The Archives of General Psychiatry published a study on October 15, 2012 which apparently emphasize and highlight the importance of appropriate and uninterrupted treatment. In the said study, about 300 young boys from New York City were followed by researchers for a long period of 33 years. About 150 young boys were diagnosed with ADHD in their childhood but they stopped their medications by the time they went to school. These young boys were recruited by a parent, teacher or a psychiatrist. The other 150 young boys were selected because they have no records of behavioral problems leading to the conclusion that they did not have ADHD.

The study showed the following findings:

• men with ADHD are 7 times more likely to discontinue schooling
• if employed, men with ADHD will make an average of less than US$40,000 per year compared with those who do not have ADHD.
• men with ADHD will likely end up in a divorce, twice more than non-ADHD men.
• 16 percent of men with ADHD showed signs of personality disorder while non-ADHD men showed none
• 36 percent of men with ADHD had been imprisoned at least once compared to the low 11 percent in men without ADHD.

Such findings reinforce the experts opinion that discontinued or interrupted treatment could have long-term impact on the person’s emotional and social wellness of men with ADHD many years after their diagnosis. It is surprising to see the difference in outcomes from ADHD and non-ADHD individuals. Mental healthcare providers should encourage and convince parents on the significance of continuous treatment in order to prevent the not-so-good outcomes.

Researchers say that a lot of children are diagnosed with ADHD when they should have been examined for sleep apnea a sleep disorder. Such confusion may be attributed to the many cases of ADHD diagnosed children. The result of such confusion is an aggravated problem due to the drug treatment recommended for those children.

The idea may have stemmed from the fact that the signs of sleep disorder overlap with ADHD symptoms. In adults, sleep deprivation could result to sluggish feelings and drowsiness while in children, sleep disorder can cause them to be moody, wired and obstinate aside from having difficulty in concentrating, getting along with friends or sitting still.

A study published in Pediatrics journal in March 2012, which connects sleep deprivation to ADHD symptoms. In said study, 11,000 British children were followed and observed for 6 years which started when the children were 6 months old. Children who snore when they sleep, or do mouth breathing or have apnea, will be 40% to 100% in the likelihood of developing ADHD-like behavioral symptoms than children who breathe normally. Also, children who had sleep disorder breathing that persisted throughout the study and most severe at age 2 1/2, are at higher risk of having ADHD-like behaviors.

Most parents do not know the signs of abnormal sleep behaviors; for instance, sleep apnea may considered as a sign of deep sleep by some parents. The parents need to be educated about the signs of abnormal sleep behaviors. The mental health providers need to explore more about abnormal sleep behaviors before giving the diagnosis of ADHD.

It is not easy to spot sleep deprivation signs in children. Parents have uniformed knowledge or impression about healthy habits of sleeping. This was highlighted in a study conducted in 2011 by Penn State University-Harrisburg researchers which was published in The Journal of Sleep Research which showed that out f 170 parents who participated in the study, less than 10% were able to correctly answer basic questions about healthy sleeping concerns.

Kimberly Anne Schreck, the study’s lead author and a Penn State behavioral analyst and psychologist noted that majority of the parents were clueless about what is normal sleep behavior and many parents thought that snoring means that their child was in deep and sound sleep.

http://well.blogs.nytimes.com/2012/04/16/attention-problems-may-be-sleep-related/

There are some ways of remedies which are deemed helpful to get good quality sleep. These have been proven to help deal with stress, tension and anxiety which all contribute to insomnia. Some of these remedies may work, some may not. Pick whatever works for you and keep doing them.

• Warm bath– a good warm bath will relax your body, soothe and calm your nerves which could set the mood for a good sleep.
• Massage– a good rubbing or soft massage before dozing off will enhance relaxing mood and make way for sleeping.
• Set the music for sleeping. Soft, calming music will get you to relax and eventually doze off. Any type of music that soothes your mind and body will work wonders in getting you to sleep.
• Warm glass of milk before bedtime – It can be milk or hot camomile or anise tea. They have natural sleep-enhancing ingredients. The calcium content of milk works directly on nerves to relax them.
• No caffeine, alcohol or cigarette. Coffee, tea, chocolate and cola drinks should not be taken near bedtime. Alcohol and cigarette disrupt sleep and should be avoided.
• Right room temperature – this should give the best sleeping condition. Not a too cold or too hot room.
• Sleep on a firm bed – this will give your body comfortable support which will prevent sleep disruption.
• Sleep on your right side or back– this is the best relaxing sleeping position. Do not sleep on your stomach as it will cause pressure on all the internal organs which can cause shallow breathing and other health problems.
• Exercise for half an hour before bedtime – the physical activity will cause the body to slow down a bit, enough to condition the body for a good sleep.
• Keep regular bedtime– making your body adjust to changing sleeping time will cause confusion to your body clock. Always keep a regular and fixed bedtime.
• Get up if you can’t sleep. There’s no point lying awake if you awaken from sleep and you can’t go back to sleeping again. Get up and quietly do something to keep your mind busy and diverted from thinking of getting sleep when you cannot.
• Keep a regular waking up time. Regardless if it’s weekend or holiday, wake up at the same time every single day. Don’t spend longer time lying on bed once you have awakened.
• Keep the bed for sleeping. Avoid doing your reading, crossword puzzles or hand-held video gaming on the bed. They tend to tell the brain that the bed is not for sleeping.
• Don’t nap. For people with normal sleeping habits, nap is good. Not for people with insomnia. Not having naps during the day will make your body feel tired as the day comes to an end, thus, forcing your brain to send signals for sleeping.
• Keep your room dark. Don’t use illuminated wall clock as this will not help you get sleep if you have awakened in the middle of the night.

Insomnia is not a disorder and there are certain lifestyle changes which can help relieve the sleeping difficulty. Sleep aids like beddings, mattress, pillows and sound machines can also induce the mood for sleeping. In severe cases, sleep medication is advised. Some sleep medication drugs include sleeping pills, non-prescription sleep aids, OTC antihistamines and antidepressants. The use of medication should be monitored by your doctor to avoid any complication or risk of addiction.

Everyone’s life is faced with problems, challenges, hassles and pressures. No one is exempted from that. For some, these experiences help them respond well to stressful situations. Unfortunately, there are those who couldn’t respond well to problems or situations that warrant stress, fear or anxiety.

Stress, like fear is a normal human response when faced with events or situations that make you upset or threatened. Technically, it is defined as the way the brain responds to any stimulation. If the situation presents some kind of danger or uncertainty, the stress caused by such will let the body and mind respond in a protective way. One becomes alert and focused, ready for any eventuality. In some cases and situations, the stress response could even be life-saving.

Types of Stress

Stress is generally categorized in three groups :

• Good stress or Routine Stress – this is when stress is used to rise to the challenges. This kind of stress usually have good outcome and can be helpful in one’s learning and growth. This usually stems from pressures derived from work, family and other daily responsibilities.

• Tolerable stress – this is the person’s response to some bad events like losing a job, but one has the inner strength to hold up and contain the emotion. A support network can also help in one’s coping with the bad situation.

• Toxic stress – this stress is elicited when something bad happens and one does not have the strength and inner resources to deal with the situation. This may cause major emotional and physical crisis.

People respond to stress in different ways. It is important that a person understands the level of stress he can tolerate and respond to well, and what level of stress can cause uncontrollable situations. Generally, people respond to stress in three ways:

• Angry or agitated response. Your emotions are high, restless, disconcerted, tense and jumpy.
• Withdrawn or depressed response. Low energy and no significant reaction or emotion. You shun people and isolate yourself.
• A tense and frozen response. It’s a concealed agitated response, showing no violent reaction. You may look paralyzed but underneath is extreme distress.

Symptoms of Stress Overload

There are signs and symptoms which indicate if your stress level is overboard.

• Cognitive Signs – The warning signs include failing memory, lack of focus or concentration, poor judgement, racing thoughts and endless worrying.
• Emotional Signs – The warning signs may range from frequent mood swings, irritability, extreme nervousness, overpowering feeling, severe loneliness, feeling of isolation and depressed mood.
• Physical Signs – The warning signs evident are constant bodily pains and aches, bowel movement problems, nausea, vomiting, palpitation or hyperventilation, tightness of chest, loss of sexual desire and frequent bouts of cold.
• Behavioral Signs – Stress is manifested by poor eating habits, bad sleeping habits, isolation from other people, forgetting about responsibilities, alcohol and drug consumption to relieve stress, constant jittery gestures like nail-biting, cracking of knuckles, etc.

Common Stressors

Factors that contribute to the onset of stress symptoms are called stressors or triggers. These factors may be external or self-generated, such as:

• Big life changes
• Work, business or profession
• Difficulties in relationships (family members, wife, children, friends, associates, etc.)
• Financial crisis
• Hectic schedule
• Pessimistic attitude
• Unrealistic projections and expectations
• Perfectionism
• Passiveness
• Negative value on self

Managing and Coping with Stress

If stress is not addressed and resolve, the effects it may have on a person might lead to an uncontrollable emotional outburst. One needs to undertake practical measures to maintain one’s physical and mental health . and help cope with stress. Learn how to:

• Maintain a good support group or network of people who can help you talk through the situations.
• Recognize signals sent out by your body about overwhelming feeling of stress like sleeping problems, increase in alcohol or drug consumption, etc.
• Focus on positive thoughts like accomplishments for the day and not dwelling on failures or disappointments
• Set priorities according to urgency. Don’t get yourself overwhelmed with numerous tasks
• Keep a regular 30-minute exercise regimen to help improve mood and get rid of stress.
• Explore and engage in relaxation activities
• Consult with a professional mental health specialist when feeling overpowered by stress, rendering you unable to function well and resorting to alcohol and drugs as coping mechanism. If you are entertaining suicidal thoughts, it’s time to seek professional help.

One’s ability to cope with stress is largely dependent on one’s lifestyle choices. Keeping it to the basics : healthy and balanced diet, good sleeping habit, regular physical and mental exercise and strong social networking, will help you get the inner strength and cope with stress.

While it is normal to get worried or scarwhen facing a stressful circumstance, it is no longer normal if that anxiety escalates to a level where it disrupts your usual activities and normal functions. If anxiety overwhelms a person that it restricts his ability to lead a normal and functioning life, it is approaching the bounds of anxiety disorder.

Anxiety disorder is a serious mental condition which occurs along with other related conditions which share a common major symptom – unrelenting or extreme fear or agonizing over situations where other people would normally not feel threatened or endangered.

Types of Common Anxiety Disorders

Anxiety can manifest in different forms and levels of fears or dread interfering with one’s performance of daily functions. According to DSM-5, the categorized types of anxiety disorders are:

Seperation Anxiety Disorder

It is usually seen in school aged children. The child experience recurrent excessive distress when he or shee need seperation from home or from major attachment figures.

Selective Mutism

Selective mutsim is usually seen in children as well. The child fails to speak in specific social situation although he or she can speak in other situations where she or he feels comfortable such as home.

Panic Disorder

This is characterized by recurring and unforeseen panic attacks without any warning. Panic attacks manifests with pounding heart, shorthness of breath, shaking, feeling of choking, chest pain, nausea, dizziness, chills, numbness, fear of ‘going crazy’, and fear of dying.

Agoraphobia

Agarophobic people have increased fear or anxiety in open spaces (parking lots, bridges, or marketplaces), in closed spaces (shops, theaters, cinemas), standing in line or being in a crowd, being outside of home alone or when they use public transportation.

Social Anxiety Disorder (Social Phobia)

This is the fear of being embarrassed in public or in front of people. It is also thought of as extreme introversion where social events or situations are avoided for fear of being judged or humiliated.

• Specific Phobia

This is anxiety manifested due to an exaggerated fear of specific situation or objects such as animals, natural environment (heights, storms, water), blood-injection-injury (needles, invasive medical procedures), situational (airplanes, elevators, enclosed places)

• Generalized Anxiety Disorder (GAD)

This is characterized by a persistent thought or feeling that something bad is about to happen for no apparent reason . People who suffer from GAD,find it difficult to control the worry. They complain of feeling restless,and keyed up,having concentration problems, fatigueness, irritability and sleep disturbance.

Substane/Medication-Induced Anxiety Disorder

Usage of some susbtances such as alcohol,caffeine, cannabis, PCP, hallucinogens, inhalants, opioids, sedative, hypnotics, stimulnats and cocaine present with severe anxiety.

Causes of Anxiety Disorders

Like other mental condition, the exact cause of anxiety disorder cannot be pinpointed to a single reason or factor. Medical researches indicated that anxiety disorder may be caused by a combination of chemical imbalance in the brain and environmental factors like stress. There are studies that proved that severe stress for a long period can alter the chemical behavior in the brain which control mood or memory. Genetic link is also a factor that is believed to cause anxiety disorder. Additionally, traumatic events or situations can also trigger the disorder.

Anxiety disorder usually becomes evident in childhood. Some may have the symptoms worsening in adolescence and early adulthood. Statistics have shown that the disorder is more common in women than in men.

Treatment Options

Before starting the treatment, your physician need to rule out the medical causes. Hyperthyroidism, anemia, or heart problems such as mitral valve prolapse may manifest with typical anxiety symptoms. After ruling out the medical causes, one needs to seek help from mental health care provider.

Similar to other mental illnesses, the type of treatment for anxiety disorder will largely depend on the severity of the condition. It can be one or a combination of the following medication and non-drug treatment approach or options :

• Medication. Doctors or mental health specialists may prescribe drugs which can help reduce and control the symptoms of anxiety disorder. These drugs include antidepressants and anxiety-reducing drugs.
• Psychotherapy. This is a non-drug treatment which involves counselling or talk therapy aimed to help the patient understand, accept and deal with the disorder.
  • Cognitive Behavioural Therapy (CBT) is a type of psychotherapy given by mental health specialists to help the patient recognize and accept the thought patterns and specific behaviour which contribute to bothering and burdensome emotions or feelings. The end result will have the patient’s willingness to alter the thought patterns in order to avoid the unpleasant feeling that go with those unreasonable thoughts.
  • Exposure therapy is another type of psychotherapy which helps and convinces the patient to confront or face their fears in a safe and controlled structure . This may take repeated activities of exposure to the feared object, place or situation. It will end when the patient has shown significant though gradual sense of control over a certain situation. Realizing that confronting the fear does not cause any harm, the patient’s anxiety symptoms are expected to diminish in time.

• Relaxation exercises or techniques also help reduce anxiety attacks. Deep breathing, meditation, yoga exercises are some of the relaxation techniques a patient should resort to when they start to feel anxiety build up within them.

Helpful Tips to Avoid Anxiety:

Keep a healthy eating habit and schedule. Start with a good breakfast and continue with small frequent meals throughout the day. Having an empty stomach for a long time will cause your blood sugar level to drop which can result to feeling anxious.

• Avoid cigarette and alcohol. These can contribute to the feeling of anxiety.
• Avoid anxiety-causing food and beverages like chocolate, coffee or any caffeinated drinks, cola, tea and sports drinks.
• Have a regular exercise regimen. This will break down stress and relieves anxiety. A 30-minute aerobic exercise will be a good way to start your day.
• If taking herbal medicines, make sure your doctor is aware as some herbal medicines may have anxiety-causing ingredients or chemicals.
• Keep a good sleeping habit. Loss of sleep can aggravate fearful thoughts or feelings. 7 to 9 hours of quality sleep will keep your emotions stable.

It is critical for a person to seek medical attention at the earliest sign of anxiety symptoms. This will help prevent the disorder from worsening and advancing to other related mental illnesses or conditions. If the doctor rules out a medical reason for the symptoms, you may need to see a psychiatrist.

A mental disorder known as ADHD (Attention Deficit Hyperactivity Disorder) is characterized by hyperactivity, inattention, and inability to control urges or drives. ADHD has proven links to various sleep disorders.

Children who have ADHD may be observed to have disturbed or interrupted sleep. Studies have shown that ADHD children have severe sleep disorder than other similar illness. The relationship between ADHD and Sleep are explained below:

• Snoring and ADHD

Snoring is caused by large adenoids or tonsils blocking the airway. This blockage may develop into sleep apnea and in severe cases, ADHD. Snoring may be a reason for poor sleep quality and this may eventually cause attention problems the following day. Studies have shown that snoring is common among ADHD children. And snoring children are likely to be afflicted with ADHD as well.

Removing the tonsils or adenoids is found to help improve the child’s sleep pattern and better behaviour without the need to take medications.

• RLS (restless leg syndrome) and ADHD

Restless leg syndrome is characterized by crawling sensations felt in the legs or arms which are very uncomfortable and annoying. This creates an overwhelming urge to move, thereby causing disruption in sleep and sleepiness during the day.

People with RLS are not able to get good sleep. Hence, they will experience inattentiveness, moodiness or hyperactivity. These are the same symptoms for ADHD. RLS is identified using polysomnogram or sleep study. Both ADHD and RLS may be treated with medications.

These cases show the clear relationship between ADHD and Sleep disorder symptoms. It sometimes happen that because of the overlapping symptoms of ADHD and Sleep disorder, some patients are misdiagnosed for the other disease.

Ways to Help ADHD Children Get the Needed Sleep

• Stay away from caffeine or other sleep-disrupting food or beverages. Check the label of the foods being eaten by your ADHD child. They increase nervousness, agitation which results to interrupted and disrupted sleep.
• Keep a consistent and regular routine for sleeping, waking up or even eating schedules.
• Soundproof your kid’s bedroom to shield from outside noises.
• Don’t take sleep medication unless it is prescribed by a physician.
• Check for other medical problem or illnesses. Asthma, allergies and other conditions which cause body pain may contribute to disrupted sleeping.
• Introduce your children to a light exercise regimen during the day. Exercise should not be done near bedtime.
• A hot bath before bedtime can do wonders. A cool-temperature room would be ideal for a child to stay into after a warm bath.

People who are diagnosed with ADHD in childhood years may have increased risk of problems with legal system, using illicit drugs or being less successfull in their adulthood.

2656 people witha diagnosis of ADHD were screened from Swedish national database to investigate whether taking ADHD medication play a role in patients’s participation in crimes. According to the study which was published in the New England Journal of Medicine, 41 percent of women and 32 percent of men who maintain medication for more than the 3-year study time frame were not quite likely to be involved and convicted of a crime compared to those who opted to skip medication. Crimes such as drug offenses, homicide, assault and other less serious crimes are some of those committed and medication taken by many was the stimulant Ritalin.

People with ADHD stand the chance of the likelihood to commit crimes but the studies suggested that those who took medication are less likely to end up with a conviction. In young adults where criminality is highly likely to occur, medication should be considered because it is more harmful for them to be involved in any way in criminal activities. On the other hand, psychiatrists are still debating whether they should prescribe ADHD drugs since drugs have different effects on individual persons and drugs sometimes do not work for everybody.

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1203241

Top cardiologists do agree that supplements can be very good to keep a healthy heart. Some of the supplements which benefit the heart are:

• Plant sterols
• Fish oil
• Fiber (psyllium)
• Niacin
• Red yeast rice
• B-Complex vitamins (B6, B12, folic acid)
• Policosanol
• Green tea extract
• Coenzyme Q10

It is a must to check with your doctor before taking any supplements since may have contra indications with the other drugs you are taking. Pregnant women for instance are not allowed to take supplements as these may have effect on the pregnancy or breastfeeding. Make sure that the supplements are approved by the United States Pharmacopoeai or USP, which means that the active ingredients contained range from 95% to 100%.

Omega 3 Fatty acids, which are derived from fish oil, flaxseed oil and algae oil, significantly reduce triglyceride level and increase HDL (good cholesterol). Omega 3 has consistently shown to enhance the health condition of the heart. They have anti-inflammatory agents which can prevent diseases like Alzheimer’s and heart diseases when inflammation is controlled. Numerous research studies have shown that regular eating of oily fish like salmon or taking of fish oil supplements for people with a history of heart attack have helped them reduce heart rhythm problems, heart attack and sudden death. Chest pains are also greatly reduced.

Fish oil supplements reduce triglycerides by 25% – 50%. The only thing to be cautious about is its mercury content. Only fish oil supplements tested free of mercury should be taken.

1. Vitamin B3, nicotinic acid or niacin, is an effective supplement to counter high cholesterol. Proven to increase HDL and decrease triglycerides, this is a common prescription given to patients with blood pressure problems. Studies show that niacin can act better than statins in improving HDL cholesterol, increasing it by 15% – 30% and reducing triglycerides by 20% – 50%. Those who take niacin have shown no heart rhythm problems.
2. Psyllium or ispaghula is derived from Plantago ovate husk seeds. Psyllium in supplement form or high-fiber foods can reduce total and LDL cholesterol. The effect of fibers on HDL or good cholesterol is not definitive although there are reasons to suggest that it may have helped improve HDL. 15 grams of Psyllium daily will reduce LDL by up to 9%. It enhances the effects of statins in lowering LDL cholesterol. Psyllium tends to affect the absorption of other medications so it is important that your doctor is consulted before taking this supplement.
3. Red Yeast Rice is a specific yeast derived from rice. This is known to lower total and LDL cholesterol and triglyceride levels. It is also known to help in the prevention of heart attack and improve blood circulation. Red yeast rice contains monacolin K, a substance that has identical function to the active ingredient of statin drug Mevacor. Red yeast rice supplements work best with the right formulation. A beginning dose of 2400 mg a day should be tried for two months, afterwhich the cholesterol level should be checked for any changes. Your doctor needs to know the results after two months so he can recommend if there’s any need to change dosage or formulation.
4. Green Tea Extract, made from dried leaves of a perennial shrub Camellia sinensis, is a Chinese traditional medicine which is said to decrease LDL by 16%. A beginning dose of 375 mg of theaflavin-enriched green tea extract every day is recommended.
5. Vitamin B6, B12 and Folic Acids are known as the B vitamins. They are known to lower blood level of homocysteine, an amino acid which may be linked to blood clots, heart disease, strokes and heart attacks. A doctor who has specialized understanding of lowering homocysteine with B vitamins should be consulted to avoid any complication concerning osteoporosis and cognitive decline which are prevented by homocysteine.
6. Coenzyme Q10 is produced by the body to help with the cells basic functioning. Studies showed that CoQ10 (coenzyme Q10) reduce angina or chest pains and help people with blocked blood vessel. Some doctors would recommend CoQ10 for people taking statin drugs to help prevent muscle pains or damage to the liver which are direct results of taking statins.

Supplements are not the cure-all treatment for diseases. Given that they help in improving one’s health, changes in one’s lifestyle. A well balanced diet and a healthy lifestyle will all have positive effects on one’s heart health.

Stimulant drugs may adversely affect the child’s growth in three ways. The first theory is when patients experience loss of appetite, reducing the consumed calories. The second theory is pointing at how increasing dopamine can suppress the growth hormone secretion and affects directly the children’s height development. The last theory suggested that the stimulant drugs may retard the cartilage tissue development which affects the growth of bone.

Latest studies have indicated conclusive findings that even in the existence of an apparent slowing down of growth observed on ADHD children taking those stimulant drugs, if a child stops the medication, he or she will be able to grow up again. It is for this reason that ADHD children are given summer breaks from taking the medication. Parents need to monitor their child’s growth curves and discuss with the doctor the possibility of having stimulant therapy breaks.

http://www.cfp.ca/content/56/2/145.full?sid=38d35d19-753a-49d2-8e10-134a1cf87329

Mental health providers may be overly cautious to diagnose ADHD in patients who abuse drugs because of the possible misuse of stimulnat mediactions in these patient population.

A study was conducted in Sydney, Australia to investigate the nature and correlates of symptomatology consistent with adult ADHD among illicit psychostimulant users. The study involved 269 users who regularly take either cocaine or methamphetamineor both. All 269 used illegal psychostimulants weekly or more for one year. About 71% of the users used the illegal substance more than three times per week for 12 months and about 88% are psychostimulant dependent. The 269 users are aged from 19 to 62 years with an average of 35.6. About 86% had received treatment for substance dependence and 52% were undergoing treatment at the time the study is conducted and 88% were jobless.

About 45% were diagnosed to be positive for adult ADHD and 90% showed signs of inattention which is more common than hyperactivity/impulsivity which accounted for 57%. Those individuals with ADHD symptoms ar more prone to have serious polysubstance dependence, and higher early school drop rate.

The researchers pointed out that if ADHD is identified as comorbid, it may assist in planning the appropriate treatment options for substance abuse and will reduce the risk of non-compliance with treatment plans due to symptoms of impulsivity, disorganization and inattention. The study concluded that it is important to recognize the high risk of ADHD in patients who are seeking substance abuse treatment because if ADHD is not diagnosed and remained untreated, it may impact the retention, compliance and outcome of treatment.

http://onlinelibrary.wiley.com/doi/10.1111/add.12086/abstract