Infinite MonkeysIn response to Joe Carter's thoughtful but over reaching post on ADD (part I, and part II), I would encourage people to take a pass on the self-quiz he points to. The guys who wrote Driven to Distraction are good guys. They've overcome a lot in their lives. But I wouldn't exactly classify them as the leading edge of research in the field. Before you write off the whole schema of ADD, please consider that the disorder may be real and take a look at a more thorough self-prescreening. Note in particular that this exam I'm recommending suggests that another person close to the subject in question answer the questions, in addition to the subject himself/herself. It's the Amen Brain System Checklist. (The multiple questionnaires that one takes as a part of the check-in procedure for the clinic are mailed to patients in advance and are composed of several hundred questions for the both subject and someone close to him or her. During the intake procedures, other questionnaire-type tests are administered orally during interviews and observation sessions.)
Readers of InfMonks may remember me posting about Dr. Amen's work on brain scans in the past. Joe Carter (Evangelical Outpost) has responded to those posts via email suggesting more posts on the fascinating new field. Which is why I was particularly disappointed to see him write, "...no biological origin for the disorder has ever been discovered." First, let me point out that no physical biological origin has been discovered for autism. But no one disputes the reality of autism. It's also sometimes misdiagnosed. Autism is evident through its symptoms and the actual functioning of the brain. Yes, there are some slight physical differences that seem to manifest themselves in the physical forms of the brains of the autistic, but researchers have yet to find the why? The simple statement that there is not yet a physical origin known to science gives the impression that there is no physical manifestation of such disorders. This is simply not the case.
S.P.E.C.T. scans of the brain in action done at Dr. Amen's clinics, and reproduced by others elsewhere, have shown actual physical differences in the functioning of the brain with noticeable patterns of over- and under- activity in known regions of the brains of sufferers of numerous brain disorders. But this is new research, and it's been slow to get out into the medical community, particularly to those pediatricians and family practitioners so well described by a reader called Bubbles in Joe's comments section.
Here's a page on a S.P.E.C.T. scan of a normal brain. This page also gives a brief introduction to what the different colors mean, and how the images are oriented. Scroll down to the bottom for the images to compare with the next set.
Here are the images of typical ADD brains. What they haven't taken the time and space to display in this online atlas is the notable lowered functioning when the subject tries to go from a state of rest to a state of concentration. This is demonstrably clear in the books that Dr. Amen has published. (And while you're at that site, I'd suggest that you take the time to use the navigation to look at the other brain scans, particularly the ones that show the effects of drugs and alcohol abuse. Yep. Compare those with the pictures of the brains of trauma, stroke, and Alzheimer's victims. You may want to think about those pictures when it comes time to talk to your kids about drugs and alcohol.)
Yes, I've been to the clinic. I've done the many tests and had a brain scan. And no, they didn't tell me I had ADD.
I've seen adult ADD close up, not in my family but within my circle of friends. I've seen how it's often missed altogether, or sometimes diagnosed for years as manic-depression (bipolar disorder). The overwhelming drive to find the stimulation necessary to overcome that effect of the shut-down that comes on when one affected tries to concentrate can lead to disastrous, life ruining consequences. This cannot be overstated. And despite the shocking number of over-diagnoses in kids, far too many (a majority, according to credible estimates I don't know how to find links for) sufferers among adults either don't get any treatment, get the wrong treatment, or get under-treated.
Yes, I believe ADD is almost criminally over-diagnosed among children. Yes, I believe Ritalin is horribly over-prescribed to kids. (One of the common misconceptions I have been fighting is that Ritalin makes chilled-out zombies out of kids. It's a stimulant. A stimulant. It only calms down those kids who have one of the types of ADD that causes them to react inversely to stimulants -- even caffeine and some cold medications like Benedryl. For the "normal" kids put on Ritalin, it's just as if you've given them a low-grade speed. Then it's a self-fulfilling diagnosis -- "see, they're obviously hyperactive and distractible, so we must have been right.") But the answer isn't to throw the baby out with the proverbial bath water. It's time to look to the work of doctors who are devoting their full attention to these topics.
The focus should turn to folks doing the cutting edge research, like that by Dr. Daniel Amen and the others who are looking to the latest methods for looking into how the brain functions in real time, and looking to treatment that goes far beyond handing someone a pill and sending them on their way. I'm all for medication. But medication alone is not wise. Seeing a pediatrician or a family practice doctor (or a church counselor -- and yes, I love my church) alone for a possible mental disorder is not wise. Nor is it wise to depend solely on the recommendations of a blog, WebMD, or the commercial endorsement of a public figure for medication alternatives or health food supplement bundle. Good, informed, and constantly learning oversight is necessary, and it's not a bad idea to get advice on diet, nutrition, exercise, and dietary supplements (vitamins, minerals, and particularly essential fatty acids) from the same person, or someone similarly trained in treating such ailments.
Yes, I'm calling such things "ailments." From all that I've learned, many mental conditions from ADD to depression, to anxiety disorders, to bipolar disorder... are as objectively real as diabetes, just as imposing, and sometimes as life threatening.
Posted by Brad at February 16, 2004 01:20 PM | TrackBack