Dr Bryan Betty: GP on ADHD diagnoses

ADHD has been getting a lot of attention lately - with Wellington Mayor Tory Whanau, and Chloe Swarbrick going public with their diagnosis, its difficulties and treatment - especially for adults.  

In NZ, 5-8% of children and adolescents being potentially affected, with 70% persisting into adulthood. 

Dr Bryan Betty told Jack Tame “It’s a very complex condition that affects people in different ways.” 

Betty said “It’s a neurodevelopment disorder – affecting people of any age, especially children.” 

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Episode Transcript

Speaker 1 (00:07):
You're listening to the Saturday Morning with Jack team podcast
from News Talks. A'd be.

Speaker 2 (00:13):
Seventeen to eleven on News Talks, he'd be ADHD. Attention
deficit hyperactivity disorder has had a whole lot of attention lately,
the likes of Tory Farno, the Mayor of Wellington, Chloe
Swarbrick going public with their diagnoses, Darcy Walldergrave of course
talking about ADHD and the difficulties around getting a diagnosis

(00:34):
and ongoing treatment, especially for adults. They reckon that in
New Zealand between five and eight percent of children and
adolescents are affected by ADHD, and for seventy percent of
those that persists into adulthood. But I've got to be honest,
I'm one of these people who and this probably doesn't
reflect very well on me. It just part of me
feels like sometimes I think, oh, it's ADHD, the kind

(00:56):
of you know, the diagnosis of the day, which I
know is not very generous of me sometimes. So we
thought we'd talked to doctor Bryan Betty just to clear
up some misconceptions. He's with us now, morning Brian.

Speaker 1 (01:09):
Oh, morning Jack.

Speaker 2 (01:10):
Yes, So let's just start off with what is ADHD.

Speaker 1 (01:14):
Look, as you're outlined. Look, it's a very complex condition
that affects people in a lot of different ways. However
you can make some comments about it. So it's what
we call a neurodevelopmental disorder, and it affects It can
affect people of any age, but especially children. Now what
it does, It affects what we call executive functions, so

(01:34):
that ability to maintain intention, control, impulses, and often memories affected.
And so people find often find it very hard to concentrate,
follow instructions and stay organized. Now that the problem, the
rise is there, and we've got to be really really
clear about this. This is a processing issue. It is
not laziness. It's not like a discipline. It's rather just

(01:56):
this issue with brain processing that has developed. So we've
got to be very very careful about our labeling of
this and what exactly it is because it is very
very real.

Speaker 2 (02:07):
And what are the different types and symptoms.

Speaker 1 (02:11):
Yeah, So look, it falls into two main clusters. So
one is mainly inattentive, so that's that struggling with attention
and focus, staying on task, following instructions. The other one
is what we call hyperactiveal and impulsive that may feel restless,
very fidgety, act without thinking about consequences. So so just

(02:32):
just really for that impulsive behavior, or you may have
a combination of two, so it becomes becomes across both spectrums.
So what people may see or start to think about
it and may see people are forgetful, maybe time management
is poor, difficulty organizing daily activities, or just making careless mistakes,
and so those are often the sort of symptoms that

(02:52):
people start to pick up on.

Speaker 2 (02:54):
See, like you hear that and I think, man, find
me a seven year old boy who doesn't have ad
you know, like, oh honestly though, I think about you know,
our boy, and I think about you know, his friends,
I think about what I was like as a kid,
and I'm like, oh yeah to tick Yeah.

Speaker 1 (03:08):
So so look, you've made a really good point there
that that kids, yeah, show all those those behaviors at times.
It's when those behaviors really start to interfere with functioning
like learning at school or doing things over a period
of time, or start to interfere with functioning as an adult,
like keeping jobs or or or just just doing doing

(03:31):
things that we'd expect. So, yeah, it's the degree to
which it affects people as things. So you're quite right,
those things can be normal in children's development. It's that extension.

Speaker 2 (03:41):
So what actually causes it.

Speaker 1 (03:44):
Well, look, it's it's unclear, but it's probably a combination
of genetic issues and in combination with environment. So what
we do tend to see it can run in families,
and there is some evidence to say, look, there may
be some difference in brain structure and chemical transmitters in
the brain, so there's some some some stuff that indicates that. However,
environmental factors can play a part. Now, smoking and pregnancy,

(04:07):
alcohol and pregnancy, and premature birth, those three things have
been associated with ADHD, which is why often the messaging
about smoking and pregnancy and alcohol and pregnancy is such
an issue, and that is put out there so ambisation
with those things.

Speaker 2 (04:25):
Like I said, we're hearing a lot about you know,
adults being diagnosed with ADHD and that sort of maybe
answering a lot of questions for them that they've had
about some of their responses to things over the years.
But what are the consequences of ADHD not being treated?

Speaker 1 (04:41):
Yeah, yeah, So what we tend to see in children
is having difficulties with behavior at school or learning at
school over time. So parents will often come to me
and say they're concerned about the fact their child is
the behavioral issues. The teachers have raised that the difficulty
maybe controlling learning is not what's expected, so you start

(05:01):
to trigger and wonder whether this could be going on. However,
the one of the big issues is not diagnosed into
adulthoods and what we do know about ADHD, it's associated
with a much higher risk of ending up in jail,
motor vehicle accidents, and alcohol and drug abuse. Yeah, but
we've got to be careful about this because on the contrary,

(05:22):
there are some positives, so people with ADHD can be
considered often more creative, high energy, good sense is humans
in enterprise and so there's a bit of the ng
and yang thing that can go on with that. But
definitely a social impact and undiagnosed ADHD is probably a concern.

Speaker 2 (05:38):
And what can you do about it?

Speaker 1 (05:41):
Well, look, we've tapped into this. It's often the difficulty
is actually diagnosis. So what we do know and it's
quite a difficult diagnosed soften. You need access to a
psychologist or a specialist psychiatrist. It takes time to make
the diagnosis and access in New Zealand is quite restricted,
so often it does go hidden. Look, one of the
things I'd say, if you're concerned about it, or you're

(06:03):
starting to trigger or think about it, please go and
see your GP and just have a conversation about it.
That's probably the first thing i'd say, to look at
what options potentially could be there to look at. This
is an issue certainly in terms of treatment. Lifestyle changes
are really important, so things like addressing alcoholic drugs for instance,
strategies to improve time management, support of friends and family,

(06:24):
exercise and time management, all those things are really really important. However,
what we do know is medication has a big, big
role to play and it can be transformed it with
a lot of people in terms of resolving symptoms, and
it can really really help with concentration and impulsivity, so
really really important.

Speaker 2 (06:44):
Yeah, so that's really interesting. So you know, I'm just
trying to be honest, and I know that this doesn't
necessarily reflect very well on me, but sometimes I do wonder,
you know, I have wondered with ADHD if maybe we're
over medicalizing, you know, the condition or the symptoms, especially
especially in an age where we will have smartphones, right,

(07:05):
so we're all kind of com instantly having things vying
for our attention, and you know, we're having our psychology
used against us and that kind of thing. Is that
a risk? You know? Is that an ungenerous Is that
simply just an ungenerous perspective.

Speaker 1 (07:18):
Or no, No, look, I think that's a very real,
real perspective. And you see this across a range of
things where we're social media and in the media in
particular as well, and sort of drive perceptions that, oh,
I have a problem, I've got a medical problem when
what you're looking at as normal behaviors. We talked about
with developmental children. We've got to be very careful about

(07:38):
this to make the differentiation of what's normal and what's not,
which is why with ADHD we've got we we do
need specialists who specialize in this area to really make
the diagnosis because it is quite complex to sift through
that and say, yes, that is where this sits, or no,
it's not. It's part of a normal behavior spectrum. So yeah,

(07:59):
complex in terms of what you're saying, Jack, and not
unreasonable than what you're saying. Yeah, right, Yeah, just careful
about it.

Speaker 2 (08:04):
Yeah, Yeah, it's just a case of being careful and
actually getting expert diagnoses as well as nice. Hey, thank
you so much. We really appreciate it, Brian. Let's talk
to Brian Beatty.

Speaker 1 (08:13):
For more from Saturday Morning with Jack Tame. Listen live
to News Talks ed b from nine am Saturday, or
follow the podcast on iHeartRadio.