There are 4 types of attention.

The first is little or not affected by ADHD.

This is simple attention. It is the attention of action-reaction. For example, it is the attention that is evaluated thanks to the X test on the screen at the neuropsychologist or the attention used when playing video games. These are tasks that require little cognitive energy.

The following 3 are more affected by ADHD :

  • The attention allows us to maintain a state of alertness or stay in one spot for a long time. If it is affected in people with ADHD, they will be distracted by stimuli, visual, auditory, or otherwise, and lose interest more quickly.
  • The focus split allows us to move from one task to another and then return to the original task at the right time. It defines our flexibility.
  • When we are busy with a task, the focus shared allows us to hear and see what is happening around us or have ideas or thoughts and come back or stay on task by inhibiting what comes to distract.

When we want to focus, we need motivation. And we have the equivalent of a conductor or a traffic cop in the brain’s frontal cortex. He determines what is important, what is not, what idea or path should be followed, what behavior is appropriate. And this system is very dependent on two neurotransmitters, norepinephrine and dopamine.

ADHD is the consequence, among other things, an imbalance in dopamine and noradrenaline. These deficiencies are responsible for a malfunction of our frontal cortex, which no longer does its job properly. The conductor, the pilot, or the traffic cop is there but is no longer effective. You no longer know how to prioritize. You are very distractible.

Conversely, an excess of norepinephrine and dopamine, caused by significant stress or by too strong medication, puts in a state of hypervigilance. You become hyper-focused with what we could call a “zombie” state.

Understanding the different attentional systems and how ADHD impacts them allows you to better understand how your brain works or malfunctions, and above all, it allows you to understand that you or your child have nothing to do with what can be blamed on you. by others, in professional, school or private life.

ADHD IMPACTS AND SYMPTOMS

ADHD or self-modulation disorder

ADHD could have been called a self-modulating disorder because it is characterized by difficulty in self-modulating :

  • Ideas:  which causes the whole clinical picture of inattention. This means sufferers cannot sort through ideas, information and stimuli, reject irrelevant ones and select and process those who are. They also cannot prioritize.
  • The movements which cause the whole picture of hyperactivity can be compared to a kind of fidgeting. ADHD is not able to wait for the right time to do or say something. This is what leads to impulsive behavior.
  • Emotions: For some, this same self-modulation problem will involve managing emotions, and sufferers will exhibit emotional hyper-reactivity, more commonly known as hypersensitivity.
  • Activation: The organization of tasks and equipment, the estimation of time, the prioritization or prioritization of tasks, and the initiation of these tasks. ADHD patients describe chronic difficulties with excessive procrastination. Often, they put off starting a task, even a task they consider very importantly to them, until the very last minute. It’s like they can’t get started until he has an acute emergency.
  • Concentration: Knowing how to concentrate, maintain this concentration and move it from one task to another. It’s like having a chat on the phone when the connection is bad. You don’t hear all of the words. ADHD is easily distracted by outside stimuli, everything that is going on around them, and their inner thoughts. Reading is also often a problem for many of them. It is as if all the words are not read or read. This causes the sentences to be read several times to fully grasp, understand, and memorize. It is also a bit as if at the end of the paragraph, you no longer know what is written at the beginning.
  • Effort: This corresponds to the regulation of vigilance, the maintenance of effort, and treatment speed. Many people with ADHD report that they can easily complete short-term plans but have a much harder time with sustained effort over longer periods. They also have difficulty completing tasks on time, especially when required to do explanatory writing or summarizing. Many patients have persistent trouble controlling sleep and alertness issues. Often they stay awake late because they cannot calm their inner thoughts. This is what I call mental hyperactivity, which is not often mentioned in ADHD symptoms. Once asleep, sleep can be either very heavy due to fatigue or poor quality if the mental activity is still too high, resulting in great difficulty getting up in the morning.
  • Emotion: It is about knowing how to manage frustration and modulate emotions. Although the DSM-IV recognizes no symptoms related to emotion control as an aspect of ADHD, many people with ADHD describe chronic difficulties in managing their emotions, positive or negative. Everything is exacerbating. It’s as if they are hyper-focusing on the emotion, which prevents their brains from focusing on anything else, further amplifying the emotion itself. It is very difficult for them to put the emotion in perspective, put it in the back of their minds, and continue with what they have to do.
  • Memory: These are the use of working memory and access to recall. Very often, ADHD people report having a poor memory. This is a direct consequence of the attention deficit. When we are there without being there, when we are constantly distracted by the environment or our thoughts, we cannot memorize what we have not read, experienced, heard. They may have great difficulty remembering where they just put something, what someone just told them, or what they were about to say. Long-term memory may be less affected, and some people remember old events very well. They may describe difficulties in keeping several virus ideas in mind or a pending task while performing another task.
  • Action: This concerns the monitoring and regulation of self-action. Many people with ADHD, even without hyperactivity, report chronic problems are regulating their actions. They are often too impulsive in what they say or do, and in the way they think, concluding too hastily that sometimes prove to be inaccurate. People with ADHD also report problems with alertness to the environment in which they interact. They may not notice when other people are puzzled, hurt, or embarrassed by their words or actions and may not change their behavior accordingly. They often report chronic difficulties to regulate the pace of their actions, slow down or speed up depending on the need for certain specific tasks.

Many infants, adults, and adolescents with ADHD say that a range of debilitating symptoms, such as inattention, become chronic, to a much higher extent than people without ADHD. These components are not independent categories. They often blend and are often interactive. In the case of ADHD, the affected executive functions are complex and multifaceted.

ADHD and motivation

One of the neurotransmitters deficient in ADHD profiles is dopamine. It is the neurotransmitter of motivation. People with ADHD have a motivation problem. They have much more difficulty than a neuro-typical person providing and maintaining the effort necessary for difficult tasks.

On the contrary, when they are interested, they can hyper-focus and no longer know how to stop. But a lot of the things that need to be done don’t spark our interest.

ADHD often end up not achieving the goals they have set for themselves or set for them, or they reach them very late. The loss of confidence and self-esteem consequent worse still a deficit of motivation and all symptoms Direct ADHD because of the difficulties of self-modulation of emotions.

But there are strategies to put in place to find and force motivation, rewards …

The lack of motivation and the loss of confidence and self-esteem also provoke and aggravate procrastination, which unfortunately often passes for laziness, reinforcing the low self-esteem …

Suppose certain tasks, such as playing sports, playing video games, or doing any pleasant activity for the person with ADHD, are not affected by the disorder. In that case, it is only because the motivation attached to these activities compensates for them—dopamine and norepinephrine deficiencies. The hypothesis too often advanced that ADHD is a lack of willpower is, therefore of course, totally false.

The child or adult with ADHD cannot control their attention, impulsivity, hyperactivity, or consequent difficulties such as motivation, procrastination, etc.

This is why it is essential to communicate about ADHD so that neuro-typical people no longer judge for lack of information.

ADHD, A BRAIN THAT WORKS DIFFERENTLY

An anatomically different brain

The brains of people diagnosed with ADHD function differently. Even though he is very different, he may be an example of this body form.

The clinical observations of psychologists, collected over many years, show a relative immaturity of young people with ADHD. A behavioral immaturity and level of emotional management. These psychologists rated this degree of behavioral and emotional developmental delay at about 20-30% of the general average.

ADHD, DIAGNOSIS, AND TREATMENT

Lack of diagnosis and therapeutic wandering

I see many children in therapeutic wandering and lost parents, sometimes at the end of their rope, psychologically and financially.

These children, already abused by a non-inclusive school and a society that judges without understanding, pass from hand to hand, from the balance sheet to assessment, without receiving a clear diagnosis. And without a clear diagnosis, there is no suitable and effective treatment. They go from weekly to weekly appointments with qualified and competent professionals, psychologists, psychomotor therapists, speech therapists, occupational therapists, etc., but who will not be able to obtain significant results because they treat peripheral problems with ADD (H)  (dyslexia, dysorthography, dyspraxia, dyscalculia)without treating the root of its difficulties: ADD (HD) itself.

Having a high fatigability, consequent of ADD (HD), this lack of diagnosis, and the therapeutic wandering which accompanies it, finish to exhaust them, physically and psychologically. And they thus worsen the direct symptoms of the disorder, attention deficit, impulsivity, mental and possibly motor hyperactivity, and its indirect consequences: great anxiety and very weakened self-esteem, which can sometimes lead to depression.

What if we trusted parents?

Parents often feel that their child is different, that something is wrong. Still, they struggle to find an attentive, caring ear and the appropriate advice because very few of our health professionals are trained on ADHD and other neurodevelopmental disorders.

And when the child has an attention deficit without hyperactivity, it can go completely unnoticed, although the learning difficulties are the same.

And the adult in all this?

However, ADHD, in the future, will be looked at as a condition that stretches from infancy to adulthood. The disorder, if it existed, was even less known and recognized when they were children. Many adults with ADD (HD) suffer in ignorance of their disorder, and those who are diagnosed continue to suffer in ignorance of the public authorities. Fortunately, some specialist psychiatrists, aware of the situation’s absurdity, agree to prescribe the Medication Assisted Treatment to adult patients.

The reasons for this lack of diagnosis

The parents’ questions will often be confirmed by a teacher or a health professional who identifies a problem. These professionals, unfortunately not trained in ADHD, will not be able to identify it, and they will be able to give guidance and advice, which will not always be appropriate.

These children are often sent to several specialists, speech therapists, psychomotor therapists, occupational therapists, psychologists, etc. The results will be multiple and sometimes even contradictory, without evoking ADHD. Because the doctors are not trained on this neurodevelopment disorder, the other practitioners are not more it, even the psychiatrists, if they have not made it their specialty.

Did you know that a general practitioner today receives an hour of ADHD class during those seven years of study? One hour for a disorder that affects about 5% of the population.

Some psychologists offer different tests. Unfortunately, they did not follow neuropsychologists’ courses and are therefore not trained in all the tests. This is how I have often seen IQ test findings by psychologists ignore the signs of probable ADHD. When it would have been necessary to carry out, or rather have carried out other tests because they are not trained to recognize the signs or they are not authorized to do it, they leave a child or an adult in the ignorance of his diagnosis.

But knowledge of the disorder leads to its understanding and possible solutions. Knowing a problem allows you to implement solutions. This is why I encourage the diagnosis. Another possibility is also available but is not officially recognized: to confirm ADHD by analyzes of functional biology of the neurotransmitter profile, which would allow the implementation of natural solutions as an alternative to drug treatment.

Should we make the diagnosis?

L is aware of the disorder leads to understanding and possible solutions. Knowing a problem allows you to implement solutions. This is why I encourage the diagnosis.

The best path to diagnosis

When I am asked about the best path leading to the diagnosis and those who wish to take the classic and official path, I advise starting by making a complete neuropsychological assessment, ideally with a recognized specialist neuropsychologist in ADHD.

A neuropsychologist takes a complete neuropsychological assessment, which, if necessary, highlights a suspicion of ADD (HD) and possibly other associated disorders or sometimes a high intellectual potential. This is why a complete neuropsychological assessment is interesting.

But beware, the neuropsychologist is not authorized to make the diagnosis. Only the child psychiatrist, neuro-psychiatrist, or specialized psychiatrist makes the diagnosis. He is attached to the ADHD department of the psychiatric ward of a hospital. He practices in the hospital, but hospitals are overcrowded and waiting times for a first appointment can reach six months. It is not uncommon that you are denied this path. The demand being much higher than the supply, the hospitals favor the care of the most serious cases and the youngest children.

Drug treatment

The only specialists authorized to make the diagnosis are also the only ones able to prescribe Ritalin or other drug treatment.

Following the diagnosis, they offer you, if they think it is relevant, a drug treatment. This treatment is often prescribed during a second appointment, generally followed by a third one a month later to assess its results, any side effects and to modify or adjust it if necessary. Your GP can then issue the mandatory monthly renewal prescription, but you will need to renew the specialist’s prescription once a year; otherwise, your GP will refuse to prescribe.

Be aware that these drug treatments, like most of them, treat the symptoms of the disorder without affecting its origin. As a result, as soon as the treatment is stopped or the drug no longer takes effect, the symptoms reappear at the end of the day.