‘Lack of resources for ADHD’
We live in a very distractible world. Many years ago, communication technology in our lives comprised landline phones, TV, stereo and transistor radios. When receiving letters, we got a little hit of dopamine opening the letterbox for the highlight of the day.
Nowadays, our phones, tablets and computers notify and stimulate us automatically.
Our brains respond as if we are at the letterbox, our receptors desensitise to the constant barrage of these events, and we get less “thrill” with each notification. Needing dopamine for motivation, enjoyment and focus we can get bored and struggle with attention span if we spend too much time engaged with technology.
Imagine being unable to sustain focus, being easily distracted by stimuli that provide your brain with what it needs to feel okay. Feeling constantly restless, as if on the go, your body literally won’t sit still.
Name tags on your shirts drive you crazy and need to be cut off.
You seem to always be told off because you forgot something, because once you do find something that is very rewarding, you lock on to it with hyper-focus, and the rest of the world doesn’t even register.
Scolding causes you to be emotionally flooded as it is too much to process, and patterns of stress in response to feedback begin, alongside lowering self-esteem.
This drives you to seek more stimulation, making you less able to complete mundane tasks.
Your teacher says you are bright, but you perform under your potential because you never pay attention and are disruptive in class. Your natural intelligence and creativity manage to get you through school, and you may have been labelled “lazy” by some.
More scolding, more flooding, less self-esteem and achievement. Exercise seems to help, but you get frustrated at sports because even though you have the ability, you underperform under pressure, making simple mistakes.
However, online gaming or playing music are areas where you can excel, due to the high levels of stimulation. Your parents worry because you don’t seem to be doing anything else.
Getting to sleep is impossible and you become dog tired during class.
The risk-taking period of adolescence begins. Experimentation with drugs is engaging for your brain, putting you at risk of becoming addicted.
Your attention, behaviour and sleep patterns get worse, so maturity and achievement are further diminished. Struggling with confidence in social situations is stressful as you often interrupt people and finish their sentences.
You can’t seem to follow conversations and often make gaffs. You are impulsive and at times you break the law.
Typically, in your early 20s, you seek counselling to discuss your anxiety and depression, which does not seem to have responded to antidepressant medication. Stopping cannabis did not help at all.
You are tearful, as your frustration tolerance is always low but worse when you are down. You lament recurring thoughts of suicide despite wanting to live a good life.
The counsellor inquires about school progress, hyperactivity and distractibility and wonders if you have Attention Deficit Hyperactivity Disorder. Online tests indicate a high probability of ADHD. This explains why you are having problems in your relationships, including sexually. Previous failures now make sense, and energy and hope for the future set in. Your partner now understands that your forgetfulness and poor listening are not about them, but about you. After trying your mate’s Ritalin, suddenly all the noise is gone. You can focus clearly, and you get all your bills and washing done. Your boss noticed how productive you were that day but wondered why it didn’t last.
Your GP advises that a psychiatrist must diagnose this neurodevelopmental disorder, but there is no option to be seen in our public system. You work in a minimum-wage job and cannot afford the large fee to be seen privately. The waiting list for this may be months anyway.
A GP who specialised in ADHD made it possible for people to access this type of treatment. The New Zealand Health Practitioners Disciplinary Tribunal last month found him guilty of professional misconduct for incorrectly prescribing Ritalin and other ADHD drugs. He faces being sanctioned.
In my view, he may know more about ADHD than a number of psychiatrists but he broke the rules for prescribing to keep patients’ treatment continuous.
In my opinion, this situation highlights the lack of resources available for an issue that can affect 2 to 5 per cent of the population.
Not all ADHD patients need medication, but they need diagnosis and support. In my view, general practices could do this, with adequate support from their specialist colleagues. We could at least pay attention to that.
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