Freudian Commando! Go!

For a few months, now, I’ve been taking the bus to work. I’ve not become King of the Bus People, but I have been adapting to bus culture pretty well. I’m not sure I want to become King of the Bus of the People, though. I don’t want that kind of responsibility. I’m just happy to read books or play with my iPad while the bus drivers do their thing.

The bus has actually been quite a boon for me. The drive times are about double what it would take in a car, but it’s saving me quite a bit in gas money. My work gave me the bus pass, so I’m not even paying for that.

The long drive time has been good for school, too. During the drive, I can study, so it’s really not wasted time. Only one of my textbooks is of the super-heavy think hardback variety. The rest are light paperbacks or ebooks so, I don’t often have to weigh my backpack down very often.

Riding the bus in winter has some unforeseen downsides, though. The cold is the most obvious. I’ve adapted by wearing heavy clothing, a heavy coat with hood, and gloves. Not so obvious is a side affect of wearing heavy clothing. Like everything else, they are subject to the laws of gravity and try to find the lowest point possible. Having greater mass than lighter clothing, they have an easier time of it. My coat, shirt and gloves have no problem, though. They rest on my shoulders and hands quite nicely, thank you. My boots are secure around my feet and ankles. My pants and underwear? Not so much.

Having a good belt helps with my pants, but the waistband in some of my undies has seen better days. They’re feeling their age as much as I am. After the long bus ride, they decided they were tired of hanging around my sorry butt and started to migrate towards my feet. My Id, sensing this betrayal on the part of my underclothes, started raising all kinds of alarms. “Ahhhgghh! Your pants are falling down! You’re going commando! Someone will see your butt!”

My Ego, trying to calm the Id, said, “No, no, the pants are still on. It’s just your underpants that are going south. Your butt is not visible.”

I tried recovering my underpants by grabbing them through my jeans, but they were having none of it. They just kept up the steady southward migration.

My Id went into full panic mode. “Ahhhh! Naked butt! Naked butt!” After thinking about it for a moment, my Id, being what it is, started thinking, “Maybe it would be fun to flash these people. They might want to have sex with me. I’ll pull my pants down, too!”

Thankfully, my Superego intervened. “No, no. That would cause great embarrassment and result in jail time. You must not pull your pants down.”

“You’re such a killjoy.” Id complained. My Ego was not quite relieved.

Eventually, my underwear cleared the bottom of my butt cheeks. My pants, ever defending my honor, caught them at crotch level and stopped them from having a conversation with my knees and ankles. I’d hate to think what would have happened if I was wearing a dress. Not that I’ve done that. My Id has a mind of its own, though, so I still think of things like that.

As I entered the building, my underwear at half-mast and my backside getting acquainted with backside of my jeans, I struggled to control my brain and act like nothing was wrong. I just needed to get to the bathroom near my desk without raising suspicions that I had become and accidental commando. The fact that my desk is on the opposite side of the building wasn’t helping.

In the end, I got my end covered back up without further mishap. Praise goes to my denim jeans for not joining my undies in their southern migratory pattern. As I sat back at my desk I could only think of one thing: I really need to buy new underwear.

ADHD: Developmental Challenges and Treatments

This was my final paper for Human Development Across the Lifespan. It deals with the developmental challenges facing children with ADHD, specifically, but I believe it may be beneficial for understanding many children with special needs, similar to ADHD. To be honest, I was was surprised where the research took me, in some cases. It was enlightening for me so, I thought it might be useful for others, as well.

Be warned. This is a research paper, so it is kind of long. References are included at the bottom.

ADHD: Developmental Challenges and Treatments

Attention Deficit Hyperactivity Disorder, or ADHD, afflicts approximately three to five percent of children in the United States. With a child population of approximately 2 million, an average sized classroom of 30 children will have at least one ADHD child in it. It is difficult for ADHD children to control their behavior, creating challenges for teachers to educate them along side other children in their classrooms. It also increases the normal challenges faced by parents raising them at home.

Although we may see ADHD as something new, knowledge of this as a disorder has been around for over a century. It was first described by Doctor Heinrich Hoffman in 1845. A poet, as well as a doctor, he wrote a book called “The Story of Fidgety Phillip,” containing an accurate description of a child with ADHD. In 1902, Sir George F. Still published a series of lectures at the Royal College of Physicians in England describing a group of children with significant impulse and behavioral problems. He attributed the cause in the group to genetic dysfunctions, not poor upbringing on the part of the parent. Today, these children would easily be identified as having ADHD.

Causes of ADHD

While the cause of ADHD remains unknown, research has shown it is likely genetic and may be linked to exposure to toxic substances. Positive correlations have been found between the use of cigarettes and alcohol during pregnancy as well as lead exposure. (Mick E, Biederman J, Faraone SV, Sayer J, Kleinman S. 2002)

Studies involving brain injury have shown that some children with brain damage exhibit ADHD like symptom, but only a small number of children with ADHD have suffered traumatic brain injuries. Likewise, studies involving diet, especially sugar, have shown no correlations. In one study, where half the children were given aspartame and half sugar, the only behavioral differences found were in the perceptions of their mothers. The mothers who thought their kids were being given sugar were more critical of their child’s behavior, whether the child had actually received sugar or not. (Wolraich M, Milich R, Stumbo P, Schultz F. 1985)

The most positive correlations seem to be genetic. 25 percent of close relatives in families with ADHD children also have ADHD. The ratio in the general population is only five percent. Many studies with twins show that both twins will likely have ADHD. Each of these factors suggests a strong genetic influence. PET scans have shown a marked difference in brain functioning between a normal child and a child with ADHD, suggesting a neurological dysfunction, not just a psychological one. (Faraone SV, et. al. 2005)

Delayed Brain Development

Recent studies conducted by the National Institute of Health suggest a delay in brain development of children with ADHD, not a total dysfunction. An earlier study found that thickening of the cerebral cortex was delayed in ADHD, specifically those sections dealing with functions such as attention, cognition, language, and sensory processing. This study tracked children over a period of seven years, scanning their brains and regular intervals between age 10 and 17, and measuring both cortical thickness and cortical surface area, both of which mature during childhood. These scans showed a marked delay in the development of these areas. For example, a typical developing child attains 50 percent peak area in the right prefrontal cortex at an age of 12.7 years, on average. ADHD children didn’t reach this peak until an average age of 14.6 years. (Elsevier 2012, July)

Psychosocial Stage 3, the Preschool Years and ADHD

Because of this delay in brain development, children with ADHD will, like other special needs children, be behind their peers in some areas and may experience problems in school, socially and academically. When we consider Erik Erikson’s stages of psychosocial development, ADHD symptoms typically begin manifesting during stage 3, the preschool years. This is a time when children being to exert more control over their environment through directing play and other social interactions. Lacking self-control, such children will try to exert too much influence, meeting resistance from their peers, teachers, parents, and siblings. Lacking impulse control, this frustration is more likely to manifest as aggressive behaviors such as yelling, hitting, or throwing objects.

At this stage, children also begin to physically explore their world, taking on activities by themselves, and developing a sense of independence. Lacking impulse control, ADHD children are more likely to take on activities that are beyond their capabilities and engage in risky behaviors such as crossing the street alone or riding a bike without a helmet. They may also attempt activities that interfere with other people’s plans and activities. Adults who are supportive of the child’s attempts, and try to guide them to make more realistic choices, help the child develop initiative: independence in planning and undertaking activities. Adults who dismiss the child’s attempts as silly or bothersome contribute to the child developing feelings of guilt about their needs and desires. Adults who are frustrated by the ADHD child’s proclivity to respond in aggressive ways may be more likely to resist the child’s efforts at independence, putting ADHD children at greater risk for failure during this stage. (Berk 2010)

Psychosocial Stage 4, Early Childhood and ADHD

As children enter early childhood, they learn to cope with greater academic and social demands. Ideally this is a time to learn more complex tasks such as reading, writing, and telling time. They may also express their independence by talking back, being disobedient and rebellious. It is also at this stage that children develop a sense of morality, recognize cultural and individual differences, and can manage most of their personal needs, such as grooming and hygiene, with minimal assistance.

Because of the delay in development in areas of the brain crucial to this stage, children with ADHD are more likely to have difficulties in the early years. Children who are encouraged to make and do things, and then praised for their accomplishments, will develop diligence and perseverance in completing tasks. They will learn to delay gratification. If they are ridiculed or punished when they are incapable of meeting adult expectations, they will develop feelings of inferiority about their abilities. It should be noted, however, that because development is these crucial brain areas are delayed, the development of diligence and delay of gratification are likely to be delayed, as well.(Berk 2010)

Psychosocial Stage 5, Adolescence and ADHD

During adolescence, children explore their independence and develop a sense of self or personal identity. This transition is marked by a need to re-establish boundaries for themselves in a potentially hostile world. No matter how the child has been raised, this is the time they will choose a personal ideology for themselves. This often leads to conflicts between adults and the developing child, especially over religious, political, and sexual orientations.

Because of the developmental delays of children with ADHD, this stage is often prolonged, well into early adulthood. It is of note that this Erikson noted this same delay in person’s of particular genius. This delay can also be prolonged by the demands of taking a longer time to master certain skills within our highly technological society. It is, perhaps, because of this natural delay, that many ADHD children grow into very intelligent and technically skilled adults. The psychosocial demand for prolonging this stage may coincide with their biological delays.

Because of this natural delay, there can still be problems. Early in this stage, peers and adults may see the child as acting “like a child” and react negatively. If adults are too insistent in choosing an identity, “acting their age,” and force closure of the normal identity moratorium early, the child may give up and take on an less health identity foreclosure status. They will be less likely to integrate their sense of self within a diverse society as they enter adulthood. (Berk 2010)

Modern Treatment Modalities

Current ADHD treatments focus on reducing symptoms and improving functioning. They include medications, various forms of psychotherapy, and education. One size does not fit all. The best results seem to be from a combination of therapies. (National Institute of Mental Health 2008)

The Risks of ADHD Medications

Stimulants are the most common type of medications prescribed for ADHD ,and are by far the most controversial. The exact medication and dosage must be individualized, and it is common to try several out before finding one that seems to work, best for that patient. As with all medications, stimulants come with a wide range of side-effects, however. These side-effects, and a general misunderstanding of the causes of ADHD, create additional stresses for parents seeking to help their children, as well as the children themselves.

The most common side-effects of stimulant medications are decreased appetite and sleep problems. Some children experience upset stomach and headaches. A few children may experience slight “tics” or personality changes such as appearing to be without emotion. These side-effects are often mitigated by changing the dosage or using a different medication.

Many people are concerned that using stimulants in this way to treat ADHD may lead to substance abuse and addiction later in life. There is little evidence to support such a claim, and far more that suggests they do not. Children who take these medications do not “get high,” although some report feeling slightly different or “funny.”

In spite of being generally considered safe, there are some rare side-effects that must be noted. Patients with existing cardiovascular disease or psychological problems may have their symptoms exacerbated by stimulants, leading to stroke, heart-attack, or sudden death. A few patients report hearing voices, hallucinations, experience mania, or paranoia even when they do not have existing psychological conditions.

Non-stimulant medications also pose risks, especially in teens. Children and teens who take medications such as atoxometine more often report thoughts of suicide than their peers who do not take such medication.

The long term effects of ADHD medication on development are not known. Some researchers are concerned that administering stimulants to children will have an adverse effect on brain development. (NIMH 2008)

The Benefits of Treatment

Because a combination of therapies seems to be the best approach, removing medication as an option seems counterproductive. The question becomes do the benefits of medications outweigh the risks? There seems to be no consensus within the medical community on this. My own research has shown that many scientists cherry pick the data to support their own theories, while ignoring the rest of the data. In some cases, medication seems to have been the key element that allowed the child to participate in other forms of therapy as well as educational activities.

When a developmental perspective is taken, it seems clear that, untreated, ADHD poses severe and known risks in the long term. Failing to achieve the developmental milestones, as given in the previous examples, creates greater risk for not developing the coping and life skills required by modern living as adults, as well as greater risk for psychological disorders that may lead to physical problems, as well. They may have lower self-esteem and be unable to cope with stress, develop expertise in vocational and leisure pursuits, have healthy intimate relationships.

References

Berk, Laura E. (2010) Development Through the Lifespan (5th ed.). Boston, MA. Pearson Education, Inc.

Elsevier (2012, July). Brain development delayed in ADHD, study shows. ScienceDaily. Retrieved December 11, 2012, from http://www.sciencedaily.com/releases/2012/07/120730094822.html

Faraone SV, Perlis RH, Doyle AE, Smoller JW, Goralnick JJ, Holmgren MA, Sklar P. (2005). Molecular genetics of attention-deficit/hyperactivity disorder. Biological Psychiatry, 57, 1313-1323.

Mick E, Biederman J, Faraone SV, Sayer J, Kleinman S. (2002). Case-control study of attention-deficit hyperactivity disorder and maternal smoking, alcohol use, and drug use during pregnancy. Journal of the American Academy of Child and Adolescent Psychiatry 41 (4) 378-385.

National Institute of Mental Health (2008). Attention-deficit Hyperactivity Disorder (ADHD) (No. 08-3572). U.S. Department of Health and Human Services; Author.

Wolraich M, Milich R, Stumbo P, Schultz F. (1985) The effects of sucrose ingestion on the behavior of hyperactive boys. Pediatrics, 106 (4):657-682.

Overstressed, Underpaid

How many of you are feeling like you've got way too much stress, but not enough money? Yeah? Me too.

This has been a very difficult month for me. My Pontiac decided it was time to shuffle off to the Heavenly Racing Grounds. I can’t blame it, really. It had nearly 290,000 miles on it. I suppose it was just tired.

I can relate. I’m not sleeping well. It's a typical stress response for me. Fortunately, I'm learning all about "response patterns to threat" in my Human Development class. Now I know what it is and, according to G.I. Joe, knowing is half the battle. If I could just figure out how to deal with the other half, I'd be in good shape.

In any case, the amount it would cost to replace the engine is worth more than the car. I don't have the money in any case. What can I say? The old stereotype of the "starving student" seems to be playing out for me. Except for the starving part. We have some food storage laid aside that’s been helping keep me in the round shape I am currently in.

My other car, a Dodge van, has some problems with the front end that need to be repaired before it will pass the state safety inspection. This is a problem because I don't have the money for that, either. We need some form of transportation, given where we live so, we have to beg family members for help on this one, which also sucks.

What makes it doubly damning is that I will have to take time off work to get it fixed. Not because I have any ability to fix it myself, mind you. I just can't get to work without paying overpriced public transportation fees and taking an additional two hours out of my day riding on and/or waiting for the bus.

I really don't want to do that. That would make things suck, more.

All of this happens just in time for midterms. Ick.

On the plus side, I get to take a couple of days off work. I’ll be able to use it to catch up on my homework and maybe do a little composing. That does not suck.

Special People

Now that I’m back in school, I’m facing a dilemma. The more I’m involved going back to school the less I want to be at my day job. This isn't much of a surprise. It’s not like my current job is joyfully fulfilling. In fact, it’s downright boring and frustrating.

I currently work for the state government. Every day I get to interact with a variety of, well, let’s just call them special people. Most of the people who come in are just honest folks with questions about how to get things done. The special people, however, are just plain stupid or mean. The worst are those who are both stupid and mean at the same time. It’s hard to blame many of them for being frustrated, though. The laws that our Utah legislators have passed, mostly to get people vote for them rather than serve the common good, are confusing, conflicting and in some cases downright stupid.

It seems that the special people have somehow gotten it into their skulls that I make up the laws by pulling them out of my ass. They don’t seem to realize that the laws are made by our very special Utah legislators. They blame me, instead, yelling, threaten litigation and question my parenthood over things I have no control of. I give them the information they need to solve their problems, but when they don’t like what they hear, they get hostile. Worse are those who think they already know the answer and argue with you. I often wonder why they call if they knew the answer in the first place.

Sometimes I wonder how the special people function in life, or why we allow them to breed, vote, and drive cars. Unless you are one of these people, it should have become obvious why my job satisfaction is waning.

More and more I’d rather take my time to work on my degree. I’d like more time to practice my musical skills and do something for money that relates more to my field. Then again, I’m not sure the lack of job satisfaction is because I’ve gone back to school. Instead, I suspect it’s one of the reasons I went back in the first place.

Does the fact that I’m frustrated over this make me one of the special people?