This large study – observed 214,417 ADHD patients taking medication, and 965,668 control kids – not taking ADHD medications. They were observed over a period of 135 days for ADHD medication users, and 609 days in non-users. The specific outcomes which were being observed included sudden cardiac death, myocardial infarction (a ‘heart attack’), stroke, and cardiac arrhythmias (i.e. irregular heartbeats).

During the observational period – the rate of these events were very low in both groups.  In the group taking ADHD medication, there were 28 deaths (incidence 1.79 per 10,000 person-years) and 607 deaths in the control group (incidence 3.00 per 10,000 person-years). There were no validated cases of MI (heart attack) or stroke in the medication group and 11 cases in the group which wasn’t on medication.

This research supports previous studies which showed that kids and teens taking ADHD medications are NOT at increased risk for cardiac death. The sad reality is that there will be a small number of kids/teens who pass away from cardiac issues (i.e. a heart problem that no one knew about), and ADHD medications do not seem to worsen that rate.

There is still a warning on ADHD medications – for individuals with structural heart abnormalities (i.e. ‘holes’ in the heart like an ASD or VSD), arrhythmias, or adults with unstable coronary artery disease. If you are concerned about this – by all means talk to the doctor, and a specialist if needed as well (like a cardiologist, or pediatric cardiologist).

This study, hopefully, will help reassure some people with ADD/ADHD who are concerned about this very serious side effect.

There is such joy in being able to hear patients say that “My life is really good Doc, I’m getting A’ and B’s in college now, my parents and I are getting along well and I actually got a part time job and my life is pretty great!”.  Those are the things that make my job worthwhile as psychologist who specializes in ADHD.

All of this because we were able to see what so many previous psychiatrists had failed to notice.  Instead of just looking at the depression and anxiety that were on the surface, we did a comprehensive evaluation and found out that this young man was struggling with Inattentive ADHD.  He was depressed because of all of the things he just couldn’t seem to accomplish in his life.  He was anxious only because he felt something was different about him, and he thought he would never get ahead in his life.  It was hard for me to remember that this was the same person who only a few short months ago was shy, uncertain,  and was really struggling to be successful.  Now thanks to medication, a little ADHD therapy, and a few coaching sessions with his parents, his feelings of discouragement and hopelessness were now nothing more than distant memories.

He, like so many other of our ADHD clients, is excelling in his college courses, noting that for the first time he could actually focus in and comprehend what his professors were lecturing about.

Now, instead of anger and resentment at home, he and his parents talk about the miracle of what this treatment has done to bring peace and cooperation to the family, good grades in college, and most of all he is confident and motivated to be the person he had always wanted to be.

Many times, the child’s ADHD-related problems cause ongoing problems in the parent-child relationship. These seemingly never ending or inconsistent problems create the foundation for an unhappy, guilt-ridden relationship between the child, parents (and siblings) that very often continues well into adulthood and beyond.  Many marriages can be strained to capacity especially if parents disagree in their belief in ADHD as well as their approach to dealing with it.

Frustrated parents come to see their kids as ”all-or-nothing” children who have difficulty calming themselves.  There is a vexing emotional rigidity and reactivity that is present in many ADHD kids that startles and destabilizes families’ attempts to encourage rules, order and predictability.  Attempts at discipline seem to never have much impact on correcting the situation. It seems as if ADHD kids, “just can’t learn” from their mistakes.

Well meaning family members often criticize both the child (for being bad) and the parents (for being ineffective).  This only creates more tension and stress between the parents and their child. These criticisms from family, teachers, and peers also play a powerful role in a child’s development of their own self-concept.  Negative messages that if they “would just listen and try harder” which were learned in youth continue on throughout adult life. As adults they often do not seek treatment or help for their ADHD due largely to the belief that they are lazy and if they would “just try harder” they could and would be more successful in life.

In an attempt to regain control of the situation, parents of kids with ADHD resort often turn to yelling, long winded criticisms as well as punishment after punishment only to find that it seems like nothing works! What does work is short, situation specific identification of what the person did, what did not happen, and what to do now and how this can be made to more successful in the future.

A good rule of thumb is the fewer words the better. Working memory is very limited in people with ADHD.  Lengthy and historic recounts of disappointments simply don’t stick in the ADHD memory. What typically results is your ADHD child saying things like “I got it already”, “Your not helping, your making it worse”, “Shut up, you always get this way”.  That usually means that the parent is using too many words and the kid is now lost and mad.

Compounding the problems is the fact that most children and adults with Attention Deficit Hyperactivity Disorder are exquisitely sensitive to any feedback or criticism from others. People with ADHD seem to be able to “dish it out” if you will, but are deeply injured when it is their turn to “take it”.  This begins a cycle of outbursts toward others seemingly without regard, and an inability to defend against the pain of incoming criticism.

Complicating things even more is the fact that Attention Deficit Hyperactivity Disorder is genetically transmitted from one generation to the next.  Often, we find an ADHD child being raised by an undiagnosed and untreated ADHD parent. A parent who has a very limited understanding of why the child is having problems, and is not able to provide the consistency and structure the child requires to be successful.

Both the undiagnosed ADHD parent and the diagnosed ADHD child have low frustration tolerance, so both seem to easily “fall apart”, dissolving into tears.  Both are emotionally reactive when either does not get their way immediately.   Parents who were never diagnosed or recognized as having had ADHD as children, often have no idea what is needed to soothe their child as they themselves never received such care.

Raising children and knowing what to do is a full time job, one that does not come with a set of instructions. There are always going to be times when as parents you question if you are doing the right thing, and if you are making the best choices for you, your partner and your family.

Remember that children come to view themselves as others see them. If ADHD kids are told over and over “you could do so well, if you would only try harder and apply yourself” they grow up believing that they are “worthless because they cannot control their behavior.”  If you want to help your ADHD child be the best they can be, tell them what they do right, what they do better than anyone else. ADHD kids will only raise to the level that others see them. If you see your child as broken and hopeless, then you will probably get an adult who still does not know what to do with themselves or their life.

Here are a few simple things you can do to help your ADHD child be the best that they can be:

1. Acknowledge that much of your child’s misbehavior is the result of an imbalance of neurochemicals in their brain, not because they are bad kids.

2. Get the best help you can find. ADHD is a complex disorder and you will need lots of support, insight and education if you are going to be successful in helping your child manage and succeed with their ADHD.

3. Pick your battles carefully. ADHD kids can be emotional and are often quick to respond.  By deciding ahead of time that your child is going to need to be and do things differently, you can adjust your mindset to allow for differences.

There are things you can do right now as the parent of an ADHD child that will make this journey much easier:

1.   Connect with a support system of other ADHD parents. There are support groups for parents of children with ADHD both online and in person.  A good place to start is finding your local C.H.A.D.D. chapter (that stands for Children and Adults with A.D.D.).

2.   Find a psychiatrist that specializes in the diagnosis and treatment of ADHD. Medications are still the most effective treatment for relief from the symptoms of ADHD.  Most pediatricians will not understand the changing needs of your child’s ADHD over time.

3.  Take a few minutes each day as a parent to do something nice for yourself. Even a few minutes in the care alone listening to your favorite song can help recharge your senses.

Our culture places a great deal of emphasis on conformity especially when it comes to raising and educating children.  Children with ADHD are simply not your average kids, and they require different approaches in order to be successful.  Much of the trouble parents have in raising ADHD kids comes as a result of trying to compare them to other non-ADHD kids.  When you can stop comparing, and start understanding and accepting your child as someone who will probably find their own unique path in life, then you are one step closer to helping your child be the best that they can be.

Please leave us your comments.

Success in Life is the Goal of ADHD Treatment

Raising successful children is hard under the best of circumstances.  When a child is being treated for Attention Deficit Hyperactivity Disorder (ADHD), everyone needs to work harder to provide the child with a solid foundation for successful outcomes later in life.

Any parent of a child with ADHD quickly becomes aware of how challenging it can be to get ADHD kids the help that they need to find relief from their symptoms.    Parents desire to make everything better for their child is natural and is the result of our readiness to protect and nurture the ones we love.   Yet, it is this desire to help and the desire to protect that often makes fighting Attention Deficit Hyperactivity Disorder so frustrating.   It is often very difficult just knowing what to do, how to do it, or even where to start.  The fact is, it is very easy to become overwhelmed by ADHD. That is because ADHD is a serious condition with has many dimensions at home, at school and in most every area of a child’s life.

It is true that many parents often first learn of their child’s ADHD symptoms from teachers.  Elementary school teachers are especially observant of children and often are the first source of feedback about how your child’s ADHD symptoms are disruptive in the classroom. ADHD children are often overly active, visit excessively with their classmates or daydream and just can’t seem to tune into the tasks at hand.   Just because school may have been the source where you first learned about your child’s ADHD symptoms, his or her developing brain doesn’t stop at the classroom door.

Medications are frequently the first line of defense in successfully managing ADHD symptoms.  However, many parents and pediatricians still hold onto the misguided belief that medications are only used to help ADHD children be successful in the classroom. While ADHD medications do often dramatically reduce complaints from teachers during the school day, it is important to understand that life in a classroom is only a portion of a child’s life.  These same ADHD symptoms don’t just somehow magically disappear when the school day ends.  Nor do children somehow acquire ADHD once they get to school.  If you have a child with ADHD, then you probably know that your child’s ADHD symptoms start when the child awakes in the morning, and often does not seem to remit until the child is fast asleep in the evening.   If we only provide relief from ADHD symptoms in the classroom, then we fail to realize the full impact the disorder has on a child’s life and ultimately parents are limiting the child’s full potential for future success in life.

While a decrease in complaints about your child’s disruptive ADHD behavior or  receiving better grades on tests is a welcome change, this progress is often misinterpreted as the child being “cured”.  It is easy to forget that a child’s behavior in the classroom is only part of the big picture of life.  Many parents are still frustrated and confused to find that despite improvements at school, homework, dinner time, and settling for bedtime are still a battle.

Parents unknowingly expect their child to focus and concentrate on homework and family life without having the proper ADHD medications on board to make that possible.  They are surprised to learn that most ADHD medications diminished in effectiveness as the school day ends. Very often the medication is completely worn off by the time the child arrives home.  This creates problems as the ADHD child moves from the more supportive and structured environment of school to a more varied and unstructured home environment.  This increase in variables, and decrease in structure can cause a spike in ADHD symptoms and make life at home very difficult for the child as well as for the family.

ADHD medication is not a “magic bullet” that relieves parents and teachers of dealing with a child’s disruptive symptoms.  It is not the pills that teach our children skills, that is the job of caring parents and skilled teachers. What ADHD medication can do is give a child a sense of clarity, a time to pause before speaking or acting, as well as improve neurocognitive functioning so that information can be stored, retrieved and processed more accurately.   This creates an opportunity to learn how to be successful and to learn new skills.  Medication also allows children to focus more and pay attention better. When kids can pay attention better they are able to build new skill sets and remember what they have learned previously and apply that knowledge when faced with new life events and challenges.

Home and family life provides many important opportunities for children to learn and grow. The critical lessons learned through interactions at home and after school teach children to recognize social cues and to maneuver through interpersonal relationships in the future. Without medication children miss these cues and are often delayed (as much as 30-40% behind their peers) in learning how to develop and handle complex emotional and social circumstances.

Loving parents will do anything for their kids, yet many are hesitant to fully provide their child with an optimal chance to achieve their best.  The stigma of medicating a child, often provoked by sensationalist media stories, can create a prison of doubt and guilt for parents.

“Am I medicating my child too much?  Will he or she become addicted to drugs later in life?”  Shortchanging your child’s developmental years by reducing or eliminating proper dosages of ADHD medication is a decision based more on fear and shame then reliable medical information.

Seeking relief from the exhausting and disruptive behavior of an ADHD child is frequently an initial motivation to begin treatment.  Left untreated, and without the proper structure, guidance and lifestyle changes, ADHD children can drain our emotional resources, deprive siblings of needed parental attention and drag entire families into an endless spiral of battles over homework, oppositional behavior and even arrests and incarceration if the condition is left untreated.

Without treatment, guidance, and lifestyle changes, ADHD children grow up believing that they are somehow defective and are robbed of the precious esteem building that occurs after school and during time with the family.  The question arises: why would a parent deprive their child of a treatment that will help them avoid these negative outcomes?  Certainly, no loving parent could conceive of such a choice.  Yet, this is the choice parents make when they limit their child’s medication to time spent in the classroom.

Taking ADHD medication is akin to a child wearing glasses.  Like glasses, ADHD medications help a child to focus, allow a child to see things clearly, and give children the ability to see life as it is.  As long as a person wears their glasses, they have relief from their vision problems, when they remove their glasses, the vision problems return. This is how we think of ADHD medication. When medication is on board, then the symptoms of ADHD remit, when the medication is removed or wears off, then the symptoms of ADHD return.  No one would ever think to ask that a child to only wear glasses during the school day, but not at home. Yet this is often what parents and pediatricians are doing when they only medicate for the school day.

As a child grows to adulthood, every experience shapes and influences their cognitive ability, emotional health, even their bodily safety.  The cumulative results are all influenced by brain chemistry.  Why then, does it make sense to deprive a child of optimized brain chemistry at any moment in the day?  If your child needs glasses to see properly, would you want the job of picking and choosing when your child could wear their glasses and when they could not? Of course, no parent would ever dream of  limiting the amount of time a child can see clearly or read without tremendous difficulty. Yet, this is the very dilemma that uninformed parents find themselves in when trying to understand what is the proper course of action for treating their child’s ADHD.  Caring parents become concerned that their children will become “zombies”, “have changed personalities” and will “lose out on being kids”, if they give them ADHD medication.

The fact is that without proper medication these children often become “the odd one out”, “never live up to their potential” and never learn the skills necessary to be able to successfully live in the world without their parent’s direct support.

When parents have the courage to let go of their desire for an ADHD child’s complete compliance, when they risk being flexible and understanding, children learn to rise to the occasions of life and chaos becomes replaced with success.  When parents arm themselves with the scientific knowledge of experts in the treatment of ADHD they too will find relief in experiencing the joy that is found in raising an amazing ADHD child.  Can any parent of an ADHD child let another day pass knowing they’re not providing that brain the medication it so desperately needs to function well and achieve success in life?

Tell us your dreams that are worth pressing on for…

Young men with early or heavy use of Marijuana appear to have a 70% greater risk of Testicular Cancer.  This risk is even higher the younger the age of first use.

Researchers at the Fred Hutchinson Cancer Research center in Seattle found an association with Nonseminoma, a fast growing and aggressive subtype of testicular cancer.  Of all testicular cancer, 40% is Nonseminoma and the rest are slower growing.

It appears that hormonal changes during puberty make young men more vulnerable.  The findings were independent of other known risk factors, such as family history, cigarette smoking and alcohol use.  It appears that the testes, like the brain, have receptors for tetrahydrocannabinol, or THC, the chemical component of marijuana.

I found this information very interesting.  In our center, we have seen so many young people with ADHD attempt to self-medicate with Marijuana.  It appears the dangers of Marijuana are greater than we initially understood.

ADHD Kids & Holiday Travel

The holidays create a special and different time for each of us. For kids they are special, and for kids with ADHD they are different, special and much, much more. As a parent of a child with ADD/ADHD you can make life easier for your child and certainly for yourself, if you take certain steps. They are not difficult, they may take a little time and may cost a bit of money [or may cost nothing at all], and they can pay dividends in the form of relaxation and a real good holiday.

The first step is to be aware that the holiday, even one spent at home, will make for a change in the life of your child. Most kids with ADHD don’t react well to change. It may make your kids behavior even more demonstrative. So know this fact; you have to prepare. Prepare yourself, prepare your child and prepare for your journey and your destination.

So let’s consider your child. Take away the surprise element and build on the anticipation aspect. Let your child in on most of the plan, if not everything, which is likely to happen. If they are going to travel, go through the rigmarole of the journey. If it’s by car, plane or train, take out a map and show your child the route. You could use a large piece of blank paper and do simple things like draw your house, draw Grandma’s house and draw the road. Let your child help. Let them have a cut out picture of your car and have the child ‘drive’ the car along the map. If there are stopping points en route, draw or cut out pictures for the McDonalds, restaurant, hotel, etc. as the place you plan to stop for a meal, toilet break, etc. The whole emphasis is on preparing your child for what is going to happen or is likely to happen. Remember the activity needs to be age appropriate. As an example, younger kids may work with crayons and paste, while older kids may prefer to put their project together on the computer.

Next, you will want to prepare your child for what will happen at your destination. If it’s a motel, explain the room, where the child will sleep, where they can play games, etc.  If it’s Grandma’s house, show your child a photo of their room, of the house and garden. Explain where the child can play, who will be in the house and anything likely to happen on the vacation.

Then there’s the actual journey.  Have plenty of ‘quiet’ activities at hand, so your child can have things to do. It might be following a homemade map, ticking off things they can see out the window, a handheld digital game, listening to a CD or MP3 player, and/or watching a video/DVD on a portable player.

So, preparation is the real key. Have a variety of activities planned and once the holiday is under way and your child behaves in an acceptable way, reward them frequently for their good behavior.  It is the best present at holiday time to give to your child; your thanks and love in recognition of their successful attitude, good behavior and achievement. A hug, a kiss and kind appreciative words (positive attention) are the best forms of reward and can carry the most significance.

Remember a child with ADHD loves security, attention and routine. You can decide if the attention they get is going to be positive or negative. If you change the routine as a result of a holiday, you need to take certain steps to help your child and yourself so that you both can have a fantastic time.

Do you have tips to manage kids with ADHD during the holidays?  Please share your tips by adding your comment on this blog.

Women Running Late

Adults ADHD in California – what is the main complaint?

Attention Disorder Hyperactivity Disorder or ADHD is believed to affect about 8% of children and about a half of these sufferers will continue with the disorder when they grow into adults. So ADHD is a significant part of the life of millions of people and of course their disorder will impact on their family, friends, teachers, fellow workers, etc.

In recent years rapid progress has been made particularly in dealing with adults who have ADHD. Professionals are better at diagnosis, understanding the full spectrum of the disorder, as well as treatments be it with medication, psychotherapy, coaching or other alternatives.

With adults, one of the major signs of their disorder is their inability tokeep appointments. They may hold down a steady job but being late on a number of occasions puts their employment at risk. Or it can show up in everyday life like meeting someone at a restaurant, attending a family gathering or even collecting your child after school. If the ADHD adult does not put systems and structures in place, then poor time-keeping may often be a feature of their lifestyle. But does not need to be so.

The interesting aspect about tardiness is that it can be overcome. It would be nice to say cured, however, we will have to settle for ways and means to reduce or eradicate your being-late behavior.

You can be proactive with physical reminders. Your email program on your computer will react if you have added details of an appointment. You can get up in the morning and turn on your computer and see your whole day. Bingo, the details come up as to where you have to be today and at what time.

Lugging your computer around everywhere may pose some problems. Some alternative choices that can help are mobile phones, clock radios and portable email receivers which can all be programmed to make a sound and/or show a text message which will remind you of your appointments and schedule. Get into the habit of giving yourself these physical reminders. And don’t be afraid of being early. If lateness is a an issue, set your arrival time to a bit earlier which will help guarantee you will not be late.

One relevant point is to check the reason or reasons as to why you are late. If you can look beneath the lateness and find its true cause, you may be able to remove or alter your being late. Are you late for work because you dislike your job? If that’s the case you may want to try to find work which is more stimulating.

Not having an interesting job is pretty much the same as not wanting to go to a meeting or get-together. We all have to go to places and events we’d rather avoid, yet once you know why you are turning up late, (as an example- you have little interest in your destination), you can tackle your lack of enthusiasm. Find out why you are late and then do something practical to challenge or remove that cause.

The good thing, if that’s the expression, about being late is that the problem can be managed. Sit down with pen and paper and plan your week. List the appointments you have for the next few days. Make notes about how you will travel and when you will depart. Put this plan in a prominent place. Check it daily and follow your own directions. You can be on time every time.

If you find it difficult to tackle this on your own, a professional specializing in ADHD can help you move beyond where you are stuck and help you reach your goals.

Business Women with Deadline

ADHD Symptoms

The ADHD brain has problems doing all sorts of things and we’ve really only just starting to find this out. The ability of scientists such as neurologists and neuroscientists to take photos of the human brain and then analyze what is happening, means we are better able to discuss, define and treat people with ADHD.

The brain is divided into sections and one of these is known as the pre-frontal cortex. Photo imaging or a kind of x-ray of the brain shows that there are differences in the structure of parts of the brain between someone with ADHD and someone who does not have the disorder. Knowing these differences is a major step towards better understanding and thus the treatment of the patient be they a child or an adult.

Referring back to that part of the brain known as the pre-frontal cortex, we know that this part of the brain is linked with executive functioning which manages the following activities – problem solving, attention, reasoning and planning. Now with imaging you can see that the brain of a person with ADHD is likely to have problems with the above activities and will need help.

If the ADHD brain has problems when it comes to planning, then the life of that person will have potential difficulties and hardships. Planning takes the ability to prioritize, forward think, manage time, and factor in consequences.  If you can’t prioritize or you get times confused by thinking that five minutes is really an hour or two, then planning successfully is difficult to impossible. You simply don’t consider  how to successfully judge the real time it takes to complete a task.

Likewise with paying attention, reasoning and solving problems. With the ADHD brain these tasks can be difficult when a person is not interested.

Because ADHD with children tends to get more publicity than the disorder experienced by adults, we need to understand that the brain of a small growing child can be shown to be different when you consider an ADHD child or a child without ADHD.

ADHD symptoms don’t disappear as children grow into adults, the symptoms tend to change from being seen externally to being experienced internally. It is important to understand that distractibility can be an on-going problem for ADHD sufferers.

Distractibility is the primary reason and clear illustration as to why ADHD brains cannot fixate or think logically when it comes to time. When the brain is not functioning normally, when the chemical balance inside the brain may be an imbalance, then the ADHD child or adult gets their timing skills out of line. They think they have been working on a task for a few minutes when in fact they have been absorbed for much longer.

Medication and cognitive behavior therapy have long been a part of helping those with ADHD. Both these methods of treatment can be prescribed to assist the sufferer to better manage their time-keeping.

Rewarding positive behavior is one typical form of treatment. Setting simple tasks, staying with the ADHD sufferer to keep them on track and then rewarding them for using time-keeping successfully is another way to improve the performances of a person with ADHD.