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For every girl with ADHD, there are three boys with the same diagnosis. But among adults, the gender ratio is more like 1:1, which is quite a large discrepancy. So what’s going on?

Studies have investigated possible predictors of childhood vs. later (adolescent/adult-onset) ADHD, and they found girls tend to develop ADHD at a later age than boys (Murray, 2017). Now a team that includes the same researchers has investigated this confirming their first conclusion, which could partially explain the discrepancy in the ADHD gender ratio between children and adults. 

The researchers analysed data on 1,571 children living in Zurich, Switzerland, whose teachers used a standard scale to assess symptoms of inattention and also of hyperactivity/impulsivity every year from age 7 (which is the children they started school) through to age 15. The two domains of ADHD were assessed separately, as previous work has found that they can develop at different rates.

60 per cent of the children had low levels of inattention between the ages 7 to 15, whereas the remaining 40 per cent of the boys had persistently high inattention levels during this period.  Among the girls there was more variation, and generally lower symptom levels: almost a third had moderate symptoms that declined with increasing age, while the others started out with relatively serious symptoms at age 7, which then declined, but still remained above average at age 15.

For hyperactivity/impulsivity, there were also some contrasting developmental profiles between the sexes. The majority of children (81 per cent of the girls and 61 per cent of the boys) started out with low levels of symptoms, which decreased even further into late adolescence. Additionally, a group of children (13 per cent of boys and 10 percent of girls) had mildly elevated symptoms in childhood, followed by a dip around age 11 to 13, but then had a rapid increase.  Finally, there was also a group of children (24 per cent of boys, versus only 9 per cent of girls) who had high levels of symptoms all the way through the study period.

So, according to this data, boys show consistently higher levels of ADHD diagnostic criteria- hyperactivity, impulsivity and inattention from a young age.  Whereas, girls tend to develop high levels of these symptoms after adolescence. 

According to the DSM, current ADHD diagnostic criteria for children require symptoms to have begun before the age of 12. This could mean that a greater proportion of girls with ADHD, than boys, are being missed by clinicians. (Exactly why adolescence might be associated with a sudden rise in these symptoms in some children, and especially girls, is not known – it could be to do with hormones, and/or increased social and academic pressures.) 

This provided supporting evidence that there are sex differences in symptoms of ADHD trajectories that have potentially important implications for clinical practice. Specifically, to guard against under-identification of females, later symptoms should now be considered in the diagnostic criteria and indicators should be more suitable for adolescence and adulthood. 

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Frankie Samah by Frankie Samah - 4M ago

As I’m reaching middle age, it has me thinking about this fragile thing we call life.  From an early age we are taught, if you study hard you will go to a good university, if you study hard at university you will get a good job, if you have a good job you will be able to buy a house. 

Jeremy Bentham was an English philosopher and is considered the founder of utilitarianism, he had a view that the ratio of pleasure to pain is all that matters.  John Mill adjusted the slightly hedonistic tendencies by emphasising it is not the quality of happiness and the calculus is unreasonable as qualities is quantified, happiness cannot be measured.

However, everything now is increasingly more measureable, such as with social media; how many followers you have, how many likes you get on a post. 

So, is this now indicative that everything has a measure and can we indeed measure happiness?

Previous studies have attempted to measure happiness, the issue of how people’s happiness and psychological well‐being alter over lifespans is of increasing scientific interest,especially it can be quantified in our measureable world.

The beautiful kingdom of Bhutan, guiding principle is to satisfy the well-being and collective happiness of its residents through an index of measurable and attainable life goals, called Gross National Happiness (GNH), with their previous king claiming GNH to be more important than Gross Domestic Product (GDP), they rank 97 on the world’s happiest list so they have a way to go, but certainly their prioroties are right and what an amazing country to visit. The Scandanaviain countries usually rank the highest, Finland for example enjoys more forest per square mile than any European country, high environmental standards and a low threat level making it one of the most peaceful places on Earth. 

But, let’s look at life stages, there is a large cross sectional evidence base which provides support for the U-shape path of happiness and well-being over the human lifespan. 

What is the U-shape curve?

Evidence suggests that in general we start off in our late teens with a high level of contentment. From the age of 18 we gradually become less happy, reaching a nadir in our 40’s.  With life satisfaction scores dipping an average of 5-10%.  But, as research suggests it is U-shaped.  Once we have hit this nadir, our levels of happiness will begin to rise again, suggesting more contentment in later life.  By the time we reach our 60’s we are at a peak happiness with our life.  The research also suggests that men tend to happier than women.

This U-shape curve of happiness isn’t just found in humans, but also in apes, who found an equivalent quadratic life‐cycle pattern has recently been reproduced in research on samples of great apes.  A study of 500 chimpanzees and orangutans rated for happiness by their zoo keepers indicated a primate mid-life crisis at around the age of 30. 

So for once I am looking forward to ageing and climbing back up the quantifiable happiness scale, even if it is quite subjective.

Virginia Woolf, in The Waves wrote “Happiness is in the quiet, ordinary things. A table, a chair, a book with a paper-knife stuck between the pages. And the petal falling from the rose, and the light flickering as we sit silent.”

This is what my happiness is tranquillity, harmony and feeling safe, surrounded by books and stars.

In case you’re wondering, UK ranked at 19th.  The world’s least happy country was Burundi, followed by Central African Republic, South Sudan and Tanzania, marking a sad reflection of life in Africa.  f0900

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Frankie Samah by Frankie Samah - 4M ago

A couple of weeks ago I had popped into my coffee shop, and on return to my car, I found a note under my windscreen wiper. It said ‘this is a random act of kindness, for their 30th birthday, and may it bring me happiness’. The gentleman from the book shop came out and asked what it was, he had received an envelope too. In his envelope, he had a scratch card, he told me how happy he was that someone had thought of him, as he had been having a bad day. My envelope had a box of chocolates that my daughter and I went on to devour. With this in mind, I wanted to bring some optimism to your feeds. Even the smallest acts of kindness and compassion can have a such an impact on peoples’ lives.

In my latest article for Worth Living, I talk about thriving after depression, http://worthliving.co/2019/01/12/thriving-after-major-depression/, in this there are lots of examples of people who go on to thrive after having depression, and this is a way we can help.

Paige (18) lives in Sunderland (UK), she wrote 40 small notes and attached those notes at the Wearmouth Bridge in Sunderland. She wrote beautiful words on those notes with positive life statements such as “Even when things are difficult, your life matters, you are a bright light in a dark world. Hang in there!” or “Don’t give up! Not today, not tomorrow, never!”.

Her goal was to show that it is totally okay to not be okay.

One of the people who saw her notes, when they were feeling desperate, said it was hard to live with depression, and they were so lonely, which is why she had gone to the bridge. She needed someone to acknowledge her feelings and tell her everything will be okay. She added that without those notes her boys wouldn’t have anyone anymore.

Research shows that helping others can be beneficial to our own mental health. It can reduce stress, improve our emotional wellbeing and even benefit our physical health.

I hope this gives hope and it shows how small acts of kindness can make a difference. Even if you don’t feel that it is such a big deal. For someone else it means the world.

So thank you to the person who thought of me on that day and Happy Birthday. I hope all the kindness you put into the world comes right back to you.

Today why not…
  1. Carry out a random act of kindness for somebody else
  2. Note a random act of kindness someone does for you
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Frankie Samah by Frankie Samah - 4M ago

Learn to lower my barriers,

I don’t need to be protected from everyone.

Open my floodgates,

When drought chases me.

Place that smile on my ageing face,

Without wondering when it’s going to be taken away.

Delve into new passions,

Forgetting the cruelty of the ones I knew before.

Give without hesitation,

Even when all I’ve known is take.

Dedicate my world to love,

Not remembering how easy it was for you to break my foolish heart.

Find sweetness in honey,

As there is peace with every sadness

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I know I am a bit late, but the holidays always seem so busy. I’m currently waiting for the software I use to mark pupils coursework to come back online after it’s scheduled maintenance. That means I can sit in the office and let the kids think mums marking we can’t disturb, which is a rare luxury. So, New year, new us and all those other cliches. Are New Years a moment of existential crisis? A kind of mental benchmark, another moment for us to measure ourselves, set goals (resolutions) or intentions.

When I was younger I would always make New Year’s resolutions, I’m going to lose weight, I’m going to brush my hair at least once a day, I’m going to be a better human, you know the usual stuff.

But somewhere down this road, I have realised life is not about the things that I can affect. Life is all about the things I can’t affect. The past few years have been tough, in fact, more gruelling, then I could ever imagine with studying, working, car accidents and not much fun in between. But, I enter 2019 feeling contented and happy. So, this year I only want things that money can’t buy.

The past few years I have mainly been operating in the flight or fight position, so I’ve lived on adrenaline, my anxiety has been so bad at points that I didn’t ever think I would be well again. So the question I asked myself was why do you do this to yourself Frankie? Why do you work so hard? I never was pressured by family or by anyone else, the only response I have is I had to prove to myself that I was worthy. So, this year my biggest priority is to feel peace within.

I want to feel good in my own skin. I want to be a woman who can accept a compliment and not blush because I deserve it. I want to walk proudly down the street knowing that I didn’t do harm to anybody. I want to feel that I am worthy.

Protect my peace- I want to protect my peace this year more so. Last year I spent so much time giving a part of myself, my energy, and my mind it exhausted me. I forgot I was important too. The ‘friends’ involved they were never thankful, they just wanted to get to their metaphoric destination and I was a stepping stone for them to achieve this. They didn’t mind how much they inconvenienced me or how much time it took, but why did I allow this? So, 2019, I will protect my peace. Of course, I will still help my friends and family but I will set clear boundaries in order for me and them to remember I am important too.

Also, I want to feel happiness in my heart. For some reason, there isn’t much happiness in my life. I remember having face ache from laughing too much all the time when I was younger, now that’s just a memory. Maybe I don’t have enough time for my private life and that’s why I didn’t feel that happiness. But on reflection, I don’t think that was the problem.

The problem is I gave myself to the wrong people, the people who didn’t deserve that time, our souls weren’t aligned. The problem might be all those calls I never got while I deserved them. The problem might be all those messages nobody sent me while I never forget them. The problem might be all those kisses and hugs I never had. And finally, the problem might be all those warm words that I never had a chance to hear.

This year, I want to dedicate more to myself and find that happiness in my heart and my soul that is fighting so hard to come out.

So, this year, my only resolution will be things that my soul needs. I need love, happiness, peace, time to be reflective, time to achieve my goals, not ones others have set for me. My soul needs hope, care, happiness, harmony, kisses, hugs and all those positive feelings I craved so much.

No matter what happens, I will try to give my heart and my soul everything that they need. Just like our body needs food to be healthy, our soul and our heart need love for our psyche to be healthy. When we practice in self-love we send a message to ourselves saying we matter, it makes our mind and body stronger, making us more resilient to stress.

And most of all, I want to be a woman with self-worth. I want to tell myself every day that I should be happy because I deserve to be, I am worthy, I am enough. I want to remind myself that I am doing much better than I think and that no matter how much some people want to see me down, I will never be there. Because I don’t give in to adversity or to bullying.

And in the end, when I get that peace within that I crave so much, I won’t selfishly keep it only for myself. I want to share it with my family and friends. I want to help all people to feel this blessing that I will feel and I want us to enjoy it forever.

So, 2019, I will stand with more love, I will be more stubborn, more heart, more dreams for me to dream and to achieve. I hope you are ready for me because I am sure as hell ready for you!

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Frankie Samah by Frankie Samah - 4M ago

With different mindsets the same situation can be seen so differently. People will always cast their judgements- but their judgements are usually projecting their own fears about themselves. “Doubt yourself and you doubt everything you see. Judge yourself and you see judges everywhere. But if you listen to the sound of your own voice, you can rise above doubt and judgment. And you can see forever.” ~Nancy Lopez

I am what you say,

Don’t try to convince me that,

I am worthy of love,

I have hate from my toes to my head and everything in between,

And I’m not going to tell myself that,

I cannot be defined by you,

So be certain that my inner dialogue reminds me,

That I am a regrettable human,

And you cannot assure me,

I deserve the precious gift of love,

Because no matter what,

I will never be loved,

I cannot believe that,

The beauty of the night sky exists within me,

Because when I see myself I always think

Am I what you say?

Now read from bottom to top

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Frankie Samah by Frankie Samah - 4M ago

I am human

Sometimes I cry uncontrollably

But I laugh just the same

I have scars some you can see

Others you can’t

I’ve been shamed

And made to feel ashamed

But I love with all of my heart

I pray for humility

For you and for I 

As what made rivers and stars 

Sunrises and sunsets

Made you and me

So can’t you see

I am human

Just as you are

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Frankie Samah by Frankie Samah - 5M ago

Sam’s new book is out- Anxiety Free and it’s amazing. Sam is one of the UK’s leading life coaches and is a regular relationship contributor for the BBC. Sam describes her three-pillar system for overcoming anxiety – identify the cause of the anxiety, identify the solution to overcome the threat, take thoughtful action to resolve the action. Sam explains how anxiety is an indication that something in our lives isn’t right and by activating the three pillars and using the five calm strengthening habits described in part 2 can root out what’s going wrong and thereby helping to resolve your anxiety. It’s definitely made me question about the root of my own anxiety. It’s available now from amazon

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The Neuroscience of Revenge

In the 1800s the French coined the term- ‘revenge is a dish best served cold’. The idea behind this is that revenge is more satisfying when one has had time to prepare vengeance that is well-planned, long-feared, or unexpected.

We feel rejected when our friends don’t return our texts, and our dates ghost us, we don’t get that promotion at work. We have all had that feeling when we have been wronged we want revenge, especially in break-ups- it brings the arsehole out in all of us.

Rejections can be so damaging that if they occur persistently it can be linked to health outcomes that are worse than smoking or obesity. Rejection’s association with poor health is likely because rejection can activate the same pain pathways in the brain as a physical injury.

Serial killer Ted Bundy murdered 30 women across multiple states of America, they all had one thing in common, but perhaps the most striking was their similar appearance. It soon became apparent that these women were remarkably similar to a woman that Bundy dated as a young man, who has finished their romantic affair. So, did this experience of rejection push Bundy along his homicidal path?

When we feel ostracised or shunned, we can behave more aggressively than usual. New research into this area tested this notion of social rejection, when we feel wounded and unwanted, it triggers a need to repair our mood by whatever means possible, including the feeling of causing harm to those who have made us suffer. It was found that aggression can be a viable method for mood repair.

The researchers asked 156 participants to write an essay on a personal topic, then to swap their essays with other participants to receive feedback on what they’d written. One group of participants received nasty feedback (actually composed by the researchers): “one of the worst essays I have EVER read”. The researcher measured the participant’s mood before and then were given an opportunity for a symbolic form of aggression: sticking pins in a virtual voodoo doll imagined as the person who had given them the mean feedback. This act did indeed repair mood for the rejected participants, to the point where their mood was indistinguishable from participants who’d received kind feedback.

In a further study conducted by the same research team, they conducted MRI’s on 60 healthy young adults. Participants played a computerised ball-tossing game inside the MRI scanner. The focus of the game was to imagine a real life game of catch with two other partners, after playing the game for several minutes, the two partners stopped throwing them the ball and tossed it to each other repeatedly while the participant watched. This seemingly innocuous form of exclusion elicited strong feelings of rejection. The participant came out of the MRI scanner calling the other participants ‘jerks’, for leaving them out.

After this rejection induction, participants were given the opportunity to get back at their rejecters and repeatedly blast one of them with a sound that would be uncomfortable. The higher the volume, the greater the revenge.

The researchers focused specific activity on the ventrolateral prefrontal cortex (VLPFC). The VLPFC serves to inhibit our feelings of pain and distress.

(I have written about the VLPFC before and the role it plays in ADHD- see link https://www.acamh.org/research-digests/cognitive-neuroscience-aetiology-adhd/).

It was found that the more that participants recruited the VLPFC during rejection, the more revenge they wanted to inflict upon their rejecters- suggesting the more our brain effortlessly inhibits the pain of rejection, the more that we seek to harm. But why?

To find out, let’s have a look at what the brain was doing during the noise-blasting revenge portion of the study- it shows during ‘revenge’, participants recruited the reward circuitry of the brain. The brain’s reward system is a group of neural structures responsible for incentive salience (motivation, desire, or craving for a reward), associative learning (primarily positive reinforcement and classical conditioning), and positively-valenced emotions, particularly ones which involve pleasure as a core component (such as joy or euphoria). Suggesting, we are conditioned to feel pleasure after seeking revenge on someone.

Therefore, the results support that revenge is indeed sweet. The more we seek to suppress the pain of rejection, the sweeter we find revenge. This may be because we have fatigued our brain’s inhibitory abilities during rejection, resulting in an unrestrained reward response during revenge.

So, how can we use these results to make the world a better place?

Somewhere down the line, something has gone seriously wrong to result in us being conditioned to think revenge is sweet. Furthermore, it shows that attempting to suppress the pain of rejection is a bad strategy. This suppressive approach fatigues our inhibitory resources and leaves our unholiest desires unrestricted. We should find ways to engage with them more mindfully.

Indeed, our biology informs our psychology and suggests clear ways to break the rejection-aggression link.

We have all heard the old phrase life is 10% what happens to us and 90% how we react to it. We should learn to engage mindful ways how to deal with the emotions. Emotions themselves are energy in motion; we are not meant to hold on to them we are expected to learn from them.

Because of these profound costs of rejection, interventions that help people better manage their social pain are needed. Such as mindfulness, this refers to a psychological process characterised by attention to and awareness of one’s current experience and also entails a non-judgmental approach towards these feelings.

People who use mindfulness in their daily routines tend to have better responses to rejection. Research into the mindful brain and rejection suggests that mindful individuals are better at coping with social rejection because they don’t attempt to suppress the experience in the first place. Such results imply that mindfully-accepting, rather than suppressing, such social pain appears to go a long way towards healing from social injuries. Harnessing these mechanisms of the mindful brain is likely to help many people cope with the sting of rejection.

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