“Measure what is measurable and make measurable what is not so.”
Galileo Galilei ~1640
This Galileo Moment
Consider the year 2014 as ADHD’s “Galileo Moment.” Galileo changed the way we think about measured observations, and that consequence became a scientific Renaissance. A similar problem exists today with ADHD medications, and it’s going to take a change in thinking to bring about a change in ADHD medical practice.
Galileo introduced advanced measurement tools [the telescope] to science. Those measurements challenged a globally accepted solar conclusion, and ultimately changed belief systems that had been previously based upon superficial observations. The sun does ‘look like’ it rotates around the earth. But when the earth and sun were measured accurately, with advanced technology, Galileo discovered the truth, the reality, was not what it seemed in appearance.
Why Consider Changes?
Common beliefs about ADHD treatment are created from a combination of public sentiment and professional protocols. However, these professional protocols are based on limited diagnostic and treatment perspectives. Much like the world’s assumptions about the sun before Galileo introduced the telescope, critical information about ADHD diagnosis and treatment is missing. As a result, all too often, public sentiment takes a firm stand against using ADHD medications for effective medical treatment.
Quite reasonably you may ask: “What is the problem with ADHD medications? Why are so many people so negative, or hesitant, when stimulant medications can prove remarkably useful for many?”
There are THREE main issues to be considered here:
1. Current Labels for ADHD Overlook Medical Reality
Currently, ADHD diagnosis and treatment protocols overlook critical information about the biomedical complexity of ADHD. ADHD labels (Hyperactive, Inattentive and Combined) describe behavior, but they do not address measurable medical challenges that effect brain function. Cellular activity and immunity issues, for example, are important, measurable complications that actually compromise brain function and impair working memory. But despite the existence of world literature confirming the link between damaged brain functioning and immunity issues, such as gluten and casein sensitivity, their consideration in ADHD treatment remains controversial.
2. Brain and body function are omitted when considering treatment
Thousands who do struggle with “ADHD challenges” meet the criteria for diagnosis, attempt treatment, and suffer from side effects of medications. But that could be improved if medication treatment included measuring how brain function and working memory affect executive functioning. For example, Hyperactivity may be corrected by medication, but executive functioning remains impaired. Or, Inattention may seem to improve, but avoidance and procrastination, (more directly associated with brain function) remain off the treatment radar. Measurements that address deeper medical imbalances, such as genetic metabolic imbalances or specific medication duration of effectiveness, should be used to provide valuable information for a physician, and ultimately minimize inaccurate medication practices.
3. COGNITION — The Essential “ADHD” Problem — is Overlooked
Balanced cognition – reacting appropriately to make adjustments to changing reality – is what distinguishes the human thinking process from that of cows, cats, and even well trained elephants. Ultimately, balanced cognition is what we’re looking to achieve when managing ADHD. Paradoxically, ADHD is a behavior diagnosis, observable from the outside. Self-observation is not reported or considered for diagnosis, which means that the current system of “ADHD” diagnosis and treatment overlooks the very objective of treatment: cognitive activity, executive function.
Because diagnosis is hyper focused on behavioral issues, cognitive impairment is overlooked. It is noteworthy that the current DSM code does not consider cognition to be impaired unless one suffers from dementia. The way the Diagnostic Statistical system is currently arranged, with it’s inattention to cognitive markers, the entire system “doesn’t get it.”
For example, a frequently overlooked issue is the sequence of working memory –- how people manage their own reality through thinking, acting and remembering on a timeline. This internal cognitive disability can cause individuals to act without thinking, think repeatedly without acting, or completely avoid reality by avoiding thinking or acting in time. Associated behavioral challenges can then be understood in the context of identifying what is happening cognitively.
Metacognition: A NEW way of thinking
Metacognition is a new, more accurate, more functionally useful word from the ADHD literature that connects biomedical reality, brain function, diagnoses, and reality-based, customized treatment strategies.
When we simply think about thinking, or the process of thinking in various real-life circumstances, treatment targets improve. Just as Galileo’s telescope changed the way we measured solar observations, looking for a different set of answers enhances metacognitive understanding of ADHD.
We must start by asking the following questions;
- Is the person thinking too much?
- Are they acting without thinking?
- Are they avoiding reality?
A “yes” to any of the above may indicate a de-synchronization in brain functioning and working memory – to then open new ways of thinking that can change the course of treatment.
Diagnostic & Medication Treatment Corrections
Applying metacognition, or thinking more carefully about the biomedical process of thinking, encourages several important changes:
- Diagnostic targets must include executive function imbalances – brain function is the new target.
- Medication management must include an understanding of metabolism and biomedical processes that modify metabolic rates – e.g. genetics, immunity, drug interactions, food, sleep, duration of effectiveness, co-existing psychiatric conditions.
- Medical awareness of changes within the “Therapeutic Window” of each medication must be customized using brain function measures for every patient at every medication check.
- Recognition and correction of nutritional and endocrine imbalances that impede medication effectiveness is imperative.
- Essential, long overdue changes with medication dosing strategies will then become a reality.
Fresh neuro-scientific evidence changes thinking. Galileo would be pleased.
Those who currently suffer with executive function challenges will directly benefit from this new thinking. For more information on how details can work for you, see the book: New ADHD Medication Rules – Brain Science & Common Sense.