Delivered from Distraction – Preface to the New Edition

Delivered from Distraction – Preface to the New Edition

delivered from distraction getting the most out of life with attention deficit disorder by edward m hollowell md and john j brady md boy whatever you is and wherever you is don’t be what you ain’t because when you is what you ain’t you isn’t uncle remus preface to the new edition since the publication of this book in hardcover various issues have come up that dr rady and i would like to discuss here more than ever we are convinced of the absolute necessity of a positive strength based approach to the diagnosis and treatment of attention deficit disorder all too often a mine’s chief disability is fear and fierce cousin shame can also make a menacing damaging appearance when the diagnosis of add emphasizes first and foremost what is wrong with the person that person immediately starts to see himself in those negative terms shame fear and self-doubt grow like the powerful weeds they are choking out the positive vines and flowers struggling to find their way to sunlight the traditional medical model emphasizes pathology what is wrong in sick and in need of remediation remediation remediation remediation however when applied to the mind this approach can do a good deal of damage the kidney doesn’t care if you call it sick but the mind does if you tell a person that she has a mental disorder you create a mental disorder not only in the patient but in those who love her as well the disorder is fear chronic fear holds more people back in life than any other mental infirmity how ironic and wrong that the helping professions all too often create this problem the strength-based model which this book explains in detail emphasizes first and foremost the search for what is good and strong and healthy in a person then secondarily what is in need of remem remediation first look for the strengths look for strengths and talents or potential strengths and talents then and only then take stock of what a miss what is a miss this method leads the patient down one of the most important avenues of treatment to development of mastery by mastery i do not mean that a person becomes the best at something just that he experiences the wonderful feeling of making progress rather than feeling constant frustration by tenderly cultivating those tendrils and buds of an interest or talent a person can blossom and achieve mastery then he is on it then he is on the way to a better life our emphasis on promoting certain life experiences mastery interpersonal closeness or connection practice and discipline play physical exercise imaginative engagement with life the development of a creative outlet and others separates what we recommend from the usual intervention that is offered which is sad to say to diagnose and medicate the comprehensive strength based plan outlined in this book certainly does not preclude the use of medication medication remains a mainstay of treatment it may not always be necessary but when used properly it is safe and effective two upsetting reports from the world of medication deserve [Music] two upsetted reports from the world of medication deserve mention not long after the release of this book in hardcover health canada the national health authority ordered adderall xr off the market because in years past a few sudden deaths had been reported in people taking the drug naturally this caused a great scare in both canada and the united states the reason the u.s federal drug administration did not follow canada’s example is that a close inspection of the data revealed that the people who died suddenly were all either in severe physical distress or had underlying cardiac anomalies both of which are risk factors for sudden death regardless of whether or not one is taking adderall xr furthermore the percentage of sudden deaths among people taking adderall did not differ significantly from the percentage of sudden deaths in the general population in the summer of 2005 health canada reviewed the data and decided to reverse its prior decision to pull adderall off the market now adderall xr is available through health canada what is to be learned from the episode even that is not clear here is what occurred to me responsible experts can disagree on scientific topics lobbyists both for and against medication can influence a scientific decisions deaths while dramatic should not always be blamed on a medication a person took prior to to dine no group or agency no matter how powerful or exalted has a lock on the truth in this information age the public can expect experts to tell us that something is true one day and that it is false the next such shifts do not reflect incompetence or a conspiracy they reflect the lie the ability of empiricism appears empiricism empiricism another report came out of md anderson cancer center a highly respected medical institution in texas which stated that a series of patients who started on ritalin experience chromosomal damage chromosomal damage the study awaits replication with a large sample of patients however a close inspection of that study suggests a major flaw the baseline data that is the data gathered before the subjects took ritalin showed few or no chromosomal abnormalities this is extremely suspect abnormalities are found in the blood cells of just about everybody therefore the damage experienced after taking ritalin may have already been there before the subject started on ritalin it just had not been noticed in earlier observations the new medication straterra held great promise a year ago as it is not a stimulant is approved for use in adults is not a controlled substance is not associated with ticks or most of the other side effects of stimulants and is active throughout the day without peaks and valleys however both dr rady and i and most of the practitioners to whom we have spoken find it not as effective as hoped with stratera it takes weeks to reach a high enough dose and the drug often fails to effectively relieve symptoms and carry some burdensome side effects in september 2005 the food and drug administration issued a warning that suicidal thoughts may be a side effect of taking strotera although this side effect is extremely rare affecting less than one half of one percent of those in the study the finding was statistic statistically significant this should not preclude the use of strategy but it does point up the necessity the necessity of close monitoring of any person who takes this medication we have found wellbutrin to be a more useful non-stimulant while medication remains a safe and effective component of the treatment of add the search continues for safe and reliable alternatives the best of these by far ought not to be considered an alternative at all the identification and systemic promotion of talents and strengths also crucial and our exercise diet sleep meditation or prayer coaching restructuring of the environment finding the right school or job and finding the right social group or mate we continue to be impressed with two treatments first mentioned in the hardcover edition of this book supplementing the diet with omega-3 fatty acids as from fish oil and can help not only one’s health in general but the moods and symptoms of add in particular we await further research confirming this finding but anecdotal evidence suggests it is true what has also proved helpful to many people who have add as well as people who have dyslexia or problems with coordination dyspraxia is physical exercise specifically designed to stimulate the back of the brain or the cerebellum the method also awaits further research but anecdotally it was proven useful although not always and not for everyone i have recently become more interested in neural feedback and alternative treatment that has been around for years i have studied with one of the leaders in the field dr barry sturman of ucla and have seen the excellent results neurofeedback can produce the patient hooks up to an electro encephalograph a machine that records brain waves and then learns how to modify his own brain waves to induce a state of focus rather than a state of distraction many patients have had such good results that i plan to get trained in the technique and offer it as a treatment myself i will do so however with the caveat that one of the leaders in research in add russell barkley mentioned in a recent article dr barkley warns that as of yet research does not document the efficacy of neurofeedback as an add treatment if a person wants this form of treatment he should get it with full awareness that it may not work it is time consuming and expensive and its positive results may be transient taking those cautions into account i still want my son to get this treatment it will not do him any harm and anecdotal evidence suggests it may help him a great deal on this my colleague dr rady and i do not agree so as you see when it comes to alternative treatments there are responsible alternative points of view as an alternative 12-step programs are usually not mentioned in association with add they should be people who have add too often use alcohol or drugs as a means of scratching the itch at the core of the syndrome the fellowship found in alcoholics anonymous for example fills that need aa remains one of the greatest self-help programs ever devised since so many people who have add struggle with issues of addiction substance abuse or simply too frequent self-medication it is worth re-emphasizing how much a good how much good a 12-step program can do the media continues both to help and to hurt that cause the cause of people getting the help they need not only with add but with mental health issues in general tom cruise famously lectured matt lar on the dangers of medications and the full-hearted hardiness of psychiatry in general it is terrible terribly sad to think that some people may not get the help they could simply because a movie star has scared them away from what psychiatry has to offer on the other hand dr phil who has been doing remarkably good work and getting high ratings no easy trick has been advocating a comprehensive and balanced approach to treating add endorsing the use of medication when it is appropriate but cautioning against diagnosing every rambunctious child with add and recommending that education and counseling be part of the treatment regardless of the diagnosis he has brought useful knowledge to millions while i disagree with him on some points dr phil’s general thrust is positive and of tremendous value in helping break down the walls of stigma that have for long separated people from the life-changing help now available most of those who are not getting that help with their add are adults adults with add remain the great undiagnosed group we emphasize adult add in this book and hope that if you know someone who might be helped by this diagnosis you slip her this book or give it to her spouse finally if you are someone picking up this book wanting to learn about this add thing for the first time welcome you may be embarking on a dramatic journey that will better your life or the life of someone you love add is a good news diagnosis this diagnosis leads to major turnarounds and improvements this journey starts with hope but it ends in reality in concrete measurable benefits good luck to you as you take this journey with all warm wishes and high hopes edward m ned hello md norfolk connecticut august 2005.
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Delivered from Distraction - Preface to the New Edition

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