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ADHD THROUGH THE MOVIES www.adhdclinicjeeva.com

ADHD THROUGH THE MOVIES www.adhdclinicjeeva.com. DR SHABEER JEEVA CHILD AND ADULT PSYCHIATRIST. LRCP, LRCS(IRELAND), D.PSYCH(OTTAWA), F.R.C.P(CANADA). Patients with “ADHD” may suffer Because…. Their parents don’t understand them; Their teachers can’t stand them;

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ADHD THROUGH THE MOVIES www.adhdclinicjeeva.com

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  1. ADHD THROUGH THE MOVIESwww.adhdclinicjeeva.com DR SHABEER JEEVA CHILD AND ADULT PSYCHIATRIST LRCP, LRCS(IRELAND), D.PSYCH(OTTAWA), F.R.C.P(CANADA)

  2. Patients with “ADHD” may suffer Because….. • Their parents don’t understand them; • Their teachers can’t stand them; • Their peers reject them; • Their spouses and bosses can’t stand their disorganization and intensity; • They themselves begin to think: “no matter what I do I can’t win…”

  3. Famous People with Attention Deficit and Learning Disorders • Albert Einstein • Thomas Edison • Gen. George Patton • John F. Kennedy • Bruce Jenner • Eddie Rickenbacker • Harry Belafonte • Walt Disney • Steve McQueen • George C. Scott • Tom Smothers • Suzanne Somers • Jules Verne • “Magic Johnson” • Carl Lewis • Nelson Rockefeller • Sylvester Stallone • Cher • Gen. Westmoreland • Charles Schwab • Danny Glover • John Lennon • Greg Louganis • Winston Churchill • Henry Ford • Robert Kennedy • George Bernard Shaw • Beethoven • Hans Christian Anderson • Galileo • Mozart • Leonardo da Vinci • Whoppi Goldberg • Tom Cruise • Henry Winkler • F. Scott Fitzgerald • Robin Williams • Louis Pasteur • Werner von Braun • Dwight D. Eisenhower • Lindsay Wagner • Alexander Graham Bell • Woodrow Wilson

  4. ADHD Diagnosis • 5-9% children with this condition • 60% of these children go on to adulthood with impairing symptoms • Core symptoms are • Impulsivity • Attentional problems • Motor hyperactivity

  5. Visual Images • Move in the academic teaching arena to use movies and visual processes as ways of teaching • ADHD patients respond better to visual systems rather than talking • Auditory processing problems • Strengths in visual-spatial ability • Ability to see the forest but not the trees

  6. Impulsivity • An urge that is difficult to resist • Dennis the Menace • The Simpsons

  7. Dennis the Menace

  8. Inattention • Loss of order and loss of presence of mind • Home Alone • Inspector Gadget • Gilligan’s Island • Get Smart

  9. Home Alone 2

  10. Motor Hyperactivity • Any movie by • Jim Carrey • Robin Williams • Howie Mandell • Tom Cruise

  11. ADHD-Developmental • You must accept that if ADHD is a lifelong disorder, then your personality must change. The Adult is still having power battles with authority figures which is similar to the power battles within themselves. • Different Examples -Officer and a Gentleman -Goodwill Hunting -The Lion King -Mrs. Doubtfire

  12. ATTENTION DEFICIT DISORDER A.D..D. IMPULSIVITY Failure to think of Consequences before acting -------------------------------------------------------------------------------------------------- “Combined” • ATTENTION • = DISTRACTIBILITY • Trouble holding focus • A.D.H.D. • + OVERACTIVITY • (easily bored/excess energy.)

  13. DSM-IV Symptom Domain Squirms and fidgets Can’t stay seated Runs/climbs excessively Can’t play/work quietly “On the go”/driven by motor Talks excessively Common Adult Manifestation Workaholic Overscheduled/overwhelmed Self-selects a very active job Constant activity leading to family tension Talks excessively Symptoms of Hyperactivity Often Manifest Differently in Adults Hyperactivity often changes to inner restlessness

  14. DSM-IV Symptom Domain Difficulty sustaining attention Doesn’t listen No follow-through Can’t organize Loses important things Easily distractible, forgetful Common Adult Manifestation Difficulty sustaining attention Meetings, reading, paperwork Paralyzing procrastination Slow, inefficient Poor time management Disorganized Symptoms of Inattention Often Manifest Differently in Adults

  15. DSM-IV Symptom Domain Blurts out answers Can’t wait turn Intrudes/interrupts others Common Adult Manifestation Low frustration tolerance Losing temper Quitting jobs Ending relationships Driving too fast Addictive personality Symptoms of Impulsivity Often Manifest Differently in Adults Impulsivity in adulthood often carries more serious consequences

  16. Becomes Becomes Becomes Becomes Becomes Becomes ADHD Impairment Persists Childhood Adulthood    School failure or underachievement Job failure or underemployment Multiple injuries Fatal car wrecks or risk taking Drug experimentation Drug dependence Oppositional defiant or conduct disorder Antisocial personality disorder, criminality Impulsivity, carelessness Unwanted pregnancy, sexually transmitted disease, etc Repetitive failure Hopelessness, frustration, giving up Courtesy of W. Dodson, MD

  17. Difficulties in Elementary or Secondary School Comments: “not living up to potential,” “spacey,” “hyper” Behavioral issues: “class clown” Difficulties in College Incomplete degree or longer time to complete degree Difficulty engaging in further education Difficulties at Work Underachievement (mixed reviews) Low efficiency: 4 times longer to complete tasks Difficulties at Home Poor organization, does not complete tasks Strained relationships with spouse and kids(who also may have ADHD) Diagnosis of ADHD in Adults:Common Clinical Histories Courtesy of T. Wilens, MD

  18. Sound of Music

  19. Patients with ADULT ADHD: Office Presentation • Are forgetful or “airheads” • Miss appointments or arrive late • Lose prescriptions • Do not carry out instructions or the treatment plan • Are hypertalkative • Are “passionate” or have emotional storms triggered by events

  20. ADHD and Comorbid Conditions Impulsivity/ Hyperactivity Inattention Comorbidity

  21. Clinical Presentation • Multiple mental health consultations • Multiple jobs • Stormy relationships • Trouble with authority figures;arrest record • Family history of bipolar disorder,substance abuse, or Tourette syndrome • Family history of ADHD • Performance and mood determinedby interest and challenge

  22. Comorbid Psychiatric Disturbances Are Common in Adults With ADHD Antisocial Disorder (10%) Major Depressive Disorder (35%) Bipolar Disorder (15%) Anxiety Disorders (40%) Substance Abuse Disorders (50%) Shekim WO et al. Compr Psychiatry. 1990;31:416-425. Biederman J et al. Am J Psychiatry. 1993;150:1792-1798.

  23. Officer and A Gentlemen

  24. ADHD Comorbidity in Adults with Other Psychiatric Disorders DisorderADHD Rate Major Depression1 20% Bipolar Disorder2 15% Generalized Anxiety Disorders3 20% Substance Abuse4 25% Re-evaluate refractory patients for ADHD 1. Alpert et al. Psychiatry Res. 1996. 2. Nierenberg et al. APA Presentation. 2002. 3. Fones et al., J Affective Dis; 2000 4. Wilens. Psych Clin N Am; 2003.

  25. Domains of Impairment Health/Injury Academic/ Occupational Impairments Substance Abuse Self-esteem Sexual Behavior Social Functioning Criminality

  26. Mrs. Doubtfire

  27. ADHD Owners Manual Many people with ADHD don’t realize they have an owner's manual. We help them to learn about themselves. This is the way you are. ---How to maximize your strengths and minimize your weaknesses. It helps people look at themselves in a more positive way and to learn why things have happened.

  28. Children Academic limitations Relationships Occupational/ vocational Adults ADHD Low self esteem Legal difficulties Motor vehicle accidents Injuries Smoking and substance abuse Adolescents Potential Areas of Impairment

  29. Sound of Music

  30. Stimulants Methylphenidate-Ritalin Amphetamine compounds-Dexedrine Magnesium pemoline (not recommended) Long acting stimulants -Ritalin-SR.Ritalin-L.A,Concerta,Adderal XR Atomoxetine (FDA-approved in adults)-Straterra Antidepressants Bupropion-Welbutrin SR SSRI/SNRI Tricyclics Other - Mood Stabilizers: Valproic Acid/Lithium - Atypical Antipsychotics: Resperidone - Clonidine Research Modafinil Pharmacotherapy in Adults

  31. ADHD, ODD and CD Integrative Interventions • Preventative interventions (i.e. preventing the development of comorbid disorders) • Patient, parent, spouse training and support • Individual counseling and therapy • Group counseling and therapy • Family counseling and therapy • Interventions at school and work place • Medication eg. Resperidone • Working with correctional systems Turgay (2001), The World of Children # 4, Winter 2001 pp:9-28

  32. Lion King

  33. Conclusions • ADHD symptoms are impairing • The symptoms continue into adulthood • Early problems of attachment lead to a false sense of self • Insight to the clinical symptoms has profound implication to treatment and compliance

  34. ?ADULT ADHD SYMPTOMS

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