Attention Deficit and Hyperactivity Disorder: A Quick Primer

31 Mar 201231 Mar 2012by Torey C. Richards, LMHCLeave a Comment

Taking a Closer Look at ADHD

Attention Deficit/Hyper Activity Disorder (ADHD) is defined in the Diagnostic and Statistical Manual IV (DSM IV) as a composite disorder including two major syndromes which are inattentive and hyperactivity-impulsivity which may occur independently, starting before the age of 7 and cause some impairment in two or more settings (i.e. home and school).

Types of ADHD

The DSM goes on to break the diagnosis down to four types:

Attention-Deficit/Hyperactivity Disorder; Predominately Inattentive Type
Attention-Deficit/Hyperactivity Disorder: Predominately Hyperactive-Impulsive Type
Attention-Deficit/Hyperactivity Disorder; Combined Type
Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified

The diagnostic criteria for ADHD is fairly broad. Most of us at some point and time could theoretically meet the criteria for ADHD which brings me to the reason for this post. Is ADHD a real disorder?

Controversy

ADHD has been a controversial disorder since the 1970s. Most of the controversy surrounds the questions of over diagnosing the disorder, using stimulants such as Ritlan, Adderal and Tenex (which are chemically similar to illegal drugs such as Speed and Cocaine) to treat the disorder, especially in children and even over diagnosing the disorder in minorities and poor people for financial gain (we’ll explore this in another post). Common side effects we know from using stimulants include:

Psychosis
Addiction
Nervousness including agitation, anxiety and irritability
Trouble Sleeping
Decreased appetite
Headache
Stomach ache
Nausea
Dizziness
Heart Palpitations
Slowing growth in children
Seizures
eyesight changes or blurred vision

These are all serious side effects that need to be taken into consideration when prescribing stimulants to anyone, especially children, but often these things are ignored in the medicalization of deviant behavior.

Most healthcare providers in America recognize ADHD as a legitimate disorder, although in the United Kingdom the disorder isn’t as quickly diagnosed or treated with stimulants due to no one really knowing the long-term effects of using these stimulants due to there not having been any long-term studies on them.

I personally believe that ADHD is a real diagnosis. I’ve diagnosis children as well as adults with ADHD and feel confident in my diagnosis. I currently work with three teenagers who I have diagnosed with ADHD and none of them are on medication although they are prescribed medication. In there cases, I personally believe that medication would benefit because when they aren’t on their medication they don’t seem to be in control of themselves and their grades and behavior suffer. However, I have evaluated nearly one hundred students this year for ADHD and I’ve only diagnosed three. The others have some signs of ADHD, but I truly believed that most of their “deviant behavior” stems from a poor educational system and poor parenting. I do feel like it is over-diagnosed and over-medicated.

A lot of the signs and symptoms of ADHD are just children being children, products of their environment, poor parenting and poor educational systems. Not everyone who meets criteria for the disorder should actually be diagnosed and then subsequently medicated with stimulants which can cause undesirable side effects.

If you have a child you think may have ADHD then get them evaluated by a school psychologist or another qualified healthcare/mental health provider. If your child is diagnosed with ADHD, see about natural remedies such as changes in diet, vitamins, supplements and cognitive behavioral treatments. WebMD has a good page on some Home Remedies to help with ADHD. Always question your healthcare provider before just taking the prescription for stimulants and getting it filled. Ask about non-stimulant medication such as Strattera and other alternative medications if medication is recommended. Always educate yourself, your child and your family and be active members of you and your child’s mental and physical health.

Taking Control of Your LIfe

We are Living Magnets

27 Mar 201227 Mar 2012by Torey C. Richards, LMHCLeave a Comment

Thoughts, Feelings, Behaviors
A Prelude

You are a living magnet. You attract into your life people, situations, and circumstances that are in harmony with you dominant thoughts.

Those words are inscribed on my sister’s wall to wall chalk board when you enter her home. I don’t know where that particular quote came from, but it sounds a lot like The Secret and The Laws of Attraction which I 100% believe, not in a pseudo-new age-science sort of way, but in a we manifest our own destiny way.

I truly believe that for the most part, we design our lives. We are natural architects of our lives, CEOs and CFOs of our lives and it all starts with our thoughts.

We have to constantly be aware of our thoughts. Our thoughts create our situations. I listen to people all the time say things like, “I’m bad with money”, “I suck at math”, “I have no luck with relationships”, etc… We have to be careful of what we say and think about ourselves because those thoughts become reality. It’s that simple , yet I’ve found that its hard to get most people to see, believe and start to change their thoughts. Even I struggle with that often enough that it has caused me to read a handful of books on the subject.

This will be the first post of several that talks about thoughts, feelings and behaviors because I believe that it is such and important and powerful part of creating the life we want and not just being passive participants or even worst, seeing ourselves as victims.

In my next post on the subject I’ll do a brief overview on rational emotive behavioral therapy which I think is a great foundation to starting to understand the way thoughts, feelings and behaviors are all connected.

Grief Counseling

Dying Changes Everything

26 Mar 201227 Mar 2012by Torey C. Richards, LMHCLeave a Comment

My New Grief Group Part 2

Grief work is definitely an extremely rewarding experience. My grief group is still my favorite group of all and we are on week four I think. There is just so much I get out of the group and yet it is one of the most emotionally draining parts of my week.

Last week one of the members came to me in private and broke down crying. She was angry, angry at God, angry at her mother and angry at herself. She blamed God for taking her mother. She blamed her mother for not telling her she was going to die (her mother was sick and she assumed her mother knew just how terminally ill she really was) and she blamed herself for not being there when her mother died (as if she were psychic).

I listened to her frustrations and processed her irrational thoughts with her, but it was hard for me to see and hear such a beautiful girl in so much emotional pain, knowing that the only thing that could make her happy was implausible. So much had changed in her life since her mother had passed away…

Her mother was her sole guardian, so right now no one has any real guardianship legally over her although she is staying with an aunt. Her grades in school are suffering and her dreams for the future have been derailed because “nothing matters any more”. At seventeen, in high school, no one should lose their mother. “It’s not fair” are the words she cried out and I agree with her, it’s not fair, but it’s what happened and now we have to try to find the strength and the courage to move on. The road ahead is not easy, but it is doable. It’s at these times I definitely try to encourage my clients spiritual beliefs, because at times like this, they are often all we have to try to make some since of what has happened, why it has happened, and how to move forward.

I would do anything to make this client and all the clients in my grief group happier, and I know the fifty minutes they spend with me a week processing and dealing with their feelings over thier loved ones death may not always be the most pleasant way to spend their time, but I know it is necessary to deal with it now while it is fresh than to bury it and have to deal with it repeatedly later in life.

Uncategorized

Saving the Lives of Butterflies

16 Mar 201216 Mar 2012by Torey C. Richards, LMHCLeave a Comment

Self-Injury

The Butterfly Project

Self-injury, also known as self-mutilation and cutting is defined as the intentional, direct injuring of body tissue mostly done without suicidal intentions wikipedia.

Self-injury is unfortunately a very common issue among teenagers. According to research, it mostly effects women from ages 13 to 30.

In a typical year at the high school I work at, I usually only see about one case of self-injury a year. Not to say that there’s only one person at the school that cuts themselves, chances are, the rest are just hiding it better. This year however, I’ve had so many instances of self-injury that I actually have a group comprised mostly of “cutters”, as they refer to themselves. Coinciding with research, three out of the four people in the group are female. Most of them cut on their arms and one cuts on her arms and thighs. All of them cut out of anger, frustration and depression. They express to me that it helps them feel alive and/or that it helps them take out their frustrations on themselves. For all of them, it has become a form of addiction.

During my last meeting with this group, one of the newest members told me about The Butterfly Project. The Butterfly Project basically is a way to try and help those who self-injure and those who know someone who self-injures. It has seven rules.

1. When you feel like you want to cut, take a marker, pen or sharpies and draw a butterfly on your arm or hand.
2. Name the buttery after a loved one, or someone that really wants you to get better.
3. You must let the butterfly fade naturally. NO scrubbing it off.
4. If you cut before the butterfly is gone, you’ve killed it. If you don’t cut, it lives.
5. If you have more than one butterfly, cutting kills all of them.
6. Another person may draw them on you. These butterflies are extra special. Take good care of them.
7. Even if you don’t cut, feel free to draw a butterfly anyway, to show your support. If you do this, name it after someone you know that cuts or is suffering right now, and tell them. It could help.

I thought that this was a very creative and safe alternative to self-injury so my entire group is trying this and maybe it will help others out there who self-injure so definitely pass this on.

The above picture is an actually picture I took of a previous client of mine who self-injures. She actually did much more damage to her arms a few days after I took this picture and required psychiatric hospitalization.

The Perplexed Minds of Teenagers

Does the Baby’s DNA Change if the Mother Has Sex with Another Guy While Pregnant?

14 Mar 201227 Mar 2012by Torey C. Richards, LMHC370 Comments

I’m a strong proponent of the “there are no stupid questions” rule (in most cases), but can I propose that there are stupid statements?

The other day, an 18 year old client of mine, who is about two months pregnant with her ex-boyfriend’s baby, told me that she hasn’t told her new boyfriend that she is pregnant because she plans on changing the baby’s DNA from her ex-boyfriend’s to her new boyfriend’s by having repeated, unprotected sex with him. I nearly passed out from the shock of her ignorance!

I explained to her that it doesn’t work like that and tried to give her a crash course in human reproduction, but she quickly dismissed me, saying that she had a cousin who did it before (the cousin was probably never pregnant the first time to begin with, but that’s another story). I was so appalled that I could’t even debate with her because apparently she knew more than I did. It just made me more concerned about our youth and our future!

I took the liberty of researching her absurd question and was shocked to find that many people have asked the same question on forums such as yahoo answers! Not only that, but they asked such questions such as, “Does swallowing semen change the baby’s DNA?” ! What is wrong with these people? I know part of the problem is that we took sex education out of schools, so now we have a whole generation of children being raised not knowing the basics of human reproduction, human sexuality and anatomy and they will soon be raising and educating kids of their own! Scary! They’re not even concerned with real things that can “change” a baby’s DNA such as the mother’s diet and toxins such as smoking cigarette’s while pregnant. These things can alter DNA and make a child more prone to things like asthma, obesity, illnesses and allergies, but they nor can anything else turn “Mike’s baby” into “John’s baby” just because the mother and “Mike” no longer are together.

Few things scare me more than the state of our children and our future and the fact that they think they know everything when they at times don’t seem to understand the essentials of life.

Grief Counseling

My New Grief Group

10 Mar 201227 Mar 2012by Torey C. Richards, LMHC6 Comments

About three weeks ago I started my first grief group. Normally I had dealt with grief sporadically. It always seemed to be one of those things that came out of the blue and I was never truly prepared for, but about three weeks ago I was referred a handful of students who’s father, brother or mother had all died within the past two months and I figured it was the perfect time to add a new group to my array of groups that had only included anger management, life skills and substance abuse groups for the past three years.

I had been hesitant about adding a grief group because I don’t really like dealing with grief. I find it to be such a sad subject and I definitely didn’t want to spend fifty minutes a week surrounded by grieving teenagers. I thought it would be draining and depressing, but today I finished my third meeting with the five students in that group and so far find it to be my most spiritual and emotionally rewarding group.

Two members of my group are sisters who lost their mother to heart disease a couple of months ago. Another is a young man who lost his brother during a botch robbery. Another young woman lost her mother to cancer. Another young man lost his father to diabetes and the newest member of our group lost her mother due to complications due to lupus. I myself lost my father a little more than ten years ago to a car accident, so I was aware that there would probably be some emotional issues rising within myself as I conducted the group.

Right now I am battling controlling those emotions. Today as I was leading an exercise that dealt with what we missed the most about the person that passed away, I felt my eyes starting to water and I fought hard to not show it. I know on one hand it may be good for the group to see me dealing with my own issues of grief, but on the other hand I feel as the facilitator of the group, I need to always (or at least 99% of the time) be in control of my own emotions. I’ve never gotten grief therapy myself and have avoided talking about my father’s death in my own personal therapy, so yes I know this is “unfinished business”, but in the line of therapy, we therapist are human and there will always be times we knowingly or unexpectedly come across unfinished business or counter transference issues.

Eventually I’ll figure this out. I’ve told the group that there may be times when we are all crying together, and that’s okay, normal and healthy. Maybe I was preparing them so they won’t be shocked when and if I too start crying. I’ve never cried in a therapy session, not that I haven’t felt like crying, I just never allowed the tears to fall. However, in this group, I not only think it may at some point be appropriate to shed my tears, but also enlivening for me and the group members as they look to me for guidance on how to deal with their own grief.