Courtney Weaver is joined by Dr. Narayan Gold from WVU’s Carruth Center to give a quick overview of ADHD and the unique treatment that’s available for students through the Mindfit program. They also chat a bit about study strategies that are useful for every student! For more information on Mindfit, visit https://mindfit.wvu.edu/.

Transcription: 

Welcome. Welcome. Welcome everyone to wellbeing. Wednesdays. I'm your host. Courtney Weaver. I'm the director over at WellWVU here at West Virginia University. And joining me today is Dr. Narayan Gold. He is a staff psychologist at the Carruth Center and he's also their assessment coordinator. So we want to say welcome to Dr. Narayan.

And how about you? Give us a little bit of an introduction of yourself and then what your role is here at the university. Sure. Thanks so much, Courtney. So, um, my role as assessment coordinator through the center is to sort of. Again, coordinate, but to sort of cohesively create an intervention or a plan for intervention for folks that have attentional concerns or learning disabilities on campus.

Um, it's a big component of our training program. A lot of our interns or all of our interns are involved in that. And we have several doctoral students often every year who do some form of assessment or testing of our student population. Attentional concerns and learning disabilities is a very significant barrier to academic success.

So we see a lot of those students during the year. Um, and as many as we can, certainly things are a little bit different now, but overall, um, sort of that is a lot of what my role is. I'm also a therapist at the center and work with clients, do supervision. We, all of those things in addition to that work as well.

And, um, I worked very closely with. Dr. Dan long over at the office accessibility services, athletics. Um, so there's a lot of, sort of different touch points in terms of student services there. Um, and it's just an area that I'm interested in and want to help students with because so many of our students struggle with it.

Um, or, or some type of difficulty related to learning or attention. That's something we'll probably talk about a little bit more signs and symptoms and some misconceptions about ADHD. Yeah. So that was a really good segue. So we are actually going to be talking about ADHD today. So no, Narayan, what is ADHD?

What does it stand for? So ADHD and, and, uh, the sort of the cluster of diagnosis around ADHD have a fault over time. Um, previously, so let's say, you know, 15, 16, maybe 20 years ago, a lot of people would talk about add or attention deficit disorder. Um, which has evolved into ADHD or attention deficit hyperactivity disorder.

There's actually two different types of ADHD. Um, there's um, the hyperactive type and the inattentive type is also a combined type of ADHD. And we're trying to sort of drill down on what those sort of three different types of ADHD look like. Um, sort of, as the names imply and attentive, ADHD is often folks who are easily distracted or have trouble focusing or honing in the hyperactive type of ADHD is folks that are.

Very difficult. They had difficulty sort of sitting still, um, uh, some of the behavioral signs and symptoms bouncing your leg, tapping your finger, um, sort of a lot of energy in the body. Um, and that's not abnormal, you know, just because a person is bouncing their leg when they're sitting still does not mean that they have attention deficit hyperactivity disorder, but it just made me wanna have extra energy that day.

Or they had too many cups of coffee. Like there's a lot of different explanations and reasons why that might be the case. Um, and, and again, a lot of students that come in, I have ADA. So, so that, that sort of previous systematical diagnosis really carries along with it. Um, ADHD is actually a diagnosis of exclusion.

A lot of people sort of go to that as the first diagnosis that this is what I have, but we have to rule out so many other different concerns first. And there's a lot of factors that contribute to ADHD, sleep, appetite, diet, um, overall holistic wellbeing. Um, and that's one of the things that I think our center actually really excels at and the mindset program excels at.

We'll talk a little bit more about that as well as thinking about the big picture and what factors, what lifestyle factors could be contributing to difficulties academically, to problems with attention, um, concerns as well. So I think that's a pretty cohesive definition, but again, we have to rule out a lot of different things.

Traumatic brain injury is the person's sleep deprived. Are they, um, Do they just simply not have the basic study skills that should have probably been instructed to them in their schooling and schooling really varies, uh, you know, depending on the person where they grow up and what was emphasized. Okay.

That is really expensive. So, um, what does ADHD look like in the college population? Like how many students would you say? So I, so I was looking at the prevalence rates before this meeting and in the, in the. United States population is somewhere between five and 6% is what they say. I'm sure that my numbers are probably skewed because we get a lot of phone calls, a lot of concerns about students who have ADHD.

Um, but, but truthfully we render that diagnosis maybe a handful of times every semester. Um, and we, we test 150 to 200 students depending, um, every year. So it's the prevalence rate is probably a little bit higher in our population. Cause everyone who's coming to us has those concerns. Um, and in terms of, you know, the combined type or the two different types, inattentive versus hyperactive, it's, it's somewhat, barely even a telltale sign and symptom.

And I think that there, a lot of folks assume like, Oh, I got to college and all of a sudden I can't pay attention. They're there in order to meet criteria for the diagnosis, you have to have had problems when you were a child prior to age 13. So that's one of the real, um, Sort of like critical points. And we'll ask about that.

When students come in in terms of what it looks like in the college student population, um, somewhat distinct from kids. So like, well, kids will get out of their class, like speak out in class, they'll get out of their chair. They have trouble sitting still. We get all of that stuff is prior to coven and whatever restrictions that are going to have in terms of movement at this point.

Yeah. But that's really what it looks like in kids, in, in college aged population. Some of those concerns as well, trouble sitting still. Trouble paying attention in class. Um, and the average human attention span is only 15 minutes. So people, you know, it's gonna have to be much shorter than that. People make this mistake, you know, construction or that this belief that if I can't sit still and study for four hours, I have ADHD.

It's really just not realistic. Our minds tend to get distracted every 15 minutes. So, you know, trouble with that placing of items. So like losing their keys, losing their wallet, losing their ID card and things like that is very common. Trouble with just general organization, missing class, missing work, being linked to work, being late to class.

Those are some of the signs and symptoms. trouble sitting still and reading a paragraph that can be a sign. Um, it, it's really hard to tell. And again, if students are really concerned or uncertain coming in and getting tested as one of the definitive ways, it's not the only way. Um, but in order to sort of open up some treatment options, that's really the best way to go about it provided it's feasible, you know, and all of those things.

But. Um, you know, a lot of students will just sort of Google symptoms, signs, and symptoms. Those are some of the more common ones that you see among the student population. And so you've talked a few times about testing. So what does testing look like for a student if they came in to see you or one of your other professionals?

So, uh, ADHD testing, various widely, depending on whether someone's going to go to the community or whether the yeah. We're going to go through our center. Um, comprehensive ADHD testing, assesses for what a person's measured potential is based on their sort of intelligence. I mean, We don't really place, we play some emphasis on IQ score, but we sort of want to see what your potential is through those, uh, tasks and activities.

Then we do some time tasks. Like how, how long are they able to focus and pay attention? What's their executive functioning. So there's a lot of different dimensions that we look at in terms of testing. And it's, it's a long day, you know, Previous battery was about seven hours. Now it's about four hours. So we've cut down on that a little bit.

That's including like, uh, interview and things like that. So, you know, just seeing if they can, like how they pay attention, behavioral observations and what the executive functioning is, what the executive functioning is, is the front part of your brain. People that have really bad attentional concerns have trouble with that trouble regulating that.

Now it's, it's hard to determine that a little bit in the college age population, because you're. Frontal lobe doesn't fully form until you're about 25. That's why they talk about, you know, you're not fully developed until you're 25 years old. Um, so we test for some of those executive functions. It's essentially your ability to like put on the brakes to slow down your process, to not jump in that that's another science symptom is like blurting out answers, interrupting people in conversations, and then we'll assess for some of those things as well.

Um, it's a, it's a significant time commitment. So, but you know, at the very least there's no guarantee of a diagnosis with the very least at the end of it. Students will ideally have a picture and an understanding of what their strengths and weaknesses are academically and just in terms of how their, their mind functions.

Yeah. Well, I think it's great that that service is offered on campus. Cause at my previous institution, our counseling center, wasn't able to provide that for students and they always have to go off campus. Isn't it cost to be extremely expensive. If it's like close to what a copay is on campus, the fee is, is $500, which is a lot for some students, but.

I've heard, you know, $2,500 for a battery in the community. So yeah, it's a, it's a great service. Um, so we've talked about some of the signs and symptoms. Are there any additional signs and symptoms of ADHD that students should look out for? It's mostly those, you know, again, onset prior to age 13, uh, interrupting other people, you know, breaking, you know, conversational stride, having trouble, sort of maintaining a conversation with someone, but, you know, they're, they keep jumping from subject to subject to subject.

Um, not being able to sit still for more than 15 minutes. So, you know, again, we're holding an attention span for about 15 minutes is pretty typical. Really depends on the person, you know, the context, um, something that's often, I think Mississippi with ADHD is like, I have no motivation. You don't want to, you know, do well, or I can't do well in school, or I don't feel like doing that.

That's really not a sign or symptom of ADHD. Um, Looking at that executive function is really, really important because I think that's really what sets ADHD apart from maybe they've had several concussions and the post concussive syndrome or a traumatic brain injury or things along those lines. Um, maybe they are not getting asleep, uh, lack of sleep.

There's a lot of studies that have been done with lack of sleep and potential problems and people that have a lack of sleep often will show signs and symptoms of poor attention, lack of focus and concentration, uh, or cognitive performance overall. Yeah, I, a previous supervisor of mine went to a conference and she went to a session about sleep and the presenter posited that if every person had, you know, at least eight hours of sleep every night, like all the world's problems might disappear and what it'll be so much better.

And it's really hard in our culture, especially, you know, again, in American culture, work, work, work, work, work, and, you know, we're, we're driven and we're sort of shamed for taking a break, but. If you really want to do well, you know, restoring your, your, your sleep and making sleep a priority and not eroding your sleep architecture is so important.

We talk about that a lot with students that come in for, for attentional concerns, it's hard, it's hard. So, you know, some of the treatment options can make sleep worse. So, you know, you have to sort of lay out those options as well. So speaking of like, what is a treatment plan for someone with ADHD? So most students that come in, um, and, and this is just, again, I think American culture in general is it's talking about medication.

So Steemit medication is a treatment option. Absolutely. Um, there's risks and side effects associated with it. So there's cardiac risks, there's trouble and difficulty sleeping often. Cause the stimulant will keep you up at night, uh, appetite, suppression. Um, so, so those are some of the side effects, but a lot of people do benefit from it.

True classic ADHD. Um, in terms of the diagnosis, people that have that when they take stimuli medication, it really is night and day. It does make a big difference. Um, the challenge though, is if a student was diagnosed at like 10 and they still put on stimulant medication at that age, and at this point, their brains have sort of adapted and adjusted to that.

And so taking it away can make it very difficult, even though they may not meet criteria for it as well anymore. Um, any ADHD, people can grow out of ADHD and, you know, the brain can learn to accommodate and learn to sort of adapt. But when it's doing that wisdom and the medication, you know, taking that away can make things very difficult.

Um, again, that's only one of the treatment options though. So there's study skills classes, there's learning skills consultations through the office of accessibility services. There's the mindset program in cognitive training and cognitive enhancement. Now we're having to put a pause on that right now because it's an in-person service.

Um, you're, you know, you're putting a cap on it on an individual and you're right there, but yeah. It's, you know, again, as we serve phase back into in person activities, again, we'll therapy kind of in training, it's just, it's one of the best treatment options. So a cognitive training is it's the mental gym it's cognitive, right.

Or a feedback it's, it's training your brain to think better, to focus better and to pay attention. And you build that strength of, it's not like we're asking you to do these hard, cognitive tasks. For 20, 30 minutes right out of the gate and wants you to do that gradually over time. And we build it through, through their games.

Essentially games are like memorization activities, mental manipulation, and math and things like that. And we do that all while watching your brain's performance. It's not electrical stimulation. It's um, we do brain mapping through neurofeedback and neurofeedback is just that it's giving your brain information about its own performance.

So let's say you start to get distracted and you're doing one of these tasks where you're like flying a ship through your space, or, you know, Solving mental math problems, the screen will darken and make it hard for you to see what you're doing. And that's a science signaling up. You're losing your concentration, sort of like focusing focus back in.

And that translates again to when a student is studying for an exam or when they need to read for a paper or when they need to write a paper or complete their math homework. So. Again, that's one of the really innovative treatment options. Um, there's a lot of great information on, on our website and on, um, the office accessibility.

So website for cognitive training and neurofeedback. Um, one of the advantages of that too, is that the far-reaching effects. So the stimulant medication, a lot of the gains, a lot of the, um, help that's benefited from it is gone and students or people just in general, discontinue their medication with the cognitive training or a feedback.

Those games are seeing six months to a year out. So it really is. It's, you know, putting that hard work in and training the brain to pay more attention. So students can certainly be able to look out for that there's limited availability and space, but, you know, we hope to expand that as time goes on and there's no other programs like that, that I know of in the country.

Yeah. That's, that's really cool. And, um, so when we talk about pharmaceuticals, that's something that my department likes to talk about because ADHD medication is often used by folks who don't have that diagnosis. The study aid, uh, and some people actually don't realize that that is illegal drug use. If that prescription is not yours.

Uh, and so let's maybe talk about some different ways that people can focus on their studying. Um, and so without the use of pharmaceutical enhancement and, you know, anybody would benefit essentially from stealing medication, not just folks that have attentional concerns. The idea is to hopefully even the playing field, but if you're taking it, you know, anyways, like if someone who doesn't have any issue is taking anyways, it does help to focus in and concentrate better.

But like you said, the legal and the ethical ramifications of that are really significant ways to study better are sort of building those foundational study skills. It's what people talk about engaging. So I'm a visual learner. I'm an auditory learner. I'm a tactile learner. That is really helpful, useful information, but if you're not strong, one of those other domains, you should try and strengthen that it's not good to just rely on what is easy for us.

It's important for us to sort of buildup and strengthen. So let's say you're not a good auditory learner. Start to pick up some audio books on subjects and things that you're interested in. It doesn't have to be school, but the more so the way that our brains work, the more ways we process information, tactile auditory visuals, any sensory processing our information.

If we do it from multiple modalities, we learn the information about. So one of the things that, um, like, so for instance, in the learning skills consultations, which I cannot recommend highly enough through AIS, we try and teach you how to memorize a page of your notes. Um, so they start with like a chunk of information, look at it, you know, put it away and then step away and then write down as much of that.

As you can remember, the engaging visual, you can audio record yourself, saying your lecture notes, doing those kinds of things, um, flashcards help, and, um, you know, doing questions online, help. The best way to do it though, is really to engage all in a different census. So saying your information into a tape recorder, listening back to that is one way, writing your notes out, see how much you can memorize it.

Um, that's, that's really helpful as well. Um, what are some of the other ways and tactics that found to be effective studying in groups? So engaging with other people, quizzing each other, if you, if you're able to teach material to another individual, it means, you know, it really well yourself. So that's something that I could certainly recommend and would.

You know, highly encouraged students to try a lot of the times it's a priorities thing and making school and studies a higher priority on your list is really important. Scheduling your day really well. That's another thing that can be done through those learning skills consultations for just taking a planner and looking all right.

I get up at eight. I have breakfast from 1830, go to class from eight 30, till 10. And I have a break here maybe in this break and can study. And again, it depends on the major. It depends on the subject and the things that you're studying, but there's a lot of them behavioral tactics to, to prioritize and to make it work.

Um, rote memorization is probably the least effective way. Although I must admit I was very, that's what I use. That's how I sort of got through school myself. It just is the least effective strategy. And I've learned better ones over the years. Right? I think my entire anatomy class was just wrote memorization.

You just say to yourself, 5 million times, it's just, it takes so long. Right. And then by still remember the, um, let's see, like the old on the radius. I know which where they are in my arm, I guess, I guess it's kind of, sort of stuck. Um, another thing that students, if they're having trouble focusing themselves, there are still services available, like tutoring or using the writing center.

And so, yeah, so you can talk with other students who have taken the same courses and have succeeded in those courses and, and really, um, Can, can I help you out? And then of course you can also visit your professors there's office hours, which some people are getting to an open floor. Yeah. People and people are really intimidated by that at first.

Um, because if their professor is seen as this really powerful figure, it can be kind of tough to work up the nerve to go to their office by yourself. Um, but your professor generally wants you to succeed. And so if you're having trouble with the material, take advantage, and then like, I think you just said.

That gets them to know you, which is really helpful down the line. Students will email the professor and say, you know, I'm 0.5 points away from getting a B in your class. Can you, can you help me out here? Just the professors, you know, you, I think are much more likely to try and help you out or yeah. Oh yeah, for sure.

So there's also tutoring offered by the way, through the mindset program at the he's in the scheduling for that are a little bit different. So you have to sign up for it before the semester starts, but yeah. Again, I can't ha I can't recommend it highly enough. It's so helpful. And so many students have benefited from it.

They hire specific tutors for each, for each, um, sort of major in each, each class type. There is a fee associated with that. Some of the other tutoring that you're talking about does not have a fee, but students really benefit from it and demand is really high. So I encourage students to look at that as well.

Yeah. And if you're still a student who's on campus or maybe back in Morgantown, but maybe still doing online classes, you know, things like the library are still open and it actually might be more advantageous to use the library in this sense, because you're physically distant from other folks. And so I think that helps to minimize distractions.

It does why it gets you out of that sort of comfort zone. You know, so many students are in the studying, reading, working, doing everything from their rooms and, you know, having that, alright, this is a dedicated study space. All I can do here is work on that. It's a, it's a common concern that students present to me or talk to me about like, I just can't get anything done.

There's so many distractions on my phone and I have, you know, my laptop and there's just so many different ways to just distract yourself. You go to the library and you don't give yourself other options, but like environmental change can really help a lot. Yeah. And I think it's important to note that if you're using your bed to study, try not to do that because really you should only be doing two things in your bed, sleeping and sex and that good, basic sleep hygiene too.

And again, we'll have that conversation with folks who are. You know, if you're doing everything, eating in bed, watching TV in bed, your brain learns, learns that like, alright, this is, you know, just for this thing. And it's hard to break those habits, but that basic sleep hygiene is so important. Yeah, for sure.

Uh, and so like wrapping this up with our wellbeing snapshot. So a lot of our students are taking online classes that are completely online. Some of them are hybrid. There are a few that are in person, but with online classes, do you have any thoughts on how to be successful in that specific environment?

Just like you had done before our meeting today, putting your phone away or putting it on silent, uh, turning off messaging and things like that. Just being as fully present as you can be is important. Again, I don't think this is going to be the major teaching method forever, but I think it's going to be for this semester and possibly next semester, maybe even to, you know, the following year.

So learning how to make this environment work, like the suggestion you made is a great idea. Going to the library, like libraries, maybe where I go and do, um, this morning classes, afternoon class, we're going into their, to their kitchen. I'm just literally leaving their bed and having, you know, they're desperate sitting on the floor next to their bed breeding.

That's that environment and making it as distraction free as possible. Engaging yourself in the conversation. So, you know, through these zoom classes, you can type in the chat as long as the professor enables it. And it's, you know, relevant, volunteering answers, um, sort of processing the material before and after.

That's another study tactic that we recommend is to read your notes ahead of time. So like, let's say we're going over chapter three and what political science. So you read it beforehand. Um, studied in class and then read it again afterwards, coming up with any questions you might have as well. It's hard though, you know, and again, if you're, if you're prone to distraction and prone to having trouble focusing, when you're sitting in a lecture hall, it's going to be even more difficult on sale.

Um, so, you know, you're, you're going to have to redouble your efforts. You're going to have to take extra steps to reduce the number of distractions that are possible. Um, but it's not going to be easy and. I hope that professors are going to be patient. I think they are for the most part, like, like you said, they want you to succeed.

So create as a distraction for your environment as you, as you can, if you really think there's something going wrong, you know, feel free to call our center. And, you know, I'd be happy to talk with folks or chat with them about what their options are as well. We're blessed to have psychiatrist on site, as you know, additionally, they can get offered some great insights as well.

You get enough sleep. Um, so an exercise can be great, making sure that you have enough fuel. So eating something in the morning is really helpful as well. Yeah. And I know with online coursework, if you have to submit things to the online portal, generally the deadline is 11:59 PM. Maybe set that deadline for yourself a little bit earlier.

And so that will encourage you to go to sleep also. So instead of 1159, maybe say, well that I'm going to turn it in by 10 o'clock and set, set that for yourself and get it taken care of. And then you can. Have a restful night's sleep is so reinforcing. So what happens is people get anxious or like, Oh, I have this paper due.

It's like, Oh no, I'll just watch Netflix for a little while. Or I'll go talk my friend, or I'll go for a walk. All of a sudden that anxiety goes away. It's like, wow. That's so that's why procrastinate is because it feels really good. It feels reinforcing until it's. 1130 and you have that paper you have to write and you only have 30 minutes to get it done.

It's very hard. And you have to train your brain to get the reinforcement earlier and not engage in the avoidance, which ends up costing you more in the end product. Yeah, definitely for sure. Well, thank you so much to Narayan for talking with us today about this really interesting subject, and we'll probably likely bring you back on it some point I'm sure.

There's way more that we could talk about. Um, and so thank you to all of our listeners out there and we will catch you next time on Wellbeing Wednesdays.