ADHD – Lessons Learned

Breaking News: The Monkey House Smells Terrible

We love going to zoo. Even as an adult in his late 30’s, my husband used to go to the zoo with his father. Anyone who has ever been to any zoo worth its peanuts knows the monkey house is a must. The monkey house is a magical place: it has the ability to trick your senses within minutes. The monkey house smells awful! In the first 5 minutes, you are overwhelmed by the smell, nearly to the point where you can taste it. But, zoo magic takes effect, and the smell seems to disappear.

It’s amazing what we can get used to or accept as normal. It’s common knowledge that we are being tracked with every click on our smart phones, scan of our rewards cards, and search on our laptops. The grocery store knows which coupons to give me the same way Facebook introduces me to a dozen pages that are close enough to the irreverent, 80s nostalgic, underdog, and teacher-focused other pages I have liked. Technology is designed to make life easier by bringing us all of our likes faster. But, it is so effective in keeping contrary opinions and points of view so out of reach that we stop growing.

Facebook is the easiest way to illustrate my point. My friends and I share similar values. So, when they post interesting stories or articles, of course I “like” them. GAME ON. I am automatically able to “like” the source. That clearly gets another thumbs up. After a very brief period of time (imagine sun cycles, not lunar cycles), feeds I have never heard of are banners between every 3rd post. My cultural ADD clicks in causing me to dole out more “likes.” My global village is now just a cul-du-sac of like-minded people. Sounds good, right? Too good. The problem is we have limited our capacity to develop to our full potential without any exposure to contrary opinions.

Growing Up is a Lifelong Journey

Developmental psychology has many different theories and models. Like the delicious cheese counter, theorists come from different countries and emphasize different aspects of aging. What they all agree on is growing up isn’t limited to children and requires HEALTHY CONFLICT.

Cognitive development: In order to increase intelligence, we need to adapt. Our physical bodies know this when our blood thins when we move to Florida to retire from the cruel winters of our New Jersey childhood. Our minds adapt by creating categories, challenging the criteria for the categories, and broadening the category. As a toddler, my son called everything with 4 legs a puppy. Great job, Jacob! You were creating a category of animals. As he went to the zoo, all of the puppies transformed into lions, giraffes, rhinos so each DIFFERENCE made the animal category expand.
Social development: Experts, the Most Knowledgeable Other (MKO), is essential for social development. My best friend was my pregnancy sherpa, my MKO, who guided me through the unique experience she survived one year prior. How else would I know about the best cream to use on my parts sore from nursing and my son’s parts red from diapers? It takes time out of your bubble, and maybe your comfort zone, to find your MKO.
Attachment: As parents, we know the bond between us and our children is vital to making our children feel safe. Helicopter Parents and Tiger Moms are notorious for not letting their children develop INDEPENDENCE because the children are too sheltered and unexposed to different people and experiences. Data tracking through rewards programs and social media are the Helicopter Parents and Tiger Moms for adults. Inappropriately attaching to strangers without the process of developing a relationship is as big as a problem as not bonding to anyone. (You all know where this is going…) Collecting followers on social media closes you off to growing and developing relationships that have a healthy GIVE AND TAKE.
Moral development: Ask any of my students from my 15 years in the classroom…they were educated in the benevolent dictatorship of Mrs. Slutzky in which I owned the air they breathed. Kids rely on consistent rules from authority figures. Their decisions are based on avoidance of consequences from breaking those rules. But, even at a young age, children progress to the next stage of moral development. Interacting with peers in different social settings cause HEALTHY CHALLENGES to the “rules”. It becomes okay that absolute rights and wrongs don’t exist. Grammy is allowed to give Jacob a cupcake for lunch despite the rule that “sweets come second”. Learning how to adapt when there are new interpretations of right and wrong, shoes off when you go into a house, eating burgers with a fork, is a proud sign that our children are using their own compass to navigate new situations. Why, as adults, have we gone backward?

Spark Note Summary

There are times when surrounding yourself with like-minded, cheerleaders who support you without exception is vital; low self-esteem days and tragic life events happen to us all. But, spending too much time in your bubble is similar to the NEXT 5 minutes in the monkey house; reality is suspended. The answer is not to avoid the monkey house or convince yourself there was no palpable stench. You CONFRONT the discomfort, readjust your expectations, and smile for surviving with a (now) bigger bubble.

LeVar Burton, Accidental Therapist Extraordinaire

Click here to bask in the nostalgia of the theme song!

Before the costume designers of Star Trek: The Next Generation chose an 80s banana clip for a futuristic visor, LaVar Burton was the host of Reading Rainbow. Each episode had a theme similar to ones that my son has in his pre-K class…space, animals, transportation, etc. Books were read to us by famous celebrities like Kermit the Frog. LeVar Burton took us on “field trips” to a fire house or farm. But, the best part of each episode was at the very end. A child just like me, a cute, book-loving precocious child, would tell us all about a favorite book. These were heartfelt testimonials that always ended with the phrase, “But, you don’t have to take my word for it.” No? But, I do! You love books…I love books! We are virtual book club buddies!

Bibliotherapy

Bibliotherapy is a real, accepted modality for treatment of some mental health issues. It started with the turn of the century when soldiers were given medical books to learn about their injuries. In the 1960s, bibliotherapy became an official modality under the American Library Association, and psychotherapists mainstreamed the practice as an additional tool during more traditional therapeutic treatment. As Lessons Learned begins adding an occasional book review, it is important to understand the mental health benefits of reading.

Pacing: Shakespeare wrote in poetry, iambic pentameter, for his audience to get caught up in the music of his words. Before you twitch into a mess of

Click here to hear modern day iambic pentameter.
horrible memories of school, it may help to understand that iambic pentameter is exactly the same cadence as the theme song from Gilligan’s Island. Prose also has an intentional rhythm. Short, choppy fragments mirror the mood of the character. Endlessly long sentences (see anything Faulkner wrote) drone you into a lull; “what did I just read in those two pages that were three sentences long?” Mental health practices of mindfulness and meditation help suffers of anxiety and PTSD, for example, use careful control of breath as a self-healing tool. Being whisked away into an author’s linguistic pacing can have the same benefits.
Guided imagery: All of my students will tell you I have a hard and fast rule about movie adaptations of books. I refuse to watch a movie in which I’ve read the book. I refuse to read the book if I’ve seen the movie. Case in point: I’ve seen all 8 Harry Potter movies without cracking the spine on any of the 7 novels on which they are based. My snobbery is based on protecting myself from dashed expectations. As I read any book, I imagine what the characters look like, how they speak, how they dress, etc. I like to use my internal CAD programming to design their homes and neighborhoods. Getting lost in the story is why reading a book with Fabio on the cover can be more healing than one with Dr. Phil on the cover. One of the most preeminent medical facilities, the Cleveland Clinic, has concluded: “Imagery can stimulate changes in bodily functions such as heart rate, blood pressure and respiratory patterns. It can help you tab inner strengths to find hope, courage and other qualities that can help you cope with a variety of conditions.”
Empathy: One of the major impacts of bibliotherapy is to see yourself, including your challenges, in a character. It is also extremely cathartic reading how someone just like you works on fighting mental illness without stigma or despite of it. This process, forming a bond with a character that reminds you of yourself, builds empathy. It also allows you to have empathy, not sympathy or pity, for yourself. Now that you are starting down the path of empathy for yourself, you have made the most difficult step in self-care: appreciating who you are without apology. Not sure what the difference is between empathy and sympathy? Watch this remarkable animated short.Spark Note Summary

Bibliotherapists are most often English majors with a depth of knowledge about “who” and “what”. Therapists are most often psychology majors with a depth of knowledge about “how” and “why”. As a woman with a bachelor degree in English Education and a master’s degree in psychology, I am your unicorn. As this blog takes on an occasional book review, have some faith in the magic of some more of the lessons I have learned.

Opening Pandora’s Box

When Jacob was four months old, he was obsessed with the color blue. He grabbed anything and everything blue. He also gravitated to anything that was Mommy’s. We got him to eat fish, chicken, spicy foods, etc. by putting HIS food on MY plate. So, the combination of Mommy’s cup and the color blue gave us this adorable picture. Then, the clever makers of Budweiser came up with a delicious, cheap, beer with double the alcohol. Problem: the bottle was blue. That is how we got this other adorable picture. The parental challenge we face is how to explain to this sweet boy (one day too soon) that drinking is not cute….or fun…or cool…or anything permissable until he is 21 years old.

I am writing this blog on the precipice of Oktoberfest, the gateway holiday for the season of playing with friends and family. That season is also a time of overdoing and undersupervising. Fifteen years of teaching and eight years of counseling have given me a front row seat to substance use and abuse. Here are the secrets I have learned from the mouths of addicts and the families who love them.

Welcome to Drugs 101

There are some common physical and/or behavioral clues that you have a loved one who is building a relationship with an illegal substance. The illegal substances we are talking about include tobacco and alcohol because of the legal ages required to consume those products. Take a breath, moms and dads…here we go:

Tobacco: In 2011, the National Institutes of Health published a study that qualified tobacco as a gateway drug. The study talks about the changes in the brain caused by nicotine. The piece of the puzzle that I have seen is how many of my clients started smoking at the ages of 8 or 9 before they wind up facing a charge of marijuana possession. The connection is a straight line. Teaching your lungs how to inhale tobacco smoke will allow kids to hold in the smoke, and addictive chemicals, of marijuana and heroin. Now who misses Joe Camel?
Alcohol: I confess. I was so drunk at my sister’s bat mitzvah (when I was 16 years old) that I forgot to duck to allow the garage door to open when I left the house the next morning. My explanation is a cultural double-whammy: in the Jewish faith, you are an adult after your bar/bat mitzvah (traditionally at 13 years old), and it was common in my family to “not mind” when a teenager drank as long as it was with family. Sound familiar?
Some states have laws that permit a child younger than 21 years old to drink

The worry for parents is binge drinking. It should take approximately 4 hours, one drink per hour, to reach the legal limit of .08; binge drinking means you have been able to reach that level in half the time. Here is something you didn’t want to know: in order to avoid consequences from parents who use a breathalyzer regularly, I have had clients who snort alcohol or soak tampons in alcohol to put in their rectums to get drunk quickly. If we an only harness that kind of clever ingenuity for good, world hunger, cancer, and global warming would be fodder for history books
Marijuana: IT’S NOT THE SAME! If you learn nothing else, please accept that whatever you smoked in your youth is not nearly as potent as what is currently available. The incredible scientific advancements that enhance crops to feed poor communities and create generic medications that save all of our budgets were used by less honorable businessmen to engineer highly potent, increasingly more addictive marijuana. And, forget trying to remember the nicknames and codes you may have used to monitor what your child knows about this drug. You will not be more clever than they are. What you should remember is how thirsty you were, how lazy you were, and how badly your eyes burned. Then, when your child blames allergies and overwork at school for those symptoms, you will be appropriately curious. Fun factoid: children that suffer from ADHD often behave more hyperactive when under the influence of marijuana.
Heroin: Thanks to the rise in our insurance co-pays, economics drew tweens and teens to the street to chase their prescription pill highs with a more affordable drug. The average street price of “oxy” ranges from $10 to $25; a $2 balloon of heroin gets you the same high. This phenomenon is not new. Finding more affordable replacements for upper class drugs, like cocaine, is what led to the crack epidemic. Your kid is afraid of needles? No problem! Heroin can be smoked or snorted. It is a versatile drug that shows no signs of decreasing in popularity. The federal government is just starting to address the national epidemic by limiting the amount of scripts and refills doctors write for injury. Sorry, parents, but if your sweet boy or baby girl is an athlete, watch what happens after an injury. Gross factoid: opiates like heroin cause intense constipation. Complaints about stomach cramping or lack of success in the bathroom may be an indicator.
Adderral, Ritalin, Xanax, Percoset, Etc.: Name brands or generics, their prescriptions or yours, there is no problem with availability or opportunity for these drugs. My clients refer to “skittles” parties, friendly gatherings where everyone brings whatever pills available to put into a communal bowl for anyone to gamble with a handful. The concern for medical personnel is waiting for blood work in order to treat an overdose. That wait time can be lethal. Sadly, grandparents are the number one unwilling accomplices to this form of drug abuse based on the amount of pills they have in their homes and the amount of love they feel when their grandchildren visit.

Spark Notes

There are hundreds of articles, books, and expert opinions on the topic of teen substance abuse. There are more drugs to discuss and tricks to spotting addiction to learn. It is important to know that you don’t need a family history to raise a child struggling with drug use or abuse. You just need a child to make a bad decision. Like most family problems, substance use and abuse are nobody’s fault and everyone’s responsibility. You can help correct that mistake like our mythological friend, Pandora…hope.

Can ANYONE Follow the Bouncing Ball?

I’m not really a do-er. Don’t get me wrong – I’m really busy. (See also: a working mom.) multitasking mom But, when it comes to down time, I talk a good game. I would love to craft something that makes my house more of a home. I need to stretch and meditate during yoga to let the toxins out of my body. Instead, I’m a self-proclaimed couch potato. Except….

My fingers are busy…

They are fast forwarding shows on my DVR.

They are clicking on Facebook and swiping back to Angry Birds. (Don’t judge; I’m still playing Angry Birds and shunning all invitations to Candy Crush and Pokeman Go.)

They are tapping on Safari to load my tracking info from Amazon faster.

Like most Americans, I suffer from cultural ADHD.

Following the Code: Nature vs. Nurture

I am surprised how often I am asked about “real” ADHD. My answer, always careful not to offend, is that there have been a lot of environmental factors, our ever-growing technology, that may have contributed to the over-diagnosis of an actual struggle for thousands of children and adults.

I was first taught about ADHD when I was studying to be a teacher. It was the latest example of a real mental illness that had become mainstream due to the dedication of altruistic doctors who felt terrible about not recognizing this illness earlier. Added to the need to correct earlier mistakes was the near-immediate impact of an early drug; Ritalin showed a marked improvement in handwriting! kid writing Now, parents were demanding the miracle drug that calmed down their sons (yes, mostly boys) long enough to care about capital letters touching the top and bottom lines of their paper.

ADHD diagnoses rose 43% between 2003 and 2011. The newest version of the DSM (released in May 2013), the manual that details names and criteria for mental health disorders, has included new guidelines for diagnosing and treating adults. But, when you actually examine the criteria, you will see that ADHD is a very specific combination of struggles.

Inattention: Someone with ADHD must check off at least 6 of the following attributes for a minimum of 6 months. Not only does inattention have to last persistently and consistently, but these behaviors should rise to the occasion of being inappropriate for age or developmental level. Some of the qualifying behaviors are: failure to pay close attention/makes careless mistakes; doesn’t seem to listen when spoken to directly; doesn’t follow through on tasks; and losing things necessary to complete tasks (glasses, paperwork, etc.). I ask you: anyone know of a pre-teen who can’t check these boxes? That’s. Not. ADHD.
Hyperactivity and Impulsivity: Another mega-list of behaviors that must add up to at least 6, over 6 months, and are not explained away by being THAT age. This list reads like a daily journal for my 4-year-old.
The face of ADHD?

I have actually met a four-year-old on ADHD medication; it’s hard to figure out how that toddler qualified. Here are some behaviors that may check boxes for ADHD: fidgeting, running and/or climbing, loud participation in “leisure activities”, and excessive talking or blurting out.

There is another set of criteria that involve caveats, like behaviors that interfere with typical activities and timelines for initial onset of behaviors. IF you can still qualify for a diagnosis of ADHD, there are a bunch of permutations of that diagnosis. I think of these like the rules for spelling: “i” before “e” except after “c” and if it sounds like “ay”…

Spark Notes Summary

Our big, supercomputer brains are always being rewired, by diet, supplements, medication, or age. Certainly, our fast-paced, technologically-driven environment can simulate a real mental health disorder. Unplugging your technology gives your brain its chance to unplug and slow down. Oh, and you know the bouncing ball on the screen that you follow to sing along favorite songs, I’m always two lines ahead…out of place and out of tune.