ADHD - Head in the clouds: 100 questions and answers about attention deficit hyperactivity disorder

DR. PAULO MATTOS M.D.

ADHD Head in the clouds

OM

MENDED BY

THE

ABOUT ATTENTION DEFICIT HYPERACTIVITY DISORDER

REC

100 QUESTIONS AND ANSWERS

O

BR

ASI

DE

ÇÃ

ATEN ÇÃO

ASSOCIA

17 TH EDITION | REVISED AND EXPANDED

LE IRA DO DÉFI

CI

T

ADHD Head in the clouds 100 QUESTIONS AND ANSWERS ABOUT ATTENTION DEFICIT HYPERACTIVITY DISORDER

Copyright © 2020 Associação Brasileira do Déficit de Atenção (ABDA)

All rights reserved by Autêntica Editora Ltda. No part of this publication may be reproduced, either by mechanical or electronic means or via xerographic copy, without prior authorization from the publisher.

The publisher is not responsible for the content, operation, maintenance or updating of links or other resources presented by the author in this book.

editor

layout

Marcelo Amaral de Moraes

Christiane Morais de Oliveira

assistant editor

Luanna Luchesi revision

Conor Hennessy graphic project

Diogo Droschi

International Cataloging Data in Publication (CIP) (Brazilian Book Chamber, SP, Brazil) Mattos, Paulo ADHD - Head in the clouds : 100 questions and answers about attention deficit hyperactivity disorder / Paulo Mattos ; tradução Rafael Bozzola. -- Belo Horizonte : Autêntica, 2021.

Título original: No mundo da lua : 100 perguntas e respostas sobre o Transtorno do Déficit de Atenção com Hiperatividade (TDAH) ISBN 978-65-5928-043-8 1. Deficiência de aprendizagem 2. Distúrbio do déficit de atenção com hiperatividade - Miscelânea 3. Perguntas e respostas 4. Transtorno de déficit deatenção com hiperatividade (TDAH) I. Título.

21-63701 CDD-616.8589 Índices para catálogo sistemático: 1. Distúrbio de déficit de atenção com hiperatividade : Neurologia : Medicina 616.8589 Maria Alice Ferreira - Bibliotecária - CRB-8/7964

Belo Horizonte Rua Carlos Turner, 420 Silveira . 31140-520 Belo Horizonte . MG Tel.: (55 31) 3465 4500

São Paulo Av. Paulista, 2.073, Conjunto Nacional Horsa I, 3º andar . Sala 309 Cerqueira César . 01311-940 São Paulo . SP Tel.: (55 11) 3034 4468

www.grupoautentica.com.br SAC: atendimentoleitor@grupoautentica.com.br

To my parents, thanks for everything.

Summary

PA G E

About the author 15 Preface to this edition 17

CHAPTER 1 – INTRODUCTION

PA G E

1

What is ADHD, Attention Deficit Hyperactivity Disorder?

23

2

But is this enough to reach a diagnosis of ADHD?

25

3

Is ADHD a made-up disease?

26

4

And why is there so much fuss around an ADHD diagnosis?

27

5

Wouldn't this be an attempt to control children's behavior?

29

6

Why isn't ADHD just a more flamboyant behavior?

31

7

But the media often disagrees regarding ADHD!

33

8

What are the problems associated with ADHD?

36

9

Can ADHD bring about benefits for the patient?

38

10

Is it possible to have ADHD without it causing troubles?

40

11

Why a Q&A book?

43

CHAPTER 2 – THE SYMPTOMS

PA G E

12 13

Are all patients similar to each other?

47

Is it difficult to reach an ADHD diagnosis?

58

14

So, the criticism that an ADHD diagnosis isn't rock solid, is correct?

60

15 16 17

Are there different types of ADHD?

62

Does ADHD exist only with inattention?

65

Can ADHD persist into adult life?

66

18

But why did doctors use to think that ADHD didn't affect adults?

67

19

How is an ADHD diagnosis reached in adults?

69

20

Can other disorders have similar symptoms to ADHD?

71

21

How can ADHD symptoms affect the life of an adult?

73

22

Why are relationship problems associated with ADHD?

83

23

Why is it that adults with ADHD keep changing what they are doing?

86

24

Is drug abuse more common in people affected

by ADHD.

88

25 26 27

I have ADHD!

89

But everybody thinks I am inattentive!

91

Are there lab tests to diagnose ADHD?

92

28

Isn't it strange that there are no lab tests to diagnose it?

93

29

How are parents able to notice if their daughter or son has ADHD.

94

30

From what age are parents able to detect ADHD symptoms?

96

31

Is there a difference in ADHD in boys and girls?

100

32

In what time in child's life is an ADHD diagnosis made?

101

33

Are there other ADHD symptoms that are not listed in the DSM system?

103

CHAPTER 3 – THE CAUSES

PA G E

34

Is ADHD a secondary effect of the use of digital media?

111

35 36 37 38 39

Is ADHD a genetic condition?

113

Is there an ADHD gene?

115

What role does the environment play in all of it?

118

Can family problems cause ADHD?

119

Can emotional conflicts cause ADHD?

120

40

Can ADHD be a consequence of how children are raised?

122

41

Can I have a genetic test made to confirm an ADHD diagnosis?

124

42

What is the main conclusion of the genetic studies of ADHD?

125

43

Are there biological risk-factors that are not genetic?

126

44 45 46

What is altered in the brain of ADHD patients?

127

Can I have a CT scan to diagnose ADHD?

131

What about other kinds of tests?

132

47

Are there other tests employed in ADHD cases?

134

CHAPTER 4 – COMORBIDITIES

PA G E

48

What other disorders can appear together with ADHD?

139

49

But doesn't ADHD by itself cause emotional problems?

142

50

What learning problems are associated with ADHD?

144

51

Are there clinical problems connected to ADHD?

146

52

How can the consequences of ADHD be mitigated?

147

CHAPTER 5 – TREATMENT OVERVIEW

PA G E

53

Will my son have to be medicated?

153

54

Can the attitude of parents towards their children “aggravate” their ADHD?

157

55

Is it normal for the parent to feel tired and hopeless?

160

56 57

What can parents do to help with treatment?

162

Shall we start right now?

165

58

But isn't it difficult to the advantages of changing the behavior?

167

59

And what about those days when I am boiling with anger?

168

60

Why don't they ever learn, even when I punish them?

169

61

What other social and family problems may occur?

172

62

Is it possible to “manage” impulsivity?

174

63

How is it possible to help with relationship problems?

177

64

Is there a solution for poor memory?

180

65

What is the most effective way to communicate with people with ADHD?

182

66

How to deal with the constant fight that is studying when they are home?

183

67

Where to start when it comes to school?

185

68

How should the study environment at home be?

186

69

How to reward positive behavior?

192

70

Is it possible to stimulate someone who doesn’t want to study?

194

71

Are there special tips regarding the time to do the homework?

198

72

What other items are important to motivate studying?

200

73

Are there ways to improve memorization?

202

74

Are there ways to improve memorization?

204

75

Is there any general advice?

205

76

And what about tips for adults?

207

CHAPTER 6 – THE SCHOOL

PA G E

77

What are the ideal characteristics of a teacher of children and teenagers with ADHD?

221

78

What should teachers expect in terms of academic performance?

223

79

How may teachers suspect of a coexisting problem?

226

80

And the behavioral problems that may be connected to ADHD

231

81

What are the main tips for teachers?

234

82

Is there a type of school that is a better fit for the student with ADHD?

238

83

Should the student with ADHD receive special treatment?

239

84

Won't special treatment embarrass the student?

240

CHAPTER 7 – MEDICATION

PA G E

85 86 87 88 89

Is it mandatory to treat ADHD with drugs?

247

How do ADHD drugs work?

248

Which drugs are used to treat ADHD?

250

Is it possible to use more than one medication?

253

Do stimulants cause dependence?

254

90

Are there serious side effects to the use of stimulants?

256

91

Well, I am still unsure whether I should take the drugs or not.

257

92 93 94 95

Does medication cure ADHD?

258

How long should drug treatment last?

260

Am I going to be a “prisoner” of the medication?

262

Does medication build up in the body?

263

96

Are there instances in which the medication does not work?

264

97 98

When is it time to start psychotherapy?

266

What is neurofeedback?

268

99

Is treatment with a speech therapist mandatory?

269

100

Are there other important measures to be taken?

270

ABOUT THE AUTHOR

DR. PAULO MATTOS is a psychiatric doctor at the Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro – UFRJ), he holds Master’s and PhD titles in psychiatry and Postdoc in biochemistry. He is also a founding member of the Brazilian Association of Attention Deficit (Associação Brasileira do Déficit de Atenção – ABDA) scientific committee.

Member of the Brazilian Association of Psychiatry (Associação Brasileira de Psiquiatria), Brazilian Academy of Neurology (Academia Brasileira de Neurologia) and of the American Psychiatric Association. He is also neurosciences coordinator of the D’Or Institute of Research and Education (Instituto D’Or de Pesquisa e Ensino – IDOR).

All copyrights were donated by the author to the Brazilian Association of Attention Deficit, a non-profit organization.

Get to know ABDA's website at www.tdah.org.br

PREFACE

Life imposes multiple challenges. Many of them transform our lives and, as a result, also the fate of millions of people. First our family, then our neighborhood, our city, our country and, in the end, we realize that we have touched the whole world.

Head in the Clouds has definitely changed the reality of people with ADHD (Attention Deficit Hyperactivity Disorder).

In the mid-2000s, ADHD was still an unknown topic in Brazil. And I was just a mother of two children with undiagnosed ADHD, in a desperate search for answers to the difficulties that plagued their lives.

In anguish of finding a solution, I tried countless treatment options and I visited different professionals: psychologists, psychoanalysts, physicians ... The conclusion was always the same: “it’s the parents’ fault” and, more precisely, the mother’s.

This statement proved the absurdity of the ignorance that, even today, is repeated by many professionals. Amid so many types of treatment and so many unprepared professionals, experiences like mine fail and generate countless losses: emotional, financial and health ones, as well as losses to family stability.

Despite my best efforts, I could not see a light at the end of the tunnel.

As unusual as this may seem, the answers that would clarify the reason for my anguish would reach me through my office door.

I am a psychologist, neuropsychologist and psychotherapist, specialized in psychoanalysis. My professional role and my life 17

purpose have always been to bring light and understanding to those in need. At that time, however, it was I who needed a light, some help for my two children. And that light came to me through the hands of a patient, who was carrying a book in her bag. I found the title Head in the Clouds funny. But the subject seemed interesting.

Although the book’s title suggested a trip to the skies, in reality, what it proposed was a way back to earth. A definite encounter of a person, who did not know what ADHD was, with themself. Little did I know of the power contained in those pages. They were just words printed on paper, but they brought the most precious and necessary contents for that moment in my life: psychoeducation and knowledge. This allowed me to let go of that feeling of “I don’t know anything about this” and to change to the belief that “now, I understand and know what to do with all of this”.

After reading Head in the Clouds, Dr. Paulo Mattos stopped being just the author of the book, and to me he became the voice of hope. And how I heard that voice! This voice not only changed my children’s lives, but redirected mine, teaching me everything I know today about ADHD and what I keep on learning.

From the meeting with the author of Head in the Clouds, who became my children’s doctor and my professional guru, the need arose to create an institution that fought for the awareness, diagnosis and treatment of ADHD. It was then that the Brazilian Association for Attention Deficit (ABDA) was born, with the aim of disseminating scientific information about this disorder in Brazil. Today, almost 20 years after its foundation, ABDA is the only non-profit association that fights for people with ADHD in Brazil. It is the largest patient association in Latin America

18

and is recognized by professionals and other patient associations around the world.

Head in the Clouds was the passport that allowed me to start a new journey with my children and my patients. Undoubtedly, like me, health and education professionals, people and families who still struggle against ignorance about ADHD, have in this book a real manual, with scientific questions and answers about the disorder. A kind of exit screenplay against stigma and disinformation.

I dedicate my eternal gratitude to the master, partner and friend, Professor Dr. Paulo Mattos, for having generously ceded the copyright, as well as all the proceeds from the book to ABDA projects, since its first edition.

To Autêntica Editora (our publisher in Brazil), which honors us greatly by taking over the rights to publish and disseminate this work, I also extend my sincere thanks for betting, supporting and believing in our cause.

Iane Kestelman Psychologist, Psychoanalyst, neuropsychologist and Voluntary Head of the Brazilian Association of Attention Deficit (ABDA)

19

www.grupoautentica.com.br/autentica-business Twitter: Autêntica Business Facebook: Autêntica Business