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.
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’scollapse 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.”
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 Controland 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.
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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.
There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.
The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.
Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.
Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.
Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.
“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.
Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.
But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.
That includes his own teenage daughter.
“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.
It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.
“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”
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AP data journalist Kasturi Pananjady contributed to this report.
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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
How a sperm and egg fuse together has long been a mystery.
New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.
“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.
The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.
Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.
It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.
Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.
Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.
The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.
The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.
The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.
The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.
The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.
“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.
When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.
“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.
“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.
The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.
Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.
The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.
“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.
They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.
“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”
This report by The Canadian Press was first published Oct. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
