Behavioral Medicine Solutions

I was in the middle of taking a full medical/psychiatric history.  The patient seemed disinterested and non engaged.  He had responded to my screening questionnaire on Adult ADHD syndrome in the worst possible light and exaggerated his symptoms.  This did not match the gestalt of his presentation.  As the interview went on, it became clear that [...]

Many ADHDers have social anxiety. The reasons are obvious: Verbal impulsiveness makes the ADHDer prone to talk without thinking in social gatherings. This leads to negative experiences in social situations and an exaggerated awareness of perceived threats from interactions with others. A delayed sense of social propriety can induce post event analysis that often lead to rumination and obsession with recalled [...]

I have addressed pornography and ADHD in an earlier post.  I have had more ‘confidential’ confessions and comments on that topic than any other that I have discussed throughout the years.  Some of my patients have commented that my points were simplistic and increased their sense of shame and guilt.  Since this was not my intention I will discuss some further issues. The [...]

You have been recently diagnosed with ADHD and are considering options for treatment.  If you have abused stimulants and have struggled with addictions in the past, your choice of future therapy needs to be tailored to your unique experience. By now you have learned about the manifold hazards of unchecked addictive behavior and have organized a comprehensive program of recovery to maintain your abstinence [...]

He was exciting and unpredictable; you liked the spontaneity and creativity he brought to your life in college. He was warm and sincere. He had an admirable sense of justice and impatience for boredom. You had never seen such an open and honest person before. You met in the third year of college and were married [...]

If you have a loved one who is afflicted with ADHD syndrome, you probably vacillate between fascination and frustration with her behavior. You have learned about the inattention, distraction, impulsiveness, restlessness, and emotional fluctuation she demonstrates.  Let’s imagine a scenario when you are both sitting in a meeting listening to a speaker who is going on about [...]

Every puff of smoke leads to a dopamine surge in the reward pathways of the brain. This causes a positive feedback loop needing to be refed continuously. The ADHD brain is particularly vulnerable since it has a dysregulation of dopaminergic function in the prefrontal cortex of the brain leading to inattention, impulsivity, and restlessness. Since it [...]

Individuals afflicted with ADHD are more prone to addictions and impulsive behavior, including abuse of drugs.  Early intervention via proper diagnosis, education, and treatment has been shown to reduce the rate of later development of full-blown addictions.  Clinical challenges arise when a person with fully-developed addictions seeks treatment for ADHD.  Here are a few guidelines I follow when working with these situations: The addiction process [...]

People unfamiliar with the internal world of ADDer would be very surprised to find out how quickly the anger rises within them and what a prominent emotion anger could easily become.  It is not unusual for these patients to come for an assessment solely based on reports of anger and being easily frustrated.  The problem lies in [...]

Here is a link to a New York Times article that summarizes many of our fears about the abuse of stimulant medications: Risky Rise of the Good Grade Drug Is it oversimplistic? Does it trivialize ADHD? Does it assume that physicians are too stupid or careless when prescribing treatments? Does it highlight some real problems we need [...]