30 Essential Ideas you should know about ADHD, 1B Inhibition, Impulsivity, and Emotion

now what is it that is delayed two traits the first is not the one after which the disorder is named and in that sense the disorder has been misnamed the first deficit to appear is inhibition a failure to develop an appropriate inhibition of your behavior and this what often emerge in the preschool years and its first sign is usually hyperactivity though it doesn't need to be so but it typically is you have an individual who is behaving too much who is not suppressing irrelevant behavior the way other children are able to do we will see this in their motor actions there's a lot of action coming out of this child we will see it in their verbal behavior there's a lot of words coming out of this individual and we will see it in their intrusive and disruptive motor and verbal behavior as well but along with that there is a cognitive impulsiveness this snap decision making this quickness to do the first thing that pops into your head without due delay and due diligence thinking about what the consequences will be and then we will also see the restlessness not just the gross motor activity but the seat restlessness which I think affects their school performance more than the gross motor activity does but this will decline with age so that is why hyperactivity is no longer the name of this disorder because it declined steeply and by adolescence it is nearly gone and by adulthood it is an internal state it is a feeling inwardly of an need to be busy and doing multiple things and its a busyness of one's mind ones ideas there is a restless quality to their cognition but not to their outward behavior in fact our research has shown that hyperactivity is have no diagnostic value in adulthood in fact being restless is more associated with anxiety disorders by the time you are 30 then it is being associated with ADHD we just don't pay attention to it it is of no relevance to diagnosis so let's understand that the real problem here is not restlessness it is in fact inhibition their is a failure to develop appropriate inhibition and it affects your behavior it affects your words it affects your mind and your thoughts and we need to return to the idea which we have gotten rid of that it affects your emotions for the first hundred and seventy years of the history of ADHD in the medical literature which began in 1798 not 1902, eight years ago the last remaining copy of a medical textbook was discovered at Kent State University this text book was written by the Scottish physician then living in colonial America Alexander Crichton and Crichton had written a medical textbook in which their is a chapter entitled diseases of attention and it is the first description of this disorder and it's very good by the way so ADHD did not begin in 1902 it started in 1798 as far as the first initial medical reference and from that point on until 1976 emotion was part I've ADHD every major theorist every paper every science paper including that of Mark Stewart when the first major scientific descriptions the Canadian papers by Whitson heckman and wary and Douglas and others back in the sixties and seventies all included emotional impulsiveness as part of this disorder but the DSM parse to decide and made it and associated problem in some people it isn't it is as much a core feature of this disorder as is any other symptom in the DSM and that was our mistake and it needs to be returned to our understanding I V DHT by emotional on pole to miss I mean this quickness to anger to be easily excitable to have low frustration tolerance to be easily angered by things around you and to display your emotions much more quickly than other people do now this is not a mood disorder even though it starts to look like one mood disorders are where you are generating too much emotion but ADHD is is a failure to regulate normal emotions it is a self regulation disorder the feeling you're having is normal that you are not moderating it is not it is this inability to self sues to self com and to then moderate the emotion to be more acceptable for the context and for what you hope to accomplish here the goal that is at hand your long-term welfare is at stake ken you modified that emotion to be more socially acceptable to be less costly less damaging he that is as much a part of ADHD is anything else and we are pushing the dsm-5 committees there are several to re incorporate emotional impulsiveness and this emotional dysregulation as being a part of this disorder because it loads on this dimension you can not be impulsive in your behavior and not be impulsive in your emotions that is impossible because they are unity they go together emotion is welded to everything you say and do sometimes is benign and bland other times it is powerful an intense it is the emotional coloring of the behavior we display if you are impulsive in one you must be in the other that needs to get reintroduced back into ADHD for a number of compelling reasons not just because historically it was always there but because it explains so much more than the current do you have ADHD explains as I will show you ADHD children are eleven times more likely to develop oppositional defiant disorder within two years at the onset of their ADHD why what are those disorders have to do with each other now they're treated as simply co morbidity all well they go together but we're not sure but if you put your motion back into ADHD you see the connection right in 20 DD because everybody with ADHD is automatically sub clinically OD'd at the get-go it on a gonna take one more symptom to cross the diagnostic threshold in other words ADHD causes oded that is an important thing to understand because the OD'd while it does have some social influences over it half %uh DD is the inability to manage frustration impatience and anger and that will set you up for the second component AVO DD which is interaction conflict defiance arguing but the first four symptoms up the H in OD'd our mood anger temper hostility easily annoyed irritability and that is part of ADHD so we need dsm-5 then we need families to both understand the emotion goes with this disorder it is not a separate comorbidity in some cases and now we know why when we treat ADHD particularly with the medications that we use we get nearly as much reduction and OD'd as we get an ADHD and when we don't it is because of the social conflict component which is learned and we will have to unlearned that little piece but the mood component is he ADHD component now by returning emotion into ADHD it also helps families to understand some of the other life course risks fifty to seventy percent of ADHD children are utterly rejected by close friendships by second-grade it is in fact one other more devastating consequences have this disorder is this inability to make and keep close sustained friendships with other children and it is heartbreaking for parents to see this happening but their child is not as liked as other children that the sleepovers the going to the movies and the other social events in which other children celebrate their peer relationships are shut off for this trial why is it there the single best predictor a peer rejection is that symptom the emotional impulsiveness friends forgive you your distractibility your forgetfulness you're working memory problems and even your restlessness they will not forgive your anger your hostility the quickness with which you emote to other people because it is offensive it is socially costly so now we can begin to understand the numerous social problems that ADHD children are prone to because it arises from this aspect above the inhibitory deficit there are other things that it explains I could do a whole hour and a half as I did a month ago in Toronto on the importance of emotion in ADHD I won't go there but suffice to say that it explains the road rage during driving the job dismissals which are not the result %uh inattentiveness but I being too quick to anger too quick to express raw emotion in the workplace %uh which employers are not tolerant especially if it occurs with a customer and it also explains to us the marital difficulties and the parenting difficulties these children may be prone to because the single best predictor of marital problems in the adult with ADHD is not distractibility it is a motion so we can begin to paint a better picture understanding ADHD in its life course Rhys by understanding the nature of the inhibitory problem and that it includes emotion as part of it and not just slide 1 I've got 85 slide do you see why i'm concerned. with 15 minutes to do is lie alright so we better get rolling here but I thought you ought to know where we're going and by the way in case you hadn't noticed I will not talk down to you today I will treat you as if you were my colleagues my students my peers because I think the parents attend these things to learn and that's not going to happen if I have to dumb this material down and it is also insulting and I won't insult your intelligence either you're knowledgeable people I'll speak to you frankly using the scientific term on K

Channel: Adhd Videos

Views: 415,203

Rating: 4.9411764 out of 5

Keywords: ADHD, Barkley, Essential Ideas, Emotion, Inhibition, Impulsive, Impulsivity, Oppositional Defiant Disorder, ODD, CADDAC, Attention Deficit Hyperactivity Disorder (Disease Or Medical Condition), Attention Deficit Disorder (Disease Or Medical Condition)

Id: wg6cfsnmqyg

Length: 11min 20sec (680 seconds)

Published: Thu Aug 21 2014

Reddit Comments

[u/Annester]

I don't know what it was like for you guys growing up, but I used to dream of having a best friend. I had friends I sometimes played with at recess or after school, but I was never their best friend. I can remember being 6 or 7 and crying to my mom about how no one would be my friend. Now that I'm a mom, the thought of hearing my daughter say that to me breaks my heart.

[u/[deleted]]

I made most of my friends way later in life. Primary school was a very lonely time.

[u/KindOwl]

I didn't have friends until maybe 2nd grade. After that point, I jumped around from friend group to friend group. I desperately wanted a best friend, but I couldn't cultivate such a friendship, so I typically ended up the 3rd wheel. And what friends I managed to make, I could rarely keep anyways, because it was so difficult for me to keep in contact.

The loneliest period of my life was probably freshman year of college, especially the first semester. I tried so hard to push past my social anxiety, but I came off as too nice and very awkward. I admit it still hurts my feelings a twinge when I remember overhearing people talk about how fake I am.

God, I wish I was diagnosed and treated way earlier. Might have saved me so much heartache and burned bridges.

[u/tausert]

I had one best friend through elementary school, lost her, then aggressively made my current best friend be my best friend in middle school. I've managed to make way more friends since senior year of high school, but I always feel like I have to keep people at an emotional distance, I turn off a lot of the emotion I feel around other people because it tends to explode and destroy my relationships when I show people all of me. Even my SO cant handle the emotionally volatile side of me, which makes me sad.