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Involuntary Eye Movement May Provide Definitive Diagnosis of ADHD
Zothecula writes: If a child who's simply very active is mistakenly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), he can end up on pharmaceuticals such as Ritalin unnecessarily. The problem is, it can be quite difficult to determine if someone actually has ADHD, and misdiagnoses are common. Now, however, researchers from Tel Aviv University have announced that analyzing a patient's eye movements may be the key. "The researchers found a direct correlation between ADHD and the inability to suppress eye movement in the anticipation of visual stimuli. The research also reflected improved performance by participants taking methylphenidate, which normalized the suppression of involuntary eye movements to the average level of the control group."
I can stay focused just fine (*flicks eyes to where Outlook just refreshed*) and concentrate for long periods of time (*glances outside - cute squirrel!*) and I can assure you my eyes stay glued firmly to the screen. (*twitches and changes tabs because the title bar just changed on one*)
Occasionally living proof of the Ballmer peak.
If used incorrect, just apply the antidote: Ritalout.
...in how they determined that their control group didn't have ADHD since it's so hard to diagnose, lol! All jesting aside I think that this is very interesting, and if it works I would love for my step daughter to be tested this way. She has been diagnosed ADHD, and I believe the diagnosis to be correct. She has trouble focusing on anything regardless of environmental variables.
I thought there already was a definitive diagnostic test. See here or here (for those who like me are not in the US or a country where you can access the videos, you will need a browser plugin to view them, e.g. I have Media Hint - sorry for the inconvenience).
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The persistence of the notion of this disorder is disturbing. The method by which it's diagnosed is faulty. You can't come in after all this legacy of crap and tell us that you can diagnose it physiologically using a single criteria like this. These assertions will be disproven within the year. The entire ADHD diagnosis phenomenon is the culture struggling with the ramifications of human interaction with technology. You can't set the example of "pay close attention to the stimulating box for long periods of time" over multiple generations and not expect a massive change in the way kids behave. Whether they fit in with our plans or not, these kids are NORMAL. It's the expectation that this generation will behave like the previous one which is faulty.
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Hardly an invented condition when people with ADHD respond to stimulants differently from others.
They put me on methylphenedate. Then they put me on Risperdone to control the psychosis induced by methylphenedate. The drugs are horrible. The only thing worse is Prednizone.
Phenotropil is effective in small doses, with fewer and less severe side effects. I did the pharmacology myself, with lots of Googling. Psychosis isn't a side effect--Phenotropil sharply controls, reduces, and prevents dementia--but INSOMNIA sure as hell is!
Okay, I found better drugs. But the drugs still have bad side effects. Let's face it: Insomnia is bad. I have always had delayed sleep phase disorder (self-diagnosis): if I don't rigidly discipline my sleep, any deviation causes me to stay awake. Stay up until 10:30? Become no longer tired, until 1-2am, then sleep until noon--and continue to do this until I somehow fix my sleep cycle, so I can't ever have a night out. On-call fucking sucks. And now, due to further conditioning, I not only can't sleep early, but I can't stay in bed past 7am; I'm sleep-deprived because my body refuses to get more than 4-6 hours of sleep!
I could take sleep drugs. Melatonin no longer works: after some occasional use, it now only works in high doses; and both high doses and chronic use cause my nuts to ache for extended periods, which I thought was just me sleeping on my side or something... until I found out melatonin affects testosterone production and can be bad for the testicles. Whoops. Valerian... I ran through a railroad crossing barrier. Ambien and Allegra I've seen do the same: you're incredibly fucking high, but you feel fine... until you crash into a parked car, or smile and nod while a pedestrian wanders in front of you. Thud.
That doesn't mean drugs are BAD; they're risk. You risk side effects against a disease. Is your ADHD worse than ... potential insomnia? Potential minor psychosis? Psychosis can be MAJOR if you're prone to dementia. Sleep drugs may not ruin your life; out of millions of cases, I know one person who almost died because Ambien affects him for 10 hours and he didn't know that. Of course you should take life-saving drugs, and life-enhancing drugs, if the side effects don't occur or are less bad than your symptoms.
I think we should drop back to Cognitive Behavioral Therapy and floatation-REST as our first attempts for ADHD and Aspergers and insomnia. CBT is a particular sticking point in insomnia: bad sleep hygiene is terrible, and parents are horrible parents for forcing their kids into bed. Go to bed even if you're not tired? Fuck you, mom. If you're not asleep in 10 minutes, GET OUT OF BED. Don't do other things in bed. Wake your ass up in the morning; if you're tired, too bad. Get up. When you're sleepy, you'll sleep at night.
So yeah. Let's eject this ADHD magic pill bullshit. Cognitive Behavioral Therapy, physical activity, and flotation-REST to start; move up to lighter drugs (lighter side effects, even if less effective), and then into the heavy shit (methylphenedate, adderall, drug cocktails). Throwing methylphenedate down someone's throat as a first option is like launching MIRV nukes three seconds after someone stands and shakes his fist at the UN table.
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I'd be interested in the basis for the claim about misdiagnosis being "common". I have known a number of people with ADHD who were misdiagnosed with something else. I don't think I've ever met anyone who got a misdiagnosis of not having ADHD.
The quality of the anti-ADHD-diagnosis rants can be pretty much summed up by the fact that people are claiming that a stimulant drug which makes people twitchy is going to "drug people into zombified submission". It really is that blatantly stupid; there is nothing remotely like "zombified submission" on the table.
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1. We hypothesize a disorder X
2. We observe eople respond differently to stimulants
3. We conclude disorder X exists
Nope, back to logic 101 for you
It must be nice to jerk yourself off with a story like that. You're absolutely right. Millions of scientists and doctors and pharmacists are all fucking conspiring to sell your kids ritalin! Are the corporate overlords also making you get vaccinated? It must be nice where you live, being able to stick your head in the sand and make up stories about why things don't exist rather than looking deeply for reasons why they DO.
The Blade Itself
It is overdiagnosed. I've seen kids with ADHD that can sit and play a videogame for 3 hours. They can watch a full-length movie no problem. But when it's time for homework or school, they "can't focus". THOSE kids DO NOT have ADHD.
And then I've seen kids that can't do any of those things. Every 5 minutes they HAVE to do something different. They can't watch a 30-minute TV show. Those are the real cases and need medication.
Peter predicted that you would "deliberately forget" creation 2000 years ago...
Ignorance is a bliss. ADD and ADHD can actually be physically shown as disorder of the brains dopamine system - but you wouldn't know that since you haven't actually studied any real information about ADD/ADHD as it's easier to hold on to your pre-determined opinions when you have no facts to confuse you.
Also, that ADD/ADHD is a "children issue" only is something that makes me angry. I was diagnosed with ADHD at age of 26. Since I've started with medication my life, in certain areas has become much easier - some would say much more "normal", but I like to avoid that term. I was finally able to get through education on IT field - something people like you claimed I had problems only because of lack of motivation. They say that lack of motivation was the reason I couldn't pass a 3-year education even though I tried for 5-years, and they happily miss seeing anything illogical in their statement.
I do sometimes wonder how different my life had been if ADD/ADHD had been known when I was a kid. For sure I would have avoided many problems with school as well as with other problems I made my family go through... Child services tried to find ways to help me and my family, but they didn't know about ADHD back then, so the reasons behind my misbehaviours remained mystery.
May I presume you are a US citizen? I apologize if I'm wrong... However if I'm right then I have less problems understanding how, no matter how ignorant and irrational, you have come to your conclusions. It is true that medical industry is milking this thing - and USA is the leader in over-diagnosing of ADD/ADHD. Still, just like with chronic depression, the fact that some doctors are over diagnosing a medical condition and the fact that pharmaceutical companies are always more than willing to milk such errors to the maximum does not mean that said medical condition is false. Also it's logical fallacy to say that because a condition had not been known before a time, it didn't thus exists before said time.
In capitalist USA corporations control the government.
The premise that over-diagnosis is a systemic problem is common, and has been propagated by the media, with very little actual scientific proof behind it.
The national average is that 7.8% of children are diagnosed with ADHD and somewhere around half (depending on where you live) get prescribed medication. So the idea that we are diagnosing a whole generation of kids as having ADHD is ridiculous. The idea that we have a culture of medicating our kids unnecessarily is also ridiculous. The statistics simply don't bear this out. The CDC did a study that has been dramatically misinterpreted to create this perception.
Here is the big article that most people reference when they say that there is a plague of over-diagnosing ADHD.
http://www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing-concern.html?pagewanted=all&_r=1&
First, they only reference ADHD's increase in the CDC study, when it wasn't the only one, nor was it the largest disorder having an increase in diagnosis. It was a 3% increase.
Second, there are three corrections, only mentioned at the very bottom that change facts stated in the study. That should tell you something right there.
Third, and increase is an increase, but they fill in the blanks as to the cause of the increase. My favorite is the change in the definition of ADHD, some media and researchers pose that the changing definition of ADHD has weakened its diagnostic criteria so it is going to be more common. But the DMS IV, the standard psych diagnostic manual in the U.S. hasn't had a change for ADHD in 20 years and the DSM V wasn't out yet, or not long enough to have an effect.
Yes, ADHD diagnosis have increased, and yes so has the rate of medication being prescribed. But at the same rate, on average (some less, some more) than other childhood disorders. Additionally, the study merely referenced the increase in the number of diagnosis and prescription, not the amount of misdiagnosis or anything like that. The only studies that I know of that did that were severely flawed. One did a survey where they told the sample of Psychiatrists to make a diagnosis of a selection of cases, some which did not show all of the symptoms for ADHD and some did. But they told them to make a diagnosis, already biasing those participating towards making some diagnosis rather than none at all. The other was a world wide study that compared the DSM IV diagnostic guide to the cases that were diagnosed, the problem is much of the world doesn't use the DSM IV but a different resource entirely. So they were judging those diagnosing using and apples and oranges measuring stick.
I of course, am not saying it never happens, clearly misdiagnosis does happen. And it may be more common with ADHD than with some other disorders. That could be due to big pharma wanting to schill pills, or it could be due to the very visible and noticeable nature of ADHD and it's commonality, meaning just the shear numbers increase the chances. It could be that ADHD has some similarities to behavior that is not ideal but not to the level of a disorder. It could be it is no worse than other cases of misdiagnosis. And to my mind, more likely, if it is happening more than other disorders, is because we need better diagnostics, which is what this research is about. No one is going to say that one test like this is the only thing needed to make such a diagnostic, not really. That is headline grabbing garbage that will never make it into a real serious clinical environment. No diagnostic manual is going to recommend a diagnosis based on one symptom or type of behavior, period.
bluefoxlucid makes some good anecdotal points, but they are anecdotal, meaning they are one specific case, specific to that person. You cannot extrapolate anything out of it to the general populace. They had bad reactions to medicine, which unfortunately happens. I can't be used to make any judgements about the whole, however. Nor can it give us any insight into the usefulness of
Nice diagnosis doctor assface.
Check the research.
Basically, ADHD isn't being able to sit still for a long time, it's not being able to focus on things that aren't fun.
For most brains, being able to get through say, homework, isn't a problem. You just sit down, figure, it's going to take about 20 minutes to do all the math problems and you go play video games.
For someone with ADHD, the brain is constantly craving rewards. So video games, movies, etc. all basically jam a fork into the pleasure centers of the brain. So ADHD kids can sit still and enjoy the fuck out of it. When the gears shift, and into say work mode, there's nothing jamming against the pleasure center and the mind loses focus.
Non impediti ratione cogitationus.
I've got ADHD for real. My doctor used to joke that I was the only kid he knew of that definitively had it, the rest he was just pretty sure about. At the time they were heavily medicating children for it... much worse than they do now and my parents refused to have me walking around like a zombie. Like it or not that was probably the most instrumental decision my parents made in my upbringing. Without the medication, I was left to cope with the symptoms on my own. If given several tasks to complete, I'd spend hours bouncing from one to the other and never really start any of them. Eventually I learned to deal with it on my own but never really knew how until I got to talk about it with a few shrinks.
What I did was learn a type of "Hyper focus" they described as common amongst the afflicted. I would drive all other thoughts from my mind, almost like a Buddhist, and then focus exclusively on my task. If I allowed other topics into my mind, I'd wander and lose track of what I was doing, so I instead learned not to let myself think about anything else. This skill has it's upsides I was told. I was able to grasp larger, more complex tasks because my mind was not preocupide with other things. It also had it's downside. I'd be so focused on the task at hand that if someone interupetted me I'd fly into a rage: :-)
Me:WHAT?!?!
Wife: Dinners ready. Is programming the thermostat really that frustrating?
Me: um... sorry?
I'm glad to see they may have a definitive test, and it seems superior drugs. I don't want to say I wish I had them... I wouldn't be me without ADHD, but I welcome any tools that help parents be more informed. I wouldn't give up being abnormal for the world, but I wouldn't wish it on my worst enemy either.
The ability to "hyper-focus" on certain stimuli (such as video games) is a hallmark symptom of ADHD...
You make a good point that would be hard to disagree with and not look like fool, but going to the other extreme and denying the whole existence of ADD and ADHD (especially in countries where over diagnosing of it is not rampant as it is in USA) would be irresponsible as well.
I don't think there is much argument that ADD/ADHD are recognized and classified conditions. It's also obvious that the treatments do help those who have it, otherwise those treatments likely wouldn't be demanded by so many parents/teachers/doctors to try to help their kids. In the US, it seems far too common that we are too quick to diagnose ADD/ADHD and give treatment for symptoms when the underlying cause isn't ADHD at all but often bored kids with unfocused energy merely acting like energetic kids.
Nobody (outside Slashdot and other highly reputable bits of the Internet) really questions whether ADD exists.
Many people wonder about a number of aspects of the problem:
- Where the break between normal and abnormal is. Like most biological issues, this behavior is on a continuum. Where do you intervene?
- Which leads to the question of diagnostic accuracy and efficiency.
We know that amphetamine class drugs are helpful in real ADD. But these drugs (like virtually all drugs) have risks and benefits. Since amphetamines carry significant risks, who do you treat and how long. It is also clear than non-pharmeceutical approaches can work, but these are typically labor and time intensive. How do you manage this?
So there is plenty to discuss within the framework of diagnosis and treatment of the disease. But it most certainly exists.
Faster! Faster! Faster would be better!
Yes, there are plenty of quack GP's who hand out these drugs like candy, However I don't agree with your first post that the stereotypical detached parent and video games are to blame for behavioural quirks. My granddaughter has mild autism, her religious grandmother on the other side doesn't "believe" in psychology and thinks she is just being "naughty" or "silly". She is not on drugs but has occupational therapy to help with her language skills, which the grandmother has deemed a "waste of time and money". Thing is the grandmother never babysits because she can't stop a 5yo fiddling with her china ornaments, I'm an old man and have no problem babysitting her and her two younger sisters. The reason why I can do this and the grandmother can't is that I listen to my daughter and use some of the psychological "tricks" she has learned from the therapist, very simple stuff such as - if you can't get her attention simply touch her on the arm while saying her name.
A large part of her therapy is in the form of video games that attempt to teach her about metaphors and other language quirks most of us never even notice, this drives the grandmother in to further confused rants. I have to say it's very satisfying to see my daughter calmly destroy her hysterical arguments with just a hint of sarcasm (although she gets that talent from her mum). The good news is that most of the specialist she has seen agree that a couple of years of occupational therapy at this age will allow her to overcome her difficulty with language. As far as her other cognitive skills are concerned she is in the top 10th percentile for all of them, raising her language skills out of the bottom 10th percentile will help her communicate that intelligence and creativity to others.
Having said that I know of at least 5 adults whose lives have been destroyed by doctors who have prescribed Zoloft to regular but moderate drinkers, one was a mentally stable 60yr old man who ended up in jail for 2yrs because he crashed his car into a row of rubbish bins and decided it was a good idea to blame his wife and physically attack the cops who turned up to investigate the ruckus. My ex wife also became an obnoxious lying hypocrite while on these pills, the changes don't happen overnight so I didn't connect it with the pills until I saw the same thing happening in other friends and relatives over the next decade or so. The change in personality is gradual, after the divorce she spent 2yrs fighting suicidal impulses before throwing the Zoloft away. Like the 60yo man she is back to her normal personality now, she's still the proverbial "swan" (peddling like crazy below the surface) and still suffers from the anxiety disorder her violent and insetuous father bestowed apon her as a child. She now says her panic attacks are preferable to no stress at all because without stress you have no physical signal to tell you which way your moral compass is pointing, which rapidly turns into having no family, no home, and no hope.
This is not to say that Zoloft doesn't work when administered correctly, in fact I have seen it work "as advertised" in several people. However it seems to me that far too many GP's (in Australia) do not have the faintest clue how to administer such drugs. They do not understand the nature and purpose of stress any better than the patient they are treating, they see someone suffering panic attacks, they don't try and figure out why, they just give them a pill, they fail to warn about serious psychological side-effects, they fail to involve family members in monitoring the patients personality and are totally oblivious to the developing sociopathic symptoms of incorrect use when the patient returns for another rubber stamp script.
The "life lesson" in this story is that if you have head problems go to a proper head doctor, ie a qualified psychologist or psychiatrist, taking head pills from a GP who doesn't first refer you to such a specialist will only bring misery and despair to you and your family.
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That's NOT what its all about. It's primarily an executive function disorder. Every aspect of day to day life, including the "pleasurable" aspects are affected. ADHD-H the hyperactivity is to increase blood flow to the brain to allow the communication to occur between the problem solving centres of the brain and the executive function. The attention and emotion centres border the executive area and so, depending on the person, they'll end up distracted or they'll become emotional/stressed.
If what you said was even remotely true then that wouldn't explain ADHD-C/ADHD-I (about 30% of diagnoses) ADHD-I can cause you to focus so intently on what you're doing and be unable to switch (be cause the executive function is screwed up) so you'll sit there doing the same thing and plow through. Doesn't matter how boring or how intensely rewarding it is. I'm just coming down off a 37 hour episode of the most mind numbingly inane research that got me zero reward and set me back. I'll take me 48 hours to recover minimum before I can get back to being productive (hopefully). It's great when I spend that time doing something productive like coding but can ruin a week.
Worst part is, I can't control when it happens or what triggers it because things like self discipline and control are regulated by the executive function centre.
Most people who don't have ADHD or who don't deeply understand the neurological research simply don't, will not, or cannot understand.
Hyperactive ADHD is at least directly observable as an abnormal condition. Inattentive ADHD, however, leads to children having their self esteem wrecked by ignorance adults telling them they "lack character" or some other treachery.
As a kid I was able to focus for 16 straight hours, daily, for weeks on end on building electronics projects. That was what my brain found rewarding, along with constant impulsive mischief. When I had to do my social studies homework, I simply could not make myself pay attention to it.
Nothing would have helped except possibly a proper diagnosis and treatment. But even then, the medications are far from perfect and not well tolerated by all, nor is the neurological understanding complete.
You could have tried beating me, sending me to military school, or endless hours of costly psychological therapy sessions. All would have been a failure (some were tried). The former may have been catastrophic, possibly rendering an ADHD kid suicidal, whereas the latter would simply have wasted a lot of money.
Because if your brain is configured to not be able to do what normal people do, which is to resolve themselves to do something they don't like but needs to be done, then you simply can't do it. No amount of effort can change this. Nor do I imply that this is a complete description of ADHD.
Having inattentive ADHD can be very painful. You can really honestly want to just do it. But as soon as you start, you find yourself either getting overcome with immobilizing dullness, or you simply can't help but to jump to some other "temporary" distraction like surfing the www, to get yourself perked up. Only to discover later that the whole day is shot and you've accomplished nothing.
In a society where the predominant world view is still that we have a "soul" (an independent actor that lives somewhere in the "spiritual" mind, that operates the body much as a construction worker operates a backhoe), there is little empathy for the condition of ADHD.
This is sad. People who can only reach the conclusion that "it doesn't exist" about an internal experience that someone else describes but which they do not themselves experience, are basically incapable of vicarious empathy.
Fortunately, we are at a time when neuroscience is finally entering the "steepening slope" phase of its learning curve about the brain, and ADHD is getting a solid science base behind it, despite the popular culture being horribly confused.