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Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

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Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#21
post #13

personally, as a retired psychotherapist Be very wary of ADHD diagnosis, The consequences are huge and have a massive impact on childrens lives. I hate all ADHD diagnoses, for me I have always seen just naughty children who need time to develop at their own pace and not develop at someone else's pace or for the benefit of any school cariculum or parental needs. Do not give any child medication to control ADHD, why wo…

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Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#22
post #6

I believe that school is a huge problem. Don’t give drugs, they can permanently mess up his mind. ADHD and ADD are defense mechanisms the mind has. His brain is basically saying that what he is learning in school is a complete waste of his time. Even though we all do it, school is a really weird behavior! No animals do it and we aren’t designed for it. I don’t believe that school is worth it for many people. They bec…

> Don’t give drugs, they can permanently mess up his mind. Reading your entire comment, but especially this sentence makes my blood boil. None of this is backed up by science and you provide no sources. This is the equivalent to flat earthers explaining how the universe works or anti-vaxxers how thoughts cure disease. The OPPOSITE is true: Medication, especially given during age when neuroplasticity is still high can…

...then post some, instead of obviously biased organisations which make a living of treating it as a problem but can't come up with better reasons than -are less likely to finish high school and college -are more likely to experience unemployment -have more difficulty paying bills -are more likely to experience substance use issues

How likely? I'm not bothering looking it up, it should be mentioned right there! Anyway, it sure sounds like the general crime of being poor + not obeying the system as the ruling classes expect. So instead of perhaps checking on the system, lets fill the child with some completely harmless pharmaceuticals:

"If a child taking a stimulant seems sedated or zombie-like, or tearful and irritable, it usually means that the dose is too high and the clinician needs to adjust the prescription to find the right dose."

No way that could mess up a childs mind, right? Everyone thinking otherwise is clearly a flat earther. Disclaimer: I happen to be a clinician, although not in that field, and drug side effects like those - on a child - usually need very, very good justifications or it's malpractice. And just because it seems to have worked for you the right way doesn't mean that it's right for anyone.

Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#23
Depending on how severe your nephews ADHD is (and it can go from borderline ADHD to severe mixed type) it might be worth doing sleep training, eating training, stimuli training etc.

In all cases I would recommend multiple psychological education courses.

Sports and diet are very important - protein rich diet has protective effect on neurological system (doesn’t mean only proteins but make sure that healthy amount is included). For the sports: dynamic, unpredictable ones work well - Tennis, fencing, fighting sports etc. (fighting sports also help with confidence and can help mitigate effects of RSD if it coexist).

In general ADHD is very well researched and with guidance of competent doctor he’ll be fine. A lot of information and research is available, but a lot of snake oil too.

Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#24
post #17

The child is in more danger from medications during the process of brain development. Thats why their are different prescribing protocols for adults and children and why pregnant women do not take any drugs because they can damage the developing fetal brain. Neuroplasticity refers to the ability of the brain to reorganize and modify its neural connections in response to environmental stimuli, experience, learning, in…

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Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#25
post #6

I believe that school is a huge problem. Don’t give drugs, they can permanently mess up his mind. ADHD and ADD are defense mechanisms the mind has. His brain is basically saying that what he is learning in school is a complete waste of his time. Even though we all do it, school is a really weird behavior! No animals do it and we aren’t designed for it. I don’t believe that school is worth it for many people. They bec…

> Don’t give drugs, they can permanently mess up his mind. Reading your entire comment, but especially this sentence makes my blood boil. None of this is backed up by science and you provide no sources. This is the equivalent to flat earthers explaining how the universe works or anti-vaxxers how thoughts cure disease. The OPPOSITE is true: Medication, especially given during age when neuroplasticity is still high can…

All right, well I didn’t mean to be offensive in what I wrote. Please forgive me, it was written quickly. I hope we can all learn from each other in this forum, it was very kind of you to post those studies!

Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#26
Beyond meds and various coping skills that may be taught via therapy or advice on the internet, I have a nutritional approach that I found to be helpful as an adjuvant to meds. Meds like adderall or provigil tend to be demanding on the brain neurochemistry, so supporting the biochemistry becomes an important part of the strategy, rather than continually going back to the doctor to bump up the dose.

Mostly focus on Omega 3s (specifically DHA, cuz 80% of the brain lipids are DHA), Choline (via AlphaGPC or Phosphatidylcholine) and Magnesium Threonate (the only bioavailable form that can cross the blood brain barrier).

Other lifestyle aspects that are extremely helpful is exercise and focusing on high quality sleep.

Meds are great, but lifestyle is the other half of the equation that's too easy to overlook. I've gone from needing provigil doses at 200mg to about 1/8th of a pill these days and on most days, I skip it because they tend to be slightly too stimulating.

Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#27
ADD is not a single issue, but a collection of issues with varied symptoms and coping methods, and which he is likely experiencing to different degrees of severity.

Thus, in my 20 years of experience coping with it, I've found the concept of ADHD to an unhelpful abstraction. Push past it and learn about all of the individual underlying issues and related concepts (attention and focus, memory (paying special attention to working memory), capacity for organization and planning, mental flexibility, emotional regulation, impulse control). Figure out how badly these individual issues affect him (they make workbooks for this purpose), then work consistently and patiently to help him understand them and to build up toolkit of coping mechanisms.

If he goes on medication, I would encourage you to investigate appropriate dosing and ensure that he starts out as low as possible so as to minimize the negative impacts. You would expect doctors to do this as a matter of course, but in my experience they do not. Don’t let some jackass turn your nephew into a zombie by proscribing 50mg of Vyvanse when 5mg of Ritalin could be both more beneficial and cause less of a change on his personality.

Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#28
> The diagnosis is not a complete surprise but it is hard on him.

My understanding of available evidence is that an ADHD diagnosis isn't helpful for everyone. This is partly due to societal stigma and lack of understanding of what ADHD is.

I can highly recommend Russell Barkley as a source of scientific information on the subject.

> He has always had problems concentrating at school, for instance he is good at math but would often misread the problems and answer the wrong question. Do you have advice for him to be able to go through his teenage years?

Know yourself. Cognitive function and executive function are different. Executive function impairment can be contextual. With time secondary and tertiary symptoms might develop depending on how well he treats his condition.

State of the art ADHD treatment is multimodal, i.e. you treat it many different complementary ways. Depending on severity medication is a very important part of it.

Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#29
This introduction to the nature of the experience of the different symptoms associated with ADHD will help you understand your nephew. Really opened my eyes.

https://www.youtube.com/watch?v=ouZrZa5pLXk

From the description:

Here’s everything you need to know about Attention Deficit Hyperactivity Disorder (ADHD) in children. Get the transcript at https://www.understood...

Thomas E. Brown, PhD, discusses ADHD diagnosis, ADHD symptoms, available ADHD treatment options, and ADHD medication. As our expert says, ADD/ADHD is not a behavior problem. It has far more to do with the brain’s management system. Remember, ADHD has nothing to do with how smart a person is.

Re: Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

#30
post #22

Earlier quoted context omitted.

> Don’t give drugs, they can permanently mess up his mind. Reading your entire comment, but especially this sentence makes my blood boil. None of this is backed up by science and you provide no sources. This is the equivalent to flat earthers explaining how the universe works or anti-vaxxers how thoughts cure disease. The OPPOSITE is true: Medication, especially given during age when neuroplasticity is still high can…

...then post some, instead of obviously biased organisations which make a living of treating it as a problem but can't come up with better reasons than -are less likely to finish high school and college -are more likely to experience unemployment -have more difficulty paying bills -are more likely to experience substance use issues How likely? I'm not bothering looking it up, it should be mentioned right there! Anywa…

> then post some, instead of obviously biased organisations which make a living of treating it as a problem

https://en.m.wikipedia.org/wiki/Management_of_attention_defi...

Wikipedia is a good start, if you are open to the idea of being proven wrong. There is in fact quite a bit of evidence suggesting that many children with ADHD benefit from getting medicated with e.g. methylphenidate and amphetamine.

Of course ADHD medications come with risks, but the question is if they are on the whole beneficial for the patient or not. Brain surgery has risks, Ibuprofen has risks, exercise has risks.

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