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Improper recognition or misdiagnosing of Attention/Focus Problems (AFP) and ADHD (Attention-deficit Hyperactivity Disorder also referred to as ADD) can lead to severe adult problems as:

• Severe job compromise or loss
• Interference with relationships and family life
• Loss of self-esteem
• Development of mental and physical health problems
• Not getting things done
• Discrimination in the workplace
• Substance abuse
• Disability

Marge* had gone to an ADHD specialist as she was losing her business and marriage. She couldn’t focus or attend to things and felt very scattered. She took a stimulant medication but developed disabling anxiety, panic and depression with suicidal thoughts.  She switched her care to a more attentive holistic practitioner. Their work together revealed recent significant trauma. Six months before the onset of her problems, she was assaulted after leaving her place of business. Soon after, she developed severe problems with attention, focus and symptoms of post-traumatic stress syndrome (PTSD). Also, it was found that she had a severe iron deficiency anemia and early signs of thyroid disease. She stopped her stimulant medication, started a PTSD therapy program and started treatment for her other medical issues. Her symptoms rapidly responded to treatment, and now her attention and focus are back to normal. Her business and marriage are now again successful.
* (To protect confidentiality, the above is a composite of many clinical experiences and does not represent an actual person or any prior patients.)

Having attention/focus problems (AFP) and ADHD difficulties can be problematic when an individual finds himself (or herself — gender assumed) in an adverse work or life situation. Examples would be: not being able to relate to others effectively, unable to get work done or meet the demands for performance and productivity.  Ill health can develop from being chronically overextended, not getting adequate sleep or from continued stress from the AFP.

There is often discrimination against people with AFP and ADHD in work, academic and social situations; however, attention problems in all forms are common in our population. ADHD, when diagnosed, allows for a workplace or school accommodations under ADA laws (American Disability Act).  Many with attention/focus (including ADHD) problems, if minor, would not be considered significantly impaired or disabled, even though they might struggle to remain focused or attentive at times . When in a positive fit with their life situation and operating within their capacity, many with AFP are some of our most creative, talented and productive citizens.

How do you recognize AFP and ADHD?

There are many conditions that can masquerade and significantly contribute to attention/focus problems or the actual condition of ADHD.  Information gathering and a holistic consultation can be helpful, especially when there hasn’t been a good response to simple or conventional treatments.

A significant percentage of childhood and adolescent with AFP or ADHD will continue to have symptoms and problems into adulthood. The inattentive type of symptoms seem to be the most prevalent ones in adulthood – as difficulties with organizing, sustaining

attention, distraction, finishing tasks, procrastination, losing things, forgetfulness and making mistakes.

In adults with AFP and ADHD, symptoms as internal restlessness, substance abuse may be common. Less likely symptoms of hyperactivity, difficulties with decision making and poor impulse control could also, though less likely, be present. In Childhood and Adolescent, one would more likely see difficulties with fidgeting, feeling settled, relaxing quietly, talking excessively, intruding into the conversation, blurting out answers, or running & climbing dangerously. See the following links for further information: ADDA, Adult ADD Univ. of Maryland questionnaire and Web MD.

A holistic approach to AFP or ADHD is important especially when:

• other safer and more natural approaches may be available
• medication are use ahead of careful examination for other causes or contributing factors
• marked improvement is possible when other causes or contributing factors are addressed in a person with AFP and ADHD

Contributing factors often overlooked (important to find before considering medication) include:

1.  medication side effects
2. drug abuse & chemical dependency
3. medical condition as: thyroid problems, hidden infection, inflammatory diseases, or nutritional deficiencies
4. mood disorders as bipolar disorder, depression and anxiety
5. Post Traumatic Stress Disorder (PTSD) or past trauma
6. environmental allergies & sensitivities
7. family disruption or dysfunction
8. major losses and worries including financial problems, job loss, marital problems
9. sleep disturbance

Holistic approaches to AFP and/or ADHD to be considered include:

• identifying environmental illness, sensitivities and allergies
• improving nutrition with diet with more organic, fresh whole foods, considering supplements as fish oil (omega 3’s), magnesium, zinc, B-vitamins (as B6, folic acid), melatonin, or iron if indicated
• avoiding food additives, chemicals, refined sugars, overly processed food
• AFP or ADHD coaching
• Seeking accommodations when needed in educational and organizations settings
• behavioral cognitive, family or other holistic therapies, to help modify dysfunctional patterns of interaction or behavior
• EEG Biofeedback

It is recommended that if any if these approaches are considered that they be done under the careful supervision of a qualified holistic health-care practitioner.

For more information and references on AFP and ADHD click here. To learn more about assessment and treatment approaches offered by Integrative psychiatry, medicine and holistic therapy practitioner. Further reading re: ADD Resources – ADD R.  Recent review available for purchase: ADHD IN CHILDREN AND ADULTS, Audio-Digest Psychiatry, Volume 44, Issue 16, August 21, 2015, Managing ADHD in Preschoolers – Robert R. Althoff, MD, PhD, Adult ADHD – James Margolis, MD.

Article by Ron Parks, MD and edited by Shan Parks August 2015

Question:

What is your next step, if you or your family is affected by AFP and ADHD?