11 Comments
Jan 18, 2023Liked by Owen Scott Muir, M.D

How timely, we are trialing methylphenidate with our son this week. Not to get into the weeds, but it has been almost 2 years since his personality and behavior completely changed, and we STILL really don't know what TF is going on. He went from happy go lucky to angry and aggressive, and his learning style went from a steel trap to a colander.

Anyway, I just wanted to plug occupational therapy for ANY child with difficulty self-regulating, whether it's ADHD, autism, or another MH diagnosis. We did not get this tidbit from his care team but from other parents. I feel like it should be a standard tool in the toolbox for children. We got our son started with OT when his only diagnosis was anxiety disorder, and there was a huge wait to get psychotherapy started. OT teaches zones of regulation, CBT-adjacent stuff (growth mindset, size of the problem, inner coach/inner critic, etc), and it explores and honors sensory differences! Plus, insurance typically covers weekly sessions. My son's MH therapist wants to see him every 2 weeks, but the reality is she can only actually get him in every 3 to 4 weeks.

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Thanks for this. I am someone who experienced pretty severe childhood trauma, and, as an adult in therapy, ADHD has been proposed as a diagnosis (bipolar disorder also.) I don’t really think either of those is accurate except for the observation that I have some symptoms that fit those conditions.

Adderall does help me focus my mind, but that’s probably true for most people so I don’t put much store in that. I was particularly struck by your mention of hyper-vigilance being a confounding condition because I have suffered from that in spades.

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It's complicated! And the understanding matters a lot. The next piece I'm gonna write on this topic has a lot to do with thinking about context, and how we can select the best contacts and timing for our minds when they are at their best. for people w/ ADHD, sometimes it's in the morning. Sometime afternoon. Trying to do your when your brain is at its best capacity is important. Similar with the role of choosing the right task at the right time, and if you have ADHD, when you are on stimulus or not on stimulants can be an important choice for any given task. Thanks a lot for the feedback, I'm glad you enjoyed this..

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Jan 18, 2023·edited Jan 18, 2023Liked by Owen Scott Muir, M.D

I will look forward to that. In my experience hypervigilance leads to a lot of ADHD type symptoms. I have found that often the real reason I can’t concentrate is because part of me is afraid of being caught unaware, or a fear that what I am doing will have terrible consequences. (It’s hard to concentrate when your body is effectively in a panic state, and there lies the hyperactivity leg of the syndrome.) Both these manifestations are directly related to my early childhood experiences. A CBT type approach is useful, but can easily become another avoidance strategy if I’m not careful.

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> The next piece I'm gonna write on this topic has a lot to do with thinking about context

This is a very important idea imo

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Jul 26, 2023·edited Jul 26, 2023Liked by Owen Scott Muir, M.D

Great article Doc., insightful and super helpful in navigating all the information out there on ADHD. Looking forward to your other articles on this.

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Mar 12, 2023Liked by Owen Scott Muir, M.D

What a comprehensive overview! spot on!

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Thank you! Please share with your friends!

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