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Description Of ADD vs. ADHD

By Barbara C Fisher & Ross A Beckley

Definition: AD/HD is the presence of a genetic biochemical disorder that does not allow people to work to their full potential.

The Brain:     a)  Frontal Lobe integrates all the information

b)     Parietal area processes sensory information

c)      Temporal – memory, balance, and hearing

d)     Occipital is the visual area

Only the Frontal and Parietal areas are involved in AD/HD.

Neurotransmitters:   The brain talks to itself chemically and electronically. The chemical messengers are called neurotransmitters.

 A chemical imbalance  is a neurotransmitter failure.

Symptoms can vary from day to day, hour to hour and sometimes cannot be seen. They affect everyone differently

Two Types:  ADD without Hyperactivity and ADHD display different symptoms, have different effects and require different treatment.


ADD without Hyperactivity


ADD with Hyperactivity

 Cause:

The cause seems to reside primarily in the parietal lobe. The frontal lobe processes are intact.

The size and structure of many brain areas differs; especially, a lack of activity in the frontal area (“Hypofrontality”). This is linked to a deficiency of the neurotransmitters dopamine and norepinephrine which are involved with arousal and alertness. Low serotonin is linked to impulsivity and problematic behavior.

           

 Main Indicators:

Fear; anxiety; low brain energy leading to a capacity problem; slow cognitive thinking; daydreaming; avoidance and procrastination; mental confusion; poor memory retrieval. But the frontal processes are intact so these people rely on logic.

 

Problems with attention, impulsivity and hyperactivity

 Impulsiveness:

Rarely impulsive but can appear so when frustrated.

Self-regulation is weak because the control mechanisms of the frontal lobe are not functioning well, e.g. self talk is not used; they are unaware of the consequences to their actions, fast cognitive speed contributes to impulsiveness.

Distractibility:

This is the primary problem. They cannot sustain attention and concentration because:

a)     low energy which causes loss of focus and follow through

b)     environmental factors

c)      their own racing or wandering thoughts

Cannot maintain focus so have poor sustained effort; race from task to task; are easily bored; forget and lose things because they missed information due to being distracted; need external motivation

Hyperactivity/   Restlessness:

Due to anxiety, not the ADHD motor issue. These people are driven and cannot relax. Daring activities are rare; activities are not for excitement but for relief from constant, wandering, racing thought patterns and anxiety

Due to motor activity, not anxiety. These people crave excitement and stimulation.

Social Problems

Shy; withdrawn, immature; often seen and not heard; information processing difficulties lead to not knowing how to talk, dress, act, etc.; conversation is difficult because of slow thinking or missed information; they can manipulate because of fear of others’ anger or guilt about asking directly; interrupt because their wandering thoughts will cause them to forget what they want to say. May appear to not be listening but this is really due to the person’s information processing deficit.

Egocentric; do not connect with others because they don’t care; are rejected socially because of inappropriate behavior; are intolerant and can become abusive; cannot negotiate so manipulate others; interrupt because of impulsivity and lack of control; do not listen because of attention difficulties and lack of concern for others.

Communication:

When not talking excessively because of anxiety, these people say little but think a lot; therefore they do not display their thoughts or feelings. They are afraid to express anger or arouse it in others.

Meaningful relationships. However, personal relationships may be difficult and uncertain. Because of egocentricity, poor focus, distractibility, intolerance, etc.

Time Sense:

Time is poorly planned; being late is common but can be improved with teaching and practice

Time is poorly planned (miscalculation of time needed to complete a task); being late is common but can be improved with teaching and practice


Impatience:

Do not need instant gratification. These people become impatient only after trying unsuccessfully for a long time at which point they are tired, disheartened and upset.

 Constantly frustrated and crave instant gratification

 Sensitivity:

Shy and fearful of others’ displeasure

 Vulnerable to criticism to which they react, sometimes angrily.

 Frustration Tolerance:

 Desperate to succeed so will keep trying too long resulting in them being overwhelmed and despairing. This tendency may show as anger.

Frustration tolerance is low, leading to irritability, anger and aggression

Rigidity of thinking:

Tend to be concrete thinkers. May lead to rigid thinking patterns.

Black and white thinkers due to the frontal processes not functioning properly. They are rigid in relationships and are NOT team players.

Planning and Organization:

May appear to have difficulty planning but these difficulties are really the result of distractibility, confusion and slow thinking processes

There may be sequencing problems due to poor frontal lobe functioning

Perseveration:

A big problem. These people will keep trying too long, burn out, and quit

Not a problem for this population.

Learning Difficulties:

Information processing is poor because information is missed. Difficulties in slow cognition are common but once they understand the material they can use it. Reading and spelling be difficult because of weak phonemic skills. Mental arithmetic can and geometry can also present problems

May have learning disabilities (e.g. dyslexia) because of differences in brain functionality.

Learning difficulties caused by the ADHD include missing information, and failing to learn from ones mistakes. They can often comprehend information but cannot make use of it.

 

 

Lying:

Aim to please. If they do lie it is usually only to avoid others anger or disapproval.

May lie for no valid reason. Lying is impulsive and fear is not involved.

Criminal Activity:

Are not as at risk for criminal behavior as people with ADHD because they have a better understanding of the consequences to their action. Stealing is usually only committed to cover up something. People with ADD make poor criminals because they have slow cognitive speed and do not tend to get away in time.

A lack of internal rules to govern behavior may lead to criminal activity. Maintaining a job may be a significant difficulty leading to low income and crime. People with ADHD are highly represented in the prison system.

Excessive Behavior:

1) talking,  2) spending, 3) gambling, 4) anger, 5) movement, 6) eating,
7) alcohol/drug abuse especially cocaine

Caused by no internal STOP sign, no guilt, and no anxiety

1) talking due to anxiety, not hyperactivity 2) alcohol/ drugs to self-medicate for anxiety (marijuana popular as it gives a sense of relaxation) 3) movement due to anxiety, not hyperactivity
Positive Attributes: movers and shakers, exciting, energetic, aggressive (all assets in pursuits others are afraid to try). Can do well if self-employed Positive Attributes: These people do really well what they know they can do
 

ADD Without Hyperactivity is not always recognizable if the person can compensate and "get by". Performance will be inconsistent because of all the weaknesses. The generalized anxiety can lead to panic attacks, phobias, sleep deprivation, depression and stress-related problems in later years.

  ADD Without Hyperactivity - Over-focused Subtype

Indications:

1.   Frontal processes are intact so it is NOT ADHD even though they look hyperactivity
2.   Always worried, even as children.
3.   Overly dramatic.
4.   Overly sensitive, emotional, "fragile".
5.    Perseverate (focus on one thing excessively) and may appear stubborn.
6. Overly focused and with rigid thinking. Can be advantageous in plugging on until the job is done.
7. Intolerant of change because of fear.
8. Their brain never stops, resulting in sleep deprivation.
9.   Overly sensitive to medications.
10. Swallowing pills is difficult
11. Clothing must be loose especially at collars and cuffs.