Excerpts from the transcript from online Conference with Dr. Paul Elliott on ADD/ADHD in Adults.

Ed Note: The internet is an excellent source of information and one way to get that information is to "chat" with others. Concernedcounseling.com is a web site which provides a weekly forum for discussions and they invite an expert to field questions from anyone for a couple of hours. Attendees submit questions in writing and a moderator selects those to be answered by the guest. I have observed from 10 to 30 people participating in sessions such as this.

The site subjects cover a wide variety of medical conditions. These excerpts are from a forum on Adult ADD.

Wednesday, October 29, 1997

Bob M is Bob McMillan, editor of our online magazine CCI Journal. Dr. Elliott is an ADD expert & family practitioner.

Concerned Counseling holds online conferences every Wednesday night starting at 8 p.m. CST, 9 p.m. ET and 6 p.m. Pacific. They are free!! and we'd love to see you there. We post the upcoming guest in our "What's New" section. (You can join one by logging onto the internet site www.concernedcounseling.com and following the instructions to the conference room. The site also has non-chat information.)

BEGINNING

Bob M: Our topic tonight is Attention Deficit Disorder in ADULTS. We are very lucky to have as our guest, Dr. Paul Elliott, M.D. Dr. Elliott has spent the last 20 years working with over 2,500 ADD/ADHD patients, so he has obviously gathered a lot of knowledge on the subject. Dr. Elliott also has some very strong beliefs in how ADD/ADHD ought to be treated. Good Evening Dr. Elliott and welcome to the Concerned Counseling website. Can we start off by having you tell us a bit more about your expertise?

Dr. Elliott: I'm a family practitioner in the Dallas area. My interest in the subject was fostered by having a younger brother severely affected by ADD. His was the non-hyperactive form: He was a mechanical genius who could not pass a 10-word spelling test in school. This was in the 1970s before the term "ADD" was ever coined. I finally figured out what he had and in the process became very much more aware of ADD than most people in the field. I actually almost learned about it by "accident," so to speak. Over the years I have improved immeasurably in my understanding of the various presentations of ADD throughout the age-span. I am very grateful to my patients and their parents who have taught me what ADD is really like and how best to treat it.

Bob M: Because this is a conference on adult ADD issues, does an adult initially develop ADD in childhood or is it something that can also pop up in adulthood?

Dr. Elliott: I believe ADD is genetically determined. I am also of the opinion that no one outgrows it. However, it can change, and sometimes dramatically, from one age in life to another. Though it is genetically determined, it's manifestations throughout life can be materially influenced by one's life experiences. An example would be one in which one person grew up in a very abusive family environment vs. one who grew up in a very supportive one.

Bob M: Does a person need to have all the symptoms to be diagnosed ADD/ADHD?

Dr. Elliott: No, especially for adults. In adults the impulsivity and hyperactivity list probably will be revised so not as many criteria must be met.

Russ S: Question: I have spent the last 2 months and over $1000 trying to get treated for what I suspect is ADD. So far I've been told I'm (pick one) bipolar, OCD, and one fellow suggested I take Prozac for a year then revisit the ADD. When I call Drs to see if they are knowledgable about ADD, their secretaries always say "yes" but when I get there, I find out that I know more about ADD and treatment than they do.

Just how does one find a knowledgable doctor?

Dr. Elliott: Unfortunately, Russ, you are describing a distressingly common story. This is a consumer driven movement. I have reluctantly come to the belief that we professionals have become part of the problem of getting a good diagnosis and good treatment rather than part of the solution. The list of reasons is myriad, but I simply encourage patients to keep searching. Sooner or later, most can find someone who really does know how to treat it, and who isn't frightened by the Class II meds. While you may have all these conditions, you may only have ADD, since all the symptoms you mention are often manifestations of ADD.

Bipolar disorder does occur 2-3 times more frequently and for ADDers, it can be treated simultaneously. Many physicians are very unsettled at that thought, however, unaware that it can be done with good patient safety. My suggestion on your next call to a physician's receptionist is to ask her, "How does the doctor usually begin treating ADD? What medications does he/she usually start with, etc.? This way you may save yourself some frustration.

Samantha Travis: I have wondered if maybe some herbs could replace medication. Has anyone done studies on this?

Bob M: And what about natural medications in general to treat add/adhd? Do they work in your opinion?

Dr. Elliott: I suppose just about anything has produced excellent results for the occasional patients. When these work well for a patient, I urge them to continue what's working. However, I've found them to be of little benefit for most patients. So far, the herbal remedies as replacements for the prescription medications have been a disappointment. Several years ago I tried them out and came back to the stimulants for the simple reason that the RXs work better for most patients.

Thepro: Are food allergies a possible cause of ADD?

Dr. Elliott: Food allergies, as well as other allergies, can certainly make ADD symptoms worse and alleviating them will help, often a good bit. But allergies don't cause ADD, therefore clearing them doesn't relieve the whole problem. ADDers have more allergy problems in general than do non-ADDers and the stimulant medications help a lot, not only because they have a good decongesting effect themselves, but because they grant the patient a smoother control of internal body control mechanisms, as well.

Bob M: One point I want to touch on, last night when we were talking you mentioned that there were some positive aspects to having ADD/ADHD. I'd like you to touch on that please.

Dr. Elliott: Statistically higher IQs; Superior "wiring" for creative thought; excellent ability to handle serious emergencies extremely well, just to mention a few.

Bob M: On the flip side, you stated that ADDers are more likely to suffer from depression and are more "successful" in committing suicide. Why is that and what should family members or friends of ADDers be looking for or aware of in this regard?

Dr. Elliott: The suicide may be a very impulsive, though all-pervasive thought. When this combination exists the "success" is more likely, I feel. I don't believe that depression necessarily has any different "face" in any population, so the usual observations and considerations about depression apply here, too. I do feel that depression in the ADDer may accelerate more rapidly than in the non-ADDer, but I've never seen any studies to support this.