Concussion and ADHD

Nearly every single day someone walks into my practice and says, I’ve got issues with focus or concentration. I feel like I’ve got ADHD. Now, the interesting thing is I’ll ask them, Well, have you had this since you were a little kid? Like five or six? Well, no. Well, when did this start? And depending on the patient, it started in high school, it started in their 20s, or even in their 30s. Now, it’s pretty odd for ADHD to start at that different points of your life like that. Now, there’s a common onset that is typically always ignored. But first, ADHD, how is it diagnosed?

Let’s say you’ve got a kid who’s being diagnosed with it. How was that diagnosis even reached? Well, it’s basically an observation-based diagnosis. So the parents are handed a questionnaire, teachers are handed a questionnaire and the provider says, based upon these, it appears your kid has ADHD. Now, if you think about it, that’s a pretty awful way to come up with a diagnosis. Do you really want to be on medications that alter your brain function and can come with unwanted side effects unless you really have to?

What is ADHD?

ADHD is a brain-based issue, there’s a problem with how the brain is connecting. So what can impact how the brain is connecting? Well, you’ve got diet, sleep, you’ve got medications, environmental exposures, and more. But there’s one major thing that is routinely ignored. And that is concussions. Concussions commonly occur in sports, in car accidents, or in slip and falls. I routinely get patients who come in, and they’re like, well, I, I started with my ADHD, my junior year of high school.

What happened before then? Well, I was actually playing football, and took a concussion or had my bell rung pretty good. And after that point, I then got put on Adderall or Ritalin or Vyvanse, or one of those many medications used for ADHD. It helped some but not fully. So that’s not true ADHD. That’s a problem with how the brain is connecting and is the result of a concussion. But unfortunately, concussions are very poorly evaluated and the diagnosis is routinely missed, despite needing to have been diagnosed based upon their symptoms and how the injury occurred. So if you’re feeling like you’ve got ADHD, but you’re struggling with focus, concentration, and there was a whiplash injury, a car accident, slip, and fall, or possible concussion, having the right evaluation lets you know if it’s truly ADHD or if there’s another reason why it’s occurring.

Even if there’s not necessarily another reason, your brain should always be looked at if you suspect ADHD because it is a brain-based issue. And not just something that can be evaluated using questionnaires.

How We Evaluate for ADHD

Evaluating for ADHD should involve looking at the brain. Yes, questionnaires should be part of the evaluation but to only use them is very incomplete. Utilizing brain wave testing through a QEEG is one way. There are patterns of activity suggestive of ADHD or not. Eye movement testing using a VNG/VOG is another way. It is very easy to feel like you have ADHD if you can not keep your eyes still on a target. You will often feel better if you are shifting your attention. Lastly, balance testing should be performed. The integrity of your balance system is crucial to brain development. If the brain has not developed appropriately ADHD is a manifestation of that.

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