"I am interested in your comment that what might look like ADD to someone without medical training is often actually something else. How are the symptoms of ADD and low-grade depression or anxiety similar?"
One of the hallmark criteria for for ADD is inattention (inability to sustain focus). With both depression and anxiety you can have difficulty with concentration. It can be difficult on the surface to determine the subtle difference between these two different and yet related issues. With poor concentration, you will have difficulty recalling information or retrieving information that you have stored in your memory. With inattention, you will have difficulty sustaining focus long enough to store information into the memory for later retrieval.
Another hallmark criteria for ADD is fidgeting or daydreaming. With anxiety, you can become wrapped up in worrisome internal (sometimes obsessive) thoughts that can be distracting, create more anxiety, and can cause hand-wringing, leg jiggling, hair-twirling, etc that are anxiety induced but can look from the outside like 'fidgeting' to the untrained observer.
A person with ADD will often report that thoughts rapidly shift in their head from one topic to another since they are easily distractible; for instance, they might be thinking about doing laundry when the cat meows and they follow the cat to the kitchen and then realize that they didn't do the dishes so they start to pile them up into the sink but hear a car outside that reminds them they have not gotten the mail.... and so on. A person with anxiety can also report rapid thoughts that are anxiety ridden (ie, worrying about finances when they hear a siren outside and then they immediately panic that someone they love might be hurt or injured, etc). Also a person with Bipolar Disorder (formerly known as Manic-Depression) who is in a manic state will have rapid thoughts that race through their head with increasing rapidity until eventually they can become psychotic with thoughts that are incomplete and make no sense whatsoever if they are untreated (or heaven forbid diagnosed as ADD and put on an amphetamine agent which would make their thoughts go even more rapidly!).
"Some ADD websites claim that undiagnosed ADD itself actually leads to depression and/or anxiety. True?"
Yes, untreated ADD can lead to depression or anxiety due to feeling constantly judged as "less than" or "lacking" by others (or by self) due to taking more time than everyone else to complete tasks, poor organizational skills, and high distractibility (being seen as flighty or an "airhead"). It can lead to anxiety about anticipating yet another comment about how inept, late, unorganized, scattered the person is perceived by others. It can lead to low self-esteem and ultimately eventually to depression that life does not seem as easy for them as others.
I have referred many women who feel such anxiety or low self-esteem to meditation courses that I have taught for 6 years where they are guided through meditations where they are able to release self-judgment, anxiety, anger and resentment about their situation. My co-author and I finally wrote the book SHIFT: 12 Keys to Shift Your Life to make our techniques and meditations more readily available to the public.
"Many women who have been diagnosed with ADD believe that their condition was overlooked for too long because ADD in girls and women is more likely to manifest in socially acceptable ways - such as being a social butterfly. True? Or not?"
ADD can present with hyperactivity or without hyperactivity (ADD versus ADHD). Most of the people who go into adulthood without being diagnosed as ADD are the ones who do not exhibit hyperactivity. It is easy to diagnose ADHD in childhood from a mile away as those children are the ones who are all over the place and terribly impulsive. It is the terribly impulsive, hyperactive ADHD patients that tend to be more socially unacceptable and seem to at times not respect body space of others. People with ADD tend to be inattentive to social cues from others and therefore can be seen as rude at time or "spacey" by others in social situations. A social butterfly in my mind tends to be someone who pays attention to all cues very well and is adept at seemingly effortlessly gliding from one situation/person/topic to another. I do not feel that this is the case for most people with ADD until they are teated.
"What behaviors or tendencies would a woman look for in herself to know whether she should consider asking for a professional evaluation for ADD?"
Inattentive symptoms (You should have at least 6 of these symptoms present.):
-difficulty sustaining attention in work-related tasks or home activities
-often does not seem to listen when spoken to directly
-often does not follow through on instructions and fails to complete work, chores, or duties (this failure is not due to intentionally refusing to do the task or not understanding instructions)
-often has difficulty organizing tasks or activities
-often avoids engaging in tasks that require sustained mental effort
-often loses or misplaces items needed for doing tasks or activities
-is often easily distracted by external stimuli
-is often forgetful in basic daily activities
-often has low frustration tolerance
Hyperactive/Impulsive symptoms (You can have ADD without any of these)
-often fidgets with hands or squirms when seated
-often unable to sit still
-often reports subjective feelings of inner restlessness
-often has difficulty performing activities quietly
-is often "on the go" or often acts as if they are the "energizer bunny"
-often talks excessively
-often interrupts others
-often has difficulty awaiting turn
"Is there a very basic explanation you can give me for why the treatment for ADD so often includes stimulant drugs when the condition itself so often seems to involve a racing mind?"
When we talk about the use of stimulant medications in psychiatry, we generally are referring to methylphenidate, amphetamine, methamphetamine and pemoline. The first two are by far the most commonly prescribed medications for ADD. The stimulant medications increase the release or block the reabsorption of dopamine and norepinephrine, two brain neurotransmitters. This increases the transmission between certain neurons. Each stimulant has these effects in slightly different ways. Thus each specific medication may have similar or different effects on the ADD symptoms of a given individual. A study using a mouse model reported in the January 1999 issue of Science suggested that methylphenidate elevates levels of serotonin, and that this may possibly account for some of its calming effects in people with the hyperactivity component of ADHD.
There have been many studies showing the effectiveness of stimulants in children, adolescents and adults. Generally, stimulants effectively decrease inattention, distractibility, over activity and impulsivity in three quarters of individuals with ADHD.
ADHD and the Brain: Self-regulation and attention are complex phenomena. There are different types of attention, including selective attention, sustained attention, strategy development, flexibility and response inhibition. Researchers are just at the beginning of their attempts to understand how different types of attention correlate with brain anatomy and physiology. However, research has shown some differences between the brain functioning of individuals with ADHD and that of normal subjects. Individuals with brain injury to the frontal lobes of the brain may show attention problems similar to those of ADHD adults.
"Is there a reliable count or estimate of how many women are diagnosed with ADD each year? Is that number growing?"
There is really no good reliable count of how many women have a true diagnosis of ADD. The CDC analyzed data from the 2003 National Survey of Children's Health and published their data in a report entitled Mental Health in the US - Attention Deficit Hyperactivity Disorder on September 2, 2005. In it they reported a national prevalence of ADHD in males to be 11.0% and a national prevalence of ADHD in females of 4.4%. ADHD is diagnosed 2.5 times more frequently in males than in females.
The awareness of ADD in the general public is likely the cause of the increase in new diagnoses that seem to be noted recently. Some of that is due to pharmaceutical companies advertising directly to the public and people presenting themselves to their primary care doctor asking to be treated for the self-diagnosed ADD symptoms. There is some thought that the ADD (without hyperactivity) diagnosis is seen more often in women and so that is why it is under-diagnosed in childhood as they are not behaviorally problematic in classrooms; but they are now being diagnosed due to increased awareness as adults pursuing answers to why they have had the plight of the guilt and shame of inattention and lack of organizational ability most of their lives.
DocTracy
