Edge Foundation Blog > Archive for the 'Mental Health' Category

Thank you to Gayla Wilson who contributed to this post.

Earlier this year we did a series on ADHD and anxiety.   You may recall that the rate of anxiety disorders is much higher in folks with ADHD than in the general public.  Are you surprised to hear that there is also a higher rate of depression among people who have ADHD than the general population?   ADHD often comes with a host of other issues such as learning disabilities, anxiety and depression.  Perhaps depression is the most life-threatening condition of all.  This post is the first of a series that explores living with ADHD and depression.

What are the known causes for depression?

There is no single cause of depression.  Depression happens because of a combination of things including:

Genes – some types of depression tend to run in families.  Genes are the “blueprints” for who we are, and we inherit them from our parents.  Scientists are looking for the specific genes that may be involved in depression.

Brain chemistry and structure – when chemicals in the brain are not at the right levels, depression can occur.  These chemicals, called neurotransmitters, help cells in the brain communicate with each other.  By looking at pictures of the brain, scientists can also see that the structure of the brain in people who have depression looks different than in people who do not have depression.  Scientists are working to figure out why these differences occur.

Environmental and psychological factors – trauma, loss of a loved one, a difficult relationship, and other stressors can trigger depression.  Scientists are working to figure out why depression occurs in some people but not in others with the same or similar experiences.  They are also studying why some people recover quickly from depression and others do not.

Why do people with ADHD have depression at higher rates than the general population?

Unfortunately science hasn’t cracked the code of why some people get depressed and others do not.  However, Aaron Beckr (who is known as the father of Cognitive Behavioral Therapy) recently gave us a clue when he said  “brain scans have found that in depressed people the prefrontal cortex, known as the seat of rational thought, tends to be underactive.”  If you’ve read much about ADHD, you’ll know that this  area of the brain that is also underactive in ADHD and executive function disorders.

Research shows that people with ADHD have a higher incidence of depression due to the many obstacles, disappointments, perceived failures, and lack of support and understanding that often comes with living with ADHD.  The typical person with ADHD has an uphill battle facing the many myths and misconceptions surrounding the diagnosis.  The years of hearing “if only you would try harder” can take its toll and low self esteem is common.

All teens — especially those with ADHD — should be tested for depression

Last April the journal of Pediatrics reported that the government-appointed U.S. Preventive Services Task Force recommends that all teens should be tested for depression by their primary care physician.  Nearly 2 million U.S. teens are affected by depression, but most suffer undiagnosed.  When you consider that a higher than average number of those kids have ADHD, it is a compelling reason to be sure your teen is screened for depression at their annual exam.

For more information on depression:

http://www.nimh.nih.gov/health/topics/depression/index.shtml

And watch in coming weeks for Part 2 in the series which will explore types of depression.

Last month Edge Foundation attended CHADD’s regional conference in Anaheim.  The keynote speaker, Mark Katz presented an inspiring talk about resiliency we felt you needed to hear.  You probably already know that resiliency means having the ability to roll with the punches.  But what you might not know is that the more resilient you are the more likely you are to be successful.  Katz knows what he’s talking about when he says resiliency is an important quality of success.  Katz wrote the book on resiliency:  On Playing a Poor Hand Well: Insights from the Lives of Those Who Have Overcome Childhood Risks and Adversities.

Do you see your intelligence as fixed?  Our society puts a lot of value in IQs.  Just about everyone has their IQ number written down on a report in a file cabinet somewhere.  But what if we told you that’s all it is, a number?  There is a growing body of research that indicates your attitude is a more important indicator of success than your IQ.  In fact, students who see their as fixed are more likely to give up when they encounter challenges.  But students who believe that hard work pay off, are more likely to achieve their goals.

In a July 6, 2008 New York Times article detailing her research on the power of attitude on your future success,  Stanford psychologist Carol Dweck says, “People who believe in the power of talent tend not to fulfill their potential because they’re so concerned with looking smart and not making mistakes.  But people who believe that talent can be developed are the ones who really push, stretch, confront their own mistakes and learn from them.”

An ADHD coach is your own personal cheering session

If you have ADHD you’ve probably had people tell you that you won’t be able to achieve your full potential. or you aren’t trying hard enough.  Or maybe they’ve offered to help.  If you just did it their way, you’d be successful.

What if we told you figuring out what to do isn’t the problem.  Figuring out how to master yourself is?  The problem is the ADHD brain works differently than everyone else’s.  This is where an ADHD coach can help.  ADHD coaches know that the same approach doesn’t work for everyone.  As the old saying goes, if the shoe doesn’t fit, don’t blame the foot!  ADHD coaches work with people just like you, every day, and help them find solutions that work for them – not for their parents or friends.  They’ll help you work with your urge to procrastinate, be accountable, study smarter not harder, assess your time, prioritize, and stick to your plan!

But most importantly, an ADHD coach will give you your own cheering section.  They’ll tell you “you can do it!” and “don’t give up” even in your darkest hour.  And having people in your life encourage you is the foundation to building your confidence and your own “can do” attitude.

If you’re discouraged or need a boost in your attitude, sign up today for a coach.  Don’t go it alone.  Let a coach help you turn your attitude around and get back on track to achieving your dreams!

What do you think?

We’d love to hear from you.  Do you believe in the power of positive thinking?  Does your attitude have more to do with your success than you IQ?  And what do you do to keep going even when you’ve made mistakes?

Over the past several months, we’ve been focusing on anxiety and ADHD.

In January we introduced the topic of ADHD and anxiety with a report of how common forms of anxiety are much more common in people who have ADHD than the general population.  We also gave you a list of physical and psychological symptoms associated with anxiety.    Last month, we outlined the 4 most common axiety disorders associated with ADHD.  Remember half (52%) of adults with ADHD will experience general anxiety disorder during their lifetimes.

This month we’ll teach you a few things you can do to control anxiety.  Of course we need to start by saying that if your anxiety feels overwhelming or gets worse over time, you should begin by seeking the help of a professional, who might possibly prescribe therapy and/or medication.  There are, however,  easy, everyday things you can do to help control anxiety without taking another pill – that you can start right now!

1. Exercise
2. Eat right
3. Get enough sleep
4. Practice relaxation

Exercise Exercise Exercise

If you’re a regular Edge Foundation subscriber, you’ll have seen our review of John Ratey’s book, Spark: the revolutionary new science of exercise and the brain.

In it Ratey explains that regular exercise alone can dramatically reduce symptoms of anxiety:

• Exercise releases neurochemicals that help you feel better (serotonin, the “feel good” neurochemical, and GABA, an important inhibitory neurochemical that basically gives the command to “stand down”. )
• Exercise helps relax your body, reducing the resting tension of your muscles and thus interrupting the anxiety feedback loop to your brain.
• Exercise teaches you that you have control over the symptoms of racing heart, sweating, and elevated breathing. That feeling this way physically is not the same thing as a panic attack.
• Exercise even helps you unlearn the habit of anxiety.

Diet

We are going to sound like your mother, but she was right.  Be sure to remember to eat regular meals.  You may be able to get by and skip a meal with a little help from caffeine or sugar, but did you know that both of these foods can mimic the sensation of an anxiety attack – and actually trigger one!

Sleep

Irregular sleep habits can actually increase your anxiety symptoms!  Stress and anxiety may cause the body to produce a “no sleep” signal in the brain that heightens arousal and makes sleep difficult. This alerting effect is a cause of more anxiety and may set in motion a cycle of sleeplessness and stress.

Sleep is such a big issue for many people with ADHD that we are planning a future post on the topic.  In the meantime, there is a lot of information on the web about sleep, sleep problems, and how to develop better sleep patterns. Here are a few places to start.

• http://www.sleepfoundation.org
• http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm
• http://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm

Relax Your Mind

Take a time out and pause to let your mind and body relax. When you are stressing, do something distracting and fun. Take a deep breath.  Or fill your mind with a challenging task like a Sudoku or crossword puzzle and you won’t have room to think about your anxiety

Relax Your Body

Relax your body and your mind will follow – we call this the relaxation response.   Relax your body and your

• heart rate decreases
• breathing becomes slower and deeper
• blood pressure drops or stabilizes
• muscles relax
• and your anxiety level decreases

Did we mention exercise?

Exercise can be a great way to release tension in your body.  There are non-strenuous ways to invite your body to relax as well.

• yoga
• medication
• relaxation excecises
• biofeedback
• and don’t forget to breathe.

Anxiety is a real and serious problem, but you don’t have to let it put you on the sidelines or eat you up inside.  It just takes self-awareness that your anxiety is getting the best of you and self-discipline to take steps every day to keep your anxiety at bay.  An ADHD coach can help you figure out which techniques are best for you and put a plan in place to help you stay on top of your anxiety.

Have you found any of these everyday habits have helped your anxiety levels?  Please share your experience in the comments.  We’d love to hear from you.

John Ratey’s book Spark: The Revolutionary New Science of Exercise and the Brain is a book everyone should read – whether you have ADHD or not.  And we mean everyone:  you, your spouse, your parents, your kids, their teachers, your doctors. EVERYONE!

You might have seen this book and put off opening it figuring it would be dry and technical, but it’s not at all. Sarah Wright, Edge Foundation Executive Director, reports “It so compelling and easy to read I could hardly put it down.” The evidence in Spark is incontrovertible: aerobic exercise physically transforms our brains for peak performance.

John Ratey is no newcomer to the ADHD community.  He co-authored (with Edward Hallowell) the best selling, Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood, and is the spouse of ADHD expert and founding Edge Foundation board member, Nancy Ratey.

The book highlights the best findings of hundreds of papers Ratey read in researching this book – most published in the last decade – giving you insight into the latest understanding of how the brain works.

A sampling of John Ratey’s brain research findings

• Exercise is truly the best defense against everything from mood disorders [depressions] to ADD/ADHD to addiction to menopause to Alzheimer’s.
• Getting your heart and lungs pumping can mean the difference between a calm, focused mind and a harried, inattentive self.
• Aerobic exercise has been shown to be as effective as antidepressants in treating anxiety
• The Brain works much as muscles do-growing with use, withering with inactivity.
• Exercise even sparks new brain cell growth!

How to buy Spark!

Of course you know how to order a book on-line, but did you know if you click on the link embedded in this article below, Edge Foundation will receive a small fee for every book you purchase on Amazon.com during that visit?

Click here to buy Spark and support the Edge Foundation today!

And here are a couple of other great books on ADHD:

Fidget to Focus:  Outwit Your Boredom:  Sensory Strategies for Living with ADD — written by Edge Foundation’s Executive Director, Sarah Wright.

Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood

We’d love to hear what books you’ve found helpful for discovering how to live with ADHD.  Post them in the comments and we will review more books in future months.

Editor’s note:  Last month we talked about how anxiety occurs more frequently in ADHD community than in the mainstream population.  This month we’ll look a little deeper into 4 types of anxiety most commonly occurring for people with ADHD.

The DSM-IV Defined Anxiety Disorders

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association defines 12 anxiety disorders:

1. Separation Anxiety Disorder
2. Panic Disorder – with and without agoraphobia
3. Agoraphobia –  without history of Panic Disorder
4. Social Phobia – exaggerated fear of embarrassment or humiliation
5. Specific Phobia – e.g. of spiders, elevators, flying, etc.
6. Obsessive-Compulsive Disorder (OCD)
7. Post Traumatic Stress Disorder (PTSD)
8. Acute Stress Disorder – symptoms< 30 days
9. Generalized Anxiety Disorder (GAD)
10. Anxiety Disorder due to a General Medical Condition
11. Substance-induced Anxiety Disorder
12. Anxiety Disorder Not Otherwise Specified

The 4 most common anxiety disorders associated with ADHD

1. Generalized Anxiety Disorder (GAD)
2. Separation Anxiety Disorder
3. Social Phobia
4. Post Traumatic Stress Disorder (PTSD)

The remainder of this article will talk in more depth about the unique characteristics of each of these anxiety disorders.

Generalized Anxiety Disorder (GAD)

General Anxiety Disorder is a serious issue for the ADHD community.  It is far more likely to occur during the lifetimes of children with ADHD than in the general population (25% ADHD versus 2.9 – 4.6% general population).  Half (52%) of adults with ADHD will experience GAD in their lifetimes – opposed to only 5% of adults in the general population.

General Anxiety Disorder is the big anxiety disorder that people tend to miss.  With the others – Post Traumatic Stress Disorder, separation anxiety, and social phobia – it’s more obvious when you have it.  And, since GAD often comes along for the ride with depression, substance abuse, and other anxiety disorders, it may be relegated to a back seat in terms of recognition and treatment.

General Anxiety Disorder is characterized by 6 months or more of chronic, exaggerated worry and tension that is unfounded or much more severe than the normal anxiety most people experience.  People with GAD usually expect the worst.  They worry excessively about money, health, family, or work, even when there are no signs of trouble.  They are unable to relax and often suffer from insomnia.  Sometimes the source of the worry is hard to pinpoint.  Simply the thought of getting through the day can provoke anxiety.  General Anxiety Disorder may also grow worse with stress.  In addition to excessive anxiety and worry, people with GAD have at least 3 of the following symptoms:

• Restlessness or feeling on edge
• Fatigue
• Difficulty concentrating or mind going blank
• Irritability
• Muscle tension
• Difficulty sleeping

Separation Anxiety Disorder

About 10 times as many children with ADHD will have separation anxiety compared with the rate in the general population of 2.4%

Separation Anxiety Disorder develops in childhood and can persist into adulthood.  Basically this means a child is fearful of being separated from his or her safety net (familiar place or person).  The child may develop excessive worrying to the point of being reluctant or refusing to go to school, being alone, or sleeping alone.  The child may also experience repeated nightmares and complaints of physical symptoms such as headaches, stomachaches, nausea, or vomiting.

Social Phobia (a.k.a. Social Anxiety Disorder or SAD)

18% of people with ADHD will have a lifetime occurrence of Social Anxiety Disorder – half again as common as in the general population.

Social Anxiety Disorder is an intense fear of becoming humiliated in social situations, specifically of embarrassing yourself in front of other people.  It includes performance anxiety issues.  It often runs in families and may be accompanied by depression or alcoholism.  Social phobia often begins in early adolescence or even younger.  The person recognizes that the fear is excessive or unreasonable.  About 13% of the general population will experience social anxiety at some point in their lives.  Social Phobia is actually the third most common psychiatric disorder in the United States after depression and substance abuse.

Post Traumatic Stress Disorder or PTSD

Although there isn’t a lot of information on PTSD and ADHD specifically, there is some evidence that people with ADHD are more vulnerable to developing PTSD.  For more information consult Adler LA, Kunz M, Chua HC, Rotrosen J, Resnick SG. (2004). Attention-deficit/hyperactivity disorder in adult patients with posttraumatic stress disorder (PTSD): is ADHD a vulnerability factor?  Journal of Attention Disorders.  Aug; 8(1):11-6.

How to manage your anxiety

Anxiety disorders are highly treatable, but you have to recognize first that they exist.  If you think this might be you, seek the advice of a professional and find out what your options are.

An ADHD coach can also help you learn to identify your anxiety triggers and things you can do to keep your anxiety under control.

Watch for part 3 of our ADHD and Anxiety series where we will talk about some steps you can take to help you manage your anxiety.

Do you have ADHD and anxiety?  What have you done to keep it under control?  We invite you to share your story here and help others learn what you have to keep your edge! You don’t have to live with anxiety, sign up for an Edge Coach and start taking charge of your life today.

Are you often worried? Nervous? Jumpy? Self-counscious or insecure?  Did you know these are all symptoms of anxiety?  And axiety disorders are much more common in people with ADHD than you might realize. 

Everyone gets the common cold, right?  Healthy adults have on average 2 colds per year and each cold lasts on average one week. That means that at any one time about 4% of adults will have a cold. 

According to the Surgeon General, at any one time, 16% of our population will have an anxiety disorder. That means Anxiety Disorders are FOUR TIMES as common as the common cold.  And some studies have indicated that as many as 25% of children with ADHD also have anxiety disorder. 

When should you worry about anxiety?

Normal anxiety comes and goes in response to real challenges involving potential loss or failure. Normal anxiety helps sharpen your attention so you can meet those challenges. 

Anxiety disorders involved anxiety that is more intense or lasts longer than normal anxiety, or that leads to phobias. Basically, if you worry when there’s no real threat, to the point where you can’t function normally, that’s an anxiety disorder.

Why haven’t I heard about anxiety disorders and ADHD before?

People know when they have a cold. If it’s so common, why don’t they know when they have an anxiety disorder?

• People may think the anxiety they live with is normal – it’s normal for them after all.
• People may deny their anxiety because it’s not acceptable to be “afraid”.
• People may be so good at avoiding what makes them anxious that they almost never experience the symptoms.
• People may have symptoms they don’t recognize as anxiety-stomach upset, muscle aches, fatigue, insomnia, irritability, twitches, heart palpitations, hot flashes, clammy hands-these can all be symptoms of anxiety.

The primary symptoms of anxiety disorders are fear and worry. But when people have physical symptoms that may mask the real issue, they will seek treatment for those instead. In fact, people with anxiety disorders are 3-5 times more likely to go to the doctor than non-sufferers.

Do you have any of these common symptoms of anxiety? 

Emotional and Psychological Symptoms of Anxiety:

• Apprehension, uneasiness, and dread
• Impaired concentration or selective attention
• Feeling restless or on edge
• Avoidance
• Hypervigilance
• Irritability
• Confusion
• Behavioral problems (especially in children and adolescents)
• Nervousness and jumpiness
• Self-consciousness and insecurity
• Fear that you are dying or going crazy
• Strong desire to escape

 Physical Symptoms of Anxiety:

• Heart palpitations or racing heartbeat
• Chest pain
• Hot flashes or chills
• Cold and clammy hands
• Stomach upset or queasiness
• Frequent urination or diarrhea
• Shortness of breath
• Sweating
• Dizziness
• Tremors, twitches, and jitters
• Muscle tension or aches
• Headaches
• Fatigue
• Insomnia

(Source:  http://www.helpguide.org/mental/anxiety_types_symptoms_treatment.htm)

 An ADHD Coach can help you manage your anxiety

If you’ve been going to the doctor with any of these and not getting relief, you might want to consider consulting an anxiety specialist.   And an ADHD coach can also help you learn to identify your anxiety triggers and things you can do to keep your anxiety under control.  For example, exercise is an important way to minimize ADHD symptoms.  It is also a powerful antidote to many symptoms of anxiety.

You don’t have to live with anxiety, sign up for an Edge Coach and start taking charge of your life today.

ADHD and anxiety resources

For more information about ADHD and anxiety visit:

• http://www.healthcentral.com/adhd/related-conditions-196320-5.html
• http://www.anxiety-and-depression-solutions.com/wellness_concerns/adhd/010305_adhd_disorder.php
• And be sure to check out John Ratey’s book, Spark:  The revolutionary science of excercise and the brain

Do you have ADHD and anxiety?  What have you done to keep it under control.  We invite you to share your story here and help others learn what you have to keep your edge!

Join Edge Foundation Board Member, Dr. Patricia Quinn, at the National Resource Center on ADHD’s Ask the Experts! chat. This month’s topic: Treatment for Women and Girls with AD/HD.

When: Wed., Jan. 14, 2009 – 1:00 pm (Eastern Time)
What: Treatment for Women and Girls with AD/HD.
Who: Patricia Quinn, M.D., Co-Author of Understanding Girls with AD/HD

From the National Resource Center on ADHD’s announcement:

ADHD is a neurobiological disorder affecting 5 – 8 percent of school age children with symptoms persisting into adulthood nearly two-thirds of the time. According to TheCenter: A Resource for Womena and Girls with ADHD current diagnostic criteria continue to emphasize traits common to boys, leaving the majority of girls with ADHD to remain undiagnosed and misunderstood.

Last month, December 2008, Dr. Kathleen Nadeau, one of the founders of TheCenter, discussed “Raising a Girl with ADHD,” and tackled questions mainly geared towards younger females living with ADHD. Due to the overwhelming response, and a number of questions regarding women as well as girls with the disorder, Dr. Patricia Quinn, another founding member of TheCenter, will pick up the topic and expand on it.

Dr. Patricia Quinn will address questions regarding women with ADHD, girls with ADHD and will discuss treatment options, including medication.

Dr. Patricia Quinn is a developmental pediatrician in the Washington, D.C. area. A graduate of the Georgetown University Medical School, she specializes in child development and psychopharmacology.

Dr. Quinn has worked for over 28 years in the areas of ADHD and learning disabilities. She gives workshops nationwide and has appeared on Lifetime TV’s New Attitudes and the PBS show, To the Contrary, discussing the issue of girls and women with AD/HD.

Dr. Quinn is the author of several books on ADHD and is also co-editor of ADDvance: A Magazine for Women with ADD.

Her books, ATTENTION DEFICIT DISORDER: Diagnosis and Treatment from Infancy to Adulthood and Voices from Fatherhood: Fathers, Sons, and ADHD have been well received. Her latest book, Understanding Girls with ADHD, was coauthored with Drs. Nadeau and Ellen Littman, a licensed clinical psychologist who has worked with attentional issues for more than 18 years, and is groundbreaking in its presentation of this population.

Dr. Quinn lives in Washington, D.C. with her husband and four children, two of whom have ADHD. All of her books may be ordered through Advantage Books or by calling (toll free) 1-888-238-8588.