ADD & ADHD
(Attention Deficit Disorder & Attention Deficit Hyperactivity Disorder)
- Do you have problems concentrating at work, school, or home?
- Do you feel like you are easily distracted?
- Do you have difficulty completing tasks?
- Do you feel like your mind is racing? Are thoughts too slow/disjointed?
These are all common complaints of people with attention problems. However, many people with these problems do not have attention-deficit disorder. My goal is to help people accurately diagnose what they experience as an attention problem, to find out what is causing the problem, and to help find the most effective treatments for this problem.
What Is Attention, Anyway?
Philosophers have struggled with this question for over a hundred years, and it is still difficult to define. I think a good description of attention was written by William James in 1890: “Everyone knows what attention is. It is the taking possession by the mind, in clear and vivid form, of one out of what seem several simultaneously possible objects or trains of thought. Focalization, concentration of consciousness are of its essence. It implies withdrawal from some things in order to deal effectively with others.
In research, we often try to break down “attention” into different types of attention, like “selective attention”, “sustained attention”, and “orienting”. Too often, treatment for attention problems is generalized and everyone is diagnosed as having “attention-deficit disorder”.
Treatment for attention problems is also generalized and often does not address a specific type of attention problem. During my initial visit and consultation visits, I work with people to understand if they have an attention problem and if so, what type of problem they have. This is important because you need an accurate and specific diagnosis to design a good treatment plan for your attention problem.
Why Should I See a Provider To Help With My Attention Problems?
Not everyone needs to see a provider for their attention problems. If someone has physical complaints in addition to their attention problem, they should consider seeing their primary care doctor first. If the attention problem is very mild and does not significantly interfere with functioning, there are many self-help websites and books available. Sometimes a simple evaluation of your sleep, eating, drinking, and exercise habits may be revealing. People who can benefit the most from a the assistance of a psychiatrist are people who:
- have significant problems functioning at work, school, or home
- have already seen their primary care doctor but continue to have attention problems
- have had another mental health problem in the past
- are taking psychiatric medications (including sleep aides)
- have not benefited from self-help approaches
- are drinking alcohol or using other substances on a regular basis
If you would like to find out more information about attention problems or arrange an appointment.
What Causes Attention Problems?
There are many possible causes of attention problems. Some common causes are :
- environmental stress (like conflict at work, school, or home)
- problems with mood (like depression or mania)
- problems with sleep (sleeping too much or too little, interrupted sleep)
- medications (including over-the-counter medications)
- stimulants (including caffeine, energy drinks, etc)
- medical problems (like brain trauma, liver problems, kidney problems, thyroid problems)
- attention-deficit disorder (ADHD/ADD)
- a substance abuse problem
Our providers will work with you to uncover the cause(s) of your attention problem. Often this involves an assessment of behavior patterns, relationships, medications, and lab work (drawing blood). In some cases, we recommend that people get an imaging study of their brain or see a neurologist as part of their workup. This workup is thorough and may take more than one appointment. It may seem long, but we strongly believe that gathering all this information ultimately results in better treatment and faster recovery.
ADHD Evaluation
ADHD is a neurocognitive disorder which manifests during childhood. Approximately 10% of all children meet criteria for ADHD and about half will continue to have difficulties into adulthood. ADHD is characterized by an individual having difficulties with inattention, hyperactivity, and/or impulsivity which occur chronically (>6 months), in different environments (i.e. school, work, home, church, clubs, sports), and cannot be better explained by something else (i.e. depression, anxiety, learning difficulties, chaotic environments).
Often times, individuals with ADHD can be labeled with terms like “stupid, lazy, and unmotivated.” The truth is that they are just as smart and hard working as others. What actually happens is the ADHD symptoms get in the way of an individuals functioning so that it takes them more time and effort to succeed. Because of this, those with ADHD may loose interest in challenging activities quicker, have lower self esteem from chronic failure, or develop less efficient coping skills to manage time compared to those without ADHD. They may also find everyday tasks mundane and seek riskier, more exciting activities instead. Consequently, a child with ADHD can be derailed from normal development which can lead to long lasting difficulties.
Although ADHD may cause a lot of difficulties in one’s life, there are some benefits. ADHD can contribute to increased creativity, energy, and sociability.
There are several different treatments for childhood and adult ADHD including medications (stimulants and non-stimulants) and psychotherapy (parent training, cognitive-behavioral therapy, and mindfulness). The purpose for treatment is target increased functioning and effective skill building. With these, someone with ADHD can build their self esteem and confidence in succeeding with modern life demands. Please discuss your preference of treatment modality with you clinician so that they can best meet your goals.