She puts the H in ADHD

She puts the H in ADHD

I often try to get my friend Sheri to run with Michelle & I by enticing her with the thought of achieving a ‘runner’s high’. You know, that release of endorphins you get when you run, which makes running feel easier and makes you feel somewhat euphoric? Well, I guess I have achieved a writer’s high!  Because I’m excited to write some more! Remember guys, my blogs are personal commentary, filled with my experiences and knowledge gained through my self-directed education on the topics. Generalizations will be made. Keep in mind, there will always be atypical cases and outliers who vary from the majority. Also, keep in mind this is meant for me to share ideas and experiences and not to be taken as medical advice. Unless you want to pay me.   

Anyone who knew Nevia when she was an elementary aged child could easily see the hyperactive component of this disease process. The child could NOT sit still. Her school agenda was FILLED with comments from her teachers stating Nevia was; disruptive, couldn’t sit still, got out of her chair, blurted out answers, wouldn’t follow in the line as they walked to lunch, was talking to other kids when she was supposed to be paying attention, disrupting class, blah, blah, blah, the list goes on. I tried everything I could to address this issue in a naturopathic manner. I gave her supplements found to help in some kids with ADHD. Chewable supplements that she found disgusting. As you can imagine, it was not easy to get her to take these!  I fed her a breakfast of eggs, bacon, and toast nearly every day. Quite the challenge for the vegetarian mom who nearly pukes at the smell and sight of eggs.  No sugar, high protein was my mantra. I walked her over a mile to school (while pregnant with Oscar, and for quite some time after he was born) as a way to ‘wear her down’ before she got to school with the hope that these measures would help her behavior. Well, of course, it didn’t work.

I made an appointment for her to go to her pediatrician. I marched in his office with her school agenda in my hands, sure that he would want to see the teacher’s comments, which would lead him to a swift diagnosis of ADHD. He never even looked at the agenda. He asked me a few questions, examined Nevia, and said ‘no, she doesn’t have ADHD.’ Seriously? Yep, you guessed it. I fired that pediatrician and found another.  

I recall one of the many times Nevia was put in time out for her behavior. I observed her trying to stand still while facing the corner of the wall. She seemed to struggle so badly when trying to do the right thing and keep still. She was trying so hard to be good. It looked physically painful and mentally draining for her to do such a simple task as standing still. But it was only viewed as bad behavior because she couldn’t follow directions and hold still. I now know better. My how differently I view things with 20/20 hindsight.

Dr. Ned Hallowell (I misspelled his name in a previous post) describes that those with ADHD have an internal ‘itch’. This proverbial itch contributes to this inability to sit still. It can be the basis for the hyperactivity component of ADHD. Kids with hyperactivity can’t turn it off like a switch. They can’t control it. Discipline and punishment have not been found to be effective ‘treatments’ for this symptom. So if your child has this symptom, medication often helps, but do both of you a favor and do your best to limit the amount of frustration and annoyance that you may feel about this hyperactivity (remember in my previous post I mentioned by the time a kid with ADHD reaches the age of 12 he/she has received more than 20,000 negative messages than the neurotypical (non-ADHD) child?).  Find ways to make it a positive. Instead of expecting a hyperactive child to sit still in a chair when doing homework, have them sit on an exercise ball that they can gently bounce on as they work.  They may actually accomplish more this way. It would be in the best interest of all involved if we would break the cycle of expecting ADHD kids to adapt to the traditional ways of doing things. Stop trying to shove the ADHD kid into a mold they don't fit in. It will never work. Be creative and find what works for your kid.

Fast forward a few years after our wasted pediatrician visit in which her diagnosis was ‘missed’. I noticed in the middle school years that Nevia wasn’t as hyperactive. She was off and on medication, but even when off the medication, the hyperactivity seemed to wane. In my recent description of Nevia in relation to the hyperactivity I commented that the hyperactivity was gone. Now she’s just a lazy teenager, I said in jest. Well, my mom-diagnosis was quite off. Hyperactivity doesn’t really go away in the kids who have this presenting sign/symptom of disease. It may diminish to a restlessness, but remains as primarily an internalized issue. This internal hyperactivity or restlessness often manifests itself as sleep issues. Insomnia is a common complaint by those with ADHD. About 85-90% of adults with ADHD experience a burst of energy at sunset or nighttime. The average person with ADHD may spend about 2 hours at night trying to fall asleep. They can’t turn off their body or brain and lie there wide awake. Sleep deprivation may cause as much impairment in people as the ADHD symptoms do.

I’ve had difficulty in finding much research or scholarly literature discussing the hyperactivity component of ADHD. I do know that this component is not present in all people with ADHD. Those without this symptom may be given the abbreviation ADD as a diagnosis. In listening to the ADHD Experts podcasts, I have heard many esteemed professionals discussing how this disorder was not effectively named. Labeling the disorder ADD doesn’t address the hyperactivity component. Calling it ADHD may classify those without hyperactivity as hyperactive. Some also address the ‘deficit’ component of the label. Those with ADD/ADHD don’t have a deficit in attention. They have what one professional I heard describe as a ‘wandering’ of attention, not a deficit. No matter what the label is or what a person’s presenting symptoms are, there is certainly a deficit in the education of many Americans (myself included) on this disorder. Hopefully with time this will change.  

Dr. Donna Poma Fife DNP, MS-ARNP