We see depression leads to difficulty with concentration
PEORIA - If you spend time on social media, chances are you’ve seen an ad asking, “Do you have ADHD?”
The ads lead to a self-diagnosing quiz and often provides viewers with misconceptions about attention deficit hyperactivity disorder (ADHD), before they ever see a medical provider.
That’s where Kyle Boerke, PsyD, director of Behavioral Health Outpatient Services for OSF HealthCare, hopes to provide clarity.
ADHD starts in childhood, not in adulthood
“Are adults being diagnosed with ADHD? Absolutely, yes. Is it that they are developing ADHD in adulthood, that’s a no. We know enough about the research, that in order to receive a diagnosis of ADHD, we have to have symptoms starting in childhood. Somewhere near 7 years of age,” Dr. Boerke says.
If you’re having symptoms as an adult that appear to be ADHD, such as lack of focus, inability to sit still, fidgeting, or excessive talking, but you didn’t have these symptoms as a child, Dr. Boerke says you may be experiencing something else.
“We see depression leads to difficulty with concentration,” Dr. Boerke says. “Something inside of them will ring true (if they have ADHD), like if they always struggled with paying attention to their teacher in elementary school.”
What to do about an ADHD diagnosis?
“The easy answer is, we need to seek treatment from a professional,” Dr. Boerke says. “If you have thoughts that you’ve had ADHD symptoms for a long time and you take one of those online quizzes, that’s fine, that can be a starting point.” But he stresses, “I wouldn’t take that quiz and all of a sudden say ‘I have ADHD.’ A great place to start is with your primary care physician.”
Dr. Boerke adds that there’s no official test for ADHD. It’s a whole set of symptoms that include how it’s impacting your daily functioning and for how long.
There are three types of ADHD1: Predominantly Inattentive
“They’re not going to be jumping all over the place, moving from activity to activity,” Dr. Boerke says. “It’s just going to be some hard times focusing, concentrating or finishing a task because your mind gets switched over to a different task all of a sudden.”
2: Predominantly Impulsive/Hyperactive
“These are the kids that just can’t sit still. They’re up out of their seats in the classroom, and this is really where ADHD in children to adults’ changes,” Dr. Boerke explains. “As we age, we do a better job managing the motoric end of things. It’s not uncommon to see kids have a hard time sitting still, it’s more uncommon to see somebody in a business meeting get up and walk around the room.”
3: Combined Presentation
Dr. Boerke describes the third type this way: “You have inattention, plus you have hyperactivity and impulsivity,” Dr. Boerke says.
Do I need to take medicine if I have ADHD?
Dr. Boerke says medicine alone isn’t the answer.
“The analogy I’ll use is Bear Grylls from Man vs. Wild. He’s an adventurer on a TV show where he goes out into the wild and he has to survive for a number of days,” Dr. Boerke says. “I liken ADHD to being on a Bear Grylls survivor show. He can do it. ADHD management without medication is like Bear gets dropped in the middle of the Florida Everglades and he has to trudge through the swamps, battle the alligators, get past the snakes and manage to get out. Can he do it? Yes, he does. Is it easy? It sure isn’t.”
Dr. Boerke says ADHD medication is as if Bear Grylls was in the Florida Everglades and producers drop him a rescue boat.
“But the reality is, he still has to get himself into the airboat. He has to start it, steer it, and do the work. It’s just easier to do the work,” Dr. Boerke adds. “Medication is not the fix. It can help, but if you don’t change your lifestyle, put in some organizational tools and do the things necessary, we’re still not going to get better and you’re going to rely on the medication.”
If you’re an adult and think you have ADHD, Dr. Boerke says seeking medical attention by a professional is the best first step. Then, your medical provider will help map out a plan moving forward. This can include ADHD medication and working to keep a strict routine to help you manage any ADHD symptoms.
ALTON - Helping children feel comfortable in their home will lead to healthier and more successful times during those formative years. But it’s easier said than done, especially for non-traditional families. That’s why Jill Schreiber, LCSW, Ph.D., an OSF HealthCare psychotherapist, is making parents aware of resources and best practices.
Defining caregiving
Dr. Schreiber says while families look different across the world, in the United States a traditional family is seen as a mother, father and children. A mom and dad with adopted children would also fall into this category because the kids are a permanent part of the home.
A non-traditional family is any unit that falls outside of the traditional definition. Examples include parents who have divorced and re-married other partners, grandparents caring for kids, two moms or two dads in a family, adults co-parenting and children in care. Dr. Schreiber says children in care is the modern, accepted way of describing foster children, or children who are in a home temporarily. The adults are simply called caregivers, not foster parents. Dr. Schreiber, herself, is a former caregiver to children in care and a parent of adopted children.
Establishing routines
Dr. Schreiber says routines allow life to be “less chaotic and more predictable.” Settling into routines will take time. But Dr. Schreiber says when a child enters a new home, it can be scary. So having some structure right away is a good idea. Talk to the child about when it’s time to sleep, eat, do chores, do homework and have play time. For example, run through the morning routine – getting out of bed, having breakfast, getting ready in the bathroom and heading to school. Same for the wind down at the end of the day.
Keep in mind that there’s no one-size-fits-all approach. Certain parts of the year, like back-to-school season, are busier. Kids with attention deficits, for example, may need more help sticking to routines. A child who always got dinner from the gas station may not know what setting the dinner table is all about.
“Adjusting is constant,” Dr. Schreiber says. “Kids continue to evolve, develop and get older. You quit having naps, for example. You have to develop new routines as you go along.”
As the child adjusts, it’s good to review successes and struggles to modify expectations. Routines also may be different in different homes.
Don’t forget the essentials
While it may not fit the definition of a routine, Dr. Schreiber says non-traditional families should also have essentials for their children. Those things we take for granted are just as important to make the youngsters feel comfortable: working heat, air conditioning, plumbing and lights; safety items like smoke detectors; keeping items like guns locked away.
“It’s helpful for kids to have their own space, and it’s helpful for kids to know where their space is,” Dr. Schreiber adds.
“Kids who have come into care often come with garbage bags of their possessions. That’s such a tough symbol for children to feel like their stuff is garbage. So, to help them put their stuff into drawers or onto shelves is a really important step to show their value and connection to the family.”
Resources for parents
Parents who need help setting up routines can talk to a mental health professional, read a parenting book or take a parenting class. There are also “parent networks” like online forums where you can exchange advice. Those informal “networks” could also take the form of bonafide support groups. Your state’s child welfare agency may also offer tips. In fact, caregivers of children in care must undergo formal training from an organization like that.
by Matt Sheehan
