Prozac—antidepressants were pretty much never given to kids at all? How huge does that tripling seem if you find out that, at the end of this nothing-to-something transition, there was still only a tiny percentage of kids—one half to 1 percent of all children—taking antidepressant meds?

It’s certainly highly worrisome to know that too many kids in foster care, for example, now get medication—multiple medications—without therapy or proper support for the traumas they’ve endured, but it’s more troubling to think of what happens to those who, like the vast majority of disadvantaged children, get no treatment at all. The story is complicated. What makes this topic difficult is that there are no pat answers. People like to have certitude. That’s why you see all these sweeping statements. But when it comes to these numbers you invariably end up saying, “Yes, but…” The truth is mixed. There are a lot of gray areas. And gray areas are hard to talk about.

14. Why do you consider this a pivotal moment for mental health in America?

We are at the brink of never-before-seen opportunities for scientific progress when it comes to mental health.  For one thing, the past couple of decades have seen a lot of big advances in understanding how the brain works and in determining what treatments are actually effective. There’s a vast body of knowledge to back up many of these treatments, but it doesn’t necessarily get out in a consistent way to parents. There’s still a lot of confusion and quackery out there. So you end up seeing many parents running in circles, trying to figure things out on their own. And because of the way health care is delivered in this country there’s not a lot of opportunity for them to sit down and talk to doctors at length.

It’s a pivotal moment, too, because along with advances have come abuses. The drug makers have acted cynically and gone too far in their direct-to-consumer marketing and advertising efforts, in the promises they make, and in promoting off-label uses for medications that are potentially quite dangerous. Doctors have helped erode the public’s trust by doing unofficial marketing for drug makers. So you have good and bad mixed together.  Not surprisingly, the bad has gotten a lot more attention than the good.

15.  Our impulse is to see children with mental health issues as victims, the “canaries in the coal mine” of our sick, out-of-whack society.  Can society cause the kinds of disorders we’re seeing in kids?

The prevailing view is that children’s mental health issues arise from a subtle interplay of genetics, biology, and environment. The metaphor that’s always used is that genes load the gun and the environment pulls the trigger. If the environment alone was the problem, we’d be seeing epidemic levels of these disorders in kids. Despite all the hyped-up headlines, the numbers just aren’t that huge. Everyone I’ve talked to believes society or parenting does play a role, but you have to have fertile terrain for those outside pathogens to take root and cause problems.

16.  There’s a perception out there, and not a false one, that it’s the kids from the wealthiest homes who get the most diagnoses and the most and best services.  For example, the most competitive schools often show disproportionate numbers of students with learning disabilities. The most affluent school districts across the country register the greatest number of children getting special accommodations in school, including things like extra time when taking their SATs. People end up feeling this is all about wealthy parents “gaming the system” in order to get even greater advantages for their kids.  But you say this situation reflects a much larger and darker reality.  What is it?

The larger and darker reality is that only parents with considerable means (and the time and the savvy that usually accompany such means) are able to work our school systems to get the services and accommodation to which kids with issues are entitled.  Even the basic special education services that public school districts are legally required to provide for children with learning disabilities or other issues are very difficult to access for parents without time and considerable energy and resources.  It’s thus not surprising that households where the parents don’t have the time to advocate for their kids, or the money to take on school systems, are disproportionately given short shrift when it comes to their kids getting the resources they deserve.

17.  You pull no punches in hammering away at the pharmaceutical industry and most particularly the alleged cozy relationship that exists between psychiatrists (and doctors in general) and big pharmaceutical companies.  You also devote significant time to looking at how agencies like the Food and Drug Administration (FDA) and the National Institutes of Health (NIH) have allegedly been co-opted by Big Pharma. How do we change this?

Things have already started changing. In the wake of several recent, highly publicized scandals there has already been a lot of “housecleaning” going on. More stringent regulations have been put in place, particularly at the NIH. Universities are self-policing more, and many of them have taken steps to make their researchers’ relationships with drug companies more transparent. More limits are being placed on allowable levels of collaboration and the kinds of money doctors and researchers can receive. And most prominent medical and academic journals now require authors to list their industry affiliations at the end of their articles.  At some point we may even see legislation for creating a national database that lists doctors’ relationships with Big Pharma. We’re clearly entering a moment of correction, and that’s as it should be.

It’s unrealistic to say doctors shouldn’t work at all with Big Pharma, because that’s how research gets done (and the government certainly doesn’t have the money to foot the bill entirely on its own).  Some collaboration is necessary. But stricter rules are also a necessity, and doctors have to find it within themselves not to work as a shadow arm of the drug industry.  For one thing, they need to own their own research.  One of the major downsides to having the pharmaceutical industry run its own show on the drug trials they’re paying for is that they own the data collected during the trials. They’re the ones who decide when or whether to publish the results.  This has led to a number of instances in which companies have suppressed data showing their drugs are ineffective or pose greater risks than medications already on the market.

18.  What’s your goal in writing this book?

For parents of children with mental health issues, I’d love it if they come away from this book with a feeling of being in community with others.  I want them to feel less misunderstood, alone, and stigmatized. For those who don’t necessarily have children with “issues”—and particularly for those who, like me, were functioning on autopilot, recycling received wisdom about children’s mental health without questioning it—I hope this book will open their eyes.  If the book makes these people see that things are more complicated than they seem, it will have served its purpose.

19.  The debate over health-care reform is very much on people’s minds at the moment. What sort of reform do you think we need when it comes to mental health care for children?

The first thing that needs to be done is to make sure mental health care is included in health insurance packages to begin with—it is in some, but not in all by any means (and legislation passed in recent years guaranteeing parity for mental health care only applies to people who have mental health coverage in the first place).  I think reimbursement rates need to be increased, and we need to reexamine what services are eligible for reimbursement.  (Those child psychiatrists who do participate in health insurance aren’t paid to do therapy, which means they can’t provide the best standard of care recognized by their profession. It means they are essentially boxed in to doing nothing more than medication management, solving each problem with pill after pill.)

And changes are going to have to come from practitioners as well. Child psychologists and psychiatrists need to make themselves available to people who can’t necessarily afford full fees. There are only about seven thousand child psychiatrists currently practicing in this country, and they’re overwhelmingly concentrated in the big cities. That means in some rural areas, there are no child psychiatrists—or even child psychologists—at all. It also means many child psychiatrists have huge waiting lists. As a result, they don’t need to take on patients whose only means of paying is through health insurance. That’s why I’d love to see health care reform that also includes a mechanism for incentivizing med school students to go into specialties where they’re really needed, like child psychiatry.

Order today on Amazon.

Thank you Judith for taking the time to answer many questions and help us to understand the value of your recent book!

Source: ADDitude Magazine

Diagnosed with attention deficit hyperactivity disorder (ADD/ADHD), my daughter struggled to earn good grades in school. In college, her professor inspired her to succeed — now she’s tutoring others.

By: Brenda Nicholson

Every parent thinks her kids are smart. I always felt that way about my three children, even when their grades didn’t reflect it. Their attention deficit hyperactivity disorder (ADD/ADHD) — all of them have it — had something to do with their poor showing in school.

My daughter Caitlin is a good example. Her sister, Sarah, calls her “the dumbest smart person I know.” Caitlin does very well on standardized tests, yet her classroom work and grades never reflect her potential.

That all changed when she entered college. A very special psychology professor — Dr. Albert Martin — finally brought out Caitlin’s best in the classroom. Dr. Martin believes that his job is to help students learn in any way he can. He is clear on what he wants students to learn, and he hands out study guides to reinforce his expectations. When Caitlin misses a class — which is not often — she knows what was covered, and knows how to make up the work.

Caitlin earned an A in his first class and is on her way to acing his next course. Her self-esteem and confidence have gone up — and the other students recognize it. A few of them asked her to tutor them after class. Imagine: My daughter — “the dumbest smart person” — is tutoring others.

I can’t tell you how proud I am, and I know that she is proud of herself. For the first time, she feels that people are seeing her for who she really is. It is the best feeling in the world — for both of us.

The Nitty Gritty
 

When: Saturday, September 26, 2009

What: A mini-equine hands on training course that will teach ADD/ADHD, Autistic and ‘learning different’ children how to raise and lower their energy levels on request.

Where: Cheers Horse Ranch

96841 Blackrock Road, Yulee, Florida

Who: This event is for kids and teens ages 5-17. It will be hosted by the Debbie Manser, Cheers Horse Ranch and taught by Instructors, Marianne St. Clair and Danielle Herb.

Why: Mental + Emotional + Physical Empowerment = Success!

It will be a fun-filled day for both you and your child.

What You’ll Need to Bring: Closed in shoes or boots, hat, sunscreen, bag lunch, chairs, cameras and willingness to have fun,

To ensure personal time with each of the participants, limited spots are available.

AM Session

AGES: 5 – 17 Years Old

TIME: Saturday 9am – 12pm

Questions? Please call Debbie (904)277-7047

For more info: Drop Your Reins.

Follow Danielle on Twitter @DanielleHerb

Follow Cheers Ranch on Twitter @CheersRanch

Follow Marianne StClair on Twitter @MarianneStClair

Also read on Examiner.com

ADDitude Magazine is a great resource for articles, tips and information on ADD/ADHD in both kids and adults.  Here is a recent article I felt is perfect timing to share with my readers.

Source: ADDitude Magazine

How to Jump-Start Friendships for your ADHD Teen

Five creative ways to help your teenager with ADHD (and poor social skills) find — and keep — friends.

When do we reward positive behaviors in children?

By Kara Tamanini

Many parents that I have seen over the years have told me that they like to reward their children for a “good job.”  Now exactly what does that mean, “a good job.”  Parents have told me that they give their child a reward such as money, going out to dinner, or buying them something every single time they do something they are told to do.  So when do we reward a positive behavior in our children?  We do this when they have performed above and beyond the call of duty.  Children should be rewarded when they have diligently worked at something and have learned something new and also when they have performed exceptionally well, whether this is at home, school, or at an extra-curricular activity.  If we reward our children every single time they do something they are told to do, we create a sense of entitlement in our children and they are not grateful or thankful when we do reward them.  They simply come to expect that they are going to get a reward for easy; menial jobs around the house or at school. 

Children should complete their homework, schoolwork, housework, and do age-appropriate things.  However, rewards such as money, buying them a new game, a trip to their favorite place, can be very powerful tools but they need to be used appropriately.  Rewards are good when your child surpasses what is “normally” expected of them and when they finally do receive a reward it will be special and mean something to them.  Once children learn a new skill that is required in life to be a responsible adult, we do not continue to reward this behavior.  For example, you as a parent decide to reward your child for learning to tie his/her shoes and you give them a reward for having done so.  You reward them once and do not continue to reward them forever for having learned an age-appropriate skill. 

Also, be careful to not instill in your child the attitude that they will only do something if they are rewarded for it.  I see this all the time!!  If a child does not perform at school or at home and they should be doing so, then a consequence should be enforced for them.  (your child does not get to go out with a friend over the weekend because they did not clean up their room.)  Having done this, you have avoided the sense of entitlement that has become so prevalent in the U.S., the attitude of getting something for having done nothing!  Everyone is required to do their part, whether it is a family unit, at work, at school, everybody has to work and  rewards are only given when your child does something “extra” above what is normally expected. 

Remember this, in today’s society no one is given a reward as an adult for doing the bare minimum and having everyone else do things for them.  We need to as parents teach our children how to be productive and responsible adults that are able to take care of themselves.

Follow Kara Tamanini on Twitter @KidTherapist

Visit www.kidsawarenessseries.com for more great articles!

If you have an ADD/ADHD child you have a bit extra to be concerned about.  As a mother of an ADHD child, I remember always being sure he had a teacher that was familiar with ADD/ADHD and worrying about things I probably didn’t have to worry about.  ADDitude Magazine has created a great starters list for us – read on!

Source: ADDitude Magazine

Follow these 10 steps to a happier, more organized, more productive school year for your child with attention deficit disorder (ADHD).

I have spoken with her mother, Marianne St. Claire, and was so impressed at all of Danielle’s accomplishments.  She is a leader for youths – and for the kids she helps.  I look forward to meeting with all of them soon!  How fortunate I am to be in the same state they are?  Very – and I can’t wait!  I grew up riding and showing horses, so this feels like it was all meant to be. 

In the meantime – I wanted to share some of her fantastic information about the Drop Your Reins program and her terrific new website! www.dropyourreins.com – Be sure to check it out!

Read on….

Drop Your Reins and Learn To Trust!

The Method
Mother and daughter team Marianne St. Clair and Danielle Herb are two dynamic, pioneering and incredible human beings who use their own journey of discovery through the challenges of ADHD to help other families find alternative healing methods.

By partnering with horses, they have created an experiential learning environment that invites open communication, personal reflection, and progressive alternatives for ADD/ADHD and Autistic diagnosed children as well as for those who support them.

The Madness

The old model of parenting and training horses, still being used by many today, is to break their spirit into submission to get them to do what you want. They are repeatedly worn down until the end result is unhappy, unhealthy kids and horses. 

 The (Danielle Herb) Experience

Danielle Herb 

Founded and run by 15-year-old Danielle Herb, Drop Your Reins is a collaborative experiential training school based in Live Oak, FL. The flagship program offered by Drop Your Reins is called ‘The Experience’, which is a dynamic and progressive program that breaks down the social segmentation that exists among humans, animals and science. The holistic and progressive program infuses direct interaction with horses, supplemental training videos, experiential coaching techniques and community collaboration to  help guide the powerful minds of ADD/ADHD and Autistic children to reach their greatest potential while maintaining their innocence and purity.  

The Same, Yet Different

Whether your art is in your pen, your keyboard or your heart the only way to nurture and foster your innate creative being is to embrace and explore it. Adults often get immersed in their ‘daily routine’ and they lose sight of this ’special creative place’ that they once thrived and roamed wild and free in as a child.  However, they often seek out this place as they continue to age and mature. Adults have choices, outlets and tools that they can use to rediscover this place and align themselves with others that celebrate their differences.

For children diagnosed with ADD/ADHD and Autism their journey is much the same, however, it exists on the opposite end of the spectrum. They are constantly immersed in their ‘creative being’ so they are in search of a serene place to escape where they can find peacefulness and tranquility. Yet, the more they seek out this place, the more the world labels them and puts them under a spotlight.  Children have no choices, few outlets and lack the tools or self-sufficiency to empower themselves on this journey. While they have differences, few people identify with them and those differences are certainly not celebrated. 

 How DYR Supports Children:

Drop Your Reins is a Youth to Youth Program designed to give kids (ages 8-14) tools that will assist them in ways to overcome fears and challenges, develop healthy loving relationships, build trust, grow their inner confidence and self esteem and explore leadership. Custom programs are available for youth under age 8 and youth/young adults over the age of 14.

How DYR Supports Parents:

After Danielle was diagnosed with ADD/ADHD at age 5 it was Marianne’s intuition that led her in the quest to assist her daughter to rid herself of the harmful mental, emotional and physical side affects associated with ADHD. Their holistic approach takes into consideration foods, additives, toxins, stressors, schooling, home life, and much more to work with parents to find healing solutions for each child and family that are touched by their program.

How DYR Supports Medical and Health Practioners:

New research suggests that animals have far more complex and cognitive social skils than we give them credit for. By collaborating with Drop Your Reins Medical and Equine Practioners alike can work closely to study these amazing creatures in a natural setting and document their relationships and interaction as it pertains to humans.

Source: ADDitude Magazine

The Truth About Your ADHD Child’s Lying

Attention deficit children may tell lies as a result of their ADHD symptoms rather than being dishonest. Learn when to punish your ADHD child’s lying and when to deal with its causes.