Antidepressants Blog

Q: What about self-help? Aren’t there things I can do for myself now that I know I have ADHD?
A: Yes. First, educate yourself about ADHD by reading books and discussing the disorder with your specialist. The more you understand about how this underlying disorder has affected each area of your life, the better you will be at improving your situation.
Next, educate the significant others in your life. This may include family, friends, and work colleagues. The more they understand about your difficulties, the more they will be able to help you.
Then it is time to structure and organize your life. While an ADHD specialist can be a valuable advisor or coach in this task, there are steps that you can follow on your own.
Define the problem. You should start by defining
your problem areas. Write them down. One at a time,
break each problem down into its components. It may
help to ask yourself just what aspect of the task or
situation makes it difficult for you.
For example, the problem of being perpetually late may have several typical causes. It may be that you don’t plan activities ahead of time and have no real idea how long it takes you to do things. Or the problem may be with your distractibility. While you may plan to do something and have adequate time to get to it and do it, you may be repeatedly distracted from the task.
Brainstorm solutions to each component of your problem. Use paper and pen to write down all solutions and alternative ways of doing things that come to mind.
Mentally test your solutions. Here you begin to use your critical faculty and, in your imagination, go through the solutions and assess the likely outcome.
Critically plan your solution. Here you can discard
the ideas that clearly won’t work and begin to plan
your new strategies for coping with certain situations.
For example, after defining the problem of lateness, you have come up with some solutions: “Run or drive faster. Just get more done in a day! Wear three wristwatches; set three alarms. Begin by estimating the time for each activity you plan to do in a day, write it down, and as you actually do the activity, record the length of time it took. Compare the estimate with the actual time.” Well, you will soon see that some solutions, like the last, are better than others, like the first three. You can discard the ideas that clearly come from your impatience, impulsiveness, and self-punitive feelings, and begin to see that if you allow yourself to tackle problem-solving in this way, you can actually come up with some good solutions.
Add organization and structure to your life. This change could benefit all aspects of your life. You can start with external structure. This may include ordering your possessions; organizing your time with lists and schedules; using filing systems, notebooks, and lists as external memory banks and reminders; and minimizing distractions in your workplace. Such external structure can also help internally: the more information you structure and record externally, the less you have to be trying to remember and deal with in your mind. In other words, you can minimize the clutter and distractions in your mind by making some of your tasks, reminders, and organizing needs external and concrete. Then you can better focus on what is essential.
Define tasks more clearly. This may include breaking down tasks into smaller components, prioritizing them, and taking into account your own attention span and need for variation, breaks, and physical activity. Perhaps you work best in forty-five-minute chunks, or perhaps you work best with a long expanse of uninterrupted time, in order to better focus your attention. Then plan your work accordingly.
Use time-out strategies to deal with intense emotions. If a major part of your difficulty stems from impulsive actions and heated emotional outbursts, then you can begin to train yourself to deliberately take time out when emotionally aroused. This may mean counting to ten, or it may mean actually going somewhere to cool out. During this cool-out period, follow several mental steps: Define the problem. What upset you and why? What is your impulsive solution, and is that really the best way to react? What would be an alternative way of handling the situation? What is the outcome of that reaction or action likely to be? Is there an even better way of handling the situation? This process allows you to delay impulsive action and to practice bringing your inner reflective skills to bear on the situation. This is often very difficult for ADHD sufferers. As I have explained in Chapter 6, psychotherapy is often necessary in order to strengthen these inner reflective skills. However, setting up a disciplined time-out strategy can be an enormous help in gradually making this reflectiveness become more automatic and in making intense emotional states more tolerable.
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As if consumers weren’t already confused enough by the hundreds of cold/flu remedies, every year several dozen new products are introduced in hopes that they will capture a significant portion of the more than $1.4 billion over-the-counter market. Most are slightly altered versions of already existing products. Many contain a mix of ingredients, only some of which may be useful while others may be counterproductive.
If any medications are taken at all, experts advise that single-ingredient products be used, chosen to counter the most bothersome of your symptoms. When treating a cold, less is best. The more ingredients you take, the more likely you will experience adverse side effects that may actually make you feel worse. Keep in mind, too, that as a cold progresses, the symptoms change, and so should the treatment.
Pregnant women should not take any medication without checking first with their physicians. The elderly, too, should exercise caution, since they are more likely to experience toxic side effects from both over-the-counter and prescribed drugs. Also, anyone with a chronic health problem, from heart disease to glaucoma, and anyone taking prescribed medication, including psychotherapeutic drugs, should check with a physician before taking any over-the-counter cold/flu product.
Whatever drug you choose, there is no inherent advantage in paying more for heavily advertised “name” brands; generic or storebrand versions will work just as well (or as poorly). Here is what you might find in a cold/flu medicine.
Active ingredients: These are the substances that are supposed to have a direct effect on symptoms. They include analgesics (painkillers) and antipyretics (fever reducers), decongestants, cough suppressants, expectorants, and antihistamines.
Inactive ingredients: These include substances like alcohol that give the medicine form and texture, flavoring and coloring agents, stabilizers, sugar, and caffeine (often added to counter the drowsiness induced by antihistamines, but not too helpful if what you need most is sleep).
Analgesics and antipyretics: The common painkillers—aspirin, acetaminophen, and ibuprofen—play two roles. They relieve headaches and muscle aches and they reduce fever. If a product containing any of these is used, additional pain or fever medication should not be taken. Of the three, acetaminophen is least likely to cause stomach upset. Before taking aspirin or ibuprofen, it is wise to eat something. Aspirin has been shown to increase viral shedding (and thus may help to spread the cold to others) and it may also prolong the infection. Remember, too, that fever is one of the body’s main weapons against infectious organisms, so unless it is very high (say, above 102°F in an adult), you may want to let it run its course.
Decongestants: These help to relieve upper respiratory congestion (stuffy nose and sinuses) by shrinking blood vessels and reducing swelling in the nasal passages. But relief comes at a price. Oral decongestants can cause dry mouth, agitation, insomnia, increased heart rate, and raised blood pressure. Pseudoephedrine is the most popular decongestant used in oral medications. Phenylpropanolamine (PPA), the most common ingredient in diet drugs, is also often used as an oral decongestant, but it is more likely than pseudoephedrine to cause a steep rise in blood pressure. Oral decongestants may interfere with restful sleep and result in daytime fatigue. Limit their use to one week to avoid a rebound reaction— an increase in congestion and dependency on the product. Fewer side effects are associated with topical decongestants in nose drops and nasal sprays. Effective ingredients include xylometazoline, oxymetazoline, ephredrine, and phenylephrine. However, nose drops and sprays should not be used longer than three days; longer use can cause a rebound reaction.
Cough suppressants: These products, also known as antitussives, are used to suppress an irritative, dry cough. Experts recommend that they be reserved for coughs that disrupt sleep. Lingering coughs that interfere with a person’s waking life are best treated with home remedies like ample fluids, cough drops, and lozenges. The most popular cough-suppressant product is dextromethorphan. Others deemed effective are chlophendianol and codeine (a prescription drug that is sleep-inducing and can be habit-forming).
Expectorants: When a cough is “productive”—sputum-producing—it is consider a “good” cough that is cleansing the breathing tubes of excess mucus and potentially infectious microorganisms. The goal is not to suppress such a cough but rather to liquefy and loosen the phlegm so that it is more easily coughed up. This is the role of expectorants. Expectorants may also help to loosen up a “tight-chested” nonproductive cough that results from an accumulation of secretions so thick they cannot be coughed up. The only expectorant approved as safe and effective for over-the-counter use is guaifenesin. Though it may seem counterproductive to take a product that contains both an expectorant and a cough suppressant, the combination may be helpful when taken before bedtime if a productive cough frequently interrupts sleep.

Antihistamines: These products are designed to counter the symptoms of allergies by blocking the effects of histamine. Histamines play almost no role in colds and flu, but antihistamines have a potent drying effect, which has prompted their widespread use in products designed to stop the runny nose that is the hallmark of the early stages of a cold. However, this is one ingredient experts say should be avoided by cold and flu sufferers because it can thicken secretions in the chest and sinuses, making them harder to expel and setting the stage for a secondary infection. The antihistamines approved for over-the-counter use also cause drowsiness, adding to the fatigue induced by a cold and making driving or operating machinery very hazardous. Other side effects may include blurred vision, dry mouth, constipation, and urine retention. The most commonly used antihistamines in over-the-counter products are chlorpheniramine, triprolidine, brompheniramine, and doxylamine.
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Positive reinforcement in daily life are smiles, a pat on the back, attention, an encouraging word or look and praise. All of us thrive on positive reinforcement. So, if something makes the child feel genuinely good about himself then it is a reinforcer. Positive reinforcement is the backbone of the Social Learning Theory.
Positive reinforcement is most effective when given immediately after the desired behaviour has occurred. A connection between the behaviour and the reinforcement is then more easily made. A delayed reinforcement loses some of its value.
It is also important to make the child realise why he is being reinforced, i.e., being praised or encouraged. Even small steps like remembering to take the early morning medication should be positively commented upon and lauded.
A child trying to learn a new behaviour or skill, needs constant encouragement and support especially in the beginning to build his confidence and pride. As the new skill or behaviour slowly becomes a habit, the amount of positive reinforcement can be reduced. Helping a child become self-sufficient requires consistent and diligent effort but the pay off is a happier, more independent child.
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