The ADD “ADHD” Club is Open for Membership – No Application Needed


ADD-HD Awareness Ribbon

Welcome to the Party – BYOB (brain!)

by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
In support of the Brain-Based Coaching Series
An ADD Awareness Post — PASS IT ON!

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Attentional Deficits:
NO ONE is Immune

As I said in Types of Attentional Deficits:

EVERYBODY living in an industrialized society in our CrazyBusy world will have Challenges with attention and focus, and ANYBODY anywhere who has current health challenges of any type will find themselves included in one of the three main categories I introduced in that article.

  • We ALL experience attentional deficits that cause problems in our lives, making it tough for us to stay intentional long enough to reach our goals.
  • Whether physical, neurological, or situational, when attentional challenges rear their ugly heads, deliberate strategies must be consciously employed to make it extremely easy for us to attend, register, and link for memory.
  • Otherwise, the chances are good that we will have little more conscious awareness of what’s happening in our own lives than a sleepwalker dreaming about being awake!

We still don’t know nearly enough about WHY

In light of recent studies of cognitive struggles following combat-related head injuries — AS the ranks of the Baby-Boomers experiencing what is referred to as “age-related cognitive decline” continue to grow larger — science is FINALLY approaching the level of urgency in the quest to understand how to overcome unpredictable dynamics of cognition which those of us with processing disorders have had to deal with 24/7 for some or all of our lives.

As I mentioned in an article entitled Processing Efficiency is all about Juggling

For decades now, we’ve been finding ways to succeed despite disbelief and derision and, in many cases, the almost total lack of understanding and assistance extended to most of us.

Through the years and bit-by-bit, we’ve built our own underground railroad of cognitive processing information and support.

Those of us with diagnoses more long-standing have NOT ONLY found ways to jump over society’s hurdles in addition to the neurological challenges we face, we have made room in our hearts, our lives and our schedules to reach out to those “behind” us on the Attentional Spectrum pathway.

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ADD-HD Awareness Ribbon
And THAT includes every single one of you! 

  • For most of you, the effects will be transient.  You’ll expect to “get better” and you will.  (I hope you will be able to appreciate your good fortune, our generosity of spirit, and your excellent neurological resiliency!)
  • For a not insignificant subset, the effects will be with you for most of the remainder of your lives.
  • You will be forced – as we have been forced – to learn techniques designed to work around  symptoms like short-term memory lapses, mood and attentional dysregulations, and Executive Functioning disorders and Cognitive Challenges of all types (and won’t you be glad that we are inclined to empathize and share rather than handing you the same “pull yourselves together and just try harder” BS that has been heaped on us for most of our lives?)

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Moving ON and Learning to Cope

Making the unlikely assumption that the rest of people in your lives will be willing to be understanding and helpful, it will be easier to adjust if “cognitive decline” comes on slowly, as happens with expectations of so-called “normal” aging.

Unfortunately, in the United States alone, the approximately 1.4 million people who suffer a traumatic brain injury [TBI] each year will find themselves suddenly plunged into a world where they struggle to drive their very own brains in any number of venues – in a fashion strikingly similar to the experience reported by most ADDults.

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Hits to the Head can have lasting effects

A brainscan of an individual with TBI -- similar to the scan of someone with ADD or ADHD

(Photo credit: Joint Base Lewis McChord)

Until relatively recently, doctors have generally been of the opinion that the ill-effects of a blow to the head would dissipate within a relatively short period of time, with little more than a bit of rest and relaxation for the victim.

The medical field USED to believe that rapid recovery would be the case in all but the most extreme head injuries, regardless of the source of these injuries — including, among others, injuries sustained as a result of car accidents, trips and falls, sports-related head injuries, as well as combat related injuries “mild” enough that little to no outside damage was sustained as a result of the blow.

That R&R theory has sustained a few knocks of its own in the last few years.

University of Oklahoma study (with aspirations of supplementing the research with a 10-year controlled, prospective study) indicates that traumatic brain injury symptoms can last for years.

  • In many cases, not only do the symptoms NOT disappear,
    they don’t necessarily decrease in intensity. 
  • Multiple injuries can result in long-lasting, even permanent damage
    to the frontal and temporal lobes, areas that regulate
    impulse control, judgment, multitasking, memory
    and emotions.

ADD-HD Awareness RibbonWelcome to the ADD experience!

Whether the effects are temporary or long-lasting, steel yourselves to be thrust immediately into the eye of the hurricane — the all-too-public debate that has raged for decades over whether those who struggle emotionally, functionally and psychologically (whether from birth or as a result of subsequent head injury) suffer from psychiatric problems or brain differences.

Brain Injuries in the Military

Since 2001, the military has confirmed traumatic brain injury in more than 220,000 of the 2.3 million troops who have served in Iraq and Afghanistan, though more than a few experts believe the actual number is significantly higher.

“Probably 10 percent to possibly over 20 percent of deployed service members develop [TBI],” said Dr. Steven Cohen, a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine, and a colonel in the U.S. Army Reserves.

He goes on to say that among those diagnosed with traumatic brain injury, 40 percent to 50 percent are what is referred to as “mild” [mTBI]“meaning that the patient did not have lacerations that were severe, did not have a skull fracture, did not require surgery on the head because of the injury.”

“With almost any medical condition, the longer you have it, the less likely it is that it will ever go away,” said Cohen, who works with patients at the Walter Reed National Military Medical Center in Bethesda, Md.

Post-concussion Syndrome and the Oklahoma Study

The Oklahoma study looked at 500 veterans who were being treated at a special traumatic brain injury clinic at the Oklahoma City Veterans Affairs Medical Center, who were found to have symptoms of mild traumatic brain injury and post-concussion syndrome. They underwent general health and depression screenings between 2008 and 2011.

A second level of screening administered to those 500 veterans was undertaken in an attempt to gauge the persistence and severity of head injury symptoms, including headaches, dizziness, poor coordination, depression, and problems with judgment or memory — symptoms that, when grouped together, make up part of the profile for post-concussion syndrome.

The [primarily male] participants were grouped according to whether their head injury had occurred within the previous two years, three to four years, five to six years, or seven to eight years.

newspaperNOT Good News

The results perplexed and dismayed the doctors. Whether the injury had occurred two years or eight years earlier made no significant difference in frequency or intensity of symptoms.

Since it was also noted that the type of injury made no difference, the same findings will most likely apply to victims of sports accidents, home accidents, automobile accidents, and other types of accidents where victims suffer concussive injuries.

By the way, it is not necessary for someone to lose consciousness to sustain a concussive injury.

Symptoms of Post-concussion Syndrome

When grouped together, the wide variety of traumatic brain injury symptoms discovered and studied have become known as post-concussion syndrome. These symptoms can include:

  • Violent and/or persistent headaches
  • Dizziness, unstable balance & poor coordination
  • Lingering depression and fatigue
  • Anxiety, irritability and uncontrollable mood swings
  • Difficulty with decisions and problems with judgment
  • Loss of concentration and lapses in memory
  • Noise and light sensitivity
  • Insomnia and other sleep struggles

What truly surprised the doctors was the fact that so few people suffering from post-concussive syndrome experienced significant symptom improvement, even after eight years had passed since sustaining the original injury.

The study was looked at through the experiences of two primary groupings. One group had suffered traumatic brain injuries in the previous four years, while the second group had been injured up to eight years previously. Unfortunately, the rate of [lack of] recovery in the two groups was strikingly similar.

The findings revealed:

  • Of those injured within the past four years, almost 50 percent said they were still experiencing headaches they described as “mild to moderate.”
  • Almost 46 percent of the same group said they were experiencing “severe” headaches.

The figures for those who were injured from between five and eight years ago were distressingly similar:

  • About 45 percent of the longer-term group reported that they were continuing to experience mild to moderate headaches, up to eight years after being injured.
  • Perhaps more alarming, more than half (51 percent) described their ongoing headaches as severe.

But WAIT, there’s more . . .

In addition to headaches, the same pattern was found in the five other symptoms of post-concussion syndrome studied: dizziness, balance, coordination, decision making and depression.

Except for depression, the majority of the 500 study participants
screened positive for ALL of those symptoms.

Dr. James Couch, the lead author of the study and a professor of neurology at the University of Oklahoma medical school, said that the increase in the number of brain injury victims in the second (longer term) group reporting severe headaches indicates that not only do traumatic brain injuries NOT get better with time, the study indicates that not only does this not go away, which is what we figured we would probably find — it may tend to get worse.”

Invisible, Overlooked and Misunderstood – just like ADD

the-invisible-manIn the absence of scarring or other disfiguring injuries, the external effects of a head injury disappear within a relatively short span of time. Dr. Couch says that, in many ways, this makes things more difficult for sufferers of traumatic brain injuries.

While individuals appear completely normal “on the outside,” they are experiencing pain and cognitive difficulties that can have a devastating effect on their quality of life.

This “invisible disability” quality can make it exceptionally difficult for the person who is struggling, because even close friends and family may not understand or believe what he or she is going through.

The study also showed that symptoms were worse for people who had suffered more than one traumatic brain injury, suggesting a cumulative effect.

This finding, which has been the subject of other studies showing similar results, could be a crucial factor in the current tidal wave of lawsuits the NFL is facing from players who were encouraged – or even allowed – to continue to play after suffering multiple concussions.

TBI means traumatic brain injury, however it is caused.

Dr. Couch said his study primarily concentrated on veterans who had sustains concussions as a result of (even indirect) exposure to explosions.  However, he added that the data compiled included people who had been injured in other ways, including vehicle accidents. The results were virtually identical in both situations, which shouldn’t surprising.

Explosions or vehicle accidents … the results are predictably the same where brain injury is concerned.

In addition to the physical symptoms suffered by victims, Dr. Couch was quick to point out that the psychiatric effects can be equally debilitating — if not more so.

  • As with ADD, long term symptoms, if not successfully treated, can lead to difficulties in a person’s ability to obtain and maintain a job, or to keep a relationship or family life on track and moving forward successfully.
  • As is also true with ADDults, losing a job or watching a family unit or important relationship crumble can have devastating effects on a brain injury victim’s self-confidence and self-respect, which can in turn spiral into destructive behavior like alcoholism and drug abuse.

Treatment Protocols can be Complicated

Complications SignDr. Couch underscored the point that treatment protocols are complicated and multi-faceted, because:

• SOME of the TBI symptoms are physical (for example, headaches, dizziness, or coordination difficulties)
• Others seem psychological (like depression, mood swings, poor judgment and struggles with other executive functions)

 Effective treatment frequently requires multiple therapies – frequently involving multiple medications and meds titrations as well.

Likewise, with ADD, some of the symptoms are physical (like hyperactivity and both fine and gross motor coordination difficulties) and some seem psychological (for example, similar rates of depression, mood swings, poor judgment and struggles with other executive functions), treatment protocols can ALSO be complicated and multi-faceted, requiring multiple interventions – frequently involving multiple medication titrations.

Hmmmm . . .

Early treatment equals better results

Dr. Couch emphasizes that — as ADD experts have been saying about ADD diagnosis and treatment for years now — early recognition and treatment of traumatic brain injuries is essential for optimal outcomes. “If we treat [them] early, we get a much better result,” he said.

Since accidents happen so quickly, it can often take hours or even days before a victim realizes they have even received a head injury.

Even once an accident victim becomes aware that something is “off,” they often delay seeing a doctor in the belief that the symptoms will go away after a few days, only to find things getting progressively worse as time goes on.

Likewise, ADD diagnosis and treatment is frequently delayed, hoping that the symptoms will resolve themselves somehow, only to find things getting progressively worse as time goes on.

In BOTH cases, even loving family and friends might not understand the extent of the struggle, because physically, the sufferer looks fine.

Do-it-now post-it whiteIt’s a BAD idea to “wait and see”

Personal injury attorneys encourage anyone who has been injured in a car accident (or any other source of head injury) — even if they think their injuries are relatively minor — to go see a doctor or other medical provider as soon as possible after the accident.

Certainly, they strongly advise, no one should go more than 72 hours (3 days) without seeking a medical opinion from a qualified “TBI-literate” physician (CALL and ask about TBI expertise before making the appointment!)

For similar reasons, I STRONGLY suggest that you to seek ADD diagnosis and treatment from an ADD-literate expert as soon as possible after discovering or suspecting that something is “off.” [Check out Ten Questions to Help you Find a Grrreat ADD Doc]

Life can wander seriously off-track while you wait for attentional challenges to magically disappear on their own!

Don’t Mess Around with Cognitive Deficits

Of injuries sustained by the approximately 1.4 million people suffer a traumatic brain injury [TBI] each year (in the United States alone), three out of four are those considered “minor” forms of TBI [mTBI] — relatively non-dramatic-looking head injuries that cause a temporary (or permanent!) change in mental status including confusion, an altered level of consciousness, or perceptual or behavioral impairments.

According to a literature review appearing in the October 2013 issue of the Journal of the American Academy of Orthopaedic Surgeons [JAAOS], falls and motor vehicle accidents are responsible for most cases of mTBI — and also are a common cause of bone and joint injuries.

“Musculoskeletal injuries are often seen concurrently with some studies estimating that 50 percent of patients with orthopaedic injuries also sustain a mTBI,” says lead study author Richard L. Uhl, MD, an orthopaedic surgeon at Albany Medical Center in Albany, N.Y.

Approximately 80 percent of patients who sustain mTBI injuries can be safely discharged from the emergency department and will fully recover and return to their baseline mental status.

However, mTBI often goes undiagnosed initially because symptoms do not appear until the patient resumes everyday life. Advanced imaging of the head such as CT scans is frequently of little use as the majority of patients with mTBI injuries will initially have a normal examination.

shhhA Silent Epidemic: mTBI by the Numbers

  • The Centers for Disease Control and Prevention and the National Center for Injury Prevention and Control declared mTBI a major public health issue and a silent epidemic.
  • Patients with multisystem trauma and mTBI are almost twice as likely as those with multisystem trauma alone to have persistent cognitive impairment and to report symptoms of depression, anxiety, and post-traumatic stress disorder [PTSD]
  • Patients with mTBI and lower extremity injuries are three times more likely to experience cognitive and behavioral difficulties at one year post-injury than those who sustain only lower extremity trauma.
  • When symptoms last for more than three months, a patient is said to have post-concussion syndrome [PCS], a disorder that can be associated with substantial financial, social, and emotional challenges.
  • Males from newborn to 4 years old are among the population most prone to suffering mTBI and have the highest rate of TBI-related emergency department visits, and are more likely than females in all age groups to sustain mTBI.

Symptoms such as headache, fatigue, dizziness, anxiety, impaired cognition, and memory deficits frequently continue to affect more than half of the patients (54%) one month after injury.

An estimated 15 to 25 percent of those who sustain mTBI can have residual symptoms that sometimes lead to compromised function that can last for a year or more after the initial injury. Females seem to be more likely to sustain long-term damage.

Repeated Head Trauma makes things WORSE

According to study co-author and orthopaedic surgeon Andrew J. Rosenbaum, MD, following an mTBI, it is ESSENTIAL for patients to be counseled on their vulnerability to second-impact syndrome — sustaining a second concussion before symptoms of the initial concussion have healed, causing greater injury.

“Second-impact syndrome can have devastating consequences, including rapid-onset swelling of the brain; worsening function of the brain, spinal cord, muscles or nerves; and instability of normal body functions.”

The study suggests that orthopaedic surgeons can play a crucial role in diagnosing mTBI because, in addition to providing long-term care for the traumatic musculoskeletal injuries, they can ensure that patients are appropriately referred to those with expertise in managing mTBI.

BEFORE you hit a brick wall, REACH OUT FOR SUPPORT!Ask4Help

JUST like their reluctance to cover ADD treatment-related expenses, insurance companies are notoriously reluctant to accept traumatic brain injury claims, and not just because ongoing-care needs can be substantial.

In most cases, insurance providers will either deny the claim outright, or they will vigorously defend it in court.

Like orthopaedic surgeons and personal injury attorneys who can help you identify and overcome TBI-related brain-based challenges, ADD Coaches, mental health advocates and disabilities attorneys can help you identify and navigate the implications of life-long cognitive struggles.

They will be able to advise you how best to work with (and around) institutions who may well prefer to insist that you are not deserving of the accommodations designed to allow you to navigate your world successfully so that you can achieve your potential.

A good personal injury lawyer, for example, will know what to expect from the insurance companies, and they’ll also be able to guide you through the process of determining how much compensation you’ll need to cover your medical expenses, lost wages, medicines and any additional or ongoing treatment you may require.

A comprehensively-trained brain-based ADD Coach advocate will know what to expect from medical professionals, schools and colleges, Human Resources offices and job placement executives, how cognitive challenges are likely to impact relationships, and will be able to guide you through the processes of, for example

  • setting up and enforcing compliance with IEP and 504 accommodations
  • when, whether and at what level of legality to “disclose”
  • the types of Reasonable Accommodations you’ll need to compensate for your particular Challenges
  • along with helping you develop you-specific compensatory strategies.

Ending on a More Positive Note

Today’s soldiers are much better protected physically, according to Oklahoma study author Couch. “The helmets are far, far ahead of what was being used in World War II or in the Korean War or Vietnam.”

Couch also noted that “the military’s management and handling of these injuries has changed gradually but dramatically over time.”

In 2002 they’d probably say, ‘Oh, you just got your bell rung a little bit; now get back out there.’

NOW they say, ‘You got your bell rung and you’re going to have to take off a day or two
and we’ll reevaluate and see if we can put you back on the line.'”

More information

The Defense and Veterans Brain Injury Center Website has more about combat-related traumatic brain injury.

ADDandSoMuchMore.com has more about working with Executive Functioning Deficits of all types — links to a relatively small number of them can be found below.

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IN ANY CASE, stay tuned.
There’s a lot to know, a lot here already, and a lot more to come – in this Series and in others.
Get it here while it’s still free for the taking.

Want to work directly with me? If you’d like some coaching help (one-on-one,couples or group) with anything that came up while you were reading this article, click HERE for Brain-based Coaching with mgh, with a contact form at its end, or click the E-me link on the menubar at the top of every page. Fill out the form, submit, and an email SOS is on its way to me; we’ll schedule a call to talk about what you need. I’ll get back to you ASAP (accent on the “P”ossible!)
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Related articles right here on ADDandSoMuchMore.com
(and in case you missed some links above)

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Forever favorites

Others Worth Your Time (and mine)

BY THE WAY: Since ADDandSoMuchMore.com is an Evergreen site, I revisit all my content periodically to update links — when you link back, like, follow or comment, you STAY on the page. When you do not, you run a high risk of getting replaced by a site with a more generous come-from.

About Madelyn Griffith-Haynie, MCC, SCAC
Award-winning ADD Coach Training Field founder; ADD Coaching field co-founder; [life] Coaching pioneer -- Neurodiversity Advocate, Coach, Mentor & Poster Girl -- Multi-Certified -- 25 years working with EFD [Executive Functioning disorders] and struggles in hundreds of people from all walks of life. I developed and delivered the world's first ADD-specific coach training curriculum: multi-year, brain-based, and ICF Certification tracked. In addition to my expertise in ADD/EF Systems Development Coaching, I am known for training and mentoring globally well-informed ADD Coach LEADERS with the vision to innovate, many of the most visible, knowledgeable and successful ADD Coaches in the field today (several of whom now deliver highly visible ADD coach trainings themselves). For almost a decade, I personally sponsored and facilitated seven monthly, virtual and global, no-charge support and information groups The ADD Hours™ - including The ADD Expert Speakers Series, hosting well-known ADD Professionals who were generous with their information and expertise, joining me in my belief that "It takes a village to educate a world." I am committed to being a thorn in the side of ADD-ignorance in service of changing the way neurodiversity is thought about and treated - seeing "a world that works for everyone" in my lifetime. Get in touch when you're ready to have a life that works BECAUSE of who you are, building on strengths to step off that frustrating treadmill "when 'wanting to' just doesn't get it DONE!"

20 Responses to The ADD “ADHD” Club is Open for Membership – No Application Needed

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  7. omega vrt330 says:

    Very good info. Lucky me I ran across your site by chance (stumbleupon).
    I’ve saved as a favorite for later!

    url: pcguide.com/vb/member.php?u=103668-E3443

    Like

  8. Ken Kochajda says:

    Any special procedure required to join the ADD “ADHD ” Club

    Like

  9. Ken Kochajda says:

    How is it going Madelyn – Great to hear from you – Just started Sandy Maynard’s Catelytic Coaching Program to bring my coaching skils current and finally start a practice.

    Like

  10. THANKS for the reblog, BB – you are super!

    I really want your TBI readers to understand and accept that their struggles aren’t volitional (i.e., like ADDers, they are NOT “lazy, stupid or crazy!”) – especially since the “normies” in their community rarely understand their struggles and dump their frustrations due to unrealistic expectations — and that there’s a lot of help available from the ADD community on how to work with a brain that’s “broken.”

    ALWAYS loved how you named your blog, btw – and underscore the Brilliant Mind part too.

    READERS: Be SURE to check out Broken/Brilliant’s articles – link to his site always available on the skinny sidebar at right. They aren’t ADD-specific, but I PROMISE you will relate to his incites (Broken Brain – Brilliant Mind). WELL worth reading for the perspective they provide – we really AREN’T alone in our cognitive struggles.
    xx,
    mgh

    Like

  11. Horrible news about the affected veterans. Another reason to hate war.

    (BTW, 72 hours does not equal 2 days.)

    Like

    • LOL – I actually tried to use my dyscalulate brain to figure out what it DOES equal – failed miserably apparently (when am I going to accept the fact that I must do EVEN simple arithmetic on paper to compensate for serious short-term memory deficits!?) Thanks for pointing out my silly error – I’ll edit to correct.

      Let’s see 24+24=48 NOT 72 – so it’s THREE days to make 72 hours, huh?

      Your eagle eyes have been a gem of a gift to me – if you keep catching my errors I’ll have to give you credit as blog editor! (seriously, I SO appreciate it!)

      Re: hating war – I am right WITH you! How do we reach the politicians? (follow the money?)

      Thanks for taking the time to read and ring in.
      xx,
      mgh

      Like

  12. Deshawn Wert says:

    Really so important to know and clear steps to take. I’m forwarding this to a friend with TBI.

    Like

    • Thanks Deshawn – I SO appreciate it. One of my favorite TBI advocates picked up on it and reblogged, but I wish that EVERYONE would forward to a friend with TBI, and that they’d take the time to pass it on as well.

      Focusing on working with (and around) attentional challenges, ADD Coaching can help SO many non-ADDers SO much – as could much of the info I’ve taken the time to post here on ADDandSoMuchMore.com.

      Understanding what’s going on (and that’s it’s not “volitional”) is an essential first-step for ANYONE who wants more than what they are currently experiencing.

      Thanks for taking time to comment – and especially for YOUR help getting the word out.

      xx,
      mgh

      Like

  13. Great stuff! Very comprehensive and clear. Thanks for putting this out there.

    Like

  14. Reblogged this on Broken Brain – Brilliant Mind and commented:
    Great info on TBI from an ADHD perspective

    Like

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