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Why an influx of Canadian adults are seeking ADHD diagnosis and treatment, according to experts – The Globe and Mail

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Adult ADHD advocate and podcaster André Brisson at his home near Ingersoll, Ont., on June 2.Geoff Robins/The Globe and Mail

Looking back, Pippa Boyd can see the telltale signs – like frequently getting in trouble in grade school for moving around too much, and needing an organizational system that relied heavily on cue cards to make it through nursing school – but only recently has she started to think she has ADHD.

“In highly adrenalized situations my focus is spot on, but in daily life it’s a struggle,” says the 54-year-old from Toronto.

That struggle has only gotten worse in the past two years, And it’s one many others are also experiencing.

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Clinicians and ADHD advocacy organizations say they are seeing a large influx of adults seeking an ADHD (attention deficit hyperactivity disorder) diagnosis and treatment.

Dr. Gurdeep Parhar says the number of adults coming to his Burnaby, B.C., clinic seeking an ADHD diagnosis is up 25 per cent since the pandemic began. Not all of them will meet the diagnostic criteria, dealing instead with a normal amount of difficulty paying attention, an understandable situation considering all the ways life has changed in the past two years. But with the pandemic’s collapse of routines and schedules – whether it’s no longer going into the office, making it to the gym or attending social functions – many people’s previously undiagnosed ADHD has been brought to the fore, Dr. Parhar says.

“COVID has brought it more to light,” he says. “People who did well in a structured environment, whether it was a classroom or an office, are all of a sudden given all of this unstructured time.”

Adults have ADHD. We should have accessible care, too

There is also a wider awareness of ADHD and its nuances than in earlier generations. This is leading some adults to consider it as a reason for why they are struggling, rather than dismissing it as a diagnosis only found in children, says Heidi Bernhardt, director of education and advocacy at the Centre for ADHD Awareness Canada, a non-profit organization based in Toronto.

Wayne O’Brien runs a support group in Toronto for adults with ADHD. Prior to the pandemic, the group had approximately 100 active members, who would meet twice a month at the Centre for Addiction and Mental Health. The meetings have gone virtual and the number of active members has tripled, Mr. O’Brien says. Many newcomers have yet to be diagnosed, but are sure they suffer from the disorder, he says.

When it was first identified in the 1960s, ADHD was known as “hyperkinetic reaction of childhood.” Thanks to a better understanding of the condition, including identifying inattentiveness as a symptom, it was finally named ADHD in 1987, when the American Psychology Association released the third edition of the Diagnostic and Statistical Manual of Mental Disorders.

ADHD is the most common mental-health disorder identified in children, affecting nearly 5 per cent of people of all ages, but an estimated 90 per cent of adults who have ADHD are undiagnosed, Ms. Bernhardt says.

Typically, it is hyperactive boys disrupting classrooms who are singled out for assessment, she says. “Those are the kids who would be picked up because they’re highly annoying to adults.”

People who struggle more with attention than hyperactivity are more likely to slip through the cracks. This is true especially of girls – boys are more than twice as likely to be diagnosed with ADHD than girls, according to the U.S. Centers for Disease Control and Prevention.

“I’ve been finding a lot of women are coming during the pandemic,” says Dr. Doron Almagor, a Toronto-based psychiatrist and former chair of the Canadian ADHD Resource Alliance, a non-profit organization dedicated to improving the understanding of ADHD among health care professionals.

ADHD is a neurodevelopmental disorder and therefore something people are born with, Dr. Almagor says. The pandemic hasn’t caused any adult to develop ADHD. It’s instead brought their ADHD more starkly into focus. “The pandemic may have tipped the balance in their functioning,” he says.

The move to working from home has likely been the biggest such balance-shift for many, Ms. Bernhardt says.

“If you’re in a good job that works to your strengths, if you have a spouse who does all the organizing, if you have good scheduling you thrive,” she says. But when “all that scaffolding disappears,” a person’s ADHD symptoms can quickly become exacerbated. “That’s what’s happened in the pandemic.”

André Brisson, who was diagnosed with ADHD shortly before the pandemic, has struggled with the transition to working from home.

Before COVID-19, he’d often be driving to Toronto from his home in Ingersoll, Ont., to meet with clients. “Constant movement is important for me,” says the 47-year-old, who runs a structural engineering company. “I get bored easily, and when I get bored my impulsivity takes over.”

Working from home has not only meant having to fight boredom, but also structuring and organizing his professional life away from an office, something that is still a challenge.

“I just created my little ADHD office in the last few months. It’s completely separated from everyone else, I’ve got nothing on the walls, it’s got no distractions,” he says.

The pandemic may have also caused some people to wrongly suspect they have the disorder, Dr. Almagor says.

“People are stressed out and might be expecting too much of themselves. There are limits to productivity and focus,” he says.

There is a strict diagnostic criteria for ADHD Dr. Parhar says. While it is based on a psychological assessment, importantly, it must cause dysfunction. If you’re not struggling with work, family or personal relationships, then you probably don’t have ADHD, he says.

As for Ms. Boyd, she will be meeting with a specialist later this summer after her family physician initially dismissed ADHD. She made it through nursing school and therefore couldn’t have the disorder, he told her.

But she has found things harder than ever during the pandemic.

“Keeping on top of e-mails, my phone, it’s hard. I’m really struggling with my organizational stuff right now,” she says.

She is meditating daily, making lists of everything she needs to do and relying on alarms on her Google calendar to try and stay focused. All the research she has done on her own has convinced her she has ADHD and it puts all her earlier challenges in a new light.

“It’s just a real eye opener,” she says.

Our Morning Update and Evening Update newsletters are written by Globe editors, giving you a concise summary of the day’s most important headlines. Sign up today.

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Kevin Neil Friesen Obituary 2024 – Crossings Funeral Care

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It is with heavy hearts that we announce the peaceful passing of Kevin Neil Friesen age 53 on Thursday, March 28, 2024 at the Bethesda Regional Health Centre.

A funeral service will be held at 2:00 pm on Thursday, April 4, 2024 at the Bothwell Christian Fellowship Church, with viewing one hour prior to the service.

A longer notice to follow.  

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Spring allergies: Where is it worse in Canada? – CTV News

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The spring allergy season has started early in many parts of Canada, with high levels of pollen in some cities such as Toronto, Ottawa and Montreal.

Daniel Coates, director of Aerobiology Research Laboratories in Ottawa, expects the elevated amounts to continue next week for places, such as most of Ontario, if the temperature continues to rise. Aerobiology creates allergen forecasts based on data it collects from the air on various pollens and mould spores.

Pollens are fertilizing fine powder from certain plants such as trees, grass and weeds. They contain a protein that irritates allergy sufferers.

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Although pollen levels declined after a cold spell in some places, he said they are soaring again across parts of Canada.

“So the worst is definitely British Columbia right now, followed by Ontario and Quebec and then the Prairies and Atlantic Canada for the upcoming weeks,” said Coates in a video interview with CTVNews.ca. “We are seeing pollen pretty much everywhere, including the Maritimes.”

He said pollen has increased over the past 20 years largely due to longer periods of warm weather in Canada.

Meanwhile, the Maritimes is one of the best places to live in Canada if you have seasonal allergies, in part because of its rocky territory, Coates said.

With high levels of cedar and birch pollen, British Columbia is the worst place for allergy sufferers in Canada, he added.

“British Columbia is going strong,” Coates explained, noting the allergy season started “very early” in the province in late January. “It has been going strong since late January, early February and it’s progressing with high levels of pollen, mostly cedar, but birch as well, and birch is highly allergenic.”

Causes of high pollen levels

Coates expects a longer allergy season if the warm weather persists. He notes pollen is increasing in Canada and worldwide, adding that in some cases the allergy season is starting earlier and lasting longer than 15 years ago.

He says tree pollen produced last year is now being released into the air because of warmer weather.

“Mother nature acts like a business,” he said. “So you have cyclical periods where things go up and down. … So when it cooled down a little bit, we saw (pollen) reduce in its levels, but now it’s going to start spiking.”

Along with warmer weather, another factor in higher pollen levels is people planting more male trees in urban areas because they don’t produce flowers and fruits and are less messy as a result, he said. But male trees produce pollen while female ones mostly do not.

Moulds

Coates said moulds aren’t as much of a problem.

“They’ve been mainly at lower levels so far this season,” he explained. “Moulds aren’t as bad in many areas of Canada, but they’re really, really bad in British Columbia.”

In B.C., moulds are worse because of its wet climate and many forested areas, he said.

Coping with allergies

Dr. Blossom Bitting, a naturopathic doctor and herbal medicine expert who works for St. Francis Herb Farm, says a healthy immune system is important to deal with seasonal allergies.

“More from a holistic point of view, we want to keep our immune system strong,” she said in a video interview with CTVNews.ca from Shediac, N.B. “Some would argue allergies are an overactive immune system.”

Bitting said ways to balance and strengthen the immune system include managing stress levels and getting seven to nine hours of restful sleep. “There is some research that shows that higher amounts of emotional stress can also contribute to how much your allergies react to the pollen triggers,” Bitting said.

Eating well by eating more whole foods and less processed foods along with exercising are also important, she added. She recommends foods high in Omega-3 Fatty Acids such as flaxseeds, flaxseed oil, walnuts and fish. Fermented foods with probiotics such as yogurt, kimchi and miso, rather than pasteurized ones, can keep the gut healthy, she added. Plant medicines or herbs such as astragalus, reishi mushrooms, stinging nettle and schisandra can help bodies adapt to stressors, help balance immune systems or stabilize allergic reactions, she said.

To cope with allergies, she recommends doing the following to reduce exposure to pollen:

  • Wear sunglasses to get less pollen into the eyes;
  • Wash outdoor clothes frequently, use outer layers for outside and remove them when you go inside the house;
  • Use air purifiers such as with HEPA (high efficiency particulate air) filters;
  • Wash pets and children after they go outside;
  • Keep the window closed on days with high pollen counts.

Mariam Hanna, a pediatric allergist, clinical immunologist and associate professor with McMaster University in Hamilton, Ont., says immunotherapy can help patients retrain their bodies by working with an allergist so they become more tolerant to pollens and have fewer symptoms.

“Some patients will need medications like over-the-counter antihistamines or speaking with their doctor about the right types of medications to help with symptom control,” she said in a video interview with CTVNews.ca.

Coates recommends people check pollen forecasts and decrease their exposure to pollen since no cure exists for allergies. “The best is knowing what’s in the air so that you can adjust your schedules, or whatever you’re doing, around the pollen levels.”

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Do you need a spring COVID-19 vaccine? Research backs extra round for high-risk groups

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Recent studies suggest staying up-to-date on COVID shots helps protect high-risk groups from severe illness

New guidelines suggest certain high-risk groups could benefit from having another dose of a COVID-19 vaccine this spring — and more frequent shots in general — while the broader population could be entering once-a-year territory, much like an annual flu shot.

Medical experts told CBC News that falling behind on the latest shots can come with health risks, particularly for individuals who are older or immunocompromised.

Even when the risk of infection starts to increase, the vaccines still do a really good job at decreasing risk of severe disease, said McMaster University researcher and immunologist Matthew Miller.

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Who needs another COVID shot?

Back in January, Canada’s national vaccine advisory body set the stage for another round of spring vaccinations. In a statement (new window), the National Advisory Committee on Immunization (NACI) stated that starting in spring 2024, individuals at an increased risk of severe COVID may get an extra dose of the latest XBB.1.5-based vaccines, which better protect against circulating virus variants.

That means:

  • Adults aged 65 and up.
  • Adult residents of long-term care homes and other congregate living settings for seniors.
  • Anyone six months of age or older who is moderately to severely immunocompromised.

The various spring recommendations don’t focus on pregnancy, despite research (new window) showing clear links between a COVID infection while pregnant, and increased health risks. However, federal guidance does note that getting vaccinated during pregnancy can protect against serious outcomes.

Vaccinated people can also pass antibodies to their baby through the placenta and through breastmilk, that guidance states (new window).

What do the provinces now recommend?

Multiple provinces have started rolling out their own regional guidance based on those early recommendations — with a focus on allowing similar high-risk groups to get another round of vaccinations.

B.C. is set to announce guidance on spring COVID vaccines in early April, officials told CBC News, and those recommendations are expected to align with NACI’s guidance.

In Manitoba (new window), high-risk individuals are already eligible for another dose, provided it’s been at least three months since their latest COVID vaccine.

Meanwhile Ontario’s latest guidance (new window), released on March 21, stresses that high-risk individuals may get an extra dose during a vaccine campaign set to run between April and June. Eligibility will involve waiting six months after someone’s last dose or COVID infection.

Having a spring dose is particularly important for individuals at increased risk of severe illness from COVID-19 who did not receive a dose during the Fall 2023 program, the guidance notes.

And in Nova Scotia (new window), the spring campaign will run from March 25 to May 31, also allowing high-risk individuals to get another dose.

Specific eligibility criteria vary slightly from province-to-province, so Canadians should check with their primary care provider, pharmacist or local public health team for exact guidelines in each area.

WATCH: Age still best determines when to get next COVID vaccine dose, research suggests:

 

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Age still best determines when to get COVID vaccines, new research suggests

It’s been four years since COVID-19 was declared a pandemic, and new research suggests your age may determine how often you should get a booster shot.

Why do the guidelines focus so much on age?

The rationale behind the latest spring guidelines, Miller said, is that someone’s age remains one of the greatest risk factors associated with severe COVID outcomes, including hospitalization, intensive care admission and death.

So that risk starts to shoot up at about 50, but really takes off in individuals over the age of 75, he noted.

Canadian data (new window) suggests the overwhelming majority of COVID deaths have been among older adults, with nearly 60 per cent of deaths among those aged 80 or older, and roughly 20 per cent among those aged 70 to 79.

People with compromised immune systems or serious medical conditions are also more vulnerable, Miller added.

Will people always need regular COVID shots?

While the general population may not require shots as frequently as higher-risk groups, Miller said it’s unlikely there will be recommendations any time soon to have a COVID shot less than once a year, given ongoing uncertainty about COVID’s trajectory.

Going forward, I suspect for pragmatic reasons, [COVID vaccinations] will dovetail with seasonal flu vaccine campaigns, just because it makes the implementation much more straightforward, Miller said.

And although we haven’t seen really strong seasonal trends with SARS-CoV-2 now, I suspect we’ll get to a place where it’s more seasonal than it has been.

In the meantime, the guidance around COVID shots remains simple at its core: Whenever you’re eligible to get another dose — whether that’s once or twice a year — you might as well do it.

What does research say?

One analysis, published in early March in the medical journal Lancet Infectious Diseases (new window), studied more than 27,000 U.S. patients who tested positive for SARS-CoV-2, the virus behind COVID, between September and December 2023.

The team found individuals who had an updated vaccine reduced their risk of severe illness by close to a third — and the difference was more noticeable in older and immunocompromised individuals.

Another American research team from Stanford University recently shared the results from a modelling simulation looking at the ideal frequency for COVID vaccines.

The study in Nature Communications (new window) suggests that for individuals aged 75 and up, having an annual COVID shot could reduce severe infections from an estimated 1,400 cases per 100,000 people to around 1,200 cases — while bumping to twice a year could cut those cases even further, down to 1,000.

For younger, healthier populations, however, the benefit of regular shots against severe illness was more modest.

The outcome wasn’t a surprise to Stanford researcher Dr. Nathan Lo, an infectious diseases specialist, since old age has consistently been a risk factor for severe COVID.

It’s almost the same pattern that’s been present the entire pandemic, he said. And I think that’s quite striking.

More frequent vaccination won’t prevent all serious infections, he added, or perhaps even a majority of those infections, which highlights the need for ongoing mitigation efforts.

Lauren Pelley (new window) · CBC News

 

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