ADHD

Attention Deficit Hyperactivity Disorder also known as ADHD, is a condition that is classified by a person’s inability to focus and/or inability to control hyperactivity and impulsiveness (1). Statistics demonstrate that approximately 5% of school-age children have ADHD (3).  In addition, ADHD is three times more prevalent in boys than girls (3).  Two possible genetic causes of ADHD include variation in the catechol-O-methyltransferase (COMT) gene and  mutation of the dopamine D4 receptor (DRD4) gene (1).  Additional risk factors that are being investigated include exposure to substances such as nicotine and alcohol before birth, and secondhand smoke during early years (1).
The three categories of ADHD symptoms are (2): inattention, hyperactivity and impulsiveness. Inattention is often characterized by problems focusing for long periods of time, trouble with following instructions, frequent distraction by irrelevant stimuli such as smells and sights, and difficulty with punctuality due to poor judgement of time (1).  Additionally, individuals may often lose their belongings, and forget about daily tasks and upcoming activities despite being regularly reminded (1).  Hyperactivity does not affect everyone with ADHD but those who are hyperactive may often squirm or fidget (1). The interviewee, Betty Smith, expresses hyperactivity through onychophagia, an oral compulsive habit, also known as nail biting (4). People who have ADHD may also express symptoms of impulsiveness such as excessive talking, and interrupting during activities and conversations (1).  Most of these symptoms present in early childhood (6). In adolescence, research suggests that individuals with ADHD struggle particularly in high school and are more likely to drop-out; while in adulthood, these individuals face many challenges in the workplace, and have three times more sexual partners than those without the condition (6).  Furthermore, individuals with ADHD are highly susceptible to stigma due to a variety of factors including diverse viewpoints concerning ADHD among health professionals and the public, as well as distrust towards the process of ADHD diagnosis.  Ethnicity, age and gender of both the person with ADHD and the respondent are important variables when considering stigma (5).  The stigma that individuals with ADHD experience may negatively contribute to their treatment, self-esteem, and general well-being (5).

When I found out that my research was going to be focused on mental health, I decided to interview a close friend, Betty Smith* who was diagnosed with ADHD.  Betty Smith was not diagnosed with ADHD until her second year of University.  This included many appointments with doctors and counselors.  The following is the interview that was conducted on. June 18, 2015.

*Names have been changed to respect privacy of the interviewee


Start of interview

  1. Who are you? Tell us about yourself? What’s your background?
I am Betty, I am Filipino but I grew up in Canada. I came to Canada when I was 10 years old and I am now 21. I come from a family that values education and goals.  I just finished my third year of university, my major is psychology, and my minor is in linguistics at University of Alberta. I want to become a French teacher.

  1. Have you previously dealt with mental health challenges?                                       I was diagnosed with ADHD in the summer of 2014 and I am taking a medication called Vyvanse, but I don’t think it is working anymore. It is hard to find a medication that works.


  1. Describe some of your experiences with ADHD.
When my ADHD was undiagnosed, I experienced a lot of anxiety and depression.  I had panic attacks, I cried, I was out of breath etc. I also struggle a lot with high sensitivity (for example: wondering whether it's me who has the problem or if the other person I am interacting with did something that I have a normal reason to be upset about).  Also it's challenging because it's easy to say to just socialize and relax instead of studying all day to prevent anxiety and depression right? But my problem with that was with doing 5 courses, I didn't have that luxury. I was trying to get into a program where without extra curriculars, it would be impossible to get in. There was a point in my life where I spent all my time on school and I was still failing...and even when I had only 4 courses, I still wasn't sure I would pass my courses if I took on an extra curricular. There's also the pressure of finishing school as soon as you can...while we are reassured that we don't need to and that there's no rush you still feel like you should.

  1. Do you have a history of mental health in your family?
Not that I know of.

  1. Did you seek help?  Why or why not?
I did seek help. The first time I sought help was in high school with the school counsellor. She thought I was depressed and told me to go to the doctor but I just brushed it off and thought I was tired.  She told me that I could go to the doctor for medication.

  1. Did you use any mental health services (counselling, psychiatrist)?
Yes, I had a psychiatrist in Edmonton who gave me medication but it wasn’t very supportive in an emotional way. The medication worked but I wanted personal support during the sessions.  I have a counsellor right now in Calgary. Currently, she helps me learn good coping strategies but she does not give me medication.  I usually see her every week, but less now because of work.  The University of Alberta SSDS helped me with tutoring and studying strategies, which I think was what helped me the most.

  1. Did you/do you still have support (friends, family, school counsellor)?
Yes I do have support with my family both financially and emotionally.  My mom is really accepting, and has helped me do what I need in order to overcome my challenges.  I still don’t think my family totally understands my ADHD or me.  My best friends mostly understand, but my friends in general do not always understand.  Sometimes they can be judgemental, sometimes I feel belittled, or they do not take me seriously (e.g ADHD and how my grades are affected by it).  They blame me for always losing things, being late and being unfocused but they do not understand that it is because of my ADHD.  They think that having ADHD is just being unfocused. They don’t fully understand the consequences of ADHD and its other effects on a person.

  1. Who was the biggest support to you?
My mother is my biggest support financially and emotionally.  She accepts me, and she did a lot of research on ADHD to fully understand me.

  1. Are there any cultural barriers that prevented you or deterred you from seeking help?
Yes, because in the Filipino culture, they do not think that it is a real mental issue. They think that I am being too sensitive, that I can help it if I try hard enough, and I do not need any medication. They think that it is just all in my head and it is nothing serious.

  1. Reflect on thoughts and attitudes towards mental health in our community/society.  How can it be improved?
It can be improved by educating people and spreading awareness but not in a presentation way.  It would be good to spread awareness in a more personal way. Encouraging people to educate themselves, and encouraging the people you are around to get educated as well. If you are struggling with mental health, it is important for the people around you to understand your situation so they can be more understanding.  
Counsellors need to be more compassionate.  A counsellor once told me to “grow up” due to my concerns about being unfocused in school. I felt like I was better off with the teachers than the counsellors.  People who helped me were the people that were involved in my daily life, not people from the community.  It is all about being kind, compassionate and understanding.  Our society needs to understand that ADHD is normal and that everybody has their mental struggles.  People shouldn’t stigmatize and stereotype specific people with mental issues.  Before they say anything or make up their minds about anything, they should make sure that they know what they are saying because some things really aren’t what they seem.




  1. What resources and services do you feel are lacking?
I feel that resources and services were lacking in junior and high school.  I felt ignored while I was trying to figure out why I was struggling.  Because of that I missed so many opportunities because I could not figure out what was wrong with me.  I feel like it would be helpful if we had a stronger mental health community and a way to communicate and help each other.  It would be nice to have an opportunity to connect with other people who struggled with the same thing, to ask questions, to see how they coped, and to feel less alone.

  1. What resources do you find most helpful?
The resources I find most helpful are the SSDS lady at the University of Alberta and my therapist in Calgary.

  1. How did you find out about these resources?
I found out about these resources through my doctor.  My aunt told me to get checked out because she thought I might have ADHD.  I found out about the therapist in Calgary through my own research.

  1. Do you have any advice for others that are having similar experiences?
If you really feel like you want something to improve in your life, keep talking to people.  Be persistent in figuring out your mental struggle if you really want to know what it is.  Talk to different doctors and keep using different resources if you are not satisfied with the response.  Keep being positive.  Don’t feel down because your peers are ahead of you, everybody is in a different speed in their life and everyone does different things at different times.  Something good always comes from the struggles you go through.  What you struggle with ends up being what you like about yourself.

  1. In your opinion, how can mental health delivery improve overall?
Human compassion.  I wish I can call my therapist anytime of the week.  I see her once a week for an hour and life is beautiful but when you get out and life starts to happen, it becomes difficult again.  I wish that my therapist was more accessible (some kind of hotline like alcoholics anonymous, but a mental health one where it is more personal and you can contact them for support would be nice).  Creative outlets such as music, pottery, and painting make me happy.


End of interview
It is important to note that children with ADHD are not irresponsible individuals who are unfocused, overactive and careless on purpose.  The interviewee for instance, strives to complete her University studies, is part of many extracurricular activities such as choir, and constantly works to have strong connections with her friends and acquaintances.


References:

1. Block RW, Macdonald NE, Piotrowski NA. Attention deficit hyperactivity disorder (ADHD). Magill’s Medical Guide (Online Edition) [Internet]. 2014 January [cited 2015 July 18]. Available from:
               
2. Hall CL, Newell K, Taylor J, Sayal K, Swift KD, Hollis C. ‘Mind the gap’ - mapping services for young people with ADHD transitioning from child to adult mental health services. BMC Psychiatry. 2013 July 10; 13:186. doi:10.1186/1471-244X-13-186.

3. Langlois KA, Samkhvalov AV, Rehm J, Spence ST, Gorber SC. Health state descriptions for Canadians: Mental illnesses. Ottawa: authority of the Minister responsible for Statistics Canada; 2012 January. 85p. catalogue no. 82-619-MIE                
4. Ahmad G. Association of nail biting and psychiatric disorders in children and their parents in a psychiatrically referred sample of children. Child and Adolescent Psychiatry and Mental Health. 2008 June 2. 2:13. doi:  10.1186/1753-2000-2-13

5. Mueller AK, Fuermaier ABM, Koerts J, Tucha L. Stigma in attention deficit hyperactivity disorder. ADHD Attention Deficit and Hyperactivity Disorders. 2012 July 8. 4(3):101-114. doi: 10.1007/s12402-012-0085-3
   
6. Searight H, Shinabarger C.  Behavioral Medicine: A Guide for Clinical Practice [internet]. 4th ed. New York, NY: McGraw-Hill; 2014 [cited 2015 July 19]. Available from: http://accessmedicine.mhmedical.com.login.ezproxy.library.ualberta.ca/content.aspx?bookid=1116&Sectionid=62689208.

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