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General
ADHD
It used to be thought that children grew out of ADHD however we now know that ADHD does NOT “burn out” or “disappear” in adulthood and challenging symptoms persist into adulthood in around 65-90% of cases. However, the way it manifests may change. For example, hyperactivity in childhood may look and feel more like restlessness in adulthood.
Can adults have ADHD?
As with adults in general, it used to be thought that ADHD didn’t occur, or was exceedingly rare in girls and women. However, we now know that this is not the case. ADHD is still diagnosed at least twice as commonly in boys compared to girls. However, this ratio tends to equalise in adulthood. We think that this is because girls are more likely to have inattentive symptoms and less likely to have hyperactivity and impulsivity symptoms compared to boys. As a result, their symptoms may go unnoticed as they may also be less disruptive. ADHD may also start later and/or become more problematic later in life for girls and women compared to boys and men, and this may be related to hormonal changes.
Do women have ADHD?
It is often mistakenly believed that high functioning individuals cannot possibly have ADHD, however ADHD is experienced by people throughout the intellectual spectrum. This means that smart people can also have ADHD and they may still be underperforming compared to their potential. This can often cause confusion and distress for both the individual and those around them. High functioning people with ADHD are more likely to run into problems and seek help later in life, often in adulthood. This may typically occur when the coping mechanisms that they have built up break down which may be related to stressful life events, such as a new job or promotion, separation or divorce and parenthood or menopause.
I finished school, got a degree and now I have a career. Does that mean I can’t have ADHD?
Studies have shown that ADHD is highly heritable and runs in families. The heritability is estimated to be around 70-80%. This means that genes contribute to 70-80% of the cause of ADHD while the remaining 20% could be influenced by things like upbringing, education, or other environmental factors.
Does ADHD run in families?
Please contact us at team@cmhclinic.com to discuss your requirements.
I already have an ADHD diagnosis. Can I just get treatment?
Hormone Health
Hormone specialists, including endocrinologists, gynaecologists and psychiatrists, address a range of conditions such as thyroid disorders, reproductive health issues, and hormonal imbalances that may also be associated with mental health concerns. The evolving landscape of healthcare means that specialists from various fields are contributing to the holistic management of hormonal health. While endocrinologists traditionally focus on the endocrine system, and gynaecologists on the reproductive system, other healthcare providers, such as psychiatrists, are increasingly recognizing the integral role of hormones in mental health and incorporating hormone-related interventions into mental health treatments.
What is a Hormone Specialist?
Hormone therapies, sometimes called hormone replacement therapy (HRT) or hormone optimization, are the therapies used to treat symptoms of the menopause, perimenopause and andropause. The aim is to balance or replace the hormones that your body is no longer effectively producing including oestrogen, progesterone and testosterone.
What are hormone therapies?
The term “bio-identical” means having the same chemical and molecular structure as a substance produced in the body. It initially started to be used as a term for hormones that were compounded (mixed) by specialist pharmacies and were marketed as “natural” compounded BHRT (cBHRT). However, many of the hormone therapies that are developed in a conventional way by the pharmaceutical industry are also bio-identical. Unlike cBHRT, these are regulated by authorities such as the FDA in the USA, the EMA in Europe and the MHRA in the UK. To distinguish them from cBHRT, these regulated bio-identical hormone therapies have been called body-identical, but more recently are being referred to as regulated BHRT (rBHRT). Many professional authorities such as the British Menopause Society (BMS) and North American Menopause Society (NAMS) do not endorse cBHRT due to concerns about the lack of regulation, including testing for safety and effectiveness. However, there are certain circumstances where cBHRT may provide therapeutic alternatives that cannot be met with rBHRT. For further information see the Resources section.
What are body-identical and bio-identical hormones and what is the difference?
Breast cancer is one of the most commonly occurring female cancers. At present, we do not have complete knowledge of all the factors resulting in the development and growth of breast cancer. However, we know that there are contributions from gene mutations as well as lifestyle and reproductive factors. Hormone therapies containing oestrogen alone are not associated with any change in risk of breast cancer, although combined therapies containing both oestrogen and a progestogen can be associated with a small increased risk when used for more than 5 years. However, smoking, drinking a couple of glasses of wine every night and being overweight increase the risk far more. Additionally, the increased risk with hormone therapy only applies to synthetic progestogens. We do not use synthetic hormones, only body/bio-identical hormones (explained above).
Do hormone therapies cause breast cancer?
HRT is not generally recommended for women with a history of breast cancer, endometrial cancer or severe liver disease. However, there are also many non hormonal therapies that are effective in treating symptoms of peri-menopause, menopause or andropause, including psychological therapies such as cognitive behavioural therapy (CBT), as well as antidepressants and other medications.
What if I don’t want or can’t have hormones?
Psychiatry is a medical field focused on the diagnosis, treatment, and prevention of mental illnesses and emotional disorders. Psychiatrists are medical doctors who specialize in understanding and treating the complex interplay of biological, psychological, and social factors that contribute to mental health. Psychiatry covers a wide range of mental health conditions, including but not limited to anxiety disorders, depression, bipolar disorder, schizophrenia, ADHD, and more. Psychiatrists are trained to assess and treat various psychiatric disorders through a combination of therapy, medication, and other interventions.
What is psychiatry?
While both psychiatrists and psychologists work in the mental health field, the key difference lies in their educational background and approach to treatment. Psychiatrists are medical doctors who can prescribe medication and often use a medical model to treat mental health issues, whereas psychologists typically employ psychotherapy and counselling techniques.
How is psychiatry different from psychology?
Telemedicine, also known as telehealth, is a modern healthcare approach that utilizes technology to provide medical services remotely. It enables patients to consult with healthcare professionals, including doctors and other specialists, through virtual (online) communication platforms. Telemedicine platforms prioritize the security and privacy of patient information and use encrypted communication channels to ensure the confidentiality of medical consultations. Many insurance providers recognize the value of telemedicine and offer coverage for virtual consultations.
What is telemedicine?
In order to facilitate increased access, our services are all delivered online via video call. Therefore it is not possible to have a face-to-face appointment.
Can I get a face-to-face appointment?
At CMH Clinic, we are currently developing our regional service provision. However, at the moment, you can only book one of the CMH Clinic services if you reside in Barbados. If you live in another Caribbean island or in the UK, you can book an online consultation with Dr Gibbs here . However, if you live in the Caribbean (outside of Barbados), she will only be able to offer an opinion on diagnosis and treatment recommendations but will not be able to initiate and prescribe medication.
I don’t live in Barbados, can I still book a service?
At CMH Clinic, we are currently developing our general mental health service provision, including addiction services. However, at present, we are only providing services for Adult ADHD and Hormone Health. You can book an online consultation with Dr Gibbs for other mental health conditions including anxiety, addictions, mood disorders (depression and bipolar disorder) and schizophrenia here. However, if you live in the Caribbean (outside of Barbados), she will only be able to offer an opinion on diagnosis and treatment recommendations but will not be able to initiate and prescribe medication.
What if I am concerned about mental health conditions other than ADHD or hormone imbalance?
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