ADD Context II: Physics, Reality, and Structure

AD/HD: Diagnosis and Treatment Often Miss the Mark
October 11, 2008
Fixing the ADD Madness: The Diagnostic Mess
October 18, 2008

ADD: A diagnosis over time – A diagnosis of context.

So what do I mean by "context?"

In the last post I told you about the physics professor with ADD – and you may very well have said: Impossible! His "management problem," that "group problem" he has, is not ADD, it is SAD, Social Anxiety Disorder.

Descriptively I agree, but functionally [from the point of view of brain function} it's more than that.

Yes, from one perspective, description and labels alone… he manifests his inability to function, his cognitive anxiety, with groups of people. There, in that people reality, symptoms of cognitive anxiety occur. Groups of people bring a change to his mathematically safe reality. People introduce an exposure to change, to unpredictable variables, and decreased structure unsettles his prefrontal cortex.

The pre-frontal cortex works vigorously to handle reality over time – its executive functions sets the brain and the person to keep in step with changing reality.

People are unpredictable for him, math is not. Groups of people present one context of reality – physics, mathematics is another reality. For him physics is more predictable. Different, less predictable realities significantly alter the process of thinking and acting with ADD.

No, ADD is not like a bacterial infection that remains present until the antibiotic works to kill all the offending bugs. It is a condition that is much more mercurial, often not categorically obvious, not present all day every day, – but exists in specific contexts of reality.

Some show no ADD in Jr High, but serious ADD arises as a freshman in High School – the context, the variables, the real structure has changed.

This simple observation is why so many have problems understanding and treating ADD – they don't get this problem of changing reality, and context. They think it appears categorically, like an infection, all or none – and if you are academically smart, all A's through several graduate schools, you couldn't possibly have that problem

Without understanding and correcting this simple point, we will continue to treat labels, categorical descriptions, and not the people where they live, in some context of changing reality.

2 Comments

  1. Mary-
    Excellent question and deserves an entire post –

    Short answer: Yes, many have ADD and comorbid conditions associated with sleep disorder. But then the deeper question arises: what is causing the sleep disorder? Some of the many questions I would want answered in answer to your question are:

    -What is the total average hours of sleep?
    -What is the time and architecture of the sleep process?
    -Is the person suffering from Phase 1 falling asleep, Phase 2 staying asleep, or Phase 3 waking up too early in the morning?
    -Is there as snoring/sleep apnea disorder?
    -What is the diet and metabolism like, do they have another contributory problem such as hypothyroidism?
    -And my old favorite bell weather: How many times a day do they go number 2? Bowel irregularity often points to metabolic challenges-
    -And if a woman how are her menses, is the hormonal system ragged with estrogen dominance? [see CorePsychPodcast for an audio on this topic]

    So many questions, and more would arise in the office – for now, sleep review and a good medical work up are in order, because all of these various problems can show an ADD surface presentation that will only slightly be corrected with stimulant meds.

    If we miss the body biology and treat only the ADD surface we often see treatment failures-

    And then if we get those underlying sleep or hormonal issues corrected the person may still suffer from comorbid ADD!

    Thanks!
    cp

  2. Mary says:

    Is it not true that an individual could be diagnosed with ADD, while also displaying some or all symptoms of narcolepsy? How is one to know whether the inability to focus or concentrate is a result of ADD or is instead a result of the sleep disorder?