ADHD in Japan: A Personal Perspective

225px Flag of Japan.svg  ADHD in Japan: A Personal PerspectiveThe “Land of the Rising Sun”…
The home of Samurai and Ninja…
The birthplace of Sony, Nintendo, and countless other technology companies which have changed our world…
The originators of Anime and Manga…
The manufacturers of Toyota, Honda and many other cars…

Japan is a country with a rich history, a strong economy, a fascinating culture, and it has a big influence on our modern world. For these reasons and others, I was very excited that I was invited to teach Japanese doctors about ADHD in early March 2012. While I was there, I presented to, and met many Japanese Child Psychiatrists and Pediatric Neurologists. I had many discussions with them about their work with ADHD.

In this blog post, I’ll share some of what I learned while I was there, and I’ll share some of my personal opinions about ADHD in Japan. Please note – this blog post really is my personal opinion. I did not see patients in Japan, I was only there for 6 days, and I did not conduct any research while I was there. Although I’ve gathered information and formed some opinions, I clearly cannot say that I have a strong grasp of Japanese culture, nor the mental health system in Japan, nor all there is to know about ADHD in Japan. That said, I hope that my thoughts can help you to understand more about ADHD in Japan. (And if you read this article, and find that my opinion has some factual inaccuracies, please let me know if the comments, and I’ll do my best to fix them.)

(and after sharing my opinions about ADHD in Japan, I’ll share about my experiences with traveling in Japan, so stay tuned…)

Firstly, you may wonder: Do kids and teens have ADHD in Japan? Do they get diagnosed, and are they prescribed medication?

The answer is: yes and yes.

Kids and teens are diagnosed with ADHD in Japan, and they are prescribed medication when they are diagnosed.

In general, to get a diagnosis of ADHD in Japan, one needs to see a Child Psychiatrist or Pediatric Neurologist. To get an assessment, a family would go directly to the specialist, as there aren’t family doctors or general practitioners in Japan. The specialists use the same assessment and diagnosis process that doctors in North America and Western Europe do.

In many ways, the challenges with getting diagnosed with ADHD are similar in Japan as they are in other parts of the world. By this I mean that there is stigma around mental health issues, and a significant reluctance for parents to give children medication. In addition to the challenges around acceptance of the diagnosis of ADHD and the use of medication which go on all over the developed world, in Japan, there have been significant issues with stimulant abuse and misuse. This has led to even more concerns around the proper use of ADHD medication in Japan. Here is a link to an article published in 1989 about stimulant abuse in Japan. There were renewed concerns about stimulant abuse in 2007, which are summarized below.

I learned about one very interesting cultural difference around ADHD diagnosis and treatment in Japan. In Japanese culture, it is important to respect other people’s personal space. When a child with ADHD has hyperactivity/impulsivity, which includes a symptom like: “interrupts and intrudes on others”, then their parents are often very concerned about this symptom, because it breaks the cultural norm. As such, parents of a child with this symptom may be more inclined to get their child diagnosed with ADHD, and they would be more inclined to give their child medication to help with ADHD. While this may be good to ensure that these children get the help that they need, it can also work against longer term treatment. In other words, when that symptom goes away (and the child is no longer interrupting and intruding on others), the parent is more likely to stop treating their child with medication. And even though that hyperactive/impulsive symptom is resolved, the child may have many other challenges with ADHD (such as inattention, restlessness, social problems, etc.).

While talking with Japanese specialists about their ADHD patients, it seemed to me that parents of kids and teens with ADHD go through issues of frustration and guilt, as they do in North America. Although I didn’t meet parents of kids and teens with ADHD in Japan to discuss this issue with them, I have a suspicion that the frustration and guilt that parents experience may be more in Japanese culture around ADHD than in Western countries.

What About Medication for ADHD in Japan?

When it comes to medication for ADHD in Japan, there are very few options. While Ritalin is available in Japan, it is illegal for it to be used for ADHD (it is currently only approved for narcolepsy). In October 2007, there was a crisis which happened in Japan over Ritalin, and a concern around its abuse. There were articles in a major Japanese newspaper – The Yomiuri (which at this point are not available on their website – and if they are, they aren’t in English). There was a significant tightening of rules around the use of stimulants for ADHD. Although I can’t access any source materials for this story, a user on ADD Forums posted a quote from the news story, when it was happening (you can find the post here). The quote said:

A panel of the Health, Labor and Welfare Ministry on Wednesday decided to remove the psychotropic drug Ritalin from its list of approved medicines to treat depression as it has become widely abused.

Following the decision by the pharmaceutical and food sanitation council, the ministry within this month will restrict the prescription of the highly addictive drug solely for the treatment of narcolepsy.

Ritalin is the brand name of methylphenidate hydrochloride, a central nervous system stimulant.

To prevent a further increase of the abuse of the drug, especially among young people, the ministry ordered Novartis Pharma K.K., the pharmaceutical company that produces and distributes the drug, to develop a system to manage its distribution.

The Minato Ward, Tokyo-based company plans to set up the system by early next year.

Under the new system, which is as strict as that applied for narcotics for medical use, doctors with expertise in diagnosing narcolepsy as well as medical institutions and pharmacies that prescribe the drug will be required to be preregistered.

Also at the panel meeting, Janssen Pharmaceutical K.K. proposed the same management system regarding the distribution of Concerta, a drug used to treat attention-deficit hyperactivity disorder.

(Oct. 19, 2007)

Prior to the release of Concerta in Japan, there were no medications officially approved for the treatment of ADHD. Doctors were treating ADHD with Ritalin, but Ritalin was only approved for the treatment of Depression and Narcolepsy. Because of the issue described above, Ritalin was only approved for Narcolepsy, and doctors are no longer allowed to use it to treat ADHD. Shortly after this issue, Concerta was released, and was approved for the treatment of ADHD.

The medications currently available in Japan for ADHD include: Concerta (OROS Methylphenidate) and Strattera (Atomoxetine).

These medicines are approved to treat ADHD from 6-18 years old.

Doctors are not allowed to prescribe the medication to anyone younger than 6 years old, and they are only allowed to prescribe ADHD medication to anyone over 18 years old if they started the medication prior to their 18th birthday. In other words, at the current time, if someone is diagnosed with Adult ADHD, and did not start medication before their 18th birthday, they would not be allowed to take an ADHD medication. I do understand that at least one of the companies which produces ADHD medication in Japan is applying for an adult indication for ADHD. If and when this is approved, it would make it easier for patients who get diagnosed with adult ADHD to receive medication for their condition.

For a published scientific article looking at the use of medications for ADHD in Japan, please view this article.

Japanese ADHD Specialists:

When I presented in Tokyo, I presented at a national ADHD meeting. There were many Japanese presenters at the meeting (which I could understand thanks to the translators). I was very impressed by the caliber of their presentations, and the wisdom and insight they shared. I have attended ADHD meetings in Canada, USA and Europe, and while all of the presentations in Tokyo were very good, there were a couple of presentations ranked in the top presentations that I’ve seen. The Japanese Psychiatrists and Pediatricians are very well trained, intelligent, they conduct great research, and they care for their patients deeply.

Prevalence of ADHD in Japan:

The prevalence of ADHD in Japan is relatively understudied. Yoshimasu published in 2006 that regarding ADHD in Japan (and Eastern countries): “the epidemiological evidence including data for incidence, prevalence, gender differences, and etiology remain insufficient.”

When it comes to the number of patients diagnosed with ADHD and the number receiving medication, my sense is that there are significantly fewer in Japan (based on population) compared to the United States or Canada. While I have no solid research upon which to base this opinion, here’s how my logic goes (from my Canadian perspective):

  • Japan has a population of approximately 135 million people; Canada has a population of approximately 35 million people
  • Japan has approximately 500 Child Psychiatrists; Canada has approximately 500 Child Psychiatrists
  • Japan has approximately 2500 Pediatricians who treat ADHD; Canada has approximately 2500 Pediatricians who treat ADHD

In other words – for the size of the population, there is an equally sized ‘work force’ of medical specialists who assess and treat ADHD. While I don’t know the budgets of mental health treatment programs (i.e. how much money is invested in psychological treatments), based on my logic above, I suspect that overall fewer patients in Japan (based as a percentage of the population) are identified with ADHD and receive help for it than are in Canada.

Hopefully these insights and opinions are helpful to you. Please share any comments below.

Before wrapping up, I’d like to share some of my personal experiences traveling in Japan.

My Personal Experiences Traveling in Japan:

I had so many great experiences while in Japan, even though it was a very busy trip (I was there for 6 days, and I had 6 presentations in 4 cities). I hardly had time to get accustomed to the time difference, so I was always some variant of tired while I was there (except for when I was presenting, because as the saying goes: “The show must go on!”). Here are a few experiences which I enjoyed:

Grateful for the translators:

I was fortunate while I was in Japan to have two excellent medical translators. They did real time translation during my presentation, so that doctors could listen to my presentation in Japanese on headphones while I presented in English. When participants asked questions, I would listen to the question in English on headphones, while they were asking in Japanese. While most doctors could speak some English, there were few who could talk about medical issues comfortably in English (and their English was always better than my Japanese!).

When traveling between cities, I was fortunate enough to have a guide to get me to the train, or airport. Because I don’t speak or read Japanese, it is very hard to get around without help, because one can’t even read a street sign! And while many people speak some English, it is hard to get around without speaking Japanese.

Excellent Train System:

JapanTrip 4 of 333 150x150 ADHD in Japan: A Personal Perspective

Dr. Kenny and the Bullet Train in Tokyo

Japan has an excellent train system. It runs like clockwork, and the trains are local, express (to an adjacent city), and there are of course the “Bullet Trains”. I did take the Bullet Train from Tokyo to Nagoya. It went approximately 160 km/h, and it was smooth and comfortable. On my last day in Japan, I was supposed to take the Bullet Train from Osaka to Tokyo (so that I could go to Narita Airport to fly home), however there had been an accident earlier, and the bullet train was significantly delayed. The message we were told was that someone had slipped off the platform when the bullet train was passing through a station, so the train was not running. While it was explained as an accident, one of the psychiatrists I had spoken to expressed concerns about the high suicide rate in Japan, and how many people jump in front of trains as their method of committing suicide. While I will never know what happened to that person that day, I was certainly concerned for that person, and their family. In the end, the travel agent found me an alternate way of getting to Tokyo (via a short flight), and I got to Narita airport earlier than I would have otherwise. Interestingly, when I had no ability whatsoever to contribute to the solution of the issue, I had a surprising calm about the fact that I could potentially miss my flight. If I were in the English speaking world, I wouldn’t have had a travel agent with me, and I would have had to figure it out, or get the right help to figure it out – and in that case, I certainly would have worried more.

Expensive Taxi Ride: One of the first things I noticed when I got to Japan was the fact that the airports are quite a distance from the cities. Narita International airport is quite a drive from Tokyo, and when I arrived on a Friday afternoon, it took around 2 hours to get there. The bill for the taxi ride? The equivalent of $300! The message here is this: when you go to visit Tokyo on holidays – make sure to take the train from Narita Airport into Tokyo. It’ll probably be faster, and it will cost a lot less.

JapanTrip 21 of 333 150x150 ADHD in Japan: A Personal Perspective

Fresh Tuna in Tsu City

Amazing Sushi: Need I say more? As a sushi lover, I had fantastic fresh sushi in Japan. I was able to go to two different local restaurants (one in Tokyo and one in Tsu City), and the food was amazing. When I say ‘local restaurants’, I mean restaurants which aren’t tourist locations, but rather restaurants where real Japanese people eat. That’s how I love to get great food when traveling, and I loved it!

Tech Tourism: When I had time to tour in Tokyo, I went to the beautiful Asakusa temple, and then the day was getting late, and things were closing. When I was asking my guide about the different options we had, I chose to go to Ginza (a part of Tokyo), where the Sony showroom is. As a bit of a ‘tech geek’, I really enjoyed seeing the Sony showroom, which included several pieces of technology which aren’t in North America yet. I then went to ‘Bic Camera’, which was like a huge department store, with floors and floors of electronics. Although I loved seeing these great technology stores (and I didn’t spend too much), I must admit that I feel pretty geeky for visiting the tech stores in Tokyo icon smile ADHD in Japan: A Personal Perspective

Wonderful People: While in Japan, I met many smart, educated, warm, caring and humble people. While I was only there a short time, I met some great medical colleagues, and made at least one good friend that I will keep in touch with.

Japan is a fascinating and complex country, and this trip has really piqued my curiosity. I look forward to my next opportunity to go back to the ‘land of the rising sun’, to experience more of what Japan has to offer.

Final Thoughts:

If you are going to travel to Japan, and you take medication for ADHD, please be very mindful of the Japanese rules and laws for stimulant medication. In a future post, I will share the current rules and restrictions (hint – you can’t bring all stimulant medications into Japan…)

Best,

Dr. Kenny

Here are some more of my pictures from Japan:

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Comments

  1. Thanks for the trip update. Definitely interesting that with over 100 million more in population they have the same amount of ADHD medical workers as Canada. Also a sticky situation for adults who missed the boat by not being diagnosed and treated as kids.

    Definitely would be interested in how Japanese culture plays into ADHD. The contrast between dedicated work ethic with long hours at the office/school and the tech kawaii anime culture.

  2. Surprising and sad that stimulants are not allowed for Adult ADHD in Japan. If it were not for Ritalin, or Concerta, I would have difficulty at work. The worst part of having ADHD are the embarrassing moments. Suffice it to say, my prescriptions have made a huge difference. But it is difficult to get people to see it as anything other than a normal problem. Everyone knows what it is like to lose focus and miss part of a conversation or a play or a movie. People I know well don’t see that there is a problem. What they don’t see is that, without my prescription, I miss MOST of a conversation, or a play or a movie. I hope your visit to Japan raised some awareness. Thanks.

  3. Thanks for sharing your insight on ADHD and treatments, and your personal photos of your stay in Japan. I guess, here in Canada, our ratio of doctors to
    patients, is much better than in Japan. I don’t know how ADHD or any other
    concern could be addressed satisfactorily, because of the ratio of doctors to
    citizens.

  4. This was a very interesting read. I have been doing research on the laws and restrictions for bringing ADHD medications into Japan.
    I have travelled to Japan on 3 previous occasions, but since then I have been diagnosed with adult ADHD. I take medikinet (same as Ritalin), and I am very concerned as what to do, as I hope to travel to Japan again in near future. I have also tried strattera, but it doesnt work as well for me, so it’s not an option to change medications.
    I do hope it’s possible to bring prescribed Ritalin/medikinet into Japan. This is the only medicin that has helped me without harsh side effects, and I don’t think I could enjoy a vacation in fast pacing Tokyo without my medicin, or even leave the hotel room.

  5. Hi,

    I am a severe Dyslexic and spent six years in Special ED.

    All Dyslexics and the majority of people with ADD and ADHD see Static like on your old TV, because of this you now can diagnose a two-year-old by asking them if they see Fuzzy’s, and stop the page from moving with t.

    Please visit my website at http://www.poofyhairproductions.com or download my iBook, The Fuzzy’s from iTunes.

    I have a lot more information about ADD ADHD and dyslexia so please contact me by email or by phone at 503-916-9110.

    Have a Fuzzy’s day,
    Mark Wood
    26707 SE Stark Street #20
    Troutdale Or 97060
    503-916-9110

    Understanding the Fuzzy’s

    The first thing you have to understand is that, all Dyslexics, and most of the people with ADD/ADHD see static; like on your old TV when a station goes out.

    There are 3 Aspects of the Static: Size, Color, and Darkness:

    Size: Big/White static, and small/dark static.

    The BIG Static is roughly 1/10th to 1/4th the size of 12 pica text. This static is mostly white with a ting of color.
    The Small Static is roughly 1/100th the size of 12 pica text, has no white and is highly saturated in the same color as the Big static.

    Color: Based on my limited testing, Dyslexic’s see Blue static, and ADD/ADHD see pink, or purple static.

    Darkness: of the Small Static. For Dyslexic’s the dark static is from middle blue to almost black. With ADD/ADHD the dark static only get’s as dark as middle gray. So it is much lighter than the Dyslexic’s.

    The more severe a person’s Dyslexia or ADD/ADHD, the darker the Small Static is, and the more intensely white the Big Static is.

    Dyslexic’s have a problem with reading because the the small static is close to black in darkness, and is blue in color.

    ADD/ADHD small static is much lighter, getting no darker then middle gray, this is why they can read, and Dyslexic’s can’t. There is a need to understand that this is one disorder, with different manifestations.

    Before Puberty the static is much stronger. This makes learning to read much more difficult. Dyslexics were found to use their right brain to read with a machine called Proton MR Spectroscopic Imaging (PEPSI). ADD/ADHD most likely use their right brain to read, however, this has not been tested.

    * * * * *

    ADD = Attention Deficit Disorder.

    ADHD = Attention Deficit Hyper Activity Disorder

    Dyslexia = Greek for can’t read.

    ADD/ADHD are terms created by Mental health professionals in the early 1900’s. From the doctors perspective it makes total sense. ADD/ADHD people are easily distracted, and can stop one task, and switch their attention (focus) over to another completely different task in less than a second. Where as, the Non-ADD/ADHD doctor has to take at least a couple of seconds to think about changing directions. So the Deficit in the Ability to pay Attention to one task without switching to something else makes perfect sense from the doctors perspective.

    The thing that doctors don’t realize is that people with Dyslexia and ADD/ADHD have the ability to think about three separate and distinct things at the same time.

    The Doctors that came up with Deficit in the Ability to pay Attention where men. Men can only Think about one thing at a time (one thought pattern on the left side of their brain). Whereas, Women can think about two things at a time (one thought pattern on each side of their brain, left and right)(go ask one).

    * * * * *

    I disagree with the label ADD/ADHD. Hyper Attention Disorder and not Attention Deficit Disorder is the way it should be described and defined. We are hyper sensitive. We notice everything. We see static, and can think about three thing at a time, and you wonder why we’re so easily distracted?

    Hadlexia ©= Hyper Attention Disorder/ Dyslexia

    Hadlexia is a term that I invented to correctly describe the condition that I have.

    There are certain traits that all Hadlexics have:

    The ability to think of 3 separate and distinct things at the same time.
    We have to say each word in our head in order to read them from the page. We have to say each letter or word in our head in order to type or write it.
    We suck at math, either basic or fractions/algebra, etc.
    Our hands shake like old men.
    Inability to sleep.
    Difficulty remembering names, dates, etc.
    Having the ability to think of 3 separate and distinct things at the same time is very distracting. Normally we have two thought patterns going on at the same time. The first thought pattern is where we do our main thinking and reading. The second thought pattern is the one that won’t shut up. For example, the second thought pattern will repeat the words to a song you heard earlier that day, over and over and over again. So in addition to holding a conversation with someone (1st thought pattern), and having the 2nd thought pattern repeating the words to “love me do” all day and night long, we are also seeing static.

    We do have the ability to use all three thought patterns from time to time. We can be on a conference call and think about 2 non-related and completely different things at the same time. I know it sounds confusing, but we can do it. And you also have to realize that those thought patterns are being processed by our brains at a much faster rate than the average person. One reason we are hard to understand is because our brain is processing thoughts much much faster than our mouths can spit them out.

    There are fundamental differences between how men and woman handle Thought. Men can only think on one thing at a time and do only on thing at a time. A man’s thought pattern is in his left brain. Woman have a thought pattern for each side of their brain. And unlike men their emotions will affect their decision making. This is known as Woman’s intuition.

    When reading we can not look at the page and have the information pop into our left brain. Our right brain is the side that does the reading. We have to say each word in our head to get it off the page.

    With non-Hadlexic’s the left brain does the reading. This is because the left brain is Symbol oriented. When reading, the left brain nerves operate in a strait ordered sequence that repeats the same patten over and over, using the same nerves in the same pattern. The left brain is also designed to store data.

    Hadlexic’s © use the right brain to read. The Right brain is Shape oriented and because of the static our eyes see, at the time we’re learning to read as a child, the right brain literally had to re-build itself in order to process the text. The nerves used to read are in clumps, and there is no set pattern when we read. The activity bounces from one cluster to another in no specific order. This is why we have such a problem with reading.

    Hadlexic’s have to say each word in their head in order to get it off the page. Even though ADD/ADHD people do not have the level of difficulties that Dyslexics have in learning how to read, they still have to say each word out loud in their head in order to get it off the page (process it). And they also have to say each letter or word out loud in their brain in order to type or write it.

    Math, either basic or fractions/algebra, etc., is a common problem for Dyslexics and those with ADD/ADHD. I think this is related to the numbers. Understanding the concepts of algebra is not a problem for some Hadlexic’s, but basic math is.

    Hand Tremors are common for both Dyslexics and those with ADD/ADHD. Our hands shake like old men. This is most likely do to the constant movement in our vision. I had a great deal of improvement in my hand writing by taking Bata Blockers. Beta Blockers are normally taken for high blood pressure. If you want to greatly decrease your hand tremors consult a neurologist, and tell them it is for academic purposes for writing. You have to explain to them that it is for fine motor control when writing.

    Sleep, Sleep, wonderful Sleep. Not. We see static with our eyes closed. So when we go to bed there is constant movement in our vision. With our eyes closed we see the small and big static. The white static rolls like a calm ocean in our vision. If we our tired the static will go into geometric patters or move like your going down a tunnel. You also have to remember that we can think about 3 different things at the same time, and one of the thought patterns does not shut up. Most nights we may get 2 hours sleep, and it is not uncommon to go an entire week without sleep. On the weekends we sleep in but on Sunday night we won’t get any sleep because we have to go to work the next day.

    We have a problem remembering names and dates.

    When I meet someone for the first time and they tell me their name, ie: Peter, the next time I talk with them (a few hours or days later) I remember his name started with a P, but I usually call them Paul, Phillip or some other name starting with P.

    Studying history was annoying because although I memorized the correct date while I was studying, during the test, I couldn’t remember if the event happened in 1849 or 1894 because I wasn’t alive then.

    * * * * *

    Hadlexic’s are hyper sensitive to Sound, Sight, Touch, Smell and Taste. We notice everything.

    Sight: Because of the static constantly moving in our field of vision we not only notice what’s in front of us, but our attention is also drawn to any movement in our peripheral vision. The average person doesn’t notice things in their peripheral vision, so I think this is one of the reasons they came up with ADD. If we are talking to someone, and another person walks into our peripheral vision we will notice them right away, because of the static constantly moving. We then look over to see who it is, and this causes the person we’re talking to, to loose their concentration. And we’re the ones considered to be ADD?

    Sound: Pitch quiet is torment to us. Having a fan or an air filter on is an absolute necessity for us to be able to sleep. Remember we can think about three things at a time, so we will spend the entire night cataloging the noises, wondering what they’re caused by (an intruder, animal, etc.) and waiting for them to come back around.

    Touch: As soon as I switched to microfiber blankets it became a lot easier to sleep. Wool blankets, or corse sheets will prevent us from getting to sleep because our mind can’t tune out the itchy sensation of the blanket.

    Smell: My sister Lisa cannot focus on the task at hand if there’s a bad smell in the air. Being highly allergic to cigarette smoke, she actually gets angry, nauseous and experiences the flight response all at the same time. Her mental focus is taken over by her bodies reaction until the air clears, then she can mentally focus back on the task.

    Taste: We are picky eaters. If something we eat has a off taste we won’t eat it.

    * * * * *

    I need to mention 2 other groups of ADD/ADHD.

    Trace-Hads ©= See Tracers/Hyper Attention Disorder

    and

    Hear-Hads © = Hyper Sensitive Hearing/Hyper

    Attention Disorder

    These are also terms I invented.

    Trace-Hads © see Tracer’s, they are kinda like firework or shooting stars in your vision. This continually stimulates the brain, like the Fuzzys but does not interfere with the left brain’s ability to understand symbols. Trace-Hads tend to be calmer then Hadlexics.

    Hear-Hads © have hyper sensitive hearing. They can be in the kitchen with the blender on and then walk out the front door of the house and irregardless of how many cars are driving by or dogs are barking, they can literally still hear the blender running.

    Both Groups do not have language disability that Hadlexics have. There may be other groups of hyper sensitive people out there. This disorder is all about Hyper-Sensitivity. We are over stimulated.

    * * * * *

    White backgrounds are very difficult for us to read from because the big and small static stick out so much. By lowering the contrast between the text and the background it makes it much easer to read. Texture also makes it easer to read, because the static has a place to hide.

    CHAPTER 2

    Fuzzy Free?
    For most Hadlexics it’s possible to remove the static from your vision with tinted lenses.
    I have developed a way to find out the specific color of the static that you see. The long term solution is to find out what is causing the chemical problem in our eyes or brain that causes the Fuzzy’s. The short term solution is wearing glasses with tinted lenses.

    Color Me Fuzzy
    In order to determine what color Fuzzy’s you see, you will need access to an Apple™ computer and a color printer.

    The procedure is rather simple. But it may be problematic reproducing the exact color in the print, so try to get the print as close as possible. You will have your lenses tinted to the same color as the static you see.

    The important thing is to get a piece of paper with the correct color printed on it, so you can give it to your eye doctor as a sample of what color you need your lenses tinted.

    In order to make a correct print sample to give the eye doctor, you will need to first calibrate your equipment. There is a screen calibration program built into all versions of Apple’s operating system, OS X. It’s in System Preferences/Display/Color/Calibrate. The goal is to balance the display so that it’s neutral in color and has the correct contrast. A color profile is then created. Your printer also has a color profile. The more accurate the profiles the more accurate the print.

    * * * * *

    First: You need to be in a darkened room. Then open up Finder. Change to the Icon view. Make the Finder window full screen so it’s easer to see.

    Choose the gear for finder setting. Choose Show View Options. In the background section choose Color. Then click on the white square.

    Change the color space (Image:) to spectrum view, and click on the space with the color bands, then move your mouse around to choose. The color will change in real time.

    It is important to close your eyes and cover them with your hands for 10 seconds, so that the memory of the static in your vision has a chance to clear.

    The first time you try this you will choose a color that is way too light. Cover your eyes for 10 seconds and try again. It can be difficult to find your exact color of static that you see. Repeat this process until the background no longer moves.

    You then can put a copy of the color into the squares on the bottom of the color space by dragging the solid color square from above the color space, down to the set of small squares on the bottom of the colors window.

    You also can download a plugin that will give you the alfa-numeric code that corresponds to the exact color, so you can copy it down.

    After finding your correct color. Make a new image in a photo editing program and then go to colors palette and choose your square. You will need to use the fill feature (paint bucket icon) to fill in the background. Next print your color on a piece of paper or transparency.

    On most printers you can adjust the overall color of your printer, in printer preferences/color match. You will need to do so otherwise you will have to make manual corrections in the photo editing program to get the color correct on your print.

    If your are Dyslexic, the contrast between the Big and Small static may be too great to get rid of. I was able to get rid of about 50% of the static with dark blue glasses. If I get the glasses dark enough to get rid of the small static, the Big static starts to stand out.

    People with ADD/ADHD have a lower contrast (between the Big & Small static) than Dyslexics do. That’s why they can read and should be able to get rid of all the static they see with tinted lenses.

  6. Good morning Dr. Handelman.
    My name is Cristian, I’ve been living in Japan for two years and I have 33 years. I have been diagnosed with ADHD in 2009 (before coming to Japan) but I realized that I can not get medication here. This is a problem for me because I can not concentrate or do anything for a long time and still do not speak Japanese. Do you have any recommendations for me? or do you know anyone who can help me? Thank you very much for your time, Criz.

  7. Thank you so much for visiting Japan and your interesting share.
    I’m a 26 Japanese male patient. This article is so impressive to me so that I could learn a different perspective on ADHD.
    While there are many knowledgable psychiatrits in Japan, my personal experience in the treatment was not that great. Finally, I have diagnosed in the begining of 2012 as ADHD over the 5 years of medical treatment as chronic depression.
    In my experience, the major approach for ADHD in Japan is taking SSRI or other antidipressant (mostly, they are prscribed with antianxieties) and reduce the incidental depression, regardless that stratera has already released for adults.
    In recent years, many people came to believe that depression is a mental disorder, not lazyness and those people knows still nothing about ADHD. I mean, in Japan, many potential patients are mistreated just as a chronic depression. Actually, I was one of them for a long time. Additionally, Japan has no restriction or regulation about long-term benzodiazepine treatment. As you know, it’s risky approach.
    I think there remains a lot of tasks to be done in Japanese ADHD recognition. But, I’m convinced this article and Dr. would be the help of those people. I’m very happy and honored to comment in here.

  8. Hmmmm… your article is very disconcerting being an American living in Japan and desperately wanting help with my ADHD (diagnosed as a child). I recently decided to look into receiving some sort of medical help and perhaps medication at the local hospitals, only to have been rejected (over the phone trying to make an appointment) by the hospital staff and doctors who told me that they can only see children with ADHD and that there is no such thing as Adult ADHD, and that even if there was, there is nothing they could do to help me.

  9. I lived in Japan for 4 years with ADD and it was very difficult what I had to do to get medicine in Japan.

    I had taken Dexedrine for 10 years, but when I went to Japan I got a prescription for Ritalin from the US and I received government permission (yakkan shomei) to bring in a years supply of it to Japan. Luckily I went to Japan straight out of college and my parents were nice enough to keep me on their health insurance, to which I went to the States twice a year to get more Ritalin.

    It’s really concerning that Japan could not just tighten the controls for getting Ritalin instead of banning it completely. Without Ritalin, I could not have functioned in my career teaching English in Japan. The only medicine they have there that treats ADD symptoms is Pemoline, which was pulled long ago in the US.

  10. I read some articles that there is a new medicine being developed by someone called Thomas Alcott?

    It gonna help reduce the symptoms of ADHD.

    Someone know anything about this?

  11. I don’t have ADHD but I have narcolepsy, so the ban on amphetamines highly affects me. Adderall & Dexedrine (also Vyvanse to a lesser extent) are the only medications I’ve found to be effective – sadly Ritalin is not, and makes me very ill.
    I’ve lived in Japan during high school, studied Japanese since I was 13, and have a BFA in Japanese Studies.
    I was diagnosed with narcolepsy as an adult after I graduated from college in 2007, and then learned of Japan’s laws prohibiting all amphetamines to enter the country.
    It pains me that due to my medication I will never be able to enter Japan again legally, and although I’ve never applied for yakkan shomei (government permission), it wouldn’t be approved I am sure.
    I realize this is a board discussing ADHD, but I am at a complete loss as to what to do. Thank you for letting me share this story.

    • Hopefully Elvanse/Vyvanse will be approved for kids around 2017, it’s in phase 3 trials right now. At least it could probably be brought into the country then, even if not prescribed to adults.
      Unfortunately that’s too late for me, I’ll be an exchange student next year and have to try switching to Concerta before that. I’m really scared it won’t work as well as Elvanse, I’m not human without it.

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