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ADD Smackdown

Posted Oct 14 2007 12:00am

EDIT: Apologies to any readers that have come by to read this post.  I was having a discussion with another blogger that necessitated me to check some links here and some have changed–thus requiring some further edits and notes.

Alright, this has been a real bugbear as it’s been sitting as a Draft for what feels like forever. And it may not even be fit to be written on several sheets of bog roll. And I think I need some more tea before I even attempt to look at again to “ADD” some more things?

So to open, what is the source or cause of ADD? Oh dear. What to say? Rather complicated to be sure.  It runs the gamut of so many theories. I’ve read a lot of things, some of which seem rather…interesting?

A genetic link, neurochemistry, smoking during pregnancy causing hypoxia resulting in brain injury/trauma, drug use during pregnancy, diet issues due to it/people being poor, children being “addicted” to milk caused by peptides that result in a poor ability to digest whey protein and lower levels of fatty acids in the body. Also, Sleep Apnoea and head injuries in general. I think the one that made me laugh truly was lead exposure during pregnancy! This was on some doctor’s blog. Unfortunately, the link talking about it resulted in a 404 error–no kidding, right? Can you say quack?

Now of course, all of these things have been unconfirmed but in my “esteemed” opinion, I prefer the two former? I suppose as far as genetics go, I think a lot of our head messiness can be passed on from other family members who are also mentally ill. There is also so much cross over between a lot of illnesses/disorders where again, there are strong genetic links that have been possibly shown. Neurochemistry? Well, the ADD meds seem to help a lot of people so a strong possible link there. And I’m a big fan of science so maybe my bias is showing.

Whoops! Better tighten my belt and pull up my pants a little!

Now, meet Dr. Daniel Amen. He’s rather interesting. He performs SPECT scans on your brain for “malfunctions” and claims that you can do several things to heal your brain and take care of it to get better. Lots of additional things besides meds–lots of “healthy” things. He’s also into some brain injury stuff as cause. He has rather a huge following and has been doing the scans since 1999. He’s also rather expensive…

He does have an interesting and fairly decent online self test here. It delves a bit into the types of ADD and areas of the brain where some things happen. He suggests some meds that may assist that he feels work best and also some natural and dietary solutions. The test also explains in some brush strokes about the brain areas and how they may function.

I did this a long time ago and in doing it again, I scored the same if memory serves. Except, for “Temporal Lobe: Not Probable” which is kind of ridiculous as I have a seizure disorder, although not defined as TLE (Temporal Lobe Epilepsy.) However, Topamax, the good ol’ Temporal Lobe drug, did a lot for my seizures but not quite enough. That tells me that something was probably going on there.

But whatever. I probably inadvertently scored myself lower as I’m on meds for some of those questions? Or Amen’s got it all wrong on his questionnaire. However, one thing that he did make clear in his results that is basically correct, is that girls who tend to have ADD Inattentive Type (me) and a lot of others as well, get missed in the diagnostic process. We’re just not so freaky hyper and more day dreamy and out of it. Nonetheless, we’re just as screwed up. Thanks Danny boy, for recognizing our little spaced out clan–much appreciated as half of the time we’re not listening anyway.

EDIT: I must stress something about Amen’s test and all tests in general.  Due to changing the dead link, I “tested” the test.  Also, you need to take a “Subtype Test” to get any “results.”  It came out incorrectly as per my actual dx.  So people, please do not take these things as gospel.  Also, I have removed another, second self test, as it now leads to a bunch of videos! Good lord!

Now, please meet Dr. Harriet Hall who wrote this on quackwatch.org. regarding Amen. Okay, now we’re getting into an ADD smackdown! She doesn’t like him at all.

I have a book called “Scattered Minds A New Look At The Origins And Healing Of Attention Deficit Disorder” by Gabor Mate M.D. Dr. Mate actually has ADD–as do his three children. Now, I love it when physicians admit that they have an illness and are open about it.

He has some interesting takes on causal factors. He isn’t opposed to any sort of genetic link but he is clear that may only be part of the picture. And he highlights that there is a difference between genetic predisposition and predetermination. This is certainly quite the obvious but perhaps sometimes people may think otherwise or forget due to the connection that they may seem to have and see with such frequency around them. He has some suggestions on environmental causes.

On the origin of ADD, he posits the idea of “attunement” with the primary caregiver (usually the mother) and infant. What this means (roughly) is that the infant bonds early and emotionally with the mother. Her actions, speech etc… reflect her internal mood states unconsciously. Anything that rocks the boat with Mommy may to mess up the kid’s head. And further it is the bonding and sharing of the emotional space that is most important with attunement.

This was tested with the “double TV experiment” as Mate calls it (apologies, I can’t find any links other than abstracts.) What happened was, the infant was shown a live feed of the mother interacting in a positive and happy way. The infant responded favourably. Within about a minute, it was played back and the infant responded as negatively or unfavourably as a mother with a “flat face,” (i.e. no positive response.) So basically, the infant needed more than happy, visual signals.

Further, the mother can’t fake it either. Due to “emotional sensory radar” that has not developed or been “scrambled” as Mate states, they pick up the false positive signals from the mother. This probably makes sense in a developing brain? Early brain formation and development is extremely plastic when younger. As an infant, with no other communication skills and a brain that is just in its infancy…it would just absorb everything like that on a different level? As adults, our “radar” has evolved and changed–along with our ability to communicate and process that communication. We can miss the cues all the time in our degrees of perception.

With attunement, the infant basically leads the “dance” as it is often called. It’s not like the mother can control the infant’s behaviour and its need for attunement in the symbiotic, emotional connection that it is. The mother needs to respond to the infant in appropriate ways based upon the infant and how it behaves, what it does etc… A stressed, anxious mother may lead the infant to not be able to understand or pick up the cues. Also, if the attunement is broken off with the infant and the mother tries to push, it can lead to too high arousal levels in the infant and that causes problems. Either way, the dance is completely thrown off.

Now, I believe the key to the issue of the arousal levels being thrown off as he mentions is that the infant brain doesn’t get a chance to “cool off” before the attunement “dance” repeats the cycle. The kid’s brain is still a bit hairy and not ready to “readjust” to start leading the dance again.

Theoretically, without proper attunement, people grow up to feel alone, isolated and that no one understands them. Attunement is the beginning of a larger issue called Attachment. That is the feeling to belong and a need for closeness to other people. These are some of the issues that people with ADD face–so says Mate. And the “Attunement/Attachment Theory” really isn’t new. Mate is simply applying it to ADD.

Okay, I sure feel alone, isolated and that no one understands me! Well, maybe they do but I don’t understand them? Or…erm… Nevermind. Well, I know I don’t understand myself. Okay, on with more Mate.

I found an interview with Mate online that further fleshes things out past the infant stage and how to “heal” ADD. This is good because the book is 323 pages long as I sure as hell couldn’t read it to write this post. You’d be waiting for ages! Crap, I’m just moving on from Dr. Seuss and getting back to reading newspaper articles. That I haven’t been able to do for months.

So as things move on, Mate still stresses that environment is still key. It’s not like after the attunement process with the infant has been completed (or rather screwed up) with your ADD kid that’s it, over, finito, bye bye. You need to create that proper environment in order to treat ADD symptoms. He states that emotional self-regulating circuits can still develop in childhood and even in adulthood. So, provide the right conditions, create development, ADD gets better–or it can.

Okay, maybe I’ve smplified things but that’s more or less it. But fear not. He isn’t anti-med.

And of course, the book is filled with all sorts of other things about ADD. Discussions with patients, lots of observations and insight to the disorder. Mate certainly understands it. And I certainly will not disagree that children with ADD need nurturing, supportive and (further to the attunement theory) a non-stressful environment to grow up in.

I’ve found it a rather good and interesting read. And I do also find his theory about attunement, attachment, infant development and ADD interesting as well. Boy, I sure know that my mother was a mess when I was an infant. There may have been a possibility of Postpartum Depression going on there? And her own mental illness(es) for sure. But I don’t know…I was just a baby. Who may have never received proper attunement from her!

But before I close, an interesting line about how he closed “Scattered Minds…”

If we can actively love, there will be no attention deficit and no disorder.

Well. At the end of the chapter there is mention about extending oneself to others or oneself in order to nurture on the basis of M. Scott Peck’s writing in “The Road Less Travelled.” On this basis, it is a difficult thing to do and particularly difficult for ADD adults. But I do find the above a rather interesting statement and it sort of makes me chuckle a bit.

Indeed, Dr. Mate…if there were more love in the world it would be a better place…

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