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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One Response to ADHD as a model of functional disorders.

  1. Nathan C says:

    Gidday Doc,
    You have blown me away with all these posts you have made. For some time now I have been trying to find answers to ALL the problems I have started to have happen to me. Ok many of the ones you describe were and are still a lot I have today but here is in a short story my life as a now 32 year old male diagnosed at 3 years old with ADHD.

    I was that kid who would be found having to sit in the corner and face the corner but still managed to keep putting my head in a position to look around and get myself into more trouble, no matter how much trouble I KNEW I would get myself into the excitement I wanted to entertain far outdated the care of a hiding with a plastic spoon across the backside. I was the kid that if you told me I had to do something I will make sure I do the opposite. I could not concentrate on the things most others seem to be able to. I could not play sports well like many others were able to, I was the one that was always the class clown and enjoyed making fun of people and mostly myself. One day I was around 11 or 12 and I was with my class on a sports day and our sport for that day was tee ball. I watched every kid go before me and so I could watch and absorb every move to be certain I was going to hit this ball which for most seemed effortless. So now I am the last person left having to have a go so I tried to get out of it by being a clown but nope I had to go up and do it so I lined it up and I was certain I had everything perfect for just even enough to make this ball go ten meters and I swung away and I missed this ball which was right there in front of me. One of the boys in my class I heard laughing and starting to say something I did not like and here I am a kid with adrenaline which was sooo furious and now wound up and hit that point of no return. I lined this kid up and belted him across the eyebrow with this bat and then I had the teacher trying to grab hold of me while I was in a rage of anger. I managed to avoid her and I saw a plastic fork on the ground and I immediately grabbed it and I remember stabbing this poor lady in the foot with this fork. I mean who as a child does these things?? I am still to this day constantly having people take the things I say in the wrong way or I perceive their own thought the wrong way so I find myself in soo much conflicting situations and fights which I used to really enjoy. I always wondered why I have found balance to be soo difficult and dancing, a girl asks me to dance and I will send her to get a new boyfriend hahaha and I knew in my head I did not want to do it because I have such terrible coordination and I just look like something not from this world. So growing up I struggled with school work as I could and still can’t read well and have to keep reading the same thing over and over to get it in my head to make sense, so this reading to me is just Ann absolute Drag!!! Now you show me something one time and you will never have to show me again!!
    So I am the person who would prefer to go to YouTube and watch interesting things. I was never good at many things so many others were but I find the one thing that I loved as a kid was hard manual labour and when I was expelled at the end of grade 7 I went to work and I started working as a brockies labourer and I was always had good definition in my pecks triceps and the muscles across the top of my shoulder blades. After five years of this I went on concreting for a couple of years but I would always be thinking of my one true passion which was only a Hobby. I was always pulling things apart as a kid and I mean everything. I could not get given something and be in trouble only a couple hours maybe days if I was lucky later from my mother finding it stuffed in my coup board into as many pieces as I could pull it apart to. I would try so hard to put it back together but I could never seem to remember them all and especially things like remote control cars which I one day got for a present and apart it went and bin was to follow only a few days later and I never even got to use it NOT ONE TIME. . Well I must have been about 14 by this time where I had developed a way that I would remember everything and anything I pulled apart and always things would go back together and I always had so many different projects and things I would start but never did I finish them, the only ones I really finished were the ones which had mechanics involved. I do not know what it is but it has always been that one thing I am good at which we all seem to have that one thing we just have to find it.
    Recently since Christmas I have went down hill really bad I started to get a really horrible itch when I would get home from work and take my boots off and socks and my lower legs would get so itchy it was so so sooo intense and nothing stopped it, that was until I said to myself if I turn the shower onto just hot and just get under it maybe I can burn it and it may stop. I got it all ready and psyched myself up and boom in I went and the heat was intense and surprisingly the itching as it was being burned by the water it faded off and as soon as it stopped I would turn the shower to a normal temp and have the shower and get out and this went on a few times and then I thought what if I just use some deep heat cream rather then burn the daylights out of my legs and again I found a remedy to stop the itching after a while which was about a month later I said to my doctor who thought I had gone mad after I told him what I would do to stop it until the deep heat cream and he told me to try a steroid cream which was actually for a small ring worm from the hospital I just picked up as I had started getting a bit of chest pain this one day and I told him of the itching and he said to try the cream and we’ll when I did about a week went by and I noticed the itching had not gotten any better and I fact it got worse.
    I was now having an itch here there and everywhere and I had always for years now had many things where I would be aching and my lower back was one I delt with for years now and when I went to the chiropractor he would give me many different treatments and all only helped the first few times and after a few MJ ths it would never improve and only seemed to aggravate it well very recently this lower back pain is now felt half way up my back and I can’t feel down at the bottom at the L5 which was where the chirp said I had a slipped L5 (though I could not see any difference on his screen when I looked after he pointed to me. But anyways I done as he said for many moths and I found it was no better off. I started getting sick and I started noticing myself pouring cereal in my coffee and as time went on over the next two months I noticed I could not keep my head together, I was forgetting so many things and still am now, I am getting angry again and upset with everyone as I can’t understand why they are not understanding the things I tell them that I have pain in now my upper right back around my right shoulder blade and it is at times swapping the pain to the other side I even have so many times I lose my breath but his is like a feeling of instant breathlessness with a sting at the point my breath is if that makes sense. A more th after my legs started to itch the left one at the ankle swelled up bad and they thought was cellulitis which they gave me a course of Cephalexin which did not help and then the swelling would go away and then return and this would then start happening to the other leg and then went onto being both and then it was both legs and stayed swelled up instead of going away a few days later and now I have not had swelling there for a while well not as bad as it had been prior. But I still get a feeling of water running down my lower legs and posture had always been terrible with me too but this chest lain is crazy and then I started to cough up blood and I was getting a taste of blood in the back of my throat before this and been to see everyone under the sun and blood tests and soo many things and listened to these doctors call me a liver and that i am being paranoid, let me tell you this pain in my upper right back is sooo excruciating and when he said to me have you ever thought maybe that pain is supposed to be there. I got up and I tensed up I was so close to punching him for that comment and I walked out of there. So since even my family has given me signs that they are maybe in a bit of disbelief because I have been to the hospital soo many times and come back with nothing. I spent the night in hospital again the other night while hey done another lot of blood tests and an X-ray on the chest and told me they are normal and I told them all the symptoms I am having and they just look at me and give me a piece of paper saying discharged. I feel I have something really bad going on and I can’t figure it out. I have however recently noticed I was living in a house where it had a dark blackish coloured mold growing which I was sick of trying to clean up all the time and I also had been and still am working on a boat which also has mold all through the engine room and when there I feel like it is attackkng me it is such a strange thing to say I know but it is the truth and then I get so sick I can’t move by the end of the day.
    I keep falling asleep when driving now. I fell asleep yesterday driving my car and I woke up from the change in height I just experienced which was my van going up the median strip. I was so frustrated with myself and I just feel so normal at times and then BAM I have my body just get a feeling come over it and my body is instantaneously heavy and a tiredness which I can’t stop!!
    All these things have been checked for diabetes negative X-rays all over and nothing, ultrasounds nothing, ct scans nothing.
    Nothing is making sense anymore and my memory is not what it was. I started my own business as a mobile mechanic 2 and half years ago and business was really booming and going well until this and I started to notice myself where my way of diagnosing a vehicle I would forget steps and I would have to go back to the start again and other times eve thing I couldn’t work out why they were all taking me so long to complete. And then I started to notice when I was writin parts down I would write the name and then the number of the part down and it can range say from 4-10 numbers let’s just say and I would look down real sure of it all too and wrote it in as I said it in my head and went onto the next one and then something clicked in my head and I said to myself that last few numbers did not look right and I went and had a look and the last few I had mixed the numbers up?? None of these things were things I would do before.
    Look mate I am lost and I am depressed more then ever as I can’t work anything out and I can hardly get my head together anymore to go to work and I am always getting side tracked my entire life but now OMG!!!! It is crazy side tracked now. I don’t know but I was looking into mold exposure based on the things they mention and I am always looking for things to make sure I am right and I found these articles of yours and it blew me away and now I wonder could all these things be the facts of your articles and that I am just having the sensory issues you say and all the rest? I do not know what else to do mate.
    Anything that will help me I would really appreciate it as it is getting in the middle of my life and I can’t sleep from pain and also I can’t ever switch my head off anyways and now since January I rarely can sleep only pass out the way I said or I am up at night and sleeping in during the day and I miss all my appointments now and just everything in my life and my body is going mental. I have lost so much weight and as soon as I start to put it on again I seem to lose it, though I could never get over 65 legs my entire life from a teenager until 2016 when I put weight on and got to 82kgs though that was after three years in prison from a life of drugs being at this particular time I’ve followed by oxy Contin and this has been my life as far as I can remember being on some kind of drug and I tell you now I am very aware of the things that amphetamines can do but I know my body so well with these drugs and I know for a fact that these things started to happen to me long before I even started to use any drug at all as I was clear of anything for about two years and I ran out of options and started to feel backed into a corner by the ones I am meant to turn to for help with medical needs and I am told it is drugs when I tell them I am now taking something but I never before which they think I am just lyjng about which is so hard to cope with but I just need answers to the truth of what this is all from. So this is the absolute truth and anything you can offer and suggest to me I am open to take on and put into practice. Also one last thing is that my vision is going all blurry and noticing my left eye twiching all the time but both seem to have started this way few months ago but the left eye is the one I seem to notice having more issues. Also getting a lot of double vision.
    Last thing I forgot to say which is to me important, my legs and my hands and my arms are always going numb lately and really really intense cramping of lower legs around the kneethrough my calves muscles and then to my toe which is like I have got a toe cramp but I recently noticed my calve was pulled even tighter then usual. Now I can’t even stay in the cold section too long at the shops cause I cramp up bad and look like a weirdo so I am in and out. That is all for now.
    Thank you for your time

    And I am sorry if this bores any of you and I know it would bore me if it was not something I wanted to know and learn so hopefully this will not be looked at in a bad way as I am just trying to give you a full understanding as best I can.

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