vrijdag 28 november 2008

Time Management

Talk notes by Maureen based on
The secrets of those who have more time then others by John Ellis

How many of you need more time? Does anyone wish that they have more time in their daily lives to get everything done? Today our worst enemy is lack of time, especially in urban and industrialised societies. We experience the urgency of things in our rapidly changing environment and mobile workplace. Modern gadgets have allowed us to communicate more rapidly and improved social connections. It is, therefore, important to organise our lives in a practical way in order to react rapidly to important decisions which affect our lives. Time does not change but the use of time varies from individual to individual. The first priority is to have a positive attitude towards time and see it as our friend. Create an inspirational and passionate vision. And spend at least 50% of our time on these activities Instead of drowning in an ocean of information, we must become selective in using this information and take as little time as possible in finding information.

I would like to share with you the "Secrets of those who have more time than others."

I will tell you about time and life-management; setting priorities and objectives, planning and time-management at work How to fulfil a number of objectives in a limited time.

Time Management:

The first thing is attitude - make a friend of time – it is not your enemy.

1. Consider your objectives as non-negotiable goals

2. Fix a deadline to realise your objectives

3. Be realistic and foresee unforeseen events

4. Be aware of your work style

5. Know your environment or workplace

6. Plan

Evaluate precisely the time required to carry out a given task taking into account unforeseen circumstances and delays.

Setting Priorities and Objectives:

Classify your tasks into four groups and make a list of the most important:

1. Important and Urgent

2. Less Important but Urgent

3. Less Urgent but Important

4. Less Urgent and Less Important

How can we create more Time?

By eliminating time thieves:

- TV and Radio

- Telephone

- Waiting in queues

- Traffic-jams

- Avoid excess

- Managements of e-mails

Create FAQs, brief replies use the telephone, block spasm,


Time Management at Work:

Work faster

1. Do not accept more than you can manage

2. Organise your documents

3. Move

4. Sleep sufficiently

5. Use tools which help you to gain time

6. Eat a light breakfast

7. Delegate: cleaning, shopping, cooking, repairs, gardening, preparation , writing, creation of a website,


I have spoken to you about time and life-management; managing your life; setting priorities and objectives; planning and time-management at work Time management is not difficult to learn. The first priority is to manage our attitude towards time, to see it as a friend and organise our lives to be effective at each moment.

I hope these tools will help you to manage your time and enjoy more free time


maandag 24 november 2008


By Werner Van den Bergh, neuro-psychiatrist in Leuven

click here to read this article in the original Flemish

A major reason why many people, including some scientists, hesitate to prescribe psycho-stimulants is the fear of possible addiction, especially following prolonged use. On the other hand, quite a few doctors often prescribe these medications but with inadequate up to date knowledge of new research, so that they cannot make the best possible defence against there critics. This article reviews some surprising and counterintuitive research, and is intended not just for lay people but also many professionals.

Addictions to alcohol, nicotine, amphetamines (speed) and cocaine occur in people with ADHD twice as often in the general population. This may be partly genetically explained. A gene produces the protein that forms the dopamine-2 receptor on the "postsynaptic" neuron in the striatum of the midbrain (postsynaptic refers to the neuron terminal after the synaptic cleft or gap between the two neurons). This receptor receives dopamine from the presynaptic neuron. The gene exists in two forms: A1 and an A2 type. The A1 type occurs in 20% of the general population, but in 50% of people with ADHD and in 87% of cocaine addicts. It is known that not everyone who smokes cigarettes or drinks alcohol becomes addicted; moreover that only 25% of cocaine users become addicted. Genetic factors could therefore play a role. Moreover, the impulsiveness of young people with ADHD and their feelings of awkwardness about themselves often lead to experimentation with drugs, which they experience as a form of self medication. People with ADHD often think more clearly and become calmer after taking amphetamines rather then feeling the’ high’ experienced by people without ADHD.

Schematic diagram of a synapse, showing, at the top of the diagram, the terminal of the presynaptic neuron where dopamine (DA) is released into the neighbourhood of the postsynaptic receptor D2 at the bottom of the diagram.

Dopamine is competitively taken up by the DAT transporter in the presynaptic neuron. Ritalin, amphetamine and cocaine block the presynaptic DAT-transporter so that more dopamine remains available in the synaptic gap to stimulate the post synaptic neuron.

It is a paradox that ADHD is often treated successfully with Ritalin or amphetamine, without addiction developing, despite people with ADHD being at a greater general risk of addiction. There are even studies that demonstrate that children with ADHD who have been treated for some years with Ritalin have a lower risk of ever developing any addiction then children with ADHD who were not treated with Ritalin. The information flow in neuronal circuits is achieved by electrical potentials that spread along the axons to the presynapse at the terminal where it is carried by neurotransmitters such as dopamine.
Dopamine then binds to a receptor on the postsynaptic terminal of the next neuron in the circuit .This triggers the ‘ion channels ‘in the post synaptic membrane to open, temporarily allowing electrically positively charged calcium ions to flow within the neuron. The change in charge leads to the generation of a new electrical action potential responsible for further postsynaptic information flow.

It is remarkable that Ritalin has much the same effect on neurons as cocaine: it blocks the dopamine receptor on the presynaptic nerve cells that normally re-uptakes the dopamine. Indeed, it been shown that a large group of people with ADHD had too many presynaptic dopamine receptors, thus too little dopamine was available in the cleft to excite the postsynaptic neurons.

Ritalin normalizes this so that the ADHD symptoms diminish. Not only improving focus, but boring tasks are better prioritized (e.g. revision) and impulsiveness is reduced.

Cross sectional image using Single Photon Emission Tomography (SPECT) of the brain of a person with ADHD. A radio nucleotide is introduced into the bloodstream, which binds to presynaptic dopamine receptors in the striatum.

The image on the left shows a greatly increased signal in someone with ADHD (yellow in colour) in the striatum of both hemispheres. On the right, imaged sometime after the administration of Ritalin. The colour is faded: this demonstrates that Ritalin blocks the presynaptic dopamine receptors and thereby normalises dopamine transmission to levels comparable to people without ADHD.

Why is it that someone with ADHD, who normally runs an elevated risk
of addiction, is helped by Ritalin or amphetamine without becoming addicted to the medication? And why, then, are there problems with cocaine addiction? The answers are many:

1) In ADHD the amount of dopamine available in the synaptic cleft is
NORMALIZED (whereas as in people without ADHD Ritalin increases dopamine abnormally).
2) Cocaine is usually inhaled or injected giving a very quick dopamine increase (peak effect after 5 minutes) and a "high" feeling. If Ritalin is inhaled or injected the same "high" feeling is obtained .In both, the "high" feeling lasts about 20 minutes. If
Ritalin is taken by mouth the peak concentration in the brain lasts about 60
minutes, without any "high”.
3) The peak concentration of dopamine after taking a Ritalin pill occurs after15-20 minutes, whereas for cocaine it is 2-4 minutes. With Ritalin the increased amount of available dopamine in the brains falls to half after 90 minutes, with cocaine it takes just 20 minutes. The rapid reduction after cocaine ingestion motivates the user to take another dose, this is not the case with Ritalin the amount of dopamine remains optimal for a long time. Moreover Ritalin releases the dopamine in a "tonic" way, that is, evenly over time, place, simulating the natural release of dopamine , leading to normalisation If an artificially regulated dosage of cocaine is given so that the dopamine stays saturated then there is no is no new "high".

4) In a therapeutic context, Ritalin is administered using a strict schedule, and is not tied to pleasure seeking. Rather, it is mainly used for boring tasks, allowing a more meaningful experience, closer to that of people without ADHD. Cocaine is used in circumstances of pleasure which in itself is more naturally associated with dopamine release.
5) Cocaine also acts on the serotonin system, which is not the case with Ritalin or amphetamine.
6) "Speed" in illicit use is taken in unmeasured dose but the estimated dose is 10 times higher than for therapeutic use in ADHD. Moreover, the drug user often injects speed rather then administers by mouth.
7) There are indications that Ritalin maybe neuroprotective (at the postsynaptic neuron)
against excitoneurotoxicity a. Also, there are indications that it will protect against deterioration of dopaminergic neurons in Parkinson’s disease. Nicotine is also neuroprotective against Parkinson’s disease and Alzheimer's disease, but, of course the disadvantages of chronic nicotine use outweigh these potential benefits.

Furthermore, there remains the delicate problem of how someone with ADHD who is addicted to cocaine can best be treated. In this area there is still much research to be done, but there are already some publications showing that in some cases it may be possible to replace cocaine with Ritalin.


It is often rightly pointed out that there are no scientific studies on the long-term effects of the therapeutic use of these medications to treat ADHD. Yet we know that almost half of children with ADHD outgrow ADHD and the need for medication.

Traditionally, there was a presumption that the lessening of ADHD symptoms was due to natural maturation so that there was no further need for amphetamine or Ritalin. But recently scientists have begun to entertain the possibility that these drugs produce long-term positive permanent change in the brain, brought about by neuroplasticity, which in recent years has become a hot topic in neuroscience.

continuing use of medication will not only provide better signal transfer in neuronal circuits, but also activate genes in postsynaptic neurons, stimulating the creation of proteins that are the building blocks of new postsynaptic dopamine receptors. Possibly, these proteins also create a decrease in presynaptic dopamine receptors. This would effectively mean NORMALISATION; we could even speak of HEALING. Therefore, it is now recommended to cease medication every 2-3 years temporarily to see if further treatment is needed. LONG-TERM EFFECTS OF RILATINE and amphetamines

Researchers using young rats treated with intravenous Ritalin found that as adults the rats exhibited symptoms of depression, ambient incentives usually experienced as pleasant (such as sugar water) seemed to give them no satisfaction and stressful or conflicted situations produced despairing behaviour. This has led to the view that the neuronal plasticity exhibited here can lead to unfavourable outcomes such as DEPRESSION. If this is extrapolated to humans, it means that after years of

Ritalin use depression could develop. This has not yet been demonstrated by researchers Moreover, there are two important points to make. First, the rats were administered with Ritalin intravenously which is quite different to oral ingestion. Secondly, the researchers used healthy rats. In theory, one can imagine that for people without ADHD this hypothesis of resulting long term depression may have some validity., but that in ADHD a normalization through neuronal plasticity occurs:. Conceivably by this hypothesis in healthy people long term use of Ritalin may lead to the occurrence of a neuroplasticity though over shooting. If that is true great importance must be attached to correct diagnosis of ADHD prior to beginning a long-term treatment with Ritalin or amphetamine.

It is inadmissible to let the decision to begin long term medication depend on the symptomatic effects of trial doses. Medication will, in the short term have positive effects in people without ADHD. It must be emphasized that an ADHD diagnosis cannot be concluded from a positive reaction to a few administrations of Ritalin.


Only with non-therapeutic use of these medications, where high doses are taken, often intravenously, and in the context of pleasure seeking does addiction arise. Often only when a genetic disposition also contributes to the addiction. In the latter case, the chronic overabundance of dopamine would trigger even more postsynaptic protein synthesis and the production of more postsynaptic receptors. Research shows that this occurs not only in the striatum (nucleus accumbens among others) but also occurs in the prefrontal cerebral cortex (orbito frontal cerebral cortex, located above the orbital, i.e. the eye socket) to which it is connected. It has demonstrated that the cocaine addict shows over activity in this area during cocaine intake or during acute rehabilitation.

Imaging using Positron Emission Spectroscopy (PET) of the brain (cross section) of a cocaine addict. Left Image, after administration of a placebo: low activity in the orbito frontal cerebral cortex. Right after intravenous administration of Ritalin (methylphenidate) there is over activation in these areas

After months of rehabilitation, the activity in this area is too low as well as in the nucleus accumbens. This leads to less activity in the prefrontal cortex in response to natural rewards, and the possibility that the drug of addiction may no longer be experienced as a reward. This also leads o the prefrontal cerebral cortex overreacting to the signalling of drug availability which induces over activity in the nucleus accumbens.

4) Rare problem of HABITUATION to long term therapeutic use of Ritalin or amphetamine in cases of ADHD
About 2-5% of patients report that after a few months (or sometimes more than one year) Ritalin no longer has a positive effect. This can probably also be explained by a form of neuronal plasticity achieving a different balance than the ones described previously. In these cases it is recommended to switch to another medication e.g. amphetamine or a noradrenergic antidepressant (desipramine, imipramine), Efexor or Strattera (also has a noradrenergic effect). It may also be necessary to switch medication a few times a year employing a rotation scheme.

translated from the Flemish by Stephanie Clark

zondag 2 november 2008

Our Favourite Adhd Related Quotes

Favourite ADHD-ish Quotes

Karma is the hand dealt, and dharma is what the player does with it”.

Mahatma Gandhi was fond of bridge .He used the game to explain the difference between karma (predetermined fate) and dharma (man’s action)

For me-he means don’t compare yourself with other people .Play what you have as well as you can .Strive to beat you own best performance. Comparisons are irrelevant -we are all playing different deals.

‘It is possible that genius tends actually to prevent a man from acquiring habits of voluntary attention , and that moderate intellectual endowments are the soil in which we may best expect, here as elsewhere , the virtues of the will, strictly so called to thrive’

William James ‘Principles of Psychology’

‘Guess why I like that one?’

Contributed by Stephanie

"To thy own self be true." Shakespeare Contributed by Maureen

"The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man."

George Bernard Shaw. Contributed by Ann.

"Blessed are those who can laugh at themselves, for they shall never cease to be amused"

. More of an old Irish saying actually. .

‘Well, often when I look at what I'm doing with my life, and the difficulties I have getting things done, I can smile. I used to get very annoyed at myself, so I hope that this is progress, though sometimes I worry that I could get a little too happy laughing at myself’

Contributed by john.

Do you know why you have a neck???? So you don’t forget your head somewhere!!

Anonymous contributed by Elizabeth ‘Don’t know how appropriate it is but you must get the voice correct !!!’’

We can't solve problems by using the same kind of thinking we used when we created them. - Albert Einstein

I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel. - Maya Angelou

Do not dwell in the past; do not dream of the future, concentrate the mind on the present moment. – Buddha

The only people who don’t make mistakes are the ones who aren’t doing anything.—Anonymous

Perfectionism spells paralysis. - Churchill

A man cannot be comfortable without his own approval.-

Mark twain

To invent, you need a good imagination and a pile of junk.
--Thomas Edison

Never wrestle with a pig; you both get dirty, and the pig likes it—Anonymous

‘What doesn’t kill us only makes us stranger’

Trevor Goodchild (Aeon Flux)

The following are from Marcus Aurelius:

You will find rest from vain fancies if you perform every act in life as though it were your last.

I shall meet today inquisitive, ungrateful, violent, treacherous, envious, uncharitable men. All these things have come upon them through ignorance of real good and ill.

(Say this before a difficult meeting and it put things into perspective!)

Living calls for the art of the wrestler, not the dancer. Staying on your feet is all; there is no need for pretty steps.

Live a good life. If there are gods and they are just, then they will not care how devout you have been, but will welcome you based on the virtues you have lived by. If there are gods, but unjust, then you should not want to worship them. If there are no gods, then you will be gone, but will have lived a noble life that will live on in the memories of your loved ones.

(Hedging his bets?)

Members True Stories of living with ADHD

A happy, happy Day

It's not all bad...

Black Devil Granny and the Ashtrays of Treason

A hyperactive 8 year old in the London of 1902. Long!

Notes on managing ADHD in the Extended family

When Mothers Lick

Running, with Aeoroplane Noises