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Tuesday, 23 April 2019

ALL ABOUT ATTENTION DEFICIT DISORDER



                                                                       







                                     NOTES FOR FILM  Attention Deficit and Neurodiverse.

                                FOR PRODUCER AND DIRECTOR TO PICK AND CHOOSE

  
My quote near castle (15secs):  Hi, I'm Tom, and I'm a retired mathematical statistician. I'm also attention deficit and neurodiverse. I was not diagnosed with my so-call attention deficit disorder until I was 67, and I have therefore led an extremely chaotic and bittersweet life. Please accompany Scott, Cameron, and I as we explore the intricacies of Attention Deficit neurodiversity and the sociopolitical issues which it raises,.

                         CAMERON'S THEME MUSIC to Opening Sequence

                                                                                      
CAMERON: Hi folk. Let's tell you what Attention Deficit Disorder is all about
Firstly, it is

NOT REALLY A DISORDER, BUT RATHER A POINT ON A NATURAL, HUMAN SCALE

which is achieved by around 1 in 30 of us. 

While it is difficult to detect in social terms it 

CAN AFFECT BOTH CHILDREN AND ADULTS

The behaviour of Attention deficit  neurodiverse people is particularly  highlighted by a

PERSISTENT PATTERN OF INATTENTION AND IMPULSIVITY THAT AFFECTS DAILY LIFE AND INDIVIDUAL DEVELOPMENT

For example, Attention Deficit people sometimes 

SPACE OUT DURING GROUP CONVERSATIONS

before 

BLURTING A PIECE OF NONSENSE

which might kill the conversation or be otherwise socially embarrassing

They sometimes

ACCIDENTALLY SUBSTITUTE WORDS WHILE THEY ARE TALKING

in a manner that can alter the meaning of what they're trying to say

OR OVER-EMPHASISE, AND EXPRESS THEMSELVES TOO FORCEFULLY

Furthermore, there can be

DIFFICULTIES WITH WORKING MEMORY, AND WITH BRAIN'S ABILITY TO BEGIN AN ACTIVITY, ORGANISE ITSELF, AND MANAGE MULTIPLE MINOR TASKS

It is therefore important to think in terms of splitting tasks and sequencing them. In particular there can be

DIFFICULTIES WITH HYGIENE e..g. CHANGING CLOTHES AND LOOKING AFTER ONESELF AND ONES' LIVING SPACE

and

SOME EXPERIENCES OF MOOD SWINGS, 

between low moods and high moods, and vice versa, which can express themselves in terms of depression or hypo-mania, in other words feeling a bit high and footloose

Also

DIFFICULTIES WITH LACK OF FOCUS AND DAY DREAMING

and

DIFFICULTIES IN INITIAL PERCEPTION AND  WITH PICKING UP ON SOCIAL PROTOCOLS, 
though if Attention Deficit people ruminate for a while over real-life situations their perceptions can be as accurate as anybody else's

and

LONG PENSIVE PERIODS DURING WHICH PEOPLE THINK CREATIVELY IN THEIR SUBCONSCIOUS MINDS BEFORE BURSTING OUT INTO CONSCIOUSNESS

For example Attention Deficit chess players sometimes stare at the board without consciously thinking anything, only to suddenly and impulsive play an absolutely brilliant move which seems to come out of nowhere,

Not all Attention Deficient people will not necessary exhibit all of these symptoms, but all will have some.

Hyperactive, naughty children are not necessarily Attention Deficit. However 

WHEN ATTENTION DEFICIT CHILDREN OR ADULTS  ARE  HYPERACTIVE, THEY ARE SAID TO HAVE A,D.H.D. or ATTENTION DEFICIT HYPERACTIVE DISORDER.  

The definitions can be slightly different outside the UK, and sometimes A.D.H.D. is used as a blanket description, even if the person is more impulsive than hyperactive.

Some of us our neurodiverse, but in other ways, Moreover, these

*OTHER FORMS OF NEURODIVERSITY OCCASIONALLY OVERLAP WITH A.D.D. These include, autism, high functioning autism (Asperger's syndrome), dyspraxia, dyslexia, dyscalclia, and Tourette's syndrome, Such complexities make screening and diagnosis even more problematic, and many medical professionals, including neurologists are even nowadays either ignorant on these matters or don't want to know, For example, it is all too easy for psychiatrists to dish out diagnoses of so'called 'bipolar disorder' for patients under stress whose mood swings can be more readily explained as part of their Attention Deficient-ness, rather than by some hypothetical chemical imbalance,

      Various modes of treatment have been employed  for Attention Deficient-ness. While stimulants such as Ritalin and Adderall or other neurotoxins can seem to do good in the short term, they are potentially quite dangerous in both mental and physical terms and can even cause violent or suicidal behaviour, A recent'wonder drug 'moclobemide' (Aurorix) has many serious short term side effects, and many of its medium to long term effects still need to be evaluated, If people with A.D.D, are badly treated then they can end up in young offenders' institutions or adult prisons, and many do.

      Recent attempts to send electric currents through childrens' brains during the night is potentially as destructive as Electro-Convulsive Therapy.
       

     Dopheide and Pliska (2009) claim that "In patients with ADHD, neurobiologic research has shown a lack of connectivity in key brain regions, inhibitory control deficits, delayed brain maturation, and noradrenergic and dopaminergic dysfunction in multiple brain region". However, the statistical validity on some of these conclusions is open to question. For example the idea that some symptoms of ADHD are related to lower levels of dopamine seems to be standard knowledge among those psychiatrists who know about ADHD. The empirical studies which are said to substantiate this claim are considered below. (&&&&)
                                 

       For us, the important thing is to screen for Attention Deficient-ness as early as possible, to make the person aware of the symptoms it explains, and then to help the person to self-organise while accommodating these symptoms. Given the right living, social and working environments,  such social and occupational therapy might well be enough, and any trumped up medical model might well be irrelevant. Since there appears to be no valid medical model for ADD, any involvement of doctors or psychiatrists, in particular beyond the initial screening or subjective diagnosis of Attention Deficient-ness might well hinder more than it helps. 

      Unfortunately, there's lots of bullying in modern working environments, because of financial pressures from above, and so neurodiverse people don't always get the sort of accommodation and support which they need.  Physically disadvantaged people also get bullied, for example if you strain your back doing too much lifting at work, you could well lose your job without compensation. Our profit making companies and institutions simply don't have a good track record in the way they treat employees who are disadvantaged or a bit different. If our employers changed or replaced themselves in a way they accommodate all of us in all our full diversity then Society as a whole would evolve and change for the better,




People from all walks of life can be Attention Deficit, and all are able, given the right social environment to nurture their talents. Some Attention Deficit people have become famous, People of the past and present who have been thought to be possibly Attention Deficit and neurodiverse, include Albert Einstein, John F.Kennedy, Walt Disney,Leonardo da Vinci and many entertainers and athletes of all genders,








Now let's look at a few key statistics

Among children  aged 5-15 in the United Kingdom it is officially estimated that 0.85% of girls, and 3.62% of boys have been diagnosed with ADD




GIRLS:   0.85%

BOYS: 3.62%

SOURCE AADD-UK



It is also estimated that a further 1.5% of boys in this age group have been diagnosed with a related condition known as Hyperkinetic Disorder

So far fewer girls than boys have been diagnosed with ADD. This may well be because girls who have ADD exhibit symptoms, such as an eagerness to chatter eagerness to chatter, which are not accepted, because of their gender,  as symptomatic of ADD. Also naughty, unruly boys, may be more likely to be screened for ADD, An underlying motive could be an eagerness to quieten down the boys by giving them Ritalin or Adderall. This is thought by some to be more civilised than the cane or tawse of bygone years, but in some cases it can be even worse, 

Women however tend to be diagnosed as they approach adulthood. An estimated 3 or 4 percent of adults have been diagnosed with ADD, with roughly equal proportions of males and females

ADULTS 3-4%

So quite a few adults are Attention Deficit and neurodiverse. They certainly shouldn't be marginalised or isolated from the rest of Society,



The situation is a bit different in the United States where over 6 million children and teens between the ages of 4 and 17 have been diagnosed with ADD.

For children and teens in this age group an estimated 5.6% of girls and an estimated 13.2% of boys have been diagnosed with ADD


U.S.GIRLS: 5.6%
   U.S. BOYS: 13.2%

SOURCE: CENTER FOR DISEASE CONTROL (2016, update???)

We believe that the big difference with the UK figures is largely explained by rampant misdiagnosis in the US as inspired by Professor Joseph Biederman of the Massachusetts Institute of Technology and many others. Once again, the diagnoses and misdiagnoses give an excuse for boys to be plied with neurotoxic medications simply for being unruly and hyperactive. 

Many children may subsequently experience the spellbinding effect of

INTOXICATION ANOSOGNOSIA

This phenomenon has been described by the leading reformer Dr. Peter Breggin as

THE FAILURE TO RECOGNIZE THE HARMFUL MENTAL EFFECTS OF PSYCHOACTIVE AGENTS AND THE ACCOMPANYING TENDENCY TO OVERESTIMATE THEIR POSITIVE MENTAL EFFECTS





In simple terms, many children and adults think that their neurotoxic medications. such as the stimulants Ritalin and Adderall are helping them, when they may indeed be harming them



But among US adults the Statistics for diagnosed ADD are  much the same as in the UK.

U.S. ADULTS 4.4%

with roughly the same proportions of males and females. So the psychiatrists mainly seem to go spare on naughty schoolboys.


But In contrast to the teachings of Dr, Joseph Biederman at MIT and Dr, Jeffrey Lieberman at Columbia University, the New York psychiatrist Peter Breggin is a critic of shock treatment and neurotoxic  medication alike. In his books, he instead advocates psychotherapy, education, empathy, love, and broader human services.
                   
DOPAMINE AND ADHD ($$$$)

PAPER A

PAPER B

PAPER C

PAPER D
                                                   





THE DIFFICULTIES ASSOCIATED WITH A.D.D. HAVE BEEN OBSERVED THROUGHOUT HISTORY

                                           



    Hippocrates of Kos (460-375 BC) attributed a condition comparable to ADHD to an "overbalance of fire over water".






                                                                             
                                                                                 





                                                                              











    1775 Dr Melchior Adam Weikard, a hunchback from Bruckenau, discussed 'inattentive people who 'know a little bit of all but nothing of the whole'.


                                                                          

    1798 Sir Alexander Crichton  (Westminster Hospital) described a mental state much like an inattentive subtype of ADHD.

                                                                        
                                                                      

    1845 Dr. Heinrich Hoffman of Frankfurt coined the term Hyperkinetic Syndrome for 'naughty restless children growing still more rude and wild'.



                                                                            


                                                                      

    1902  Sir George Still of King's College Hospital, London documented cases of impulsive behaviour, and called the condition  Defect of Moral Control.


                                                                              


    1922 ADD-like symptoms were diagnosed as Minimal Brain Damage by the eugenicist Dr. Alfred Tredgold of Royal Surrey County Hospital. (The terms Minimal Brain Dysfunction and Hyperkinetic Disorder of Childhood were later used for this condition)


                                                                          

    1931  Drs. E.A. Bond and K.E. Appel of the Pennsylvania Hospital discussed the treatment of ADHD-like symptoms diagnosed since the 1920s as Post-Encephalitic Behaviour Disorder


                                                                        



    1937 Children with ADHD-like symptoms were treated with stimulant Benzedrine by Dr. Charles Bradley of Babies Hospital, New York.Today, the Drug Enforcement Administration classifies Benzedrine as a Schedule II narcotic, which means that it has some medicinal uses, is highly addictive, and has some serious side-effects



                                                                          

                                                    Image from whizolosophy.com


    1961  Ritalin gained FDA approval for treating  hyperactive children.  During 1960s, stimulants were increasingly used to treat such hyperactivity.


                                                                              
                                                            Image from understood.org

    1970s. More symptoms recognized, including impulsiveness (verbal, cognitive, or motor), lack of focus, and daydreaming.

                                                                        

    1980 Name Attention Deficit Disorder invented by American Psychiatric Association.

    1987  Name in USA revised to Attention Deficit Hyperactive Disorder.

                                                                        


  


1996 Adderall was approved to treat ADHD



                                                                                  

    1998 American Medical Association stated that ADHD was one of the most researched "disorders"

                                    



                                                                            

The Massachussetts Institute of Technology (Dr. Joseph Biederman) and Columbia University (Dr. Jeffrey Lieberman) are regarded by the psychiatry profession as leading centres for research into the diagnosis and treatment of ADD as a supposed medical condition,













Tuesday, 9 April 2019

THE PATIENT VOICE: AN ANALYSIS OF PERSONAL ACCOUNTS OF PRESCRIBED DRUG DEPENDENCE AND WITHDRAWAL (




                                                                       



http://prescribeddrug.org/wp-content/uploads/2018/10/Voice-of-the-Patient-Petition-Analysis-Report.pdf


The Pa'ent Voice: an analysis of personal accounts of prescribed drug dependence and withdrawal submi;ed to pe''ons in Scotland and Wales. (MARION BROWN el AL)


This report collates and analyses 158 personal accounts of people impacted by prescribed drug dependence and withdrawal (specifically for antidepressants and benzodiazepines) that were submitted in response to two petitions lodged with parliamentary Petitions CommiIees in Scotland and Wales in 2017. The report blends qualitative data in the form of verbatim quotes with quantitative data derived from a formal thematic analysis structured using a ‘lean thinking’ approach to process improvement. The analysis identifies eight systemic ‘failure points’ 






https://bjgp.org/content/69/681/163/tab-e-letters?fbclid=IwAR3EVrkWveSDWMb5l5w_f57YZW2-bUz9ZBmmDD99HyytMNSdNYzT3cnlEps


The right stuff - or the wrong stuff?

As last month, Roger Jones's April 2019 Editor’s briefing has given cause to revisit, again, my response1 to his ‘Do no harm’ Editor’s briefing two years ago.  The challenge of learning from medically unexplained symptoms’ is surely urgent.  I and others have been flagging this up2 and have repeatedly been patronised and ignored.
There is a ‘medical’ explanation for many ‘unexplained’ symptoms: medicine.  However, doctors are being actively trained to disbelieve patients’ experiences3 and to assume ‘unknown aetiology’ and/or ‘psychosomatic’ causes.
'The Patient Voice: an analysis of personal accounts of prescribed drug dependence and withdrawal submitted to petitions in Scotland and Wales"4 was published October 2018.  The aetiology of burgeoning 'medically unexplained symptoms can be clearly seen in the published patient testimony collated in this report.  The systems analysis 'Lean thinking' framework identifies clear ‘failure points'. These common failures are resulting in consequences where patients' health is being (presumably unintentionally) worsened by prescribed medicines, and over the longer term. "For some of theresponders all consultations, no matter what the problem, are now being seen through the root cause in anxiety/depression because of their history with these medications, sometimes when that wasn't even the reason for being prescribed the drug in the first place". 
Clearly this is ‘unwanted’, difficult and uncomfortable territory for prescribers.  Patients are courageously trying to raise the alarm and are being silenced.
Together with patients themselves, I and others are researching and sharing what people have learned from their/our own experiences.  My own professional psychotherapy body, Human Givens Institute, has been publishing our findings.5  My ‘Patient Journey’ infographic, linked within article,5 summarises the pattern of what we are seeing. Repeatedly.
The challenge of self-harm and suicidality in young people may also be exacerbated by medication – another medical ‘no-go’ area, despite ample evidence that there are significant links.  Instead, attention is being diverted to ‘social media’ factors.
The medical profession apparently obscuring and denying these very serious prescribed harm issues is not OK – and the newly released antidepressant prescribing figures for England are deeply alarming.6 
Courageous leadership is sorely needed
References
1. Brown M.  Br J Gen Pract 2017 67(656) 99 E-letter response February 2017.  https://bjgp.org/content/67/656/99/tab-e-letters#do-no-harm---a-serious-concern  (accessed 04 Apr 2019).
2. Brown M.  Update: Managing patients with medically unexplained symptoms.  GP View Sept 2017.  https://gpview.co.uk/update-managing-patients-with-medically-unexplained-symptoms/ (accessed 04 Apr 2019).
3. National Collaborating Centre for Mental Health. The Improving Access to Psychological Therapies (IAPT) Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms. Helpful resources. London: National Collaborating Centre for Mental Health. 2018.  www.rcpsych.ac.uk/docs/default-source/improving-care/nccmh/nccmh-iapt-ltc-helpful-resources.pdf?sfvrsn=1fd8e50f_2 (accessed 04 Apr 2019).
4. Guy A., Brown M., Lewis S.  The Patient Voice: an analysis of personal accounts of prescribed dependence and withdrawal submitted for petitions in Scotland and Wales.  All Party Parliamentary Group for Prescribed Drug Dependence, 2018.   http://prescribeddrug.org/wp-content/uploads/2018/10/Voice-of-the-Patient-Petition-Analysis-Report.pdf (accessed 04 Apr 2019).
5.  Human Givens Institute.  Case History (James): My experience with antidepressants 2018. www.hgi.org.uk/resources/delve-our-extensive-library/case-histories/case-study-antidepressant-experience  (accessed 04 Apr 2019).
6. Read J., Lewis S., Moncrieff J., Kinderman P., Davies J.  How many antidepressants is too many? BMJ 2019; 364: l1508/rr-0   Rapid Response 2019. www.bmj.com/content/364/bmj.l1508/rr-0 (accessed 04 Apr 2019).