Tigger Goes to a Therapist

A Therapists Consultation: TIGGER

(Winnie the Pooh’s Irrepressible Friend.)

Diagnosis:

Attention deficit hyperactive disorder (ADHD): Tigger’s continual bouncing, hyperactivity and irresponsible attitude cause problems for him and those with whom he lives, as well as those he interacts with in the wider community.

Physical presentation:

Rarely sits still. He’s always running, climbing, or fidgeting.

Diet:

Having tried – and firmly rejected – honey, haycorns and thistles, Tigger settles on extract of malt as his food of choice. While this particular substance is unlikely to exacerbate his condition, a more balanced diet would almost certainly benefit him and perhaps contribute to an improvement in his behaviour.

Family background:

No information is available on Tigger’s life before his arrival at Pooh’s house. Nothing is known of his previous address or his family of origin, although it has been said that he is the only Tigger.

Patient notes:

Tigger’s arrival at Pooh’s house in the middle of the night is evidence of his inability to control his impulses. A less disordered individual would have known that it is more appropriate to visit people during the day, especially when dropping in on someone one scarcely knows or has never met.

Impulsive behaviour, interrupting and intruding are at the heart of Tigger’s problems. Soon after their first meeting, for example, Tigger suddenly interrupted Pooh, climbed on to the table, wrapped himself in his host’s tablecloth and brought everything crashing to the floor.

When questioned by Pooh about his behavior, rather than accepting responsibility for his actions, Tigger accused the tablecloth of trying to bite him. Tigger makes bold statements, such as declaring that he is only bouncy before breakfast. He proclaims impulsively that whatever food he is offered is what Tiggers like best, then gulps down large mouthfuls of the food in question, only to find he dislikes it very much.

More evidence of Tigger’s recklessness and poor impulse control is displayed by his belief that he can do anything. He has no sense of fear or responsibility. This was apparent when he climbed up a high tree with Roo on his back before he had ascertained whether he was able to climb a tree in the first place. Inevitably, they then got stuck when he realised he had no idea of how to get down.

On one occasion, Tigger grabbed Roo’s medicine from Kanga, which he proceeded to swallow, almost devouring the spoon as well. Obviously the medicine might have proved dangerous to him. Tigger never learns from his mishaps, bouncing back almost immediately after a frightening and potentially hazardous incident. As a result, Tigger’s behaviour causes concern to those around him.

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Living with someone suffering from ADHD can be trying. Perhaps this is why Rabbit suggested the rather extreme measure of taking Tigger into the forest and losing him in the mist. Rabbit and his friends believed the shock of being lost might cause Tigger to calm down a little on his return, a strategy that backfired, however.

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The Challenge of ADHD

ADD/ADHD or Attention-deficit/hyperactivity disorder affects thirty to fifty percent of adults who had ADHD in childhood. Accurate diagnosis of ADHD in adults is challenging and requires attention to early development, and symptoms of inattention, distractibility, impulsivity and emotional changes.

ADHD Symptoms

 The most prevalent symptoms of ADD / ADHD are inattention and distractibility and/or hyperactive and impulsive behaviors. Difficulties with concentration, mental focus, and inhibition of impulses and behaviors are chronic and pervasive and impair an individual’s daily functioning across various settings — home, school or work, in relationships, etc.

Inattention

Individuals who are inattentive have difficulty staying focused and attending to mundane tasks. They are easily distracted by irrelevant sights and sounds, shift from one activity to another, and seem to get bored easily. They may appear forgetful and even spacey or confused as if “in a fog.” Organizing and completing tasks is often extremely difficult, as is sorting out what information is relevant versus irrelevant. An individual with inattentive symptoms may have great difficulty keeping up with items, frequently losing things and living life in a disorganized way. Time management is also often an issue. Inattentive behaviors are sometimes overlooked because they are often harder to identify and less disruptive than hyperactive and impulsive symptoms. An individual with the predominately inattentive type of ADHD may even appear sluggish, lethargic and slow to respond and process information.

Hyperactivity

Individuals who are hyperactive have excessively high levels of activity, which may present as physical and/or verbal overactivity. They may appear to be in constant motion, perpetually “on the go” as if driven by a motor. They have difficulty keeping their body still — moving about excessively, squirming or fidgeting. Individuals who are hyperactive often feel restless, may talk excessively, interrupt others, and monopolize conversations not letting others get in a word. It is not unusual for an individual with hyperactive symptoms to engage in a running commentary on the activities going on around them. Their behaviors tend to be loud and disruptive. This difficulty regulating their own activity level often creates great problems in social, school and work situations.

Impulsivity

Individuals who are impulsive have trouble inhibiting their behaviors and responses. They often act and speak before thinking, reacting in a rapid way without considering consequences. They may interrupt others, blurt out responses, and rush through assignments without carefully reading or listening to instructions. Waiting turns and being patient is extremely difficult for someone who is impulsive. They prefer speed over accuracy and so often complete tasks quickly, but in a careless manner. They go full swing into situations and may even place themselves in potentially risky situations without thought. Their lack of impulse control can not only be dangerous, but can also create stress in school/work and in relationships with others. Delayed gratification or waiting for larger rewards is very hard for an impulsive person.

Three Types of ADHD are Identified:

  • ADHD, Combined Type – Individual displays both inattentive and hyperactive/impulsive symptoms.
  • ADHD, Predominantly Inattentive Type – Symptoms are primarily related to inattention. Individual does not display significant hyperactive/impulsive behaviors.
  • ADHD, Predominantly Hyperactive-Impulsive Type – Symptoms are primarily related to hyperactivity and impulsivity. Individual does not display significant attention problems.

Related Conditions

As many as one third of children with ADHD have one or more coexisting conditions. The most common of these are behavioral problems, anxiety, depression, learning and language disabilities. Adults with ADHD show an even higher incidence of additional or accompanying disorders. These adults may also suffer from depression, mood disorders, substance addictions, anxiety, phobias or behavioral problems.

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Treatment options from About.com Health’s Disease and Condition content is reviewed by the Medical Review Board.

http://add.about.com/od/treatmentoptions/a/ADHDtreatment.htm

WebMD ADHD Information page.

http://www.webmd.com/add-adhd/guide/adhd-adults

ADHDNews page.

http://www.adhdnews.com/adult-adhd.htm