Thursday, January 19, 2012

Wearing “ADHD Eyeglasses” with Care


Maybe this has happened to you. As soon as you started learning about ADHD, you suddenly saw it all around you. No, it's not that new people with ADHD suddenly started popping up in your midst; rather, you started seeing oh-so-familiar behaviors in a new light, through the lens of ADHD knowledge.

Thanks to 21st century brain-science breakthroughs, we’re developing enlightened attitudes about the organ linked to everything we do, feel, or think: the brain. Yet resistance remains, so we can't expect everyone to openly embrace what, after careful study, we've come to accept: ADHD is real, it is more common than anyone knew, and, when left unacknowledged, ADHD symptoms can limit the options and self-realization of those who have it—and their loved ones, too.

Is there a parallel in history, when knowledge that promised to vastly expanded human potential somehow gained acceptance only slowly and amid great opposition? Yes indeed, and now we can’t imagine how our ancestors didn’t immediately “see” the benefits of one such invention: eyeglasses.

Eyeglasses debuted in the 13th century, though crude attempts date back to ancient Rome. It took a few hundred years to perfect the design but much longer to erase the stigma. That’s right, the stigma from wearing eyeglasses. To avoid making “spectacles” of themselves, many people preferred stumbling around.

These days we call eyeglasses “eyewear”—chic accessories for those who need them and vanity items for some who don’t. Eye exams take place routinely, and nobody questions the necessity of "vision correction." More relevant to our analogy, no one suggests that if you can’t see well enough to read then you’re probably not smart enough to understand what you’d be reading. Three cheers for progress.

Vision: A Function of the Brain as well as the Eye

The example of eyeglasses offers a practical application in explaining ADHD. Consider this fact: Vision is only partly a function of the eye. Yes, the eye receives sensory input in the form of light hitting the retina.  But those light patterns are then converted into electrical signals, which travel along brain pathways to a visual processing center. That’s where your brain tells you what you’ve seen and makes sense of it. Or doesn’t.

For some people, no set of eyeglasses will help to correctly process all that they are seeing. For example, some individuals with ADHD might see the words on the page perfectly but not remember their meaning or how to put them in context. They might see a car traveling in the oncoming lane but fail to process accurately its speed and whether they have time to turn left in front of it.

Other sensory difficulties can arise with ADHD, too. The brain signals relating to hearing, touch, taste, and smell—even the respiratory and cardiovascular systems—can also become “lost in translation” on the journey to the brain centers that process them. If you have trouble grasping this concept, you're not alone; many physicians don't understand it, either. Which might account for why they fail to see untreated ADHD at the foundation of so many conditions presenting in their treatment offices: obesity, restless legs syndrome, sleep apnea, diabetes, hearing disorders, and so forth.

As exciting as you might find your newfound ability to detect possible ADHD symptoms all around you, thanks to your new ADHD Eyeglasses, you might want to stifle the common temptation to start “diagnosing” loved ones and acquaintances or that fidgety guy ahead of you in the grocery check-out line. For one thing, you might be wrong; only a trained professional can make a diagnosis. More critically perhaps, you could be right.

Certainly, many might welcome your observation with gratitude, relieved to finally understand why their lives often seemed unnecessarily frustrating.  Others, however, will greet your news with defensive walls that, once erected, might remain immoveable. Either way, the manner in which you initially share your insights can dramatically affect outcome.

Many People with ADHD Cannot See They Have it

What’s more, no matter how clearly you start seeing ADHD, it’s important to know that many people with ADHD might not see things the way you do.

The person with weak vision may not realize what they’ve been missing until trying on eyeglasses. Personally, I’ve gotten a shock when I've neglected to remove my reading glasses before ambling into the kitchen. (And here I'd thought the counters were spic ‘n’ span!) Likewise, a person with undiagnosed ADHD knows only the way life has always been. Moreover, the very “brain wiring” associated with ADHD symptoms can impair people’s ability to accurately see themselves or you.

Let’s hope it doesn’t take society much longer to start seeing that ADHD symptoms, left unaddressed or even unrecognized, can hinder individuals from accurately perceiving the world and finding a fulfilling place in it. Moreover, just as a loved one’s ADHD deficits can distort their self-image, it can also distort his or her image of loved ones. Who wins in a world full of misperceptions and distortions?

                                                               --Gina Pera

A note to this blog's readers. I apologize for my unplanned hiatus. Look for monthly posts again now.

I welcome your comments!

25 comments:

  1. I am just glad ADHD explains the "misperceptions and distortions"....and it is not all me that has distorted the self-image of loved ones. How I will continue to be perceived is entirely another issue.

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    1. What a great concept to use visual impairment as an analogy to understand ADHD! I enjoyed this, Gina! I certainly remember being judged by my eyeglasses (nerdy, awkward, unattractive) as if nearsightedness was a reflection of my poor choices, laziness, or bad parenting! ADHD, like other brain glitches, is an "invisible disorder", and therefore even more likely to be judged unfairly. We just need to keep speaking up and educating people to understand that our brains do not all process the world the same way! Sensitivity and tolerance come through education and understanding!! Linda V.

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    2. Hi Jacky -- I hope that perceptions become more clear for you and your loved ones.

      Hi Linda - Thanks. I'm glad you like the eyeglass concept.

      How unkind was that for people to judge you by your glasses. :-(

      That's more evidence to me that humans don't like to think and they let their impressions be overly influenced by appearances. It takes a lot of cognitive strength to tell ourselves that our eyes are lying. ;-)

      You also remind me, a friend's daughter whose ADHD wasn't recognized for several years also struggled with eyeglasses. I felt so sorry for the little thing. She had such trouble keeping those glasses on, and they were always horribly smudged. Her mother meant to be patient but she'd end up scolding her for her glasses slipping down her nose. Poor kid!!!

      I've often wondered if sometimes ADHD is so severe or so localized (for lack of a better term) in the brain that it greatly impedes visual processing (as I suggested in this blog post). I wonder how much ADHD medications can minimize these vision problems. And I wonder if opthamologists have any clue about this.

      Thanks for your comments....

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  2. Hi Gina,

    Thanks for the different points of view & observations. I feel as though I could be the poster child for Adult ADHD. I wouldn't doubt that visual processing is effected by ADHD. There are times when I can see clearer than others. I just don't know how it's affiliated with my meds. I also am afflicted with fun things such as sleep apnea, RLS, being perpetually overweight (not what I would consider 'obese', but I'm definitely about 40lbs over my BMI target. All I know is, I'm afraid that in my lifetime the effects & reality of ADHD, will not be realized fully. And people like myself will continue to have their lives in complete disarray & chaos, to a point that their families & friends won't have anything to do with them, and even their marriages will be destroyed in front of their very eyes, and they just can't understand why. It's sad, but it happens...I know!

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  3. Hi Mike,

    It surely does happen -- and happen too often. And it's beyond sad; it's a tragedy of epic proportions.

    On the bright side, we have learned a tremendous amount about ADHD and its treatment strategies. We are also learning a great deal about the effect of nutrition, exercise, and other lifestyle changes on brain function. In fact, never in the history of mankind have we had such resources at our disposal. The trick is in making use of them when you're disorganized, confused, and sleep deprived.

    You've gotten a diagnosis, found information sources such as this blog....you're ahead of many, Mike. I hope you continue to progress on your path to a healthier, happier, life.

    g

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  4. Hi Gina,
    Thanks for getting back on the Blog cycle! This is a good one!
    :)
    Mary Kay L. (from ADDpro...)

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  5. Hi Mary Kay, :-)

    You're welcome and thanks.

    Last fall was a demanding time for my CHADD-related volunteer work. For example, I wrote an article for Attention magazine featuring four "as told to" stories of late-diagnosis adults with ADHD.

    I really wanted to do that piece to show the wide-ranging effects of late-diagnosis on individuals' lives. Also to show that people with ADHD are, in fact, individuals, with often very different issues, strengths, challenges, etc.

    I think the stories turned out very well, especially the design format. And I am so grateful to the interviewees for their generosity and forthcoming attitudes.

    Also, the CHADD conference in November required some planning and time -- I gave a pre-conference institute with Dr. Arthur Robin and presented at the main conference on "ADHD Symptoms or Late-diagnosis Coping Strategies?"

    Plus, I participated in the CHADD fundraiser: "Lunch with Luminaries," where four ADHD expert/notables (Chris Dendy, Rick Green, Ned Hallowell, and I) enjoyed lunch with the highest bidders (the auction was quite exciting!).

    The "luminaries" switched tables every 15 minutes. I don't recall having time to eat, but I greatly enjoyed talking with these great supporters of CHADD.

    By the time I got home, I was exhausted. Not to mention the rest of my life requiring my time, including leading the Silicon Valley chapter of CHADD. ;-)

    But I promise to post monthly for the next year. All suggestions for topics are welcome and appreciated!

    Gina

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  6. Hi Gina, I found your link on ADDerWORLD.com, and I love informative blogs. May I please put a link to your blog on my blog list? You can go to (www.abbieaw.blogspot-dot-com)to see. Thanks for all the work you put into supporting (us). : )

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  7. Hi Abbie, Of course, please do!

    I enjoyed your piece about "kitty hoarding." Great topic. ;-)

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  8. I was late diagnosed - in my fifties - and one the most remarkable things about my experience of medication was the insight it gave me into ADHD in action. For a few brief minutes, at the point when the Ritalin started to drain out of my body and the task I had been engaged on turned from easy to almost impossible, I would get an insight into exactly what part of that task, and what skill it was that was draining away with the medication.

    I always knew I had difficulties, but, until I had the 'spectacles', I could never, even after decades of struggle, pin down what it was that I was or I was not doing, or what it was about the environment I was in that so interfered with my efforts.

    Now I have a much better idea of what I can do and when I can do it and a much greater understanding of why I find some environments so difficult.

    Excellent post. Thank you.


    Love


    Peter

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    1. Thank YOU, Peter. Your eloquence conveys the phenomenon perfectly!

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    2. I have felt that I go in cycles. I do really well for a while and then all of a sudden everything seems complex. I always feel that I am seeing everything different and the cognitive dysfunctions keeps me in this place where I can never quite be successful. I was not diagnosed until I was in graduate school. I thought I was crazy up until then. I am not sure if my medication works anymore. It did in the beginning for sure..all of a sudden everything stopped and I could stop running. I feel now that I will never meet anyone that will understand me...I have a hard time with relationships-having or keeping. I am just trying to connect with others like me.

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    3. Hi Always Running,

      You are not alone. And a big part of the healing process is realizing that. At least that has been my observation in leading an Adult ADHD group for many years.

      Many adults think that their medication has stopped working -- or aren't sure if it's still working. Until they run out!

      As one woman said to me the other day, after forgetting to pick up her monthly prescription" "I woke up and realized my body was alive but my brain wasn't."

      It was a shock to her, because she really thought that the medication wasn't doing much.

      I always advise adults with ADHD who are just starting the treatment process to keep a note book -- first enter all the challenges that are felt to be ADHD-related. Then track the positive changes. Then, months later, when they forget about all this, they can review their notes. And congratulate themselves on the progress made thus far. This feeling of progress can lead to optimism, which can lead to more progress.

      good luck in your continuing journey,
      Gina



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  9. My husband was diagnosed with ADHD Inattentive Type at age 60. After learning about ADHD I began to realize that my own mother had some form of ADHD that had effected us all through our childhoods and into adulthood. It helped me to understand her. At age 90 we have no plans to seek medication, but just understanding helps us know how to help her and accept her.
    My husband has worked with his psychiatrist for about a year and they have finally figured out the best combination of medication. The past month has shown great improvement. He is finally able to focus and use the tools that help him and to show the intelligence that he has. Our relationship is also improving and I really do feel hopeful.
    We both wish there had been some way to identify ADHD earlier in his life. Since he was never hyperactive, he was never a problem in school. But teachers thought he wasn't very intelligent because of the lack of focus and they were quite wrong. Life has been difficult for both of us due to so many of the problems that are inherent in lack of focus and inability to organize. We suffered through 4 periods of job loss and a near bankruptcy of his firm. If he had not had a high level of intelligence in the area of math and engineering and I had not been able to assume responsibility for our finances, I doubt we would be married and I doubt he would have the career he has.
    As a group, those of us who have been affected by ADHD, whether we are the person with the diagnosis or the spouse/family, need to show tolerance and acceptance toward others, no matter what their difficulty. We all know what intolerance and being harshly judged feels like. We need to demonstrate tolerance to those around us whether we think they have ADHD or some other problem, as a way to teach others how to be tolerant and less judgmental. When our kindnesses can open up a conversation, then we have a better chance to teach and to learn.

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  10. Thank you for sharing your story here.

    The public that decries the "overdiagnosis" of ADHD fails to realize that ADHD was missed for millions of people, for many generations.

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  11. Hello. First of all, I'm sorry I'm posting this on what is probably the wrong place ._.

    Now to the point.
    I'm twenty-two years old and I have been reading extensively about ADHD in adults, and find myself very much reflected in the symptoms and characteristics. However, I have not been diagnosed, nor have I been diagnosed as an ADD child. And most importantly, I dread doctors, because they have always made me feel like I'm wasting their time.
    So, my question here is... how can I talk to my general practitioner and tell him that I want to get tested without him telling me to fuck off and stop with the self-diagnosing?

    I seriously believe I might have ADHD because every symptom described is a description of me, my personality for as long as I can remember, and it really is getting in the way of my career and my relationships with people.

    Thank you for reading this and I'm sorry if it was too long.

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  12. Hi Georgina and welcome,

    No apologies needed, and you didn't go on too long.

    I'm sorry to hear that you don't feel confident that your physician will listen to you. But your concerns might be well-placed. So it's good that you start thinking with a solid strategy in mind.

    The general public fails to understand how variable ADHD knowledge is among physicians, even among psychiatrists.

    First, is it necessary to first talk to your gp about this? Do you have an HMO that requires a "gatekeeper" to make the referral?

    If so, you might want to find an ADHD specialist within your network. Talk to that person and ask how you can get a referral from your gp.

    Whatever your insurance situation, I think you should try to find your own ADHD specialist and not rely on your physician for a referral.

    In the end, it is you who, not this gp, will suffer if you don't see someone with true expertise in this area. So it behooves you to do some research.

    I encourage you to check the CHADD chapter locator: http://www.chadd.org (click under "finding support")

    Attend a meeting if you can and talk to other people there about local resources. Even if it is primarily a parents group, it will still be a good place to get started.

    If there is no chapter near you, do a Google search for your city + ADHD and see what you find.

    I hope this helps.

    Gina

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    1. Thank you so much, Gina.
      I live in Uruguay (South America) and here the system works that way, you do need your gp to refer you to a psychologist or a psychiatrist. But I will try and search on Google to see if there are specialists in my country or somewhere nearby at least.

      Thanks again for the reply, it was very encouraging :)

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  13. Hi Georgina,

    You're most welcome. Uroguay....yes, you might have your work cut out for you finding ADHD expertise there.

    But the important thing is that you remain determined and remember that you deserve care for ADHD. Sometimes that resolve can move mountains. ;-)

    I would still try to identify an ADHD specialist and ask that person's advice for working within the system and with your gp.

    In the meantime, maybe you could contact my friend Norma Echevarria, MD, who is a psychiatrist specializing in ADHD. She is from Argentina, though I believe she lives part of the year in the U.S. She might know someone in your region who could help you. You could not ask for a more knowledgeable person in South America than Norma. She's wonderful.

    here is her Twitter page.

    https://twitter.com/nocnocnor

    And here is her blog:

    http://adultosdesorganizados.blogspot.com/

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  14. Wow, thanks! I'll get in touch with her, she probably knows somebody here since we're so close.

    Thanks so much for all the help!

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  15. Thanks for getting back on the Blog cycle! This is a good one!

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  16. I'm having trouble getting to CHADD meetings but they have been useful as have these blogs. I have a question. I seem to do well on Concerta but it's so costly that I tried the generic and that did NOT work for me. Why is this? I've read others have had trouble too. Also, is it too late in the day to take a Concerta at about lunchtime? I'm having trouble sleeping. I'm searching for a new psychiatrist because I don't feel like I'm seeing one that's as competant as I'd like otherwise I'd just ask him! Thanks. MM

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    1. I didn't know that Concerta had a generic. What is it called?

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  17. Hi there,

    I wrote about generic Concerta in two other blog posts:

    http://adhdrollercoaster.org/adhd-in-the-news/update-on-generic-concerta-counterfeits/#.T2s6KsyAGcw

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