Last week 100 of you skimmed through my email on ADD, hit reply to say, ‘Dr. Sara, that’s me!’ but then forgot what you were supposed to be doing, and went to the kitchen for a snack.
This happens to me a lot.
How do you know if it’s a symptom of stress, internet brain, not enough sleep--or if maybe it’s ADD?
To put you at ease, here are the official, Harvard-approved DSM-IV questions--which represent just a sampler of the 18-Item Scale that psychiatrists use.
(Too distracted? Give this to your partner, who will be happy to illuminate you.)
1. Carelessness: Is your desk so messy that you have trouble finding things?
2. Difficulty sustaining attention: Do you have unusual trouble staying focused on boring or repetitive tasks? [Yes, I’m also terrible at laundry and grocery shopping.]
3. Doesn't listen: Do people (spouse, kids, friends) complain they have to repeat themselves, that you don't seem to pay attention or respond? [My darling husband filled out the form for me and scored this one "severe"].
4. No follow through: Do you have trouble finishing things (work or chores)? Need deadlines?
5. Can't organize: Is it hard to prioritize at work? [Professional organizer on speed dial?]
6. Avoids/dislikes tasks requiring sustained mental effort: Do you have to force yourself to do complicated tasks? [Yes, and for me, grocery shopping is a complicated task.]
7. Loses important items: Keys? Important work papers? [Children?]
8. Easily distractible: Do you need relative isolation to get work done? [Virginia Woolf was not only right about a room of one’s own, but this is friggin’ essential to your ability to accomplish most anything?]
If you've answered yes to 3 or more of these, that’s good cause to make an appointment for an evaluation with me or another trusted physician. Don't settle for getting Kaiserized, as I did recently. It’s worth getting very clear about why your memory or attention is slipping, and to turn the ship around.
I happen to have noticed in my concierge integrative medicine practice that brain fog is increasing in my 40+-something patients, and they are noting more ADD symptoms. My psychiatry colleagues agree. One in particular said that women tend not to have the hyperactive component of ADHD, and that attention seems to sleep for many of us starting in our forties. Is it related to our sleep getting less restorative? That is, maybe you’re more disrupted in your sleep because of perimenopause? I’m also finding that some of my patients are getting the same quantity of sleep, but the quality has eroded, leading to a less restored feeling when you awaken. I believe this may be due to less deepwave sleep in perimenopause and menopause. Less restorative sleep seems to result in worsening working memory for women. How can you assess this? Ask for a Zeo Sleep Coach
for Christmas/Hannukah. If you want to read more about it, read the article in O Magazine (December 2011 issue, page 154).
What about the prescription stimulants that are handed out like candy to our children for ADD/ADHD? Well...Ritalin, Adderall, and the like don’t do your adrenal glands any favors--so you must be super careful about getting the right diagnosis and the right treatment. I find, for instance, that there are more than 6 different types of ADD. Some of my patients have low norepinephrine and that causes poor focus. Others have low dopamine, the neurotransmitter of pleasure and satisfaction. Still others have a combo of low GABA, which is like your body’s valium, and low taurine. There are several proven, evidence-based, natural treatments for ADD in adult women. They’re worth looking into. I’ve got a rather long list.
Finally, there is a recent article worth checking out from the New England Journal of Medicine, October 6, 2011. The title is: Can age-associated memory decline be treated?
by D'Espositio and Gazzaley. They review the data to support a trial happening now that is looking at the use of a prescription stimulant to help with memory.Here’s to becoming a highly-attuned hormone superhero who is excellent at grocery shopping and never loses the keys.
PS: I received so many potent, poignant and titillating questions from you all about hormones, holidays and metabolism.