Radio Interview -Marion Ross and Tracy Latz

We will be on the Bonnie D. Graham show at 6pm est on Friday December 12, 2008.
"Up Close & Personal with Bonnie D. Graham" streams LIVE worldwide at http://www.am1240wgbb.com/home.htm [Click LISTEN LIVE NOW button at top of the page].

We hope that you can join us.
Much Love and Light to all,

Docmarion

Adult ADD or Something Else?

Adult Attentions Deficit Disorder (ADD) has been talked about and diagnosed more in the past few years. I recently had someone interview me on this topic and thought I would share some of it with you as I certainly have had more inquiries about this in my private practice in the last 2 years.

"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

Common Scents

Nature has provided a healthy solution for stress and stamina.
Here are a few great sniffs:

Peppermint: Inhaling the vapor from peppermint tea or oil reduces congestion. Add a few drops to a cotton ball and put it near an air vent and it will reduce fatigue.The scent of peppermint causes your capillaries to constrict and dilate and sends a rush of blood and oxygen through the body.

Vanilla: Sniffing vanilla beans or burning a vanilla scented candle can calm you down because it increases serotonin levels in the brain. It can leave you with a delicious feeling of security. Some find it addictive.

Lavender: Widely used for soothing and relaxing as lavender contains linalool,which helps block the stress response. Lavender has also been used to treat hyperactivity and insomnia. Just light a lavender candle, sniff some in a bowl or use some lavender oil in an infusor and feel your pain diminish.

Common Scents to be continued...
Doc Marion

Suicide Prevention During the Financial Crisis

The World Health Organization is predicting an increase in suicides as a result of the financial crisis.

It is not a surprise to those of us in the day to day trenches working with
psychiatric patients to acknowledge that there is an increase in suicide risk. I have seen several patients who were struggling with failing businesses and the banks will likely be foreclosing on their homes in the next few weeks.

I have also seen an increase in cases of stress, anxiety, and depression as a result of the international financial crisis in both adults and children (as they pick up on their parents' fears, anxiety and sadness). I have had some people reporting suicidal thoughts as a result of their perception of doom, guilt and shame over their financial dilemmas. It is helpful for people caught in this to focus on changing their perceptions of recent events. I suggest that people stop listening to the news except for a brief period once a day so that they do not have continual stimulation of their worst fears. I reassure them that this is just a moment in time and that everything concerning the financial crisis will predictably change over time;that the stock market and financial down trends will gradually improve. I tell them it is much like watching clouds floating by in the sky- there is a beginning, a middle and an end to any major crisis no matter what it is and that the sun will certainly reappear.
For those who truly seem to be on the edge of personal financial collapse I discuss considering bankruptcy, which was developed specifically to give someone a chance to start over financially, which is not necessarily the case in other countries.When people are living in fear of the loss of retirement or college fund monies, yet have no intention of retiring or having children leave for college for 5 or more years, I point out that the loss of money for them is either only on paper or in the ethers of the computer databases, as their wealth will begin to grow again as the market recovers from the down trend and that it will indeed improve with time.

I assist people with taking a look at their priorities and realizing that there are so many things that are more important than possessions and perceived status of cars, jobs, houses... such as family, relationships, and health.

I have had some people who think of suicide as an option to get life insurance
monies for their family.I point out that many life insurance policies have an exclusion of payment for anyone who commits suicide. Some people believe that suicide is a "way out" and that their "troubles will end"- to those people I say that suicide creates a whole list of new troubles for the ones who are left behind to pick up the pieces. Risk of suicide increases dramatically once another family member has taken their own life; suicide then becomes a viable option for dealing with problems. Children, friends, and loved ones almost always blame them selves for the person's death, even if a suicide note is left.

I recommend that people who are dealing with stressful situations be mindful of getting regular sleep, taking care of their body with good nutrition and some regular exercise. Exercise is a means of natural stress reduction and helps reset neurotransmitters to assist with combating anxiety and depression. Taking time to take care of our own self to relax and play is important all of the time, not just during crisis situations.

If you are having have suicidal thoughts it is important to talk with someone about what/how you are thinking and what you are feeling such as trained mental health professionals (therapists, counselors, psychologists, psychiatrists, social workers), your family physician or family or friends. You are not alone. There is help available in the form of psychotherapy, support groups and antidepressant medication that can work fairly rapidly to improve mood.
Your perception and where you focus your thoughts are of key importance to transform suicidal thoughts. We can look at everything as if the glass is half empty constantly or we can choose to look at things as if the glass is half full. We energize what we think about- if we are always looking for the worst case scenario,then that is all we can see and we will have difficulty seeing the things that are still beautiful and wonderful in our life. Exercise, spending time with people and doing things that we love are helpful with keeping us focused on what is right and joyful in our lives. Antidepressant medication (Serotonin specific reuptake inhibitor agents) and/or mood stabilizing medication can help a great deal for those who seem to remain depressed in their mood for 2 or more weeks without relief. Hospitalization is an option for those who do not feel that they are able to keep them self from acting on suicidal thoughts.

What's the gift in this crisis? Maybe it's time to recognize that we need to set new priorities in our lives and understand what is really important to us and not be defined by our jobs or possessions. Take a moment to recall in Greek mythology the story of Pandora's box. After Prometheus stole the secret of fire, Zeus ordered Hephaestus to create the woman Pandora as part of punishment for mankind. Pandora was given a large box and was told never to open it by Zeus, but she did. It contained all the evil of mankind including greed, vanity, lies, slander and envy which escaped the box. When she managed to close it again one value was kept inside represented by a tiny winged angel. That was HOPE.

Holidays After Divorce

5 Things to Do:
1. Be sensitive to the fact that your children are looking forward to the holidays with you and also with your ex. Do not take it personally that children like to spend time with both parents. Create new or continue old holiday traditions to make your children feel good about the holidays.

2. Do coordinate big gifts with your ex. There is nothing like the let-down of both of you getting your child the same big gift. It is a let-down for both the parent and the child and is completely avoidable by communication between both parents.

3. Do send a card to your ex's family if you are close to them. It is natural to still have feelings for them if you were close emotionally to them. However, do not say anything derisive or negative about your ex in the card.

4. Call a truce with your ex in the spirit of the holidays if you do not have mutually respectful relationship or still harbor animosity toward them. The holidays are a time to transform anger and to have goodwill to all men (and women)... even if that includes your ex.

5. Do take care of your self during the holidays- take time to de-stress in healthy ways (exercise, massage, good nutrition, refrain from over-indulging in food or alcohol). If the children are not with you over the holidays, then plan to do something that would be fun and nurturing rather than sitting at home and being miserable.

5 Things Not to Do:

1. Do not compete with your ex to out-do in gift-giving.... it only spoils the children and makes everyone feel uncomfortable (including the children).

2. Do not punish the children for having a good time with your ex or sharing stories of the good times they had at your ex's home. Don't you want your children to have good memories of their holidays? They have a good time with you too and are also sharing that with your ex. Your children need to feel happy and loved in both homes and not be made to feel guilty about it.

3. Do not send a mean card to either your ex or your ex's family. If you can't say something nice (especially during the holidays), then don't send anything at all.

4. Do not tell your children how lonely you are when they are not with you over the holidays. It is NOT fair to make your children feel responsible for your feelings, thoughts or behaviors. We are very powerful in our choices, and we can either choose to be miserable or choose to be happy. After all, the adults were the ones who chose to get a divorce. The children are just having to deal with the situation.

5. Do not over-extend your self over the holiday with attempts to be super-parent to outdo your ex (by volunteering in the school, with sports team, or community parties).

DocTracy

Insomnia and Stress

Humans are very much affected by biological rhythms (Circadian rhythms) and these rhythms are determined by length of daylight hours. In the center of our brain we have a structure called the pineal gland that is instrumental in regulating hormonal balances in our body based on our length of exposure to daylight. Primitive man only had to deal with light in the form of daylight of moonlight; however, modern man has a more chaotic light exposure with the advent of technology such as the electric light bulb, computers, video games and television. We are no longer limited in our activity by the length of our available sunlight or moonlight.

Much of the early sleep studies were done at Van Cauter Sleep lab at the University of Chicago. A 1999 study there showed that chronic insomnia could trigger metabolic and endocrinological changes that mimicked aging. A 2001 study revealed that sleep deprivation could lead to insulin resistance, a risk factor for the development of adult onset diabetes. A 2002 study showed chronic sleep deprivation could decrease immune function and make a person more susceptible to infection.

A study done at the University of Chicago (published in the Annals of Internal Medicine in December 2004) found that sleeping only 4 hours for 2 nights had the effect of decreasing the hormone leptin by 18% and increasing the hormone grehlin. Grehlin is produced by the stomach and triggers the sensation of hunger. Leptin is released by fat cells and stimulates the brain to feel satiety or fullness. These 2 hormones can play a long-term role in regulation of body weight.

We have long known that women's menstrual cycles are influenced by Circadian rhythms as menstrual cycles run on 28-day cycles, the same as the lunar cycle. A study at the University of California Sand Diego Sleep Lab revealed that the length of women's menstrual cycles were altered by exposing women while they slept to artificial light around the middle of their cycles (near the time of ovulation). Hormones that trigger ovulation and even sperm maturation process are tied to natural biological or Circadian rhythms. The pineal gland is instrumental in a calibrated release of melatonin and cortisol during restorative sleep stages. Compared with good sleepers, people with insomnia secrete more cortisol in the evening before bedtime and in the first half of their sleep.

Stress is the principal cause of insomnia and affects millions of Americans. How does stress cause insomnia? Falling asleep is a natural process that involves a series of events. As we approach sleep, metabolism gradually decreases, heart rate slows and blood pressure lowers. Breathing becomes deeper and more regular; and we utilize less oxygen. the muscles in our body, which have been tense much of the day to keep us upright and moving about, begin to relax. At the same time, the processing activity of the wakeful brain shifts. The activity of neurons in the cerebral cortex slows and becomes more synchronized, indicating a transition from the complex, activated patterns of waking consciousness toward a more homogenous, deactivated state. As a result, we stop paying attention to the sensory messages coming in from the outside world, and we slip into a peaceful, quiet sleep.

Cortisol, released during a stress response, is excitatory; it wakes us up. Blood levels of cortisol have been shown to increase between 50 and 160 percent within thirty minutes of waking; that produces the powerful jolt to awaken us and get us up and moving in the morning. After that, cortisol levels should decrease as the day progresses and reach their lowest point in the evening, allowing us to rest, relax, and then drift off to sleep.

Cortisol levels are often affected by the stress of our daily hectic lives. Threatening or demanding events cause us to temporarily secrete higher levels of cortisol. Typically, that's a good thing, because we need to be aroused and vigilant in order to face and deal with the tests and challenges that arise in our lives. However, when we experience prolonged stress, whether real or perceived, our cortisol levels get stuck at a chronically high level, that's bad news for our bodies and emotions, and especially bad news for our ability to sleep and relax. Chronically elevated cortisol leaves us perpetually hyperaroused. Numerous studies indicate that insomnia is accompanied by excessive activation of the stress-response system during both waking hours and sleep as well. Furthermore, chronically high levels of cortisol and its precursor, adrenocorticotropic hormone, can make sleep shallow, broken, and unrestful with a delay in the onset of sleep.

Meditation, stress reduction techniques and mindfulness exercises can assist with significantly decreasing stress and improving the quality of sleep and periods of relaxation. Our book SHIFT: 12 Keys to Shift Your Life was written after teaching the concepts in seminars and courses for 6 years and using the tools and techniques to dramatically decrease perceived stress, anxiety, and mild depression in patients, colleagues and friends.

DocTracy

Positive Intention- Nice, Airport

Today I spent a few hours at the airport waiting to take off. Our flight was delayed again and again and I was inspired to do a short experiment. I set my intention to center myself in my heart and look around acknowledging that every single person I saw was not only just another complaining and frustrated passenger, but also a fellow creation of God/Universe /Source. I further acknowledged that we were all connected and a reflection of one another. With that feeling in mind(consciousness)and my heart expanded I attracted so many people my way. I had been standing in a relatively empty space and after 3 minutes there was a large number of smiling, laughing, positive and chatty people around me.

Living in your heart is a very loving and powerful feeling. The power of our energy to attract like energies and effect the collective consciousness of others is enormous. Don't wait to go to the airport to try it!

DocMarion