ADHD, hobbies

Is My ADHD Child Addicted to Media and Video Games?

To my ADHD friends

I apologize for the length of this post. I am warning you ahead of time that it is over 5,000 words –which is long even for me. As I have done in the past when I wrote extremely long and detailed posts, I have broken this article into sections with titles and italicized important information. If you just read the headings and the italics you should get the gist of the article. I did that just for you. Because I love you.


Introduction

For the last few decades as the internet has become more a part of our lives, articles and news reports of the evils and dangers of media and video games have grown increasingly common. It is not lost on me that the media is hating on media. Unfortunately, often these articles and news reports are fraught with hype and hysteria and in many cases with nearly no source material to back it up. It is a sensational concept and makes great clickbait, but how valid are those claims and assertions?

That is what we are going to discuss in this blog post.


Media likes to sensationalize cultural fears

It is important to mention here that long before the internet was hooked up to every digital device in US homes, newspapers would report the evils of everything from board games to video games to television. Random fact: Scientific American says you’re drawn to watch more or less TV based on your genetics. I remember reading a biography based in the 1700s, and at that time many wealthy young women spent all their time reading (novels were a relatively new concept). These young women had their “heads in the clouds” and were so “lost in their imaginary world” that parents, religious leaders, and political leaders alike warned of the dangers of reading novels! Even as a young person, I remember being scolded for reading too much. And, yes, I once read an article saying board games were bad for you, but I have forgotten the reasons they gave; I think I filed it in my brain under “Asinine Articles” and forgot the details. Here is an article that gives some reasons that board games are bad if you are curious. The game Dungeons and Dragons even created a full-scale panic in the 1980s when it was erroneously associated with the deaths of multiple people. The TV show Forensic Files even attributed the death of a mom and her daughter to Dungeons and Dragons (and, strangely, to mosh pits) rather than simply acknowledging that the criminal was not mentally stable, but that wasn’t the only time the TV show made the ludacris accusation that the game was somehow to blame for a crime. Contributing to the panic over video games was the Columbine High School shooting when “Kids who immersed themselves in games of Dungeons & Dragons, who found solace in Goth music, and who played computer games were lumped together as potential enemies of public safety,” blaming the problem again on games instead of on the choices of mentally unstable people.


Humans fear new things

Everytime there is a new advancement –whether it is the printing press, the locomotive, space travel, or the internet– someone, somewhere will sound the alarm that these new things is evil and dangerous. As a group, we humans can be rather alarmist. There’s always a Chicken Little somewhere close by. When train travel became a thing, it was said that we were never intended go that fast. When airplane travel became common it was said that if we were supposed to fly we would have wings. At one time, even the telephone was considered dangerous. There is always someone in the crowd that resists the change. Apparently, there’s a few millennia of history to back up the idea that adults generally object to whatever is new and cutting-edge and that adults blame the younger generation and have since long before millennials were around. It has been going on for generations.


Let’s focus on facts not fear

Now, being cautious isn’t always a bad thing. Being aware of actual problems is prudent, but we need to be sure our information is based on fact and not internet drivel. Let’s face it, there is a lot of misinformation on the internet –as any parent of an ADHD child knows well. And, even those who say that media, video games, and TV are dangerous rarely actually stop using them. So, do they even really believe what they are preaching? Case in point: how often does someone post about how evil Facebook is while on Facebook?

This topic regularly comes up in my Facebook group for parents homeschooling ADHD children. Are TV, media, and video games dangerous for my child? Will my child become addicted to them by using them?

The answer is that it is complicated, but in most cases, the answer is no.


Media has educational benefits

First of all, it is important to point out the benefits of media. Educational apps, games, and videos have made it possible for visual-tactile learners to get information in a way that works better for their brains. Not all learning styles learn best by reading and lectures. Just because that is how it has always been done doesn’t mean that works best for everyone.

Since approximately 50% of ADHDers have learning disabilities, media can provide excellent resources for struggling children. Text-to-speech is a significant aid for those with dyslexia, for example. My son has dysgraphia and uses speech-to-text frequently. He also does best with online learning or any type of learning which doesn’t require handwriting as this is an area in which he struggles. I cannot imagine how challenging it would be to educate him if we lived 50 or 100 years ago! Newer research shows that game-based math (like online math, for example) work better for all children even those without learning disabilities. Online math programs also help children with learning disabilities by offering a more customized learning experience. Many children with these disorders were simply left behind in times past. In fact, I have an older relative with dyslexia who graduated from high school without knowing how to read or write. He was simply moved along to the next grade level because the school didn’t know what to do with him. Technology has made living with learning disabilities much simpler.


Multi-sensory learning provided by media is more effective

In general, involving all senses in learning is more effective anyway. Here is a study from the University of California which explains the value of multi-sensory education. Dave from Boy in a Band on YouTube also included information about multi-sensory education in his video about alternative school options. Media provides us with a vast array of options for education. Media makes learning far more enjoyable than a book. I mean, would you rather watch a reenacted documentary with decent acting to learn about the history of Rome or slodge through pages and pages in a textbook? Not only is the documentary (especially if it is well made) likely to be more enjoyable than the book, but you are likely to remember more of what you learn. Media has a very real and practical use especially when it comes to education.

Parents may be unnecessarily depriving their struggling learners of a viable learning method because of the false information that has been perpetuated about using media.


ADHD is not caused by watching too much TV (or any other media)

I feel it is important to mention here that —contrary to the myth passed around for decades– ADHD is not caused by watching too much TV. I think this is where part of the “Oh, no, screens are bad for ADHDers” idea came from. It is impossible for television to be the source of ADHD since ADHD was identified, accurately described, and documented in the 1700s by Scottish physician Sir Alexander Crichton (although it has changed names a few times since then). Television wouldn’t be invented for nearly two more centuries which means it is incapable of being the cause. In fact, we know the cause of ADHD. Dr. Russell Barkley, a leading ADHD researcher, mentions in his video series (located at the bottom of this blog post) that ADHD is caused by genetics in nearly all cases and toxins like lead in the remaining cases. Similar information can be seen in this article from NIHM.


Social media and screen time scare is not backed by science

“Frequent social media use and screen time have been portrayed as universally bad for our health. However, a lot of research on this phenomenon has been characterized by poorly done studies and bad science. The vast majority of evidence suggests that our smartphones are not uniformly harmful, and in some cases, they may be a force for good…The vast majority of the large and well-designed statistical studies on smartphones and the brain actually suggest these technologies are having little to no effect on our health and well-being. And in some cases, the availability of social media and phones may be a power for good.” from Erin Brodwin at Business Insider. I encourage you to follow the link and read the whole article. Erin has some great points.


Correlation is not causation

Please, when you are considering this issue, remember that correlation is not causation. Just because two things are happening at the same time doesn’t mean that they are connected or that one caused the other. Here is an entertaining, media-based explanation of correlation versus causation that is likely to help you understand and appreciate the concept better. Remember what I mentioned above that media makes learning more enjoyable and that it helps us retain the information? Just because a child has a bad attitude while playing video games doesn’t mean that the video games caused the bad attitude.


World Health Organization declares video game addiction legitimate

The WHO —the World Health Organization, not the 1970s rock band– recently (as of 2018) declared video game addiction a legitimate medical condition. Last fall, I did extensive research for a post on my Facebook page for ADHD Awareness Month in October and didn’t find anything reliable to support the idea that it was a medical condition. As of writing this blog post, it is still not a recognized condition in the USA. The DSM-5 says that more research needs to be done.


The debate about video game addiction’s legitimacy goes on

In fact, it appears that the many researchers are reluctant to declare it a condition. That is not surprising to me as my research into this issue revealed that there can be many causes for so-called gaming addiction. One concern is that these symptoms could be part of another diagnosis –a different issue than a mere addiction. Another concern is that the research is not based on consistent diagnostic criteria making the results less than reliable.


Professor Mark Griffith says the condition is rare

However, “Professor Mark Griffiths is a Chartered Psychologist and Director of the International Gaming Research Unit at Nottingham Trent University, and he was part of the WHO Working Group that provided input on the decision to add gaming disorder to ICD-11. He says that there is overwhelming evidence for gaming disorder:

‘Hundreds of studies that have shown that a small minority of people, when gaming to excess, have major problems in their life. I’ve published more papers on video game addiction than anybody else in the world. What we’ve got is country after country, study after study basically showing that a small but significant minority of people where gaming is something that completely takes over their lives – and we’re not talking about kids who play 3 or 4 hours a day, that is nothing to do with gaming disorder. We’re talking about something that completely compromises that person’s life. It’s something where people have withdrawal symptoms if they can’t engage in the behaviour, they’ve built up tolerance over time, needing more and more gaming to get those same mood-modifying effects. They are people that use the behaviour basically as a way of self-medicating: they use it either to get buzzed-up highs, aroused, excited, or they use it for the exact opposite, to tranquilise, to escape, to numb, to destress.’”

According to Mark Griffiths, only 1% to 4% of the gaming population are even at risk for gaming addictionand far fewer than that actually have it.

In order for it to be a legitimate gaming addiction, it must meet some pretty strict criteria. Most children —even most ADHD children– will not meet these criteria. I know a lot of people who love video games, but I have yet to meet anyone who actually has bonafide withdrawals from not playing video games as Griffith describes in the quote above. I have played games on and off for decades. I can go for months or years without playing a game with no problem.


The WHO’s definition of video gaming addiction

The WHO defines the symptoms of gaming addiction thus:“1) impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context); 2) increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and 3) continuation or escalation of gaming despite the occurrence of negative consequences. The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. The pattern of gaming behaviour may be continuous or episodic and recurrent. The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are severe.”


Gaming addiction is different than playing video games a lot

Professor Mark Griffiths “is keen to point out that gaming addiction is by no means the same as just playing games a lot. ‘It’s nothing to do with the amount of time you do something, it’s to do with the negative knock-on effects on that person’s life. I’ve published one case study where a guy was playing over ten hours a day but clearly wasn’t addicted.’” “‘I’m in no way anti-gaming,’ he cautions. ‘I do it, my kids do it. It’s a bit like drinking alcohol: there is no evidence that doing any of these things moderately has any negative effects whatsoever,’ adding that gaming can have great therapeutic benefits.

Griffiths has been dismayed by coverage of ‘gaming addiction’ in the mainstream media that is clearly not addiction at all. He points out that if there were reports of children watching TV for three hours a night, no one would care, but that playing games is seen as morally reprehensible, a waste of time. ‘My son is playing two or three hours of Fortnite a day at the moment,’ he notes. ‘It’s just something that’s life enhancing, life affirming, has no effect on his education, the chores around the house or his interaction with his friends, but the media have taken what is essentially a normal behaviour, and it’s been pathologized. This is nothing to do with gaming disorder whatsoever.'”

“‘I’ve commented on story after story about people who are so-called “addicted” to Candy Crush, and it’s just people who are playing it far too much. That’s not an addiction, that’s not gaming disorder. When we’re talking about gaming disorder, we’re talking about an activity that clinically impairs somebody’s life to such an extent that they have to seek treatment for it, and the number of people who do that in this country are few and far between.’”


The WHO’s diagnostic criteria is still subject to change

“The current version of ICD-11 won’t be endorsed by the WHO members until a meeting in May 2019, and there is still a chance it might be amended before then. After that, national governments could still take years to formally adopt ICD-11, and they may well add their own amendments.”


Issues with the WHO’s diagnostic criteria

My problems with the WHO’s criteria and description of gaming addiction is that it looks an awful lot like ADHD hyperfocus or even autistic special interests. I wouldn’t have as much of an issue if the criteria specified that the condition should only be diagnosed if there wasn’t another condition that explained the symptoms (perhaps that is assumed?).

What if I was obsessed with painting? All I wanted to do was paint, and I ignored everything else in my life to paint. It started affecting my family, my school, my work because I was completely obsessed with painting. Is that an addiction? Or is it a passion? If I was a gifted painter, no one would think twice about me acting like this. Under the WHO’s approach, the Absent Minded Professor would have been diagnosed with addiction to science. Are we now going to put those with ADHD, autism or those who are gifted through a 12-step program because symptoms of their known conditions are being misdiagnosed as an addiction? I think this is a slippery slope and that the criteria for addiction need to be better defined.


Our culture views video games as evil

Also, what a way to spin a great thing and make it seem horrible. As an ADHD person, I find it outrageous and repugnant that my hyperfocus would be misconstrued as an addiction. But in our culture, it is generally considered okay to be obsessed with painting or anything that produces a tangible result –but not okay to be obsessed with anything on a screen. Remember: screens are evil, right? That was established as a cultural belief decades ago, but I have yet to see any science that says screens are actually evil.

Screens are not evil. They are amoral… neither right or wrong. What we do with them makes them right or wrong just like I can use a bat to play baseball or I can beat someone to death with it. It is not the bat’s fault that I used it for evil. The bat itself is not responsible for the evil that was done with it. That bat is not inherently evil. It didn’t cause the evil. The responsibility belongs to the human behind the bat –or in the case of video games the human in front of the screen.


Hyperfocus is my superpower (Can I trade it for flight? Or invisibility?)

In fact, this article you are reading is actually brought to you by ADHD hyperfocus. I heard about the WHO’s decision about 10am this morning, and it is almost midnight now. I spent nearly all day reading and working on this article because my brain is completely captivated by the topic (by the time I finished the post it was 3 days later). This is not a bad thing. I consider hyperfocus to be my superpower. I am thrilled that my brain works this way and refuse to let anyone say that it is okay to try to make ADHD people feel ashamed of their hyperfocus. 


Video game panic leads to bad conclusions

Calling this issue an addiction makes it simple. “Video games equal bad, so we get rid of video games” is a simple answer. We humans like simple answers. But, we aren’t simple creatures. The general objection to video games in the culture and media has created what some refer to as “the moral panic over video games.” Mark Coulson, Associate Professor in Psychology at Middlesex University, London, says that the “presence of a current moral panic regarding video games may cause the medical community to take ill-considered steps, despite ambiguous research evidence, that do more harm than good to the global community of video gamers through the pathologizing of normal behavior.

I wrote another post about my family being judged for our hobbies because we like watching movies and playing video games which are considered by many to be inferior hobbies. Reading is currently considered a “good” hobby, for example.


Alternate explanations for the symptoms of gaming addiction

So, how can you tell if your child’s behavior is normal? And, if it is not normal, what else could be going on?

From my research last year and the opinions of those who objected to the WHO’s decision, it seems that other conditions, diagnosed or undiagnosed, could be causing this behavior that is considered an addiction. Without a proper diagnosis, these children will not get the help they need and could be unnecessarily deprived of their phones, gaming devices, and online educational resources.


Sending your ADHD child to Alcoholics Anonymous?

There currently isn’t really a standard treatment plan for gaming addiction. The treatments I have seen recommended are similar to a 12-step plan –and in some cases, children are actually attending Alcoholics Anonymous (AA) meetings because there’s no support available yet for gaming addiction. As of when I’m writing this, I know of a family whose child is going to AA for gaming addiction. The problem with sending an ADHD child to AA is this: ADHD is a regulation disorder, and AA is based on your ability to self-regulate. AA is self-willed and self-driven, but what if, by the very nature of your neurological condition you are not strong in the area of self-control? It is widely known that ADHDers struggle in this area of regulation. In his video series, Dr. Russell Barkley discusses that this regulation struggle can take many forms: physical (like hyperactivity), emotional (like outbursts), or mental (like hyperfocus). I’m not sure that a 12-step program is the best way to help an ADHD child regulate themselves better –especially when we have proven scientific, medical methods to do it.


What if gaming addiction is really part of a different disorder?

Many problems in an ADHDers life are caused by them trying to self-treat. Gaming is no different. Even the advocates of gaming addiction say that what they are calling gaming addiction is a person’s effort to self-medicate. Self-medicate for what? Why are we not diagnosing the condition that is causing the lack of control over gaming?  Even the doctors and researchers who objected to the WHO’s inclusion of gaming addiction as a disorder agree that some people have problems with gaming. “Their argument was simply that these problems should not be attributed to a new disorder.” What if this behavior was just part of the ADHD person’s failure to regulate well? Failure to regulate well has to do with low neurotransmitters as a result of ADHD, namely low dopamine. …nicotine, caffeine, alcohol, opiates, risky sex, pornography, gambling, physical risk-taking, reckless driving, and compulsive buying increase dopamine even more.” Almost all risky behavior that ADHDers participate in is an effort to increase their neurotransmitters.


Video games increase ADHDers low dopamine

ADHD…due to the typical symptoms of motor restlessness, poor concentration, and distractibility, it is thought at least in part to be caused by problems with dopamine levels or the efficiency of dopamine receptors in the brain.

One of the trademarks of ADHD is low levels of neurotransmitter dopamine –a chemical released by nerve cells into the brain. People with ADHD are ‘chemically wired’ to sneak dopamine, says John Ratey, M.D., professor of Psychiatry at Harvard Medical School in Boston.” (See image 2 at this link)

We also know that video games increase dopamine.


Dopamine-seeking behavior

But, is trying to fill up your low neurotransmitters the same as an addiction? If you know the child has a disorder that includes low dopamine and other low neurotransmitters, and, as Dr. Russell Barkley says, ADHD medication increases those low neurotransmitters, is addiction really an accurate diagnosis? Or is the child not medicated when he needs medication? Or not properly medicated if he is medicated? Perhaps there are other activities that the child can do which will up his dopamine such as one of the activities listed here. According to Dr. Barkley, exercise is the most effective treatment for ADHD after medication. According to WebMD in this article explaining the benefits of exercise for those with ADHD, “When you exercise, your brain releases chemicals called neurotransmitters, including dopamine, which help with attention and clear thinking. People with ADHD often have less dopamine than usual in their brain.” Here is research about the effectiveness of ADHD and exercise in adults and children.


Properly medicating ADHDers reduces addiction problems

Another myth that is passed around the internet is that all ADHDers are addicts. I have been told that all ADHDers will get addicted to something because they just cannot help it. I have been told that we ADHDers are even addicted to our own medications and that those medications cause addiction, even though research doesn’t back that up.

The truth is that, when ADHDers are properly medicated, studies show that they are less likely to develop addictions. Addictions in the ADHDer is nearly always an attempt to self-medicate. If the person is well-medicated –meaning the medication is doing it job– then they will not look for ways to self-medicate.Stimulant treatment of ADHD appears to result in reduced alcohol and drug problems, not increased substance abuse.

My mental health nurse practitioner told me that her patients who are ADHDers and former drug addicts will not return to drugs if she can get them properly medicated for their ADHD. Why would they? Illegal drugs destroy their lives and are a poor substitute for being properly medicated. Overall, addictive behavior is reduced by proper ADHD medication. You can see more about ADHD medication and abuse rates if the patient has a history of drug abuse here.


What if the medication doesn’t work?

However, a for a small percent of ADHDers, medication doesn’t work. In his video series, Dr. Russell Barkley says that medication doesn’t work for about 10% of patients. CHADD says that medication works for about 80% of patients leaving 20% it doesn’t work for. When the medication doesn’t work it could be the wrong medication, the wrong dose, or even the wrong diagnosis. I am not a mental health professional (or a medical professional, for that matter), but I have worked with adults and children who have ADHD since 2012. In my observation (which I admit isn’t research), many times when medication doesn’t work it is because there is an undiagnosed psychiatric condition. According to this research, 50% of ADHD people also have a comorbidity like a mental health disorder. So, if the child is properly medicated and still exhibiting addictive tendencies, maybe there is another condition at play. This is why I recommend a full psychological evaluationnot just ADHD screening, because we cannot treat what we do not know about.

Although, as we mentioned above, the Columbine High Massacre in 1999 was blamed on video games, music, Dungeons and Dragons, and even bullying, further research has shown the true issue: the perpetrator, Eric Harris, had severe psychiatric disorders including “a disturbed personality with prominent antisocial, narcissistic, and sadistic traits.” This is not surprising, because mentally healthy, emotionally stable individuals do not go shoot up a school murdering a bunch of innocent people. A healthy person doesn’t see a movie or video game with a murder and say “Gee, I think I would like to do that” –not even if he was bullied. Lots of kids, including me, are and were bullied. It made me a more kind, more compassionate person –not violent.


What if your child is violent?

If your ADHD child exhibits this kind of violent behavior, this is not part of the ADHD. There is something else going on. Please get your child help! Many hospitals have psychiatric wards that will take in children who are exhibiting violent tendencies. Please, consider those hospitals an option if you need them. Please, seek treatment, and don’t try to handle this yourself.

If you are concerned that your child is going to exhibit these characteristics as a result of exposure to media, then look into the dark triad disorders and sadism and be aware of the symptoms –it is pretty obvious when a child is exhibiting these. Many ADHDers are highly sensitive and suffer from rejection sensitive dysphoria making it unlikely that they would engage in activities to intentionally hurt other people. Many ADHDers are extremely empathetic and the idea of hurting others would be too painful to handle.

I once read an article explaining that children with ODD, bipolar, and conduct disorder can get more violent when exposed to media and video games. These children are already experiencing a social disconnect, the writer explained. Media can increase that disconnect making the child more aggressive when he or she walks away from it. I cannot find the article I read, but here is a study that has some similar findings. If your ADHD child has one of these comorbid conditions (like ODD, BPD, or CD), you need to be aware that screen time could cause increased aggression. But, again, there is an explanation for it, and it is not addiction.


Video games do not cause increased violence

In general, though, video games don’t cause an increase in violence: “…the latest statistics show youth violence at a 40-year low despite the popularity of video games… something that has to be considered, especially with media psychologists insisting that game violence is directly responsible for shooting rampages….


It could be an emotional regulation problem

ADHD children are 30% behind their peers in their ability to regulate according to Dr Russell Barkley. There’s a nifty chart explaining this concept in this post. Due to this problem with regulation, ADHD children, especially young children, often react with extreme emotions to being taken away from the television. My children were this way with TV and video games –among other things. As a result, we had certain times of the day we watched TV and one day a week when we played video games. Having a schedule made it predictable, and my children knew that at a certain time, the TV or video games would be turned off. It didn’t remove all the drama, but it certainly minimized it. We were able to do away with this as my children got older.

Why do ADHD children react this way? They have big feelings and lack the ability to regulate those feelings due to the underdeveloped parts of their brains. It is not that they are addicted to TV or video games. Every child experiences disappointment when mom turns off the TV or says they cannot play video games anymore. But, an ADHD child may be unable to contain his disappointment due to his poor regulation which results in a meltdown. Many parents –like me back when my kids were young– freak out that their child is addicted to screen time without knowing that the real cause is the ADHD. After we all got diagnosed with ADHD, their reaction to screen time started to make so much more sense.

A friend of mine pointed out that parents often refer to this as “an addiction” for lack of a better way to describe it. A more accurate description would be, “My ADHD child is failing to regulate their emotions regarding media and video games.”


While addiction to games is possible, it is not likely

We should approach this topic informed. We should be aware that the possibility exists that gaming addiction could be a problem, but that it is exceptionally rare. We should not call the symptoms ADHD or other psychiatric conditions “an addiction” when we know there are other explanations.


We can use video games to our advantage

Video games can actually be used to our advantage, too. Dr. Barkley says that video games work in a way that helps the ADHD brain. Gamification can be a wonderful tool in the arsenal of teachers and parents if they can get out of the mindset that screens are evil and understand the way that the ADHD brain works.

Gamification is “the process of integrating game mechanics into a system that already exists to motivate participation, engagement, & loyalty.Wikipedia defines gamification as “the use of game thinking and game mechanics in non-game contexts to engage users in solving problems.” It was first used in business to engage employees, but many ADHDers have found it a very helpful method to motivate themselves. There are even benefits to using gamification in learning environments.

I wrote a post about using motivation tactics similar to gamification to help my son completed his chores. Although I received a lot of online hate for giving my child half a dozen mini M&Ms (which is just silly since that is hardly any sugar), it worked really well! I know now that rewarding him with a small piece of chocolate after each task was motivating just like he might receive a small reward for a quest in a video game. This worked so well that after a while he didn’t even need the chocolate anymore. He is now able to complete his chores without it, but at the beginning, it really made a difference in his motivation level.

I haven’t even addressed how useful media and video games can be in helping calm ADHD children with comorbidities like sensory processing disorder, autism or anxiety disorders.


Gamification is a fabulous tool

So, not only is gaming not evil and most likely not the source of the ADHD child’s problems, but it could be a huge answer for many parents who ask how they can motivate their child. Make a game out of it! Every parent knows that children –whether ADHD or not– do better when you can make the tasks fun. That is even more true for ADHD children. Don’t believe me? Listen to Jessica from How to ADHD explain how gamification has helped her.


Conclusion

So back to our original questions: Are TV, media, and video games dangerous for my child? No, they can even be useful tools. Will my child become addicted to them by using them? According to what I have read, probably not, unless they have symptoms not already explained by their developmental disorders or psychiatric conditions. But, due to their ADHD, they may need help regulating themselves. Dr. Barkley calls this scaffolding.

Of the thousands of parents I have worked with over the last six years, more than half of them were incredibly concerned about the effect that media, social media, TV, video games, and even internet-based or computer-based education were having on their ADHD children. It seems important to mention before I end that even those doctors and researchers who support the WHO’s decision to include gaming addiction as a medical diagnosis admit that the condition is exceptionally rare. “Gaming is not being classified as a ‘disorder’ – a disorder is being recognised that affects a tiny fraction of gamers.

It is unlikely that the gaming addiction condition is as common as the parents who are concerned their children have it.

I hope you found this post helpful. There are many links in the post to follow if you are interested in learning more about this topic and if you want to know where I got my information. Let’s learn the facts and stop hating on video games and media. Instead, let’s use them as a force for good!

And, let’s not give into the uproar created by the media.

Blessings,
Sarah Forbes

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ADHD

Adhd and Self-identity: Read This Before You Comment

From time to time, I receive criticism for the phrasing that I use to describe ADHD people.

I use “people with ADHD” and “ADHD people” interchangeably. But, honestly, I prefer to describe myself as “an ADHD person,” not as “a person having ADHD” or “a person with ADHD.” I have Hashimoto’s Thyroiditis –it is a disease that is attacking my body, but it is not who I am. I don’t really “have” ADHD because it is not a disease. It is part of who I am, part of my genetics –just like green eyes and brown hair are part of my genetics. It is not a disease that needs to be eradicated. It is just a different way that my brain developed.

But, regardless of whether or not you agree with my reasoning, basically it comes down to this:

As an ADHD person, I get to decide how I prefer to describe myself.

There are various terms used to describe ADHD people: ADHDers, shiny, squirrels, and many others, I am sure. These are all terms we use to describe ourselves. For every label, you will probably find an ADHD person who objects to it. So, that is why it falls to the person who has the ADHD to decide how they want to be described or addressed.

It may surprise non-ADHDers to find that there are actually many people on both sides of the “ADHD people” versus “people with ADHD” debate. This blog is not the place to debate such things.

It is unreasonable for those who do not have ADHD to try to dictate to me how I should describe myself. It is doubly unreasonable for those who are not ADHD to be offended by how I choose to describe myself or to tell me that I should be offended by how I choose to describe myself. I will describe myself and my community of ADHD people how I see fit. Other ADHD people are –of course– welcome to their own opinions and preferences, but since this isn’t their blog, they don’t get to dictate to me how I describe myself or my community of ADHD people here on the blog.

And, honestly, there are so many bigger problems in this world than how we describe ADHD! Let’s not make a mountain out of a molehill.

Let’s focus on things that are really, truly important:

• getting proper diagnosis and treatments for those who need it.
• educating parents of ADHD kids and ADHD adults about the disorder.
• curbing the misinformation that permeates our culture, media, and the internet.

If you want to be an internet social justice warrior, there is plenty to fight against in the list above!

Thank you for handling this topic in a reasonable and rational manner. A mature person scrolls past something they disagree with on the internet instead of attacking the person they disagree with. When in doubt, be kind. It doesn’t cost you anything to just be nice. Don’t be one of the people who spreads ugliness when they could spread beauty, joy, and sunshine.

Blessings,
Sarah Forbes

ADHD, faith

The Shoulds of Life Can Destroy You

Should is a messy word.

It’s a messy word that messes with my mind.

I should do this.

I should be able to do that.

Should is like an arrow that shoots guilt into the heart of the receiver and drags them down to the bottom of the Pit of Despair.

With one word, I can make someone else feel like a total loser.

With one thought, I can make myself feel like a total loser.

As my children get older, should takes on a new approach: I should have done this or I should not have done that.

Should doesn’t just destroy me: it can destroy my kids.

How many times have I said, “Well, you should be able to do that!”

I have kids with special needs and should isn’t a fair gauge.

I have ADHD and some massive health problems. Should isn’t a fair gauge for me either.

Should doesn’t have realistic goals.

It looks at the ideal.

Should is a perfectionist who doesn’t want to face reality.

It asks “What would happen if no one had any roadblocks?” and measures everything by that ruler.

The problem with this? We don’t live in an ideal world.

We don’t live in a world free of roadblocks.

We live in this world.

Everyone –no matter who they are– has some impediment ….mental illness, chronic health issues, learning disabilities, childhood trauma –just to name a few.

Should criticizes and tears down the confidence we have and ignores the progress we’ve made.

It changes around our thought process from being content with what is working to being dissatisfied with life.

This is what I have learned about should:

  1. It’s a liar. A lot of times, the things I tell myself I should be able to do aren’t true, or at least they aren’t true for me. “I should be able to do calculus.” Really? I have dyscalculia, a math-based learning disability. I need to change the should to something rational. Something like, “I might be able to do calculus if I get a tutor who specializes in learning disabilities.” Here’s another, “I should be able to keep my house clean.” That pang of guilt from the should kills me, but it’s also not based in reality. I have over 20 medical diagnoses. Some days, I can barely walk. Would I expect a friend in that condition to keep her house immaculately clean, the standard I hold myself to? No. A more reasonable thing to say to myself is: “I might be able to keep the house clean if I get help.”
  2. It’s destructive. If I allow the shoulds of life to take over my heart and mind it destroys every bit of joy I have. There’s only so much that I can control. What is in my power, I can reasonably expect myself to do. What’s outside my control –my health, my children’s disorders, my friend’s attitudes– those I should not guilt myself about and should not second-, third-, and fourth-guess myself. One thing that’s in my power: how I use my words and what thoughts I entertain and encourage. Every little bit of joy, happiness, and confidence can be destroyed by that little word should if I let it have control over me.
  3. There are many versions of should. For example: “If you really loved her, you would have put her in Karate so she’d be able to protect herself.” What is that statement really other than a veiled should intended to bring shame and heartache? How many times have I hidden a guilt-inducing should in a sentence that stung someone like a dagger?

Should is just a helping verb.

Am I really going to let a little verb have this much power over my life and my family’s life when I have the power to change the narrative, power to change my own outlook and happiness, not to mention that of those around me?

Words are very powerful.

Although we liked to reject the power of words as kids (Remember “I’m rubber –you’re glue….”?), the truth is that words have the power to build up, to tear down, to sustain us through the hard times, or compel us to give up. Words can even make us believe there is no hope.

Worse yet, if we say something often enough or loud enough, we start to believe it no matter how far from the truth it may be.

So, I’ve started intentionally changing my narrative. I am trying to rethink my shoulds.

For instance, when I’m panged with guilt and say to myself, “You should have had him in piano years ago!” I change it to, “I could have had him in piano years ago, but we didn’t have the money. I had to make the best decision for the whole family.”

This is truth.

Truth sets me free.

And, poof, the guilt is gone.

Should has lost its power.

When I’m frustrated and think “He should be able to write this” about one of my kids, I change the words I’m using to “could.” “He could write this if he didn’t have this learning disability. I’ve worked really really hard to get him to the place where he is. He may not be where other kids are, but he’s actually doing really well.”

I’m truth-checking my own statements so they do the least damage possible to me and to those around me.

I know should is a liar and that his lies are destructive. So, I’m not letting his lies –no matter what form they take — settle in my heart and mind and contaminate my joy and peace.

Check your shoulds at the door.

Don’t let them ruin you –or those you care about.

You have the power over your inner voice and over the words you speak to others.

Speak truth.

Blessings,

Sarah Forbes

If you found this helpful, you might find these posts about seeking peace and about giving yourself and your kids grace helpful, too.

17 Things Your ADHD Child Would Tell You If He Could

What Is My ADHD Child’s Executive Function Tank

How Do I Do It All?

ADHD

Posts You Might Have Missed

With the recent changes on the blog, there seems to have been some hiccups. For some reason, it seems that many of my followers were not receiving emails notifying them of new posts. I hopefully have the issue resolved, and so I decided to do an update post in case you missed some of my recent posts.


I created a much needed ADHD Clinician Database. Do you know an awesome clinician? Please, share it with our members in the comments of this post. It is such a great need. It is so hard to find good doctors!

ADHD Clinician Database


 

My family has a history of hoarding. When you have ADHD, mental health issues, or chronic health problems, you can easily fall into hoarding. This post is an honest, plain look at the multi-generational effect that hoarding has on families and my endeavor to break the hold the possessions have over our lives.

Overcoming Hoarding


 

What do you do if you think that you or your child has ADHD? Where do you start? How do you know if the doctor you are seeing is a good doctor to treat ADHD? This an more is discussed in this pose about getting an ADHD diagnosis. It is especially important to have a full phycological evaluation to rule out other conditions. 50% of ADHDers have additional psychiatric conditions and these conditions can significantly complicate ADHD and its treatment.

How to Get an ADHD Diagnosis


 

Hopefully, the glitching is over, but thank you for your patience as we work on upgrading and improving the blog.

Blessings,
Sarah Forbes

ADHD, hoarding, illness

Overcoming Hoarding

Many people with mental health conditions, ADHD, and chronic illness deal with hoarding tendencies. Our relationship with stuff can be incredibly complicated and overwhelming.

This is the story of my family and my struggle with hoarding.

Do you know the difference between hoarding and collecting? A collection that is not actually valuable, useful, organized, and accessible is likely hoarding because if you can’t manage your things, you will easily fall into hoarding.


Now, before I get started, let me apologize to my family for any of the details that I may have gotten wrong. My intent in writing this post is to help other people who are struggling with hoarding. My writing is only as accurate as my memory. Since many of the things described in this post happened when I was a child or even before I was born, I am doing my best to accurately convey them to the best of my recollection. Please forgive me if I am less than totally accurate about some of the details. Please know that I am not disparaging anyone’s character in this post, but rather giving commentary on the effects of mental and physical illnesses.


This is the story of four Sarahs. Four girls, all named Sarah, spanning nearly a century.

This is the story of how hoarding has affected our lives and the story of my pursuit to break the generational hold that stuff –possessions– has on our lives.

Sarah Number One

My great grandmother’s name was Sarah. I never had the pleasure of knowing my great-grandmother as she died before I was born. I know that she was a very caring, loving lady who had only one child: my grandmother, also named Sarah. While my grandmother described my great grandmother as loving, she also described her as controlling and obsessive. If she were alive today, I have no doubt that she would be diagnosed with Obsessive Compulsive Disorder. She required everything to be meticulously clean all the time. She held my grandmother –who was not naturally meticulous– to her standard. My grandmother was not allowed to save treasures or things that were important to her. Everything always had to be perfect in their house –and if it was not, then my grandmother was not even allowed to have friends over. Once, my great grandmother decided that her curtains were not right, therefore my grandmother was not allowed to have company. Listening to my grandmother describe her relationship with her mother, it was quite obvious that –while she loved her mother very much– she did not agree with how her mother chose to interact. Her mother put a huge emphasis on things, on perfection, and on tidiness at the expense of all else. This attitude would greatly influence her daughter.

Sarah Number Two and Three

My grandmother is Sarah number two. She grew up, got married, and had children. From what I have heard, she didn’t really start having problems with hoarding until after her fourth pregnancy. There were complications, she was hospitalized, and the baby –named Sarah Jane– died. Sarah Jane is Sarah number three. Sarah Jane was one of eight babies my grandmother lost. My grandmother’s health –physical and mental (which often go hand-in-hand)– declined from there. From what I understand, it was sometime around then the time of Sarah Jane’s death that my grandmother started hoarding. My father describes a memory of being so happy once when the living room was cleaned out that he has his siblings danced around happily because there was finally enough room to play.

Grandma probably had many of the same conditions that I have. Unfortunately for her, in the 1950s and 1960s, doctors were less likely to diagnose and treat conditions in women, and many of the conditions I have were unknown –undiagnosable– at the time. If I had to guess I would diagnose her with a thyroid problem, estrogen dominance, ADHD (maybe even a form of autism?), OCD hoarding –just from the limited knowledge I have. Since I spent very little time with her as an adult, this is mostly based on my memories of her as a child. Even in the 2000s when my mother was taking care of my grandmother, her doctors dismissed her symptoms and didn’t take it seriously. If they had taken it seriously, we may have discovered her cancer in time to save her life –but that is another story for another time.

Before Great Grandma died in the 1970s (when I was yet to be a gleam in my daddy’s eye), she bought Grandma a beautiful Civil War era house with a wrap around porch on a hill. It was certainly large enough to house my grandmother’s family of (by then) seven children.

In 1976, my mother visited my father, her then boyfriend, at this house. During the visit, their freezer died, and my mother assumed it would be dealt with.

But like many things, it was not.

By the time I knew Grandma, her house was full to the brim with stuff. So full of stuff that I don’t know what her house really looked like. All I could see was goat trails through piles. Even the outside of the house was cluttered and obscured with stuff.

In the 1990s, something got too close to the coal burning furnace in the basement, and that beautiful house burned to the ground nearly killing my grandfather who was sleeping on the fourth floor. That same fridge was still where it had died in December of 1976. It had never been cleaned out –never even opened I was told.

My grandmother moved a trailer onto the property with the intent of sorting through the rubble of the fire for her “treasures” that were in the fire. Due to her mental health issues or the physical health issues which restricted her movements, this sorting didn’t happen. She wouldn’t let people clean out the property. Even years later she complained about the things she hadn’t been able to save. What she did save was often ruined by water or smoke damage but it was still vital to her –absolutely essential to her that she had these things.

Eventually, the county forced them to sell the property and the debris from the house was cleaned up. What she had saved was moved into one of her children’s houses merely transferring her hoarding to a new location.

Unfortunately, the actual issue was not addressed.

What follows is my opinion based on conversations with my Grandmother when I was in high school (some of my family may or may not agree): My grandmother’s mother was an OCD clean-freak, critical of my unknown-then-probably ADHD (among other things) grandmother. My grandmother never learned to view possessions in a healthy way. She was forced to never keep anything –even special things– as a child, and she reacted as an adult by keeping everything.

This has been passed on to her kids, grandkids, and now great grandkids. It’s like our brains are wired to see possibilities and struggle to get rid of them. We make emotional connections to and plans for the things we possess. We can see the possibilities and struggle to look beyond that to the problems those possessions are causing in our lives.

I’ve read about epigenetic and how researchers believe that certain traumas in your family history can trigger a switch in your ancestors genetic make-up inclining you toward certain behavior or certain conditions.

Sarah Number Four

Hi, I am Sarah number four. Actually, I am Sarah number seven in our family according to my grandmother, but I am only including four of the Sarahs for the purpose of our story.

I am very much like my grandmother in many ways. I am gifted, artistic, and not naturally organized –totally ADHD. I look like her, even down to the same weight problems she had. I love dresses and long hair, just like she did. My aunt likes to remind me how much I look like Grandma. We have many of the same health problems, likely a result of shared genetics.

I recognized this struggle with possessions in myself in my early twenties.

I didn’t want to copy the same mistakes that my grandmother had made. I wanted to make wiser, better choices about my possessions.

I don’t want my possessions to rule my life.

So, I started actively working on my own view of possessions until I could get rid of things. More than once, I cleaned everything surplus out of my house –then I would relapse due to my illness. So, I would clean it all out again. At one time, I hauled 3 truckloads of craft and art supplies out of my garage to the local thrift store.

It took a few years of forcing myself to face this issue and my approach to possessions before I saw real progress.

The first few times, I will be honest –it was really hard. I had plans for those things when I bought them. But, my ideas are always greater than my time and my energy. Learning to accept reality was very important to my ability to part with my stuff and not bring more stuff into my home –as was dealing with my health and mental health issues (an option that was not available in my grandmother’s time).

Here is the reality: I will always have more ideas and plans than I have time and energy for. Once I accepted that as a fact, it made getting rid of things so much easier. Knowing that my ideas were greater than my ability to fulfill my ideas meant that I could put a priority on the things that were really important and get rid of the other things.

It was then that I started noticing this same hoarding tendency in my children.

I am fighting a multigenerational battle.

This battle –as far as I know– started with my great-grandmother and how she interacted with my grandmother and has been passed down from generation to generation.

Now, it’s passed to my children.

I am now fighting for my future grandchildren.

I am fighting to break a pattern of behavior that is neither healthy nor ideal. It is not what I want for my children and grandchildren.

Although sometimes due to my health and my inability to clean my house still resembles that of a hoarder, it is not because I cannot get rid of things.

I have learned to get rid of things.

At one point, a group of ladies came to help me clean out my house. In one day, we overhauled and cleaned out the whole house. I was getting rid of things hand-over-fist as fast as they could bring them to me.

For me, overcoming this need to have things just in case or because they were special, unique, or important to me came down to a few factors:

1) I’m a Christian. If I believe God will provide what I need then I don’t need to keep every little thing just in case. We need far fewer things than we think we need. Most of what we think of as needs are actually wants. I should be storing (hoarding) treasures in heaven not here on this earth.

2) There are very few things that are truly unique, and nearly everything I own could be bought again on Amazon or eBay if I truly and actually needed it. The toll of the possessions on my life is not worth keeping things just so I feel like I have been frugal.

3) Our things must fit in our space. If they don’t, we are not good stewards of our space. Our space –such as our homes– is also something God has given us. If things don’t fit in our space, it makes everyone miserable.

4) Even if I saved it for later, if I can’t manage my stuff, then even when I need it, I will not be able to find it, in which case I have wasted the storage space and my time.

5) I decided that people were more important than things. If I am choosing to fill up my home with things, to make my home unsafe for my children, to force my children and husband to work around my possessions that I refuse to get rid of, I have prioritized things over people –over my own family. I cannot do this in good conscience.

6) I decided I was not bringing new things into our house unless they were necessary. If I have the mindset that I am not bringing new things into the house, it saves me a lot of hassle. My first answer is “No new things.” If we actually need new things, I can adjust. But, assuming I will not bring new things into the home helps keep me from the mindset of always collecting new things. It was a change in the way that I think about possessions.

With the intent of teaching my children to not cling to possessions too tightly, I have begun to embrace minimalism. Not entirely –because I still have way too much stuff, but I have found the idea of not having more than we need very helpful.

I have worked really hard with my children on this issue. We have discussed at length –with kindness and understanding as well as honesty– about my grandmother’s issues.

I remember how traumatic it was when I came home from school at age five and many of my favorite things were gone. I know my mother meant to help, however, it made me cling to things more tightly. I do not force my children to get rid of things. Instead, we discuss what’s needed, why we keep things, the nature of possessions and how they can possess us if we aren’t careful. I’m trying to teach them how to get rid of things. How to be rational about possessions.

They have a drawer in their dresser that they can keep special things in and a box on their school shelf for special papers. When the box is full, they have to choose what to keep. Sometimes, we photograph special items and save the photo if we have to get rid of the item. I try to treat them –and their feelings– with respect. As an adult, their things may not seem important to me, but it is very important to them. If I want them to value what I value, I need to be willing to value what is important to them.

I’m not going to lie and say that this is an easy topic. It’s not. I’m fighting generations of genetics that incline us to certain behaviors.

I don’t get rid of everything. For instance, I have never gotten rid of one piece of my art. Somethings are important to keep.

With my children, I have decided to pick my battles, to be more concerned about if they’re learning to be discerning than if they get rid of every little thing.

It’s a journey.

One that I’m still on.

But I know there’s hope because I can see how much I’ve improved. I can see how much my children have improved.

I have learned to be thankful for what I have and thankful to have just what I need instead of clinging to everything for the one-day-plans that I had. Being thankful has greatly improved my outlook on things! If I’m thankful for what I have I’m less likely to feel the need to acquire more.

I posted a version of this article on one of my facebook groups and inspired a self-proclaimed hoarder to start cleaning her house. So, I am posting it here, honestly and plainly, in hopes that it will help and inspire others.

I do not claim to have conquered this area — on the contrary, it may be something I struggle with for my whole life.

But, if you struggle with it, you are not alone. There is hope. There is progress. It can get better. The first step, in my experience, is to get a proper diagnosis. A lot of hoarding is a result of unaddressed anxiety. You can’t help what you don’t understand. Thankfully, unlike in my grandmother’s day, there are doctors who will listen to women and treat them.

Be your own advocate.

Fight for yourself, for your family, for your future.

Your choices now don’t just affect you: they affect the generations to come.

Blessings,

Sarah Forbes

P.S. To any of my family who reads this, please give me grace as I tried to deal with this topic as graciously and honestly as I could.

If you found this post helpful, I would be honored if you would share it. 

ADHD

How To Get an ADHD Diagnosis

If you are an adult who thinks you have ADHD or if you are the parent of a child who you think has ADHD, where do you begin? How do you go about getting a diagnosis?

Caveat: Because I live in the USA, this will be written from the perspective of someone using our medical system here in the US. If you live in a different country, you may have to go about getting your diagnosis in a different way.

First of all, look up ADHD symptoms online and write down every symptom that you or your child has. Check multiple web pages, because one webpage may only list hyperactive type or another might only focus on inattentive type.

If you or your child are female, I recommend looking for pages that list women’s and girl’s symptoms specifically, because the ADHD often manifests itself differently in women and girls who are much less likely to get a diagnosis than boys are.

Write down any and all symptoms.

If the list is for you, an adult, write down any symptoms you had as a child on a separate list. Ask an adult who knew you as a child, if possible. I was surprised to find that my mom remembered me having anxiety as a child when I did not remember, for example.

Go to your primary care doctor and request a physical –a full blood panel including thyroid– and a sleep test. You want to rule out other conditions that could be mimicking the ADHD before you pursue a diagnosis. I would also recommend food allergy testing as some ADHD people find that their symptoms go almost entirely away when they remove trigger foods from their diets. Unfortunately, our PCP refused to do allergy testing for me when I requested it.

I recommend at least thyroid blood tests even on children because many times thyroid problems in children go unaddressed because doctors assume they are too young for thyroid problems. That is a misnomer. Children can have thyroid problems, especially if endocrine problems run in their family. Many ADHD people –including children– have sleep problems which exasperate their ADHD symptoms.

If your bloodwork and sleep test come back normal, or if you are already medicated for a condition such a low thyroid or sleep apnea and are still experiencing ADHD symptoms, I recommend contacting a mental health professional.

Depending on your healthcare plan you may need to go to your primary care doctor first and get a referral to a psychologist. Call the psychologist before setting up the appointment to make sure that this doctor knows about ADHD.

Here is an unfortunate reality: even many mental health professionals do not understand ADHD and do not believe it is real.

ADHD is very complicated. For this reason, it is best if you do not see a primary care physician or a regular pediatrician for ADHD diagnosis and treatment.

Mental health professionals that I would recommend seeing for ADHD diagnosis:

  • Mental Health Nurse Practitioner
  • Psychologist
  • Psychiatrist
  • Developmental pediatrician
  • Neurologist

As I mentioned before, I recommend calling before you set up an appointment –even if it is with a referred doctor.

You want to find out what percent of the doctor’s clients have ADHD and what percent of the doctor’s clients are adults with ADHD.

The reason the percentage of adults matters is that –while children may have no choice as to where their parents take them for treatment– adults do have a choice. ADHD adults have a low tolerance for nonsense and are unlikely to tolerate subpar treatment. If they have adults with ADHD in their care, it is likely that the care will be better quality.

When you go in for the appointment, bring your list of symptoms that you made.

Here are some warning signs to watch for:

  • The doctor prescribes medication without a formal diagnosis.
  • The doctor doesn’t believe in ADHD and refuses to test you.
  • The doctor tries to give the computer-based child’s test to an adult.
  • The doctor refuses to test if the child isn’t struggling with his grades in school.
  • The doctor always only uses one kind of medication to treat ADHD and won’t even discuss other options.
  • The doctor refuses to test for ADHD because he blames the symptoms on the parent’s: parenting style, homeschooling, divorce, low income, etc.
  • The doctor patronizes or dismisses the parents’ concerns because he or she is the expert.
  • The doctor refuses to prescribe ADHD medication but will only give antidepressants.

(The last may be necessary with a young child, but it is common for a doctor to diagnose ADHD adults with depression instead of ADHD. The antidepressants just made me not care that my life was falling apart. It didn’t help my ADHD at all.)

The standard way to test for ADHD, in my experience, is via a set of questionnaires that are filled out by 3 adults in the child’s life –often the parents, a teacher, and an additional adult. If you homeschool, you can have one parent fill out one set, and the other parent the second. We had my children’s questionnaires filled out by one of their grandmothers, a Sunday school teacher, and me. Anyone who works with the child should be able to fill out the form.

Don’t listen to a doctor who says you cannot get a diagnosis if the child is homeschooled or that homeschool children do not have ADHD. That belief represents a misunderstanding of how ADHD works –the causes and severity of ADHD– and you do not need that kind of negativity. Get a new doctor.

Although each doctor has a different way that they go about diagnosis, since the paperwork style evaluation seems to be the most common, that is what I am describing. If you see a doctor who does brain scans and more detailed testing, that is awesome, too.

When you bring the paperwork back, the doctor will evaluate the results and usually interview the child. Our psychologist talked to our children while playing board games, so it was not stressful for the child at all. I recommend cognitive behavioral therapy, too, if you can find someone who really understands ADHD. It can be very helpful if you find someone who actually understands ADHD.

Regardless of how the results of the ADHD screening test come back –whether yes or no to the ADHD diagnosis– I recommend that you get a full psychological evaluation done next. Some doctors will allow you to skip the ADHD screening and go straight to a full psych eval. Other doctors will not.

If you suspected ADHD and the test came back negative, then what else is going on that made you think ADHD? Could it be bipolar? Oppositional Defiance Disorder? Something else? A full psych eval will tell you.

If you got a positive ADHD diagnosis, now you need to know what other mental health conditions the child has. 50% of people with ADHD have an additional psychiatric condition. Those conditions can significantly complicate the treatment of the ADHD even if you choose not to medicate. Either way –medication or not– you need to know what is going on so you can help your child or yourself.

A full psychological evaluation is worth every penny even if your insurance will not cover it. It could save you from tons of heartache later, such as when you try to medicate the ADHD with a stimulant and find your child in fetal position in the living room floor having panic attacks for hours or days and unable to function because he has a separate anxiety disorder that was just made significantly worse by a stimulant. This is a true story. This is why you need to know about the comorbidities.

Another example: if you have bipolar, going on a stimulant can send you manic –something you really don’t want to happen. Another reason for a full psych eval.

Maybe your child doesn’t have comorbidities, but you need to know for sure before pursuing treatment of any kind.

Dr. Russell Barkley explains (in the video series that I recommend every person with ADHD or parent of an ADHD child watch) that ADHD is a neurogenetic disorder –ie a genetic disorder affecting the brain. ADHD medication is a neurogenetic treatment. It fixes the problem cause in the brain by the genetics.

Since ADHD is genetic, there is a genetic test –called Genesite— available which will tell you based on your genetics which medication will work to treat your ADHD. I wish such a thing had been available when my children were trying medications! The cost varies based on what percentage your insurance will pay. I have heard prices from free all the way up to $350. But, it is definitely worth asking your doctor about.

If you have a child with ADHD, do not be surprised if the doctor wishes to evaluate you and the child’s other parent as well. ADHD is genetic and runs in families. This means that there is a high probability that you or the other parent have ADHD. Since 20% of adults with ADHD do not get diagnosed and treated, doctors try to make sure the parents have access to answers. Also, 50% of people with ADHD who take ADHD medications are able to function like a completely neurotypical person, and 80% see improvement in their condition. According to Dr. Barkley, ADHD is the most treatable condition in psychiatry. The doctor would be remiss in his duties if he didn’t at least bring it to the attention of the potentially-ADHD parent(s).

Medication for ADHD is tricky –especially when comorbidities are involved. This is why a trained mental health professional and not just a general practitioner is so important. Dosing medications, knowing side effects, and having experience with multiple medications and how they interact are all things that you get when you opt for a mental health professional.

It is unreasonable to expect your primary care physician to stay up-to-date on all the various special conditions that his clients have. He undoubtedly does not have the time to dedicate to educating himself on the complexities of ADHD in addition to all his other duties as a doctor. It is really unfair to expect him to –this is why we have specialists like mental health professionals. I do know some people who have had good luck with primary care physicians, but these are usually people who have only ADHD and no comorbidities.

How complicated is ADHD to treat by itself? Well, one researcher proposed that ADHD should be divided into different categories based on how the executive function issues affect the person with ADHD. He came up with 36 different kinds of ADHD based on the different executive function deficits. His proposal was rejected because of its complexity, but it goes to show how complicated and varied ADHD is. This is why one medication will not work for everyone with ADHD and why one medication works great for one person but will not work for another.

You need to be treated by someone who understands the complexity of ADHD –not someone who thinks all ADHD people look like Tigger from Winnie the Pooh (yes, a doctor actually told me that).

When you begin medication, you can use this chart to evaluate your child’s symptoms and see if the symptoms have improved on the medication.

Never hesitate to fire a doctor who will not listen to you, dismisses you, belittles you, ignores your or otherwise marginalizes your opinions. If you are the parent, you should not be treated like you are not important. If you are the patient, you know yourself better than anyone else. Don’t let an arrogant doctor undermine your confidence.

The first mental health nurse practitioner we saw for our children was a nightmare. She treated me like I was an idiot –the patronizing should have been a warning to me (but she came highly recommended). She only used one medication to treat children and wouldn’t even consider any other options. She refused to treat my children’s comorbidities even though we had the results of a full psych eval showing that there were other conditions which needed to be treated. It was horrible, and some of the worst few days of my entire life were while he was on that medication that she claimed: “always worked for ADHD.”

I fired her and found a new doctor. It was the best choice I could have made –I wish I had made it the first time I had doubts about her. My son’s experience on that medication was so traumatic that he actually blocked them out and has no memory of them.

Advocate for yourself.

Advocate for your child.

And don’t stop advocating until you get the answers you are looking for and the treatment you need.

Keep looking for a doctor who will listen to you. I went through six doctors in about five years trying to find someone who would just diagnose me with adult ADHD. I have no regrets about firing doctors and moving on to the next until I found someone who actually knew how to diagnose ADHD in adults.

The diagnosis was life-changing even though I am not medicated. Just understanding that my brain is different has been so impactful in my life that I lack the words to accurately articulate it.

I am not broken.

It is not my fault.

I have a unique brain that works differently –and I have discovered that along with that different, abnormal, unconventional brain comes beauty that I couldn’t see until I stopped shaming myself for all the things I thought I should be but couldn’t.

I found answers to questions I had been asking my whole life.

I found beauty in the ashes.

Blessings,

Sarah Forbes

If you found this post helpful, please consider sharing it!

ADHD, charts, homeschooling

ADHD Comorbidities That Parents Should Be Aware Of

ADHD is hard.

It is hard to live with ADHD when you have it.

It is hard to live with ADHD when your friends and family have it.

It is hard to accurately diagnose sometimes, and it is hard to find treatments that work –because everyone is different and how the ADHD affects them is different.

But, ADHD by itself can seem simple compared to ADHD with comorbidities.

Comorbidities are ADHD’s mean, ugly cousin who came to visit and just won’t leave.

Comorbidities take a condition that is complicated but successfully treatable in 50% or more of the cases and make it incredibly complicated to live with and medicate.

The definition of a comorbidity is “an additional condition” or “two conditions coexisting at the same time.”

By itself ADHD can be life-threatening –or at least the side effects of undiagnosed and untreated ADHD: suicide, car accidents, drug abuse, etc.

But comorbidities complicate everything.

It is often hard to tell where the ADHD ends and the comorbidity starts which is why a knowledgeable clinician or doctor is incredibly important and why I don’t recommend going to a primary care physician for diagnosis and treatment of ADHD.

It took me six doctors to find someone in our area who could diagnose adult ADHD.

The primary doctor said I didn’t have ADHD because I wasn’t bouncing off the walls in her office at age 30 –hyperactivity is one part of ADHD that most people outgrow by internalizing the restlessness.

My psychiatrist who I was seeing for postpartum depression didn’t even believe ADHD was a real thing –yes, even many mental health professionals still do not recognize ADHD as legitimate.

The first psychologist I saw used the childhood ADHD diagnostic computer test for my evaluation and declared that I did not have ADHD –the kid’s test doesn’t work on adults.

You get the idea.

If it was that hard for me to get diagnosed with almost no comorbidities –I have some anxiety but not enough to need medication– then imagine how hard it is to get a child who cannot explain what is going on in their head a proper and accurate diagnosis if there are overlapping serious conditions.

If you think your child has ADHD –and especially if you think they have comorbidities– I implore you to find someone who is very informed about these disorders.

We had great success with a developmental pediatrician, a mental health nurse practitioner, and a psychologist who had ADHD himself.

They key to finding a good clinician in my experience is calling around and finding out what percentage of adults with ADHD are seen in that clinic. ADHD adults will not stay with a bad clinician. If they see a lot of ADHD patients and a lot of those are adults, you can probably count on decent treatment there.

The following graphic addresses six possible comorbidities, but these are not the only comorbidities know to hang around with ADHD. This is just a starting point to raise awareness of comorbidities. I encourage parents to do their own research.

Informed parents can better help their child.

Depression symptoms:

Persistent sadness, Withdrawal, Changes in sleep patterns, Loss of interest, Talk of suicide, Problems in school

Anxiety Disorder symptoms:

Sleep problems, Increased irritability. Withdrawal, School refusal, Argumentative, Hair twirling, Skin picking, Compulsivity, Panicking

Bipolar Disorder symptoms: Bursts of energy and restlessness, Impaired judgment, Depressive and manic episodes, Severe mood swings, Family history of bipolar

Conduct Disorder symptoms:

Family history, Trauma, Harming others, Animal cruelty, Aggression, Disregard for rules, Running away from home, Bullying

Sensory Processing Disorder symptoms:

Sensitivity to taste, touch, light, textures, etc., Coordination problems, Too rough/gentle, Weakness, Alternating dominant hand in writing

Oppositional Defiant Disorder symptoms:

Aggression, Antisocial behavior, Impulsivity, Screaming, Self-harm, Resentful, Argumentative, Vindictive, Rebellious

ADHD Comorbidities That Parents Should Be Aware OfDownload the PDF: ADHD Comorbidities That Parents Should Be Aware Of

There is more information about additional comorbidities based on a survey of adults with ADHD in this post called Should I Medicate My ADHD Child?

You can find more graphics about ADHD here.

This a reminder that I am not a doctor or a scientist. I am just a writer and author making graphics and posts based on information I have read from leading authorities on ADHD. I encourage you to research these issues yourself and watch the Dr. Barkley videos at the bottom of this post called What You Need to Know About Your ADHD Child for more information about the science behind ADHD.

I hope this information is helpful. If you enjoyed this post, I would be honored if you would subscribe to my blog and follow me on Facebook.

Blessings!

Sarah Forbes

ADHD, charts, children, homeschooling

How Do Executive Function Problems Affect My ADHD Child?

#ADHDFacts

#DrBarkley

#GraceUnderPressureBlog

#ADHDAwarenessMonth


If you or your child have ADHD, you have executive function issues.

ADHD is basically all about problems in executive function.

What is executive function?

“Executive functions (collectively referred to as executive function and cognitive control) are a set of cognitive processes that are necessary for the cognitive control of behavior: selecting and successfully monitoring behaviors that facilitate the attainment of chosen goals. Executive functions include basic cognitive processes such as attentional control, cognitive inhibition, inhibitory control, working memory, and cognitive flexibility. Higher order executive functions require the simultaneous use of multiple basic executive functions and include planning and fluid intelligence (i.e., reasoning and problem solving).” –from Wikipedia

How executive function problems affect someone varies by the person.

For instance, I don’t struggle with time management as much as some of my ADHD friends. I struggle in some areas, like keeping on a strict schedule, but I don’t struggle to arrive places on time or to make plans.

Some ADHD people have a hard time thinking up creative solutions, but that is one thing I am really good at.

So, while ADHD does involve executive function, how it looks in each person is as individual as the person themselves.

The following chart lists the various areas of executive function that could be deficient in an ADHD person.

How Do Executive Function Problems Affect my ADHD Child

It was very helpful for me to identify which areas I am good at and which I am not.

There are some of these areas that I am not struggling with which was very encouraging for me.

It also helped me to see these all written out because I was able to look at this chart and see how my children struggle compared to how I struggle.

At least if I can identify the problems, I can give them more grace and help in that area. If I can identify the issue in myself, then I can realize when one activity is going to cause more stress than another.

You can download the PDF of this graphic here: How Do Executive Function Problems Affect my ADHD Child PDF.

Follow this link to read a detailed description by Dr. Barkley of the 7 areas affected by executive function.

To learn more about executive function, take a look at these posts:

What Is My ADHD Child’s Executive Function Age?

What Is My ADHD Child’s Executive Function Tank?

For additional posts on ADHD:

What You Need to Know About Your ADHD Child

13 Facts Parents of ADHD Children Should Know

17 Things Your ADHD Child Would Tell You if He Could

10 ADHD Statistics Parents Should Be Aware Of

ADDitude Magazine Endorses Homeschooling When Public School Isn’t Working

Start Here to Learn More About Homeschooling an ADHD Child

So, You Want to Homeschool Your ADHD Child


 

Disclaimer: I am not a doctor or mental health professional. I cannot diagnose your child or offer you medical advice. A lot of the ADHD information on this blog comes from Dr. Russell Barkley’s videos –many of which are available on YouTube. There are many links in this post to more information about these topics, but since I am not a scientist or a researcher, I am unable to provide you with double-blind studies. I am just a writer and artist making articles and graphics based on information I have seen and read from ADHD professionals in an effort to raise ADHD awareness. I encourage you to look into these ideas yourself and follow the links provided. You can see more of those videos from Dr. Barkley at the bottom of this post.


 

You can also download a pdf worksheet to evaluate if your child’s ADHD treatment is helping his or her symptoms here.

If you found this information helpful, I would be honored if you would subscribe to my blog and follow my Facebook page.

Blessings,

Sarah Forbes

ADHD, children

10 ADHD Statistics Parents Should Be Aware Of

As part of ADHD awareness month, I have been posting ADHD facts regularly on Facebook. More than once I have been asked if I could back up my facts with studies and data. For some of these facts, I was able to find data; others I only have videos or articles by experts. I hope you find this information helpful. Please consider following the links and looking into the sources yourself.

An educated parent is better able to help their child.

Statistic adhd


1. ADHD is the most treatable condition in psychiatry, and yet 40% of ADHD children and 90% of ADHD adults are not recognized and treated for their ADHD meaning that the issue is under-treatment, not over-treatment. [source]


2. 80% of people with ADHD will be on medications at some point in their life which is a good thing because ADHD is a neurogenetic disorder and ADHD medication is an effective, proven neurogenetic therapy making medication completely justifiable. [source]


3. Less than 20% of adults with ADHD have been diagnosed and treated.
[source]


4. Approximately 2 million children in the USA have ADHD which means that in a classroom of 30 children, at least one will have ADHD. [source]


5. Only 50% of young children with ADHD are receiving services for their ADHD. [source]


6. At least 50% of ADHD children have a comorbidity or additional psychiatric condition. [source]


7. About 80% of ADHD patients respond positively to the medication. [source]


8. When ADHD people use stimulant medication it lessens the likelihood that they’ll abuse drugs and alcohol not increases it. [source]


9. ADHD people often use drugs and alcohol as self-medication which would likely be reduced if they were medicated properly. [source]


10. Exercise helps ADHD more than any other psychological disorder, so everyone who has ADHD should be in an exercise program of some kind. [source] and [source]

For my ADHD boys, I think Fruit Ninja on the Kinect was the best exercise program of anything we tried.


BONUS:

11. 50% of ADHD people who take medication are completely normalized meaning that the medication allows them to function like a neurotypical person. [source]

12. 50% of children with ADHD also have a learning disability. [source]


I hope you find this information helpful!

You can download the printable PDF of this image here: ADHD Statistics That Parents Should Be Aware Of.

You can also download a pdf worksheet to evaluate if your child’s ADHD treatment is helping his or her symptoms here.

If you found this information helpful, I would be honored if you would subscribe to my blog or follow my Facebook page.

Blessings,

Sarah Forbes

PS If you enjoyed this post, there are many other posts on my blog about ADHD such as:

13 Facts Parents of ADHD Children Should Know

17 Things Your ADHD Child Would Tell You If He Could

Start Here to Learn More About Homeschooling an ADHD Child

What Is My ADHD Child’s Executive Function Age?

What Is My ADHD Child’s Executive Function Tank?

DISCLAIMER: I AM NOT A DOCTOR or mental health professional. I cannot diagnose your child or offer you medical advice. A lot of the ADHD information on this blog comes from Dr. Russell Barkley’s videos –many of which are available on YouTube. There are many links in this post to more information about these topics, but since I AM NOT A SCIENTIST or a researcher, I am unable to provide you with double-blind study reports. I am just a writer and artist making articles and graphics based on information I have seen and read from ADHD professionals in an effort to raise ADHD awareness. I encourage you to look into these ideas yourself and follow the links provided. You can see more of those videos from Dr. Barkley at the bottom of this post.

ADHD, children, homeschooling

What Is My ADHD Child’s Executive Function Tank?

#ADHDFacts
#DrBarkley
#GraceUnderPressureBlog
#ADHDAwarenessMonth

Executive function is defined as “self-directed actions needed to sustain problem-solving towards a goal.”

“Executive functions (collectively referred to as executive function and cognitive control) are a set of cognitive processes that are necessary for the cognitive control of behavior: selecting and successfully monitoring behaviors that facilitate the attainment of chosen goals. Executive functions include basic cognitive processes such as attentional control, cognitive inhibition, inhibitory control, working memory, and cognitive flexibility. Higher order executive functions require the simultaneous use of multiple basic executive functions and include planning and fluid intelligence (i.e., reasoning and problem solving).” (from Wikipedia)

ADHD is an executive function disorder.

Because of the asynchronous growth in their brains, ADHD people struggle with executive function.

It is a daily struggle.

Since so much of life requires executive functions, it is easy for those of us with ADHD to deplete our executive function ability –or our executive function tank.

Different activities can either fill or tax our executive function. When the tank runs out, the ability for self-restraint is gone resulting in blowups and meltdowns –even in adults with ADHD.

“The executive function has a limited fuel tank, and you can spend it out real quick. Every time you use an executive function and you use it continuously, you empty the tank. And, if you get to the bottom of the tank, in the next situation, you will have no self-control. This is the ADHD child after school. It [the executive function] is gone, and you want to do homework? You’re out of your mind! So, you’ve got to refuel that tank, and that tank has a very limited capacity.” –Dr. Russell Barkley

What taxes the tank? How can we refuel the tank?

What Is My Child's Executive Function Tank-

You can download a printable PDF of this graphic “What Is My Child’s Executive Function Tank” by clicking here.

The most useful perspective on ADHD is to view it as a chronic disability.

“ADHD is the diabetes of psychiatry. It is a chronic disorder that must be managed every day to prevent the secondary harms it is going to cause, but there is no cure for this disorder. They [those with ADHD and their loved ones] need to view ADHD as diabetes of the brain. It’s a chronic disorder.” –Dr. Russell Barkley

Like with any disability, those with ADHD will need the support from those around them to succeed.

I hope this chart helps you better understand what is going in with your ADHD friends and family.

You can learn more about executive function on this post:

What Is My Child’s Executive Function Age?

To learn more about ADHD in general, there is a great video at the bottom of this post. The video is a 3 hour long series by the wonderful ADHD advocate Dr. Russell Barkley.

What You Need to Know About Your ADHD Child

Many of the ideas in this post have come from Dr Barkley. The concept of an executive function tank came from the video in the bottom of this blog post:

13 Facts Parents of ADHD Children Should Know

I hope you find this information helpful. If you enjoyed this post, I would be honored if you would subscribe to my blog or follow me on Facebook.

You can also download a worksheet here to help you evaluate if your child’s ADHD treatment plan is working.

Please remember to give your ADHD loved one or friend lots of grace. They have a brain that works differently than the brains of neurotypical people.

Blessings,

Sarah Forbes

Disclaimer:
I am not a doctor or mental health professional. I cannot diagnose your child or offer you medical advice. Most of this information comes from Dr. Barkley’s videos –many of which are available on YouTube. There are many links in this post to more information about these topics, but since I am not a scientist or a researcher, I am unable to provide you with double-blind studies. I am just a writer and artist making posts and images based on information I have seen and read from ADHD professionals in an effort to raise ADHD awareness. I encourage you to look into these ideas yourself and follow the links provided. If you Google “Executive Function + Dr. Russell Barkley” there is a lot of information available online.