In the UK, it's not easy getting an assessment for adult ADHD. And if you do, there are some doctors who don't believe in adult ADHD.

Assessment for ADD/ADHD in adults is still very difficult in the UK. There are only 2 NHS Clinics, one at the Maudsley Hospital in London and one at Addenbrooks Hospital in Cambridge. They will only take referrals from a local health service provider- GP or consultant Psychiatrist. This means that they will not take self-referrals or contacts before a referral.

Preparing for an ADHD Assessment in the UK

The first step is to speak to your GP and ask for a referral to your local Psychiatrist- there are waiting lists, which can vary in length in each area.

Once you have a referral and an appointment has been made, you do need to be prepared.

Gather together up-to-date information including the diagnostic criteria for ADHD in adults and some up-to-date research and if possible some old school reports and some evidence of why you feel you do fit the diagnostic criteria for ADHD. Try to keep some sort of diary of how the ADD-ADHD symptoms affect you and how they disrupt your daily life.

Some Psychiatrists Don't Believe in Adult ADHD

There are still many adult psychiatrists who believe that children outgrow ADD/ADHD and are therefore very sceptical of the condition in adults. It is therefore quite possible that they will disregard any mention of a referral for assessment of ADD/ADHD.

Below are some quotes from professionals who were asked about the prevalance of ADD/ADHD in adults. They're very interesting and may help when trying to get the professionals to take notice of what you are saying.

"The estimated rates of persistence of ADHD into adulthood range between 50 - 60% (Faraone, Biederman,et: Attention Deficit Hyperactivity Disorder in Adults; An Overview. iBiological Psychiatry, 2000;489-20). In practice however, the rates seem to be much higher." Ricardo Castaneda, MD, NYU/Bellevue

"The problem comes out of semantics. I think of ADHD as a genetic disorder which some circumstantial issues can mimic (alcohol and drugs in utero, concussions, lead poisoning, drug abuse) thus creating 'pseudo-ADHD.' In this view, you are correct: it is 100% persistent. No one who truly has ADHD 'gets rid' of it till there is a way to exchange chromosomes. Some adults cope with it better than others (so do some children!) and don't 'need' medication or coaching or education or structure or or or... You can see where this goes--who could not use a little better structure or organization? Who defines how good of coping is 'good enough?' What those people are saying when they say X% of ADHD patients have the disorder is that, by the standards of the one judging it, (100-X)% of ADHD patients are doing well enough that they don't need help (again, what is 'help'?--would they suddenly develop ADHD again if you took their secretary and Microsoft Outlook away from them?)"

"On the other hand, if you define ADHD by function, you have a moving target that is about as easy to pin down as to nail the proverbial Jell-O blob to a tree. I go with the 100%." John I. Bailey, Jr., M.D., Center for Attention & Learning, Mobile, AL.

This is when they will look into many other conditions and this is then when you need to politely suggest that they read the literature you have with you and ask if they would at least consider the up-to-date evidence. You may also ask if they can get in touch with one of the NHS Clinics to discuss things further before dismissing the referral request completely. Hopefully, after this (it may mean a 2nd appointment to give them time to look through things), they will try to be helpful and look into a referral. Bear in mind even if they do believe in the condition, they still have to get the authority of the local health authority to refer you to one of the clinics. So there may still be problems with obtaining the referral. Don't blame them directly if this is the case, but talk to them and see how you could maybe help to get the authority to understand the condition in your area.

What To Do When the Doctor Doesn't Believe in Adult ADHD

If, however, the local Psychiatrist still does not believe in the condition after reading the evidence, then you may have to get in touch with the local Health Authority directly.

If you do have to contact the local Health Authority either because the Psychiatrist will not consider a referral or if the Authority has told the Psychiatrist that they cannot refer you then you can start by writing direct to the Director for Mental Health Services at your local Authority or Trust. The best thing would be to get in touch with your local PALS and ask for the contact name for the Director of Mental Health Services and also where they are based so that you can write to them direct.

You need to start by explaining the problem, that you have asked for a referral for an assessment of ADD/ADHD and the local service providers have not agreed to refer you to one of the NHS Adult ADD/ADHD Clinics and that you feel that you do fit the Diagnostic Criteria and that you do not fit the criteria for other Mental Health conditions. Say you are requesting them to look into the problem and for them to arrange the referral for you, explain that you accept that if after an assessment by a doctor at the clinic they say that you do not fit the criteria you would at least appreciate the referral to at least know for sure that this is not the cause of your problems.

It is worth remembering at this point that you try to ensure that you point out the problem and what you want the person you are writing to do in the first paragraph and then maybe go on to give the evidence as to why in the following paragraphs - these are busy people so need to have a good idea in the first paragraph of any correspondence as it is more difficult if they have to read through reams to get to the point of the letter.

It is also worth enclosing evidence such as that prepared for the local Psychiatrist - Diagnostic Criteria, up-to-date information, up-to-date research and any personal evidence including old school reports if you have them. However, in the main body of the correspondence, keep things simple and to the point. It is therefore worth writing something like the following where you mention things and enclose them separately i.e.

"I am requesting a referral for an assessment of ADD/ADHD at one of the two ADD/ADHD NHS Clinics¹ as I feel I fit the Diagnostic Criteria² and have enclosed evidence to this effect³ and some up to date information⁴ and research⁵. Then at the bottom of the letter list the items enclosed:

1 Name of Clinics
2 Diagnostic Criteria
3 Personal diary type of evidence and/or school reports
4 Information
5 Research

Make sure you also number the pages you enclose so that they match the list you have in the letter.

If you do not get any response in a couple of weeks, either an acknowledgement that your letter has been received, or that the person you wrote to is looking into your problem and they will get back to you when they have completed their investigations, write back to them asking if they received your initial correspondence and if they have been able to read the enclosed documents and ask how they will be able to progress with your request for a referral for assessment. You are entitled to at least ask for an initial reply within a certain time frame - maybe 2 weeks. This at least gives them time to acknowledge they have received the request.

It is also worth at this time considering sending copies of all correspondence to various other members of the Health Authority, i.e. Director for Psychiatrist Services, the Trust Director, Director of Mental Health Nursing, Director of Psychology Services, Director of Patient Services (you can get the contact names and addresses from your local PALS so that you can address all correspondence direct to the person rather than just an office where it may not get to the right person) and maybe also your local MP. Remember to send a covering letter to each and also to enclose all the attachments you enclosed in the first main correspondence all listed correctly. You also need to remember to list at the bottom of each letter all those you have sent carbon copies to i.e. c.c. Name local MP.

If you continue to get no response to any of your correspondence keep going, don't give up. Give it another couple of weeks and then write again to all those you wrote to asking if they have received your letter and how they are going to look into the situation for you. It may be then also worth making an appointment to see your local MP or Patient Liaison people.

Even if it seems you are not getting anywhere DON'T GIVE UP in the end you will be able to get the help and services you are looking for. Try not to get too frustrated with the services - at least try not to let it showJ and try to make those you write to know that even if after an assessment it is found that you do not receive a diagnosis that you will accept this but what you are asking for is the opportunity to at least have the correct assessment by a specialist who is experienced in the condition rather than one who is not, to confirm or rule out the diagnosis of ADD/ADHD.

The Private Option

There is also the private option, there are a number of private consultants who are experienced in ADD/ADHD and some will take NHS referrals ad work with your local Authority. The best thing to do is to get in touch with a local support group, as they will know if there is anyone in your area or at least the contacts for some specialists in adult ADD/ADHD who will be able to help.

It is also worth considering that if you do receive a diagnosis from an experienced private consultant you may be able to recover costs from your local NHS Trust if it can be proven that they have not been willing to consider an assessment by a qualified experienced consultant on the NHS.

Says book based on 25-year study

You may feel as if you grew up on a desert island, far from the mysterious world of lasting romantic love.

You may believe that even if you do fall in love, you are destined to jinx the relationship, or be abandoned, or be terribly hurt.

You may fear conflict and change and have a tough time separating from your parents, even though you left home years ago.

A new book, based on a lengthy study, argues that emotional complications like these are common among adult children of divorced parents -- and that they may not be fully evident until decades after the breakup.

"The Unexpected Legacy of Divorce,'' by Marin County psychologist Judith Wallerstein, San Francisco State University psychology professor Julia M. Lewis and New York Times science correspondent Sandra Blakeslee, is based on a 25-year examination of the lives of 93 Marin County adults.

Wallerstein, founder of the Center for the Family in Transition in Corte Madera, began examining this group in 1971, when they were children and adolescents. Now they are between the ages of 28 and 43.

Initially, researchers expected that the study findings would be different -- that the most stressful time for the children would come right after the divorce.

Instead, they found that post-divorce difficulties become most severe when the children of divorced parents reach adulthood, as their search for lasting commitment moves to center stage.

"They are terrified because they are convinced they are going to fail,'' said Wallerstein in a telephone interview from Massachusetts, where she was on tour promoting the book. "They don't know how to choose. They make bad choices. They divorce a lot.''

"It breaks their hearts,'' she said. ``They don't take marriage lightly, but they don't know how to do it.'' Many of the study participants said that seriously searching for a life partner felt like going through their parents' divorce all over again.

The findings are not without critics. Some experts question how many of the problems Wallerstein identifies can be truly attributed to divorce and not to other causes such as poor parenting skills.

"There are a lot of other family processes associated with divorce, like the extent to which parents support or undermine each other,'' said Gayla Margolin, a professor of psychology at the University of Southern California, who studies the effects of marital conflict on children.

Others question the reliability of a study based on such a narrow sample, or say the effect of divorce is not as wrenching as the study concludes.

Mavis Hetherington, a sociology professor emeritus at the University of Virginia who also studies divorce, said her studies have shown that although children of divorced parents do have more problems, the majority of them function well.

"Judy really views divorce as a terminal disease. That's just not true. When kids move into a happier family situation with a competent, caring, firm parent they do better than they do in a nasty family situation,'' Hetherington told the Associated Press.

The book's researchers say they are not opposed to divorce. Indeed, they argue that children raised in highly dysfunctional marriages were no better off -- and sometimes worse off -- than children of divorced parents.

Rather, what the study shows is that parents, society and the courts need to pay closer attention to the consequences of divorce on children, said Lewis, who began working with Wallerstein about 10 years into the study.

For example, none of the child- support arrangements made by the divorcing parents included provisions to pay for the children's college educations, and few of the young people in the study received money for college from their fathers, many of whom were wealthy professionals.

"One of the main findings of the book is that what makes adults happier isn't necessarily what makes kids happier. That, I think, is hard for a lot of adults to swallow,'' Lewis said.

Although some of the divorced parents in the study did go on to lead happier lives, that did not translate into happier lives for the children, Lewis said.

"If you're in a middling marriage where it could go either way, you have to look at the quality of the parenting,'' she said. "If you're both pretty good parents and you're putting the kids first, then you work harder to save that marriage. That's really what we're trying to get across.''

Today, a quarter of Americans ages 18 to 44 are children of divorced parents, and Wallerstein said her latest book is meant primarily for these people, who may be struggling with problems they do not even know are related to divorce.

Wallerstein found that these otherwise well-functioning adults must fight to overcome such feelings as a fear of loss because of childhood anxiety about abandonment or fear of conflict because it leads to emotional explosions.

The study, based on extensive individual interviews, also found that adult children of divorced parents are more likely to become addicted to drugs and alcohol in adolescence, and they seldom match their parents' educational and economic achievements by the time they reach their 20s.

Their adolescence lasted longer, the study found, because the children were so preoccupied with their parents. For example, Wallerstein said, many girls end up fearing success, thinking: "How can I have a happy life when my mother or father has been unhappy?''

On the positive side, the researchers found that the adult children of divorced parents are survivors.

The same experiences that hindered relationships helped in the workplace. The study participants were very good at getting along with difficult people, Wallerstein said. And with mothers who often said one thing and fathers who said another, the grown children also became adept at making up their own minds.

The study also compared the adults from divorced families to 44 adults from intact families.

Children of intact marriages took strength from their parents' decision to stay together, the researchers found, even though the marriage may have had conflict and unhappiness similar to those of families that broke up.

"In intact marriages, the young people had a much different childhood -- this is what startled me,'' Wallerstein said. "I couldn't get them to stop talking about their play. . . . I realized that children divorced families never mentioned play. They all said that `the day my parents divorced was the day my childhood ended.' '' FACTS ABOUT DIVORCE

-- More than 25 percent of Americans between 18 and 44 were children of divorce.

-- One-half of people marrying in the 1990s were getting married for the second time.

-- Eighty percent of divorces occur by the ninth year of marriage.

FINDINGS FROM THE WALLERSTEIN STUDY:

A landmark study on the long-term effects of divorce by Marin County psychologist Judith Wallerstein followed 93 children of divorce over 25 years. Among the study's findings:

-- Children of divorce were far more likely than children of intact families to marry before age 25 -- 50 percent versus 11 percent.

-- The failure rate of these early marriages was 57 percent for children of divorce, 11 percent for children of intact families.

-- Among the adult children of divorce, 38 percent had children. Among adult children from intact families, 61 percent had children.

-- The use of drugs and alcohol before age 14 among the children of divorce was 25 percent, while among children of intact families it was 9 percent.

Source: "The Unexpected Legacy of Divorce: A 25-year Landmark Study" (Hyperio, 2000)

This story appeared in the San Francisco Chronicle - Sept. 2000.

next: Analyzing Feelings When A Relationship Ends

These organizations offer a wide range of information and services related to children, adolescents and adults with attention deficit disorder also known as attention deficit hyperactivity disorder.

Attention Deficit Information Network (Ad-IN)
475 Hillside Avenue
Needham, MA 02194
(617) 455-9895

Provides up-to-date information on current research and regional meetings. Offers aid in finding solutions to practical problems faced by adults and children with an attention disorder.

Center for Mental Health Services
Office of Consumer, Family, and Public Information
5600 Fishers Lane, Room 15-105
Rockville, MD 20857
(301) 443-2792

This national center, a component of the U.S. Public Health Service, provides a range of information on mental health, treatment, and support services.

Children and Adults with Attention Deficit Disorders (CH.A.D.D.)
499 NW 70th Avenue, Suite 109
Plantation, FL 33317
(305) 587-3700 (800) 233-4050

A major advocate and key information source for people dealing with attention disorders. Sponsors support groups and publishes two newsletter concerning attention disorders for parents and professionals.

Learning Disabilities Association of America
4156 Library Road
Pittsburgh, PA 15234
(412) 341-8077

Provides information and referral to state chapters, parent resources, and local support groups. Publishes news briefs and a professional journal.

National Center for Learning Disabilities
99 Park Avenue, 6th Floor
New York, NY 10016
(212) 687-7211

Provides referrals and resources. Publishes Their World magazine describing true stories on ways children and adults cope with LD.

National Dissemination Center for Children with Disabilities (NICHCY)
P.O. Box 1492
Washington, DC 20013
(800) 729-6686

Publishes free, fact-filled newsletters. Arranges workshops. Advises parents on the laws entitling children with disabilities to special education and other services.

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Many parents of ADD-ADHD children, at least at first, aren't sure what to do. Dr. Phil and Dr. Frank Lawlis, author of The ADD Answer, provide some helpful suggestions.

In the United States, 17 million children are diagnosed with Attention Deficit Disorder, and oftentimes it is accompanied by hyperactivity. Dr. Phil and Dr. Frank Lawlis, author of The ADD Answer, offer advice for parents whose children are diagnosed with ADD-ADHD.

Educate yourself about ADD.

In his book, Dr. Lawlis explains that an ADD diagnosis is not a sign of inferior intelligence or a handicap. It does not result in a damaged personality, criminal tendencies, or immoral behavior. ADD is not necessarily a learning disability or a mark of mental immaturity, although such conditions can coexist with ADD. Much of the time, the problems of ADD are related to the brain performing at lowered, subdued ranges.

Obtain a proper diagnosis.

Many times, parents are quick to make evaluations of their children's unruly behavior. "I always look for other reasons, other causation, whenever I see behavior spinning out of control," Dr. Phil explains. The symptoms a child exhibits may be caused by factors such as divorce, death of a parent, or a change in school and living situation.

There are at least two well-documented ways to determine if your child has a neurologically based disorder of ADD or ADHD: a spectrogram or an EEG can identify specific patterns in certain parts of your child's brain.

Examine your parenting style.

Is the child more difficult with one parent than with the other? It could be that your parenting style is contributing to the problem. Parents need to have a unified front that they both can stand behind and enforce. You must support one another in your actions and discipline. Look at ways that you can change your child's environment, including avoiding fights in front of the kids or reacting to your child differently.

Don't feel guilty about disciplining your child.

Dr. Phil tells one mom whose child suffers from ADHD: "You have to be willing to visit the structure. You have to be willing to bring the predictability, the consistency and the discipline. It's not something you should feel guilty about; you should feel guilty if you don't do it because he needs the structure. He needs the guidance. He needs the order. He needs the rhythm. He needs all of the things that are necessary to give him a chance to have a flow to his life."

Know all the facts before giving your child medication to treat ADD.

Dr. Phil and Dr. Lawlis both agree that we are overmedicating our children. In his book, The ADD Answer, Dr. Lawlis asks, "Are we using drugs to control our children's behavior instead of being responsible parents? When we teach our children at a young age to rely on medications, I fear that we are in danger of creating a generation of pill poppers as a result." Also, medication is only about 50 percent effective, and it decreases in effectiveness from the day your child starts taking them.

Dr. Phil clarifies his views about medication for ADD: "If it's working for you and your children against a backdrop of responsible parenting, then good for you and you shouldn't substitute my judgment or anyone else's for your own."

Monitor your child's diet.

"The brain doesn't necessarily use all the foods we give it in the best way, and actually the rawer the food, the more natural the food, the easier it is for the brain to metabolize it and use it for its use. So when you create a food that's not natural, that's been fried or created with a great deal of heat, it just doesn't work as well," Dr. Lawlis explains.

Consider alternative options.

Children can learn to control their brain activity to the point that it can affect their ADD or ADHD. The symptoms of ADD can be controlled through Biofeedback, computer images and sounds that show what's going on in the brain. (Dr. Lawlis devotes a whole chapter to this in his book, The ADD Answer).

This approach is not an absolute cure for every aspect of ADD. However, it has worked well in helping children learn to control disruptive racing thoughts and impulsive behaviors that impair the ability to focus and concentrate. It offers therapies that help ADD children learn to control basic other reactions, such as heart rate and cardiovascular activity.

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A Primer on Depression and Bipolar Disorder

A. Why This Pamphlet?

Perhaps the most common reaction people have to mental illness in general, or to depression/bipolar disorder in particular, is to ask ``Why in the world would anyone want to discuss such an unpleasant subject?'' This perhaps along with an (unspoken) intimation that the subject is also in rather bad taste. The answer to this question is long and complicated; indeed it is the subject of the entire essay. Yet there are a few basic points that need to be made from the outset. First, mental illness of varying degrees of severity affects many people. The estimates differ a good good deal from one source to another, partly because the criteria used in different surveys differ from another. But it is clear that something like 3% of the population of the United States (i.e. roughly 7.5 million people) suffer from chronic depression or bipolar disorder. A similar number suffer from chronic schizophrenia. And another 1% or so suffer from various other mental disorders (e.g. obsessive-compulsive disorder, dementia, ...). These are the people who have chronic mental illness (CMI), the ones who must (and whose families must) struggle with the illness day-by-day, year-by-year, perhaps for a lifetime. Isolated episodes of serious depression are far more common. It is conservatively estimated that something like 25% of the U.S. population will have at least one bout of depression serious enough to merit medical attention during their lifetime.

Second, depression and bipolar disorder can be extremely unpleasant. It can blight a person's existence for years. In its more severe forms it can incapacitate a person as completely as any serious physical disability; often employment becomes impossible, which implies severe economic and social hardships for both the individual and his/her family. In its most extreme form, depression can lead to suicide, destroying one's life as surely as cancer.

Third, all mental illness strikes at the very "part'' of us which makes us human: the mind. Depression and bipolar disorder are mood disorders; they affect how we feel about ourselves, our surroundings, our lives. In their most severe forms they can make life a living hell. Schizophrenia is a thought disorder; typically it causes major distortions in the victim's perception of reality, producing delusions and hallucinations. All of these illnesses tend to dehumanize the victim, leaving him/her more vulnerable to loss of self esteem, loss of will to live. It is one of our most sacred obligations as humans to reach out to our fellows who suffer, through no fault of their own, the extreme misery of these illnesses.

Beyond all of this, I want to offer a message of hope. I want to say from first-hand knowledge that depression and bipolar disorder are treatable, often with truly remarkable results. In fact, among other people who have CMI, I sometimes joke that depression and bipolar disorder are the ``Mercedes of mental illness'' just because they are so treatable. Next, I want to say first-hand that there is life after treatment; often a very rich and rewarding life. There are no guarantees, of course, but I can truthfully say that since successful treatment of my illness, I have enjoyed the very best period of my life.

Finally, I want to do what little I can to help break down the stigma associated with mental illness. It is bad enough to have to suffer the horrors of an illness, but it is insufferable to be cast out of society just because one has the bad luck of being ill. The time has come to end this practice. Society has to change its views. I offer myself as an example of a someone who has CMI and who, thanks to treatment, can continue to function at a valuable level of creativity and productivity in a highly technical and demanding profession, and as a counterexample to the common picture of a mentally ill person as violent, disordered, and/or "crazy''.

next: About the Author Dimitri Mihalas
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Interview with Jason Alster, author of "Being in Control" on alternative and natural treatments for ADHD.

Quite unexpectedly I received an email from Jason Alster.

It said this:

I am the author of the books BEING IN CONTROL: Natural Techniques for increasing your Potential and Creativity for Success in School and for Improving Concentration and Learning in Children with ADHD and Dyslexia and the book CREATIVE PAINTING FOR THE YOUNG ARTIST. I have been working with natural treatments of ADHD and test anxiety and dyslexia and have developed, over the last 15 years, a very powerful program to treat most cases of ADHD naturally and successfully. Whom may I speak to in your organization about workshops in the UK or distribution of these books and relay more information upon request? I do plan on being in the UK -London sometime in April and would be happy to meet up if possible. Sincerely, Jason Alster MSc, Center for Psychophysiology/Peak Performance and Learning Strategies, Zichron Yacov, Israel. Jason Alster

Intrigued by the man's confidence, I decided to meet him. We met at his hotel opposite the Natural History Museum. I was immediately struck by Jason's intensity and passion for his work.

I asked him to explain how he'd become involved in treating ADHD.

"I began treating children with ADD quite unexpectedly in 1991. I had been a biofeedback therapist as part of an anxiety clinic in a mental daycare setting in Tel Aviv, Israel. I had absolutely no experience in treating children but was doing quite well with adults suffering from stress disorders and teenagers who had test anxiety and social phobias. The biofeedback clinic had just opened and each type of patient was a new experience. With my medical-technological training in neuro-electro diagnostics and sleep/wake disorders, I was more into the neurological and psychophysiological disorders while a child psychologist working with me wanted to try biofeedback on ADD. Then he had said that there was no treatment for this poorly understood syndrome. The only remedy was Ritalin, although reports about EEG (electroencephalogram) biofeedback and Joel Lubar's research with neurofeedback were just coming out.

At first I used EMG (testing muscle tension). Then over time found that GSR (electrodermal resistance) was better and easier to use. At the time, there were no studies of GSR biofeedback for ADD. After starting to treat a handful of children with biofeedback the psychologist I was working with had to leave the unit and I had to take over his patients. All I knew then about ADD was from a television program showing a hyperactive child literally jump off the walls and I worried about what this child would do to my biofeedback equipment!

I had absolutely no knowledge of learning disorders either. I mention this lack of knowledge for a reason. I had to begin treating ADD without a prior predisposition to what was written in the literature. I had to see for myself what worked, and fast. "

How did you decide what would work?

"On my very first ADD patient I performed a regular biofeedback stress baseline for anxiety. That is, I hooked the child up to galvanic skin resistance (GSR) sensors, muscle and peripheral temperature monitors, but not EEG. I had to start to treat ADD with what I knew and that is how to treat stress and anxiety. I was lucky. My very first patient's baseline EMG (electromyogram or muscle activity potential good for measuring stress) showed that the more she sat quietly the EMG gained in amplitude. That is, sitting quietly was stressful for her. I tried relaxation training and she improved her baseline in just 6 sessions and began to do better both at home and in school. This was not supposed to happen. Biofeedback in ADD was supposed to be a stubborn neurological problem that takes 60 sessions to treat."

Your book, Being in Control, indicates that you have extended the range of tools you now use to treat youngsters with ADHD. It says that your methods are natural, integrative, and holistic and comply with recent theories in educational research. Does this mean you are against using ADHD stimulant medication?

"No, not at all, stimulant medication for ADHD has its place for some youngsters and their parents. I wanted to find an effective, alternative method to offer those young people and especially parents who wouldn't, or didn't want to, use medication to treat ADHD. At least these children wouldn't be left untreated. I then found that my method worked so well with the many children in our trials that it could be a viable alternative to medication and should perhaps be tried as a first line treatment.

In my readings at the time, a number of avenues were being pursued in the treatment of ADD. Some of these ADD treatments were nutritional, sensory integration, guided imagery, art therapy, natural meditation, yoga, Bach flower remedies, homeopathy, chiropractic, and the use of aromatic oils. In biofeedback, animated computer games were being introduced. I decided I could use each method and observe its effectiveness. I could develop an integrated and holistic approach. I could match the method to each child individually. One of the first things that I found that can cause the GSR to become stable in ADD children and adults is holding a soft or smooth stone in your hand. Who would ever expect that this piece of nature could compete with Ritalin? But it does. I got this idea from the worry stones and beads of the Middle East." (end of interview)

Jason Alster is keen to not only promote his books Being In Control and Creative Painting for the Young Artist, but he also wants to run workshops to train facilitators in his methods. He feels that any practitioner with an existing qualification, such as teachers, social workers, psychologists, classroom assistants and so forth could easily learn, employ and devolve his methods and these would be beneficial to any children that were struggling with ADHD, Dyslexia and other learning disorders.

His books are not big learned volumes full of highly technical information, but encapsulate the thinking and methods that he uses. They are small, soft backed books written and illustrated in such a way as to be immediately accessible to the children who will use them and easy for parents to facilitate the steps required.

Jason Alster convinced me that his 6 pillars approach - Animated Biofeedback, Sensory integration, Emotional intelligence, Accelerated learning, Creativity and Natural nutrition could add to the armory of ADHD treatments for all affected children, on its own for some and in conjunction with ADHD medication and psychological interventions for others.

What Causes Attention Deficit Disorder?

Attention deficit disorder can have many causes. It is believed to have a hereditary or genetic cause. It can also be caused by damage to a fetus' brain during pregnancy, or to a child's brain at birth, or after birth.

How Is Attention Deficit Disorder Diagnosed?

The signs and symptoms of attention deficit disorder are usually not apparent in infants. It is most likely to become apparent when a child is of an age where learning and instruction become emphasized and a child begins to show difficulty with learning.

Usually, this is when a child is about 7 or 8 years of age or is in the second or third grade of schooling.

Sometimes, however, signs and symptoms may appear during the infant stage. These may include restlessness or problems with sleeping or feeding.

Signs and symptoms may include:

1. On-going or habitual inability to pay attention

2. Easy, excessive distractibility

3. Lack of ability to organize

4. Excessive impulsiveness

5. Hyperactivity

6. Restlessness

7. Forgetfulness

A physician will ask many detailed questions about the child's personal and family medical histories. He or she will observe the child's behavior.

The physician will also perform a physical examination of the child. He or she may recommend more extensive testing to rule out other causes, or to identify any sensory or neurological disorders.

The physician may also refer the child to specialists for additional testing or diagnosis.

Some ADHD children may be underweight. Here are some ideas for getting your ADHD child to eat more.

Many parents of children with ADHD worry that their child is not eating enough, and that their child is light for his/her height.

This can be for a number of reasons:

• The child won't sit still long enough to eat much.

• The child is so busy and hyperactive that he/she burns off such a lot of energy that he/she actually needs to eat more than other children of the same size just to keep going.

• The ADHD medication (e.g. Ritalin, Ritalin SR, Concerta XL, Methylphenidate, Dexedrine etc.) the child takes stops him/her feeling very hungry.

The following are ideas for you to try. They won't suit everyone, but they may give you some help to get over what can be a tricky problem!

1. Eat together at a table, and then all get down from the table together when everyone has had enough (like in a restaurant). Some children eat very little just to be able to go and play sooner, but choose to eat more when there is no option but to sit at table and get bored - while they watch everyone else eat.

2. If the child gets bored and fed up with eating, try

a. Playing a story-tape on a cassette player at meal times.

b. When he/she has eaten a little for themselves, but stops because he/she gets fed up with coping with cutlery etc, why not put a few mouthfuls on the fork for him/her? It may seem odd to be "feeding" your 8 year old - but not many of them will still be letting you feed them when they are 18! Or you could let him/her use a spoon or his/her fingers - as long as they have eaten some of the meal with "proper" cutlery first. It is important that children learn to use cutlery, even if it is hard going, or they will feel left out later. However, many children with ADHD find fiddly things like cutlery very difficult to manage - so help them to eat when they have got fed up themselves, rather than get into a battle over it.

c. Make ordinary food look fancy - sausages and mash looks more fun if you serve it with the sausages sticking out of the potato like a hedgehog. You could make a face or pattern by arranging the food differently on the plate.

d. School packed lunches can be made more appetising by trying small amounts of a wider variety of food. Why not try a small sandwich, Cheese Strings, Peperami or Baby-bel, a small piece of fruit, raisins or dried apricots, some crisps, a few biscuits and maybe some chocolate? For the drink, send a milkshake - Yazoo or similar. This may not fit with a school healthy eating policy - but being too thin isn't very healthy, either. You could tell the school that your child has a "special dietary requirement" of a "low volume, high calorie" diet.

e. Vegetables served raw can be fun - especially if your child has helped to prepare them. Carrots, cabbage, broccoli, cauliflower, and cucumber can be tried. Also frozen peas - still frozen - are often popular.

3. Whole milk, rather than semi-skimmed or skimmed milk can make quite a difference - especially if you use it everywhere (in cooking, on cereal, in milk-shakes and custard and for drinking).

4. Try to avoid low fat spread and low fat yoghurt. The yoghurts sold "for babies and toddlers" and as "luxury" are generally more full of energy than the low fat ones. The same applies for ice-cream, too. Low fat food becomes more important for your child's heart as he/she gets older - but don't forget that being too thin isn't healthy either.

5. Sometimes these children forget to drink or don't feel thirsty in the normal way. This means that when they sit down to a meal and find that they are thirsty, they fill up with drinks and don't have room for the food.

a. Offer a delicious drink (to encourage your child to drink it) about an hour before a meal, so it has gone down before he/she starts to eat.

b. Allow one drink of whatever he/she normally has at the meal, but make any further drinks only of water.

c. Avoid fizzy drinks at meal times, as the bubbles can be very filling.

6. Don't try to force your child to eat. Meals will become a battleground that only your child will win. It is much easier to modify your family's eating habits a little than to enter World War III! Have firm boundaries of what you will not tolerate in your house - and be sure that everyone knows them. However, try to be flexible within those boundaries. A lot of what we think is important is really just tradition. Does it really matter if your child has cake and Yorkshire pudding for breakfast and breakfast cereal for lunch - or if he/she will only eat vegetables if they are covered in tomato or mint sauce? As long as the diet is well balanced overall, with plenty of good food, it may not be worth worrying too much about the fine detail.

7. Fussy children are very hard to cook for! Again, it isn't worth starting a battle. Arguing over the size of a piece of meat or counting peas is no fun (for you, anyway). Some people insist on their children eating everything. Others happily cook different meals for each member of the family. The best answer is probably somewhere between. Some children are fussy about the feel or texture of a food, rather than the taste. Problems with slimy things like onions and mushrooms are particularly common. Sometimes homemade meals, like stews and casseroles taste awful without the "hated" food, in which case liquidising the onions or mushroom before you cook them makes the finished dish taste OK, but without the little bits for your child to fuss over.

8. Children, like cars, don't run well when they are empty! Regular meals can make a big difference to behaviour. You may find that a mid-morning and mid-afternoon (or after-school) snack improves your child's behaviour. Try not to skip meals yourself, as it is easy for your child to copy you - especially if he/she isn't feeling hungry. It is important to eat meals - however small - at reasonably regular intervals.

9. It is often possible to get most of the day's food eaten before the first dose of the day starts to work, or after the last dose has worn off. You could try some of the following:

a. If your child is taking the short acting (10mg) tablets of Ritalin, it is sometimes possible to time a meal for the "dip" before the next dose is due, when the child will be hungrier.

b. A big cooked breakfast, before the morning dose has taken effect, is excellent. If sausage, bacon, potato waffles, eggs, beans and fruit juice sounds too much for you to cook, why not try a bacon sandwich with a milkshake - or even a bowl of Angel Delight, or fruit pie and custard? Some supermarkets now sell Muller Sponge and Custard, Chocolate Sponge etc. in yoghurt-pot sized microwave-able portions.

c. Add a good supper before bed. Try a thick milkshake, a cheese or bacon sandwich, some yoghurt, a bowl of cereal with whole milk, rice-pudding or something similar, along with some fruit.

d. Little ones sometimes eat quite well if fed in the bath! A few bath toys, a plastic jug, and the cold tap set to a trickle will keep the child facing in one direction to give you the opportunity to spoon in all sorts of goodies - with no worry about the mess! Try baked beans, spaghetti hoops, hot dog sausages, sponge or pie and custard, boiled egg with toast soldiers, rice pudding, yoghurt, ice-cream...the possibilities are endless!

Milk Shakes:The easiest way to make a good THICK milk shake is with a packet of Angel Delight - or your supermarket's "own brand" version which will be cheaper. Instead of using the amount of milk it says on the packet, use 1 PINT of whole milk (or ½ a pint for half a packet). If you whisk it up well you will end up with a wonderfully frothy drink. You could even sprinkle chocolate or those little coloured sprinkling things (100s of 1000s, I think) on top for added effect, and serve with a straw!

You can also make gorgeous home made milk shakes in a liquidiser.

To serve 2:

8-10 Strawberries or 1-2 Bananas
½ pint of whole milk
3 scoops of vanilla ice cream
A small dollop of single cream. (Don't worry if you don't have any - add an extra scoop of ice cream instead)
Some people like to add a teaspoon of sugar, too.

About the author: Clare is the mother of 2 children with ADHD and is a doctor working in Child Psychiatry.

next: How Do I Know If I have ADD/ADHD? (Children)
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"Yesterday is ashes; tomorrow wood. Only today does the fire burn brightly."
- Old Eskimo saying

1) Responsibility
2) Deliberate Intent
3) Acceptance
4) Beliefs
5) Gratitude
6) This Moment
7) Honesty
8) Perspective

6) Live In This Moment Now

Unhappiness lives in the past and the future, there is no unhappiness in the present. What are you unhappy about? Is it about something that might happen in the future or something that happened in the past? When we spend time regretting the past, or worrying about the future, there isn't room for happiness in the present.

What amazed me was the amount of time I was not fully in the present. It seemed like I was always thinking about what was next, or thinking about some event in my past.

Even while engaging in a conversation with someone, I would either be thinking about what they had said, or anticipating how I was going to respond to what they were saying. How many times do we miss vital information from those we love because our minds are elsewhere? Test this for yourself. Become a monitor of your own thoughts. I think you'll be amazed at how often you "aren't really there" with what is happening around you.

"The secret of health for both the mind and body is not to mourn for the past, not to worry about the future, not to anticipate troubles, but to live the present moment wisely and earnestly."

- Buddha

Many times when we have insecurities and doubts, we have difficulty focusing on what is happening right in front of us. We're thinking about what we said to so-and-so, how we could have handled this situation differently, thinking about what we're going to do if this or that happens, all the while, missing what is happening now.

When you bring your awareness into the moment of now, all worries of the past and all imagined fears of the future gently fade away until all that's left is the vivid experience of the present. It is in this state that you actually start to see life. You'll see colors you never saw before. It is in this awareness where appreciation grows.

Happiness is not experienced in the past or in the future. Happiness is always experienced in the moment. If you are waiting to be happy sometime in the future, you might be waiting a very, very, very long time.

next: 8 Ways To Happiness: Honesty

Many people don't understand the implications of having ADHD. Here are some important points to consider when you are married to a person with ADHD.

What is ADD/ADHD?

ADD/ADHD is a fairly recently recognised disorder yet the first definition was published about 100 years ago by Dr. G. Still in London.

ADHD and difficulty with social relationships

Many people with ADD/ADHD have difficulty in understanding how others think and feel. This may lead to naive, or socially inappropriate behaviour. They often try hard to be sociable and do not dislike human contact. However, they still find it hard to understand non-verbal signals, including facial expressions.

ADHD and difficulty with communication

People with ADD/ADHD may speak very fluently but they may not take any notice of the reaction of people listening to them, continuing to talk about one topic regardless of the listeners interest or lack of it. Their voice and facial expression may be flat or unusual and they may have odd gestures or eye contact. In many cases they may take jokes or expressions literally and have difficulty in understanding sarcasm.

ADHD and lack of imagination

People with ADD/ADHD often find it difficult to think in abstract ways. They may have restricted interests, narrow, unsociable and unusual hobbies, and sometimes have an obsessive insistence on routines.

Many people with ADD/ADHD have difficulty planning and coping with change and, despite average or above average intelligence, there may be a notable lack of common sense. Everybody is different, and every person with ADD/ADHD has his/her own particular difficulties and strengths, but social problems, unusual verbal and non-verbal expression and narrow interests are the common features of ADD/ADHD.

Some people with ADD/ADHD may only receive a diagnosis in adulthood, and others may remain undiagnosed. Some individuals will manage very well, while others need a lot of support.

People with ADD/ADHD seem to have difficulty understanding what those around them think and feel. Because of this, they often behave inappropriately in social situations, or do things that may appear to be unkind or callous. The wife of one man with ADD/ADHD described his condition as causing "extreme emotional indifference" which was neither voluntary nor deliberate.

What ADD/ADHD is NOT

Many ordinary people have little eccentricities, certain obsessions, or a tendency to be shy in large social gatherings. ADD/ADHD is not simply normal eccentricity. People with ADD/ADHD usually do not want to be different, but do not know how to fit in better with those around them. The pattern of difficulties appears to start early in life, and people with ADD/ADHD have persistent social and communication problems from early childhood onwards. It is not just a bad phase. This means that an individual with previously close good friendships and normal everyday communication is unlikely to have ADD/ADHD. Knowing about childhood adjustment is important in diagnosing ADD/ADHD, because other disorders may resemble the condition.

How common is ADD/ADHD?

As ADD/ADHD has only fairly recently been recognised there are not yet good figures to estimate the prevalence rate. However studies suggest that approximatly 5% of school children will have the condition and of these 70% are likely to carry symptoms into adulthood. No doubt there are many cases which have never reached clinical attention. What causes ADD/ADHD?

ADD/ADHD, like autism, appears to be caused by some biological difference in how the brain develops. In many cases this may have a genetic cause; autism and ADD/ADHD often run in the same families. Indeed, it is not unusual for parents of children with autism to feel that they recognise certain features of the disorder (eg social difficulties) in other relatives. If you are concerned about possible genetic risks, you should ask your GP for information on genetic counselling. At present there is no cure for ADD/ADHD, although the help and support of family and friends can make a big difference.

ADD/ADHD in the family

Living with a person with ADD/ADHD can be very difficult because of the very subtle nature of the disability. There is no physical sign of the disorder, and it can be hard to explain to friends and family that the peculiar behaviour is not deliberate.

What can you do for yourself?

Because ADD/ADHD can be seen as a disorder of insight into thoughts and feelings, it may be very difficult to engage your partner in the sorts of discussions that marriage counsellors or family therapists use. Indeed, such therapists may not have heard of ADD/ADHD and may need information from you in order to avoid misunderstandings. You may like to think about other approaches instead - perhaps it will be more useful to talk to a counsellor on your own, to have a chance to think through your feelings and decide possible coping strategies.

In brief, the following three steps have been useful for some partners:

1. Contact with others in the same position, for understanding listening, support and advice.
2. Counselling for yourself and your family.
3. Consider whether diagnosis would help.

What can you do for your partner?

As well as your partner having difficulty understanding your needs for emotional closeness and communication, it may also be hard for you to understand your partner's needs. He or she may be interested in things that seem very boring to you, or may find apparently normal social situations very stressful. Try and remember that he/she may not be able to read all the social cues which you understand without even trying. So getting very emotional (even when you have every right!) may not be the best way to get through - while a calmer, reasoned discussion (even writing things down) may work better. Avoiding personal criticism can help; one partner suggests a more impersonal approach, e.g. instead of saying "You shouldn't do that", saying "People don't do that in social settings".

It may be hard for your partner to change from routine, and he/she may need plenty of notice when such disruptions will occur.

If your partner acknowledges his/her social difficulties, it may be useful for him/her to see someone who knows about ADD/ADHD and could offer practical advice, or social skills pointers, rather than more insight-centred talking therapy.

For more help, information and support check out ADDChoices

A FEW STRATEGIES AND WORDS OF ENCOURAGEMENT

THE MAIN COMPLAINT seems to be that the ADDer regularly fails to complete projects/chores at home.

Don't take this behavior personally. The ADDer is not lazy or insensitive to your requests. Most adults with ADD/ADHD spend an enormous amount of energy maintaining focus at work. Upon arriving home, there is little get-up-and-go left to focus. It takes an enormous amount energy to maintain attention, avoid impulsiveness and stifle hyperactivity at work. Adults with ADD/ADHD really do need to "recuperate" after wrestling with the trials and tribulations of "staying on task" at work all day.

• Do chores with your spouse rather than delegating chores
• Maintain daily routines especially for repetitious tasks

IMPORTANT!

Have the ADD/ADHD spouse make out a schedule such as:

• Laundry done every Tuesday and Saturday
• Grocery shopping Wednesdays right after work
• Pay bills on the 1st and 15th of every month
• Walk the dog by 5:30 daily

YOU GET THE IDEA

YOU MUST REALIZE THAT: ADDers tend to agree with you, and then neglect to follow through. This can be intensely irritating! Strive to depersonalize your reaction to such forgetfulness. You must understand that the ADDer will agree without paying attention to the discussion. He/she can be so wrapped up in their own thoughts that your voice doesn't register in the brain! Really! They will later claim "You never said that!".

If you are irritated by some action not being done consider this strategy:

Make your request. If the action is not taken, either do it yourself or pay to have it done.

You need to know that nagging, coercing, whining, intimidation, threatening, yelling, throwing a fit etc. are all strategies that will not work!

GO EASY ON YOURSELF

The non-ADD spouses frequently blame themselves for not "helping the ADDer enough". Don't blame yourself for being unable to micro-manage your spouse. It may seem like an honorable goal but, in the long run you are not doing yourself or your spouse any favors. It is not your fault your spouse neglects paying bills, calling their parents, picking up the kids, and so forth. It is not within your power to change your spouse. ADD/ADHD adults must change themselves.

FIND OUT ALL YOU CAN ABOUT ADD/ADHD

Many adult ADDers are in denial. Be ready to impart information to your spouse occasionally. Some partners have designed clandestine ways to educate their spouse by strategically placing articles, books and pamphlets on ADD for children around the house. They approach the education of the adult through discussing the ADD nephew, daughter, neighbour.

OTHER

• Compliment your spouse often. You can mold behavior (somewhat) through positive comments.
• Ignore behaviors that aren't worth the hassle.
• Take a deep breath and relax.
• Use a soft tone of voice and gentle gestures.
• Use humor to diffuse difficult situations.
• Realize your spouse needs/tries/wants to be in control because their thoughts are out of control. You don't have to "lay down and roll over" constantly but realize that at times an argument is due to an ADD/ADHD thing - and doesn't have anything to do with the subject YOU are arguing about.

Say this to yourself often:

It's an ADD/ADHD thing!

IT'S YOUR CHOICE

Having an ADD/ADHD spouse can be difficult, exciting, stressful, unpredictable, fun, infuriating, invigorating, etc.... just like other marriages. The difference is, it is extremely difficult to have the attention of someone with AN ATTENTION DIFFICULTY. You must figure out how to deal with your spouse's inattentiveness, impulsiveness and hyperactivity. Focus on your mate's talents, accomplishments and positive attributes -- after all, you married this person!

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