| Attention Deficit Disorder is a complex condition that is | | | | True ADHD with hyperactivity is rather easy to |
| not well understood at the present time by many | | | | diagnose. However, only in the last ten years was |
| clinicians and the general public. New information is | | | | ADD inattentive type recognized. This diagnosis is hard |
| being discovered rapidly however. Dr. Amen is one of | | | | to spot and often is characterized by a general |
| the pioneers in this field and this article is meant to | | | | spacyness and inability to track conversations. It also |
| summarize his work. | | | | used to be common knowledge that children were the |
| Attention Deficit Disorder (ADD) and Attention Deficit | | | | only ones to suffer from this disorder and that once |
| Disorder with Hyperactivity (ADHD) occur as a result | | | | they became 14 they grew out of it. What is more |
| of neurological dysfunction in the prefrontal cortex of | | | | common is that in the normal course of |
| the brain. This is the newest part of our tri-brain | | | | experimentation with drugs and alcohol a person with |
| system in evolutionary terms. It is the part of our brain | | | | this disorder finds amphetamines and becomes |
| that performs executive functions. The functions of | | | | addicted to them. Almost the right drug, wrong dose! |
| this brain deal with 1) attention span, 2) perseverance, | | | | Most people do not grow out of the disease. |
| 3) judgment, 4) organization, 5) impulse control, 6) | | | | Interestingly enough, even with hard-core Methadrine |
| self-monitoring and supervision, 7) problem solving, 8) | | | | addicts, if they are put on a small dose of Adderall, 20- |
| critical thinking, 9) forward thinking, 10) learning from | | | | 30 mg. of sustained release 1-2 times a day, they |
| experience, 11) ability to feel and express emotions, 12) | | | | thrive and it does not reactivate the addictive process. |
| interaction with the limbic system, and 13) empathy. | | | | Dr. Daniel G. Amen is one of the acknowledged |
| Whenever there is a problem with this part of the | | | | leaders in the field for the study of Attention Deficit |
| brain, a number of skills that many human beings take | | | | Disorder. He has expanded the classifications of this |
| for granted would not be available in any optimal way. | | | | condition within the last two years from the standard |
| The following are problems that develop when the | | | | two types of Hyperactive and Inattentive by adding |
| prefrontal cortex is affected. 1) Short attention span, 2) | | | | four more distinct types of ADD. He has done this by |
| distractibility, 3) lack of perseverance, 4) impulse control | | | | exhaustive research and has been aided by the |
| problems, 5) hyperactivity, 6) chronic lateness and poor | | | | SPECT scan, which is a sophisticated brain scanning |
| time management, 7) disorganization, 8) procrastination, | | | | tool that measures and clearly shows what part of the |
| 9) unavailability of emotions, 10) misperceptions, 11) poor | | | | brain is most active. What is most impressive about his |
| judgment, 12) trouble learning from experience, 13) | | | | work is that he stresses the need for a multi-treatment |
| short-term memory loss, and 14) social and test | | | | approach. This includes attention to diet, exercise, |
| anxiety. | | | | vitamins, supplements, traditional psychotropic drugs, |
| The exact neurological problem with ADD is unknown | | | | and behavioral techniques. |
| at this time. However SPECT scans, single photon | | | | In "Healing ADD" Dr. Amen lists the six types of ADD |
| emission computed tomography, which measures | | | | as 1) Classic hyperactive, 2) Inattentive, 3) Over |
| cerebral blood flow and metabolic activity patterns, has | | | | focused, 4) Temporal, 5) Limbic, and 6) Ring of Fire. |
| noted that when someone with ADD concentrates, | | | | Each of these types has much in common, but also |
| their prefrontal lobe activity decreases significantly. This | | | | differences in symptoms and treatment. |
| essentially means that under stress and concentration | | | | All of the types of ADD have as their primary feature |
| someone with these disorders cannot bring to bear | | | | periodic impairment of the prefrontal cortex of the |
| their full cognitive capacity. | | | | brain and dopamine involvement. Classic ADD is |
| It is theorized that our usual ability to screen out and | | | | characterized by both hyperactivity and |
| attend to stimuli of our choice is impaired with these | | | | inattentiveness. It is usually quite easy to treat by a |
| individuals. I like to think of it as going to the mall during | | | | combination of a high protein diet, aerobic exercise, a |
| the summer. It is too bright and there are too many | | | | stimulant such as Adderall or Ritalin, and possibly the |
| people around, but it is not overwhelming. However, at | | | | supplement of L-Tyrosine. Often an anti-depressant is |
| Christmas time after a couple of hours at the mall | | | | used as well. |
| people are so over-stimulated that it is hard to find the | | | | Inattentive ADD lacks the hyperactivity, but people |
| car. People with ADD feel this way almost all the time. | | | | who suffer from it have a difficult time focusing and |
| There are five recommended courses of treatment | | | | are often very scattered. As with the classic type the |
| for someone with ADD or ADHD. Physicians often | | | | prefrontal cortex is involved. The treatment for |
| give an antidepressant such as Wellbutrin and | | | | inattentive ADD is usually exactly the same as the |
| Strattera, which tends to calm the limbic system and | | | | classic type. |
| increase dopamine, a neurotransmitter. In my | | | | Overfocused ADD exhibits the same problems and |
| experience as a therapist, this can be helpful but | | | | symptoms of prefrontal cortex as with classic and |
| stimulants, the second course, seem to do a better job. | | | | inattentive ADD, but the difference is that the sufferer |
| Stimulants given in small doses, so the mood alteration | | | | of over focused often cannot break away from a |
| is minimal, act in a paradoxical manner. This means that | | | | thought or behavior. This is because the cingulate |
| instead of accelerating a person they help to focus | | | | system of the brain is overactive and often locks a |
| and calm them while still allowing the prefrontal lobe to | | | | person into self-destructive, negative, or repetitive |
| remain active. They also seem to increase dopamine. | | | | behavior. Often a stimulant will cause temper problems |
| This neurotransmitter is negatively affected with | | | | if used alone. Therefore, it is usually helpful to have the |
| people suffering from ADD. The third regimen, a | | | | person take an anti-depressant first and only later to |
| combination of an anti-depressant and a stimulant, | | | | add the stimulant. Another possible treatment is to use |
| seems to work best for most people suffering from | | | | St. Johns Wort, a natural herbal anti-depressant, but it is |
| most forms of ADD. The fourth treatment consists of | | | | important not to use both a traditional and an herbal |
| teaching relaxation, stress-management, organizational, | | | | anti-depressant at the same time. The other forms of |
| and socializing skills. This should always be included as | | | | treatment such as diet and exercise is the same as |
| part of treatment whether or not medication is used. | | | | the first two types of ADD. |
| Another form of treatment is the naturopathic | | | | Temporal ADD is still characterized by problems with |
| approach. Due to my background I cannot adequately | | | | the prefrontal cortex, but the temporal area of the |
| discuss this method, and as yet am not sufficiently | | | | brain is often affected. This could be from a previous |
| familiar with the treatment to be able to measure its | | | | head injury, but not necessarily. All the symptoms |
| efficacy. At the present time, supplements, vitamins | | | | remain the same, but often extreme bouts of anger |
| and chiropractic care seem to be effective as an | | | | are also included. The treatment for this type is usually |
| adjunct to stimulants. | | | | a stimulant and an anti-convulsant such as Depecote. |
| There are numerous misconceptions about Attention | | | | All other treatment is the same except the following |
| Deficit Disorder and a lot of emotional fervor about the | | | | supplements can be used: GABA, Ginkgo Biloba, or |
| diagnosis. It reminds me of the debate over Prozac | | | | Vitamin E. |
| several years ago or whether or not Alcoholism is a | | | | Limbic ADD is when the limbic area of the brain is also |
| disease or a moral defect. It is understandable that | | | | affected in addition to the prefrontal cortex. This type |
| people worry about giving young children a | | | | of ADD has the symptoms of inattentive ADD, but a |
| mood-altering drug. However, any time medication is | | | | significant amount of depression is also present. A |
| considered as an approach, the physician needs to | | | | stimulant and an anti-depressant are indicated. Aerobic |
| carefully assess both the costs the benefits and the | | | | exercise is needed, but often a complex carbohydrate |
| severity of the problem. Most medication difficulties | | | | and protein mixed diet is indicated. The following |
| with ADD result from mismanagement. When the | | | | supplements are used: SAMe or L-tyrosine. |
| appropriate amount of medication is used with ADD | | | | Ring of Fire ADD is a very disorganized and severe |
| the benefits are immense and the cost is minimal. A | | | | form of ADD that is a combination of all the other |
| person's life changes dramatically for the better. It is as | | | | types. The entire brain is lit up on a SPECT scan. In |
| if for the first time a person can think clearly and their | | | | addition to the standard treatment of a stimulant and |
| self-esteem soars. | | | | an anti-depressant, an anti-psychotic like Respiridal is |
| There is still a tendency in this country to feel that | | | | often called for. Dietary and exercise treatment is the |
| people need to pull themselves up by the bootstraps | | | | same as in inattentive type. The following supplements |
| regardless of the severity of the problem. They are | | | | are possibly needed: GABA or Omega-3. Other |
| often blamed for their own illness. This happens a lot | | | | supplements that have been found helpful with ADD in |
| with ADD. | | | | general are Zinc, Flax seed oil, and Serephos. |