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Copyright: Dr. Erika Schimek 2013

ADHD - WHAT IS IT?

September 18, 2015

 

Helping kids reach their full potential is a passion of mine. One of my favourite conditions to treat is ADHD because there are so many great interventions to choose from and kids respond so well to treatment. Today I'd like to take some time to talk about each of these conditions and how they're diagnosed. 

Diagnosis
I wish there was some blood test that could come back as saying "YES! YOU HAVE ADHD." and it would be even better if this blood test then gave you the extreme specifics of how you would best benefit from treatment. Let's talk about testing in a minute, because first I want to talk about how these conditions are typically diagnosed. This revolves around a questionnaire as the main criteria, which may seem odd at first but most mental health conditions are not diagnosable in other ways. 
There are 3 subtypes to AD/HD: 

  • Inattentive type (what was referred to more commonly as ADD)

  • Hyperactive-impulsive type

  • Combined type. 

All of the subtypes have to have issues being observed in at least 2 environments, such as home and school; has to have been present for at least 6 months; some symptoms before the age of 7; symptoms that can't be explained by other mental health conditions; and has to be clearly impacting their quality of life. 

Inattentive Subtype
This is really what is sounds like. Poor attention to work, poor listening, inability to follow through with a task, trouble organizing tasks, avoids things that require sustained concentration, easily distracted, and is forgetful. 

Hyperactive-Impulsive Subtype
Fidgeting, leaves seat when it's socially appropriate to stay seated (like meal times or during work), runs or climbs excessively when it's inappropriate, difficulty with quiet activities, talk excessively. Looks basically like what everyone has come to associate with ADHD - as if you just chugged 4 XL coffees and followed it up with a redbull!
The impulsivity symptoms are: blurting answers before the question has been finished, trouble waiting for their turn, interrupts others. 

Combined Subtype
Just what you'd expect: most symptoms from both inattentive and hyperactive subtypes are present. 

One of the helpful reasons that we classify these subtypes is because it helps target treatment, which is where I come in. Different mechanisms are at play for each subtype!

Testing
There are so many different tests that you CAN do. Now I know that I said there isn't a blood test that says "YES YOU HAVE ADHD", but there are tests that look into how you process things or what your levels are of other things. ADHD can be caused by a multitude of deficiencies, exposures, or excess and ends up looking like ADHD. There are so many that it would be impossible to list them all - so i'll group them for you. 

  • Excess: heavy metals for one! Exposure to lead can look a lot like ADHD

  • Diet & Gut: this includes reacting to food on a small level, but this level builds up over time. Having a negative reaction to food can also cause local gut inflammation, which will eventually leak into other areas of the body. The brain is a place where susceptible people can get a lot of inflammation and start to develop mental health issues. Testing could include sensitivity testing or even just elimination diets. Assessments should also be made about the quality/content of food and if all the macronutrient requirements are being met.

  • Inherent mechanisms: poor processing of vitamins and minerals can lead to deficiencies of one item and excess of another.  Testing here looks into metabolites that gives us a bigger picture of what is going on and what isn't working right. Testing could include an Organic Acids Test such as those from Great Plains Laboratory, glutathione/detoxification pathway testing. 

  • Deficiencies: this is kind of included with the latter two items but can't be underscored enough. Items such as magnesium, folate, vitamin D, and zinc in particular should be assessed in anyone presenting with ADHD. 

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