ADHD as a model of functional disorders.

It has been known for some time that “head injuries” can produce a pattern clinically indistinguishable from ADHD. In his book “Total Concentration” the psychiatrist Harold Levinson discusses this and cites some very clear case histories. The medical profession has been slow to catch up on this- but we are now seeing some talk about head injuries and subsequent ADHD symptoms.

What is usually neglected is that head injuries are usually accompanied by injuries to the upper neck and that the upper neck houses the lower brainstem- important for vital functions and also for orienting reflexes. Equally brain injuries are often torsional and mostly involving axonal rupture in the midline structures- so not what we thought.

Upper neck injuries tend to be difficult to resolve because they scramble the proprioceptive (body position) information coming from the neck- causing each side to differ and neither side to match the other senses.
About 80% of that body position information comes from the small muscles innervated by the second cervical vertebra. The basic set of information our brain needs to construct even a crude map of the outside world is proprioception +vestibular+ vision ( see my earlier blog post titled “Upper Cervical Subluxation and the Reality Hologram).

What complicates matters further is that the scrambled proprioceptive information makes it harder to co-ordinate eye movements, and once they are a little out of sync, you get what the behavioural optometrists call “convergence insufficiency”.

The lack of convergence then creates a situation where the images from each eye do not match and that means that the brain has to suppress one for vision, and the other for balance. This maintains the loop by maintaining the eye muscle co-ordination problem.
Eventually that leads to all sorts of knock on effects in activation of other brain areas- but usually ends up with a lack of drive to the L prefrontal cortex.

Now the symptoms of convergence insufficiency and of ADHD are virtually inseparable.

We now have a significant literature that shows that oculomotor problems are usual in ADHD, and also literature that this symptom is responsive to stimulants.
That fits with reports I have had from ADHD individuals that they note an improvement in visual acuity after starting stimulants.

Now the bottom line of this is that serious brain tissue damage is relatively uncommon.
Most of these problems are what is called “functional brain disorders”- which means that they are effectively self maintaining loops of unhelpful activation patterns.

We have not had effective treatments for these problems until recently, but there is now a field growing called “functional neurology” or applied “neuroscience”. It has been pioneered by a chiropractor called Ted Carrick in the US. His major interest focus around serious head injuries, but his team are working with a wide range of disorders, getting substantial improvements in functioning in conditions clinically intractable.

This work has been gradually improving me over several years– but my situation has been complicated by decades of neglect – leading to significant spinal issues- widespread osteoarthritis and instability; severe clumsiness and oculomotor problems, episodic and unpredictable severe fatigue and a chronic pain syndrome involving my right upper back.

Now 2 weeks ago I was taught (as a practitioner) an attentional gating exercise for chronic pain. That worked so well that I was able to largely unlock my back and adopt a straighter posture, then within a week able to re-stabilise my neck, with massive improvement in visual clarity, and in co-ordination and spatial perception.– all due to that improved proprioceptive input. Strength at the gym improved enormously because of the better muscle co-ordination.

There are still a few kinks to be ironed out- but they are now manageable.

It has taken 7 years from the initial neck treatment, and a great deal of patience to source the right sort of treatment.

However, I am now juggling with a model of ADHD as a functional problem involving a series of self maintaining feedback loops- some of them operating across a number of levels:
ie neurological-musculoskeletal behavioural-interpersonal autonomic- behavioural etc.

the next step becomes one of formalising a way to systematise looking at the feedback loops.

 

 

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