Just Gimme Some Truth

When I was a child, I had an extremely wild imagination. In retrospect, it seems I really had no choice, given our limited income. I’m not saying that I was deprived, quite the contrary. I was encouraged to be creative and use my imagination to have fun. And I did, a lot.

I began reading and writing at an early age. I would write short stories and make illustrations. I loved writing assignments through school. As early as my elementary years, I was winning awards and recognition for my creativity and writing abilities. I was also getting more and more interested in the mystery and crime genres and writing stories similar to something you might find in a Trixie Belden book.

As I reached middle school, I became interested in Stephen King and true crime novels. I love to figure things out, and it seems that the more horrific the scene, the more compelled I feel in solving the case. I then entered high school and began studying psychology. By the time I was out of high school and became pregnant the following year, I was immersed in murder trials and obsessed with the hit television series, House M.D.

A few years passed by and I took a special interest in local journalism, aiding an independent newspaper. I covered stories relating to child abuse awareness, autism awareness, and the nationally recognized April 2011 tornado events. I also acted as a photo journalist and spent a lot of time (and energy) on recording events through my own camera’s lens. And I didn’t get paid one red cent.

Fast forward to the present day and it’s quite obvious I still care very much about a) solving problems, and b) ways to avoid problems in the first place. My daughter is now a teenager, and over the past couple of years has experienced numerous social obstacles relating to autism and mild ADHD characteristics- or symptoms– the term some people still insist on using.

My challenges as of late in relation to my own autistic features- along with anxiety and depressive bouts- have been centered on ignoring the events, people, things in general which (are completely out of control) are completely out of my control. These exercises, while helpful in the moment, aren’t exactly swaying my overall interest in our damned society, investigative journalism relating to the events within our damned society, and the general passion contained within my deepest core to help those in need who are struggling to thrive within our damned society.

I’ve mentioned a few journalists and programs within the state of Alabama and the southeastern United States which share that common goal of providing justice to those who have been robbed of it. Tonight, I came across an article by accident and was yet again reminded why this kind of work, while heavily criticized, is 100% necessary.

I recently wrote about an issue revolving around racism within my daughter’s high school, actually stemming from the elected school board president’s own son. I wrote her an email, which I have yet to receive the slightest acknowledgment or receipt for. However, I also wrote an email of a different nature to the school principal.

My daughter’s school principal is a special lady. When they went on a NYC band trip a couple of years ago, they visited the Strawberry Fields site, and she bought my daughter an Imagine pin. (She collects pins which cover her leather jacket and backpack.) My daughter really likes her principal, as she has always shown kindness to her and encouraged/supported her. In my email, I thanked her whole heartedly for her kindness and expressed my concern about recent events, and the behavior of a certain breed of students that has been quite the opposite towards her. She immediately responded and humbly thanked me, and encouraged me, saying that my daughter’s uniqueness and gifts are valued- that’s what she loves about her.

This past Friday, my daughter told me that her principal sat with her during the second half of her lunch period to discuss some ideas. They are planning to form a leadership group to act as a sort of liaison between the minority and the majority, in order to verbally deescalate hostile situations and bullying. I told her I thought that was a great idea and she should consider being involved in order to better communicate her perspective. She is thinking about it.

I may not be able to control a lot. I don’t want to. But when there are problems that hit home that seem to revolve in a never-ending cycle, I believe sitting on the sidelines just isn’t an option for me. It is in my blood to take a stand, to speak up, to engineer an Underground Railroad, to fight the Battle of Atlanta, to share my truth and my peace and articles like the one above.

Fear not. The truth is within me as much as it is out there. Discovering it is only half the battle.

My daughter, way back when

Psychiatry in Alabama

This subject is a very familiar one within my blog but I write about things I know and this particular subject is one I’ve been exposed to every weekday for years, so I know a little bit about it. I think it is an important subject and should be talked about more often, but I seem to be one of very few people willing to openly discuss mental health in my local area. However, we have a problem, and the problem seems to only be getting worse.

The internet, in my opinion, is both a blessing and a curse. With the ease of use and access to tools we never before imagined possible, half of my life has been engineered to adapt to these technological advances and increasing speeds. The problem is that many people in my neck of the woods have resisted these advances for decades. But thanks to passing generations, and with most processes becoming automated, common people are basically forced to adapt or opt out of particpating altogether. As a result, we have seen more and more (for lack of a more accurate term) backwoods people either learning how to use the internet, or learning how to make meth.

We have also seen how this has impacted society over time- on any level you prefer to measure. But for the sake of my argument, I’m keeping it local– and appropriately so, as I’ve been incessantly encouraged to shop, eat, listen and live my life locally within the confines of this triangular county for as long as I can remember. That alone can drive a person to the brink of insanity- as I begrudgingly learned during the God forsaken pandemic.

The impacts of social media and the increasing access to the world wide web has done a number on the locals. On one hand, it’s driven people to a level of crazy I didn’t think possible. On the other, a lot of people are getting a deeper understanding of how truly important it is to care for your mind, and not only that- but also that there is no shame in doing so. The stigma around mental healthcare is beginning to dissipate around here and that gives me hope.

I think about the year I was going door to door to offer flyers for a clinic, and the confused, eye roll, or otherwise brutal reactions I received, and compare that to my day today, when the phone endlessly rang as people on the other end were biting their nails, praying for an appointment. Unfortunately, offline access and resources are incredibly limited, and it’s wearing me the fuck out.

I’ve worked in patient access and as a front desk receptionist for three different mental healthcare facilities across the Tennessee Valley for basically a decade. I have helped two of those companies in marketing, intake coordination, scheduling, insurance verification, and more. I have seen first hand how difficult it is for a person to get on a schedule to see a provider. I have seen the quick turn arounds of providers within facilities. I have witnessed countless patients come and go based on their levels of income or whether they were able to have access to insurance. And, as I mentioned yesterday, I have received news of suicide more times than I can count. My heart has been broken on a regular basis for a very long time, and my God- something needs to change.

My plea and prayer is that anyone who works in the field of Psychiatry and has a heart and maybe a nugget of bravery take a moment to examine the dire need of prescribing providers within the sick, sad state of Alabama. Every single day I see reports of child rape and abuse, domestic violence, drug convictions, murder, and so forth. I realize that it is everywhere, but these are the lines that are published on a daily basis- these are the stories that are shared. Each day that passes, I count higher numbers of intakes that I conducted. People are trying to take care of their psyche and the wait time to see a provider is up to nearly three months into the future.

Locally, we have two facilities that house M.D.’s who are able to write prescriptions for psychiatric medications. Our ever expanding population is making it more and more difficult for low income families to have any mental health access at all because many are unable to make the forty-five minute drive north or south to Huntsville or Birmingham. So they feel literally stuck, with no one to turn to. This is disastrous for a growing town. Jobs have increased dramatically, which is great, but access to schools, housing, and medical needs have not. It is creating great problems for facilities like that in which I answer phones for. It is gut wrenching to me when I have to inform someone seeking help that, well, sorry- we can’t take your case. And here’s the only other number I can give you to try elsewhere. And good luck, because their turnover is atrocious because they don’t get paid shit.

If you are qualified and willing to take on a great challenge, Alabama needs a helping hand that can write drug names on prescription pads.


Two of my most recent blogs (yes, I have kept more over the years) have held a central theme throughout: starting from the bottom and working your way up. This could be taken literally in fact, as I do encourage anyone who cares to read what I care to write to begin at the beginning, and then continue reading in the order in which my entries are posted. It may make more sense this way, and the natural timeline allows the reader to see how I may have progressed- both as a writer and as an individual human.

As I get older and wiser, I can look back on my writing and the subject matter and opinions which I once held sacred. Tonight, I wanted to touch on this subject because I’ve been doing a lot of reflecting lately in between busting my ass (I work… a lot). My first therapy session entailed a lot of recounting and brought me back to mental spaces I’ve kept buried down deep for a long time, and others I’ve replayed like a broken record to the point I feel completely helpless.

Yesterday, my best friend found two small toddlers playing in the middle of the road. Thankfully, he saved their lives. Earlier today, I spoke to a mother who felt helpless, as she described her son who has been feeling hopeless. Thankfully, I was able to reassure her and help is on its way, and she even told me I had such a peaceful tone and my voice alone helped her relax, which in turn brightened my day and gave me more confidence to continue doing my extremely challenging job to the best of my ability. This evening, I spoke to a childhood friend who gave me some terrible news about someone we know who ended their own life. Thankfully, uh… well…


There is no upside or happy ending or saving grace in suicide. There are only broken hearts.

A lot of shit happens throughout a person’s life when you allow yourself to live long enough. Sometimes, things do not make a lick of sense. Sometimes, pieces of the puzzle look like they just don’t want to fit into that frame. Sometimes, Bob Ross paints the trunk of a tree down the fucking middle of the canvas and you think he must be completely insane. But that’s life. And that’s Bob.

I hear the phrase “it is what it is” multiple times a day it seems. Yeah… it IS what it is, I GUESS. But could we perhaps look at life using a different lens? Could we possibly see the world for its possibilities? Are we able to treat ourselves and each other with mutual respect, kindness, gratitude, and love? Can we offer help even when we need help ourselves? Can we offer hope when our own situation appears hopeless? Can we extend any morsel of understanding to those who desperately seek to touch another human soul so they not feel so utterly alone in the world?

Is it really what it is? What else can it be?

It can be better. That is the one thing I’ve known from the beginning. And every day that passes- every entry I’ve ever posted, every soul I’ve ever touched, or that’s ever touched me… I know beyond a shadow of a doubt- it can be better.


Life, Death, and then more Life

“Today a young man on acid realized that all matter is merely energy condensed to a slow vibration, that we are all one consciousness experiencing itself subjectively, there is no such thing as death, life is only a dream, and we are the imagination of ourselves. Here’s Tom with the weather,”

said Bill Hicks, years ago. Bill Hicks is one of those comedians that will live forever. He is one of my favorites, for a number of reasons. He was genuinely himself, and wasn’t really afraid to be. He was born in Alabama and then lived elsewhere, which is the dream for a certain kind of Alabamian. The dreamer. The big fish. Is it true- that life is but a dream?

I think comedians are like magicians. The observant odd fellows who permiss themselves to explore elsewhere. It can be dangerous. Or worse, confusing. Will I get it? Is this funny or no? “What does it matter?” oh, the frequency of this being spoken in the Hicks household, in my household… I, too, didn’t understand this or that, but I especially couldn’t understand why some people just refused to have any sense of humor. About… anything at all. I guess it’s no one’s business. Some people just get it and some don’t. Simple, right?

I recently read Tom Scharpling’s (I give five stars) memoir, It Never Ends. In it, he describes many things relating to his struggles- specifically, his near-crippling depressive state and the suicide attempt as a teenager which resulted in electroshock therapy and half lifetime of suppressing associated feelings of humiliation being Tom Guiliano. He may still be playing hide and seek with his former self while simultaneously embracing his assumed role (newly adopted life) as the creative, hilarious, and loveable Mr. Tom Scharpling.

Tom Scharpling is my damn hero. And after getting to know pre-Tom as Scharpling, I say Tom Giuliano is also my hero. Giuliano was the inventor of Scharpling, after all. What a gift.

I actually discovered Tom while watching the best episode of Aqua Teen Hunger Force, called The Shaving, which was aired on Adult Swim (one of the best things to come out of Atlanta) in 2003. Tom voiced a mild mannered lunatic (onion?) named Willie Nelson. It is super incredible to have this sentimental attachment to this character, particularly because he mentions Willie Nelson (the actual WN) in his book, describing a highlight of his career as Mr. Nelson reads a line that Mr. Scharpling wrote for the Emmy award winning show Monk. Side note: he was one of two writers who contributed to this show from beginning to end, which is an incredible accomplishment for any job- but I imagine especially for a writer. And dang- Mr. Scharpling has many, many layers so the four legged onion named Willie Nelson character now makes perfect sense.

I later bought this season of Aqua Teen on DVD and I used to spend hours binge watching these episodes, The Shaving being my all time favorite- and Willie Nelson (the monster who feeds on human blood who simultaneously wants no part of killing to be scary) my favorite character. I wondered, and immediately thereafter, researched (like everyone does) who was behind the character, voicing it to life perfectly. Tom was. So I read more and more about Mr. Scharpling and that is when I discovered The Best Show. It was in its toddler phase at that point, or maybe in middle school- I can’t remember- but when I found out his comedy partner was also the drummer of Superchunk, I remember feeling like I found a key to this long lost magical box of goodies that I’d been missing since Kindergarten. I opened the box and so many amazing pieces of the puzzle appeared and it started making a lot of things in my life naturally gravitate together.

Later still, I discovered Kurt Vile, partly in thanks to Tom, but also because based on the shit I listen to, my Youtube suggestions aligned me with Vile and I probably credit him and Tom with getting me through the shitstorm that was my personal life beginning at age 30.

I’m 35 now and all I can say is, yet again, Tom Scharpling has given me (and I realize others as well) a gift. His personal journey is not only gut wrenching- it is gut mending, too. He rose from the grave, so to speak. This gives losers like me a ray of hope that one day, too, shall I be free from the constant bullshit that is in my head.

I’ve mentioned my own suicide attempt when I was a teenager. And even before that, I wrote my own obituary at age 12. (I was a famous journalist loved by thousands who died by drowning in the Gulf of Mexico, BY THE WAY.) I don’t recall writing this (which is even crazier if you think about it- especially when you consider I DO remember writing a fourth grade essay contest detailing why I would be the best Vice Principal there ever was*), but MY GRANDMOTHER FOUND IT and GAVE IT TO ME twenty years later. I couldn’t help but laugh. But after the suicide attempt, no one was laughing then. My dad had no clue what to do for his fifteen year old daughter who had just endured abandonment from the Almighty Iron Woman that was my mom. My mom was in L.A. at the time- and honestly, I couldn’t say if she was even aware that it had happened. She still may not know. My dad called Doc at the ER (an actual ER Physician we went to church with at the time) for advice and he then instructed me to jam my finger down my throat to induce vomiting (“or else they’re going to make you drink tar at the ER, your choice”). So I gave myself the finger. *I won the contest and was awarded by being Vice Principal for an entire day which means I sat in the Principal’s office all day chowing down some Oreos, MISSING DOMINATING A GAME OF WAR BALL WITH MY FUCKING FRIENDS

I have also mentioned that my baby daddy gave me one of the best pieces of advice I’ve ever received regarding harmful thoughts: just add something nice. The simplicity of the sage he brushed against me stuck and, over time, rooted in the central command center of my psyche. (Coming from a guy whose name would appear on my phone which would result in physical tremors. Another obstacle I have overcome.) And so, the mindset blossomed into an action that took a lot of practice, and it has taken me years to not only find that balance word that has been BEATEN INCESSANTLY in self help sections, but work towards tipping the fragmented imagined scale the other way and grow the flowers in my garden head and actually find some REAL MEANING in my existence. What a difference!

I grew up listening to the radio, and my family’s abundance of musicians and artists meant I was destined to grow up either back stage or on stage or directly in front of the stage. Only in recent years (thanks to my 50% hearing loss- which I will soon be having fixed) do I enjoy a concert from a greater distance. I think the straw that broke my back was Helms Alee at Bottletree in Birmingham (one of the last performances at Bottletree- RIP) when I was standing directly in front of the stage, headbanging until I felt my two beers and whatever food I’d ordered start making me nauseated. All I remember after that was making my final exit out of Bottletree (forever) with a hefty load of barf pouring from my mouth directly in front of the entrance and the workers looking completely stunned. My friends literally carried my ass to the backseat of the car, where I curled up into a ball and I don’t remember anything after that.

So back to the radio- I have a deep appreciation for DJ’s and the knowledge their minds contain about music. I, like Tom, grew up listening to various DJ’s and reading music magazines and listening to my cool family members discuss the superior underground scene around a Scrabble board during the better majority of my childhood. In short, I love digging for good music. I appreciate good music. When I was a child, we listened to 107.7 the X, which was an alt rock station out of Birmingham, Alabama. I listened to the morning DJ’s on the way to school, and by late middle school, was ditching class and faking sick to listen to the entirety of the show. One particular experience I’ll only forget as I enter mid-stages of dementia, was when I was about fourteen years old and got to talk to SPACE GHOST LIVE ON THE AIR FOR A SOLID FIVE MINUTES. So rad. I also distinctly remember Tuttle and Kline (who are now country station DJ’s in TX last time I checked- gross), scolding me for skipping school just to call in to their show for the tenth time within that six weeks grading period. Did I fail? Not because of my grades. I was a straight A student being told I had to either do night or summer school simply because of my unexcused absences. And I didn’t care.

Another DJ I called a lot was the late night DJ who shall remain nameless. The reason is because when I was seventeen years old, this FORTY-SOMETHING YEAR OLD MAN DROVE AN HOUR NORTH TO MEET ME AND ATTEMPTED TO LURE ME INTO HIS VEHICLE. (It didn’t happen. He had the face of radio- ugly.) So, yeah. That experience was definitely icky, and it wasn’t long after that, The X was X’D and I let radio go and instead got back to my own mixes.

I’ve been making mixes for-eh-ver. Whether on cassette, cd, mp3, or Youtube Music Premium (shut up), I THOROUGHLY enjoy curating playlists. Our local indie station, Live 95.5 got wind of me thanks in part to my friend Sandy, a Certified Health Coach, who would help instruct a laughter yoga class that we led for an assisted living facility in town- which was actually a great time. I would sometimes guest on her show, called Pathchangers: Habits of Health, and contributed bits relating to mental health. Our friend- ironically also named Tom* (who owns a music/recording equipment store and also founded K-99 Rocks, a small but effective Birmingham rock radio station that hosts and records local live shows)- would also appear and provide sound, practical (and incredibly helpful to me) money advice. It was a well rounded, health goals oriented show, and I’m very proud to have been a part of it. *all the good ones are

The station’s owners, Jay and Melissa, became friendly with me and I mentioned my love of music and creating playlists and told them if they ever needed assistance with their station, I’d love to help. Tom also invited me to guest DJ on K-99 Rocks, and he showed me how to navigate his program, but I just didn’t have the time to do what he was looking for. So yeah, I volunteered time, “talent”, energy, whatever for Live 95.5 fm, and came up with some ideas which later developed into my own radio show. Oh. What was it called?

My Radio Show. It was called My Radio Show. So, partly because I could care less to have a catchy name and wasn’t getting paid for being a creative genius and didn’t want to put TOO much thought into it, and also partly because of my friend Tom Scharpling (only friends of Tom will understand) and the inspiration he has lent me (and others as well) over the years. I worked hard on my show, though, using equipment and software I’d never used before- learning it all very quickly. And working from my own home- the house on the hill- on my own time. I was laser focused the minute I started until the minute I finished. And when it aired, I made time to listen intently without interruption, critiquing myself and usually being satisfied afterwards. I know probably five people, tops, would regular-ish-ly tune in. But it was something that I created and was- am- proud of.

The evil pandemic began in my neck of the woods around the same time I began My Radio Show. Concert tickets were refunded (maybe one day I’ll write about the Band of Horses fiasco), and frowns ensued, so My Radio Show was definitely something I was holding on to for a piece of normalcy and a tinge of sanity. It kept me from drowning in sorrow over the fact that my daughter and I were going yet another year without seeing one single concert together- when I’d been to a billion. It was all I ever wanted- to have this incredibly magical concert experience with my child. We currently have tickets to numerous shows but one has already been post-poned to next year and I have found myself biting my nails again… which is definitely a good idea, because… Covid.

So I worked on My Radio Show for a year and a half, and last Sunday I announced that I was airing the final episode. I came to the conclusion that I was finished with this project for a few reasons. One, I wasn’t getting paid. Yeah, I volunteered for it, and I never expected to get paid- but when you find yourself volunteering, and then other things come up, a non-paying gig is hard to commit to. I just didn’t want to be committed to something that wasn’t going to keep me afloat. I had to carve time out for other things that were actually working for me. This blog is another example of a non-paying hobby. And, like the radio show, it is something I truly enjoy. I’ve loved writing ever since I possessed the ability. In fact, I used to win awards in school and attend Writers’ Conferences and publish poetry as young as age 15. But this is not something that has a regularly scheduled timeslot attached. I can come and go as I please- and based on the timestamps of my previous posts- it’s pretty obvious I do this whenever the fuck I feel like it. And I’ll likely crawl back to Jay while shoveling coal in my mouth to visibly appear as desperate as I may someday feel. But until then, I’m good and yes, I know the invitation is open so I don’t have to succumb to that dramatic low in order to revive my local indie radio dj pipe dream.

So what is the point of this post? I just wanted to write. Tom Scharpling just wanted to write, too, and eventually, he made a real name for himself- LITERALLY! I often wonder with an embarrassing last name like the one on my Birth Certificate, if I shouldn’t change mine as well. Maybe I, too, could develop a new persona and my own confident character that, like Tom, steamrolls chumps. Maybe that’s why I like what I like. As mentioned in his book in his run-in with a fellow King Crimson fan who spied his KC tee…

you either get it or you don’t.

My favorite line from his book goes like this and can be found on page 215, referencing fried Oreos and Twinkies on the New Jersey Boardwalk:
“They are as common as a pair of horn-rimmed glasses at a Wilco concert or a misspelled tattoo at a Tool show.” Mr. Scharpling, thank you. Everything in my life- both good and terrible- makes perfect sense.

Tom is right about so many things, but the key takeaway from the book he wrote is this: you are not your trauma.

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. 


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?