Discovering You Have ADHD as an Adult

Attention-Deficit/Hyperactivity Disorder (ADHD) is not just a childhood disorder. As a neurodevelopmental disorder, ADHD is usually identified in childhood, but several individuals reach adulthood without being accurately identified as having the condition. An estimated 8 million adults in the United States suffer from ADHD. In many of these cases, it is attention, rather than hyperactivity, which is the primary problem; this form of the disorder, formerly called “ADD,” is one of the more common types of ADHD in adults.  

 Missing ADHD in Childhood 

While all adults who meet criteria for ADHD will always manifest some form of significant symptoms in childhood, the level of impact of these symptoms can be quite variable. Several children do not manifest the hyperactive or impulsive symptoms sometimes associated with the condition. Their behavior in the classroom and at home may not be entirely problematic. Instead of being disruptive, talkative, or irresponsible, they may only appear forgetful or flighty. Some children learn how to hide their distractibility or compensate for attention concerns. They may be embarrassed by their limitations, but may be motivated to keep up appearances. Some children are able to compensate for attention concerns with high intelligence, perseverance, flexibility, creativity, and other strengths. Many children might have difficulty understanding their symptoms. They might lack insight into whether there is a problem. They might not verbalize their symptoms in a way which would impel an adult to seek a consultation. 

Because of these reasons, the full impact of ADHD-related symptoms in a child may not be obvious to others. When parents or teachers do not see that there could be a problem, it is unlikely that the child will be referred for an assessment. Even more obvious cases are not always given the opportunity to be assessed for ADHD. Some parents may believe that there is a problem, but may be hesitant to access mental health services. 

 Noticing the Impact of ADHD 

As academic demands, work demands, and household responsibilities increase in adulthood, problems with attention can become more noticeable and more frustrating. Some adults may question whether they themselves have a problem as they see their siblings or their own children struggle with symptoms of the disorder. Many of the risk factors for ADHD, after all, are genetic factors. Adults who previously felt like they had effectively covered up their attention problems may sense that their coping mechanisms are losing their effectiveness.   

How ADHD can be Identified 

For adults who believe their own attention problems may have flown under the radar, there is a way to determine whether ADHD is present. Self-report questionnaires, used to compare an individual’s symptoms to hundreds or thousands of other individuals, can be helpful in providing information about the problem, but these are just one aspect of a comprehensive evaluation. An individual’s developmental history is important and this is usually obtained through a comprehensive interview with a psychologist, psychiatrist, or other qualified mental health provider. Computerized tests and performance-based tests can also help to assess the full extent of the problem. 

Sometimes attention problems can be due to normal forgetfulness. Sometimes these problems can be directly caused by depression or anxiety. Sleep problems and other medical problems can also negatively influence attention. Not everything that looks like ADHD is ADHD. Participating in a psychological assessment with a qualified provider can be an effective way to know the difference. Understanding the cause of symptoms is the first step in finding ways to improve.  

Originally published on Utah Valley Health and Wellness Magazine

CCD Smiles: One in a million

I am the only one in my family with CCD (Cleidocranial Dysplasia), which was a random mutation. Having CCD influenced my studies and career choices. I have always been fascinated by the body, genetics, and helping others with physical or emotional health problems. I started my career as an emergency room registered nurse. I did my Master’s thesis on CCD and then went on to obtain a Doctorate in Nursing Practice (DNP) degree. I have been a nurse practitioner for the past 14 years, working in family medicine and mental health. My background in medicine helps me better understand CCD. I want to share my experience and medical understanding with others.  

I was born in Reedley, California in 1975. When I was born, it was obvious to my parents and doctors that something was wrong. My body, mostly my head, was shaped differently than a “normal” baby’s. At 3 months of age, I was diagnosed with Cleidocranial Dysplasia. 

I grew up knowing I was different. The most difficult part of CCD was all the oral and facial surgeries. My baby teeth never fell out on their own, my permanent teeth didn’t grow in on their own, and I had several extra teeth which had to be surgically removed. Everything in my mouth had to be done manually. I started having oral surgeries at age 7 and I spent most of my Christmas, Spring, and Summer breaks undergoing surgery. My last major surgery was when I was 19 years old. 

 CCD dental treatment was not easily navigated. My dentists, orthodontists, and oral surgeons had never treated anyone with CCD. Everything they tried was experimental. 

Medical insurance and dental insurance did not cover the cost of my surgeries. Medical insurance considered my teeth problems to be dental. Dental insurance considered the surgeries cosmetic. My parents were paying for my surgeries until I was in college. 

When I was growing up, I didn’t know anyone with CCD. In 2001, technology helped me to connect with other people with CCD for the first time. I heard about other people’s experiences as I conducted phone interviews for my Master’s thesis “CCD: The lived experience.” Eight years ago, I met Steffani and her daughter Hally, who have CCD, for the very first time. 

 CCD Smiles 

I felt inspired to create a nonprofit organization to help others with CCD. I started working on the foundation in 2013. In 2016, Gaten Matarazzo’s dad contacted me. Together, we made CCD Smiles an official IRS approved nonprofit organization in January 2017. Since it’s official beginnings, we have had gatherings and fundraisers across the country. I have met 38 other people with CCD, which has been a tremendous blessing in my life.  

 Gaten Matarazzo, from the series Stranger Things, is a huge part of bringing awareness to CCD. As his popularity in Hollywood has grown, so has familiarity with CCD and CCD Smiles.  

CCD Smiles is still in its infancy, but you can go to www.ccdsmiles.org to learn more about us and watch us grow! Currently, the website is a place for donations, purchasing CCD swag and education about CCD. In the future, the website will be a place where those with CCD can connect, share pictures, exchange stories, and find hope. I want others to know they are not alone. It will also provide current and accurate medical information, written in plain English. Doctors, dentists, orthodontists, and surgeons can come together and discuss treatment, research, and options for their patients. 

As CCD Smiles grows and donations are made, we can help cover the costs of oral/facial surgeries. If insurance isn’t going to help, then we can. I don’t want the medical/dental expense to keep parents from being able to provide beautiful smiles for their children. 

My ultimate dream is coming true. July 13-15, 2018 will be the first national CCD conference in Salt Lake City.  Watch the website for more information. If anyone is interested in donating time, money, or talents to this event, please email me at kellywosnik@ccdsmiles.org. 

CCD Smiles Mission Statement: We bring global awareness, provide assistance for dental care, and support research to improve outcomes and quality of life for individuals with cleidocranial dysplasia. 

CCD Smiles can be found in the media and on social media— Instagram, Facebook and Twitter (@ccd_smiles, #ccdsmiles) 

Originally published on Utah Valley Health and Wellness Magazine

Now That My Teen Has Come Out – WHAT DO I DO NOW?

Ive told my son that nothing changes, that I still love him, but I expect him to live the same standards as the rest of the family, and yet he seems more and more depressed. Why isnt this working? 

I dont want my daughters ideas about being lesbian to influence the younger kids in the family, so Ive told her not to talk about it at home. 

I think if my son is going to wear makeup, hes going to get made fun of at school. I cant stop that. 

In the September/October issue of Utah Valley Health and Wellness, I talked about parental self-care. It’s important for parents to have people to talk with who understand and don’t blame them for what they are feeling and experiencing. In the July/August issue, I talked about how to keep lines of communication open when a child “comes out” as lesbian, gay, bisexual, transgender, etc.  In this issue, we’re going to talk about how to keep you and your teen connected. 

Some families consider that their main responsibility to a child that comes out is to continue to teach truths about sexuality and gender, and to make sure their teen does not misunderstand or ignore these teachings. In my experience with hundreds of teens from good homes, this emphasis generally results in a disconnection that makes communication feel tense and difficult. Because teens need a good relationship with parents in order to navigate the experiences of being a healthy teen, I recommend that parents: 

  1. Consider that your child may not be choosing to rebel against your teachings and beliefs as they learn new things about themselves and want to share them with you. 
  2. Recognize that your child knows where you stand with regard to teachings about sexuality and gender. 
  3. Learn to be open to hearing from your child what internalizing these ideas has been like (both recently and in the past). 
  4. Find out what your child’s hopes and dreams for themselves are, and how they may be changing. 
  5. Show respect for your child, especially as your child’s experiences are different from yours. 

These five things will make a dramatic difference in your child’s interest in re-opening a relationship with you. The most important thing is that you – as a parent – remain a steadfast connection with the world of respectful and loving relationship with your child. Children who do well – that is – avoid risky sex, drug abuse, alcohol abuse, and suicidal behaviors – have parents who show respect for their childrens sense of what is true about them. (For details about the retrospective studies of families who demonstrate accepting and rejecting behaviors and the outcomes for teens, see http://familyproject.sfsu.edu/) 

If you want help navigating how to support your teen while making sure they are safe and mentally healthy (especially if identifying as a gender or sexual minority goes against your beliefs), you may want to:  

  1. Meet with other parents who have found peace in this journey ( the last issue listed several groups that meet in Utah County) 
  2. Meet with a therapist who can help you and your teen navigate issues of safety and mental health. 

Many families have found their way through this journey with greater love and appreciation for each other and for their relationships, which strengthens everyone, including parents and the younger children in the family. 

Originally published on Utah Valley Health and Wellness Magazine

 

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Utah Valley Health and Wellness magazine September/October 2017

Check out articles on health and wellness from our therapists!

 

3 Steps to New Habits by Joan R. Landes, M.A., AMHC

stock-2A wise person once said, “We make our habits, then our habits make us.” So we set goals and make resolutions, but our good intentions and resolutions often end in disappointment. Isn’t there an easier way to create a good habits? The answer is “Yes!”

In three simple steps, a new habit can be formed in just a few days.
1. Anchor your goal to an existing habit
2. Start small with an easy behavior
3. Validate your efforts

First, use an existing behavior as an anchor for your new habit. For instance, if you wish to develop a habit of doing daily push-ups, and you already brush your teeth every morning, use brushing your teeth as your prompt for your new habit. After you finish brushing your teeth, begin to do the pushups.

goalsSecond, start with something ridiculously easy like one push-up. Or, if your goal is flossing your teeth, start with flossing just one tooth. While you do the behavior consciously tell yourself that you enjoy the activity: “I like the way my muscles feel alive when I do push-ups!” or “My teeth feel great when I floss!”

Third, after you complete your small goal, validate your efforts aloud. It can be as simple as saying “Great job!” or “Awesome!” Saying it aloud is more powerful than just thinking the words, so don’t be shy. Throughout the day make sure to keep telling yourself you did great when you think of your goal. The great thing about this type of self-validation is that it doesn’t cost anything, it’s legal, non-fattening and immediate.

That’s it! After a few days, you will find yourself looking forward to engaging in the new behavior. Gradually, you can increase your small goal into a bigger one.

Close-up of four business executives standing in a line and applaudingSince I try to practice what I preach to my clients, I have used this technique in my own life. My goal: Develop more upper body strength through morning push-ups. First, I thought of my existing morning habits and the first thing that came to mind was simple – opening my eyes! It’s hard to do push-ups while lying on a mattress, however, so I had to come up with another anchor habit. I chose to anchor my goal to my current habit of making my bed.

After tucking in the blankets and tossing the pillows on the duvet I dropped to the floor on my hands and toes for three standard push-ups followed by three modified push-ups (knee style!). I told myself, “This is very cool!” Easy, right?

Afterwards I said, “Awesome!” My sleeping husband pulled the bedspread and pillows off his face and called out, “What’s awesome down there?”
“I’m doing my morning push-ups, honey,” I told him.
“Good grief, all that grunting woke me up.”
“Wait till you feel my biceps,” I bragged.
“Keep working on it, Sweetie,” he said. “Someday you’ll find them.”

But it was too late. I couldn’t be discouraged because I had already validated myself and was looking forward to the next session! I haven’t missed a day since before Christmas, and the really cool part is that I don’t dread exercising. Hey, don’t mess with success, right? As my son who is a cadet at the military academy at West Point said, “Not bad for a 50-year old, Mom.”

“Fifty-one,” I said. I want every kudo I can get!

joan297x222About the Author: Joan Landes is a therapist at the Center for Couples and Families. She feels that therapy should be an adventure for her clients and (gasp!) actually fun. Joan loves learning the latest neuroscience underpinning human resilience and is enthusiastic about skill development in her clients. She has been married for 32 years and is the mother of 7 children who make this world a better place.

A Healthy Dose of Back-to-School Anxiety by Brent Black, LMFTA, MS

?????????????????What is a Healthy Dose of Back-to-School Anxiety?  As a family therapist, I often meet with parents who want to know if their child has anxiety and my quick response is “I hope so!” Today the mere mention of the word anxiety tends to induce stomach knots, racing hearts, and cold sweats. However, a proper dosage of anxiety is a key component for healthy and successful children. On the other hand, excessive anxiety and the absence of anxiety are debilitating. Since the launching of school can also launch levels of anxiety for many students, here are a few points for parents to consider as they look forward to a successful year.

MP900405644Too Much?
The better question about anxiety is “does my child have excessive anxiety?” All healthy individuals experience at least some anxiety, but excessive levels of anxiety can lead to harmful behaviors. In order to diagnose an individual with Generalized Anxiety Disorder they must meet certain criteria which include excessive anxiety or worry more days than not for at least 6 months, difficulty controlling the worry, restlessness, fatigue, difficulty concentrating, irritability, or muscle tension. These symptoms cause significant distress or impairment in social, educational or other significant areas of functioning. So, a helpful question in determining excessive anxiety is — “has my child been significantly impaired for an extended amount of time in important areas of their life because of the anxiety that they feel?”

The beginning of the school year is a fitting time for parents to consider the possibility that their actions might be creating additional anxiety. One parental trend that often leads children to experience greater anxiety is an excessive family emphasis on achievement. Children who feel like they have to achieve in order to win the approval and respect of their parents are often filled with anxiety. Their motivation for achieving becomes less about personal growth and more about fear of letting parents down.

Kids on School BusNot Enough?
The opposite of anxiety is apathy or carelessness. Children who are apathetic give off a vibe of indifference, laziness, boredom, and unconcern. Faces are unflinching and tones are flat. The default response for many questions is simply “I don’t know.” There is not an official term of diagnosis to describe these characters but they are easily identifiable.

One parental trend that could lead a child toward apathy is a parent who is inconsistent, indifferent, and un-opinionated about their child’s success. I see exceptions to this trend, but I am often unsurprised by a child’s apathy after meeting both parents and understanding that a child is simply following the example of at least one of the parents. In these cases the apple really doesn’t fall that far from the tree.

Achieving the Right Amount of Anxiety
???????????????????????A great question from parents is ‘how do I help my children have the proper amount of anxiety?’ One of the best ways of helping kids reduce to a healthy level of anxiety is by maintaining high expectations while also assuring children both verbally and non-verbally that parental love is not dependent on child outcomes. In other words, parents need to convey that regardless of achievement level their children will always be genuinely loved.
One of the main ways that parents can increase the anxiety level of their apathetic children is to get actively involved. Parents who sincerely check-in and follow-up with their children are likely to see the kind of anxiety that will help motivate their children to succeed.

Although anxiety is often viewed in a negative light, a healthy dosage of anxiety helps children to be successful. Of concern are children who are experiencing excessive anxiety or no anxiety at all. Great parents are those who feel appropriate anxiety about helping their children to be balanced in their anxiety.

brentAbout the Author: Brent is an Associate Marriage and Family Therapist. During his Master’s Degree at Brigham Young University he worked at Wasatch Mental Health where he gained experience in working with families who have children that struggled with depression, anxiety, autism, trauma, or addictions. Learn more about Brent at st.georgefamilies.com.

The Power of Meditation by Kenneth Jeppesen, LAMFT

Lone Tree in SnowMost people I meet don’t meditate, though many have tried it once or twice. What we know about meditation usually comes from TV shows and movies, where wizened gurus tell us to think of nothing, or to clear our minds. But anyone who has ever tried to think of nothing knows how impossible that is. How do you visualize and think about something that doesn’t exist?! I’m not sure you can. The irony is, we think of “nothing” by thinking with intense focus on something.

There’s more than one way to meditate, but in general, the important part is that we concentrate on something in our present reality. For most, that means concentrating on our breathing, how do we do that? It’s helpful to pick one aspect of our breathing like the way the air feels in our nostrils, or the sound the air makes as it goes in and out. Focusing on our breathing anchors our awareness to the present moment, and that is the essence of mindfulness. We become more aware of our existence. We get out of our head and start to concentrate on being. We notice the signals coming from our body, we become more connected to ourselves, more in touch with what we are experiencing in the moment. As we become focused on just being, existing without having to do or think about anything, we find a stillness that begins to settle on us. It is an amazing feeling and one that you just don’t experience unless you’ve practiced calming your mind. Some people like being out in nature because it helps them find this clarity and calmness. But we don’t need to plan an expedition so that we can feel peace. The brain can’t really tell the difference between being in the woods and imagining being in the woods.

balanceVisualizing being in a beautiful place where nothing is required of you, where you are your perfect self is an incredibly powerful way to let go of the sorrows and worries we usually carry around. For the time we are meditating, it’s like we’re a different person who doesn’t feel stress. Really though, this is our true self, this is the person we are when the baggage of the world is stripped away. We can access this blissful, stable, and happy self of ours whenever we pause to meditate. With practice, we strengthen the neural pathways of peace in our brains. Where once there was an overgrown and hard to find path to peace, with frequent use, we can pave it to create a wide freeway leading to serenity. It took me about a year of consistent practice to get to that point. It was well worth it, because now at any time, I can concentrate and return to stillness without actually having to meditate. Frequent meditators enjoy more happiness, deeper sleep, better immune systems, and less fear. It is a skill worth practicing, that I hope someday will come to rightly be seen as important as eating our vegetables.

Kenneth-Jeppesen-Headshot-e14380277335081About the Author Kenneth Jeppesen is a Licensed Associate Marriage and Family Therapist and a member of the American Association for Marriage and Family Therapy. He earned a bachelor’s degree in Child and Family Studies from Weber State University, and a master’s degree in Marriage and Family Therapy from Converse College in Spartanburg, South Carolina. Kenneth is a therapist at the Provo Center for Couples & Families.

Mediation: An Alternative to Litigation and Pathway to Healing Chris Turner, TMCA Credentialed Distinguished Mediator

Several years ago, as a young mother, I was a patient undergoing a superficial procedure during which a scalpel severed many layers of tissue, tendons and muscles in my shoulder. I compassionately understand that mistakes, both professional and personal, are a part of life. However, In order to avoid involvement in a possible lawsuit, doctors waited for the statute of limitations to end before surgically exploring my injury and attempting to repair the damage. The inability to correct that mistake is what, to this day, still causes an emotional response in me that I am not proud to harbor.

This experience led me to a career for which I am very grateful. It began with this simple question: “What if the doctor was able to disclose mistakes and repair damage, both emotional and functional, prior to the point at which it became a lifelong hurt?” It is a question that I attempt to answer, as a mediator, with each person I meet that is in conflict.
Conflict is a constant in life. It is often what encourages us to make changes in our lives, thereby providing us with an opportunity for growth. How we deal with conflict directly correlates to the value we will have when the conflict is past. Most of us avoid conflict because the risks and cost are too expensive: emotionally, financially and/or personally. The investment in relationships at home, school, church and work can easily inhibit open communication and honest interaction in an effort to prevent further damage. As a result, small issues escalate and the gaps in a relationship grow larger. A mediator can provide the necessary tools to structure interactions that move people toward resolution of conflict.

leader 2Very simply, mediation is the process through which a neutral third party assists others in resolving disputes.
It is the role of a mediator to facilitate communication and to help parties resolve issues, forming a plan of action which guides their future interactions. Mediation is not counseling, nor is it the practice of law. Mediation involves two or more parties voicing their opinions and generating options for resolving issues with the goal of creating a written document that reflects their agreement. In some cases, the agreement may be binding and irrevocable. Mediation can be utilized in many different situations: from divorce to disputes among students, and from damages from an oil spill to neighbors arguing about the placement of a fence.
Although most often used as part of a legal process, mediation is available whether or not legal action is pending. In addition to being significantly less expensive than litigation, mediation is helpful in resolving issues before they escalate to the point of legal intervention or a total breakdown of communication. Mediating early in a dispute can serve as a formal time out, setting ground rules, both personal (such as when and how parties will communicate) and functional (such as how bills will be paid).

The agreement may also document the understanding between parties, such as what assets and benefits of the partnership will not be affected and if intervention during the period of the agreement, such as counseling, refinance, etc. will occur. By instituting a plan, parties are able to have a time out from emotions and stress that a dispute is creating while maintaining relationships and assets which have been mutually supported. Many times, the initial agreement may be the basis of a more permanent resolution, such as a divorce or dissolved partnership. In some cases, it provides needed respite, which enables parties to reconcile and move forward. Mediation can be used informally or as the basis of a legal settlement. The process is confidential, collaborative and cost effective.
Conflict resolution through mediation can be an effective agent for change. It is not about who is to blame, it is about being honest about what exists today so that a plan for tomorrow can be made. From that plan hope and healing are often found.

Chris TurnerAbout the Author: Chris Turner, TMCA Credentialed Distinguished Mediator, is working with the Center For Couples and Families in the South Houston area.

Creating a Meaningful Mother-Daughter Relationship by Erik Labuzan-Lopez

yellow flower 2The mother-daughter relationship is complex, complicated, and ever evolving. Some mothers and daughters talk all the time, while others speak more sparingly. Some deal with conflict head on; others avoid fighting at all costs. No matter how you relate to one another, there will be arguments between mothers and daughters. How is it that mothers and daughters are masters at pushing each other’s buttons?

Becoming the mother of a daughter can inherently trigger issues you have with your own mother, and those feelings start influencing this new relationship. You’ve probably told yourself, “I’ll never do xyz, like my mother did!” Then later, you hear yourself saying that exact phrase that used to drive you crazy. Women also tend to communicate verbally, which leads to more interactions that are perfectly aligned for conflict. A mother makes a comment about her daughter’s hair, with the intention of caring for her daughter and making sure that she is set up for success (and underlying that, proving she’s a good mother), whereas the daughter interprets that as a criticism, which triggers fears that maybe she’s not perfect.

If you are noticing tension in your mother-daughter relationship, know that it’s normal. There are easy steps you can take that can improve your relationship, although admittedly, they will require some practice in both of your parts.

Communicate clearly – Sometimes mothers and daughters feel so close that they assume the other person just knows what they need, and therefore don’t communicate at all. Neither of you are mind readers, so you still have to be clear about what you need. It’s ok to say, “Mom, I just really need you to listen” or “I feel hurt that you yelled at me in that way.” You can also reflect back what the other person just said so that you make sure you understood their point.

Repair damage quickly – In healthy relationships, people don’t avoid conflict. Differences of opinion are unavoidable, and therefore, we have to find a constructive way to deal with conflict. By not dealing with issues, we actually hold on to them and carry them into our future relationships. Make decisions about what will be most helpful and pick your battles about what to argue over. If you’ve lashed out or said something hurtful, apologize and take the time to explore your feelings and why that took place.

Set boundaries – Boundary setting in very important no matter what stage of the relationship you are in. Here’s one of the best definitions of boundaries that I’ve ever heard: “What’s ok and not ok.” You can decide for yourself exactly what behaviors are ok and not ok, and then you have to communicate those and follow through.

The mother-daughter connection is incredibly special, but also challenging. It’s worth putting effort into this important relationship, as it’s a foundation for other healthy interactions in life. You both deserve to have a meaningful connection, enjoy being together, and find support from one another. What will you do to grow your relationship today?

Erika headshotAbout the Author: Erika Labuzan-Lopez, LMFT, LPC is passionate about working with couples and families looking to understand how the tough stuff plays out in interactions and how to move past the fighting. She specializes in couples therapy, infertility counseling, and the transition to parenthood. Erika is located at the South Shore Center for Couples & Families