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ADHD, Newsnight and knowledge.

Last Chance Saloon is the story of Neil ‘Twink’ Tinning, a troubled, magnificent man living with bipolar disorder, and his unique attempt to understand the science behind his, and many other, mental health conditions – all while getting ready to play the biggest gig of his life.

In part 6, Twink realises science has its limits and his mood continues to dip as he anxiously waits to watch the results of having been filmed by the crew of Newsnight for a special edition on mental illness. His investigations into mental illness bring him to the kitchen of Professor Anita Thapar, an expert on attention deficit hyperactivity disorder (ADHD).

Previous episode: Part 5 - Post-partum psychosis and motivation

Next episode: Part 7 - Post-traumatic stress disorder


[Previously on Last Chance Saloon…]

Twink: I’m actually on 17 tablets a day. Noel Gallagher, this is drug taking.

Woman: I had these slightly scaring hallucinations where I remember my brother gave me this brown teddy bear and I just kept seeing it all over the place in strange places, and maybe that was in some way my subconscious kind of warning me, you know, be careful, you could do something silly here.

Twink: The process of actually lying on a slab made me feel a bit like I was being laid out in a morgue. To be honest with you I was terrified.


Anita Thapar: It’s very lonely for these children and their families and then they have to face stigma. You know, whatever you feel about diagnosis, these individuals have got to be – are asking for help, and we have to apply evidence-based knowledge to help individuals and recognise as a society that being judgemental is really not very helpful for these children or their families.

Twink: Hi Barry, quarter to nine. I’ve had five really bad days and I’m feeling quite bad. It’s been unusual to have five bad days on the trot. I’m hoping that I’ll feel better tomorrow. I don’t know whether it’s because of the Newsnight thing going out tonight or other issues, I don’t know, but I’ve just had five bad days. I’m still feeling a bit anxious about how the film’s going to be cut and just trying desperately to get to the next day, just trying to prepare myself for the Newsnight broadcast, so I’ll sign off now and say see you later.

[Newsnight broadcast]

Jeremy Paxman: Tonight and later this week our science editor Susan Watts brings news of medical developments which promise a revolution in the way many mental illnesses are treated and so literally may offer the promise of life over death.

Susan Watts: The statistics are shocking. One in four of us will suffer some form of mental illness during our lifetime. And mental illness costs lives. One in six people with bipolar disorder, or manic depression ,will kill themselves.

[End of broadcast]

Twink: Could you just explain what is ADHD?

Anita: Is ADHD the same as kind of naughtiness? And a lot of people ask this and the answer is no. ADHD is one of the neuropsychiatric disorders, it falls under the group of what we would call early-onset disorders, like for ADHD by definition the problems have got to be there and causing problems before the age of seven.

There are three main sorts of features of the disorder. First of all, there’s very marked hyperactivity, so these children are unable to stay seated in situations that children of their own age and developmental level would ordinarily be able to do, so for example they cannot – going to the cinema, going to church, they are constantly moving so they find play activities very difficult. But it’s not just this, they have very marked concentration difficulties and of course once they reach school that causes major problems with learning and education even when – they can be very bright, they’re unable to organise themselves, lose things, forget things. And then the third feature is impulsiveness, doing things without thinking which are dangerous, constantly interrupting. Again everyone interrupts at times, but just to the point where it really interferes with discourse.

Twink: I thought prior to doing these films that I could ask simple questions and get simple answers. And there’s not simple answers, there are complex answers, but when you probe a little bit deeper, just to try and get under the skin a bit, you find out that the experts don’t even know. And when the experts don’t know, then it prompts the question of why don’t they know?

Anita: Not only have you got to have severe symptoms, for there to be a diagnosis you’ve got to have them in more than one setting, so it’s not just at home, it’s got to be in another setting. And then the final thing, before making a diagnosis, is that these symptoms have to be resulting in significant impairment – problems with school, educational failure, lack of friendships.

Teacher: Let’s have a look, look at the size of that, that’s a monster isn’t it?

Child: Wow.

Twink: Yeah, like over your shoulder, because I want the top of your teeth.

Twink: How do you actually treat ADHD?

Anita: A diagnosis is just part of a person, so you have to take into context the person as well as the disorder, so where children for example have got very severe ADHD, you would tend to use a combination of school support and school-based intervention, medication, and behavioural treatment. When they get older, something that is called cognitive behavioural treatment, which is ways of thinking and control of your thoughts.

Twink: The illness is so engrained and so part of me, I can’t actually distinguish between the two, between the one trying to find out about the illness and the one that is the illness. It seems to be an enigma wrapped up in a riddle. How long’s it going to take for us to understand how this organ works? We don’t know enough. We don’t know enough about the brain, we don’t know enough in research terms about bipolar, but I still want to continue doing the films, I want to keep asking the questions until I find not closure but encouragement that we can find the answers. That’s – we need that encouragement, we need the level of investment, we need everybody to go, ‘hang on a minute, we need to know more about the brain’.

[Newsnight broadcast]

Man: Can you just tell us how things have been going over the last four years Twink?

Twink: Yeah. I’m starting to see the green shoots of getting better. The last four years have been challenging, at times been desperate.

[End of broadcast]


Twink: Does anybody know what causes ADHD?

Anita: You need a number of different approaches to really understand something as complicated as the brain and a complex condition like ADHD. There are multiple factors that work together in increasing your risk but what we’ve been focusing on mainly in Cardiff is the genetics and how genes work with environment, with regard to ADHD. Why are we interested in that? Not because a gene is going to predict with certainty ADHD; it will hopefully give us clues about the underlying brain processes and biology and give us clues then as to how it arises and clues for future interventions. It’s like having a little window into the brain and then working out what sorts of - how it arises and what makes it worse.

Twink: It strikes me that we know very little about the brain.

Anita: Yes, absolutely.

[Music followed by Newsnight broadcast]

Watts: As scientists begin to unpick the workings of the brain, the challenge is to find new, more effective treatments. Until now it’s been pretty hit and miss, almost stumbling across drugs that happen to work. But with new tools such as brain scans and genetics, scientists are talking about a much more sophisticated approach, bringing the medicine of mental health out of the dark ages and into the 21st century.

[End of broadcast]

Twink: Mm, didn’t get very long for six hours of filming. Apart from that it was alright. And how well it goes down with the mental health community, time will tell.


[Coming up in part 7…]

Twink: I saw my sister a few months ago and I was talking about doing the album and stuff and she says, “Oh do you not remember Ally Bally that mum used to sing?” And I looked it up on the internet and I started strumming the cords and I broke down. The tears that were just streaming out of me; it reminded me of my mum.

Scientist: Not surprisingly you’re much more likely to develop post-traumatic stress disorder after some traumas than you are after others. So for example, rape, a horrific, traumatic event, is the trauma that most research shows is most likely to result in you developing PTSD. So some studies have shown that over 80% of people who are raped go on to develop post-traumatic stress disorder.


Twink: Right, promise me to do one thing – on your way to work, when you come back from work, you play Tinstones CD in your car. And then that’s the only way to get it into your subconscious.


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