ADHD – The Galileo Moment

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Galileo, ADHD diagnosis and treatment, neuroscience
Seize This Galileo Moment

Measure what is measurable and make measurable what is not so.
Galileo Galilei ~1640

Consider this year, 2014, as “ADHD’s Galileo Moment.”

Galileo changed the way we think about measured observations, and that consequence became a scientific Renaissance. A similar, remarkably parochial disdain exists today with ADHD medications, and it’s going to take a serious change in thinking to bring about a change in ADHD medical practice.

The pervasive, unmentionable problem: too many write for meds without any training on the reality of diagnosis or treatment specifics for ADHD, thinking that labels provided sufficient maps for mind travel.

The Challenge | The Lesson Opportunity

Collectively we stand on the frontier of an inevitable Mind Renaissance – if we can move forward from Neo-Freudian labels to data-driven, measured mind solutions that address mind complexity beyond oversimplified diagnostic conjectures.

Galileo introduced advanced measurement tools [including the telescope] to science. Those measurements challenged a globally accepted and incorrect solar conclusion, and ultimately changed belief systems based for centuries upon superficial observations.

The sun does ‘look like’ it rotates around the earth. But when the earth and sun were measured accurately around 1616 with that telescopic advanced technology, Galileo confirmed the Copernicus measurements, the now well known Heliocentric Reality, that contrasted markedly with emotionally held beliefs based upon Geocentric Appearances for thousands of years. Data matters.

Why Consider ADHD Changes in 2014?

Common beliefs about ADHD treatment arise from a combination of public dissatisfaction and professional appearance protocols. However, these professional medication protocols are based on limited diagnostic [and treatment] perspectives. Much like the world’s assumptions about the sun before Galileo introduced the telescope, critical biomedical information about ADHD diagnosis and treatment isn't missing, it's disdained.

We don't use easily available technology, we don't test of helpful answers, and too many wish to metaphorically kill the biomedical technology Galileo Mind Messengers – the innovators, the evidence crowd. As a result, all too often, public sentiment takes a firm destructive stand against using ADHD medications for effective medical treatment, and often with good reason.

Quite reasonably you may then ask: “What is the problem with ADHD medications? Why are so many people so negative, or hesitant, when stimulant medications can prove remarkably useful for many?”

The Indisputable AnswerVagary, born in appearances, drives the current inadequate ADHD medical standard of care.

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There are THREE main issues to be considered here:

1. Current Labels for ADHD Overlook Medical Reality

Currently, ADHD diagnosis and treatment protocols overlook critical information about the biomedical complexity of ADHD. ADHD labels (Hyperactive, Inattentive and Combined) describe behavior, but they do not address measurable medical challenges that effect brain function. Cellular activity and immunity issues, for example, are important, measurable complications that actually compromise brain function and impair working memory. For example, despite the existence of world literature confirming the link between damaged brain functioning and immunity issues, such as gluten and casein sensitivity, their consideration as reasonable ADHD treatment remains astonishingly controversial. Remarkable, but true.

2. Brain and body function are omitted when considering treatment

Thousands who do struggle with “ADHD challenges” meet the criteria for diagnosis, attempt treatment, and suffer from side effects of medications. Treatment will improve if medication treatment include measuring how brain function and working memory affect executive functioning. For example, the symptom of Hyperactivity may be corrected by medication, but executive functioning can remains  markedly impaired.

Inattention may seem to improve, but avoidance and procrastination, (more directly associated with brain function) remain off the treatment radar – considered as personality disorders. Measurements that address deeper medical imbalances, such as genetic metabolic imbalances or specific medication duration of effectiveness, provide valuable information for both physicians and patients, and ultimately minimize inaccurate medication practices.

3. Cognition — The Essential “ADHD” Problem — both Overlooked and Denied as Significant

Balanced cognition – reacting appropriately to make timely adjustments to changing Reality – distinguishes the human thinking process from that of cows, cats, and even well trained elephants. Ultimately, balanced cognition is the treatment objective when managing ADHD. Paradoxically, ADHD is a behavioral diagnosis, observable from the outside. Cognitive self-observation is not reported or considered for diagnosis, which means that the current system of “ADHD” diagnosis and treatment overlooks the very objective of treatment: cognitive activity, executive function. This unacceptable consequence perpetuates vertical medical management systems and encourages the truth that anyone is an expert on the basis of such superficial protocols. 

The Behavioral Paradox – Metacognition Denial

Because diagnosis is hyper focused on behavioral issues, cognitive impairment is overlooked. It is noteworthy that the current DSM code does not consider cognition to be impaired unless one suffers from dementia. The way the Diagnostic Statistical system is currently arranged, with it’s inattention to cognitive markers, the entire medical system “doesn’t get it.”

For example, labels inherently overlook issue of the sequence of working memory –- how people manage their own reality through thinking, acting and remembering on a timeline. This internal cognitive disability can cause individuals to act without thinking, think repeatedly without acting, or completely avoid reality by avoiding thinking or acting in time. Associated behavioral challenges can then be understood in the context of identifying what is happening cognitively.

ADHD and Metacognition: A NEW way of thinking

Metacognition is a new, more accurate, more functionally useful word from the ADHD literature that connects biomedical reality, brain function, diagnoses, and reality-based, customized treatment strategies.

When we actually think about thinking, or the process of thinking in various real-life circumstances, treatment targets improve. Just as Galileo’s telescope changed the way we measured solar observations. The process of looking for a different, improved set of answers enhances metacognitive understanding of ADHD.

We must now walk with Galileo by asking the following questions;

  • Is the person thinking too much?
  • Are they acting without thinking?
  • Are they avoiding reality?

A “yes” to any of the above may indicate a de-synchronization in brain functioning and working memory – to then open new ways of thinking that can change the course of treatment. Executive function, dealing with changing reality remains the primary target. All detailed much more in New ADHD Medication Rules.

Diagnostic & Medication Treatment Corrections

Applying metacognition, or thinking more carefully about the biomedical process of thinking, encourages several important improvements in both targets and process:

  1. ADHD Medication Diagnostic targets must include executive function imbalances – brain function is the new target.
  2. Medication management must include an understanding of metabolic and biomedical processes that modify metabolic rates – e.g. genetics, immunity, drug interactions, food, sleep, duration of effectiveness, co-existing psychiatric conditions.
  3. Medical awareness of changes within the Therapeutic Window of each medication must be customized using brain function measures for every patient at every medication check.
  4. Recognition and correction of nutritional and endocrine imbalances that impede medication effectiveness is imperative.
  5. Essential, long overdue changes with medication dosing strategies then arise as the Reality-driven standard of care.

Those who currently suffer with executive function challenges will directly benefit from this new thinking. Fresh neuroscience evidence changes thinking. Galileo would be pleased.

For more information on how details can work for you, see the paperback, the eBook or the Audible: New ADHD Medication Rules – Brain Science & Common Sense.

Urgent     Galileo and ADHD

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Dr Charles Parker
Author: New ADHD Medication Rules – Brain Science & Common Sense
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25 Comments

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  8. Shortest article I’ve EVER written on the recent “doesn’t exist” crappola – sending people to you in response to the ONE thing he says that makes sense: your point that dx based on appearances vs. science is rubbish.

    Article: “New title sells books – sells OUT lives”

    xx,
    mgh
    (Madelyn Griffith-Haynie – ADDandSoMuchMore dot com)
    – ADD Coach Training Field founder; ADD Coaching co-founder –
    “It takes a village to educate a world!”

    • Madelyn,

      Thanks so much for the serious effort you put in on the ‘refutation of gossip’ over at your site. As Dr Hallowell so correctly points out in his article – these data points are truly beyond belief. Reality is not a belief system, gossip is clearly a belief system. I’m pleased you included me in your pantheon of neuroscience observers that continue, collectively, to make a difference in this important debate. Why is it important? Because ‘beliefs’ can build a kingdom, or prevent the assembly of a new one.
      cp

  9. Naysayer says:

    Firstly I wanted so start off by saying your Blog and Approach are refreshing in a world where traditional Doctors shoot from the Hip with medications and ask questions later. I have fixed my DOE and ADHD symptoms using your videos and blog – have proven a revelation for me..

    I had some questions about Functional Health in general which I wanted to ask you: I have taken time to read a selection of books recommended on Core Brain:
    -Gut and Psychology Syndrome (Campbell McBride)
    -Ultramind (Hyman)
    -Grain Brain
    -Nutrient Power
    -Why Isnt my Brain working

    While all the ideas are compelling and interesting they all advise different strategies – I feel more confused having read them all than before I started. For instance Campbell McBride and Kharazdian are pretty strong armed – not much scientific proof in the pudding!
    Your insights all involve measurable targets..
    What are your thoughts on the conflicting advice from each book?

    • Naysayer,
      I’m working on a book to be published in the fall which will attempt to resolve some of those glaring differences. Notice also the difference between Perlmutter at Grain Brain and Esselstyn Prevent and Reverse Heart Disease. I can assure you I won’t connect all the dots, but I certainly will try to address some of the obvious disparities.

      Thanks for your input! Glad you’re turning the corner 😉 Good show!
      cp

  10. AJ says:

    Dr. Parker,

    Very interesting to read about procrastination and avoidance. I’ve also read that dexedrine can decrease magnesium levels, and am starting a supplement. However, I do not know which form to take. I purchased magnesium oxide, but several people on forums have suggested that it has a low bioavailability. Do you recommend a formulation? I talked with my pharmacist, and he advised me to ask my doctor to test my blood for magnesium levels, however he said there should be no negative effects to starting now, as long as I take the directed dose.

    Also, you mentioned that procrastination and avoidance are directly related to brain functioning and not just personality issues. Do you have any more information on this? I have your book–I looked but couldn’t find this specifically, so if it’s in there could you recommend a chapter?

    • AJ,
      Don’t have New Rules right here but know there are three chapters in sequence 1. Acting ADHD, 2. Thinking ADHD and 3. Avoidant ADHD – take a look at #3 for details. For chelated Mg: Citrate is easy, Gluconate is widely available. As for me I don’t recommend “just try this,” – as that’s my whole message: why mess around guessing when you can simply measure? Know your levels first… you could already be too high on Mg – not likely, but that’s the preferable way to approach these issues.
      cp

  11. Marty says:

    Dr. Parker..

    I was told to stop looking for answers and accept the reality of Tony’s diagnosed ADHD, bipolar, GAD, OCD, ODD, CD, and personality disorders. I found this unacceptable based on how much is being discovered and/or understood these days. As a “layperson” I have devoured whatever I could find in web sites Psychiatric Times, CDC, Neuroscience Research Techniques, David Perlmutter, M.D., Andrew Weil, M.D., many others, and, more importantly, your information and commentary relative to Core Psych.

    I am what I consider a devotee at this point to your efforts and will certainly be acquiring your book on Medication Rules. Oh, and on the “house arrest” thoughts, I really do believe the state of mind reality such as practiced by the likes of Wayne Dyer, and Andrew Weil. Thank you for all you are doing…and keep it up “doc”.

    • Thanks so much Marty, it’s folks like you with inquiring minds who will make the difference in actually seeing the value of evidence. It’s a deeper dig process – until it’s there in the light of day.

      Glad we’re on the path together,
      cp

  12. Jeff Copper says:

    Well put Dr. Parker… and I like the Galileo comparison.

    Galileo’s was controversial within his lifetime. He met with opposition from astronomers and the Pope. He was tried by the holy office and spent a portion of his life under house arrest.

    My hope is you can get the word out without being put under house arrest!

    Jeff