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Oct 27

ADHD Trick Of The Day


ADHD Trick Of The Day from: Adam Dachis

The best way I remember something is if I actually do something a little out of the ordinary. By myself, I’m pretty quiet, so when I have something like remembering if I locked my door before leaving my place, I’ll say “I’ve locked this door, Scotty.” That way if I have to remember, I can just think to myself “I told Scotty I locked the door. He shouldn’t be complaining.”

It sounds crazy, but it works. Do something strange, and note doing that strange thing. That way you can remember mundane things. You provide a mental hook to hang something on.

Oct 27

Who’s at Risk for Postpartum Depression?


By Madeline Vann, MPH Medically reviewed by Lindsey Marcellin, MD, MPH
Welcoming a child into the world is always a joyous event, right? In truth, the “baby blues” strike a significant number of women — by some estimates, up to 85 percent of moms feel some sadness after their baby is born. But for 7 to 13 percent of women, baby blues are more like mood indigo: a diagnosable condition called postpartum depression.

If you’re planning a pregnancy, it’s natural to wonder whether you’re at risk for this type of depression. In fact, many researchers and doctors say they wish more women would seriously consider postpartum depression’s risk factors. That way, new moms could get help before depression wreaked havoc on their lives and their parenting.

Will You Feel Blue After Your Baby Is Born?

Fortunately, new studies are shedding light on just what those risk factors are. A recent review of data from 1,863 new mothers (surveyed as part of the 1996–2006 Medical Expenditure Panel Survey) showed that more than half the women who had postpartum depression had a history of mental health issues, either before or during pregnancy. Those whose mental health problems occurred before pregnancy were twice as likely to have postpartum depression, while those who struggled with mental health issues during pregnancy had an 11-times higher risk of postpartum depression.

“We really showed that a woman’s mental health status before and during pregnancy is a strong predictor of poor mental health after delivery,” says study author Whitney Witt, PhD, MPH, assistant professor in the department of population health sciences at the University of Wisconsin School of Medicine and Public Health in Madison. “We looked at the domino effect: If women are in poor mental health before pregnancy, then they are more likely to have poor mental health during pregnancy, and even more likely to have poor mental health afterwards.” Dr. Witt’s study is the first to consider the predictive value of mental health during pregnancy as a risk factor for postpartum depression. “There are a substantial number of women who have poor mental health postpartum who could be identified earlier,” she says, adding that women should let their doctors know if they have concerns about their mental health status. In addition, these results speak to the need for access to quality health care for women before and during pregnancy, she says.

10 More Risk Factors for Postpartum Depression

In addition to your mental health status before and during pregnancy, other risk factors exist — and they vary in degree.

Hormones. After delivery, a woman’s shift in hormones is often blamed for intense mood swings. However, current research shows that there may be a more subtle interplay between hormones (even during pregnancy) and the risk for postpartum depression. Race. Women of Asian or Pacific Islander descent have three times the risk for postpartum depression than other women. Age. Some studies have found that younger mothers have an increased risk for postpartum depression (with moms younger than 20 at highest risk, and moms 20 to 24 next in line) — but other studies are inconclusive. Education. Women who have not achieved a high school education have been found to have a four-fold higher risk. Stress. Some studies have shown a link between the risk of postpartum depression and stressful life situations, such as difficult relationships with partners, low income, or problems balancing the needs of all children in the family. Pregnancy complications. Conditions of pregnancy that correlate with postpartum depression include anemia, preterm birth, pregnancy-related high blood pressure, diabetes, low lying placenta, and toxemia. Pain after delivery. Severe pain in the first 36 hours after delivery triples the risk for experiencing postpartum depression two months later. Health status. Generally poor physical health during pregnancy puts a woman at risk for postpartum depression. Family history. Women with a family history of depression or bipolar disorder are more likely to have postpartum depression. Previous postpartum depression. Women who had postpartum depression in a previous pregnancy are 50 percent more likely to get it a second time. Researchers are gaining a better understanding of the risk factors for postpartum depression. And as they do, women and their physicians will have more information with which to make appropriate medical decisions — such as whether to consider early intervention for a mood disorder or to have pain levels after delivery monitored more carefully.

ScienceDaily (Oct. 22, 2012) — Parents with a higher number of stressors in their lives are more likely to have obese children, according to a new study by pediatric researchers. Furthermore, when parents perceive themselves to be stressed, their children eat fast food more often, compared to children whose parents feel less stressed.

“Stress in parents may be an important risk factor for child obesity and related behaviors,” said Elizabeth Prout-Parks, M.D., a physician nutrition specialist at The Children’s Hospital of Philadelphia, who led a study published online October 22 in the November issue of Pediatrics. “The severity and number of stressors are important.”

Among the parental stressors associated with childhood obesity are poor physical and mental health, financial strain, and leading a single-parent household, said Prout-Parks. Although previous researchers had found a connection between parental stress and child obesity, the current study covered a more diverse population, both ethnically and socioeconomically, than did previous studies.

The study team suggested that interventions aimed at reducing parental stress and teaching coping skills may assist public health campaigns in addressing childhood obesity.

The researchers analyzed self-reported data from 2,119 parents and caregivers who participated in telephone surveys in the 2006 Southeastern Pennsylvania Household Health Survey/Community Health Database, conducted in Philadelphia and neighboring suburbs. The households contained children aged 3 to 17, among whom 25 percent were obese. Among the variables included were parental stressors, parent-perceived stress, age, race, health quality and gender of children, adult levels of education, BMI, gender, sleep quality, and outcomes such as child obesity, fast-food consumption, fruit and vegetable consumption, and physical activity.

Of the measured stressors, single-parent households had the strongest relationship with child obesity, while financial stress had the strongest relationship for a child not being physically active. Unexpectedly, neither parent stressors nor parent-perceived stress was associated with decreased fruit and vegetable consumption by their children.

However, this study was the first to find an association between parent-perceived stress and more frequent fast-food consumption by children. Fast food, often containing high quantities of fat and sugar, is an important risk factor for obesity and child health. The researchers speculated that parents experiencing stress may buy more fast food for the family, to save time or reduce the demands of meal preparation. The authors also suggest that actual and perceived parental stress may result in less supervision of children, who may then make unhealthy food and activity choices.

“Although multiple stressors can elicit a ‘stressor pile-up,’ causing adverse physical health in children, parent’s perception of their general stress level may be more important than the actual stressors,” the authors write.

Future research on child obesity should further examine other family behaviors and community factors not available in the current study, conclude the authors. In addition, “Clinical care, research and other programs might reduce levels of childhood obesity by developing supportive measures to reduce stressors on parents,” said Prout-Parks. “Teaching alternative coping strategies to parents might also help them to reduce their perceived stress.”

(Edmonton)By Bryan Alary Children who bask in the nighttime glow of a TV or computer don’t get enough rest and suffer from poor lifestyle habits, new research from the University of Alberta has shown.

A provincewide survey of Grade 5 students in Alberta showed that as little as one hour of additional sleep decreased the odds of being overweight or obese by 28 per cent and 30 per cent, respectively. Children with one or more electronic devices in the bedroom—TVs, computers, video games and cellphones—were also far more likely to be overweight or obese.

“If you want your kids to sleep better and live a healthier lifestyle, get the technology out of the bedroom,” said co-author Paul Veugelers, a professor in the School of Public Health, Canada Research Chair in Population Health and Alberta Innovates – Health Solutions Health Scholar.

Veugelers, director of the Population Health Intervention Research Unit that works with the Alberta Project Promoting active Living and healthy Eating (APPLE Schools), said the research is the first to connect the dots on the relationship between sleep, diet and physical activity among kids.

Nearly 3,400 Grade 5 students were asked about their nighttime sleep habits and access to electronics through the REAL Kids Alberta survey. Half of the students had a TV, DVD player or video game console in their bedroom, 21 per cent had a computer and 17 per cent had a cellphone. Five per cent of students had all three types of devices.

Some 57 per cent of students reported using electronics after they were supposed to be asleep, with watching TV and movies being the most popular activity. Twenty-seven per cent of students engaged in three or more activities after bedtime.

Researchers found that students with access to one electronic device were 1.47 times as likely to be overweight as kids with no devices in the bedroom. That increased to 2.57 times for kids with three devices, with similar results reported among obese children.

More sleep also led to significantly more physical activity and better diet choices, researchers found.

Co-author Christina Fung noted that children today are not sleeping as much as previous generations, with two-thirds not getting the recommended hours of sleep per night. In addition to healthy lifestyle habits, a good night’s sleep has been linked to better academic outcomes, fewer mood disorders and other positive health outcomes, she said.

“It’s important to teach these children at an earlier age and teach them healthy habits when they are younger.”

The research was published in September by the journal Pediatric Obesity, in an early online release. The REAL Kids Alberta evaluation was funded through a contract with Alberta Health.

Oct 23

Are Schizophrenia and Autism Close Relations?


ScienceDaily (Oct. 23, 2012) — Autism Spectrum Disorders (ASD), a category that includes autism, Asperger Syndrome, and Pervasive Developmental Disorder, are characterized by difficulty with social interaction and communication, or repetitive behaviors. The U.S. Centers for Disease Control and Management says that one in 88 children in the US is somewhere on the Autism spectrum — an alarming ten-fold increase in the last four decades.

New research by Dr. Mark Weiser of Tel Aviv University’s Sackler Faculty of Medicine and the Sheba Medical Center has revealed that ASD appears share a root cause with other mental illnesses, including schizophrenia and bipolar disorder. At first glance, schizophrenia and autism may look like completely different illnesses, he says. But closer inspection reveals many common traits, including social and cognitive dysfunction and a decreased ability to lead normal lives and function in the real world.

Studying extensive databases in Israel and Sweden, the researchers discovered that the two illnesses had a genetic link, representing a heightened risk within families. They found that people who have a schizophrenic sibling are 12 times more likely to have autism than those with no schizophrenia in the family. The presence of bipolar disorder in a sibling showed a similar pattern of association, but to a lesser degree.

A scientific leap forward, this study sheds new light on the genetics of these disorders. The results will help scientists better understand the genetics of mental illness, says Dr. Weiser, and may prove to be a fruitful direction for future research. The findings have been published in the Archives of General Psychiatry.

All in the family

Researchers used three data sets, one in Israel and two in Sweden, to determine the familial connection between schizophrenia and autism. The Israeli database alone, used under the auspices of the ethics committees of both the Sheba Medical Center and the Israeli Defense Forces, included anonymous information about more than a million soldiers, including patients with schizophrenia and ASD.

“We found the same results in all three data sets,” he says, noting that the ability to replicate the findings across these extensive databases is what makes this study so significant.

Understanding this genetic connection could be a missing link, Dr. Weiser says, and provides a fresh direction for study. The researchers are now taking this research in a clinical direction. For now, though, the findings shouldn’t influence the way that doctors treat patients with either illness, he adds.

This work was done in collaboration with researchers at the University of North Carolina, Karolinska Institute in Sweden, Kings College London, and the Israeli Defense Force Medical Corps.

Symptoms of physical pain often are associated with mental health issues. People who have anxiety or depression may experience a number of somatic symptoms long before they are diagnosed with a mood issue. But can these somatic symptoms, which often go untreated, be an indicator of future psychological concerns? When adolescents experience depression, it can put them at risk for future mood problems. However, when they experience physical pain with no identifiable physical cause, they often are never referred for psychological evaluation. Hannes Bohman of the Department of Neuroscience at Uppsala University in Sweden wanted to find out if somatic symptoms in adolescence predicted future mental health issues.

Bohman conducted a study that compared somatic symptoms and mental health symptoms in adolescence to adult outcomes 15 years later. In all, Bohman had longitudinal data from 369 individuals. He found that the best indicator of adult depression was the presence of somatic symptoms and depressive symptoms in adolescence. However, Bohman also found that adolescents without depression, and only somatic symptoms, had a high risk of future mental health issues. “Several somatic symptoms concurrent with adolescent depression are strongly linked to later high rates of suicidal attempts, bipolar disorders, psychotic disorders, posttraumatic stress disorder, recurrent depression, and chronic depression,” Bohman said.

As the number of somatic symptoms increased, so did the severity of future issues. Specifically, those with the most somatic symptoms in adolescence were at risk for bipolar, psychosis, and suicidal ideation. The most common and telling somatic symptom was abdominal pain, a symptom often dismissed by health care professionals as anxiety related even though it may not be. This suggests that somatic symptoms, and adolescent abdominal pain in particular, may be more accurate indicators of adult psychological issues than symptoms of depression. Bohman believes that the link between adolescent abdominal pain and adult mental illness should not be ignored. Further, he hopes that the results of this study will prompt other research efforts aimed at isolating factors that could identify young people most at risk for mental health problems in adulthood.
Bohman, Hannes, et al. Prognostic significance of functional somatic symptoms in adolescence: A 15-year community-based follow-up study of adolescents with depression compared with healthy peers. BMC Psychiatry 12 (2012): 90. Health Reference Center Academic. Web. 28 Sep. 2012.

Oct 18

Coping with panic disorder


The condition affects around 3.5 percent of the population during their lifetimes. What treatments exist to prevent attacks?
Coping with panic.

Josh is a 35-year-old man who came to me for help dealing with his long history of panic attacks. They started after his army service and have continued off and on ever since.

Josh explained that as a result of his panic attacks, he only goes to work and avoids most social gatherings. Describing a typical anxiety attack, he explained that his breathing becomes very heavy and he feels like he is choking, gasping for air. His heart often pounds and he is certain that he having a heart attack. He added that when he has a panic attack, he feels like he is losing complete control and is going crazy, and finds himself hyperventilating and terrified that he is going to die or that something terrible will happen. He sought my help because he was tired of living a life of fear and avoiding friends and social places. Josh’s wife also strongly encouraged him to seek help and was hoping that professional treatment would help alleviate his suffering.

Josh is not alone. Panic disorder affects around 3.5 percent of the population during their lifetimes, affecting twice as many women as men. At least 23% of the general population has reported an isolated panic attack some time in their lives. The average age of onset for panic disorder is from adolescence to 40. Panic disorder often cooccurs with depression and other anxiety disorders, for instance on exposure to the feared object in specific phobia, the fearprovoking memory in post-traumatic stress disorder, the obsessive thought in obsessivecompulsive disorder, or a social phobia.

People like Josh frequently show up at hospital emergency rooms with a whole array of frightening physical symptoms, which become the focus of their anxiety and in fact trigger more anxiety. This is not surprising if one considers the intensity and degree of physical manifestations present in a typical panic attack. Many sufferers from panic disorder lose all semblance of rationality when they are going through an attack. Furthermore, they live in constant fear that the next attack is right around the corner.

Josh’s avoidance of social situations and people outside of his work is one of the most common fallouts of panic disorder. In describing his symptoms, Josh noted that he had always taken buses to work, but after having a powerful anxiety attack while waiting for a bus, he subsequently began to avoid bus travel. Instead, he began to take taxis to work, which led to a major dispute with his wife because of the expense involved.

THE BEST and most scientifically proven treatment for panic disorder is a combination of psychiatric medication, usually in the category of selective serotonin reuptake inhibitors (SSRIs), like Prozac, together with cognitive-behavioral treatment (CBT). As a rule, there are some important considerations to rule out when someone seeks out psychological help for panic disorder.

A complete physical exam is always recommended to make sure there are no underlying medical conditions that could be causing panic symptoms. The therapist must make sure that there is no current drug use that may be triggering the panic attacks.

Use of stimulants such as caffeine, decongestants, cannabis and cocaine can cause panic attacks. It is also important to know whether the panic attacks are part of a longterm pattern or just some isolated cases. For example, an evaluation may reveal that a trigger, such as being near or involved in a traumatic experience like a terror attack, has brought on the panic attacks.

CBT helps patients to understand how automatic thoughts and false beliefs/distortions lead to exaggerated emotional responses, such as anxiety, and how they can lead to secondary behavioral consequences.

Josh found psycho-education about panic attacks to be very helpful. Cognitive restructuring (CR), a central component of CBT, helped Josh to change some of the negative thinking that reinforces and maintains a panic episode. CR involves substituting positive thoughts (e.g. “I am only feeling a little uneasiness” or “my feelings will soon be gone”) for the maladaptive thoughts that accompany panic (e.g. clients feeling that they are having a heart attack or going to die).

Two points that significantly helped him were to understand that the panic attack rarely lasts more than 10 minutes and that many of the symptoms that his body was producing would not really hurt him. It helped to realize that his symptoms were the result of a rush of adrenaline released by the brain during the panic episode. Experts understand that the individual’s subjective reactions to the panic episode and the frightening events that follow are a central culprit in escalating the attack.

While panic disorder is a terrible and frightening psychiatric condition, help most definitely exists.

The writer is a psychotherapist for children, adults and couples and practices in Jerusalem, Tel Aviv and Ra’anana.

Oct 17

Excessive & Compulsive Internet Use


Internet use can be a great convenience but overuse can turn into a sad and lonely state

Can too much time on the Internet lead to depression and loneliness? Is the Internet addictive? Internet use has carved out a niche of research in communication and psychology.

A recent study surveyed tech savvy Internet users to investigate problematic Internet use.

These researchers looked at the difference between excessive and compulsive Internet use, which often showed a person’s lack of ability to curb or stop spending time on the Internet.
Talk to a therapist about compulsive Internet use.

Joseph Mazer, PhD, assistant professor of communications at Clemson University, and Andrew M. Ledbetter, PhD, assistant professor at Texas Christian University, led the investigation.

For the study, researchers recruited participants via university campus, Facebook and a professional listserv of people interested in communication and technology.

A total of 352 participants were selected, aged 18-59, 69 percent of which were undergraduate students.

Each participant answered a 31-question survey to determine thoughts and attitudes about Internet use. Questions focused on opinions about self-disclosure, social connection, apprehension/anxiety, communication/miscommunication and convenience.

Researchers looked at problematic Internet use by separating it into excessive Internet use (EIU) and compulsive Internet use (CIU).

Convenience and communication/miscommunication were found to be at the root of EIU. Problematic emotional or psychological outcomes did not appear to result from EIU.

People with CIU felt more comfortable with online self-disclosure and social connection, which often resulted in anxiety, depression, loneliness and reduced social contact.

Authors said, “[E]xcessive users seem to have a more realistic perception of online communication as temporally convenient but sometimes limited by [a lack of nonverbal communication that can only be understood in person].”

“In other words, whereas anxiety motivates CIU, efficiency seems to motivate EIU.”

Further research is needed to determine the best methods of intervention and appropriate treatment for compulsive Internet behavior.

This study was published in October in Southern Communication Journal.

Oct 16

Mom and Dad and TMI: Are You an Over-Sharer?


Dr. Peggy Drexler
Twelve-year-old Jessie knows how her dad, Sam, feels about her grandmother, Sam’s mother-in-law. Exactly how he feels. “I think she’s great, but my dad always talks about how judgmental, critical, and demanding she is,” says Jessie. “Sometimes I guess she makes my mom feel bad. Whenever she’s coming for a visit, my dad gets stressed out.” Most times, Sam says, he uses a joking tone when bashing his mother-in-law. Other times, he admits, he is straight-up biting.

We’re always hearing about children and teenagers who share too much: with their friends; with their parents; online, with the world. But what happens when it’s Mom and Dad dabbling in TMI? How do we know how much–and what sort of–information our kids can handle?

Thanks to Facebook, Twitter, Instagram, and all the rest of social media, we have quickly grown accustomed to the concept of over sharing. Revealing the most mundane details of our daily lives–not to mention our formerly private innermost thoughts–feels normal to us; it’s what people do. But this lack of boundaries has also resulted in a generation of mothers and fathers who share too much with their kids, from too-early talks about sex to what we really think about the neighbor, the high school math teacher, or Grandma.

Part of this tendency stems from a desire to be close to, and connect with, our children. We think that sharing secrets, or interacting with kids as we might other adults, breeds a level of intimacy. In some ways, it does: Sharing some personal information with your child is necessary in order to build trust. But children aren’t meant to play the role of confidante to their parents. They’re not meant to be your sounding board, and they can’t process information in the same way you do. You might have spotted the school principal last weekend hitting on a woman that wasn’t his wife. But that’s news for you–and not your kids–to deal with.

That’s because kids, even older ones, aren’t intellectually or emotionally prepared to shoulder the burden of TMI. They don’t have the capacity to try to figure out how they should react–or why–to what you’re telling them. What’s more, they’re terrible at keeping secrets. You can say, “Dad and I are having an argument.” You can’t say, “I think your father is having an affair.” Similarly, it’s okay to tell a child, “We can’t afford that” if you can’t. But not “I just don’t know how we’re going to pay the mortgage this month.”

Jenna and Bart divorced when their son, Luke, was a baby. Bart has remarried; Jenna has not. And she’s told 8-year-old Luke that she never will, a statement he’s since repeated to most anyone who asks about his mother. Perhaps Jenna’s confiding in Luke was a way of differentiating herself from Bart, the “bad parent” who had left. Or maybe it was just something she wanted to share. At 8, however, Luke is too young to know how to process this information, and what it means to him.

Divorced parents will frequently use over sharing when competing for a child’s affections, which puts the child in the middle. (This can happen even when both parents aren’t outwardly bashing the other, just as it can happen between parents who are still married.) At times, Luke will tell Bart that he is unable to play with him because “Mommy says you lie.” Katie was a 15-year-old who told me she couldn’t live with her mother because she was “passive aggressive and controlling.” Those were words she got from her father, and they were words that Katie used against her mother, especially as she got older. One day, she would also use those words against her dad.

Here, we see how over sharing can disrupt the natural order of the parent-child dynamic. When you make your child your confidante, you’re sending the message that you and she make decisions together. This, of course, is not true. While you should encourage your child to assert her opinion, you, as parent, make decisions–even minor ones. Too much information leads a child to believe that he or she has a role in the decision making, reducing your authority and skewing your child’s view of the world and how things work.

It’s easy to think that by telling your child things, he will, in turn, tell you things. Sometimes that’s the case. More often, it’s not. What’s more, it’s important for kids to individuate from their parents–and important for parents to learn to let their kids do that. Many parents use over sharing to try to halt this very necessary process. But kids aren’t our friends; they are still learning to be friends to others. It’s important that you provide that model. To do that, give your kids enough information to meet their age-appropriate needs, and to keep them safe. They don’t need to be freaked out, worried, or caught in the middle between adults. They’re kids. Don’t take that away from them.

This first appeared on Psychology Today.

ScienceDaily (Oct. 15, 2012) Men who were diagnosed as children with attention-deficit/hyperactivity disorder (ADHD) appeared to have significantly worse educational, occupational, economic and social outcomes in a 33-year, follow-up study that compared them with men without childhood ADHD, according to a report published Online First by Archives of General Psychiatry, a JAMA Network publication.

ADHD has an estimated worldwide prevalence of 5 percent, so the long-term outcome of children with ADHD is a major concern, according to the study background.

Rachel G. Klein, Ph.D., of the Child Study Center at NYU Langone Medical Center in New York, and colleagues report the adult outcome (follow-up at average age of 41 years) of boys who were diagnosed as having ADHD at an average age of 8 years. The study included 135 white men with ADHD in childhood, free of conduct disorder (probands), and a comparison group of 136 men without childhood ADHD.

“On average, probands had 2½ fewer years of schooling than comparison participants … 31.1 percent did not complete high school (vs. 4.4 percent of comparison participants) and hardly any (3.7 percent) had higher degrees (whereas 29.4 percent of comparison participants did). Similarly, probands had significantly lower occupational attainment levels,” the authors note. “Given the probands’ worse educational and occupational attainment, their relatively poorer socioeconomic status at [follow-up at average age of 41 years] is to be expected. Although significantly fewer probands than comparison participants were employed, most were holding jobs (83.7 percent). However, the disparity of $40,000 between the median annual salary of employed probands and comparisons is striking.”

In further comparisons of the two groups, the men who were diagnosed with ADHD in childhood also had more divorces (currently divorced, 9.6 percent vs. 2.9 percent, and ever been divorced 31.1 percent vs. 11.8 percent); and higher rates of ongoing ADHD (22.2 percent vs. 5.1 percent, the authors suspect the comparison participants’ ADHD symptoms might have emerged during adulthood), antisocial personality disorder (ASPD, 16.3 percent vs. 0 percent) and substance use disorders (SUDs, 14.1 percent vs. 5.1 percent), according to the results.

During their lifetime, the men who were diagnosed with ADHD in childhood (the so-called probands) also had significantly more ASPD and SUDs but not mood or anxiety disorders and more psychiatric hospitalizations and incarcerations than comparison participants. And relative to the comparison group, psychiatric disorders with onsets at 21 years of age or older were not significantly elevated in the probands, the study results indicate.

The authors note the design of their study precludes generalizing the results to women and all ethnic and social groups because the probands were white men of average intelligence who were referred to a clinic because of combined-type ADHD.

“The multiple disadvantages predicted by childhood ADHD well into adulthood began in adolescence, without increased onsets of new disorders after 20 years of age. Findings highlight the importance of extended monitoring and treatment of children with ADHD,” the study concludes.

Oct 16

Ways to Spot a Twice-Exceptional Child (2e)


Does your bright child have special abilities – but also some special issues? Did you know that it is common for gifted children to be “too old and too young” at the same time? For example, you might have an 8-year-old who has the reasoning ability of a 15-year-old, the mathematics skills of a 12-year old, the social skills of an 8-year-old, and the emotional regulation of a 4-year-old – all at once.

In addition, many gifted children struggle with anxiety, attention problems, dyslexia, Asperger’s disorder, and more. These kids are called “twice-exceptional” or “2e” because they have abilities at both ends of spectrum. They are both more advance than, and behind, their same-aged peers. Unfortunately, 2e kids usually are not identified as gifted, and do not receive support for their gifted abilities – or their deficit areas – because their strengths and weaknesses cancel each other out. Understanding whether your child is 2e is critical for his or her life-long development – for both maximizing strengths and addressing weaknesses.

Your child might be 2e if he or she:
1. Is not achieving in school the way you believe she or he should
2. Seems “bright but lazy”
3. Gets easily frustrated and melts down often
4. Has attention and organizational problems that undermine her or his achievement
5. Struggles with social skills and making and maintaining friendships
6. Fails to hear correctly, see correctly or is overwhelmed by sensory stimulation (i.e., noises, sounds, smells, bright light, textures)
7. Has difficulty with sound/symbol relationships, reversals, spelling, and writing, but manages to power through reading using contextual clues and unusual effort
8. Shows high verbal ability but extreme difficulty in calculation skills and rote memory
9. Isn’t able to show what he or she knows on tests
10. Worries all the time and refuses to try new things
Dan Peters, Ph.D., is co-founder of the Summit Center (

Oct 9

Adult ADHD: Tips for Time Management


By Marie Suszynski Medically reviewed by Pat F. Bass III, MD, MPH
Adults with attention deficit hyperactivity disorder, or adult ADHD, tend to be restless and impulsive, and have a hard time paying attention. That makes time management a real challenge. ADHD symptoms may mean you aren’t adept at being aware of time passing, predicting how long tasks will take, monitoring how you’re doing, and making adjustments accordingly, says Ari Tuckman, PsyD, a clinical psychologist in West Chester, Pa., vice-president of the Attention Deficit Disorder Association, and author of “More Attention, Less Deficit.” Here are some techniques that can help turn a chronic procrastinator into an efficient time manager.

Create a Daily To-Do List

When you have adult ADHD, creating a to-do list can be a great way to set goals for the day, but the key is to not overdo it and keep the list small. “If you have too much on a to-do list, the more important items get lost in the clutter,” Tuckman says. He recommends keeping a master to-do list and pulling items from it for your daily to-do list.

Color-Code Your Priorities

“Prioritizing is actually a fairly complicated process, and it’s one that people with adult ADHD struggle with,” Tuckman says. How do you do it? Consider your deadlines and think about what needs to happen first, second, third, and so on, Tuckman says. Then color-code your to-do list according to priority. You might use a yellow highlighter to color-code the things that are most important to get done in the morning and a blue highlighter to code the tasks that need to get done in the afternoon.

Schedule Enough Time

A fundamental piece to getting past adult ADHD symptoms is having the ability to get yourself moving on a task before a deadline is upon you, Tuckman says. As you plan your day, be realistic about how much time it will take you to complete a goal. When you start to procrastinate, remind yourself of the reward for reaching your goal early: You avoid the anxiety of rushing to finish and you have the time to do your best work. That’s the essence of time-management skills.

Break Tasks Into Manageable Chunks

For people with adult ADHD, the first challenge of taking on a big project is stopping long enough to think about how to break it down into smaller tasks, Tuckman says. Too often, they tend to jump into a project without planning it well. Having better time-management means you start by thinking through what needs to be done each step along the way to finish a project on time.

Invest in Planning Software

If you have trouble doing it on your own, project planning software can enable you to sit down, think about a project, and break it down into pieces, Tuckman says. It can help you make interim deadlines, consider what resources you need to get the job done, and provide reminders of deadlines. But it can be a hindrance to your time-management skills if playing with the program becomes a distraction to getting your work done, Tuckman adds.

Rely on Visual and Audio Reminders of Time

Because someone coping with adult ADHD doesn’t have a reliable internal clock, one strategy is to rely on external markers of time. Tuckman recommends putting up plenty of clocks in your workspace so that you can always see the time. And a more active solution, he says, is to set an alarm to go off or vibrate every 15 minutes. This will be a reminder that time is passing and will give you a chance to evaluate where you are and what still needs to get done.

Use Technology to Your Advantage

The biggest challenge to using a paper calendar is that you have to keep looking at it to know what’s coming up. For adults living with ADHD it can be easy to miss appointments or fall behind. But when an automatic reminder on an electronic calendar, Blackberry, or cell phone pops up on your computer screen or beeps in your pocket or purse, it’s hard to ignore. Consider one of these high-tech options as a time-management tool.

Carry a Notebook

It may help to keep track of different projects with notebooks. Chana Klein, a Teaneck, N.J.-based certified professional coach who works with people with adult ADHD and has struggled with ADHD herself, says that she uses a different notebook for every business relationship she has. That way, the information is organized and easy to find and it’s better than writing something down on a random piece of paper and then losing it, she says. Klein also keeps a notebook on her desk and another in her bag, so she always has a place to write down notes to help her remember later.

Take Time to Recharge

Everyone needs a break from work, and some people who have adult ADHD stay on track when they schedule breaks ahead of time, Klein says. “You need to know when you’ll have a day off and when you’ll have an hour off,” she explains. But don’t let a break derail your time-management skills. Tuckman recommends setting an inexpensive kitchen timer to alert you when it’s time to go back to work. “It comes back to time awareness,” he says.

Oct 9

Why Can’t I Get the Job Done on Time?


by Melanie A. Greenberg, Ph.D. I received this letter in my email the other day. Because lateness is a common problem that can interfere with relationships and career achievement, I made it the subject of today’s blog post. I would love to hear readers’ comments about whether you have ever experienced something similar, either as the person missing the deadlines or the person affected by tasks not getting done on time, as promised. What do you think is the reason for the behavior in your situation? What strategies have worked best for you in trying to deal with it?

Dear Dr G,

I have a chronic problem with being on time, getting projects done by deadline, or keeping on top of the housework. I forget close relative’s birthdays and have a hard time getting my daughter to school or getting dinner on the table on time. I am always losing my keys or papers and have wasted a ton of money by paying my bills and returning library books late. My husband, friends and bosses understand at first, but, after a while, they become irritated with me. I know my behavior inconveniences them and causes them stress. In my own mind, I genuinely want to follow through, but don’t seem to be able to. I often have to stay up all night to catch up, then am too tired to function or think clearly for days afterward. After I was late to lunch for the umpteenth time, a friend accused me of being passive-aggressive. Do you think this is the reason or is it just because I’m a multitasking working mom and have too many balls to juggle?

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“Sleepless in Seattle”

Dear “Sleepless,”

The problem you write about is something many people have experienced at some time in their lives, either in themselves or having been affected by another person who does this. I think lateness can be a sign of be passive-aggression, but can also be due to a variety of other causes, both in the person’s current situation, or as a behavior developed to cope with childhood circumstances, that has become a dysfunctional pattern. As a psychologist, my ethics never permit me to provide a definitive diagnosis without a personal interview and more detailed assessment. However, I can suggest some possibilities based on my work with clients who seek help with these issues.

Possibility 1: Passive-Aggression

Passive-aggressive behaviors are those which involve thwarting another person’s plans or causing chaos for them, without admitting that this was the intended goal. Making promises you don’t keep, or failing to act to take care of a situation which then deteriorates due to the inaction are two classic passive-aggressive strategies. What makes it passive-aggression is that it is resentment-based. At some level, there is an intent to harm, frustrate, or retaliate. People may act passive-aggressively when they feel controlled, deceived, or unfairly treated. They may perceive the other person’s expectations as unreasonable, given the circumstances, or feel they are not being compensated sufficiently or appreciated for their work. At the same time, they may be avoidant of conflict or not feel they have the power in the situation to express aggression directly. A common example is a teenager who wants greater independence and escape from parental control. They may deliberately disobey house rules and lie about the reason as a way of expressing resentment and trying to assert some power they feel entitled to.

Possibility Two: Entitlement

Jeffrey Young, Ph.D. is a Psychologist who has developed one of the best therapies currently in use to treat dysfunctional personality patterns. He suggests that dysfunctional behaviors are the result of “life scripts,” or deeply ingrained sets of beliefs about ourselves and the world. People are not necessarily consciously aware of these motivators, but a skilled therapist can pinpoint them in the course of longer-term therapy. One such life script is “entitlement,” or the idea that we are entitled to special privilege and don’t have to follow the same rules or put up with the same discomforts that other people do. Entitlement is a feature of narcissistic personality disorder but does not, in itself, mean you have the disorder. Its origins can lie in being part of a privileged group in the society, such as having wealthy parents. Kids who are in the popular group at school due to charm, good looks, or athletic abilities may feel they are special and get used to being treated this way. Similarly, if parents doted too much on a kid and did not set limits or require that they do their share of chores and contribute to the household, they can raise an entitled kid. Entitlement can lead to chronic lateness because at some level the person feels that their time or agenda is more important than yours.

Passive-aggression has its origins in resentment
Possibility Three: Subjugation

Another common life script is the exact opposite of entitlement in that people feel that their needs are not as important as pleasing or going along with the other person. Kids who are punished by parents or made to feel guilty when they naturally assert their own needs and opinions often become adults who do not feel entitled or know how to assert their own agenda. Kids raised in the emotional chaos caused by abuse, bullying, or addiction may become habitual rescuers of others, unaware of their own needs and feelings. A person with this schema may let the other person set the rules and expectations and just go along. Later, they may realize that they aren’t getting their fair share, having their say, or are in some way being exploited in the situation. This can lead to seething resentment and failure to comply as an indirect way of asserting their needs, changing the rules, or expressing anger. They may feel that direct confrontation or even acknowledging their own angry feelings is dangerous because of past punishment. Subjugation can also result in a failure to organize one’s life so as to prioritize the activities that are most related to one’s own goals and rewards. Inability to say “no” and wanting to please other people all the time can produce overcommitment which makes it impossible to get the most important tasks done in a timely manner.

Possibility Four: Attention Deficit Disorder (ADD)

Lack of follow-through may not be due to passive-aggression but to a deficiency in the brain’s executive functions which interferes with the ability to allocate attention appropriately. A person with this disorder may be unable to sustain focus on a task and instead, is chronically distracted by interfering stimuli such as the television and internet. They may take too long to grocery shop because they focus on all the other interesting foods on display or the magazine headlines at the checkout counter. Or they may have a hard time disengaging their attention from an interesting task such as reading or writing, and moving onto the more mundane stuff such as loading the dishwasher. This can result in not getting a project done or in making careless mistakes so the final product looks sloppy. Unlike the schemas discussed above, the behaviors here are not necessarily motivated by any interpersonal agenda. They are the result of genuinely limited capacities. Another facet of ADD is impulsivity, or being unable to resist acting on what you want to do in the moment, rather than delaying gratification to meet longer-term goals. If you suspect ADD, it is important to obtain a psychological assessment as there are medications and behavior strategies that can help you modify these interfering behaviors.

These are only some of the explanations for behaviors such as procrastination that get in the way of your own or other people’s goals. Other possibilities are disorganization, perfectionism and overcommitment that result in insufficient time for the most important tasks. These habits can interfere with the ability to advance in your career and take care of your family. A good psychotherapist can assess all the factors in your situation, including your physiology, thoughts and feelings, life scripts, relationships, history and current circumstances to come up with a diagnosis and specific treatment plan. Dealing with these apparently passive-aggressive behaviors can result in improved focus, better performance at work, and more satisfying relationships.
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By Rick Nauert PhD A new study suggests a mother’s depression and use of a common class of antidepressants can influence language development in babies.

Researchers at the University of British Columbia (UBC) and Harvard University determined that maternal depression treatment with serotonin reuptake inhibitors (SRIs) can accelerate babies’ ability to attune to the sounds and sights of their native language.

Conversely, maternal depression untreated by SRIs may prolong the period of tuning.

The research is published in the Proceedings of the National Academy of Sciences. “This study is among the first to show how maternal depression and its treatment can change the timing of language development in babies,” said Dr. Janet Werker of UBC’s Dept. of Psychology, the study’s senior author.

“At this point, we do not know if accelerating or delaying these milestones in development has lasting consequences on later language acquisition, or if alternate developmental pathways exist. We aim to explore these and other important questions in future studies.”

The study followed three groups of mothers – one being treated for depression with SRIs, one with depression not taking antidepressants and one with no symptoms of depression. Researchers measured changes in heart rate and eye movement to sounds and video images of native and non-native languages. From this, the language development of babies at three intervals, including six and 10 months of age was calculated.

Researchers also studied how the heart rates of unborn babies responded to languages at the age of 36 weeks in the uterus. “The findings highlight the importance of environmental factors on infant development and put us in a better position to support not only optimal language development in children but also maternal well-being,” said Werker, who adds that treatment of maternal depression is crucial.

“We also hope to explore more classes of antidepressants to determine if they have similar or different impacts on early childhood development.” “These findings once again remind us that poor mental health during pregnancy is a major public health issue for mothers and their infants,” said co-author Tim Oberlander, M.D.

“Non-treatment is never an option. While some infants might be at risk, others may benefit from mother’s treatment with an antidepressant during their pregnancy. At this stage we are just not sure why some but not all infants are affected in the same way. It is really important that pregnant women discuss all treatment options with their physicians or midwives.”

Previous research by Werker has found that during the first months of life, babies rapidly attune to the language sounds they hear and the sights they see (movements in the face that accompany talking) of their native languages. After this foundational period of language recognition, babies begin focusing on acquiring their native tongues and effectively ignore other languages.

Findings from the current study show that the key developmental period – which typically ends between the ages of eight and nine months – can be accelerated or delayed, in some cases by several months. In another recent study, Werker has found that this development period lasts longer for babies in bilingual households than in monolingual babies, particularly for the face recognition aspects of speech.

Oct 7

Daily Emotional Training Exercises


Just as physical fitness exercises improve your physical health, practicing these exercises daily will strengthen your ability to control negative feelings.

EXERCISE ONE: Practice gratitude. Remember all you have to be grateful for—life, love, a beautiful world. List in your head at least three specific things you are grateful for.

EXERCISE TWO: Remember what matters. We are all charged with moving the world forward. Some say what matters most is buying the newest car, the latest fashions, the most up to date gadgets; others say how you look; still others think it is how smart you are or what school you went to, how much money you have, have many jewels you wear, or how fancy a car you drive and life’s important missions. They are wrong.

Research shows these are less important than being kind and caring, forgiving others for their flaws, forgiving yourself for not being perfect, and working with others to make the world a better place. The importance of caring is a long recognized value. Across all ages, throughout all religions and all philosophies, it is believed the good life cannot be found unless it involves being caring and just. You care for yourself when you care for others. Such selfishness is not bad.

EXERCISE THREE: Move your body. Moving your body for only 20 minutes a day, and just hard enough to raise your heart rate, not only improves your emotional fitness, but helps you stay physically healthy. Brisk walking works well. So does some heart raising dancing. Two ten minute periods work as well as one twenty minute period. A quick stretch off and on during the day, or before and after walking, is also important.

EXERCISE FOUR: Practice Kindness: We need positive connections to others, and kindness builds those connections. Practicing kindness is a major self-care skill. Being kind to others almost always gets repaid with kindness. Smile at someone and most of the time you will get a smile in return. When you don’t, at least you have done the right thing. One of the easiest ways to practice kindness is to compliment strangers. Giving and getting kindness is not only essential to your health, it is a way to act on The Mission.

EXERCISE FIVE: Value all you do. Modern life disconnects us from the fruits of our labor. For some, paychecks are often the only concrete measurement of work done; for others it might be a grade or a report card. Sometimes the full results of all our work will not be visible for years. In the helping professions we might never know how we have helped. This is not good for our souls. Doing something, no matter how small, that yields an immediate, concrete, and positive result nourishes our well being. Folding a basket of laundry, cleaning out one messy drawer, washing dishes, pulling some weeds, chopping wood or writing and mailing a postcard to a distant friend, are examples of small goals.

It also helps to make one of the small goals you reach for each day, exercising your creativity. Write a few lines in your journal, work on a poem, start a painting, knit a few rows of an afghan, add some lines to the great American novel, sing a song, dance a dance, tend a garden, bake some bread, carve some wood. As always, remember to take pleasure in all your small steps toward fulfilling The Mission.

Finally, several times during the day, stop and review all you have done. We often complain about our to do list, but don’t keep adequate track of all we do. Stop right now and start a little list of “done that” for the day.

Here’s how mine would go for the first hour and half of a day when I care for my grands: up, showered, combed hair, brushed teeth, dressed, put coffee on, walked Punky the pup. While walking picked up trash littering complex’s lawns. Made breakfast for self and hubbie, ate, answered five emails, read about a hundred tweets, re-tweeted ten; pinned two items to my Pinterest Board and then my two grandchildren arrived. And I am retired. My daughter-in-law had followed much the same routine without the tweets, but also had to get two kids up, dressed, fed, put in their car seats, drive half an hour to our apartment, cart the kids into the house, and then drive another twenty minutes to her job.

Everyone of us does so much and are valued for so little. Make a point of valuing all you do.

EXERCISE SIX: Honor past gifts. This exercise asks you to pay special attention to those responsible for all you have or are right now. We are the continuation of all the generations leading up to ours. We are the continuation of the caring our immediate, extended families, friends, and teacher gave. Some gave a great deal, others gave less. Each gave all they could.

The most powerful way to honor past gifts is to focus on a memory of one person from your past who gave the gift of caring. That person may not have always been nurturing; nevertheless, the gifts they gave became part of who you are today.

You can honor the gift from a different person each time you do the exercise. You honor gifts by taking a calming breath, shutting your eyes, and recalling a time you and the person spent together when you felt cherished, cheered on, or otherwise nurtured. When you honor such past gifts, you give yourself the gift of caring all over again.

EXERCISE SEVEN: Be with beauty. Look at a beautiful picture. Listen to music that stirs your soul. Recall a song you love. Watch a bird soar. If you cannot actually do any of these things at the moment, remember the last time you did. “Beauty is in the eye of the beholder.” What is beautiful to you may not be beautiful to the next person. There is no world wide standard for beauty. One person’s slender star is another’s bag of bones. One person’s scenic view is another person’s desolate and lonely vista or barren dessert. Surround yourself with what you find beautiful in every way you can, and take the time to be with that beauty. My Pinterest Be With Beauty Board is a great place to start.

EXERCISE EIGHT: Laugh and play. The day is empty that does not hold a few minutes of play and laughter. Make room for such time in your day. When possible, include others in both the laugher and the play. Playfulness is another important component of self-care. Play is thought by many researchers to improve intelligence. Minimally, it helps build the social skills needed to get along with others. Finally, play is also a useful way to move your body, combining two Emotional Fitness Training® Exercises in one.

EXERCISE NINE: Indulge in a healthy pleasure. Do one thing each day that you consider a luxury or an indulgence. Do it in a healthy way. This might involve giving yourself a hand or foot massage, eating and fully savoring a favorite food or a cup of tea, doing a cross word puzzle, letting one piece of chocolate melt in your mouth. The important thing is this be something just for you, and that it be an indulgence of your needs.

EXERCISE TEN: Practice forgiveness. Forgive another. Forgive yourself. Past hurts wound only if you keep the hurt alive. Practicing forgiveness daily is important. Review the day. Maybe some hurt or anger lingers on from when someone said something unkind. Did someone treat you unfairly? Take without giving in return? Break a promise? Betray a hope? Embarrass you in public? Say or do something cruel? Forgiveness does not mean forgetting, or staying with those who are abusive. As Bishop Tutu tells us, forgiveness means letting go of revenge and stopping the circle of hurt. To practice forgiving another, see the person coming to you as a small child, sad and upset, and asking you to forgive them. No one is perfect and all of us start our march through the world innocent.

Perhaps the negative you need to let go of is some wrong you did. Maybe you treated another unfairly. Maybe you were angry or thoughtless and now regret your actions. When you need forgiveness, it means stopping the wrongful behavior, not repeating it and sometimes making amends. We all fail to do or be our best. We all make mistakes. We all need forgiveness for one thing or another. When you need forgiveness, see yourself as a small child approaching the person you want to forgive you. See that person smiling down on you with forgiveness and acceptance.

EXERCISE ELEVEN: Observe the now. Yesterday is gone. The past cannot be changed. What was good in the past can and should be savored. The hurts of the past should be honored for their lessons and then laid to rest.

The future has not yet come. Worrying about what will be is useless. As the humorist Mark Twain noted: “I have known a great many troubles, but most of them never happened.” Making thoughtful plans for your future is reasonable. Worrying about what might happen is not. Do what you can and then let the future take care of it self.

Observing the now is a way of letting go of the day and preparing yourself for sleep. In fact it works so well for some that they often don’t stay awake long enough to practice the next exercise. If as you are observing the now, you find yourself drifting off, be grateful.

1.Take a calming breath.
2.Breathe normally and just notice what it feels like to breathe in and out.
3.As you breathe in and out, notice how your body feels.
4.Watch how thoughts come and go.
5.If a negative thought seems to get stuck in your head, take another calming breath.
6.As you breathe out, say “Now is all.”
7.Notice again what it feels like just to breathe.
8.When you are ready, take a final calming breath and go on.
EXERCISE TWELVE: Hold on to the positive. End every day by spending a minute honoring your strength, your ability to endure and to stay on the side of good, to keep caring and striving to do what is right. Then remember all you have and be grateful. Fall asleep holding good thoughts in your heart and mind.

MORE MAY BE NEEDED: If you practice these exercises as directed, but still cannot control anger, fear, or depression, more is needed. Think support groups, coaching, counseling, therapy, and properly prescribed medication. Life is difficult, but the good should outweigh the bad.

Oct 7

How to Recognize Teens at Risk for Self-Harm


By Janice Wood Associate News Editor

It’s a startling statistic: Suicide is the third-leading cause of death for teens, according to the Centers for Disease Control and Prevention.

In response, a University of Missouri public health expert has identified factors that will help parents, medical professionals and educators recognize teens at risk for self injury and suicide.

“For many young people, suicide represents an escape from unbearable situations — problems that seem impossible to solve or negative emotions that feel overwhelming,” said Lindsay Taliaferro, Ph.D., an assistant professor of health sciences.

“Adults can help these teens dissect their problems, help them develop healthful coping strategies, and facilitate access to mental health care so their problems don’t seem insurmountable.”

Taliaferro analyzed data from the 2007 Minnesota Student Survey to pinpoint factors associated with self-injury.

Of the more than 60,000 Minnesota high school students who completed the survey, more than 4,000 teens — roughly the same size as the student bodies at two large high schools — reported injuring themselves in the past year. Nearly half of those who reported self-injury also had attempted suicide.

“Of the teens who engaged in non-suicidal self injury, hopelessness was a prominent factor that differentiated those who attempted suicide from those who did not have a history of suicide attempts,” Taliaferro said.

Parents, teachers and medical professionals sometimes avoid talking to teens about self-harm because they aren’t sure how to help, she said, noting that adults don’t need to solve all the teen’s problems, just act as a sounding board.

“Sometimes just talking about their feelings allows young people to articulate what they’re going through and to feel understood, which can provide comfort,” she said.

Taliaferro recommends that parents strengthen connections with their teens and help foster connections between their children and other positive adult influences.

“One of the most important protective factors against teens engaging in self-injury was parent connectedness, and, for females, connections with other prosocial adults also were associated with reduced likelihood of engaging in self-injury,” Taliaferro said.

Although parents play influential roles in teens’ lives, Taliaferro said mental health professionals are the best resources for troubled teens. Medical professionals, such as primary care physicians, can also serve crucial roles by identifying teens who self-injure and referring them to community support systems and mental health specialists before their behaviors escalate, Taliaferro said.

Taliaferro’s study was published in Academic Pediatrics. She collaborated with researchers at the University of Wisconsin-Eau Claire, the University of Minnesota and the Pennsylvania State University.

Source: University of Missouri

By Rick Nauert PhD Senior News Editor

Attention deficit hyperactivity disorders (ADHD) is now a common diagnosis with the U.S. Center for Disease Control and Prevention estimating that almost one in ten (9.5 percent) children aged 4-17, has at some time, received a diagnosis of ADHD.

Common treatment strategies for ADHD include cognitive-behavioral therapy and pharmaceuticals. The Food and Drug Administration has now approved Quillivant XR (methylphenidate hydrochloride), the first once-daily, extended-release liquid methylphenidate available for patients with ADHD.

The new medication is a welcome addition to traditional medication regimens as authorities say that in 2011, there were more than 52 million prescriptions filled for ADHD medications, representing a 10 percent increase over 2010.

“The approval of Quillivant XR fills a void that has long existed in the treatment of ADHD,” said Ann Childress, M.D., president of the Center for Psychiatry and Behavioral Medicine, Las Vegas, who was an investigator in the Quillivant XR laboratory classroom study.

“We routinely see the struggles of patients who have difficulty swallowing pills or capsules. Having the option of a once-daily liquid will help alleviate some of these issues while still providing the proven efficacy of methylphenidate for 12 hours after dosing.”

Researchers determined the efficacy of Quillivant XR by performing a randomized, double-blind, placebo-controlled study of 45 children with ADHD.

For the study children received an initial 20mg dose of Quillivant XR once daily in the morning. The dosage was then titrated weekly until an optimal dose or maximum dose of 60mg per day was reached.

After this, a two-week double-blind study was performed on the study using a crossover design (meaning that kids would alternate between receiving the medication or a placebo.

At the end of each week, trained observers evaluated the attention and behavior of the patients in a laboratory classroom using an established behavioral rating scale.

Quillivant XR significantly improved ADHD symptoms compared to placebo at the primary endpoint of four hours post-dose, and in a secondary analysis, showed significant improvement at every time point measured, from 45 minutes to 12 hours after dosing.

“We are pleased with the FDA’s approval of Quillivant XR and believe it will address an important need for many patients with ADHD and their caregivers,” said Jay Shepard, President and CEO of NextWave Pharmaceuticals.

“We are eager to enter into the ADHD market and believe the unique liquid formulation of Quillivant XR—which was developed in conjunction with NextWave’s technology and manufacturing partner Tris Pharma—will provide another treatment option for patients with ADHD.”

Quillivant XR is expected to become available in pharmacies in January 2013. Quillivant XR was developed using Tris Pharma’s patent protected drug delivery platform.

Oct 5

Exercise Instead Of Medication


By Gerti Schoen, MA, LP
Exercise can be just as effective against depression as medication, especially in mild to moderate cases. Study after study has come to this conclusion, and it can help even with major depression and to prevent reoccurring episodes of it.

Just like many alternative health professionals talk about how “food is medicine”, the corresponding view is now “exercise is medicine“. For example, a recent news item claimed that exercise is more crucial in managing diabetes than food.

Having a stronger body increases overall well being even in people with low self esteem. Body and mind cannot be seen separately – an insight that athletes back in ancient Greece were well aware off.

Of course, it’s difficult to motivate yourself to move when you are depressed. It’s important to find an activity that suits the pace you are comfortable with. If walking is all you can do, then walking it is (especially when done in nature). If dancing feels possible, do that. If you like Yoga, great.

You don’t have to hit the gym. Find something that appeals to you. Being active on a regular basis (say two or three times a week) is much more beneficial than doing something strenuous once in a while.

If you can avoid medication and exercise regularly instead, even better. Drugs can have serious negative side effects, especially when taken over a long period of time. Some studies even suggest that antidepressants can lead to chronic depression.

This phenomenon seems to occur in many people, who had an initial positive response to SSRIs, then stayed on the drugs, relapsed and became treatment-resistant. This is when the depression may become permanent.

Other cautionary tales include that psychiatric drugs have led to impairment in brain development in animal studies. Robert Whitaker, author of “Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness”, points out that the widely believed theory of chemical imbalances in the brain had turned out to be false.

It is undeniable that drugs have helped and still help countless people, especially with severe mental illness. It’s equally undeniable that many people take medication that is unneeded and may turn out to be harmful.

Everybody has to evaluate their individual situation very carefully. Take control of your treatment and inform yourself of the pros and cons of it.

There is no one treatment that fits all. Ultimately, you are the one who knows your body and mind best.

Oct 5

Chewing Ability Linked to Reduced Dementia Risk


ScienceDaily (Oct. 4, 2012) — Can you bite into an apple? If so, you are more likely to maintain mental abilities, according to new research from Karolinska Institutet in Sweden.


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The population is aging, and the older we become the more likely it is that we risk deterioration of our cognitive functions, such as memory, decision-making and problem solving. Research indicates several possible contributors to these changes, with several studies demonstrating an association between not having teeth and loss of cognitive function and a higher risk of dementia.

One reason for this could be that few or no teeth makes chewing difficult, which leads to a reduction in the blood flow to the brain. However, to date there has been no direct investigation into the significance of chewing ability in a national representative sample of elderly people.

Now a team comprised of researchers from the Department of Dental Medicine and the Aging Research Center (ARC) at Karolinska Institutet and from Karlstad University in Sweden have looked at tooth loss, chewing ability and cognitive function in a random nationwide sample of 557 people aged 77 or older. They found that those who had difficulty chewing hard food such as apples had a significantly higher risk of developing cognitive impairments. This correlation remained even when controlling for sex, age, education and mental health problems, variables that are often reported to impact on cognition. Whether chewing ability was sustained with natural teeth or dentures also had no bearing on the effect.

Oct 5

Can a Relationship Survive an Affair?


By Nathan Feiles, LMSW
It depends.

People respond to learning of a partner’s affair in different ways, depending on personal values. Some may respond by immediately leaving the relationship without looking back. Some may believe in the concept of working through adversity together and seeing if they can make it through as a stronger couple. Some may believe that the family is paramount (especially when children are involved) and want to work things out for the sake of the family staying together. And so on.

No matter the personal value systems at play, a relationship can survive an affair only if both partners actively want it to. If only one partner is interested in fighting for the relationship, it will be a frustrating uphill battle that can have compounding negative effects (e.g. lowered self-esteem and self-worth).

Affairs have several components to them. There is the emotional impact (e.g. hurt, betrayal, anger, etc.) of the affair. There is figuring out what led to the affair in the first place — behaviorally and psychologically for both partners. As part of this component, there’s acknowledging the state of the current relationship (e.g. what was missing or happening in the current relationship for the one who cheated? What was the role of the other partner?), as well as the personal psycho-emotional state of the one acting out by having the affair (e.g. what was going on inside that enabled this behavior?).

Basically, there’s the experience and state of each partner, and there’s the experience and state of the unit as a whole, which all need to be considered in recovering from an affair.

So, after the affair has been revealed, and the emotional dust has had some time to settle, the first question to answer will be if each partner is interested in working to repair the damage caused to the relationship. Of course, for both partners, this question is not usually an easy one to answer. There are many things to consider before deciding which direction you want to see the relationship go. Here’s a list of questions to help figure out the next step:
•How willing am I to work through the process of repairing the relationship?
•Where do I draw the line? (setting boundaries).
•What am I fighting for if I stay, and what will be impacted if I leave (emotionally and actively)? This can take the form of a pros/cons list.
•Which process am I more willing to take on (working to move forward together? or ending the relationship and dealing with all that comes with this?)
•How will I feel later if I decide to leave without trying to repair the relationship first?
•What do I generally want to see happen?

Being able to answer the questions above can help each partner understand the implications the decision will have.

Couples and individual therapy (for each partner) is encouraged as part of the relationship healing process. It is necessary to understand what in the relationship dynamic led to the affair in the first place, in order to prevent a recurrence. However, both partners have room to benefit from individual therapy (not only the one who engaged the affair). The hurt partner could use support to sort out emotions and learn their own role in relationship troubles. Also, the hurt partner at times can develop urges to act out in response to the affair, possibly by engaging in an affair of their own as revenge, or other forms of revenge, including even consideration of physical harm to their partner. So the triad of couples and both individuals in therapy is heavily encouraged for a relationship to make a healthy recovery from an affair.

So the answer is, yes, a relationship can survive an affair. The real question is how much do both partners want it to.

Oct 4

Two behaviours, two brain systems

The peak of inappropriate behaviour and emotional reactivity during adolescence is described as risky and impulsive. However, impulsivity, or lack of cognitive control, should not be treated as the same phenomenon as the act of taking a risk. In fact, separate regions in the brain mediate each behaviour, and each region matures according to a different timetable.

At the front of the brain is a region called the prefrontal cortex, which is associated with cognitive control and managing emotion. The prefrontal cortex is the last brain region to fully develop, with maturation continuing through the teen years. As the frontal lobes mature, the ability to regulate impulsivity and make better goal-oriented choices improves. As a result, some researchers have proposed that the immaturity of the prefrontal cortex explains the poor judgment of adolescents. But if this neurobiological model of teenage behaviour was correct, it would follow that children, whose frontal lobes are even less developed, would make poorer decisions than teenagers do. This is not the case. So what else could be going on?

Risk-taking is linked to an older part of the brain: the limbic system. This set of structures, deep in the brain below the cortex, is involved with judging incentives and emotional information. Unlike the prefrontal cortex, which develops slowly into adulthood, these subcortical limbic systems are almost completely developed by adolescence. Brain imaging shows that risk-taking and processing emotional information intensifies the activation of the limbic system, and that this intensification is exaggerated during the teen years. This means that when a risky choice has a strong emotional incentive, such as winning the admiration of peers, the limbic system is strongly activated by the emotional heft of the situation. The emotional, incentive-driven limbic system wins over the immature prefrontal control system – and a risky choice is made.

There is evidence from animal studies to support this model, with structures of the limbic system maturing earlier than those of the frontal cortex in many species. During adolescence, many animal species become more socially active with peers, fight with their parents, and are more likely to engage in novelty-seeking and risk-taking behaviours. At the same time, sexual hormones increase. The authors suggest that this developmental pattern, which is consistent with adolescents seeking sexual partners, may have evolved to promote leaving family and village to find a mate. Heightened emotional reactivity during this period could give some protection from the dangers in a novel environment by enhancing vigilance and awareness of threats.

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