By Julie Le Franc, Psychoanalytic Psychotherapist and Psychologist
We can all have good and bad days but are able to press on in everyday activities. However, adult ADD can lead to ruined lives. People with ADD can struggle to be motivated or may get stuck in trying to accomplish daily activities (cleaning, tidying up, paying the bills). They can wrestle with racing thoughts, have trouble in sustaining relationships or employment, can have problems with domestic violence, drug abuse (especially amphetamine abuse) and may suffer from depression and anxiety.
Dr Daniel G. Amen, M.D., psychiatrist and clinical neuroscientist has published books around the world on ADD/ADHD. Dr Amen through SPECT (single photon emission computed tomography) images of ADD patients has identified areas of compromised brain function and good brain function (Amen, 2001). His research has shown how the brain works and summarises aspects of the brain: 1.
Deep limbic system, at the centre of the brain, is the bonding and mood control centre. Poor brain functioning can result in moodiness, low energy, irritability and negativity.
Basal ganglia, large structures deep within the brain, control the body’s idling speed. When this part of the brain works too hard; people struggle with anxiety and panic, fearfulness and conflict avoidance. When it is underactive, people often struggle with concentration and fine motor control problems.
Prefrontal cortex, at the front tip of the brain, is your supervisor. When this part of the brain is underactive, people have problems supervising themselves and also have significant problems with attention span, focus, organisation, and follow-through.
Cingulate, a part of the brain that runs longitudinally through the middle part of the frontal lobes, is the part of the brain signifying a “gear shifter”. When this part of the brain is overactive, people have problems getting stuck in certain loops of thoughts or behaviours.
Temporal lobes, underneath the temples and behind the eyes, are involved with memory, understanding language, facial recognition and temper control. People with problems with the left temporal lobe can be prone to temper flare-ups, rapid mood shifts, and memory and learning problems (Amen, 2001).
The brain is involved in everything we do, how we think, how we feel, how we act, and how well we get along with other people. The brain even determines the kind of person you are; the kind of mother, doctor, receptionist, husband, daughter, student (Amen, 2001).
Dr Amen has used SPECT brain imaging to define the seven distinct types (or variations) of ADD each with its own treatment options as outlined in article in the June/July 2015 – issue number 100 of the Medical Link Magazine. Dr Amen also has used anticonvulsant medications with a stimulant (Ritalin, Adderall, and Dexadrine) to stabilise temporal lobe activity to help symptoms of aggression, mood instability, headaches, and in some cases learning problems. There are also non stimulant medications (Strattera, Concerta). The new antidepressant, Cymbalta, also shows some promise in improving ADHD (Meler, 2005). Furthermore, many patients with bipolar have had lifelong ADD a genetic “cousin” of bipolar disorder (Meler, 2005).
When working with people with head injuries, common causes of ADD outside of genetics especially to the left prefrontal cortex (Amen, 2001), we need to think about the psychological and social aspects, dysfunctional family dynamics, relationships and behaviour as well as stress and conditioning. I believe that we need a more holistic approach to psychotherapy with knowledge of how the brain works. I have found that people with ADD flourish with the proper treatment. They are less negative, have extra energy and their impulsivity motivates them to create new businesses and they can organise their lives to achieve financial and creative successes.
(1) Amen, Daniel, G. (2001). Healing ADD: The breakthrough program that allows you to see and heal the six types of ADD. New York: Berkley Books
(2) Meier, Paul, (2005). Blue Genes: Breaking free from the chemical imbalances that affect your moods, your mind, your life, and your loved ones. Wheaton, Illinois: Tyndale House Publishers
The Medical Link March/April 2009 – issue number 063