Attention Deficit Disorder
Attention Deficit Disorder, widely known as ADD, is a brain disorder which many people suffer from daily. The symptoms described by three authors all go hand in hand, but ADD varies greatly from person to person and some may have completely different symptoms than others. The diagnosis of ADD varies in each author with their own technique. ADD treatment is a long debated and very rough subject, as the authors have different views. The authors express their outlook on the symptoms, diagnosis, and treatment. There are eight common symptoms of ADD.
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The carriers of ADD mostly have varying symptoms thus causing need for a different diagnosis and treatments. The best known symptom of ADD is inattention or distractibility. This symptom results in the sufferer being unable to sustain attention on a task or activity. This can greatly affect a childs education while in class and trying to pay attention to a boring teacher. The second symptom is impulsivity, meaning acting out before thinking. An example of an impulsive ADD action is a child jumping in a swimming pool forgetting that he did not know how to swim.
The third symptom is impatience. The word speaks for its self; the patient will desire something and strive to get it no matter what. The fourth symptom is hyperactivity. This is more prominent in males and causes kids to go off the walls. The next symptom is emotional over arousal. The result of this symptom is extreme happiness on the positive side, and extreme anger on the negative side. The sixth symptom is noncompliance. This is one of the worst symptoms because it can cause a sufferer to not follow rules, and lead to aggressive behavior including arguing and yelling.
The seventh symptom is social problems. The patient may have a difficult time getting along with others possibly because of being too intense, bossy, aggressive, and competitive. The final symptom of ADD is disorganization. Disorganization causes one to be forgetful, lose track of time, and lose things. These symptoms can all be caused by ADD but do not all have to be present in order to have ADD. The diagnosis of ADD is done differently from doctor to doctor. Thomas A. Phlenan, Ph. D, diagnoses ADD in an 8 step program.
The first step is a parent interview used to discover present problems, developmental history, and family history. The next step is the child interview. Third, behavior rating scales are done describing home and school functioning. Fourth, data from school, such as grades, achievement test scores, and current placement are all noted. Fifth, psychological testing for IQ and learning disabilities are sometimes done. Finally, a recent physical exam is used. (Phelan, 1993, p63)
Daniel G. Amen, M. D. s a different approach at diagnosing ADD. Amen uses an imaging technique called SPECT to measure brain blood-flow and activity patterns in the brain. He has found that the ADD brain is different, and depending on his findings, he can give appropriate treatments for ADD patients that were not helped by former treatments. (Amen, 2001, p72) Dale R. Jordan, author of Attention Deficit Syndrome, diagnoses simply by the symptoms after close evaluation of the patient in and out of the office (Jordan, 1988).
The three doctors all vary slightly in their diagnosing of ADD. Like diagnoses, treatment for ADD varies from author to author as well. Phelan believes unless there are contraindications for using stimulants, they should be tried for all ADD patients. The medication he has used is Ritalin, Dexedrine, Cylert, Tofranil, Norpramin, Clonidine, Tegretol, Lithium, and Mellaril. Ritalin, Dexedrine, and Cylert are all stimulants used to calm down patients in hopes to be more focused and more organized.
Tofranil and Norpramin are antidepressants Phelan uses in most cases where stimulants are not successful, when the parent does not want to use stimulants, or when stimulants benefits do not last long and need to be prolonged with additional medication. Clonidine is actually a high blood pressure medicine that has similar effects of Ritalin but takes a lot long to kick in. Tegrtol and Lithium are sometimes used in cases of extreme behavioral problems. Mellaril is sometimes used by Phelan where a child shows symptoms of ADD but may also be extremely aggressive.
Phelan, 1993, p112-3) Amen classifies six different types of ADD, each with a specific treatment. Type one is what he calls Classic ADD, it consists of the primary symptoms and is best treated by stimulant medication such as Adderall or Ritalin. He also found that these patients benefited from higher protein diets. Type two he calls Inattentive ADD, which consists of the primary ADD symptoms with low energy and motivation and is diagnosed later in life, if at all. The treatment is the same for Type one and two.
Type three he calls Over focused ADD which consists of primary ADD symptoms with cognitive inflexibility and difficulty with shifting attention. They worry, bear grudges and are argumentative. He prescribes an antidepressant, combined with a stimulant and a high-carbohydrate diet. Type four he calls Temporal-lobe ADD, marked by primary ADD symptoms with a short fuse, periods of anxiety, memory problems and difficulty reading. For this type he prescribes a combination of an anti-seizure drug like Neurontin, a stimulant, and a high protein diet.
The last type he nick-named the ring of fire. It features primary ADD symptoms with extreme moodiness, anger outburst, inflexibility, fast thoughts, and excessive talking. He gives these patients Neurontin, combined with antipsychotic medication such as Risperdal or Zyprexa. Amen quotes ADD is a multifaceted illness that usually responds to well-targeted treatment. (Amen, 2001, p72-3) Jordan differs from both of the previous doctors in the belief that medication and diet control need only be used in the more severe ADD cases.
His standpoint is to work with the patients who experience mild ADD instead of giving them medication. (Jordan, 1988) The biggest controversy over ADD is and always will be in the treatment of the disorder. People question the moral use of stimulants, anti-depressants, and high blood pressure medication to treat ADD. They worry about the side effects, allergic reactions, or just the idea of something unnatural in their body. The symptoms and questionable diagnosis and treatments of ADD are compared by Dale Jordan, Thomas Phelan, and Daniel Amen.