At what age does ADHD appear?

The youngest I had to start treatment was 3 years of age after all intense sensory therapy, psychosocial management and parental courses failed rather badly.

This was to prevent the little boy killing gold fishes fished out of from the bowl, pushing down his little infant sister down the stairs, running away and disappearing in the malls/ London tube station, waking up at 5 am opening the front door and digging holes in the garden to pee in it, being EXCLUDED from nursery after nursery (mum gave up her work).

Basically to prevent endangering himself or others. Medications did help!!!

Would exercise help relieve ADHD symptoms?

ADHD is a dopamine deficit disorder.

When someone is deplete in Dopamine, one finds ways to pump it into the areas of brain needing it desperately to keep your attention intact on the environmental stimuli and your inner environmental needs (conscience, morality, daily chores, routines, hygiene etc..).

Eating, rewarding with positive comments/ gifts, sex, any thrilling activity as well as physical activity pumps in your innate dopamine. That’s the sad reason why children remain hyperactive to keep their focus on tasks and activity of daily living intact. Not because they want to be naughty, but actually they are trying very hard to focus on what you are instructing them. I recognise the same pattern in parents when I’m giving a ‘long talk/ advice session’ on ADHD strategies, when they start to jerk their legs in a fidgety manner as if trying hard to listen (and I know where the chikd’s ADHD has come from).

This is effectively used in class rooms as movement breaks, fidgety toys, wobble cousins etc etc where some activity- discreet or obvious keeps this action in brain going.

Hence a run three times up and down the stairs before doing homework, walking to school or staggering physical activity with mental activity promotes learning episodes.

Best wishes.

How does it feel to be an ADHD victim?

ADHD is a blessing. But unfortunately if left unbridled, it can turn a curse.

The abundant energy and the tireless drive one has is incredible. When everyone is tired, this hero has the enthusiasm to carry on.

He is called the soul of party – comical, full of fun and the clown, keeping everyone laughing and entertained, even if he harbours sadnes in private.

He is always full of original ideas as he thinks out of the box. He however might not be there to complete the project, as often others take over the lead (something that he doesn’t really get mind)

He speaks out courageously for the underprivileged, the discriminated, the marginalised (as he just can’t tolerate injustice) unlike the rest- and openly campaigns for them, even the ones on the receiving end. He not surprisingly wins enemies as a result, but can’t fathom why they dislike him.

He would always be there for friends.. going out of his way to support, stimulate and encourage them to achieve their maximal potential. But he understands they cannot be accessible all the time once they are riding the crest of success as he understands that obviously they are busy and his pride will not let him ask them for help.

He has an amazing wide circle of friends for whom he will be there anytime any where- but he cannot count the number of close ones on his hands, the ones who could trust and would turn up when he really needs them,

He wishes every one good, with not a sinew of ill will in him they all know, but can’t forgive him for his annoying habit of ‘’things slipping from his mind’. They don’t understand why he can’t get to a meet in time, buy gifts or send a card for their birthday like they do!

Most of all although he keeps them in splits in their private circle, they look away to avoid him as he can prove a source of perpetual embarrassment by his loud voice and antics..

And sadly he knows all this, but just doesn’t have any control on it.

My Views on the NHS

I might sound very negative here, as clearly NHS mental health services benefits millions of people – providing immense comfort, solace and succour to patients and their families.

I cannot speak for the adult Mental Health services – but as a Paediatrician with an interest in behavioural paediatrics, do come in frequent contact with Child & Adolescent Mental Health Services- and in one word the experience is bad. This is based on my experience of working in 6 different boroughs of the country.

To begin with, the criteria for accepting referrals is so complicated and exclusive that rate of rejection is significantly disparate and high compared with acceptance rate. Parents who chase up referrals are literally told that ‘ the child is unlikely to be accepted as he/she is not suicidal yet! ‘Hearing voices’ is an accepted mode/ ploy often used by paediatricians to circumvent around this unwanted obstacle. I feel sad when this happens.

If at all these kids are unfortunately admitted to Paediatric wards for self harm or attempted suicide, the response to plea for help (from paediatricians) is rather sluggish and often unexpected! The one’s we have serious concerns about are often discharged and the ones of no major concern linger on forever without being discharged from wards. And Paediatricians are protocol bound from discharging unless CAMHS team have made an assessment and certified ‘’unlikely to harm themselves imminently”.

We often wish they were l assessed from an A&E setting, that could actually prevent millions of blocked beds and millions of pounds down the drain every year across the U.K. Often paediatric wards remain pure child minding services, particularly when services haven’t decided where to send the child with difficulties to. This includes the ones with eating disorders and the violent aggressive ones, as there is no clear uniform pathway or services catering to these increasing numbers.

If finally accepted to be seen, these children with severe anxiety, depression, early psychiatric disorders are seen by untrained play therapists, social workers, nurses and only rarely a psychiatrist or psychologist, as such is the heiratchy of care. They are given some sessions and discharged with a letter often repeating what was put in the referral letter or what parents said. This letter does not convey strategies or a plausible plans of action.

Often it is sad that a referral by a consultant paediatrician is not honoured by a reciprocal review by a consultant psychiatrist. This is considering the fact that the major bulk of behavioural patients in the U.K. are dealt with by a paediatrician and a referral is made to CAMHS only when in a dire situation.

I remember one case where a teenage boy clearly showing features of Bipolar Disorder was referred to CAMHS with an urgent phone call to a psychiatrist I knew. To my consternation, referral was rejected after first appointment by a social worker who saw him – as the boy said ‘ I am fine’ to the question ‘ How are you feeling today?’. Even the significant history that his father (divorced) had BPD and would rape his mother in front of his children in a state of mania was not taken into account! This was clearly mentioned in my letter and was the major source of concern for the distraught mother who had brought him to my clinic!

When I spoke to the consultant I had referred the child to, he says ‘sorry my hands are tied, it is in the hands of the multi-disciplinary team that triaged the case, as to who reviews the child!

I was truly appalled.