Welcome to the NorthShore ADHD and Addiction.
Our goal is to empower you to meet your full potential in life.
We do that by providing meticulous assessment, evidence based treatment and patient advocacy
NorthShore ADHD and Addiction Clinic
To whom it may concern,
The impact that NorthShore ADHD Clinic has had on my life is inexpressible. When I came to see Dr. Ocana it felt like there were so many moving pieces I didn't have the tools to communicate my needs. Anyways, he just cut right through all the static. It changed everything and set me on the path to --not just actualizing my potential-- but finding contentment within myself (I can't overstate the difference it makes to a confused kid, just having somebody on your side; someone to speak for you, when you aren’t able to speak for yourself)
It was a real turning point in my life.. He made a difference. Sorry if it's a little cheesy, I just don't think I've ever properly thanked him.
The Overlapping Genetics of ADHD and Addiction
ADHD is the most common neuro-developmental disorder in children. It is more heritable than hair or eye colour and more common than anxiety and bipolar combined. At least 50% of those kids grow up to be adults with ADHD.
People who have ADHD are more likely to drop out of school, become parents in their teens, have their electricity cut off, get fired, go bankrupt, fail in relationships and get injured in car accidents. But the greatest injury of all, is the steady decline in self esteem that accompanies repeated failure, despite their best effort.
ADHD is not a religion that you have to "believe" in. A physician saying they don't believe in ADHD is like a cardiologist saying they don't believe in diabetes.
On the topic of substances... since I have started treating my ADHD, I have been able to deal with things that have been piling up for the last 5 years or more. It's been very liberating.
This medical intervention has also changed the way I approach music. I have clarity, because I'm not stoned or drunk, which has allowed me to play at a completely different level...the best shows of my life, actually. The experience is overwhelming.
Artists, as you know, are prone to self sabotage. I am getting a lot of praise and I'm not used to it. So, last night I reached for the bottle again. It's a bad habit. But I have to say, it was largely unsatisfying.
I know it's a bit of a long answer, but I guess I'm prone to that.
The Overlapping Neurobiology of ADHD and Addiction
Decreased perfusion in the pre-frontal cortex
Addiction, like ADHD is marked by decreased dopamine neurotransmission in the circuits that govern cognition, executive function, motor control, impulsivity and reward.
People with severe addictions, have both lower dopamine voltage at baseline and dopamine levels fluctuate more compared to people without addiction challenges.
In other words, people with severe addiction, feel worse all day. Then when they use substances, dopamine does not just rise and fall gently, it spikes and crashes. It is this instability in dopamine transmission that remains, even in recovery.
When your dopamine crashes, it feels really bad. Since mother nature designed us to correlate survival promoting behaviors like sex, socializing and eating with increases in dopamine hitting the pleasure centers of the brain, having dopamine hit the ground, feels literally, like you are dying. If you've ever seen someone in full detox, you'll know what I mean. That is why people with substance addictions often trade their substance of choice for another substance or an addictive behavior like smoking or eating.
ADHD, like Addiction, manifests as impulsive behavior. People. with severe addictions may also have ADHD. In the residential facilities addiction facilities where I have worked, I have found that more than 50% of those inpatients also meet strict criteria for ADHD. If you look at people with methamphetamine addiction, that number goes up to 75%. That is astonishing.
Therefore, if a person with addiction also has ADHD, not only will they suffer from craving and compulsive drug seeking, but they also show symptoms of poor concentration, disorganization, impulsivity and hyperactivity. Of note, these will persist even in recovery. It's not persistent post-withdrawal syndrome. It's co-morbid, untreated ADHD.
Treating my ADHD...
Hello NorthShore Clinic,
As I sit here at my desk with a coffee on a rainy day, I'm reflecting on all that has transpired in the last 6 months: I finally decided to treat my ADHD, again and I wanted to share the changes I have noticed.
I can manage my efforts better at work. I am meeting my deadlines. When I need more time, I ask for it, instead of being late.
Things are more orderly at home. When it does get messy. I don't obsess about it. I dont feel bad about it.
My moods are not so extreme. There are no more huge-highs, or low-lows. I feel like normal people. I can feel sad without feeling depressed. And, I am sleeping really well, which is weird for me.
I wasn't taking care of myself. On what planet would someone not fix their teeth. You were the only one who called me on it. I guess you don't know what you dont know, until you feel better.
My dad passed away recently. During his illness, I realized that my mom and I had always had this painful dynamic. Now we spent the week together in the hsopital and we didn't clash. I did not get triggered by what she would say. That would not have happened before I started seeing you again. There is no way.
Last year, my partner and I had split and were living apart. Since I restarted my medication, we saw a counselor and now we are moving back in together. That is the other place where I used to explode. Now, I can ask for what I need, without blowing up and scaring the shit out of him.
My diet Is better. I make sure, I eat so I don't have the side-effects that I used to have.
My fitness took a nose dive since COVID. But I'm walking, at least. It should be better, but I don't beat myself up anymore. It is what is is.
After you retired in 2019, I went off all my medication and I got to feel all my problems. Now you're back. I'm back too.
ADHD, Addiction and Compulsive Behavior
Addiction to substances like cocaine and heroin, are governed by the same neurobiology as compulsive gambling, gaming, shopping, sex, status and risk taking. Behind all these, is the quest for dopamine.
The feelings and emotions associated with dopamine became, through natural selection, the signal that a behavior was associated with survival.
That's why people with the most severe addictions would do anything, even kill themselves for dopamine.
Therefore you can't treat ADHD or Addiction or Compulsive behaviours until you stabilize their circuits, helping craving and withdrawal recede, and allowing them to better regulate their emotions and themselves.
That is why treating people to regulate themselves works. Whether it's meditation therapy, hugs, group support or medication. Whatever it takes.