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ADHD and Executive Function

January 27, 2013 Leave a comment
Human Eye with different lines. The line of si...

Human Eye with different lines of sights.

We know that ADHD exists, so I’m not going to go into proofs that the child is not “raised irresponsibily”.  On the other hand, having a child with any disability does require you to be a more sophisticated parent and more sympathetic.

Executive Function (EF)

Executive Functions or EF are the skills used to filter, organize, and prioritize stimulus and cognition to perform a function.  Kids with ADHD  “exhibited significant impairment on neuropsychological
measures of response inhibition, vigilance, working memory, and planning”.   

Tests

From the neuropsych perspective, the Wisconsin Card Sort,  the Rey–Osterreith, and the Tower of Hanoi have been used to test EF.  You may have seen these tests on the Neuropsych Report when you had your child tested at the psychologists office.

EF part of ADHD or IS ADHD?

The International Journal of Disability, Development and Education, published a paper about how ADHD can be looked at with respect to EF with two perspectives: 1) Executive Function is part of the ADHD diagnosis or 2) Executive Function is the reason you have ADHD in the first place. 

Many meta studies have shown that while there is weakness of executive functioning in a part of the ADHD population it is not a singular representation of ADHD behaviors and outcomes.  Some studies show that only 30% of those diagnosed with ADHD have executive functioning problems.  And  people with autism, oppositional defiant, traumatic brain injury and other disorders also show EF problems.

Others like Denckla, Barkley, T.E. Brown and others show that there is significant cognitive impact, especially the ability to inhibit.  Brown has modeled the areas where this cognitive deficit can be seen:

  1. Activation: Organising, prioritising and activating to work.
  2. Focus: Focusing, sustaining, and shifting attention to tasks.
  3. Effort: Regulating alertness, sustaining effort, and processing speed.
  4. Emotion: Managing frustration and regulating emotions.
  5. Memory: Utilising working memory and accessing recall.
  6. Action: Monitoring and self-regulating action.

Brown argues that tests traditionally used in a neuropsych report are insufficient indicators of EF strengths.  The reason for this is that dissecting a problem into constituent parts is reductionist and does not reflect the whole.  While you can put body parts together and add electricity, you will not get a whole functioning human from it.  Rather a test of normal daily functions is a better indicator of EF ability.

Stealth Dyslexia

Sometimes EF problems can result from Stealth Dyslexia.  Have you or child made “stupid mistakes”?  You know that 3+12=15, but on a test you may multiply the left hand side and come up with an answer of 36, and not know you made the mistake.  Even if you go back and check.  Dyslexia originally thought to be a reading disorder may manifest in several ways not currently recognized as dyslexia.  What if the dyslexia manifested cognitively outside of just reading?  Eides and Eides have determined that Stealth Dyslexia have these in common:

  • Characteristic dyslexic difficulties with word processing and written output.  This is sometimes found as high IQ and verbal comprehension but trouble with output: terseness, spelling mistakes etc.
  • Findings on neurological and neuropsychological testing consistent with the visual language, auditory, and motor processing deficits characteristic of dyslexia.  Visual Percepetion issues and not attention could be the cause of coding/tracking problems.  Visual Problems can often be addressed by seeing a Developmental Optometrist.  Central Auditory Processing Disorder (CAPD) is found in many kids (and adults) where one cannot manage and filter background sounds from primary communication.
  • Reading skills that appear to fall within the normal or even superior range for children their age, at least on silent reading comprehension.  But writing and listening may be problematic.  Sometimes one can tape the lecture knowing that ideas will be recorded for later recall, several times if needed.   That way one can listen to the lecture and absorb the concepts.

Processing Speed

Yes slow processing speed is a recognized condition and can contribute to the impulsivity of ADHD.  People with SPS (I just made that up), cannot participate in dynamic conversations because just as they’ve figured out the pace, direction and tone, it has moved on.  They also have trouble “getting” things that are taught.  You might find very intelligent people teaching themselves, and rather than get behind they teach themselves ahead of everyone else. If you cannot keep up, you might just  forget it and decide to go for things.  And this may become a habit, that manifest as EF.  Some studies show that processing speed normalizes around 27 years of age, but if you can’t wait that long…or have regressed because of TBI, you can consider neurofeedback or SimplySmarter which works on sequential processing  and therefore could help processing speed in general. 

Medications have not been known to help with any of these things that interfere with clear EF, but knowledge of these aspects may allow you to have the sympathy to support your child (spouse?) better.

Categories: Affect/Emotion, Anxiety, Autism

The Myths of Happiness

January 6, 2013 Leave a comment

I heard a review of this book on the radio, and thought you may be interested in the discussion. Sonya Lyubomirsky is a psychologist who has studied happiness. She has found that happiness is not “attainable” but rather a state that is maintained regardless of the highs and lows in ones life.

I’ll be Happy When

I get that job, get that girl, get that money, have that house, have that baby.  But those big events only give you a bump in terms of happiness, the little things over a sustained basis are the ones that really affect your happiness. Whether negative or positive.  So little bursts of daily positive things will help you more than winning the lottery.

Is Happiness Important?

Hedonic Adaptation means that human beings adjust to whatever pleasure/happiness they have in their lives.  Got a bigger car, fantastic!  The afterglow won’t last that long, because even with that car, you will go back to your normal level of happines.  This could mean that you are always searching for another fix…or you could accept your level of happiness and not try to live at that level of stimulation (and potentially become antisocial in the process).  So it turns out there is a set point for happiness.

What about Striving?

If we were all happy with our situation…I’m looking at you meditators, would we ever try or enjoy anything?  Why go to the moon?  Why find cures for diseases?     It turns out that the heritability index for happiness is 50%.  Which means the half of things that make you happy are NOT your genes. 

Making You Happy

Smile

What helps you get happy (or stay happy) is,  Relationships!  Primary, Seconary and Tertiary: Family, Friends and Associates.  Studies have shown that the poorest societies are still happy because of close family connections.  Richer societies often loosen the family connection when wealth arrives.  Nonetheless there is a certain level of wealth that removes draining problems and this contributes to more happiness.  It’s just that dynamic of happiness creation has a limit.  Which is why more and more wealth does not lead to ultimate satisfaction.  Spending the money on worthy causes can contribute to happiness!  According to the book, the happiest countries are in Latin America (7/10), probably up and coming in terms of wealth but maintaining strong social bonds.

But what is happiness anyway?  It has two components: Frequent Positive Emotions and that you are progressing towards your life goals.

This means that people’s happiness is subjective.  An introvert can be happy with limited social interaction while an extrovert would suffer at the same level, and vice versa.   However generally speaking extroverts are on average happier than extroverts.

 There is also a level of happiness that comes through contrast, such as only being able to pet a favorite animal once a day (hedonic adaptation in reverse).  Could this be why many spiritual leaders give away their stuff rather than hoarding it?   Why start the hedonic snowball?

I’m not happy

If you are already not happy, how can you get it back? 

  • Do things you like
  • Serve others, volunteer, or bake!
  • Stay away from social comparison (Facebook)
  • Remember it’s the journey and not the destination
  • Replay good memories
  • don’t dwell on bad ones
  • Join a supportive group (like church, masjid, book club!)
Categories: Affect/Emotion, Anxiety Tags:

Abdominal GI webinar by Kurt Woeller

December 27, 2012 Leave a comment

He’s taken a  lot of information in research areas and combined it together in a webinar.   It should be available for a few more days and then you have to subscribe to it. But here are my notes; I didn’t note dosages because I don’t know your current setup.  Let me know if you need any explanation of what is here, I will do my best.

Constipation

Abdominal X-Ray might find impacted colon.  Could be caused by too few digestive enzymes.  CDSA testing can find alastate which is a reflection of pancreatic output.  Can take enzymes

  • Peptizyde-Gluten/Casein
  • ZymePrime for general

Could be an HCL deficiency, bu this is stomach acid so I’ve not gotten comfortable taking it.

Normal bowel movements are 2-3 times per day. These days we can tolerate once per day.  If less than that we must address it.

Irritability and moodiness can result.  Stools should be soft and fall to the bottom of the toilet.

Interventions

  • Worms (pin and round), morning coughing, worstening behavior during full moon
    • Vermox 100mg chewables (prescription)
  • and bacteria can cause gas, we usually think Candida, bu it may be others.
    • Black Walnut Extract.  Don’t take this willy nilly it is powerful. 
  • Can take High Dose Vitamin C, if no oxalate problems
  • High dose probiotics to improve motility
    • VSL3
    • Therbiotic complee
  • Prebiotic
  • Magnesium
  • Aloe Vera juice
  • Fiber

Diarrhea

  • Food if intermittent
  • Yeast
  • Bacteria — continuous
  • Parasites-suspect if cyclical
    • Flagyl for clostridia
    • Alinia for giardi, crytospiridium
      •  still under patent
  • Alternating
    • fecal plug or
    • chronic inflammation
  • Gi Specialist with pillcam: Krigsman www.autismgi.com

Anxiety

  • GABA
  • Theanine (can work with GABA)
  • Inositol – good for OCD (also good with GABA)
  • Magnesium Citrate
  • 5HTP
  • Oxytocin (available sublingually)
  • Respen A- contains Rauwolfia  but is low dose.  Rauwolfia used initially for hypertension. Could cause irritability and low calcium cramping at higher doses. It upregulates MAO-A which reduces serotonin.  Makes kids more empathetic and happier.
  • Namenda-used in Alzheimers
  • Gluten or Casein Infraction
    • Pepcid AC
    • Epsom Salt Cream or Bath
    • Peptizyde (DPP-IV) enzyme
    • Activated Charcoal
    • Alka Seltzer Gold

Hand Flapping

  • Ammonia causes hand flapping
  • treated with Alpha-Ketoglutaric Acid
  • Activated Charcoal may cause constipation so take
    • Magnesium

Hyperactivity

  • Diet
    • wheat
    • soy
    • dairy
    • artifical colors and flavors
      • Feingold Diet
    • Salicylates and Phenols
  • Supplements
    • Cod Liver Oil
    • Active forms of B vitamins
    • Yeast overgrowh
    • Methyl Folate
    • Methyl B12
    • Pycnogenol
    • Taurine
    • No Fenol enzymes
    • Nicotine Patch
      • Jeff Bradstreed MD proposed
      • reduces neurological inflammation
      • improves
        • hyperactivity
        • attention
        • focus
        • memory
        • Stimulate nicotince receptors that modulates acetylcholine
      • 1/4 to 1/2 7mg patch
      • Can apply or 24 hours or 16 if hyperactivity

Aggression

  • hypoglycemic
  • Food or Environmental
  • Constipation
  • Clostridia rom Organic Acid Test
    • HPHPA marker elevated means dopamine
    • Culturelle
    • Sacchromyces boulardii
    • Antibiotics
      • Flagyl
      • Alinia
      • Vancomycin
      • Only treats bacteria but not spores
        • VSL3 does
  • High Oxalates
    • OAT checks this too
    • causes kidney stones
    • VSL #3
    • Cal/Mag with meals
    • Fibromyalgia can have oxalate problems

Sleep

  • less sugar in evening
  • Peptides?
  • Iron deficiency or ferritin > 50
  • Avoid zinc and B6
  • Avoid Full Spectrum light bulbs, it suppresses melatonin
  • Chamomile, Passion flower or Valerian
  • Melatonin or Melatonin PR
  • 5-HTP
  • Tryptophan

Stimming

  • Yeast
  • Allergens
  • Soy etc
  • Chlorine from swimming
  • Remedies
    • CLO for visual stims
    • Tauring, Zinc, Glycien
    • GABA and lithium
    • Theanine
    • RespenA
    • Namenda

So you can always reach DrWoeller.com.

Categories: Anxiety, Genetics

Mercury levels are going up!

December 3, 2012 Leave a comment

And not just from vaccinations.

Dr. Hyman has the greatest video on mercury and health impacts such as

  • colitis
  • nervous system toxicity such as shyness or nervousness
  • parkinson’s like tremor
  • slurred speech
  • fatigue
  • depression
  • kidney toxicity
  • dermatitis

So where do you get mercury? 

  1. red tattoo dye
  2. contact lens fluid
  3. vaccines
  4. fish
  5. vapors
  6. mercury water
  7. dental fillings
  8. skin lightening creams

Dr. Hyman says it better than I can.

Categories: Anxiety, Depression, Sleep

PTSD

October 28, 2012 Leave a comment

 Do you ever feel like you may have PTSD?  I have been known to tell myself that I do.  Not because I’m a hypochondriac but because it actually does feel like I’m different from what I used to be.  Contrast that with some people who are always like that.  What is “that” anyway?
This Mindhacks article spells out that PTSD is defined by 3 characteristics:

  1. Intrusive Memories
  2. Hyper-arousal, and
  3. Emotional Numbing

I think my memories are not intrusive but otherwise, I do feel I have the the other two symptoms, and that of course creates a barrier in relationships.  Relationships are what you need to help you through this, so this doesn’t seem like a good situation.

The Mindhacks article implies that there was no documentation of similar symptoms during the Civil War, but during that time, men didn’t really express their problems, and if they did, it was not shared, discussed, blogged.  The term “shell shocked” came into existence during WW1, and that really does sound like PTSD.  Nonetheless the point is made that PTSD during that time  (and now) may just have looked like alcoholism or depression instead.  The implication is that some people do not manifest PTSD while others do.

On the genetic side, the RORA (retinoid-related orphan receptor alpha) gene has been associated with trauma. The hypothesis is that brains that make less serotonin are then more susceptible to PTSD.

So if you have this genetic setup do what every lame article tells you: avoid stress.  Now that you have picked yourself up off the floor from laughing, let’s look at some other direct suggestions on what to do after you already have PTSD.  Generalized suggestions will follow in the next section, but I want to highlight the topics that will be coming up in subsequent posts terms of treatment.

  1. EMDR
  2. Trauma Releasing Exercise
  3. Ear Training (Polyvagal)
  4. http://www.traumahealing.com/

Now if you have the gene, how do you avoid PTSD? I know these sound obvious, so I won’t elaborate too much on these:

  • Supportive and large kind families — the larger the (and kinder) family the more likely that assisting with your symptoms will be spread out amongst several people.  But friends who are like family will help too.  Being a loner single parent is probably not the situation to be in.
  • Support your detoxification-Physical stress through lack of detoxification can also build up.  Take Vitamin C, lipoceutical glutathione, epsom salt baths, magnesium, fish oil to help support your body
  • Simplify — Our world continues to get more complex, you may have to consciously simplify to reduce points of stress. This might mean automation of certain things, but it could also mean staying off the computer!
  • Nutritious Food–this seems obvious right? Do what you can, but do more than you are already doing.  Take the proper folate to help you detoxify.
  • Meditate..no really!  It has been shown to help alleviate stress.

Once you have trauma/PTSD you stay primed for response, but the methods mentioned above may help modulate it a bit.

Sleep and Fibromyalgia

April 15, 2012 Leave a comment

Gang,

A great set of videos from the National Fibromyalgia (FMS) and Chronic Pain Association.  They show how people with FMS have the sleep patterns of a very old person.  Interesting things found in the study include how FMS was induced into healthy college students my interrupting their deep sleep and mirroring “alpha intrustion”.  When alpha waves, found when awake, interrupt deep sleep.

Also shows the results of using  Sodium Oxybate improves sleep and (resulting?) pain from FMS, as monitored through the use of QEEG.  Sodium Oxybate (SXB) aka GHB, which is a metabolite of GABA.  It is approved for narcolepsy.   Has been shown using the gold standard of studies to show a statistically significant difference with placebo in the first week!  Also known as Xyrem.  GHB is illegal in many countries so it may be useful to take GABA, it’s precursor instead.  In the US it is legal for narcolepsy.

Watch the videos, which also compare to Benzodiazepines and Antihistamines.  The former are good for short term treatment but in the longer term actually interfere with deep sleep!

Also covers betablockers which may impair melatonin production.  SNRIs may help with pain, but sometimes worsen insomnia.  Energy drinks are a no-no.

In terms of obustructive sleep insomnia.

So you may consider buying a Zeo, which is a band that rests on your head while you sleep and sends a signal to a smart phone to track your sleep.  If you find interesting information there, you might consider getting a sleep study.

this snip from the presentation shows how if your airway is obstructed what happens to your body that then awakens you through sympathetic arousal and increased cortisol.    This could explain why I wake up in the middle of the night cursing because I forgot to do something.

The videos also cover:

  •  restless leg, which could be caused by an iron deficiency
  •  narcolepsy (caused by post-strep autoimmunity, that destroys the hypocretin/orexin cells of the hypothalamus. (Would hypothalamus glandulars help?).  Diagnosed by a daytime sleep study.

Check them out!

Categories: Anxiety, Sleep Tags:

Frankincense fights cancer but also depression and anxiety!

March 6, 2012 1 comment

There are several articles some on pubmed that indicate that Boswellia Carteri grown in southern Arabia and parts of eastern Africa has been known to cause cell apoptosis in cancer cells.  Fascinating! 

However burning frankincense can also help with depression and anxiety too.  This article from Science Daily says that certain ionic channels presumably that help transport substances through the cell wall are doing this with some particular substance that is helpful to brain cells and alleviates depression and anxiety.

 

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