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

 

Now accepting SelectHealth insurance

We are excited to announce that we are now paneled with Select Health. This includes the following plans – Select Choice, Select Care and Select Med. Call us to set up an appointment today!

Now accepting SelectHealth insurance

We are excited to announce that we are now paneled with Select Health. This includes the following plans – Select Choice, Select Care and Select Med. Call us to set up an appointment today!

We are giving away a TIMPVIEW HIGH SCHOOL ACTIVITY PASS! Like our fb page to enter drawing.

We are giving away a TIMPVIEW HIGH SCHOOL ACTIVITY PASS! 6 family members get into activities and sports events for Free! LIKE this post and our our fb page to enter yourself into the drawing. Pass is valued at $450. Good luck!

Welcome American Fork couples therapist Tiffany Winegar, MS, LAMFT

 

New to the American Fork Center for Couples and Families team, Tiffany Winegar is taking new clients! She specializes in couples therapy, family therapy, anxiety/depression, self-esteem/self-actualization, perfectionism and teen/adolescent girls. Tiffany received her Masters degree in Marriage and Family Therapy (MFT) from Brigham Young University, one of the top MFT programs in the world. Prior to, and during her masters program, Tiffany was mentored by world-renowned social relationships psychologist, Dr. Julianne-Holt Lunstand and worked as a member of her research team studying social relationships and health. In addition to her work with Dr. Holt-Lunstad, Tiffany has been involved in additional research in the field of health psychology including the study of stress and emotional regulation. She is passionate about applying the principles from her clinical training and research to improve the lives and relationships of her clients. Tiffany is a member of AAMFT (American Association of Marriage and Family Therapy) and NCFR (National Council on Family Relations). Tiffany grew up in Southern California and now resides in Draper, UT with her husband and two boys.

Our Brains, Our Bodies, Our Relationships

As I work with individuals and couples, I like to educate them on how our brains and our bodies impact our relationships. Understanding the correlation between these elements seems easy enough, however, I often get the question, “How do I change my brain?” The answer to this question is a great starting point to create healing and allow new interactions to take place.

Our brains are wired for connection. Each interaction we have either strengthens or weakens the connections in our brains, thus influencing the relationships with those around us. The ability to allow one or two more heartbeats before reacting or responding to one’s partner is the ultimate goal. The better you are able to emotionally regulate (by allowing more heartbeats before reacting), the more positive your interactions with others can be.

There are many ways you can impact emotion regulation and the ability to create new experiences that improve relationship interactions. Some are easier than others, and some have been targeted to help with other areas of life. I’d like to highlight two very important ways to help increase heart rate variability and improve cognitive functioning so you are better prepared the next time you might want to fly off the handle. They are exercise and sleep.

Everyone knows that exercise is good for physical health, but it also has great implications for mental health and relationship health. Increased exercise impacts the way your heart pumps blood. Long-term exercise increases your heart’s efficiency in pumping blood to the body. It doesn’t have to work so hard, and this increases heart rate variability, or the amount of time in between heart beats in a given minute. Increased heart rate variability means more regulation (more parasympathetic, or calming, influences) on the heart, and thus, more flexibility in emotional responses. This means that you have more capacity to keep the breaks on when your fight or flight response is triggered, allowing you more time to thinking critically, solve problems, or socially engage before flying off the handle and reacting to environmental stimuli.

Additionally, exercise increases the volume of the prefrontal cortex—the area in the brain associated with learning and memory. Exercise also stimulates the growth of cells by releasing chemicals in the brain. These new cells are then cleaned, solidified, and bonded together to create new memories for individuals.

We have all heard that sleep is important and should be a priority. Sleep does a lot of thing for us—it helps with creativity, remembering physical tasks, and making decisions. Sleep also does two important things in the brain: creates and consolidates memories and clears out toxins. As neurons fire together (and therefore wire together), sleep helps to connect recent memories with earlier memories. This allows individuals to remember how they reacted in past situations, and react differently next time if they desire a different outcome.

Cleaning out toxins in the brain increases attention and memory, helps individuals think clearly, and even impacts the regulation of insulin. Not getting enough sleep inhibits the ability to clear out the toxins, which can be harmful to the connections that are trying to take place in the brain. Sleeping allows us the opportunity to create new and improved experiences each day.

There are many ways individuals can have more influence on emotional responses. These are only two, but by changing our brains and our physiology in the body, we are prepping ourselves for better interactions. Being mindful of how we can impact the physiology of our bodies allows us more control over how we interact with those around us. We increase our capacity to engage more positively and be more satisfied in our relationships.

Originally published by Utah Valley Health and Wellness

Written by Dr. Kayla Mennenga

Roads to Ruin, Bridges to Recovery

 

Lisa started drinking when she was 16, just casually with her friends. After her parents’ messy divorce, she started to overdo it. Later, in college, things started to get out of hand, and soon she was on a downward spiral of excessive drinking. She knew it was destroying her life, but she couldn’t stop.

Mark first saw pornography when he was 13, but he didn’t make a pattern of looking for it until he was 16. Mark wasn’t close to his parents, and felt like a loner at school, and when he felt bored or stressed he found pornography made him feel a lot better. Years later, he was fired from his job for looking at pornography at work. Soon after, his wife started talking about separation.

Looking for a Fix

It can be hard to understand why people continue with an addictive behavior, even when it threatens to destroy their life. What we often don’t understand is that things like alcohol, drugs, gambling and pornography can sometimes feel like the only options people have to deal with the mess in their lives.

When our need feels desperate, the pressure to find a solution can be overpowering. Think of what it would be like to crawl through the desert for days, mouth as dry as sandpaper, only to come across a pitcher of cold water, with a sign that says “do not touch.” Would you be able to restrain yourself? This gives you some idea of what an addict feels when their brain is pushing them towards meeting a need, or in other words, getting a ‘fix’.

Our brain is wired to solve problems for us. It builds bridges between problems (hunger) and solutions (eating). If we are lucky, we have felt the incredible comfort that can come from someone who loves you and is there for you in your time of need, and so when we feel lonely or sad, it makes sense to turn to one of these people—our brain has built a bridge. But what if this isn’t an option in our mind? Maybe, like Lisa, our family doesn’t feel safe, or like Mark, we don’t have many friends. Where can we build a bridge to?

Fortunately, the brain is a great problem solver, and it will find a solution somewhere else. Unfortunately, under pressure, sometimes it will find a solution that leads down the path of an addictive behavior. Our brain will remember how great that thing felt, and how useful that could be right now. Each time we indulge the impulse, the bridge grows a little stronger, until after a while it feels like the only possible option, and becomes relatively automatic.

Building New Bridges

The good news is, this understanding can open up some big possibilities for recovery. Instead of focusing on just stopping the behavior (which is often frustrating and ineffective) we can instead focus on what the underlying problem is that the addiction is responding to. Then we can find an alternative solution that lines up better with the way we want to live, and gives us the comfort or support we really need. Often, this is best achieved by developing a supportive relationship, and learning to go there for comfort and support.

For example, Mark came to a full awareness of the impact of his addiction, and wanted to make changes. He was so used to hiding his issues and feelings and using pornography to deal with them, that it was hard to open up and be honest—with himself, his therapist, and his wife. But as he learned to go to his wife when he needed comfort and support, they both found that their marriage soon improved to a point where they felt closer than ever.

After crashing out at school, Lisa was referred by her school counselor to an AA meeting. There, she met with people who understood the pull of alcohol, who didn’t judge her, but instead supported her to overcome her addiction. She started to repair relationships with family and friends, and this, along with the support of her group and sponsor, gave her the motivation to get her life back on track.

Addiction affects everyone, everywhere. Often, the best thing we can do to overcome it is to develop caring and supportive relationships that address the underlying need, and help the addict know that they are loved and they are not alone. Recovery can be scary and difficult at first, but it becomes easier as you walk a new path of openness and connection to the people and things that are truly important to you.

Written by Sam Ryland, LCSW

Originally published on Utah Valley Health and Wellness

Turning Holiday Stress Into Holiday Joy

happy family mother and baby little child playing in the winter for the Christmas holidays

It was getting dangerously close to Christmas. I had all but finished my shopping for the season when I realized that I had one more gift to buy. I knew I couldn’t order it online because it wouldn’t arrive on time, so my thoughts turned to how to navigate the stores with other last-minute shoppers. I dreaded the prospect of full parking lots, busy aisles and long check-out lines, and lamented not finishing my gift buying earlier. There was no choice, however; I had to go. I don’t know what it is about shopping that close to Christmas, but the atmosphere seemed to be charged with holiday stress rather than holiday joy. When I arrived at the store, shoppers were rushing in and out, elbowing me out of the way—almost battering me with the gifts they had so lovingly chosen for their family. The drive over to this part of town didn’t help either. It was almost as if driving a mini-van was license for some to weave through traffic like the Apocalypse was here, and that the only thing standing between them and their empty cupboards at home was the last loaf of bread being sold at the store. This is where I started to get stressed and thought to myself, “Isn’t this supposed to be the best time of the year?” On that day, it didn’t feel like it.

How many of us experience an increased level of stress or even anxiety during the holidays? There are many reasons this could be the case: Trying to balance success at work and fitting in an abundance of errands, buying the “perfect” gift, lack of money/resources, more time with family or reminders of family losses (death or absence of a loved one).

The holidays, for some, equates more to holiday stress than holiday joy. Stress often leads to anxiety, a natural response to uncomfortable situations. Anxiety isn’t necessarily bad; it can cause us to act in ways that solve our problems. If experienced in excess or handled in an unhealthy manner, though, anxiety has the potential to cause mental health issues as well as ruin experiences that could bring us joy.

Given that holiday stress has the potential to turn into serious anxiety, and that anxiety is the most common mental health issue adults face (according to SAMHSA), we need to not let holiday stress turn into a holiday anxiety disorder!

The question, then, is how do we do this? How do we not let holiday worries and tasks become more than we can bear? Focusing on holiday rituals can help. Rituals are similar to traditions, in that they are actions or behavior we routinely participate in that have meaning to us. In his article “The Value of Rituals in Family Life,” Evan Imber-Black (2012) pinpoints five purposes behind family rituals. These can help us refocus our celebrations, and perhaps aid in letting go of unnecessary seasonal stress.

Relating – We create rituals during the holiday season to connect with others. It is easy to forget that the most important part of the holidays is being with the ones we love. Plan simple activities or gatherings that allow you and your loved ones to be together. Years after the wrapping paper has been thrown away, children often remember what you did together as a family more than what was under the tree. A ritual my family had when I was younger was cutting down our own Christmas tree. I am sure my siblings don’t remember every Christmas gift they received, but they do remember the year the Christmas tree we were cutting down fell on and trapped our youngest brother. This ritual has created humorous and loving memories for our family over the years.

Changing – Holiday rituals can highlight or ease us into changes in our family. As children grow older, we might celebrate this by having them participate in different and meaningful ways during the festivities. Perhaps give them tasks you normally took on, like organizing a game or making a treat. When children turn into young adults, some serve LDS missions. To mark this transition in life, ask them to prepare a traditional holiday meal from where they served. This allows them to participate and share a significant part of their life as they grow older.

Healing – During the holidays, we often remember those who have passed away or who are not present. It can also invoke memories of better times or more comfortable circumstances. This can be a stressful and painful experience. Creating rituals to honor and remember those who are gone can be healing and freeing. One family watches a home video of their son and shares memories about him as they sit together. This allows them to celebrate his memory and gives him a place in their family rituals. This family is able to heal and feels free to live even though their son is gone.

Believing – All too often, the meanings behind the holidays we celebrate are forgotten as we become focused on tasks, decorations, and planned events. In order to decrease anxiety and stress, make an effort to remember why you choose to celebrate this holiday. Deliberate attention on creating rituals that honor our beliefs helps us to refocus on what is most important.  Perhaps it will help simplify our celebrations, ease the task load, and teach younger family members the reason we celebrate.

Celebrating –  The holidays we choose to celebrate show what we value and who we are. They connect us with family members and others in the community. Choose to celebrate in ways that address the previously mentioned areas—creating relationships, changing, healing, and believing. If you are in a bicultural or interfaith family, discuss together how to share rituals that are important to each person so that all can feel included and connected in celebrating. If we say to ourselves after the holidays are over, “I thought that was supposed to be more fun,” then we might want to re-evaluate how we celebrate this time of year.

While it is impossible to turn off the traffic, crowds and even some of the busyness, it is possible to find holiday joy in a potentially stressful season. The tasks on our to-do lists can be part of family fun, but if they take away joy and create imposing anxiety instead, perhaps we could examine the purpose of our holidays. Let go of holiday stress and embrace healthy, simple and meaningful rituals.

Written by Triston Morgan, PhD LMFT

Originally published by Utah Valley Health and Wellness