Thursday, December 28, 2006

A Review of "ADD: Practical Coping Methods" by Barbara Fisher

Although a lot of books have been written on ADHD there are very few books that focus on Inattentive ADHD.

Best sellers like Driven to Distraction usually devote a few pages to discussing this disorder and often leave the reader confused about which type of ADD the author is referring to.

In ADD: Practical Coping Methods, Barbara Fisher, a neuropsychologist, takes an in-depth look at the differences between ADHD Inattentive type and the impulsive/hyperactive type of ADHD.

A summary of Fisher's desricption of the two types of ADD can be found here.

According to Fisher, Inattentive ADHD is an anxiety driven disorder. People with inattentive ADD tend to have introverted personalities and are physically restless because they have high levels of anxiety. This helps explain why many people with ADHD Inattentive type have a poorer response to stimulant medications than those with classic ADHD. The boost in concentration that stimulants provide is often undermined by increased anxiety and muscle tension.

Fisher claims those with ADHD have a profound problem with impulse control, which is not shared by those with inattentive ADD. Genuine hyperactivity in ADHD is caused not by anxiety, but by problems with the frontal lobes of the brain, which encourages people who are impulsive and hyperactive to seek out novel, dramatic or dangerous situations.

Fisher claims that many people with inattentive ADD are being misdiagnosed because their restless anxiety is being mistaken for impulsive hyperactivity.

From the perspective of someone with inattentive ADHD, Fisher's book is the best on the market, simply because there aren’t any other books which devote as many pages to discussing this type of ADD. The only book which comes close is Sari Solden’s Journey’s Through Addulthood.

Fisher’s book does have some shortcomings. For example, she suggests that people with inattentive ADD should take calcium with stimulants to reduce anxiety, despite the fact there are no scientific studies (as far as I know) that support this idea. Fisher is no English major and her prose is pretty stiff and awkward at times. She is also unable to explain why some people with inattentive ADD appear hypoactive and don’t seem to have significant problems with anxiety.

However, Fisher’s book is clear and well reasoned and unless someone comes up with something better it will remain the best book on inattentive ADD for some time to come.


AlvaroF said...

Hi Mike,

Just responded to your comment in our blog (you left it in our old URL, so I just moved it to the new one)

Also, in this post you refer indirectly to the role of anxiety. Being more familiar with a) working memory issues in the context of attention deficits, b) the need for anxiety and stress management overall, can you suggest good resources on the role and implications of anxiety in this domain?

mike said...

Hi, thanks for the comment.

I'm not an expert in this area so I don't have a record of alot of the material I have read. Subsequently, I can't provide references to specific papers.

My viewpoints are based on general reading over the years and personal observations/experiences.

However, Fisher has produced another book, which I think is called "the misdiagnosis of add", which has alot of references on this topic.

Another ADD expert, John Ratey, is also an expert on anxiety disorders and has written a popular book called "worry", which discusses the link between the two disorders.

I think Russell Barkley was the first expert to identify inattentive add, and he discusses the of comobidity of anxiety disrders and add in his publsihed material.