ADHD Diagnoses More Common in Youngest Kids in Class

Children who are the youngest in their class are more likely than their older classmates to be diagnosed and given medication for attention-deficit hyperactivity disorder (ADHD)—suggesting that immaturity may be part of the problem, not ADHD.

The finding is from a study of more than 900,000 Canadian children aged 6 to 12, and it dovetails with two U.S. studies that found the same thing in 2010.

In fact, the youngest boys were 30% more likely than their oldest classmates to get an ADHD diagnosis, and the youngest girls had a 70% greater chance, according to the study conducted by E. Jane Garland, MD, a child and adolescent psychiatrist at the University of British Columbia in Vancouver and colleagues.

“The younger children in a grade were significantly more likely to be diagnosed, labeled, and treated with medication for what in some of them must simply be immaturity,” Garland says.

The researchers looked at children born in December, the month before the cutoff date for starting school (in this case, December 31), who were therefore the youngest in their class. They compared those children to youngsters born in January, who missed the cutoff date and so were the oldest in their class—almost a full year older than those with December birthdays.

Of the boys born in December, 7.4% were diagnosed with ADHD and 6.2% were given medication. In contrast, only 5.7% of boys born in January were diagnosed with ADHD and 4.4% were given ADHD medication. Similarly, 2.7% of girls with December birthdays were diagnosed with ADHD and 1.9% were given ADHD medication, while 1.6% of girls born in January were diagnosed with ADHD and 1.1% were given medication.

As for children born in other months, the younger they were relative to their classmates, the more likely they were to be diagnosed with and treated for ADHD. The study, published in the Canadian Medical Association Journal, included 937,943 children who were 6 to 12 years old between December 1997 and November 30, 2008, representing all children in this age group in the province of British Columbia.

“It definitely looks like it’s a real effect, we now have three studies, and it would be good to know more about it,” says Joel Nigg, PhD, a professor of psychiatry and behavioral neuroscience at Oregon Health & Science University in Portland. Nigg studies ADHD, but did not take part in Garland’s research.

Diagnosing ADHD can be tricky. For one thing, problems with attentiveness and hyperactivity fall along a continuum, says Garland. “The symptoms of ADHD are very nonspecific,” she says. “If someone is tired or they haven’t eaten breakfast, they’ll be fidgety and unfocused.” There’s no lab test that says yes, you have ADHD, or no, you don’t, she notes.

Should I Slash My Salt Intake?

The internist says:
Donna Sweet, MD, Professor of Internal Medicine at the University of Kansas School of Medicine in Wichita

High-sodium foods increase blood pressure—whether you’re among the one in three Americans who has hypertension or not. That’s why the new federal dietary guidelines recommend lowering sodium intake to 2,300 milligrams a day from the 3,400 milligrams most of us eat daily. If you already have hypertension, the recommendation is 1,500 milligrams a day, since research shows there’s a substantial drop in blood pressure when you reduce sodium intake to that amount.

We could all stand to try. I’m not going to tell someone with normal blood pressure to cut sodium to 1,500 milligrams a day—yes, it’s ridiculously low. But I do think we should all be eating less than 2,300 milligrams and definitely no more than 3,000. Just because your BP is normal now doesn’t mean it will be forever—your risk of hypertension increases dramatically with age. 

It’s easier than you think. If you eat a lot of anything, your taste buds become desensitized to it. People who have a lot of spicy food, for instance, become desensitized to hot peppers. Studies show if you cut back on high-sodium foods, you eventually don’t need as much to make food taste good. In fact, after about a month—the amount of time it takes to retrain your taste buds—you won’t even miss it.

The dietitian says:
Joan Salge Blake, RD, spokesperson for the American Dietetic Association and professor of nutrition at Boston University

It depends on your numbers. If your blood pressure is low—and some people are just genetically predisposed to having low BP—you don’t need to radically cut back on sodium. But that doesn’t mean you should start eating more salt; 2,300 milligrams is still a good target. (Talk to your doctor, of course, if you’re experiencing side effects like lightheadedness or fainting, which could mean your blood pressure’s dangerously low.)

Salt also affects your waistline. Sodium’s like a dry sponge; it attracts water. The more of it you consume, the greater your risk of water retention and uncomfortable bloating. Plus, getting too much salt may mean you’re not eating enough fruits and vegetables, which are naturally low in sodium and good for your heart and your weight. 

Cutting back on sodium-filled restaurant foods helps a lot. Try ordering entrees with more vegetables and less meat, like pizza with peppers instead of pepperoni—you’ll get more fiber, lots of flavor, and less salt. And watch out for sauces and marinades, which can be high in sodium. 

Our advice:
Know your numbers. If you have low or normal blood pressure (120/80 or less), keep your intake at 2,300 milligrams a day. If your BP’s high (140/80 or higher), try to lower sodium intake to 1,500 milligrams, which is actually the American Heart Association’s recommended upper-limit intake for everyone. A good starting point: Cook fresh, whole foods at home. No one expects you to reach the 1,500 mark—or even 2,300—overnight, but for most people any reduction is better than none. 

How can struggle with depression (new Article)

With the economy stuck in neutral, people have more reasons to be depressed—and less money to treat their depression—than in the past.

The cost of medication and talk therapy add up even if you have health insurance—and more than 46 million people in the U.S. (and counting) do not.

If you’re depressed, and especially if you have bipolar disorder, lifestyle changes and other do-it-yourself strategies are not a substitute for professional help. But even if you are already taking antidepressants or seeing a therapist, there are many things you can do to help yourself feel better—and they don’t cost a dime.

What Is Postpartum Depression new Article

Postpartum depression is a serious illness that can occur in the first few months after childbirth. It also can happen after miscarriage and stillbirth.
Postpartum depression can make you feel very sad, hopeless, and worthless. You may have trouble caring for and bonding with your baby.
Postpartum depression is not the “baby blues,” which many women have in the first couple of weeks after childbirth. With the blues, you may have trouble sleeping and feel moody, teary, and overwhelmed. You may have these feelings along with being happy about your baby. But the “baby blues” usually go away within a couple of weeks. The symptoms of postpartum depression can last for months.
In rare cases, a woman may have a severe form of depression called postpartum psychosis. She may act strangely, see or hear things that aren't there, and be a danger to herself and her baby. This is an emergency, because it can quickly get worse and put her or others in danger.
It’s very important to get treatment for depression. The sooner you get treated, the sooner you'll feel better and enjoy your baby.

What causes postpartum depression?

Postpartum depression seems to be brought on by the changes in hormone levels that occur after pregnancy. Any woman can get postpartum depression in the months after childbirth, miscarriage, or stillbirth.
You have a greater chance of getting postpartum depression if:

• You've had depression or postpartum depression before.
• You have poor support from your partner, friends, or family.
• You have a sick or colicky baby.
• You have a lot of other stress in your life.

You are more likely to get postpartum psychosis if you or someone in your family has bipolar disorder (also known as manic-depression).

Magnet Therapy & May Ease Hard - to-Treat Depression Article

MONDAY, May 3 (HealthDay News) — Using magnets to stimulate the brain may ease depression in people who have not found relief from antidepressants, new research has found.
“We have settled a fundamental question about [transcranial magnetic stimulation, or TMS] therapy, which is: ‘Does it work?’” said the study’s lead author, Dr. Mark George, a professor of psychiatry, radiology and neuroscience at the Medical University of South Carolina. “The answer is ‘yes.’”
The researchers administered the magnet therapy to half of a group of 190 adults who had been depressed for at least three months, but not longer than five years, and who had taken medication for depression but were not helped. The others were given a sham treatment — simulated magnet therapy that was mostly indistinguishable from the real thing, the researchers said.
After three weeks, about 14 percent of those receiving magnet therapy were no longer depressed, compared with 5 percent who were getting the fake treatment.
The researchers continued the magnet treatment for three more weeks for those who were still depressed and also offered the real treatment to participants who’d gotten the sham treatment.
After that period, about 30 percent were no longer depressed, the researchers said.
“In a rigorous, industry-free multisite trial with a convincing sham, we found unambiguously that TMS worked better than the sham. It’s watershed,” George stated.
The findings are published in the May issue of Archives of General Psychiatry.
Psychiatrists have been interested in the possibilities of treating depression with magnet therapy for more than a decade, the experts said. Magnets are believed to work by creating electrical currents in the nerve cells in the left prefrontal cortex, a region of the brain involved with regulating mood. The current may jump-start the area, which has been shown to be underactive in people who are depressed, George said.
But testing magnet therapy has been difficult. “Double-blind” studies, in which neither the researchers nor participants know who is getting the real treatment and who is getting the fake, have been difficult to carry out.
The current study overcame that by creating an elaborate sham. During magnet therapy, participants were painlessly zapped by a pulsing electromagnetic coil 3,000 times over 37 minutes. The current created a head-tapping sensation that some people said reminded them of a woodpecker, George said.
The coil, which is aimed at the brain area to be stimulated, creates a magnetic field that passes through the skin and skull, inducing an electrical current in the brain.
Participants receiving the sham treatment felt the same head-tapping, but a metal insert below the magnet blocked the magnetic field from entering the brain while electrodes on the scalp delivered the tapping sensation.
Using electrical current to treat brain disorders has been around in some form since the 1940s and 1950s, said Tony Tang, an adjunct professor in the psychology department at Northwestern University. However, electroconvulsive, or electroshock, therapy can induce seizures, and some studies showed it might cause memory loss and brain damage. Though effective in some people, electric shock was viewed with suspicion by the public, and today is used only as a last resort, Tang said.
Magnet therapy is essentially a much gentler, less invasive form of electric shock therapy, Tang said.
“Transcranial magnet therapy is one of the most exciting new developments in our field,” Tang said. “There are new drugs coming out every year, but they are all fairly similar to each other, and we don’t see much difference in efficacy. With TMS, the mechanism is completely different. It’s a very, very safe and gentle, noninvasive way to do electric shock therapy.”
In 2008, the U.S. Food and Drug Administration approved the marketing of a device used for magnet therapy to treat depression that is considered mildly resistant to treatment, according to background information on the study provided by the U.S. National Institute of Mental Health, which funded the study.
The next step, the researchers said, is to fine-tune the treatment to determine if higher levels of magnetic stimulation or changing the location of the magnetic coil might be even more effective or if magnet therapy might work best in conjunction with medications.
In the study, the only significant side effects were headaches and mild discomfort at the stimulation site. Most participants remained depression-free for several months after treatment stopped, according to the study.
More information
The U.S. National Institute of Mental Health has more on depression.
SOURCES: Mark George, M.D., professor, psychiatry, radiology and neuroscience, and director, Brain Stimulation Laboratory, Medical University of South Carolina, Charleston, S.C.; Tony Tang, Ph.D., adjunct professor, department of psychology, Northwestern University, Evanston, Ill.; May 2010, Archives of General Psychiatry