Writing and Distraction

When you are an adult and read more and more about the disorders which have somehow plagued (/blessed) your life for decades, it becomes really apparent that resources about disorders, while often are helpful, are not nearly as helpful, uplifting, or inspiring as engaging with others who experience the same feelings, emotions, habits, etc. that you do. Some of the best reading I have done, especially in relation to autism and bipolar disorder, were written by those who have been diagnosed as autistic or having bipolar disorder. In a previous post I mentioned that some therapists still to this day regard autism as a disorder, when in fact, it is not. It is a neurotype, and should be treated as such. Likewise, we treat being bipolar as having a disorder, and while it is most certainly still classified as such, I feel that being bipolar is a lot like being autistic- it isn’t something you have, rather- it is just how your mind works. Genetics, conditioning, environment, experience all plays its own individual role in the manner or extent the disorder affects your day to day life.

General mental health studies refer to alternative thought patterns that would not be considered “healthy” or “normal” as disorders or illnesses. Therefore, they are treated as such. Whether your mind produces lack of happiness, motivation, attention span, stability, or an over abundance of various moods or personality traits, we tend to treat anyone who thinks or reacts “differently” as having a “problem”. I see this in of itself as problematic. We would not experience the incredibly vast ocean of art, music, film, comedy, sports, literature, scientific, medical, and technological advances, so on and so forth, had it not been for people who “think outside the box.”

One of the best videos I have seen in discussing the drive, humility, and overall nature of an outcast would be Rodney Mullen’s short twenty minute video relating to his skating career and the resilience skaters have in finding their own unique styles and abilities, and their challenges in shaping their communities and honing their skills. Even the manner in which he speaks and moves and makes eye contact and how excited and emotional he gets rocked me to the core, as I witnessed someone who I thought just fucking gets it. How refreshing is that? For someone like me? EXTREMELY.

We see a lot of media about mental health and well-being and how to achieve better by blah blah blah. There is a lot of exposure relating to depression, anxiety, and adhd. Bipolar, schizophrenia, and borderline? Not so much. Years ago, I wrote a blog post (wish I could remember the link!) about borderline personality disorder. As I’ve said before, I was diagnosed as being bipolar when I was 15, and borderline is a bit like bipolar. Additionally, being autistic can introduce you to these “disorders” and you may feel overwhelmed in learning that you are just different. Guess what- it’s okay.

I know it’s okay because I am thirty five years old now and I’m still here. I made it. I work multiple jobs and have multiple hobbies and have raised a child since I was nineteen years old. Is my life a rollercoaster? Yep. But whose isn’t these days? Distractions are everywhere. There are noises everywhere. There are bright screens and colors and shiny objects in your face everywhere. Stimulation is constant. And hey, that reminds me- I forget shit constantly.

You know how I know distractions exist? I initially had the idea of writing about adhd and when I began to actually write, I wrote all those things above instead. Anyway, let’s talk about adhd now, shall we?

This is a paper I wrote in 2015 and I wanted to share this with you to shine some light on the research that continues to shape the way mental health providers diagnose and treat a person who is hyperactive and gets easily distracted:

  • The purpose of this post is to provide information related to the treatment of children and adolescents diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).  Thorough knowledge related to this topic is imperative in pediatric primary care settings.  The diagnosis of the ADHD condition is prevalent, and the prescription of stimulant medication is a common treatment choice.  The advanced practice nurse practitioner (APRN) must serve as the patient advocate and recommend treatment modalities that maximize patient outcomes. 

ADHD is defined by the “DSM IV criteria as hyperactive, impulsive, or inattentive behavior that causes impairment prior to seven years” (Vierhile, Robb, & Ryan-Krause, 2009, p 1).  ADHD is a chronic condition that affects millions of children, and its effects may continue into adulthood.  The current statistics are staggering for ADHD incidence: “up to eleven percent of four to seventeen year olds have had the diagnosis, eight percent currently have the diagnosis, and six percent of those are receiving medication for ADHD” (Felt, Biermann, Christner, Kochhar, & Van Harrison, 2014, p 456).  Levy et al. (2014) found that a positive link exists between the impulsivity associated with the ADHD personality and the risk for future risk taking behavior, such as substance abuse.

The prognosis PICOT question that is pertinent to this topic is as follows: in children and adolescents diagnosed with ADHD, how does the utilization of education and behavior therapy compared to not receiving behavior therapy influence the risk of subsequent substance abuse over a ten year period of time? Behavioral therapy has been confirmed as an effective treatment modality in ADHD patients (Antshel, 2015). The ten year time frame should cover from adolescence to early adulthood, the period that is most associated with substance abuse behavior. 

The goals of ADHD treatment are to improve symptoms and to maintain an appropriate level of function. In order to provide a proficient level of care, the APRN must be aware of current interventions. Research is necessary to determine if education and behavior therapy are an effective treatment for the risk of substance abuse in children and adolescents diagnosed with ADHD. The challenge for healthcare providers in dealing with ADHD conditions is to intervene early and to provide the best treatment plan that optimizes the patient’s long-term condition. 

References:

Antshell, K. M. (2015).  Psychosocial interventions in attention-deficit/hyperactivity disorder.  Child & Adolescent Psychiatric Clinics of North America, 24(1), 79-97.

Felt, B., Biermann, B., Christner, J.G., Kochhar, P., & Van Harrison, R.  (2014). Diagnosis and management of ADHD in children.  American Family Physician, 90(7), 456-464.

Levy, S., Katusic, S.K., Colligan, R.C., Weaver, A.L., Killian, J.M., Voight, R.G., & Barbaresi, W.J. (2014).  Childhood ADHD and risk for substance dependence in adulthood: A longitudinal, population-based study.  PLoS ONE, 9(8):e105640. doi:10.1371/journal.pone.0105640 

Vierhile, A., Robb, A., Ryan-Krause, P. (2009).  Attention-deficit/hyperactivity disorder in children and adolescents: Closing diagnostic, communication, and treatment gaps.  Journal of Pediatric Health Care, 23(1), S1-S21.

Discussion Response

I have a close member of my family who was recently diagnosed with ADHD at nineteen years of age. He was not diagnosed in childhood, but as he got older, he found that he was often bored and craved for some sort of stimulation. He made impulsive decisions that only later he would think about and feel shame and embarrassment over the poor choices he had made. In college and newly diagnosed with ADHD, he had found that he was starting to drink before he would study. Just a beer or two, but it seemed like he needed it to slow his mind down enough to concentrate on the material he needed to concentrate on. He was also suffering from very low self-esteem, because he felt he was dumb and couldn’t learn very well. His well-wishers could see him opt for bad choices and see where this could quickly cause someone to lose ambition and follow a self-destructive path. The fact is that stimulant type drugs can slow the racing thoughts of a person with ADHD and make them feel more “normal”. He was actually shocked when he was first put on stimulant medications because he noticed the insomnia he experienced since childhood was finally cured.

As you can see, someone diagnosed with adhd later in life can absolutely occur. The same applies to any other disorder. Additionally, it is my personal belief that any person could schedule an appointment with a counselor or Psychiatrist and sixty minutes later, walk out with some type of diagnosis/es. The extent which the diagnosis/es affects your life is ultimately up to you. Can you embrace who you are and how your mind functions? Can you cope with the habits, ticks, moods, traits, stimuli, fears, etc. in life, in school or on the job, or while you’re alone or in a huge crowd at a concert?

Why don’t we ask these questions instead:

Can society accept you for who you truly are? and more importantly,

How can society function in such a way that is more accepting and accommodating to those who are considered or classified abnormal?

What do you think about mental disorders?
What do you think about the conversation about mental disorders?
What do you think about current available treatments?
What do you think about the way you think?

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