Attention! Are you creative?

2013-09-20 11:00

They struggle to concentrate and often depend on medication to deal with attention deficit disorder, yet some people with ADD are more creative than the rest of us.

‘I’m always distracted,’ says Albert Bredenhann, a 39-year-old photographer from Pretoria. ‘I can’t even concentrate for five minutes to make coffee – but put a camera in my hands and I’ll work for 12 hours straight without losing focus.’

Johann Fölscher (27) studied film-making in Cape Town and graduated with honours. He has struggled to settle down and lives with his parents on a farm near Pofadder.

He writes every day and still dreams of working in the film industry. One of his Facebook status updates reads:

‘It’s because everything’s so normal that everything is so boring. Normal is the mill of life. Be careful, it can poison you.’

Albert and Johann both have ADD (attention deficit disorder). Many famous people also have it, such as actors Jim Carrey and Will Smith, British chef Jamie Oliver, TV presenters Howie Mandel and Ty Pennington and singer Justin Timberlake. It’s also thought that famous names such as Mozart, Einstein and Picasso had ADD.

But what these people all have in common is they are all creative.

In 2011 Dr Holly White of the University of Memphis and Priti Shah of the University of Michigan found that children with ADD think more creatively than other children.

The best known medications for ADD and ADHD (attention deficit hyperactivity disorder) in South Africa are Ritalin and Concerta. Now the question is: do these medications fuel creativity?

‘It’s controversial,’ says Prof André Venter, academic head of the department of paediatrics and child health at the University of Pretoria.

‘Stimulants don’t make you more creative and theoretically they also don’t dampen your creativity. But there are artists who feel they are more productive when they are on medication and others who feel they can’t get their “creative juices flowing” without it.’

‘In some cases they do suppress people’s expressive thoughts,’ says Dr Louise Lindenberg from Durbanville, a medical practitioner and homeopath who specialises in autism, ADHD and ADD.

‘Some of my adult patients have noted that they feel as if they’re wearing blinkers and can only think in a ‘straight line’. They thus lose their creativity or extended thought processes.

Having said that, I think the medication assists with the discipline of focusing and not veering off on tangents as often happens in creative moments. It probably helps more with time management and a sense of responsibility than with creativity.’

Johann started taking Concerta last year.

‘There’s now a sense of calm that quiets my brain,’ he says. ‘I focus better. It makes it easy for me to complete a task. It definitely doesn’t dampen my creativity.’

Albert’s wife, Nadia, says it’s not always easy living with someone with ADD. ‘I’m a very organised person,’ she says. ‘It’s difficult for me to understand that although there is help, Albert doesn’t use it.’

He was advised by a doctor to go for tests to determine whether he could use medication such as Ritalin but, like anyone with ADD, he’s very good at procrastinating.

‘I’m busy with a thousand things all the time,’ Albert admits. ‘At the moment there are 18 webpages open on my computer, seven other programmes that I’m busy with. There are 191 emails that I haven’t finished writing! I have lists everywhere, but nothing gets done.’

Nadia says: ‘The moment he starts doing things he doesn’t enjoy, he gets distracted...’

Dr Susan Annandale, a paediatrician from Pretoria who specialises in learning- and behavioural problems, says: ‘I like the term attention preferential disorder. If a patient with ADD finds something they like, they can do it for hours. But this doesn’t help with what has to happen in the rest of their lives.’

Susan was nearly 50 when she started using Ritalin for the first time herself.

‘I’ve had ADD all my life and have had to work twice as hard to qualify as a doctor and later to specialise. I still take Ritalin when I know I need to study for long hours or when I’m attending a conference and need to concentrate for a long time.’

She says there’s a misconception about the medication ‘Parents enter my surgery and the first thing out of their mouths is: I’m not going to put my kid on medication. Then I need to explain that medication is what will help to bring the child back to reality, that they won’t turn into zombies.’

There are also stories about teachers insisting on medication so that children will sit still in class. Prof Venter says this makes no sense. ‘Medication is only used if the person’s social and educational development is not progressing, and the correct diagnosis is made. If someone is prescribing it for the benefit of the teacher, that’s unethical.

The so-called dangers is an argument many parents use not to give it to their children.’ Venter sympathises with this because parents are exposed to so much negative publicity.

‘But the low self-esteem of a child with ADHD and ADD is one of the strongest reasons not to postpone treatment,’ he says.

Dr Lindenberg also feels there is pressure to put children on medication. ‘Teachers see how well it works for other children,’ she says.

‘Then it’s suggested that all children with behavioural or learning issues will benefit from stimulant medication, which is, of course, not true. Specific learning problems and the reasons for them aren’t taken into account. Other treatments are not considered.

‘We need to remember that these are performance enhancing drugs: Everyone who takes them will have better learning abilities, but then underlying problems are not diagnosed. What follows is that children give it to each other, parents take their kids’ medication and everyone’s grasping for something that requires less of an effort than sitting on your bum and learning.’

Correct diagnosis is very important: ‘ADD and ADHD that is left undiagnosed can lead to anxiety, depression, obsessive-compulsive disorder and self-medication,’ Dr Lindenberg says.

‘The patient also needs to learn coping mechanisms and how to manage the condition. There are ways of dealing with it without medication. ‘Each person needs to be seen as an individual. There are other therapies that are also important, such as exercise, occupational therapy, psychotherapy and sensory integration therapy.’

Johann says he went for occupational therapy. ‘It definitely helped me to organise my life better.’

And Albert says: ‘Maybe photography is my medication!’ Ritalin vs Concerta? ‘The difference lies in the release mechanism,’ explains Dr Lindenberg. ‘Ritalin and Concerta contain exactly the same ingredient – methylphenidate. The release mechanism of Concerta is OROS, which means you swallow the pill whole and it is released over a longer time period, about 8 to 12 hours.

Ritalin comes in various forms: short acting, that’s released immediately and works for four hours, or LA (long acting), which is released in two phases - partially immediately and partially later. It works for about 6 to 8 hours. The short acting pill can be crushed or the LA capsule can be opened and mixed with food, but Concerta has to be swallowed whole.’

What you need to know

‘These pills suppress appetite and it’s important to follow a balanced diet,’ says Dr Lindenberg. ‘Proteins and fats and the B-vitamins are important. There is data that shows that omega-3 oils decrease the side effects of stimulant medication.

‘You don’t outgrow ADD,’ says Dr Susan Annandale. ‘As you get older, most people will learn ways to live with it.’

‘First make sure your child does in fact have ADD,’ says Prof Venter. ‘The negative consequences of not treating it are much bigger than treating it.’

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