Undiagnosed ADHD

ADHD

16 year old Johnny isn’t lazy – He has ADHD.

John just started Grade 11. Although the school year just started, his parents are already worried about him. John is smart and has always done well in school, but his grades started to slip last year and the trend continues. John is generally well behaved but seems to be floundering in school. He is disorganized, leaves everything to the last minute and just can’t seem to get his act together.

But John does want to do well in school. He wants to get his work done. He can’t seem to figure out why he procrastinates and leaves everything to the last minute. He sees his friends doing well on math tests and knows he could do the same, if he just studied and paid attention.

John’s parents have tried everything to get him on the right track. They’ve taken away his gaming system and his phone, told him to “buckle down” and have threatened to take away his extra-curricular activates. Nothing has worked. They are quickly running out of options and feel helpless to make things better.

What John and his parents don’t know is that he has Attention Deficit Hyperactivity Disorder (ADHD). There are three subtypes:

  • Primarily Hyperactive and Impulsive ADHD
  • Primarily Inattentive ADHD (formerly called ADD)
  • Combined Type ADHD

You can spot youth with Hyperactive ADHD a mile away. These are the kids in school who are fidgety, restless, and excessively active.

But the Inattentive type are another matter. These young people are not disruptive and tend to “fly under the radar” within the school system. They are often seen as bright children who, “just won’t apply themselves”.

Many Inattentive types can get by in school on their raw intelligence. They have trouble focusing and paying attention, but in their younger years they still manage to get good grades. But then, in High School, they hit a wall. They can’t skate along like they used to – they need to write essays and complete complex assignments – things that take time and attention. And this is often where they start to struggle.

 

Are you wondering if your child may have ADHD? Here are some points to consider:

  • If your family is going out somewhere, is this child always the last out the door?
  • Is your child easily distracted?
  • Has homework time become a “battle” in your home?
  • Are you constantly reminding them to get homework started? Are they constantly looking to “take a break”?
  • Do they start a homework assignment but can’t seem to finish?
  • Do they have difficulty completing tasks that are “routine but necessary”?
  • Is your child constantly late getting things done?
  • Do they leave everything to the last minute?
  • Do they often make careless mistakes?
  • Have you often thought that your child can get higher grades, “if only they applied themselves”?
  • Do you feel, despite these issues, that your child genuinely wants to do well in school and takes pride in getting good grades?
  • Have you often thought that your teenager may be somewhat immature for their age?

If you’ve answered “yes” to many of these questions, this may be indicative of something that requires further investigation. Clearly, not every child who is struggling in school has ADHD. Some children have undiagnosed learning disabilities and there may be a host of other possible explanations. However, three things are clear:

  • Most children attending school want to do well. If they’re not reaching their potential, they know it. But they often don’t know why.
  • Sticking the label “lazy” on a child serves no useful purpose.
  • If the only tool a parent has in their toolbox is “punishment”, then we need to find ways to support parents in exploring other options.

The school year has just started. Taking a “Wait and see – let’s see if he grows out of it” approach may not be the best strategy. There are many adults with undiagnosed ADHD. For those who are finally diagnosed in their 20s and 30s, many wish they had received treatment sooner.

Brian Kenny M.S.W., R.S.W.
Registered Therapist
Riverside Therapeutics

Anxiety, Depression, and your Morning Shower

Anxiety Depression, and your Morning Shower

Anxiety and depression are really two sides of the same coin- where you see one, you often see the other. For people suffering from anxiety/depression, just getting out of bed to start your day can be a chore. So, here’s what happens. You wake up, find your way to the bathroom, turn on the shower…and that’s when the ANTS start flowing. 

What are ANTS. They are Automatic Negative Thoughts. And they can be merciless. Here’s what it sounds like: 

“I have to get dressed and get to work. You wonder if your favorite shirt is clean. Which for some reason reminds you of that favorite shirt you had in high school. Which reminds you of that school dance you went to, the first time you wore that shirt. Which reminds you of the time you asked the cute girl to dance, and she said no, which reminds you of the stupid feeling you had as you walked away…”

So, you’re not 5 minutes awake, your standing naked in the shower and for some reason you will never understand, you’re remembering a time in your life when your self-confidence took a punch in the gut. 

Another great start to another morning. 

You’ll probably never see this in any textbook about anxiety/depression, but you’d be surprised how many people tell me they hate their morning routine. They wake up, their mind slowly comes to life, and then the negative thoughts start to flow. The negative thoughts that say:

Labeling: You’re not good enough.

Minimizing: Yeah, you’re a nice person, but nice guys finish last.

Maximizing: That joke I told yesterday really bombed, didn’t it, man I can’t do anything right. 

Mind Reading: The boss was just being nice to me; he really didn’t like my idea. I don’t know why I keep opening my gob.

Fortune Telling: There’s no way I’m ever going to get back in shape. It’ll never happen. I just can’t do it. 

Emotional Reasoning: That feeling in the pit of my stomach, that’s proof that I’m never going to meet someone. Other people can find love after a divorce, but they’re the lucky ones, it’ll never happen for me. 

Catastrophizing:  my gut tells me I’m going to flunk this test I’m about to take (emotional reasoning), I just know I’m going to fail (fortune telling) and my teacher will think I’m stupid (mind reading) and everyone will think I’m an idiot (labeling), yeah I’ve done pretty well so far in the course but so what? (minimizing) I’ll probably end up flunking out of school. 

Does this ring any bells?  I had a client a few years ago, his morning flood of ANTS became so troubling, he started showering at night. If that wasn’t possible, he’d skip the morning shower all together. 

Why does this happen? Frankly, I don’t know. It just seems to be a quirky feature of this two-headed creature. But we do know what you can do about it. 

If you’re suffering from anxiety/depression, your negative thoughts fuel your negative thinking. It’s a vicious cycle. If you spend any time on social media, you’re quickly told the solution to your problem.  Positive thinking. That’s the answer to all your problems. Just snap out of it. Turn your frown upside down. Look on the bright side. 

Anyone tired of hearing that? It gets old fast, doesn’t it?  So, what do you do? 

You learn the strategies of cognitive behavioral therapy and then you start your morning this way, engaging in Rational Self Talk:

“Okay, my Counsellor and I have talked about my anxiety/depression and how this leads to having a lot of ANTS. I used to take my ANTs at face value and believe them, merely because of sheer repetition in my head. I no longer do that. My Counselor has taught me a new motto, DON’T BELIEVE EVERYTHING YOU THINK”.

So, now each morning I step into the shower. I have no control over what pops into my head. I will not try to force these thoughts out of my head – that’s doesn’t work. I will notice these thoughts. But I will no longer instantly believe them. I will ask myself the question, “Is this negative thought fair, is it true? 

Yes, I’m about to take an exam. I’ve studied for it. No, I’m not going into this final with an A average, but I’ve been getting low to mid Bs all semester. It’s a tough course. In the past, I’d be standing here in the shower, fortune telling and catastrophizing, getting myself all worked up. I am anxious about this exam. I won’t pretend that I’m not. But if I was looking at this situation, as if it was happening to someone else, I think the only reasonable conclusion to come to, is that this person will probably get a decent grade.  That is a reasonable conclusion to make. It won’t make my anxiety go away completely, but it allows me to distinguish between a rational thought and an irrational, anxiety fueled ANT”. 

And that is the beginning of your journey, as you learn how to manage, (not control, but manage), your automatic negative thoughts. 

Brian Kenny

Mental Health Clinician 

Female Intuition – It’s Relationship to Anxiety


I am a therapist in private practice in St. John’s.
My Mom is 90 years old. Years ago, she told me the story of the time my sister, who by then was married with a child, came over to the house for lunch. Mom looked into her eyes and knew instantly that my sister was pregnant with her 2nd child.  Several weeks later, my sister announced to the family that she and her husband were expecting their 2 nd child. Mom’s response, “Yeah, I
already know”.

I’m not here to debate whether female intuition exists or not. I accept it as a real thing. You are free to believe something else.

But, here’s the thing. Female intuition is often the most accurate when you are observing something outside yourself. It’s that radar that tells you, as you’re walking to your car at night, that something is not quite right. It’s that feeling that you get, when you meet a guy for the first time, that he’s a “player”. It’s that feeling you get when you know someone is lying to you.

All these intuitions have one thing in common. They are about other people or situations involving your external environment.

Now, what does this have to do with anxiety?

We all have ANTS, Automatic Negative Thoughts, that fuel our anxiety. And there are different kind of ANTs:
Labeling: I’m stupid.
Minimizing: Yeah, I’m a kind person, but so are a lot of people.
Catastrophizing: I bet that mole on my leg is cancer.
Mind reading: My boss is scowling, what did I do wrong?
Fortune Telling: I just know they’re going to hate my idea.

And the BIG ONE, EMOTIONAL REASONING.

Emotional Reasoning is that feeling you get in your gut that tells you things, ABOUT YOURSELF. Female intuition is different – it’s about other people and your external environment. So, if you are a woman with social anxiety, and you are at a party where there are several strangers, you may get a knot in your stomach. To the person with social anxiety, this knot is “proof” that you don’t belong. It’s evidence that you shouldn’t be there. It’s telling you that others (Mind Reading) are wondering how you got invited. It’s telling you (Fortune Telling) that you’ll say/do something stupid. It’s that gut feeling that says you don’t make the grade and you should leave.

Of course, that knot in your stomach is not “proof” of anything. It’s merely a symptom of social anxiety. NOTHING MORE. But you interpret the knot as a sign that you don’t belong.

So, here’s the thing. You may have amazing female intuition. It may be deadly accurate about others, their intentions and about the external world around you. BUT, that doesn’t mean the negative things you believe about yourself are true.

As a therapist, I’ve worked with many women who have been through divorce who firmly believe, “I will never meet someone, it will never happen, I just know it”.
That is not female intuition. That is the Fortune Telling anxiety ANT messing with your head.

Cognitive Behavioral Therapy forces us to examine our thoughts with an objective lens. It reminds us, ‘Don’t Believe Everything You Think”. Knowing the difference between intuition and ANTs is an important tool to manage anxious feelings.

 

Brian Kenny M.S.W., R.S.W.