Comments on: ADHD needs more than drugs to appropriately treat

By: Truce T. Ordona, M.D.

Truce T. Ordona, M.D. — Tue, 11 May 2010 15:34:38 +0000

I am an Adult and Child Psychiatrist working in a mental health center with a catchment area of about one million people. We just received a fouryear research grant by the NIMH to study and treat early onset psychosis.
One of the issues that distressess me is the issue of longterm outcomes of children misdiagnosed as “simple ADHD” as I see them in our center with serious and, often tragic outcomes.
There are 3 tiers of symptom and behavioral complexes associated with Bipolar Affective Disorders from childhood upwards The most common tier has 23, the less common has 19, and the least common has 4. In the first tier, one of the most common–and beguiling as well as misleading is the symptom cluster called ADHD. If the practitioner does not carefully solicit input from the school and the whole family, one can fall into the trap of treating the smoke (ADHD) and aggravating the fire: Cognitive, affective, and behavior disorders that can, in fact, be aggravated by CNS stimulants which, some practitioners treat with anxiolytics or atypical antipsychotics.
We all need to be more impeccable about our diagnostic formulations heeding the caution written by Ludwig Wittgenstein who said:
“The limits of my language mean the limits of my world.”

By: Lisa

Lisa — Thu, 29 Apr 2010 15:08:09 +0000

I also have adhd and I see both a psychiatrist and a psyhcologist. I made the choice to take medication and I believe it goes hand in hand with therapy. The medication helps me in so many ways, not just simply helping me concentrate better. Seeing a psychologist is a necessary part of treating adhd because there are adhd-related issues that only a psychologist can address. If a person with adhd just takes a medication, they’re missing out on part of their treatment.

By: Susan

Susan — Thu, 29 Apr 2010 12:05:45 +0000

As a psychologist who works exclusively with children with ADHD and autism and their families I want to thank Dr. Gold for this article. It would be terrific if more pediatric practices could bring in developmental psychologists into the practice to work with families such as the one she describes. We could help children and families so much more quickly and easily if all it required was a walk down the hall and a passing of the medical record, rather than needing to offer referrals and hope the family follows up and the therapist is available and takes insurance.

By: Bruce Ziebarth

Bruce Ziebarth — Mon, 26 Apr 2010 20:44:36 +0000

Steffan,
I whole heartily agree. As ADHD subtypes go, I have what they call “Ring of Fire” ADHD. Stimulant medications are necessary in my case to begin slowing my mind down. However, medication alone does not cover all symptoms. Non-medication strategies are necessary to alleviate all symptoms.

By: Bruce Ziebarth

Bruce Ziebarth — Mon, 26 Apr 2010 20:42:18 +0000

That was intelligent.

By: Bruce

Bruce — Mon, 26 Apr 2010 20:17:42 +0000

As a patient with ADHD, I enjoyed this post. However, I really think that… Oh, look! An airplane!!

By: Steffan Lozinak

Steffan Lozinak — Mon, 26 Apr 2010 02:41:10 +0000

As a person diagnosed with ADHD, I can honestly say I do not feel medication is the answer. In fact, I think medication is a bad thing to give to a person with this “disorder”. I feel ADHD, Aspergers, and Autism are all essentially just varying levels of the same mindset, and I don’t think actually thing there is anything “wrong” with people like this. I feel it’s a disorder as it removes order from things, but I feel society should be malleable enough to work well with people like this. It shouldn’t be the goal of society to make them fit in, so much as it should be the goal of society to work with everyone.

By: Bruce Ziebarth

Bruce Ziebarth — Sun, 25 Apr 2010 19:35:44 +0000

This article leads me with several questions. Initially, this doctor sounds like a pediatrician. You would expect a “medical” doctor to treat the problem and send the patient home.

Since I live with ADHD, I would say that it does take follow up visits. ADHD may be accompanied by many accompanying issues. Once, one symptom is learned to be dealt with there may be more.

The doctor eludes to the fact that patients do better with therapy. In my experience, this is the best treatment. If for no other reason then to provide another point of view. My doctor would not prescribe me stimulant medications. He stated that should come from a psychiatrist.

As I said, this article left me with more questions than answers.