Dr. Phillips received his bachelor's degree in Psychology from Stanford University. After graduating from medical school at the University of Southern California, he completed his residency training and served as Chief Pediatric Resident at UCLA- Harbor General Hospital in Los Angeles.
Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What is the relationship between ADHD and other disorders, such as
learning disabilities, anxiety disorders, bipolar disorder, or depression?
While the recognition and understanding of ADHD has advanced greatly, it is
still frequently under-recognized by most laypeople and many physicians that
coexisting conditions affect as many as 50%-60% of all children with ADHD. Many
of these coexisting conditions have many of the same symptoms of ADHD, and these
symptoms are often the first signs of problems in youngsters under 5 years of
age. At the time of the initial evaluation and diagnosis of ADHD, as well as
throughout the lifetime of the ADHD patient, these other conditions must be
looked for. They include the following.
Disruptive behavior disorders (in up to 35% of children with ADHD) include oppositional defiant disorder (ODD) and conduct disorder (CD). The behaviors in these areas go well beyond the usual "limit testing" of childhood and adolescence. Patients with ODD repeatedly demonstrate major defiance and hostility toward authority figures, refusal to follow rules, frequent loss of temper, deliberate annoyance of others, and generally angry, vindictive, and resentful behavior. Conduct disorder is more extreme and is defined as "a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate social rules are violated." CD extends into serious acts of violence against people and/or animals, school truancy, running away, vandalism, stealing, and so on. The person with CD is often labeled as "a delinquent" and has the potential for serious legal problems. It has been shown that early introduction of stimulant medication improves not only the basic ADHD symptoms but also the ODD or CD symptoms as well. Frequently, additional measures are also needed, especially in the CD category. These may include therapy from professional behavior-therapist intervention to special classrooms set up for more intensive behavior management to residential school placement with psychiatric involvement.
Mood disorders (in up to 15%-20% of children with ADHD) such as depression and bipolar disorder are often more difficult to recognize than the disruptive behavior disorders. Many children with ADHD alone are noted to be irritable, moody, easily frustrated, or immature emotionally. When these symptoms become severe enough to dominate the child's life, mood disorders must be considered. Children with combined ADHD/mood disorders (especially the more severe bipolar disorder) are at greater risk for drug abuse and suicide. Children in this category often require referral to a developmental/behavioral specialist or a psychiatrist, as there are a variety of behavioral/psychotherapeutic methods along with additional medications that can be very helpful.
Anxiety disorders (in up to 25% of children with ADHD) often involve symptoms that are largely internal and, again, more difficult to immediately recognize. These symptoms may be extreme fear, worry, and feelings of panic associated with physical findings like racing heart rates, muscle tension, nausea, vomiting, or extreme sweating. These bouts of anxiety are severe, ongoing, and frequent (at least
three to five times per week and lasting for more than one hour). The use of stimulant medication alone may help both the ADHD symptoms and anxiety symptoms as well. If not, behavioral therapy and/or additional medication in the tricyclic antidepressant family or the selective serotonin reuptake inhibitor (SSRI) family (Celexa, Zoloft, Lexapro,
and Prozac, etc.) can be very helpful.
Learning disorders are conditions that can interfere with the child's mastery of specific skills like mathematics or reading. They can include auditory perceptual problems, visual perceptual problems, and so on. The school should be approached to carry out testing for these specific learning disorders. Depending on the type of learning disorder detected, altering teaching techniques can help the student bypass areas of weakness and utilize other pathways of learning that may actually be quite strong.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Antisocial personality disorder (ASPD) has many symptoms, signs, and causes. Therapy is one treatment option for antisocial personality disorder. It is closely related to other personality disorders (PD), such as borderline personality disorder and narcissistic personality disorder.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
ADHD afflicts approximately 3 percent to 5 percent of school-age children and an estimated 60 percent of those maintain the disorder into adulthood. Symptoms of adult ADHD include chronic lateness, anxiety, low self esteem, employment problems, difficulty controlling anger, impulsiveness, poor organization skills, procrastination, chronic boredom among others.
Alcohol is the most frequently used drug by American teenagers. Teens that drink are more likely to drive under the influence, have unprotected sex, and use other drugs, like marijuana, cocaine, and heroin. Symptoms of alcohol abuse in teens include lying, breaking curfew, becoming verbally or physically abusive toward others, making excuses, smelling like alcohol, having mood swings, and stealing.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Drugs commonly abused by teens include tobacco products, marijuana, cold medications, inhalants, depressants, stimulants, narcotics, hallucinogens, PCP, ketamine, Ecstasy, and anabolic steroids. Some of the symptoms and warning signs of teen drug abuse include reddened whites of eyes, paranoia, sleepiness, excessive happiness, seizures, memory loss, increased appetite, discolored fingertips, lips or teeth, and irritability. Treatment of drug addiction may involve a combination of medication, individual, and familial interventions.
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
About 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
Asperger syndrome (AS, Asperger's syndrome) is an autism spectrum disorder. Asperger syndrome is characterized by a degree of impairment in language and communication skills, and repetitive or restrictive thoughts or behaviors. The most common symptom of Asperger syndrome is the obsessive interest in a single object or topic. Other conditions that may co-exist with Asperger syndrome include: ADHD, tic disorders, depression, anxiety disorders, and OCD. Diagnosis of Asperger syndrome is complicated, and treatment is generally directed toward minimizing the symptoms of the syndrome and behavioral and educational interventions.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Attention deficit hyperactivity disorder (ADHD) can be challenging for a parent or caregiver with a child with this disorder. There are steps, routines, and help for parents and caregivers of children with ADHD to help guide the family toward a productive and healthy life.
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly, preventing injuries and screening annually for potential health conditions that could adversely affect teenage health.
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