Attention Deficit-Hyperactivity Disorder

              Rightly or, more likely, wrongly, ADHD is the Mother of All Conduct Problems in modern America, especially with respect to boys.  The symptoms are so vague that they could apply to anyone who finds the classroom boring.  Attention deficit symptoms include inattention, not listening, not finishing homework, difficulty organizing tasks that require sustained mental effort and forgetfulness.  Hyperactivity and impulsivity symptoms include fidgeting, excessive talking and restlessness.  “There must be clear evidence of clinically significant impairment in social, academic, occupational functioning.”  Some of these symptoms should be present before age 7. 

            Obviously, a major difficulty is distinguishing a true “illness” from an excitable or easily distracted personality.  Much of the concern about our society over-medicating its children stems from what some believe is a tendency of mental health professionals and the teaching profession to diagnose energetic, unsettled children as having ADHD and prescribing medications to sedate them (i.e., “calm them down.)  It is important for parents to participate in these judgments and observe their child.  This is a very appropriate  illness in which to recall this website’s mantra – know your own child, learn about the illness yourself, and respectfully question and challenge the experts.

            ADHD usually is treated with amphetamines (Ritalin, Adderall and other drugs) which cause the child to go from “upper” to “downer” over the course of a day.   Depression may be mistaken for ADHD or ADHD may be present in combination with depression.  Amphetamines are not prescribed for depression, and there is some suggestion in the literature that Ritalin and other ADHD drugs are contra-indicated for depression.  It is critical that an accurate diagnosis be made.  This site believes that a family history of alcoholism (which often goes with depression), depression or suicide should be given considerable weight in making the diagnosis.  What may be ADHD may be much more dangerous bipolar behavior, or, as noted, just an exuberant personality.  This is the middle of the swamp of uncertainty when it comes to the mental health of children.

           A newer drug to treat ADHD, atomoxetine, marketed as Strattera, has been on the market since 2003.  This is the first ADHD drug which does NOT contain a stimulant and is NOT listed as a Schedule II drug as are amphetamine-based drugs Ritalin and Adderall.    This means the FDA believes the drug will be less subject to abuse.  According to a spokesman for the manufacturer, Eli Lilly, Strattera increases the level of norepinephrine, a chemical in the brain that transports signals between nerve cells.  Most previous medicines have targeted another neurotransmitter called dopamine.  Both are believed to play a role in ADHD.  [Depression and anger generally seem to be more effected by a reduction in a third neurotransmitter -- serotonin.]

            Jump to the link below and you will find a questionnaire you  can print out to be answered by your child's teacher for an indication if your child has ADHD.  If results suggest ADHD, you should consult further with professionals.  Don't forget, ADHD shares characteristics with depression, but the treatment of the two varies significantly.  We have a test to be administered to your child for depression, too, also listed below.

                        [Source note:  These are summaries prepared by the Webmaster from various materials, the most important of which are the DSM IV (4th ed.), published by the American Psychiatric Association, and Bright Futures in Mental Health, a joint publication of the U.S. Department of Health and Human Services Maternal and Child Health Bureau and the National Center for Education in Maternal and Child Health at Georgetown University.  Editorial comment is by the Webmaster.]

DISCLAIMER:  Unless otherwise indicated, all commentary and information on this web site is provided by persons who have no formal training in medicine or mental health.  You should weigh the information and comment on this site in consultation with a mental health professional.