ADHD and self-destructive behaviours: Part 2 of 3

As I said in my blog yesterday, adolescents with ADHD often suffer from low self-esteem and self-harm in different ways as a cry for help in a world they find difficult to understand and find their place in. When ADHD is undiagnosed the combination of normal pubescent issues and those associated with ADHD can be extremely challenging and in addition to self-harm, adolescents often suffer from Eating Disorders- which I’m going to post about today in part two of this series.

Eating disorders

According to several sources, including Anorexia and Bulimia Care, approximately 1.6 million people in the UK suffer from eating disorders and in the US this figure is around 8 million, according to The National Association of Anorexia Nervosa and Associated Disorders. While eating disorders have been recognised for many years, their association with ADHD is relatively new.

The most well-known eating disorders are Anorexia Nervosa, Bulimia Nervosa and Binge-eating Disorder which are all characterised by dietary chaos and sometimes extreme weight control that is harmful to both physical and emotional health and affects many organ systems of the body.

Anorexia Nervosa is characterised by restricting food intake, often to the point of starvation, which can lead to a low, unhealthy body weight as people with Anorexia try to avoid gaining body fat.

Bulimia nervosa is marred by recurrent binge-eating episodes- a person eats a large amount of food in a short period of time and then purges by self-induced vomiting, laxative use, excessive exercise, fasting, or the use of diuretics to prevent weight gain.

Binge-eating Disorder is characterised by binge eating episodes without the purging behaviours that are present in Bulimia.

The link between ADHD and eating disorders is due to multiple factors, and many of the characteristics of ADHD have been shown to influence some disordered eating behaviours.

The three key features of ADHD- inattention, hyperactivity, and impulsivity- could be linked to eating disorders as the binge eating and purging of Bulimia Nervosa can be impulsive. One study I read mentions that people with Anorexia Nervosa and Bulimia Nervosa can show impairments in attention in neuropsychological testing compared to healthy control subjects. Excessive exercising can also be considered as hyperactive or restless behaviour and restlessness at eating times may cause a person to avoid eating out of anxiousness.

Food can also act as self-medication for anxiety, stress, anger, and boredom as the act of eating is stimulating, and food can also be used as an emotional crutch, so when people feel empty emotionally- food can fill that gap. People with ADHD who feel inadequate and incompetent sometimes turn to food as a source of comfort. Eating is used as an unhealthy outlet to take control of their lives. Both binge-eaters and people with ADHD have trouble heeding their internal cues of satiety and hunger.

The risk factors for Anorexia are also more significant for people with ADHD. People with ADHD and Anorexia have said that information about diets and healthy foods leaves them overwhelmed and although individuals with ADHD take an all-or-nothing approach in decision-making, and eat very little, they are obsessed with food. They often read cookbooks and watch food shows an television. A hyperfocus on food may affect people with ADHD as it simplifies their thinking about food.

According to a study in the Journal of Developmental and Behavioural Paediatrics, girls with ADHD are 2.7 times more likely to develop Anorexia Nervosa and 5.6 times more likely to develop Bulimia Nervosa than those without ADHD. Additionally, the Journal of Eating and Weight Disorders reported that 26.7% of severely obese women had ADHD as adults and they reported issues with impulsivity, distractibility, attention and staying focused.

The Journal of Abnormal Psychology linked eating disorders and ADHD with:

  • pathological eating
  • desire to lose weight
  • peer rejection
  • punitive parenting
  • disruptive disorders
  • internalising disorders
  • externalising disorders
  • internalising symptoms

Given the serious implications eating disorders can have on people’s bodily organs and the risk of death with some eating disorders, it is important that young people be supported and not judged if they are experiencing difficulties with their eating. Eating disorders are not a “fashion statement” and are rarely influenced by celebrity and it cheapens a very serious condition. As teachers it is important for us to know the serious implications of undiagnosed ADHD and how this can go on to affect children in adolescence.

What to do if your child has low self-esteem, self-harms or has an eating disorder

**If you suspect your child of having problems associated with self-esteem, self-harm or eating disorders it is very important that you seek the appropriate medical advice. While internet sources may give you some ideas, a doctor is a professional and probably comes across these issues frequently, so they will give the best and safest advice. **

Other things which could be tried at home to improve a person’s self-esteem are:

  • Regular praise when a person has been helpful can be a good introduction to praise. Some people with low self-esteem find it hard to accept praise about their achievements but are more comfortable being thanked for being helpful. When they are more able to accept this praise then praising their achievements could develop.
  • It is important that a person knows you love them without condition and that even if they have misbehaved.
  • If low self-esteem is linked to achievement, then setting smaller and more manageable goals can stop a person from feeling so overwhelmed.
  • Depending on a person’s interests, joining a club or hobby can help their self-esteem as it gives them an opportunity to achieve away from their normal environment in an area they are interested in and meet new people. People with ADHD can often be interested in many different hobbies and make time to settle on one they like.
  • Growth Mindset training may help with this if it is practised in school. There is lots of information and resources available online to help with Growth Mindset at home- I’ll post links on a later blog.

Criticism

Many people find criticism difficult, whether they have ADHD or not, but for people with low self-esteem, criticism can be even more challenging.

If someone is to accept criticism it needs to be given in a constructive way and finding positive points to balance the criticism helps e.g. saying ‘I loved the way you read the first page. It’s only a couple of words you’re stumbling on. That word is…’

Modelling ways of giving good constructive criticism is more likely to produce constructive criticism from others.

How can you tell if someone is self-harming or has an eating disorder?

Until a person talks to their parents or doctor willingly, detecting self-harm can be difficult as people who self-harm are prone to covering up their scars and teenagers, who are more body conscious are also more likely to cover up.

Scratching or scarring on the upper arms or legs evidence of hidden razor blades or knives should also cause concern.

Loss of weight, secrecy around food, evidence of food storage in bedrooms or frequent overeating followed by long periods in the bathroom could be indicators of eating disorders.

It is important to:

  • Stay calm and approachable
  • Listen without judging
  • Seek professional, medical help

In addition to these upsetting and damaging symptoms of ADHD, the condition is also linked to risky sexual behaviour and inappropriate use of alcohol and drugs, particularly in those who are undiagnosed and who have accompanying conduct disorders. I will take a look at this in tomorrow’s blog.

Sources

http://www.anorexiabulimiacare.org.uk/about/statistics

https://www.anred.com/stats.html

https://www.everydayhealth.com/columns/lisa-aro-living-a-distracted-life/self-harm-girls-with-adhd-silent-pervasive/

http://www.addandadhd.co.uk/why-do-teenagers-with-adhd-self-harm.html

https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-14-133

http://www.adhdandyou.co.uk/adhd-support-and-resources/tips-for-everyone/adhd-self-esteem/

http://adhd-institute.com/adhd-may-be-associated-with-low-self-esteem-in-adulthood/

http://www.netdoctor.co.uk/conditions/adhd/a5237/self-esteem-and-adhd-child/

https://www.additudemag.com/adhd-linked-to-eating-disorders/

https://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring-dual-diagnosis/ocd-obsessive-compulsive-disorder/adhd-as-a-co-occurring-disorder-with-eating-disorders

http://eating-disorders.org.uk/children-with-adhd-and-eating-disorder-risk/

http://totallyadd.com/adhd-and-the-disregulation-of-eating/

https://www.elementsbehavioralhealth.com/news-and-research/adult-adhd-linked-to-severe-eating-disorders/

https://adultaddstrengths.com/2011/08/15/girls-and-women-with-adhd-have-higher-rates-of-anorexia-nervosa-here-are-some-reasons-why/

https://www.psychologytoday.com/blog/how-expect-what-you-werent-expecting/201710/childhood-adhd-and-poor-self-esteem

ADHD and self-destructive behaviours: Part 1 of 3

Amongst the unfortunate side effects of undiagnosed ADHD are cripplingly low self-esteem, self-harm, eating disorders and risky sexual behaviour. In a world where you feel like you do not fully fit in, where you have no control over the way other people perceive you or how to regulate your emotions and behaviour, being able to control something in your life becomes increasingly important in your teenage years- and your own body is often the only thing that you are able to fully control.

Unfortunately this can often have devastating effects.

Adolescence is difficult for everyone, regardless of neurodevelopmental conditions, and as children grow into teenagers and start to gain freedoms they never possessed before, develop new friendships, discover their sexuality and begin to find their place in the world it can be very challenging. Hormones are raging, the body is changing, acne, braces, voices are dropping, breasts are developing, there are growth spurts, and everyone feels awkward about themselves- whilst also developing attraction to each other.

I do not think anyone would go back to that period of their lives if they were paid.

As a teacher who has been based in the upper Primary -Primary 4-7 (Year/Grades 3-6)- for the last seven years, I have often been dismayed and alarmed by the introduction of social media into the mix for our young people and have dealt with particularly unpleasant incidents of online bullying that have caused me to lie awake at night with distress. As the mother of a 12-year-old son, part of me wishes I could fast forward a few years so that my son does not have to experience these horrors, but equally I realise that this is a great age to enjoy a brilliant young man who, so far, is uninterested in social media and to fast forward would mean losing out on some great memories we could create.

It is a tough life being a teacher and parent these days.

Even tougher still if the adolescent(s) in your life have a neurodevelopmental condition and if that condition is undiagnosed, it can take an incredible toll on both the child and family.

This post is the first of three looking at self-esteem, self-harm, eating disorders, risky sexual behaviours and how we can help children with ADHD to tackle these issues that can blight their lives from childhood, through adolescence and beyond.

**I am not a doctor, I am a teacher and adult with ADHD. It is important to remember that if you suspect someone you know of self-harming or having an eating disorder to be open, listen to them, refrain from judgement and seek appropriate medical advice**

 

Self-esteem

Self-esteem is a measure of how we see ourselves, our personal achievements, our value and our sense of worth and is important because it helps children feel proud of who they are and what they do. Children, adolescents, and adults with ADHD may hear negative or naive comments from classmates, teachers, friends, and family so may have lower self-esteem if they see themselves as “different” to others.

Sometimes the symptoms of ADHD mean that the child needs extra time to take tests or finish tasks, which can draw attention in school and lead to further embarrassment and negative comments.

How is self-esteem affected by ADHD?

Many children with ADHD have problems in school and sometimes have difficulties at home and many find it difficult to make and keep friends.

Children with ADHD report feeling stupid, naughty, bad or a failure and unsurprisingly, their self-esteem takes a battering and they find it hard to think anything positive or good about themselves.

Hyperactive or disruptive behaviour is sometimes observed in children and young people with ADHD and while they can’t help their behaviours, teachers with a lack of adequate training and support often exclude children with ADHD from class as a way of managing the behaviours associated with ADHD.

This can then have social implications as other parents may not want to invite a child with a reputation for bad behaviour to birthday parties or social events- which reinforces the idea that they are ‘naughty’ and unwelcome.

Signs of low self-esteem

The following are signs of low self-esteem that parents or family may recognise in a child or adult:

  • Difficulty with praise- the person may interpret everything they hear as criticism.
  • Loss of confidence in familiar tasks or hobbies.
  • Lacks interest in trying anything new due to fear of failure or criticism.
  • Moodiness, anxiety and depression.
  • Poor concentration.
  • Unable to make decisions.
  • Difficulties sleeping.
  • Communication difficulties- including difficulties with asserting themselves.
  • Neglect of their person- including personal hygiene.

Self-harm

Self-harm is a major public health issue amongst young people worldwide and numerous studies have indicated that ADHD is associated with suicide, suicide attempt and suicide ideation- but ADHD is also associated with other self-harm behaviours.

Self-harm is where a person seeks to relieve their pain or distress by cutting or burning themselves, banging heads or parts of their bodies against walls, hair pulling or biting. Self-harm can also include self-poisoning and overdose. During teenage years, self-harm is four times as prevalent in girls as boys.

The main triggers behind self-harm are severe anxiety, impulsivity, depression and low self-esteem.

Whilst there is no reliable method of predicting which children might seek to self-harm, it appears to be prevalent in children who face a combination of pressure in their school and home life and research has shown that self-harm is more likely amongst children who have strong feelings of guilt, frustration, anger and impulsivity.

These emotional and psychological factors are especially prevalent in children with ADHD, and where the condition is not adequately addressed at home and school.

Self- harm is not a suicide attempt, it is also not attention seeking behaviour as many self-harmers go to great lengths to conceal the damage they cause themselves and it should not be dismissed as a cry for attention but rather as a cry for help or an expression of extreme anxiety, frustration and lack of control. Children and adolescents with ADHD often find social relationships and interactions very challenging and this frustration can manifest itself in self-destructive ways that harm the person while they seek ways to manage their feelings and seek control.

It is estimated that more than 50% of girls with combined type ADHD engage in self-harm and 22% attempt suicide in a 2012 UC Berkeley study, and whilst girls with Inattentive Type ADHD aren’t as likely to harm themselves as girls with Combined Type ADHD, they are still more likely to harm themselves than girls without ADHD.

It is also important to note that the majority of studies into self-harm focus on girls but in recent years it has been found that boys are more likely to self-harm than previously thought, particularly if they have ADHD.

This obviously has massive implications across several sectors- mental health, accident and emergency, sexual health (as I will explain tomorrow) and education being the most obvious. But undiagnosed ADHD and these problems has a wider reach in terms of housing, criminal justice and employability- so an understanding of ADHD in children from an early age and a recognition of the wider implications is necessary in order to help children reach their full potential- educators are crucial in this.

Tomorrow I will continue my posts on this topic by looking at eating disorders and risky sexual behaviour and the links to ADHD.

Please leave constructive feedback and share with anyone you think may benefit from reading this post.

Laura

 

Sources from the series

https://www.everydayhealth.com/columns/lisa-aro-living-a-distracted-life/self-harm-girls-with-adhd-silent-pervasive/

http://www.addandadhd.co.uk/why-do-teenagers-with-adhd-self-harm.html

https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-14-133

http://www.adhdandyou.co.uk/adhd-support-and-resources/tips-for-everyone/adhd-self-esteem/

http://adhd-institute.com/adhd-may-be-associated-with-low-self-esteem-in-adulthood/

http://www.netdoctor.co.uk/conditions/adhd/a5237/self-esteem-and-adhd-child/

https://www.additudemag.com/adhd-linked-to-eating-disorders/

https://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring-dual-diagnosis/ocd-obsessive-compulsive-disorder/adhd-as-a-co-occurring-disorder-with-eating-disorders

http://eating-disorders.org.uk/children-with-adhd-and-eating-disorder-risk/

http://totallyadd.com/adhd-and-the-disregulation-of-eating/

https://www.elementsbehavioralhealth.com/news-and-research/adult-adhd-linked-to-severe-eating-disorders/

https://adultaddstrengths.com/2011/08/15/girls-and-women-with-adhd-have-higher-rates-of-anorexia-nervosa-here-are-some-reasons-why/

https://www.psychologytoday.com/blog/how-expect-what-you-werent-expecting/201710/childhood-adhd-and-poor-self-esteem

 

 

 

 

 

 

 

#metoo and ADHD

I thought long and hard whether not to include this post on ‘Me and my ADHD’ but decided that I would for several reasons. Firstly, the debate surrounding #metoo is of national and international importance, secondly because people with ADHD are not immune to sexual harassment and thirdly because my reaction to incidences of sexual harassment has been influenced by my ADHD and for a long time I believed that I over reacted to these incidents because of the ADHD emotion of ‘flooding’ and thought that I was in the wrong… I wasn’t.

I am not a special person, I have not been targeted for sexual harassment in the past because I have ADHD or because of any physical or personality attribute that I may possess, in all of the incidents I mention below I was targeted specifically because I was a woman and the perpetrators of the harassment- and those who witnessed it- thought it was ok.

My first experience of sexual harassment occurred in high school when I was 11 years old. I have always possessed particularly “full” lips, particularly my bottom lip which sits in a natural pout and many people have commented on photographs over the years with the likes of, “Look at the trout pout on you.”

When I was in Primary 6 (Year 5/Grade 5) a number of the children in my class took to calling me “fishy lips” which, after a sustained amount of name calling upset me to the point I remember sitting in the girls’ toilets of my primary school crying my heart out to my Primary 6 teacher, Mrs C, after I had ‘over reacted’ with emotional flooding- as is typical of someone with ADHD- and had apparently upset all of my tormentors by my reaction. Instead of shouting at me or giving me into trouble, which I had come to expect any time I was unhappy, Mrs C consoled me and she said, “You know, a lot of people pay good money to have lips that look like yours.” At the age of 9 I failed to see why anyone would want to be subjected to the constant torment about my lips and I reacted by wailing loudly in tears about how stupid these people were, “Why would anyone want to be called names because of their lips?”

When I moved into high school, the attention towards my lips morphed from “fishy lips,” a comparison I actually understood, into “blow job lips,” something I definitely did not understand, nor should I have understood at that age. As an 11-year-old girl who attended a private Catholic high school, had attended a Catholic primary school and grew up in a strict Catholic family- I had absolutely no idea what a blow job was and it took three years of being called this name, that I did not understand, before I finally found out its true meaning and implications. Another girl in my year group, who I will not name, told a story in our third year of high school about visiting a spa with her family where a couple were engaging in ‘oral sex’ in a hot tub. Not understanding what that meant I asked, “what is oral sex?” (Bearing in mind that my knowledge of what sex was also extremely limited).

The assembled group of boys and girls laughed hysterically at me, “You should know, blow job lips!” was one of the replies.

But I did not know what that terminology meant any more than I knew what “blow job lips” meant, and when it was explained to me whilst mocking my lack of knowledge I felt disgusted, ashamed and dirty.

There was no way I was going to tell my parents or teachers that boys (and apparently girls) had been calling me “blow job lips” for the last three years- I would probably have gotten into trouble for even saying the words to them. So, I kept quiet and lived with that term all through high school and later into University until I managed to sever every single relationship with people from my year group in high school so that the name did not follow me about.

As referenced in other blogs, I had spent most of my high school years in trouble for “over reacting” to incidents that upset me, if I reacted to this name in the same way I did to other incidents I was sure that I would be in trouble for saying the words- a risk I was not willing to take.

Aged 16 I took a job in Conference and Banqueting at a well known Glasgow hotel on one of the Zero Hours contracts that are spoken about so often nowadays. My job involved serving food and clearing tables at functions in the hotel ranging from weddings, corporate events and even serving the entourage of Mike Tyson. My uniform consisted of black shoes, black tights and a black skirt and the hotel provided a white, button down, jacket with gold buttons and gold epaulettes.

In those days I was quite thin and was a UK size 6-8, several of the girls I worked with were similarly thin, so I always arrived at work early to ask for the smallest sized jacket from the laundry. It was a size 8 and swamped me but as there were only three or four available and the next size up, a 10, was like wearing a large tent and almost reached my knees.

The fashion at the time was for short skirts and all the women I worked with wore black skirts that were no longer than their mid-thigh, no matter their size, and the size 8 jacket that the hotel provided was short enough for my skirt to show quite well, but when wearing the larger size 10 top it swamped me and sat below the line of my skirt.

Despite my efforts to get into work early to get the better fitting jacket, I had to wear this larger size on several occasions and as this same issue affected several of us, it was quite normal that staff would be wearing ill-fitting uniform. There was one occasion that sticks with me that made me incredibly uncomfortable, ashamed an embarrassed and I distinctly remember it to this day.

At one particular dinner, the Chefs in the Conference and Banqueting kitchen thought it would be funny to comment every time I walked into the kitchen to pick up food or clear plates. They made comments about not being able to see my skirt, suggested I wasn’t wearing a skirt and said that I was “asking for it” by not wearing a skirt to work. Several times I told them that I was wearing a skirt, lifting my jacket to show it more clearly, which set off cat calls while they accused me of stripping for them. Those not involved in the torment, Chefs and waiting staff, laughed along as I became more anxious and unhappy every time I went into the kitchen.

On one occasion after clearing plates, listening to their lewd comments and hearing them shouting across the room behind me, I left the kitchen visibly upset and one of the older men working as a waiter told me, “they have no right to speak to you like that, they are out of order, speak up.” Buoyed by his support, the next time I entered the kitchen to pick up desserts, a Chef called Chris made yet another lewd comment about my legs and I turned towards him and said, “That’s sexual harassment.”

You could have heard a pin drop in that kitchen the moment I spoke, I can still visualise exactly where everyone was standing.

Chris screamed at me to put the plates down and ordered me to get out of his kitchen- I did not need to be told twice. Seething and very upset I left the kitchen and told the supervisor what had happened. In an attempt to appease the situation, the supervisor said I needed to be able to serve and clear for the remainder of service but Chris launched into an expletive ridden tirade about how I had dared make an accusation of sexual harassment about him in front of his kitchen staff and that I was no longer welcome in his kitchen while he worked in the hotel- no one else had much to say. Immediately, I thought that I was in the wrong to have provoked such a reaction, that I had crossed a line and it was my typical ADHD over reaction (I was undiagnosed at the time but aware that I quickly reacted to things) that had gotten me into trouble and I would lose my job. An uncomfortable situation was made far worse.

I did not want to enter the kitchen that night and I was clearly not welcome so I was told I could finish early and before the next shift I was told to come in and meet with the conference and Banqueting Managers. Neither of them wanted to lose me as a member of staff but they also wanted to appease the kitchen so I was told by the female manager that the Chefs found short skirts “distracting” and the fact that my jacket covered my skirt was a problem, so in future I should think about that and wear a longer skirt- there was no effort to ensure they provided me with a correctly fitted jacket or that the comments made towards me had been lewd and inappropriate.

I was held accountable for the Chefs’ comments and the length of my skirt was blamed for “distracting” them.

What I distinctly remember about this conversation was the female manager, who was telling me off, really trying to brush over the whole affair. She was giving me into trouble but I’m not sure that she really felt that I was at fault, she was appeasing the Chefs who were more important than me.

Workplace harassment was not limited to this incident. Circa 2001-2002, I worked in a popular nightclub  in Glasgow City Centre. It opened from 4pm till 3am most days and I worked nearly every night of the week there, building up a great set of friends amongst the staff. The bar area was a square shape in the middle of the club and as one of the only female members of bar staff, I had the additional responsibility of carrying out toilet checks once an hour- clearing glasses that were abandoned, sweeping for broken glass, flushing toilets, making sure toilet roll was refilled and generally ensuring no one was being sick in there. It might sound like an unattractive part of the job but at the time I was a smoker and you could still smoke in bars and nightclubs at that point, so it was actually a way for me to get off of the bar and have a sneaky cigarette every hour- so I enjoyed having that responsibility.

What I did not like was the frequent occasions where I would leave the bar into the incredibly busy club, moving at a snail’s pace through the club to get to the ladies’ toilets and where I would often have my breasts, buttocks or vagina grabbed in the crowd.

This did not happen every night or indeed more than once a night but it happened at least every week and those unfortunate enough to get caught by me got a verbal bashing, usually full of expletives, usually calling them perverts. But more often than not, I would be grabbed and turn into the crowd to find the perpetrator, only to see a crowd of guys standing, none of them looking at me and all looking like they were just chatting to their friends. As bad as it is to face the person who gropes you smiling like they have done nothing wrong, it is far worse to not know who did it in a sea of faces- faces knowing they have done wrong and refusing to acknowledge it.

I should have had a reputation for taking no shit from guys who groped me by shouting at them (actually I should have called the bouncers down and had them ejected, but I knew the managers would not have supported that- the bouncers would have as they were great guys) but instead I had a reputation for not being smiley at all times to customers- no matter the innuendo or whether they groped me. The management of the club saw my reaction to being groped as an over reaction and I left there knowing that I didn’t want to be groped but struggling to reconcile how I could communicate this without “over reacting” like I had been accused of.

I have worked in several night clubs, hotels, retail banks and in the education sector since these incidents and have not experienced sexual harassment at work in any other employ- and believe me I have reflected upon it as I do tend to reflect on all my social interactions. This is probably because sexual harassment does not exist in every workplace and because not all men engage in harassment, but does not mean that I have not experienced harassment since. When you have ADHD and are already afraid of speaking out because of the reactions you receive, it can be all that more difficult in cases of harassment.

 

Laura

Information about ADHD

As I have said in previous blogs, if you suspect that you or your child have ADHD then your first port of call should be your GP who will be able to talk to you about the correct steps to take forward and while blogs and internet advice are helpful, medical advice is always the way to go to get a diagnosis, treatment and advice for your individual situation.

Below I have included some helpful links to relevant websites in the UK providing relevant health based information about ADHD.

NHS: For a brief summary of ADHD, its subtypes and treatments you can find generalised information on the NHS Choices website.

https://www.nhs.uk/conditions/Attention-deficit-hyperactivity-disorder/Pages/Introduction.aspx

In England, Wales and Northern Ireland: National Institute for Health and Care Excellence (NICE):

“NICE’s role is to improve outcomes for people using the NHS and other public health and social care services. We do this by:

  • Producing evidence-based guidance and advice for health, public health and social care practitioners.
  • Developing quality standards and performance metrics for those providing and commissioning health, public health and social care services.
  • Providing a range of information services for commissioners, practitioners and managers across the spectrum of health and social care.”

The specific guidance relating to ADHD is available at:

https://www.nice.org.uk/guidance/cg72

In Scotland:

“The Scottish Intercollegiate Guidelines Network (SIGN) was formed in 1993. Our objective is to improve the quality of health care for patients in Scotland by reducing variation in practice and outcome, through the development and dissemination of national clinical guidelines containing recommendations for effective practice based on current evidence.”

http://www.sign.ac.uk/sign-112-management-of-attention-deficit-and-hyperkinetic-disorders-in-children-and-young-people.htm

The Royal College of Psychiatrists:

“The Royal College of Psychiatrists is the professional medical body responsible for supporting psychiatrists throughout their careers, from training through to retirement, and in setting and raising standards of psychiatry in the United Kingdom.

The College aims to improve the outcomes of people with mental illness, and the mental health of individuals, their families and communities. In order to achieve this, the College sets standards and promotes excellence in psychiatry; leads, represents and supports psychiatrists; improves the scientific understanding of mental illness; works with and advocates for patients, carers and their organisations. Nationally and internationally, the College has a vital role in representing the expertise of the psychiatric profession to governments and other agencies.”

https://www.rcpsych.ac.uk/healthadvice/parentsandyoungpeople/parentscarers/adhdhyperkineticdisorder.aspx

The Royal College for Psychiatrists in Scotland has produced a guidance document for ADHD in adults in Scotland.

http://www.rcpsych.ac.uk/workinpsychiatry/divisions/rcpsychinscotland/faculties/generaladultpsychiatry.aspx

Laura

Hyperfocus: The Superpower of ADHD

So while a lot of my blog posts have talked about the struggles us ADHD types face with focus, we also have an amazing superpower called ‘Hyperfocus’ that I want to tell you more about today.

Not everyone with ADHD experiences Hyperfocus, I do, and while it is often a blessing for me it can also be a curse for many others.

What is Hyperfocus?

Hyperfocus is the ability to focus intensely on a project or activity for hours on end, often leaving the person in their own world and oblivious to everything else around them. Usually this will be on a subject or activity that interests them, but it does not always mean subjects that they know about already, it could be something new that they discover and enjoy.

This could mean a video game, reading a book, painting, writing or a whole host of activities and varies between individuals- all that matters is that the person becomes interested in the subject intensely and devotes a great deal of focus and attention to it.

This is why I said in a previous blog post that many believe the ‘Deficit’ part in Attention Deficit Hyperactivity Disorder is slightly misleading, rather than a deficit it is more of a problem with regulating attention.

There has not been a great deal of scientific research carried out into the causes of Hyperfocus but it is thought that the same problem with low levels of dopamine that cause so many of the issues in other symptoms of ADHD can also be the cause of our Hyperfocus.

Dopamine is a neurotransmitter that is active in the brain’s frontal lobes and the low dopamine levels, typical of those with ADHD, could make it difficult for people with ADHD to switch tasks from something they find stimulating to a task they find boring or unnecessary, where others are more able to move onto something else.

Other medical professionals have argued that Hyperfocus is a coping mechanism and people with ADHD use it as a way of dealing with distraction as it can help them to accomplish tasks like completing an assignment (or writing a blog about ADHD).

My Hyperfocus

When I Hyperfocus, I tend to focus on my creative pursuits and interests or things connected to them.

For a period of time a few years ago, a friend and I used to enjoy making beaded jewellery and I loved buying bags of beads in all shapes and sizes and colours from bead shops and the internet. I made bracelets, necklaces and even tiaras in every shape, size and colour imaginable- even though I do not wear jewellery- and eventually I lost interest in this hobby (as is common with ADHD). I now have a huge plastic box full of beads in boxes and bags and last year I decided I needed to organise things in my bedroom so out came the bead box for me to put into order. As I will explain in a later blog about organisation, I need to order the items in my house in certain ways so that I can feel organised and so that my life is less chaotic and this bead box is no different. So I took out that box and for four hours I sat separating any of the bags of beads that had gotten mixed together into separate bags of colour and size and making sure the box was in order. I did not eat during that time, I did not go to the bathroom or check my phone, I just sat sorting the beads.

Similarly, I enjoy painting and drawing and if I decide I want to paint or draw something I will focus on it for hours on end, completely oblivious to the world until something or someone breaks my concentration or until I decide I’m finished.

I also display this same behaviour with reading and writing. If I decide to read a book then I must finish the book in one sitting and it does not matter how long the book is. This was one of the first areas of Hyperfocus that I identified in myself as I am an avid reader but the need to finish a book every time I started it would impact on my sleep- which is already poor- as I wanted to sit up and read it. The same issue exists in writing, if I start writing a piece for my publisher or something for one of my blogs (this one included) I can be lost for hours until I have finished it or I am interrupted by something more pressing.

I have my own theory about my Hyperfocus- that is probably not scientific but I do reflect on my behaviours very regularly. I am a creative person but do not always get to enjoy my creative pursuits as much as I would like to with a full-time job, motherhood and a house to run so when I do get the chance to pursue them, I go all out. I have dealt with this by limiting my reading of books until I am on school holidays so that it doesn’t interfere with other tasks that I’m supposed to do.

Some adults with ADHD have reported that they have missed important deadlines or meetings because they have been so focused on a task that they have lost track of time.

 Coping with Hyperfocus

If Hyperfocus is a problem, there are some strategies to help channel that focus more efficiently.

  • Schedule in Hyperfocus activities so that they do not take over from tasks that need to be completed.
  • Use markers to end the activity e.g end of a level on a game, end of a show or finishing a certain part of a painting.
  • Prioritize tasks so that common Hyperfocus tasks are left to the end.
  • Use a timer to help keep track of time.
  • Use family members or friends to call you or help you end a task so that it doesn’t take over.

While Hyperfocus has never been a problem for me, it can add to the difficulties that children and adults with ADHD have when fitting into this world, so teachers and parents should be aware of how it manifests in children and use strategies to help them use it to their advantage.

Sources

https://www.additudemag.com/understanding-adhd-hyperfocus/

https://www.healthline.com/health/adhd/adhd-symptoms-hyperfocus#3

 

International Success and ADHD

Following on from yesterday’s post about successful British people talking about their ADHD. Today I am sharing some words from successful people internationally who have ADHD.

Again, I have used their own words, rather than things that people have written about them as we learn more from people with ADHD talking about themselves than what other people say about them.

Despite the obvious success of the people I posted about yesterday and today, they all talk about challenges before their diagnosis. As teachers it is really important for us to listen to their stories and realise that we need to change the way we approach ADHD in the classroom.

 

Karina Smirnoff

Karina Smirnoff, from ABC’s “Dancing with the Stars” shared her story of finding out about her ADHD

“I’m an adult with Attention-Deficit/Hyperactivity Disorder (ADHD). I learned that the inattention, hyperactivity, and impulsivity that affected me as a child and into adulthood were, in fact, symptoms of ADHD.”

Howie Mandell

Howie Mandell is a Canadian comedian, actor, television host, and voice actor but is best known as the host of the US version of “Deal or No Deal.” He says of his ADHD,

“When I was in high school, my impulsivity led me to all kinds of acts
and pranks. I had trouble sitting still and could hardly focus or pay
attention in class. It wasn’t until I was an adult that I was diagnosed
with ADHD, I’m involved in the Adult ADHD Is Real campaign
because I want adults to know that it’s never too late to seek help for
ADHD. I hope that sharing my story encourages people to seek help. I didn’t
let ADHD prevent me from achieving my goals and neither should anyone
else.”

Michael Phelps

Michael Phelps is an American former competitive swimmer and the most decorated Olympian of all time, with a total of 28 medals.and he is also an ADHD success story. His mother Deborah is an advocate for her son and for others with ADHD:

“In kindergarten, I was told by his teacher, ‘Michael can’t sit still, Michael can’t be quiet, Michael can’t focus.’   I said, maybe he’s bored.   The teacher said that was impossible. “He’s not gifted,” came back the reply. “Your son will never be able to focus on anything.”

Michael himself says;

“I saw kids who, we were all in the same class, and the teachers treated them differently than they would treat me. I had a teacher tell me that I would never amount to anything and I would never be successful.

Growing up, I was someone who was constantly bouncing off the walls — I could never sit still.

I think the biggest thing for me, once I found that it was okay to talk to someone and seek help, I think that’s something that has changed my life forever, now I’m able to live life to its fullest.”

Justin Timberlake

Justin Randall Timberlake is an American singer-songwriter, actor and record producer and he also has ADHD and OCD.

“I have OCD mixed with ADD, you try living with that.

My earliest memories as a kid was I would always try to make my mom and my stepdad laugh at dinner. Or make my friends laugh in class. And I don’t know, it’s something I just really enjoy doing.”

 

Adam Levine

Adam Levine is an American singer, songwriter, actor, and record producer. He is the lead singer for the band Maroon 5

“I struggled with ADHD throughout my life. It was hard for me to sit down, focus, and get schoolwork done. My parents were patient and helped me, along with my doctor, to move forward with a treatment plan that worked.

My struggles continued as an adult. I had trouble sometimes writing songs and recording in the studio. I couldn’t always focus and complete everything I had to. I remember being in the studio once and having 30 ideas in my head, but I couldn’t document any of them.

So, I went back to the doctor to discuss my symptoms, and I learned that I still had ADHD. It was affecting my career the way it had affected me in school. I got the word out that ADHD doesn’t go away when you grow older.

If you were diagnosed with ADHD as a kid, you might still have it now. ADHD isn’t a bad thing, and you shouldn’t feel different from those without ADHD.

Remember that you are not alone. There are others going through the same thing.”

 

Will.i.am

William James Adams, known professionally as will.i.am, is an American musician, rapper, singer, songwriter, DJ, record producer, entrepreneur, actor, and philanthropist.

“I have ADHD; I admit it. I’ve got all these thoughts running around in my head at the same time as I’m doing other things. I can’t seem to stop or slow down. But the good news is, I know how to control it. For every obstacle, there’s some type of solution. So, if you have ADHD, it becomes your passion point to find ways to deal with it.

My ADHD makes it hard for me to focus on any one thing and to sit still. I’m always moving and thinking about a whole bunch of things. But those traits work well for me when I’m in the studio or coming up with creative ideas for songs or lyrics. If I were stuck at a different job, I’d be a horrible employee and wouldn’t survive.

I don’t control my ADHD with Ritalin, but with music. Music brings control to my thoughts. When I write music, I make order out of disorder. If you think about it, the songs I write are very ADHD-ish. They have five hooks in one, and it all happens in three minutes.

Music is my ADHD therapy and my straitjacket. It keeps me sane and keeps my mind focused.”

 

https://www.additudemag.com/will-i-am/

 

https://www.additudemag.com/adam-levine-adhd-is-not-a-bad-thing-and-you-are-not-alone/

 

https://www.verywell.com/justin-timberlake-reveals-he-has-both-add-and-ocd-3972107

 

https://www.healthcentral.com/article/its-adhd-awareness-week-celebrities-speak-out-about-their-adhd

https://www.si.com/olympics/2017/04/28/michael-phelps-opens-about-adhd-struggles-teacher-told-me-id-never-amount-anything

 

 

 

ADHD and Success: UK

While ADHD has its challenges and I have documented them well on here, ADHD can actually be a very powerful gift as some of our traits can be particularly beneficial in some situations.

Impulsivity might lead a child to call out answers in class but it can also make someone a quick and decisive decision maker and if they already have a lot of industry knowledge, this could make them a great leader in their chosen career.

The ability to hyperfocus on a special area of interest means that someone with ADHD can throw their heart and soul into a business if it interests them and give it their all.

In fact, people with other neurological conditions such as Dyslexia, Dyspraxia and ASC are also found to have these same traits. Youtuber Jessica McCabe of “How To ADHD” said recently in the TedX talk (I posted the video in an earlier blog- take a look) that “people with ADHD don’t think outside the box, we don’t have a box.”

When you live in a world that is constructed in a way that you just don’t quite get, you have to come up with solutions to get you through and many people with ADHD choose career paths that suit their personalities and interests (possibly why obvious symptoms of ADHD decrease in some adults).

With that in mind, I thought I would celebrate some the success of some well-known people with ADHD- but when I started to research this topic there were so many examples that this post would be about 10k words long!

So today I am writing about some well-known British people who have ADHD and that we don’t often hear about. I have shared their own words, taken from different publications (links at the bottom). Tomorrow I will share what some successful people from around the world have to say about their ADHD.

I hope you enjoy their stories.

 

Louise Mensch

Louise Mensch started off working in PR in the music industry before going on to publish a series of “chick-lit” novels. She is a former Conservative Member of Parliament and well known for asking very tough questions of Rupert Murdoch in the Parliamentary enquiry into phone hacking. She now works as a journalist and once tried to launch an alternative to Twitter.

“With ADD your whole focus is on what you are good at, which is why I loved politics but couldn’t keep my bedroom tidy. You are great at what you are good at, but incredibly scatter-brained when it comes to anything else. It’s the stereotype of the ‘absent minded professor.”

“It’s something a lot of creative people have.”

 

Trudie Styler

Trudie Styler is an actress, film producer and director. She is also the wife of the musician Sting.

“Those who have primarily the inattentive type of ADHD, rather than the hyperactive—most often girls—tend to be overlooked, because they’re well-behaved… You want to sit up straight, you want to do what the teacher asks you, you want to please people, but you’re operating in a fog a lot of the time.”

“What my learning difference has done is taught me to be a great communicator. My mother’s advice was always, when you’re lost, always ask a policeman, and there’s a bigger truth there. To reach out. To communicate. Help is always there.”

“Yoga has been an amazing tool for me. The physical practice has helped me maintain my body and given me strength, but the meditation aspect has been incredibly useful in stilling my mind, clearing the traffic that goes on in a chaotic mind like mine.”

 “I’ll put my hand up to taking Adderall on days when I have scripts to read. It’s a great tool for me getting a lot done.”

 

Louis Smith

Louis is a British gymnast who won a bronze medal and two silver medals on the pommel horse at the 2008 Beijing Olympics, 2012 London Olympics and the 2016 Rio Olympics respectively. He also won Strictly Come Dancing in 2012.

“I always thought I was a normal kid but my mum told me I was very restless. I couldn’t sit still and I was very loud.

Mum said I was always looking for attention too, and my behaviour got me into a few scrapes – people said I was naughty.

I remember once I went to a petting zoo with a summer play scheme during the holidays. I started pulling the hair out of a little pig. The people who were looking after the animals were horrified but I thought I was just a typical kid.

Sleeping was an issue for me. Mum said as a baby I never slept and I still have problems now. I tend to sleep better when I share a bed with someone else. When my ex-girlfriend used to stay over, I would get a good night’s rest.

I still get bored in the middle of the night though. Quite often, I watch TV, which I used to do as a boy. When I was at school I tried to turn the TV on quietly when everyone was in bed.

I started gymnastics when I was four because my mum thought it would be a good way for me to burn off energy and give me some discipline.

I was hyperactive so I did a lot of different sports such as football, basketball, hockey and climbing.

Being in a gym was a safe environment with coaches around to support me – if I wasn’t there, I would just be messing around in fields and climbing trees and my mum would be worried.

I got better and better at gymnastics but I was always getting sent out of training for bad behaviour. I started going more and more, until by the time I was nine, I was going five times a week.

I was seven when I was diagnosed with attention deficit hyperactivity disorder, or ADHD, and put on the drug Ritalin.

My mum always thought I was different, and one day she was talking to another parent at gymnastics training.

This woman said her son had ADHD and Mum said that sounded like me.

She made me an appointment with a specialist, and I was diagnosed with the condition. Nobody knew much about having ADHD then.

If you have it, you don’t understand the consequences. You think what you are doing is fun and move on – you don’t think of the effect you are having.

Even a few years ago, I would make a decision and only think of the real impact it had afterwards.

At the time, ADHD was just a name to me – I didn’t think I had anything wrong. It is only when you get older and look back that you think there might have been a problem.

Gymnastics taught me discipline and respect and overall, I didn’t get into too much trouble.

But I was still hyperactive and sometimes I would take a joke too far, but I didn’t get into trouble with the police and I didn’t drink or do drugs. I concentrated on my gymnastics instead.”

 

Billy Connolly

Billy Connolly, CBE is a Scottish comedian, musician, presenter and actor and is also known as “The Big Yin”.

Connolly has revealed how he used to think that he was stupid.

“I don’t anymore, because I’ve since found that there’s something wrong with me. I have this attention deficit thing. I have an inability to focus. Sometimes it’s so intense that I want to sleep.”

“People say it’s awful clever the way I’ll leave a story in the middle and come back to it later. No, it’s not. I leave the story because I can’t f***ing remember it. I’ll have had another thought, and this thought will spoil the story I’m on. So, I have to talk about the thought until it’s finished. That’s the way my brain works. I’m allowed to be like this on stage. And I’m very good at it.”

“People say, ‘You should get your head examined’. Well, I did and I was found wanting. I am attention deficit apparently, which is fair enough, I don’t care. I don’t feel any different from when I thought I was stupid. That was the diagnosis before.”

His wife said, “Everyone who knows Billy today is aware of his considerable, albeit unusual, intelligence. However, he does not process information the same way that many others do. Psychologists currently ascribe a diagnosis such as ‘Attention Deficit Disorder’ or ‘Learning Disability’ to such a way of thinking and, in the more enlightened educational environments, there is understanding and help for such children. Instead of writing his material down, and then performing it, Billy just rushes on stage and “hopes funny things will come out”.”

 

Ashley McKenzie

Ashley McKenzie is an English Olympic Athlete competing at the men’s 60 kg division of Judo.

“For as long as I can remember, I’d always been a naughty kid. Whether it was right or wrong, if I wanted something I would take it, if I wanted to do something, I’d do it.

Nobody thought there was anything seriously wrong with me though, and ADHD wasn’t obvious at that point.

I had physical health issues though. I’d been born with a hole in my heart and needed surgery when I was 18 months, and I needed hearing aids because I was 60% deaf in one ear and 40% in the other.

I also suffered from eczema and asthma, though they were mild. I had fits as a result of epilepsy which seemed to stop before I reached my teens and generally, I was a pretty fit kid. But by the age of 11, my bad boy ­behaviour was becoming a real issue.

It started with small things when I was about five. At home in London with my mum, dad and two brothers Aaron, 27, and Jack, 20, if someone ran a bath I’d just jump in it. It didn’t matter whether I wanted a bath, or if it was for someone else, impulsively I’d just have to jump in. My parents thought I was mischievous, but as I got older things got worse.

Then aged seven, I kicked some boy in the head and was expelled from school. Then I was excluded over 60 times from a new school in Hackney. At eight, I started getting into fights and flying off the handle all the time. It was so hard for my mum Susan because I was constantly being expelled from any primary school I went to.

When I reached secondary school, I got a lot of help from a teacher, Melissa Johns, but then I got sent to a special school for kids with behavioural problems. I must have had about 100 exclusion notes sent home with me from that school alone.

Finally, at 11, I was assessed and ­diagnosed with ADHD and placed on Ritalin, a drug which helps regulate ­chemicals in the brain, which I took three times a day. It really calmed me down and made me feel like a normal kid. The trouble was it also reduced my energy and made me tired all the time. It wasn’t a long-term solution.

I was still so violent and abusive, usually to other kids, that my mum agreed to have me placed inside a psychiatric unit for six months. She just couldn’t discipline me because I had no remorse. I didn’t care about life and had no fear of consequences

But it was an awful experience. If you were naughty they would put you in what they called the ‘cosy room’, which was basically a padded cell. The walls were really high with a security camera at the top, and the only air in the room came from a window with bars over it.

It just felt like being in prison and I ended up in the ‘cosy room’ a couple of times. I think my mum knew how horrible it was, but she did it for my own good.

I could go home for a couple of days at the end of the week and every time I’d have to leave her I’d cry and cry.

I just didn’t think a naughty boy deserved that much ­punishment. It just felt so wrong to me.

Then one day I got into a fight with a guy over Pokemon cards and he just threw me with a judo move. I was amazed and from there I joined the same club as him, Moberly Judo Club, in Kilburn, North West London.

I still had a temper and attacked other kids, but I never misbehaved when I was at judo. And as I got into my teens, judo played a big part in gradually calming me down.

When I started to get really good at it, judo gave me a focus for all my energy and anger. Even then, I knew, without it, I would have ended up in prison.

Judo made me change so much. Throughout my teenage years my mum would say: “If you behave for me all week, you can go to judo.” And that was enough to keep me on the right tracks.

Everyone could see how hard I was trying to keep it under control. And most importantly, when I started competing, I couldn’t take Ritalin any more as it was a banned substance in professional judo, so was a good way for me to stop.

I initially trained once a week, then three times a week, and within a couple of months I started competing in tournaments.

By the age of 19, I’d won the British Judo Open. From there, I went on to scoop both the judo World Cup and European ­Championships before taking part in the London Olympics 2012.

I missed out on a medal, but some of my pride was restored last year when I won gold for England in the Commonwealth Games under 66kg judo final in Glasgow.

The constant need for discipline keeps my ADHD in check, and I take supplements like whey protein and fish oil, which helps me to focus.

I’m ticking off the days until Rio 2016 and nothing, especially not my ADHD, is going to get in my way.”

 

Zayn Malik

Zayn Malik is an English singer and songwriter who used to be in the band One Direction and now performs by himself.

“Growing up I was pretty wild, I could never focus, couldn’t get a handle on where my brain wanted to go. I was constantly getting in trouble. Once, when I was at Tong High School, I was collared for a BB gun in class, It wasn’t loaded or anything, but me waving it around didn’t go down too well. I was later diagnosed by doctors as having super-hyperactivity — or ADHD as they like to label it.”

 

 

Sources

http://www.telegraph.co.uk/news/politics/conservative/10044694/Louise-Mensch-reveals-her-battle-with-attention-deficit-disorder.html

http://www.adders.org/news60a.htm

http://www.clevver.com/zayn-malik-adhd-diagnosis/

https://childmind.org/article/trudie-styler-on-adhd-and-dyslexia-dont-give-up-do-reach-out/

http://www.mirror.co.uk/news/real-life-stories/adhd-wrecked-life-until-discovered-5760391

http://www.mirror.co.uk/lifestyle/health/louis-smith-how-adhd-helped-2137169