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Thread: ADHD is BS...

  1. #31
    Senior Member compulsiverambler's Avatar
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    Quote Originally Posted by InsatiableCuriosity View Post
    Most paperwork I have coming through still lists the diagnosis as ADHD, albeit incorrectly now I gather?
    Well most people still use the notation ADHD, I do as well sometimes, but that's not how it's listed in the DSM-IV. It just makes it a bit clearer in my opinion that the hyperactive-impulsive symptoms and inattentive symptoms are two separate spectra and you don't have to be at the dysfunctional end of both. It's the notation ADD that can cause serious confusion though, because the condition used to be called ADD for hyperactive and non-hyperactive patients alike, and now the reverse is true with ADHD and AD/HD used for hyperactive and non-hyperactive patients alike. Some people still use ADD to refer to any subtype of AD/HD while others use it to refer to AD/HD Predominantly Inattentive Type. Many of these see the term ADHD, as you did, and understandably assume that anyone diagnosed with it must be hyperactive. The DSM writers decided there just wasn't enough confusion and misconceptions about the condition, you see.

    Many of those who are medicated claim that they have difficulties with their creativity since taking the medication. The interesting issue for me is my observation that many of these kids have an amazing aptitude for left brain/right brain balance work in the hybrid technology and arts.
    I've seen a few people claim this but the majority report the opposite, at least over on addforums.com. There have been polls there and most people report either no change, or an increase in creativity. I like a quote by W. Timothy Gallwey: "Concentration is the supreme art because no other art can be conceived without it - whilst with it anything can be achieved."

    Probably some people do experience a drop in creativity as a side effect but that can happen with medication for any condition, even non-mental ones. You just adjust the dose or find a drug that suits you better. I've never seen anyone report the same side effects and results on every available AD/HD drug, but unfortunately a lot of people give up after one or two, assuming they'll all have the same effects on them.


    I still question whether this is indeed a disability or an environmental issue or whether it is evolution - much like the discussion on ASDs that has recently been going on at TC.
    Why do you see these as mutually exclusive? The frequency of both sickle cell disease and cystic fibrosis in the population results from evolutionary processes and these conditions are still certainly disabilities.

    Do you think nature in its evolutionary course makes an error of judgement of this magnitude?? Figures in recent years in Australia placed an estimate in the 20% range for incidence of AD/HD in the population. This is an enormous percentage of population to advise that they are dysfunctional and need medicating to fit into societies expected behavioural pattern??
    Oh now I see why. Evolution doesn't make judgements any more than gravity does, it doesn't try to support and influence the development of life and certainly not quality of life any more than gravity does. It's just a group of inevitable processes with the result happening to be the genetic spread that we see today. In many other planets, gravity happens to be too strong or two weak for life to flourish. This isn't a 'failure' of gravity as gravity has no intentions in the first place, it's merely a statistical probability that on one or more planets gravity will be adequate for life forms to take root.

    Likewise sometimes the processes underlying evolution support reproduction and the recurrence of particular genes across generations, and sometimes these in turn support better quality of life for the creatures carrying them, but other times they don't. Most genetic changes are neutral or negative in terms of reproductive rate and/or quality of life, so other times processes result in genes being created that are not passed on to many members of the next generation because they make the carrier less likely to reproduce in some way, or, as with AD/HD, they result in genes being passed along in considerable numbers that reduce quality of life for the carrier.

    People with AD/HD are much more likely to get pregnant or contribute to pregnancy earlier in life than they would have wanted. This is one known factor influencing the rate of AD/HD genes in the population, and it's obviously undesirable for society and the individuals involved. Other possible factors have been proposed, for example people with neurodevelopmental disorders or even just a few of the associated genes and traits of them seem to be more likely to have long-term relationships with other people with this group of conditions and so have children with twice the chance of inheriting enough of those alleles, for reasons that aren't clear yet (though in my personal experience it's a lot to do with feeling more comfortable with and even intrigued by people who stand out in similar ways that you do yourself).

    Finally, once a genetic trait is present in the population as a particular proportion of it, it won't be lowered as a percentage unless carriers of those genes start reproducing at a lower rate than those without it. There are currently not many common genetic conditions around that result in the carrier dying before reproducing and passing the genes for them on - precisely because they have that effect. Many potentially deadly genetic conditions, e.g. Alzheimers, don't kill the victim until they're old enough to have had children, and these affect more people.

    AD/HD does actually increase the chance of dying young to some extent, due to the higher rate of suicide, drug abuse, serious accidents and involvement in violent crime - probably homelessness too but I have no statistics on that - but not enough people with it die before having children for it to be as rare as say, cystic fibrosis, which until very recently almost always killed people before they reached adulthood (the infertility rate of the males obviously has a lot to do with that too). The processes by which AD/HD genes are getting passed along must compensate for the increased death rate, and then some.

    This doesn't mean they are desirable to us. It doesn't mean that evolution 'wants' them to be there or cares or knows about it, as it's not a calculating force but the end result of a group of complex processes. And if evolution were a force and did want them there, it must be an evil force because it would be desiring something that causes suffering for no apparent reason.

    I'll finish replying to your post soon. I've been 'perseverating' as Barkley would say, instead of getting ready for bed.

  2. #32
    Senior Member InsatiableCuriosity's Avatar
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    Hope you slept well My class went very well and I am now off to work to complete my marking load. I look forward to reading more of your thoughts when I return this evening or whenever you choose to post.
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    Senior Member Iriohm's Avatar
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    Quote Originally Posted by yourfriendjaneen View Post
    I dont think people with ADHD have a disease. They are just people with a certain personality type. What are your thoughts on this?
    I can't say "I think you're wrong", since that would be untrue, yet neither can I say "I think you're right", since that would be redundant.
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  4. #34
    Senior Member compulsiverambler's Avatar
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    Quote Originally Posted by InsatiableCuriosity View Post
    Dr Lucy Jo Palladino's book Dreamers, Discoverers and Dynamos (formerly The Edison Trait) makes some interesting observations on her treatment of children who had problems likely to be seen as AD/HD.

    Better understanding of the children's communication and learning styles by the parents, and subsequent changes in interaction between parents and children, with incredible positive results, make me wonder whether medication is really a panacea for people who cannot afford adequate psychological counselling and intervention???

    Indeed the works of the likes of Edward G. Hallowell, Thomas West and Thomas Armstrong PhD give me further pause to consider this line of thought, as do Thom Hartmann's books - ADHD a Different Perception and The Edison Gene in particular.

    What are your thoughts on this?
    I haven't read these books but I'm familiar with the opinion. The trouble with these models of treatment is as far as I've seen they're not backed up by scientific research. Cognitive behaviour therapies alone have been found to improve functioning in the short-term but not the long-term, while medication and medication plus cognitive behavioural therapy works both to greater extent and in the long-term as well (the combination of both results in the best outcome - see this video, which also demonstrates how poorly the mainstream media cover the issue).

    My guess is that these books focus on carefully selected and non-peer-reviewed anecdotes of success without providing proper statistics on how many medicated vs. unmedicated children have good outcomes, especially long-term outcomes, am I right? This is what I've seen from money-spinning pop psychology websites with the same themes.

    Furthermore, there is now evidence that stimulant medication actually makes the brain look less like an AD/HD brain when used during childhood, and not by shrinking any region that's larger (the only known one is the promotor cortex anyway) but by increasing the size of some of the parts that are smaller and increasing the amount of white matter that there's less of. This in my opinion makes it a moral responsibility for parents to try to provide their children with the only treatment that's been shown to do that, and the only treatment that's been shown to highly effectively cut the rates of the long-term complications I mentioned previously.

    To pick out one of the authors you mention though, I do know a little about Dr. Halliwell's work and it seems to me he actually doesn't reject the notion of AD/HD as a potentially seriously problematic way of being that needs to be addressed by society (whether he chooses to use the word 'disorder' or not) or of medication as a worthwhile treatment for it. He just incorporates some of the flattery and feel-good sentiments characteristic of the less scrupulous peddlars, which must be easy to do when you happen to be a rare success story in terms vocational success and fulfillment yourself.

    The online AD/HD community is also somewhat split over the issue of whether AD/HD confers any advantages, but very few believe it does the individual more personal good than harm overall - especially when any kind of intervention is absent - at least the individual living in developed societies of the world today, and my impression is Halliwell is just believes that it can be turned into an advantage or overall neutral trait if taken seriously. I've not seen him back this up with data but I give him the benefit of the doubt where his intentions are concerned.

    Personally I don't believe there's convincing evidence yet that AD/HD confers any significant advantages - unless you consider a slightly greater sensitivity to smells while also being less able to distinguish between smells to be a significant advantage - but other AD/HD adults do, and many or most of them I've seen also take or want to take medication for the problems that they acknowledge it causes them.

    I do suspect that certain types of subclinical AD/HD traits can be advantageous in terms of financial success because of an epidemiological study from the UK that studied people with higher scores on AD/HD screening measures but didn't assess them for diagnosable AD/HD beyond that. It found that while as a group they were more likely to be in the lower earning bands and the majority earned less than average, the group also contained an inflated percentage of people in the highest two bands. Perhaps some level of some symptoms could be advantageous, whereas studies of people who meet the criteria have not found that effect. This again reminds me of the sickle cell and cystic fibrosis phenomena.

    Perhaps confusingly I do also suspect that in some cases people who do meet the criteria and so are significantly impaired will as a result end up more highly paid than average, but indirectly and rarely enough that it doesn't impact the statistics we have of AD/HD earnings. AD/HDers are more likely to set up our own business, probably because of our employment problems and often a lack of other options, and the risk-taking tendency of many, and while their AD/HD will impede them in this endeavor too to some extent, a few will happen to have sufficient compensating talents or support to be very successful at it.

    That's not quite the same as the AD/HD making people better at running a business than they would be without the AD/HD, in fact I would be surprised if the risk weren't even less likely to pay off for them than it is when others take it, it just makes them much more likely to end up trying it in the first place so we have more people with AD/HD being or having been self-employed, however successfully. The same I suspect is true of the entertainment and sports industries, which seem to have their fair share of AD/HD-like or diagnosed individuals who often report that they don't think they'd manage many other jobs, but I don't know of any studies that have looked at the figures there.

    Anyway I'll stop there, not good at summing up but I hope that's interesting and readable to you, or to someone out there. My medication has kicked in completely now and given me that elusive gut sense of time and of the future being directly connected to the present... which is a very welcome novelty after years of never knowing what such a sense felt like.

  5. #35
    Senior Member InsatiableCuriosity's Avatar
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    Quote Originally Posted by compulsiverambler View Post
    Anyway I'll stop there, not good at summing up but I hope that's interesting and readable to you, or to someone out there. My medication has kicked in completely now and given me that elusive gut sense of time and of the future being directly connected to the present... which is a very welcome novelty after years of never knowing what such a sense felt like.
    You have done well I would love to continue a discussion either here or via PM but am too brain dead tonight and it is freezing (last night was 0.1C and we are not used to that here) - going to curl up in front of heater with a rug for now and an early night after last night and today's efforts.

    I do however reserve the right to question and probe your thoughts at a later date
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    Furthermore, there is now evidence that stimulant medication actually makes the brain look less like an AD/HD brain when used during childhood, and not by shrinking any region that's larger (the only known one is the promotor cortex anyway) but by increasing the size of some of the parts that are smaller and increasing the amount of white matter that there's less of.
    This is really interesting. My 9 year old nephew was recently diagnosed ADHD+PI and my sister is extremely reluctant to medicate him, hoping that a change in schools plus behavioral therapy will suffice until he's older. She acknowledges that he may likely need medication in the future, but is concerned about the effects it might have on his growth and development. Any chance you can point me in the direction of this research so I can share it with her?

  7. #37
    failure to thrive AphroditeGoneAwry's Avatar
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    Quote Originally Posted by Idioteque View Post
    It's not a disease, it's a functional limitation. Wich for me means that starting and/or finishing projects take way, waaay too long, being distracted easily, probably not paying attention, have a hard time articulating because of a constant chaos or "buzz" in my head, have to read instructions over and over and OVER because I forget easily, losing track of time and sometimes be extremly short-tempered. The fact that you claimed ADHD is just part of "personality", without any reasoning or evidence pissed me off, partly because that's a stupid thing to do and partly because ADHD constantly fucks with my life. ADHD is a neurobehavorial development disorder you know.. you might want to read up on things first before throwing worthless theories out there.

    On the upside though, individuals with this kind of functional limitation are often extremly creative and imaginative, so yeah maybe that made me an N.. or just made me a bigger sensotard, I don't know.

    Quote Originally Posted by InsatiableCuriosity View Post
    From a teaching perspective I have found that engagement and linear vs abstract thinking in the way that students are taught can make the difference in attention being maintained. I have a friend who is ISTJ and had often wondered what relationship functions had on distractability. When the friend refused to come to see The Matrix because he found the abstraction too boring and difficult to follow I realised that Linear concepts are boring to Abstract thinkers who learn in leaps of association driven by relative imperatives, and Abstract concepts with no deliberately scheduled purpose are boring to Linear thinkers. Each scenario increases distractability.

    When we eliminate the distractability caused by poor nutrient intake, and situational distractability, we are left with a much smaller portion of the population with true difficulties. One of the problems with medicating these distractable people is that many have unique creative capacity and, like many who suffer from bipolar disorder, there is a tradeoff in reducing the distractability with meds.

    I have a reported, but not memorable, history of being hyperactive and my mother put me on ritalin sometime in my toddler years. I must not have taken it for long, because I have no memory of it, but she did start having me drink coffee, so she was fairly progressive for the time. My husband's mother says he had it too, but this is anecdotal, and I cannot be sure if he really did, although he has some signs of adult ADHD for sure.

    I found my third child to be extremely difficult to manage when he started getting close to the age of 2. Having practiced positive and attachment parenting from my first child, I still found my patience constantly tried and put to the test. I also homeschooled all my kids from the beginning. Before I realized my son was ADHD, I found coping mechanisms for myself, namely some deep well of patience I didn't know I had. I tapped into this by using a calm, slow voice (which actually sounds kind of psycho, but, hey, it works because it slows me down) and really focusing in on direct physical and mental contact with this child. Whereas my other children could be given verbal instructions, and could follow through with chores or activities with verbal interaction, my ADHD child needed actual hands on guidance to do the simplest tasks, like brush his teeth. The transition to bedtime hygiene every night involved a temper tantrum and I had to physically guide him into the bathroom and 'help' him brush his teeth until he was like 7 or 8. I still remember a homeschool friend's shock when I also had to help him blow his nose at the age of 5 or 6. For me, it was normal to have to stop everything and guide this child. Because he was home with me, I could do this, and did it gladly. Somewhere along the way, I looked up ADHD with impulsivity and he easily fits the diagnosis (this from some google search). My son has, or had the bolded:

    DHD is a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for the child's age and development.
    Symptoms

    The Diagnostic and Statistical Manual (DSM-IV) divides the symptoms of ADHD into those of inattentiveness and those of hyperactivity and impulsivity.
    To be diagnosed with ADHD, children should have at least 6 attention symptoms or 6 activity and impulsivity symptoms -- to a degree beyond what would be expected for children their age.

    The symptoms must be present for at least 6 months, observable in 2 or more settings, and not caused by another problem. The symptoms must be severe enough to cause significant difficulties. Some symptoms must be present before age 7.

    Older children have ADHD in partial remission when they still have symptoms but no longer meet the full definition of the disorder.

    Some children with ADHD primarily have the Inattentive Type, some the Hyperactive-Impulsive Type, and some the Combined Type. Those with the Inattentive type are less disruptive and are easier to miss being diagnosed with ADHD.

    Inattention symptoms:
    Fails to give close attention to details or makes careless mistakes in schoolwork
    Difficulty sustaining attention in tasks or play
    Does not seem to listen when spoken to directly
    Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
    Difficulty organizing tasks and activities
    Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)
    Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
    Easily distracted
    Often forgetful in daily activities

    Hyperactivity symptoms:
    Fidgets with hands or feet or squirms in seat
    Leaves seat when remaining seated is expected
    Runs about or climbs in inappropriate situations
    Difficulty playing quietly
    Often "on the go," acts as if "driven by a motor," talks excessively

    Impulsivity symptoms:
    Blurts out answers before questions have been completed
    Difficulty awaiting turn
    Interrupts or intrudes on others (butts into conversations or games)

    Actually, in writing this, I realize my eldest has the inattentive type, but I missed it, as he was a frustrating and stubborn child and student, but functional overall. (and he just aced his SAT!)

    I think the key is totally as insatiable curiosity said, environment control is essential for these kids. I never thought of putting him on meds or even having him officially diagnosed. I knew that with extra effort on my part, we could function, and we have. He is easily my most creative child, playing secret imaginative games for hours on end in his room. He is now almost 12 and he still has all the symptoms he did before, including impulsivity, but he has learned how to control himself, and the difficulties have been conditioned out of him, resulting in such a low frequency that now it really isn't a problem anymore, and nobody really notices he's even got ADHD.

    I am an adherent to nature>nurture, but conditioning works.

    I used to not even be able to go to friend's homes because he would climb in their cupboards looking for cookies, despite all kinds of discipline to the contrary. He was definitely a hands-on child from the ages of 2-10. How could I ever expect a teacher with 20-30 kids to manage that? I barely managed him with 4. It would be awesome if there was a class for these kinds of kids, a really small one, say no more than 6 with a trained teacher. But, alas, it is just easier to pop a pill, as with so many other things.........

    And he is one of the only ones where I struggle to figure out his type. I've tested his functions and he is off the charts for Fe,Ne,Ni, and has high Fi as well. Suffice it to say, he is highly intuitive, and people love him, and always have.



    On another note, I recently stumbled across this new diagnosis:

    Executive Functioning:

    The term executive function describes a set of cognitive abilities that control and regulate other abilities and behaviors. Executive functions are necessary for goal-directed behavior. They include the ability to initiate and stop actions, to monitor and change behavior as needed, and to plan future behavior when faced with novel tasks and situations. Executive functions allow us to anticipate outcomes and adapt to changing situations. The ability to form concepts and think abstractly are often considered components of executive function.

    Description

    As the name implies, executive functions are high-level abilities that influence more basic abilities like attention, memory and motor skills. For this reason, they can be difficult to assess directly. Many of the tests used to measure other abilities, particularly those that look at more complex aspects of these abilities, can be used to evaluate executive functions. For example, a person with executive function deficits may perform well on tests of basic attention, such as those that simply ask the individual to look at a computer screen and respond when a particular shape appears, but have trouble with tasks that require divided or alternating attention, such as giving a different response depending on the stimulus presented. Verbal fluency tests that ask people to say a number of words in a certain period of time can also reveal problems with executive function. One commonly used test asks individuals to name as many animals or as many words beginning with a particular letter as they can in one minute. A person with executive function deficits may find the animal naming task simple, but struggle to name words beginning with a particular letter, since this task requires people to organize concepts in a novel way.

    Executive functions also influence memory abilities by allowing people to employ strategies that can help them remember information. Other tests are designed to assess cognitive function more directly. Such tests may present a fairly simple task but without instructions on how to complete it. Executive functions allow most people to figure out the task demanded through trial and error and change strategies as needed.

    They must be testing with the game Scattergories here. And I know I personally SUCK at Scattergories. I always attributed that to my weaker Ne, but who knows.

    Now, if this just isn't totally a weakness of Te, Ne, or Si or other various preferences, I don't know nada. Perhaps adults tend to forget that children are NOT well-rounded, and using a typology framework, they really only have a good grasp of ONE, maybe TWO (with one being much weaker), cognitive functions at a young age.

    Lack of executive functioning also corroborates the seeming existence of P types typically having ADHD (ADHD seems to be diagnosed frequently along with lack of executive functioning). P types are not Te dom or aux. Makes you wonder if there IS somewhat a personality basis for some of these disorders.

    I really tend to think of these disorders as a problem in our environment more than a problem with individuals. We take individuals and cram them into one homogenous environment, which is the suburban home, daycare, institutionalized education, and expect them all to behave basically the same.

    Why can't anyone see that this the biggest disorder of all?
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  8. #38
    Senior Member compulsiverambler's Avatar
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    Quote Originally Posted by eclare View Post
    This is really interesting. My 9 year old nephew was recently diagnosed ADHD+PI and my sister is extremely reluctant to medicate him, hoping that a change in schools plus behavioral therapy will suffice until he's older. She acknowledges that he may likely need medication in the future, but is concerned about the effects it might have on his growth and development. Any chance you can point me in the direction of this research so I can share it with her?
    Gladly. See the fifth paragraph of this piece:

    Brain Imaging Data of ADHD - Psychiatric Times

    And the fifth of this one:

    The Shape of Things to Come in Attention Deficit Hyperactivity Disorder -- Shaw 167 (4): 363 -- Am J Psychiatry

    Animal studies with relevance:

    Influence of methylphenidate on brain development-... [Behav Brain Funct. 2006] - PubMed result

    I strongly recommend googling around for statistics about life outcomes in AD/HD, including the differences early medication makes. Here's a long presentation by Russell Barkley talking through some of his own findings, if she has the time and inclination to get through it:

    [YOUTUBE="http://www.youtube.com/watch?v=WroDEcG7tJc"]http://www.youtube.com/watch?v=WroDEcG7tJc[/YOUTUBE]

    As for growth stunting, my understanding is that at least one study has found children given stimulant medications long-term end up, on average, shorter. I have several reasons to suspect that people with AD/HD as a group might be shorter than average regardless of medication, but as far as I know, medicated AD/HD children have never been compared to unmedicated ones, only with the general population, which IMO is a massive oversight.

    If it does turn out to be the medication doing it, I have to give a big shrug, I'm sorry. The average difference identified is not one that would be clinically significant for the vast majority of people, otherwise armies of AD/HD adults would be trying to sue drug companies for making them too short to do... something. I'm a whole three inches below average height for my gender and country (and was never medicated for any psychiatric condition as a child or adolescent), and it's had no negative impact on my life worthy of complaint. I can't reach high shelves or clothes horses... oh well, when I have my own place I won't put anything up there.

    Unless a child is a basketball prodigy and needs all the height they can muster, or they're already in danger of ending up disablingly short for some reason, then it seems an extremely trivial risk to worry about when there are so many serious risks associated with AD/HD that don't get the same mainstream attention. If a child is otherwise anticipated to reach a perfectly reasonable height, then they won't miss a centimeter or two if the choice is between that and how much brain matter they can expect to grow.

    Just my opinion of course, but the fact that it comes from someone who wishes they'd been medicated as a child and who also has the experience of living with the terrible disease of BABS (Being A Bit Short) might make it count for something at least.

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    Considering that right now we're expecting him to grow to about 6'6" at the very least, you'd think it wouldn't be a concern. (Mom is 5'11", Dad is 6'6" and at 9 and half he is just shy of 5'). I think for my sister, growth rate is just a short hand for "I don't know what this stuff will do to my kid!" I'll definitely pass on the research.

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    Senior Member compulsiverambler's Avatar
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    Quote Originally Posted by aphrodite-gone-awry View Post
    I think the key is totally as insatiable curiosity said, environment control is essential for these kids. I never thought of putting him on meds or even having him officially diagnosed. I knew that with extra effort on my part, we could function, and we have. He is easily my most creative child, playing secret imaginative games for hours on end in his room. He is now almost 12 and he still has all the symptoms he did before, including impulsivity, but he has learned how to control himself, and the difficulties have been conditioned out of him, resulting in such a low frequency that now it really isn't a problem anymore, and nobody really notices he's even got ADHD.

    I am an adherent to nature>nurture, but conditioning works.

    I used to not even be able to go to friend's homes because he would climb in their cupboards looking for cookies, despite all kinds of discipline to the contrary. He was definitely a hands-on child from the ages of 2-10. How could I ever expect a teacher with 20-30 kids to manage that? I barely managed him with 4. It would be awesome if there was a class for these kinds of kids, a really small one, say no more than 6 with a trained teacher. But, alas, it is just easier to pop a pill, as with so many other things.........
    It's probably not conditioning that's done it, just normal neurological development that's somewhat delayed. The only way conditioning can make someone with underdeveloped inhibition centres and/or an overdeveloped premotor cortex of the brain less impulsive and hyperactive is by making them anxious or depressed, which happened to me to such an extent and so chronically that I was actually less hyperactive as a child than I am now. When you're anxious, levels of noradrenaline increase, and this is one of the chemicals that the AD/HD brain lacks when in its normal state of arousal and mood. When you're depressed, your energy levels drop, from normal to below normal if you're not hyperactive, or from above normal to normal if you are hyperactive. This is obviously not desirable, and neither is it what I think you are probably seeing, which is the behavioural manifestations of neurological development that's to be expected.

    Almost everyone becomes less active and impulsive with age, including people with AD/HD. However, people with AD/HD remain more active and impulsive (in 2 out 3 cases, anyway) than people their own age, well in to adulthood. You're comparing him to how he was when younger, whereas others he meets, and he himself, will compare him to people his age for his whole life, and not understand why he can't or won't 'grow up' faster. Most adults with AD/HD actually meet the criteria for AD/HD In Partial Remission, which means the symptoms are still causing impairment, often worse impairment, despite having reduced in real terms, because there is usually much greater demand placed on executive function when you're an adult and worse consequences for failing.

    For the majority, it's the persisting inattentiveness that will cause the most serious problems. In the 2 out 3 cases I mentioned, this doesn't appear to others to recede much, unlike the hyperactivity which usually becomes mild enough that it bothers only the sufferer and not onlookers, at which point of course they were traditionally deemed to have outgrown it, despite the considerable suffering that can be caused by feeling like you've got creepy crawlies running up and down your body whenever it's still and that the only way to relieve the sensation is by finding some way to keep moving a little all the time, which makes you look weird or annoying if you can't suppress or disguise these movements adequately, and can even make certain jobs physically unbearable or undoable, even if they stimulate and suit you mentally.

    As responsibilities and commitments mount and structure and support are gradually withdrawn (very suddenly withdrawn when it comes to moving out of the parents' home), the distress and impairment caused gets worse and worse, hence the increased rate of depression and anxiety disorders in adults vs. children with the disorder. They're usually complications, not just 'comorbids'.

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