Learning The Basics Of ADD Treatment

While I am not an expert on ADD--Attention Deficit Disorder--I do have it, have had since God only knows when, was not until my early forties diagnosed with it, and have in the past four years read up on and written on ADD and the options for ADD treatment. So I offer you some information as I have experienced it and as I understand it.

First, I must stress that though I don’t adore this disorder, I do appreciate it and prefer it over other disorders (if, like Vonnegut’s Harrison Bergeron we each must be saddled with one flaw of extreme degree, anyway). I am blessed with creative skills, have a reputation for being hyper-aware, cautious, and correct, and have a respect for challenged thinkers and learners.

I also will note that when I was first diagnosed, when my brilliant and life-saving therapist suggested I look into ADD and ADD treatment alternatives, I had been trying to understand what was wrong with the way I approached the world... to the point of conceding to having a behavioral problem and a subsequent or precedent drug addiction—to speed (street meth). So at the time of discovery and the blessings of a real name for the disorder, I had been twelve-stepping in recovery programs like Narcotics Anonymous, and was reticent about getting medical/chemical ADD treatment.

But after reading the best books, magazines, and on and offline articles on ADD and finding that 1) all those years of snorting crack pointed not to a rebellious adamancy to staying a dope fiend but to an authentic and savvy self-medicating effort; 2) I was not an addict who needed more and more to normalize; and 3) there are medications that are designed for ADDers that are BETTER than stepped-on street speed... I decided to take a look at available ADD treatments.

So here are the treatments I read about (or studied up on), as defined and described by the greatest ADD specialists in the country--David Sudderth, Joseph Kandel, Thom Hartmann, Sari Solden, Thomas Whiteman, Michelle Novotni, Kate Kelly, and Peggy Ramundo:

Biofeedback

Certain impulses and electrical activity in the brain that are typically involuntary, can be voluntarily modified. The ADDer, whose brain wave patterns are evidently different than non-ADDer brain wave patterns, is hooked up with electrodes (no pain). The ADDer sits facing a video screen/monitor, as the technician amplifies the brain's electrical activity. The resulting patterns appear on the screen, and the ADDer manipulates the controls of electronic devices to manipulate and take control of brain wave activity.

Behavior Modification/Cognitive Behavioral Therapy

You might already understand behavior modification as consisting of a system of punishments and rewards, each applied to reinforce positive behavior. For the ADDer, the disorder is as much about "unacceptable/inappropriate" behavior as it is about miserable feeling and unique thinking. There are approximately 69 symptoms of ADD, most of them behavior-based: perception of social cues is skewed; the ADDer interrupts/blurts; he/she has demanding difficulties with organization; he/she has trouble with time and timing; he/she is challenged by waiting; he/she cannot easily relax or enjoy leisurely activities. With behavioral therapy, which targets one or a few of such challenges at a time, the ADDer learns to "self-regulate."

Food Changes/Dietary Intervention

A close investigation of foods that are or contain allergens and irritants to the nervous system has revealed the possibility of ADDers being especially negatively impacted. ADD treatments in this area include eliminating or curbing intake of white flour, sugar, and/or additives/preservatives. But the controversy still roars on this one, and FDA and other regulatory bodies have not acknowledged the efficacy of gross dietary changes... yet.

Psychotherapy

A schedule of sessions with a trained and qualified therapist enhances one’s understanding, gives one a reflecting surface (human), and provides one with the social tools of communication (the give and take), self-improvement, and social protocol. Therapy is often recommended in conjunction with medication or other treatments, as one method compliments the other and one method’s weaknesses are compensated for by the others' strengths, and vice versa.

Medication

Taking pills is an abhorrent practice to some. To others, pills are a "crutch" we too easily lunge for when a hint of an ailment appears. But for those with a chemical insufficiency or imbalance, the replacement or stabilizing effects of external chemicals is a Godsend. Consider it this way, the way it was explained to me: when I was pre-ADD (before they identified the exact problem), I was severely depressed. (ADD and depression are bedmates, best friends.) I finally went [back] to therapy, seeing a doctor of psychiatry who volunteered at the clinic I visited every Friday. I rarely was awake and dry-eyed. I heard my own brain rationalize at least twenty times a day that after the walking, hiking, praying, writing, helping others, etc., the only solution was to kill myself. Not in any dramatic way, but as a utilitarian solution, as an out. After initial intake discussions, Dr. N. announced he would put me on Prozac.

Now, I was an NA veteran by this time, having been in recovery for over ten years. I was terrified of drugs (ironically, after being ruled over by them for so long). He explained, "So you’re walking down the nastiest part of town at 3 a.m.. You get stabbed. You don’t stand in the middle of the street with a huge gaping, bleeding, and painful hole in your chest, pontificating on the pros and cons of getting medical treatment. You have a hole in your heart. We are going to give you medical treatment for that."

Dr. N was right. And he made me laugh at my resistance and my philosophizing--as some are wont to do--about how horrible you are if you take a pill. So I take pills. I take Dextroamphetamine capsules, but you may go for something different... for different reasons:

• Amphetamines: the formula/dosage I take is perfect for me, for focus, for emotional and (ugh, yes, behavioral) control or balance or leveling or calming or whatever you wish. Interestingly, speed is perfect for this ADDer who is normally speedy (in action, thought, and blunder). It somehow counteracts, or does a reversing of the very properties it and the speedy one have. It has a half-life (lasting effect) of about 6 hours, and in the time-released form for me lasts over 12 hours. At the same time, I can eat, sleep, and do other things that a dope fiend on a bag of speed cannot... like have great sex, laugh, etc.
• Ritalin: Ritalin is one of the grandparents, the elders, of ADD treatment drugs. It is also still debated over constantly, especially with regards to children. (Do we dope every little imp that acts like a class clown or swings like a chimp on the jungle gym?) Ritalin is still mysterious as an agent for quelling ADD symptoms, but many swear by it for or despite its minimal side effects (weight loss, mood swings, and others) compared to its positive effects, which lend themselves to clarity, stability, patience (physical and mental focus), and other nuances I cannot speak to here. The half life is approximately four hours, but Ritalin also now comes in time-released pills, so the effects can be sustained for longer periods of time.
• Other more commonly used meds: Also in contention with the two most "popular" or most often used or most studied meds are the increasingly introduced Adderall; Cyclert; and some of the SSRIs and MAOs. As with all medications, with these and the others I describe from a personal (and not professional) point of view, you must research thoroughly before asking a doctor about one in particular, before, that is, committing to one. Each works in mysterious ways, still, and each works differently for and on each individual.

For me, the luck of history (of speed "abuse") pointed to the med, and the blessing of having been with a therapist for four years--both together--have become my [literally] life-saving grace. May you, too, be so blessed.