Dr. Patricia Quinn: girls with ADHD face special challenges

Editor:  We are honored to have had Dr. Patricia Quinn involved with the Edge Foundation since our founding.  Dr. Quinn is a leading ADHD expert who has worked with, written about and provided training in the field of ADHD for more than 30 years.  This month we are pleased to be talking with her about one of her primary concerns:  girls with ADHD.

Key ideas:

  • Many girls with ADHD are left undiagnosed because their symptoms look different than boys.
  • Hyperactivity in girls can appear as being hyper-talkative or hyper-reactive (more emotional).
  • ADHD girls have greater problems with disorganization than boys.
  • Depression and anxiety are symptoms to watch for in older girls with ADHD.
  • ADHD coaching can help girls with ADHD learn what works to be successful in school and in life.

Edge: Thank you for all you’ve done on behalf of people with ADHD over the last 30 years.  What are the ADHD projects you are most excited about these days?

Dr. Patricia Quinn:   I can honestly say that working with young girls with ADHD, helping them understand the disorder and learn to live happy, productive lives is very close to my heart.  My most recent book, Attention, Girls!  A Guide to Learn All about Your ADHD, is special because it focuses on the lives of girls ages 7 to 13 years.

I also feel passionately about my work with college students with ADHD most of whom are newly diagnosed and struggling to stay in school.  When I get a call from someone who has just earned his law degree, and he says that he couldn’t have done it without my help when he was in college, it makes my day!

Edge: Girls have had a history of being under-diagnosed with ADHD in part because their symptoms can look very different from boys who have ADHD.  Can you speak to that a little bit?

Dr. Patricia Quinn: Boys with ADHD are easy to spot in the classroom, and are much more likely to be referred for an evaluation.

  • Most questionnaires used to screen children for ADHD emphasize items that describe these boys, items about hyperactivity, impulsivity and defiant behavior.
  • Only those few girls who are like these boys with ADHD are sent for assessment.
  • The ratio of children referred to clinics for ADHD evaluations continues to be about four or five boys for each girl.

What we are beginning to realize is that there are many girls left undiagnosed because their symptoms look different.  One big difference is that girls are less rebellious, less defiant, and generally less “difficult” than boys.  Sadly, they lose out due to their good behavior.  It’s the squeaky wheel that gets oiled.  When a boy is causing frequent discipline problems, either at home or in the classroom, he will quickly be referred for treatment.  Parents and teachers alike want quick relief from their constant challenges.  Girls with ADHD are more compliant, and are not as easy to spot.  Often they are left to drift along from one school year to the next, never working up to their potential and suffering silently.

Edge: So you are saying girls have the same symptoms as boys, they are just less rebellious?

Dr. Patricia Quinn: Basically there are core symptoms of ADHD that are critical to the diagnosis.  These include problems with attention and hyperactivity/impulsivity.  In general, girls usually have more problems with attention.  However, girls can also have hyperactivity, but it manifests in different ways.  For example, girls with ADHD can be hyper-reactive rather than hyperactive.  They are more emotionally labile with tantrums, slamming doors, etc.  Instead, of running around and being motorically hyperactive and disruptive like boys with ADHD, they can be hyper-talkative.  In addition to problems with attention, girls have problems with disorganization and, after puberty, have greater incidence of coexisting depression and anxiety.

Edge: Is there any advice you can offer to high school or college age young women to help them work with their ADHD to be successful?

Dr. Patricia Quinn: To successfully deal with and manage both ADHD symptoms and their lives, girls with ADHD must accurately assess their strengths, as well as weaknesses, and develop a plan for going forward.  For many girls, this means facing and shouting down the shame, low self-regard and those self-defeating scripts they have in their heads that tell them how terrible they are.  In addition, they need to develop a plan, building on their strengths, to deal with time management, disorganization and the other issues that get in the way of their success.

High school is the perfect time to begin developing strategies to deal with their ADHD symptoms.  However, teens do not need to face these challenges alone.  Family members, teachers, therapists and ADHD coaches are there to help.  By enrolling the aid of a coach early on, the girl with ADHD can learn what works for her and what she needs to do to be successful in college and life beyond.

6/2010 Editor’s Note:  For more about ADHD and Girls, check out the latest interview with Dr. Quinn.

ADHD from A to Z &For Coaches &For Parents &For Students &For Teachers Peggy Dolane 10 Aug 2009 7 Comments

Our Mission

VISION – to give  each student a coach, especially those who are at-risk of dropping out of school — specifically, non-traditional learners with Executive Functioning challenges, ADHD being the most severe — so that they can complete their education,  realize their full potential and pursue their passion.

MISSION – to ensure that each student, regardless of their economic circumstances, who wants and needs an Edge Executive Coach gets one so that they can complete their education and not drop out.

Edge Foundation 04 Apr 2009 Comments Off

ADHD and Anxiety: non-drug treatments everyone can try

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.

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
  • meditation
  • 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.

ADHD from A to Z &For Parents &For Students &How To's and Tips &Mental Health Edge Foundation 02 Mar 2009 9 Comments

The 4 most common anxiety disorders associated with ADHD: Anxiety and ADHD – part 2

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.

 

ADHD from A to Z &For Coaches &For Parents &For Students &For Teachers &Mental Health Edge Foundation 13 Feb 2009 18 Comments

ADHD and anxiety

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

(Sourcehttp://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:

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!

For Parents &For Students &How To's and Tips &Mental Health Edge Foundation 21 Jan 2009 9 Comments

Treating ADHD with Exercise

Regular exercise has been shown to reduce the symptoms of ADHDAs the days grow shorter, it’s easy for all of us to get less active.  If you think about it, how much more time do you spend on-line or watching TV during the winter, when in the summer you would be out riding your bike or at the beach.

For people ADHD, keeping active year-round isn’t just a good idea, it’s key in reducing symptoms of anxiety and depression and is also known to help with symptoms of ADHD.  It’s no surprise that Michael Phelps is able to manage his ADHD without medication – the man’s life is built around exercise.

Studies reveal exercise treats ADHD

There are multiple studies that show exercise is critical to brain functioning:

Spark:  The Revolutionary New Science of Exercise and the Brain by John Ratey – was published earlier this year is filled with case studies which demonstrate the connection between exercise and brain functioning including ADHD.  (Click the link above to purchase the book and support the Edge Foundation.)

Inactive Teens More at Risk for Behavioral Problems,  Health Day, October 14, 2008.  A recent study of teenagers in Finland revealed that inactive boys and girls were more likely to have attention problems than their active peers.  It asserts that exercise is a highly effective method in easing depression and anxiety and urges teens to build regular exercise as a lifelong health habit.

ADHD Coaching Keeps Your Exercise Program on Track

It’s hard to start and exercise program, and even more difficult to make it a long-term habit.  ADHD coaching can help you stay on track with your exercise goals.  Checking in with someone about your weekly exercise goals, can be a way to set goals you can keep over time, stay on track and problem solve when you aren’t able to meet your goals.

The Edge Foundation offers coaches who are specifically trained and experience in working with high school and college students.  Sign up and get your EDGE today!

And while your at it, consider exercising outdoors.  This week another study shows that a walk in the park is also highly beneficial to improving attention in children with ADHD.

Now it’s your turn, what do you do to keep on track with your exercise goals?  Leave a comment and share your success or struggles with other Edge readers.

ADHD from A to Z &Edge in the News &How To's and Tips Edge Foundation 17 Oct 2008 8 Comments

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