Can Changes in Diet Improve ADHD Symptoms?

Parents often ask me if certain food may make the ADHD symptoms of their children worse. One of the purported culprit is sugar and the "sugar rush" phenomenon is well known. Despite a lack of studies to support these claims, anecdotal reports are aplenty. In this news article a mother reports success with diet changes such as adding vitamins and omega 3's, avoiding addatives- red dyes in particular and skipping the simple processed sugars.

Read about symptoms of ADHD here.

Most adolescent suicidal behavior preceded by mental health treatment

A recent research(1) showed that the lifetime prevalence of suicide ideation among adolescents was 12.1%, suicide plans 4%, and suicide attempts 4.1%. One-third of adolescents with suicidal ideation went on to develop a suicide plan and 33.9% made an attempt. Most adolescents (88.4%) who transitioned from planning suicide to attempting suicide did so within a year.

Most adolescents who had suicidal ideation (89.3%) and attempted suicide (96.1%) met lifetime criteria for at least one DSM-IV mental disorder, which included major depressive disorder, specific phobia, oppositional defiant disorder, substance abuse, intermittent explosive disorder and conduct disorder. Most disorders significantly predicted suicidal behaviors, and the prevalence of mental disorders generally increased with the increasing severity of suicidal behaviors.

From this study, we can see that it is important to identify and provide early treatment for these troubled youths. Unlike physical illnesses, parents tend to ignore mental health issues and to believe that such problems will go away by themselves. Otherwise, they may feel that seeking help from a mental health professional is too stigmatising and may do more harm to their children.

Such ignorance, often lead to delay in seeking treatment and may result in the youths and parents defaulting follow-ups. Today, suicidal behaviors are among the leading causes of death in Singapore and worldwide, especially among adolescents and young adults. Seek help early and contact a psychiatric clinic in Singapore.

(1) Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents Results From the National Comorbidity Survey Replication Adolescent Supplement  
Matthew K. Nock, PhD; Jennifer Greif Green, PhD; Irving Hwang, MA; Katie A. McLaughlin, PhD; Nancy A. Sampson, BA; Alan M. Zaslavsky, PhD; Ronald C. Kessler, PhD
JAMA Psychiatry. 2013;():1-11. doi:10.1001/2013.jamapsychiatry.55

3 Ways to Prevent Depression

A Squidoo lens by Dr Lim Boon Leng.

Should We Be Leaving Infants to Cry Themselves Back to Sleep?

A new study from Temple psychology professor Marsha Weinraub gives parents some scientific facts to help with that decision. The study, published in Developmental Psychology, supports the idea that a majority of infants are best left to self-soothe and fall back to sleep on their own. Read here.

A Study on Empathy

Empathy is an innate quality in humans. It ensures that we have the ability to feel for one another and this further promotes kindness and co-operation. The more people are alike, the more they identify with one another. In fact, it has been found that if you did not identify with a victim of  any kind of trauma, you are unlikely to be vicariously traumatised. This may be protective for rescue workers in major disasters or healthcare personnels dealing with patients with PTSD.

In this interesting study on empathy in rats. Watch the video!

Adult ADHD: Simply a Myth?

There has been many research done on adult ADHD which have shown that many adults continue to be affected with ADHD symptoms. Despite this, many still think of ADHD as an illness affecting only children. There is a lack of understanding about adult ADHD both in healthcare professionals as well as the public in general.

In this paper written by doctors from the Institute of Mental Health (IMH), Woodbridge Hospital, Singapore, it is estimated that 5.29% of people may have ADHD. Only 10% will recover fully such that the symptoms no longer affect their lives in any way. This means that in Singapore, 265,000 people have ADHD and about 240,000 people will have ADHD symptoms into adulthood!

Based on this report, about 140,000 Singaporeans suffer from asthma. This is about 100,000 less than ADHD. Yet, it is not uncommon to hear of adults getting treatment for asthma whilst you will almost never hear adults getting treated for ADHD. In fact, many adult with ADHD today may have never been diagnosed in their childhood as the illness was poorly understood in this part of the world when they were children.

This can be due to the fact that the symptoms of adult ADHD is somewhat covert and hidden. As the child grows older, the hyperactivity symptoms (ie fidgeting,  running around, talking excessively) subsides. The adult can control their hyperactive symptoms much better. However, they continue to have inattentive symptoms like forgetfulness, poor time management and disorganisation. These symptoms can often be very disruptive. This is especially so students undergoing tertiary education where academic work can be fast paced and stressful. The ADHD mind may find itself unable to cope or manage in these times of stress where time allocation, organisation and prioritisation of work is critical.

Psycho-stimulant medications like methylphenidate is a very effective treatment for these symptoms. Other therapy such as behavioural modifications or cognitive behavioural therapy are helpful for the individuals suffering from adult ADHD.

Depression: Should I See A Doctor?

In life, it is not uncommon to be down and out especially if you have experienced an upsetting event. Clinical depression however, is a separate entity whereby the mood is low for more than two weeks accompanied by various other symptoms (see here). Clinical depression is a medical condition that requires treatment.

Why see a Doctor for Depression?

Many a times, people feel that they are strong enough to will themselves out of depression. Despite wanting to get away from everything, those with depression often soldier on with work and social commitments. In front of friends and family, they put up a strong front as if nothing is wrong. Sometimes in milder cases, the individual may recover shortly but in many cases, without help, the depression and ability to cope will worsen. This results in a vicious cycle.

Physical Assessment

In the assessment of depression, the doctor or psychiatrist will also perform a physical examination and sometimes blood tests to make sure that the low mood is not caused by medical problems such as hypothyroidism.

Suicide Assessment
The psychiatrist is also the most qualified person to perform a suicide assessment. If your friend of love one has depression, there is a risk that he or she may harbour suicide thoughts and may act on them in the future. A suicide risk assessment will help identify individuals at high risk of completing suicide so that immediate help and treatment can be performed.

Brain Changes in Depression
One cannot simply will away depression. It is not due to moral deficits or weakness in personality. It has a biological basis. In depression, actual structural changes of the brain occurs. Depression is associated with changes in metabolism and blood flow in the brain. Medication can protect the brain from these damages and potentially reverse these changes.

Treatment of Depression
Depression is very treatable. 70-85% of sufferers respond to medications. There really is no need to suffer the sleepless nights, endless guilt feelings and hopelessness. In addition to medication and psychological treatment, psychiatrist will advise their patients about practical steps to take to improve their mood. Watch this space for more advice about depression.