By: Isabella Peppersack

ADHD stands for attention deficit and hyperactivity disorder, it is one of the most common neurodevelopmental disorders. “It is a complex brain disorder that impacts approximately 11% of children and almost 5% of adults in the U.S'' (ADDitude Editors, 2017), it is first diagnosed in childhood and lasts all the way into adulthood. People who have ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking), and may be overly active (Centers for Disease Control and Prevention, 2018). There are three types of ADHD, primarily hyperactive-impulsive ADHD, primarily inattentive ADHD (formerly ADD), and combined type ADHD. Primarily hyperactive-impulsive ADHD is as if someone is driven by a motor with little to no impulse control, they are almost always moving, squirming, talking at may be inappropriate times, they are impulsive, impatient, and they may interrupt others. The primarily inattentive ADHD type is when they have difficulty focusing, finishing tasks, following instruction, easily distracted and forgetful, they may be daydreamers who lose track of homework, cell phones, and may forget conversations with regularity. The combined type is when you have a mixture of all of those symptoms. 
ADHD is a developmental impairment of the brain's executive functions and self-management system. It is not a brain disorder, a mental illness, or a specific learning disability, it is a confusing, contradictory, inconsistent, and frustrating condition. ADHD is the first disorder found to be the result of a deficiency of a specific neurotransmitter. The deficiencies in specific neurotransmitters underline many common disorders including anxiety, mood disorders, anger-control problems, and ocd. Low levels of a neurotransmitter called norepinephrine which is linked with dopamine make it harder to focus, causing symptoms of ADHD. Norepinephrine is a neurotransmitter in the central nervous system that increases alertness and reaction time, studies have also shown to play a role in someone's mood and concentration. Dopamine is a neurotransmitter that the body makes and the nervous system uses to send messages between nerve cells. It plays a role in how we feel pleasure, it helps us strive, focus, and find things interesting. The ADHD brain had impaired neurotransmitter activity in four functional regions of the brain: frontal cortex, limbic system, basal ganglia, and the reticular activating system. The frontal cortex controls high level functions such as attention, executive function, and organization. The limbic system is located deeper in the brain and regulates emotions and attention, the basal ganglia can cause inter-brain communication and information to “short-circuit” and results in inattention or impulsivity. Reticular activating system is the major relay system among the many pathways that enter and leave the brain, it can cause inattention, impulsivity, or hyperactivity. A deficiency in one region may cause a problem in one or more of the other regions, ADHD may be the result of this. Children and/or adults with ADHD have a higher raclopride binding, which is a synthetic compound that acts as a selective antagonist on D2 dopamine receptors, so we “see” that their dopamine levels are low. ADHD is not a difference in behavioral preference, but instead appears to be partially attributed to differences in how the brain is structured.  
There are many symptoms of ADHD and the different types of ADHD. For the inattentive type of ADHD the symptoms can be simplified down to having a hard time organizing and/or finishing a task, paying close attention to details, following instructions or conversations, being easily distracted and forgetful of daily routines. They have trouble paying close attention to details or make careless mistakes in school or job tasks, trouble staying focused on tasks or activities, they don’t seem to listen when spoken to (seems to be somewhere else), does not follow through on instructions and has trouble completing school work, chores or job duties, they are easily distracted, forgets daily tasks and have a hard time organizing tasks and work. (ADDitude Editors, 2017; Centers for Disease Control and Prevention, 2018; Parekh, 2017). The hyperactive/impulsive type of ADHD will fidget with or taps hands or feet, they squirm in their seat, they are unable to sit still and stay seated. They may run about or climb on things where it is inappropriate, they seem to always be on the go and may feel restless and have trouble with impulse control. Unable to play or do leisure activities quietly, have difficulty waiting his/her turn, interrupting or intruding on others, they may talk too much. (ADDitude Editors, 2017; Centers for Disease Control and Prevention, 2018; Parekh, 2017). With the combined type of ADHD, you experience almost all or all of these symptoms, you have trouble focusing, sitting still, being organized, getting things done, impulse control, all of the symptoms from both types are present. There are some co-occurring with ADHD like anxiety, learning disabilities, mood disorders and symptoms that aren't really talked about like an interest-based nervous system, emotional hyperarousal, and rejection sensitivity. An interest-based nervous system is the trouble to focus, but ADHD causes the inconsistency of attention, people with ADHD can hyperfocus on something that causes a momentary sense of interest, competition, novelty, or urgency. Emotional hyperarousal is when you have passionate thoughts and emotions that are more intense then the average person, the highs are higher and the lows are lower, low frustration tolerance, they can experience both happiness and criticism more powerfully. It's hard to regulate feeling and emotions and can cause low self-esteem. People with ADHD, mostly females, are misdiagnosed because of this symptom. Rejection sensitivity is an intense vulnerability to the perception of being rejected, teased, or criticized by important people in your life, it causes extreme emotional pain and some may experience it as physical pain. It's hard to describe and people with ADHD who feel emotional hyperarousal and rejection sensitivity will often keep it hidden from other people (ADDitude Editors, 2017). 
ADHD has a major impact on everyday functioning, experiencing significant and lasting impairments across multiple domains including, mental health, academic, cognitive, social, and family functioning (Silk et al., 2016). 
People with ADHD have been found to have less chance to have graduated from high school or achieved a college degree because of the inability to to handle large workloads, inattention, disorganization, difficulty following directions and making careless mistakes. It isn't the failure to learn that creates an issue, but rather the gap in the ability to carry that understanding into their schoolwork, they might miss out on important instructions because of the need to move and being easily distracted, it's hard to remember what is being taught. Kids with ADHD go into school before they are diagnosed and it is normally the teacher that sees the signs of ADHD first. (Impact of ADHD - ADHD Institute, 2019). 
ADHD symptoms may delay some forms of employment, with difficulties in time management and impaired social skills. They find it difficult to retain a job, but on the other hand, some forms of employment may be well suited for adults with ADHD, more creative and active jobs. People who have entreated ADHD face multiple issues with employment, lile interpersonal conflict, tardiness, high absenteeism, high error rate, inability to change and lack of dependability. (Impact of ADHD - ADHD Institute, 2019).
People with ADHD may have difficulty maintaining relationships with the people around them, they may experience irritability, inattention, impulsive talking and forgetfulness which can contribute to misunderstandings in social interactions. ADHD can cause problems within family relationships, may have less family togetherness, and more conflict for families that have a kid with ADHD, parents, siblings, and other family members can feel less satisfied with their everyday life. (Impact of ADHD - ADHD Institute, 2019).
ADHD can look different in girls and boys, girls will often display symptoms of the inattentive type of ADHD while boys show more of the hyperactivity. Girls with ADHD rarely get diagnosed with ADHD or they get misdiagnosed, and are less likely to receive appropriate treatment. Boys can also go undiagnosed because it can be seen as “boys being boys”, but males are still three times more likely to be diagnosed with ADHD than girls. The symptoms for ADHD are more externalized in boys, while with girls it is typically more internalized, the symptoms are more subtle and harder to identify in girls. And because it is more subtle and they often display fewer behavioral problems, their difficulties are often overlooked. Females with ADHD can experience greater emotional turmoil, they try harder than males to compensate and cover up the symptoms, they have a higher risk of developing mood disorders, self-injuring behavior, and eating disorders than males. Girls with ADHD seem to show a wider range of difficult outcomes than males, anxiety, stress, and low self-esteem that can come with ADHD feels almost intolerable by early adulthood for young women. Girls with ADHD usually turn their pain and anger inward, while boys externalize their frustrations. Both males and females share the risk of school failure, rejection by peers, and substance abuse. ADHD that is undiagnosed can have a negative impact on people's self-esteem and mental health.

Works Cited
ADDitude Editors. (2017, March 14). What Is ADHD? Everything You Need to Know. ADDitude; ADDitude. https://www.additudemag.com/what-is-adhd-symptoms-causes-treatments/
Centers for Disease Control and Prevention. (2018, September 19). What is ADHD? Centers for Disease Control and Prevention; CDC. https://www.cdc.gov/ncbddd/adhd/facts.html
Impact of ADHD - ADHD Institute. (2019). ADHD Institute. https://adhd-institute.com/burden-of-adhd/impact-of-adhd/
Kerner auch Koerner, J., Visser, L., Rothe, J., Schulte-Körne, G., & Hasselhorn, M. (2021). Gender Differences in the Comorbidity of ADHD Symptoms and Specific Learning Disorders in a Population-Based Sample. Sustainability, 13(15), 8440. https://doi.org/10.3390/su13158440
Kinman, T. (2012, December 17). Gender Differences in ADHD Symptoms. Healthline; Healthline Media. https://www.healthline.com/health/adhd/adhd-symptoms-in-girls-and-boys
Parekh, R. (2017, July). What Is ADHD? Psychiatry.org; American Psychiatric Association. https://www.psychiatry.org/patients-families/adhd/what-is-adhd
Quinn, M., & Lynch, A. (2016). Is ADHD a “real” disorder?. Support for Learning, 31(1), 59–70. https://doi.org/10.1111/1467-9604.12114
Quinn, P. O. (2005). Treating adolescent girls and women with ADHD: Gender-Specific issues. Journal of Clinical Psychology, 61(5), 579–587. https://doi.org/10.1002/jclp.20121
Rothenberger, A., & Banaschewski, T. (2007). Informing the ADHD Debate. Scientific American, 17(2s), 36–41. https://doi.org/10.1038/scientificamerican0607-36sp
Silk, T. J., Genc, S., Anderson, V., Efron, D., Hazell, P., Nicholson, J. M., Kean, M., Malpas, C. B., & Sciberras, E. (2016). Developmental brain trajectories in children with ADHD and controls: a longitudinal neuroimaging study. BMC Psychiatry, 16(1). https://doi.org/10.1186/s12888-016-0770-4

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If you are a cigarette smoker, you already know what I’m going to say, QUIT! You’ve probably heard this piece of advice before and maybe you’ve tried to quit multiple times without success. You already know the health risks of Lung, mouth and throat cancer, emphysema, and COPD. You are aware of the yellow stains on your teeth, the nagging cough that never goes away, and the damage to your skin. Maybe you think you can’t quit, maybe you’re scared to try, or maybe quitting hasn’t even crossed your mind.  There are plenty of options for helping you quit smoking, but which ones work and which don’t?  
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We all know that quitting smoking can significantly reduce your risks for heart disease and lung cancer. After only 12 weeks your lungs regain the ability to ‘clean’ themselves, and in only a year it will halve the risk of heart disease. It will also save the pack-a-day smoker approximately four thousand dollars a year. So, how do you do it? 

​Prepare to Quit
Think of this stage as getting pumped to quit. Some find it easy to write down a list or keep a journal, thinking about things like “What don’t I like about smoking?” or “What do I miss out on when I smoke?” The best piece of advice for quitting would be to plan for cravings and triggers. 

Nicotine Replacement Therapy (NRT)
According to the National Institute of Health, Nicotine Replacement therapy is the MOST commonly used method for quitting.  NRT reduces both cravings and withdrawal symptoms by giving you small, controlled amounts of Nicotine, while withholding all the other harmful chemicals found in cigarettes.
NRT comes in a variety of forms  and can be used in different ways. Research shows that Nicotine Replacement therapy is safe and effective and can be an important part of every smoker’s quit strategy.
 
Types of NRT

Prescription Quitting Aids
Medications like Chantix can curb cravings and make smoking less satisfying. Other prescriptions, like Wellbutrin can ease withdrawal symptoms, such as depression and issues concentrating. Your insurance company may require you to take a Smoking Cessation Class before paying for Chantix and prescriptions like it, to find out more, contact the customer service desk at your insurance company. 


Smoking Cessation Groups
Finding a smoking cessation program is easy! Talk to your primary care physician, your local health department, or even your employer. You can also call The National Cancer Institute Quitline at 877-448-7848, The American Cancer Society Quitline at 800-227-2345, the Idaho quit line at 1-800-784-8669, or The American Lung Association, which has online and phone advice programs.
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Having a group of people who are there to support you, and going through the same thing can make quitting easier. The best programs combine numerous approaches to quitting and can help target fears and road blocks that often occur when you are trying to quit.
 

​The most important thing to remember when you are quitting is that you will make mistakes and that is okay. It is normal to slip once and awhile and smoke a cigarette, the important thing is to keep trying and making an effort to quit. Don’t give up on quitting.
 

Compiled By Rachel Fabbi, LMF,  CADC

​July is UV Protection awareness month. UV stands for Ultraviolet rays, which is a type of radiation produced by the sun that causes sunburns. UV can also damage the eyes, cause premature aging, and skin damage, which can lead to skin cancer. However, ultraviolet rays are the best natural source of vitamin D, also known as the “happiness vitamin.”
You may have heard of something called the UV index which is a scale by which the intensity of ultraviolet rays is measured. The scale starts at 1 and goes to 11+, any UV index above a 3 requires sunburn prevention. Ultraviolet rays are invisible and can’t be seen or felt until your skin is already damaged and the destruction is irreversible.
If you have a sunburn the only way to heal it is to wait patiently, here are a few tricks to speeding up the healing process.

1. Drink lots of Water, Your Probably dehydrated as well as sunburnt!
2. Apply Cold or Cool Compresses or Bathe the area in cold water (Avoid using soap as this may irritate your skin).
3. Don’t pop blisters as this can cause infection.
4. Talk to a local pharmacist to find the best products to soothe your skin. Choose a spray-on solution rather than a cream applied by hand.

 
You should see your doctor or seek treatment from your nearest hospital emergency department if you experience symptoms including:

• severe sunburn with extensive blistering and pain
• sunburn over a large area
• headache
• nausea and vomiting
• fever
• dizziness or altered states of consciousness.

 
Of course, the best way to cure Sunburn is to prevent it from happening. Here are four ways to prevent sunburns.

1. Wear Sunscreen of at least 25- 50 SPF (A rating of anything above 50 SPF has the same level of efficacy), even on cloudy days, and make sure to reapply it every hour while you are out in the sun.
2. Check your local UV index here https://www.coppertone.com/uvindex/ and don’t go outside during high-intensity times, usually from around 10 in the morning until 4 in the afternoon.
3. If you plan on being outside for a prolonged amount of time buy yourself a sun shirt. You can find these protective shirts on Amazon for less than twenty dollars.
4. Wear sunglasses with UV protection to prevent damage to your eyes. Even young children should wear sunglasses while outside. 

There are many types of bullying. Some bullies use verbal or written tactics like teasing, name-calling, or inappropriate sexual comments. Some bullying is social and includes a whole group of people, these situations include, leaving someone else out on purpose, spreading rumors, or embarrassing someone publicly. The third and most aggressive kind of bullying is physical. These situations include hitting, kicking, and punching or taking and breaking someone’s things.
 
Tips for Children Being Bullied:
 
1.Understand the Bullying
Bullying is a learnt behavior. Bullying is often a coping mechanism for children who are going through stressful situations at home, which may include verbal, emotional, or physical abuse.
 
2.If You Feel Safe Enough: Speak to the Person Bullying You
Sometimes the person bullying you may have no idea that you are affected or hurt by their actions. Speaking to the bully can be an affective way to check their actions and words.
 
3.Never Stay Silent
Bullying affects many people but almost half of those people never mention it because they are embarrassed or afraid. Speak to someone even if you don’t want to report the behavior, you should never feel alone.
 
4.Is Bullying a Crime?
Bullying can be a serious crime. If someone physically or sexually attacks you, uses racist or prejudiced language towards you, or shares your private information or images online – these are all important signs that you should reports your bully to the police or a school official.
 
5.Don’t See Yourself as the Problem
People do not experience bullying because of their sexuality, gender identity, race, appearance, disability, or any other personal traits. Bullying happens because of the bully’s attitude towards these unique factors. The person bullying you is the one with the problem, not you.
 
Tips for Parents Whose Children are Being Bullied:
 
1.Talk About it
Talk about bullying with your kids and have other family members share their experiences. Discuss the different types of bullying, cyber, verbal and physical bullying. If your child opens up about being bullied praise him/her/them for being brave enough to talk about it. Consult with your child’s school to understand their policies and find out how staff and teachers can address the situation.
 
2.Remove the Bait
If the bully targeting your child is after lunch money or techy gadgets, you can help neutralize the situation by encouraging your child to pack a lunch or go to school gadget free.
 
3.The Buddy Rule
Two or more friends standing on the playground at recess are less likely to be picked on than a child alone. Remind your child to use the buddy system when on the school bus, in the bathroom, or in between classes.
 
4.Keep Calm and Carry On
If a bully strikes, your child’s best defense may be to remain calm, ignore hurtful remarks, tell the bully to stop, and simply walk away. Bullies feed off the response to their hurtful remarks or actions. A child who isn’t easily ruffled has a better chance of staying off a bully’s radar.
 
5.Don’t Fight the Battle by Yourself
Speaking to the bully’s parents can be effective, but it is generally more successful and constructive when a school counselor or official can mediate. 


​If you are interested in taking Acacia's Anti-Bullying Class, contact us at (208)-498-1760

​When working with individuals who struggle with substance abuse or dependence there are many strategies that can be beneficial.  Both individual and group therapy can be utilized to help the patient have a greater chance in their recovery and overcoming addictions.
Individual therapy allows the patient to build a trusting relationship with a counselor that will not judge them and allow the individual a place to discuss their feelings and problems thus freeing themselves from their burdens.  In many cases this allows the individual to feel better about themselves and the recovery process.  However, individual counseling is not just about allowing the patient to talk, it allows the counselor to teach a variety of important life skills and coping skills that will help the individual manage the stress in their lives.
Some benefits to individual therapy include:

• Discovering the motivation to use drugs and alcohol
• Addressing various stages of recovery
• Discussing sensitive topics such as relationships, sex, and self-esteem concerns
• Developing new life skills and perspectives working through anxiety, depression, and much more.
• Reclaiming a sense of power to move forward.
• Building and strengthening relationships.

Group therapy allows individuals to be in a setting in which they can resolve problems in relating to other people in the group, problems from which they have attempted to "escape" by means of addictive substances.  As social beings, individuals are, whether they like it or not, part of groups; they are born into a group (family) and throughout life join groups that shape their behavior , self-esteem, and affect their physical and mental health.
Some benefits to group therapy include:

• Positive peer support and pressure to abstain from substance use.
• Limiting isolation which many substance users experience.
• Enabling members to witness the recovery of others.
• Helping members learn coping skills from other members when dealing with substance use and other problems.
• Providing information to new members new to recovery.
• Providing and receiving feedback from other members in the group.
• Encouraging, supporting, and reinforcing members in their recovery.
• Groups teach members social skills.
• Allows members to effectively confront other members about their substance use and other harmful behavior.
• Allows members to gain some sense of structure and discipline in their lives.
• Instill hope

There are advantages to utilizing individual and group therapy, but by incorporating both individual and group therapy in the recovery process the individual is likely to become successful.   Each form can build on the other as one can work with internal struggles and the other helps relate to others and feel less isolated from the individual's problems.  Recovery is not about abstinence, although it helps, it is about changed behavior and a changed lifestyle in which making decisions are no longer harmful to oneself and to others, that is the ultimate goal in recovery.  

References
​Benefits of Individual Therapy in Recovery (2015) - The River Source. https://www.theriversource.org/blog/benefits-of-individual-therapy-in-recovery/
Substance Abuse Treatment: Group Therapy (2005) - Treatment Improvement Protocol Series, No. 41. Center for Substance Abuse Treatment.  Substance Abuse and Mental Health Services Administration.  https://www.ncbi.nlm.nih.gov/books/NBK64223

​The holidays are here, and with them comes snow, presents, Santa Claus, and increased depression for many patients. This can be because the holidays remind people of time spent with loved ones who have since passed away. Grieving for the past can cause a melancholy sadness, which is experienced as depression.
                Another reason people's mood can be affected by the change of the season is the shorter days. Dark mornings and evenings can not only affect a person's ability to feel happy, it decreases the exposure of vitamin D the "Happy Vitamin."
                The holidays can also be a difficult time for people who are recovering from drug or alcohol addiction. Take the sadness that comes with the holidays and add that to the stress of attending parties, buying lots of presents, and spending time with family and friends, which can be a big trigger! The holidays bring drinking and "partying" to so many people, and that can feel like the normal or accepted thing to partake in, which can be very dangerous for a recovering addict.
                Here are some great strategies to combat the "Holiday Blues,"

1. Talk about it! Discuss the feelings and emotions with a trusted friend, a doctor, a counselor or someone who can understand and validate the feelings being expressed and will have suggestions for good self-care.
2. Have pre-planned ways to redirect thinking to the present, things like calling a friend, arts and crafts, joining a book club or a sports team are all examples of activities that keep the mind busy.
3. Volunteer at food banks, kitchens, animal shelters, or adopt a soldier or child in need for the holidays. Helping others is a great way to distract from personal issues and feelings.
4. Stay active! Exercise naturally releases endorphins which is the "happy" chemical in the brain.
5.  Cuddle with your furry friend. Snuggling up to an animal can be the most relaxing  and fulfilling experience. If you don't have pets of your own, volunteer at the local animal shelter!