Sluggish Cognitive Tempo Disorder

Dr. Diana Mercado-Marmarosh: I am so excited to talk to you guys today about something that is called Sluggish Cognitive Temple Disorder. They used to think that it, was a category of A D H D. They weren't sure, but now they're working on figuring out that it's totally separate from A D H D, although they can correlate.

And I wanna. Explain the differences between them and explain that because it's so important for you to be aware whether you have that in A D H D or if you just have that and not a D H D because the treatment that you use is different. And yeah. So I think it's so important. Okay, so sluggish cognitive temple disorder is something that is been talked about a lot or by Russell Barkley.

He is a clinical professor of psychiatry from Virginia Treatment Center of children in Virginia in Richmond Virginia. But anyways I learned about this sluggish cognitive temple disorder during one of his presentations while I was working to become a clinical certified life coach for A D H D.

He has a Barclay rating scale for the sluggish cognitive temple disorder. And on there he talks about some of the characteristics that really make it stand out different from A D H D. So when you think. The Barclay Rating Scale. He wants you to think, to wonder whether you have you're somebody who is daydreaming excessively if you're having trouble staying alert or awake during boring situations.

Whether you're somebody who is easily confused, whether you're somebody who is spacey or seems to be like in a fog. Mind seems to be elsewhere or who is staring off into stage, or whether you're somebody who feels lethargic or more tired than others, or whether you feel like you just. Have no energy.

You're slow moving or sluggish, or whether you are somebody who seems like you're having a hard time processing information as quickly or as accurate as others, or whether you feel like you are withdrawn like you get lost in thoughts, or you seem to be very slow to complete a task.

So the important distinction that he makes or that he wants you to differentiate this from A D H D is that it seems like A D H D is more of a productivity disorder and he wants you to think of sluggish cognitive temple more as. Accuracy disorder. I thought that was important to point out.

And what he was saying is that when you wanna think about this, whenever with a D H D, we know that it's not. One part. But with A D H D, it's more like the executive function. It's the emotional dysregulation, it's the processing and the implementation and the planning.

So there's so many other stuff, but people with a D H D, some of them, they tend to have Endless amounts of energy, and I guess that's what people usually say about me, but we also have to remember that it's a spectrum. But what makes this a little bit different from A D H D? It seems like there is a slowness to the behavior.

There is a slowness in the information processing, and there seems to be some mental confusion or slow activity instead of like impulsiveness that can be seen in a D H D. And I wanted to point that out because I know I had several clients and I've had several of my own patients where they just come and they tell me.

I am so tired I cannot seem to focus long enough what people are telling me. So I want you to be aware of this possibility because we might incorrectly label them as a D H D and give them the treatment for A D H D, and then that was not the right diagnosis and it might not help. And interestingly enough what Dr.

Barkley says is that we're not even sure if this naming of this disorder is correct because luggage cognitive temple disorder it might not be appropriate to be labeled that because it almost implies that you have a cognitive deficiency and it might not be, it's just that maybe the processing speed of it is a little bit slower.

And so he thinks like maybe it would be better to call it like a concentration deficit per se. But anyways there was a recent study in the Cincinnati Children's Hospital. They treated the kids with this disorder with Ritalin to help with their daydreaming sluggish symptoms, and it really didn't seem to make a difference.

And then there was another study that was published in an article by WTA at all in 2013. And there they noticed that the children that had a D H D or dyslexia. In addition, they also had this luggage, cognitive temple disorder when they were treated with stratera, or the other name for it is Atomoxetine that actually had a benefit to it.

So as you know that this is a non stimulant type of medication, and this type of medication will help with not only neuro it will help with serotonin and nor. Which is different from sometimes the stimulants help, right? And so it's important to realize this because we might have a patient, or you myself, may be somebody who is not quote unquote benefit from stimulants.

And if you are given a non stimulant like this, you might have a great benefit. So with A D H D, think more about it. Pro productivity problem sometimes versus with s e t or an accuracy problem. And so there is some data out there and this disorder just slowly started to get look into since the 1980s.

It's not like it's been around forever. There some of the data out there right now shows, it seems like kids are able to be more self-identifying. Like they can tell you that they feel that they're slow to processing or they feel tired or that something is. Wrong compared to when you're making the diagnosis of an A D H D, we usually tend to look at the external perspective.

Like we ask the parents, the teachers, like in different settings coworkers. But with s e t, it seems like you have more internal awareness that this. You are daydreaming too much. Your mental confusion or there's some, your hyperactivity is a heightened, you have more of that awareness versus with a D H D you need to rely more on external awareness.

And with that also being said, there's some correlation that says s c t there is some correlation that having some type of like family or child psychology or adversary can increase the likelihoods of you getting this. For example, if you have parents who are divorced or maybe they come from a low socioeconomic household or a low parent Education, those social stressors are more likely to lead to this S C T versus not necessarily the case that these same things would lead to a D H D.

So all those is all that information is of cool and interesting. And there is some data also that shows that 60% of kids with s C. Might have a D H D and interestingly enough, 40% of people with A D H D might have S c T. So the point is that it doesn't necessarily mean that you have both, but it could.

B that you have both and being aware of that might open up the possibility of maybe not only being on a stimulant, but being both on a stimulant and non stimulant to help you treat both things. So that would be interesting. And I actually, looking back now, I can think of a couple of my personal patients that I have them on, both stratera.

And also stimulants and now it makes sense why they're doing so much better, because both facets are being addressed. So anyways, I wanted to share that information with you. I was surprised to learn about these things. And, as adults It's more likely that the older we get, the more likely might have S C T and A D H D.

But interestingly enough, 55% of a D H D in attentive type might have the S C T. And again it makes sense, right? Because I just told you that this is more like a sluggish and. The hyperactive A D H D people are not going to necessarily have s e t because they're impulsive. And this is like the opposite, not necessarily impulsive.

Okay. One last thing that I thought was more interesting too. Sometimes with s e t it can affect it, it can give people problems with math. And so if you have a person who just recently. Diagnosed with a D h, ADHD, and they've always had problems with math. You might want to consider if they actually have sluggish cognitive disorder or both.

Okay. So it was so great to talk to you guys about this. So takeaway point here is that you might have. something else, not just necessarily A D H D or you might have D H D and sluggish cognitive temple disorder. So if you're somebody whose stimulants didn't necessarily work and you always feel of tired and you always feel like you're daydreaming excessively or you're confused easily, you might want to look into sluggish cognitive temple disorder.

And I hope you have a great one. And as always, I'm here to support you. Send me questions of whatever topics you wanna talk about.