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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
ADHD THROUGH THE MOVIESwww.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
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…”
famous people with attention deficit and learning disorders

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
adhd diagnosis
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
visual images
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
impulsivity
Impulsivity
  • An urge that is difficult to resist
    • Dennis the Menace
    • The Simpsons
inattention
Inattention
  • Loss of order and loss of presence of mind
    • Home Alone
    • Inspector Gadget
    • Gilligan’s Island
    • Get Smart
motor hyperactivity
Motor Hyperactivity
  • Any movie by
    • Jim Carrey
    • Robin Williams
    • Howie Mandell
    • Tom Cruise
adhd developmental
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

attention deficit disorder
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.)
symptoms of hyperactivity often manifest differently in adults
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

symptoms of inattention often manifest differently in adults
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
symptoms of impulsivity often manifest differently in adults
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

adhd impairment persists

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

diagnosis of adhd in adults common clinical histories
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

office presentation
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
adhd and comorbid conditions
ADHD and Comorbid Conditions

Impulsivity/

Hyperactivity

Inattention

Comorbidity

clinical presentation
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
comorbid psychiatric disturbances are common in adults with adhd
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.

adhd comorbidity in adults with other psychiatric disorders
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.

domains of impairment
Domains of Impairment

Health/Injury

Academic/ Occupational

Impairments

Substance Abuse

Self-esteem

Sexual Behavior

Social Functioning

Criminality

adhd owners manual
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.

potential areas of impairment

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
pharmacotherapy in adults
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
adhd odd and cd integrative interventions
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

conclusions
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