THERESA CERULLI, M.D.,: CHANGING THE PARADIGM FOR TREATMENT OPTIONS FOR ATTENTION DEFICIT DISORDER AND ATTENTION DEFICIT HYPERACTIVITY DISORDER
Theresa Cerulli, M.D. has an innovatingly refreshing approach to treating Attention Deficit Disorder ("ADD") and Attention Deficit Hyperactivity Disorder ("ADHD"). I recently had an opportunity to chat with Dr. Cerulli and to learn how she is creating new paradigms for the treatment of ADD and ADHD.
D.A. Sears, Managing Editor - IN SEARCH OF FATHERHOOD(R)
She is a graduate of Tufts University, the University of Massachusetts Medical School, the Harvard Longwood Residency Program in Adult Psychiatry, and the Harvard Fellowships in Medical Psychiatry and Neuropsychiatry. She is THERESA CERULLI, M.D., a former Medical Director for the Hallowell Center in Sudbury, Massachusetts, and the co-founder and Chief Medical Officer for the ADD Health and Wellness Center in North Andover, Massachusetts where she specializes in the holistic treatment of children and adults with Attention Deficit Disorder (“ADD”) and Attention Deficit Hyperactivity Disorder (“ADHD”) and co-existing behavioral health conditions. Dr. Cerulli is a Board Certified in Psychiatry and is on staff at Beth Israel Deaconess Medical Center in Boston and Hallmark Health's Lawrence Memorial Hospital. A recipient of the 1997 Harvard Residency Teaching Award, Dr. Cerulli has published several journal articles in the Harvard Review of Psychiatry and was an Instructor at Harvard Medical School for 8 years where she lectured on a range of neuropsychiatric topics including Attention Deficit Disorder, Depression and Electroconvulsive Therapy.
Dr. Cerulli has served nationally as an expert witness for ADHD and works as a consultant and speaker for Shire and Novartis Pharmaceuticals in their CNS divisions. Currently she is a sub-investigator with East Coast Clinical Research for two Phase IV psychotropic medication trials. Her work on ADD and ADHD has put her in the media spotlight. Dr. Cerulli has appeared on Channel 7’s Urban Update where she participated in a debate on the use of psychotropic medications in children with ADHD and was the subject of interviews on WBCN Radio where she discussed ADHD diagnosis and treatment and on Channel 56’s Health Watch regarding ADHD and the use of Quantitative EEG. Recently, Dr. Cerulli accepted a Medical Advisory Board position with Kiwi Magazine.
Where did Dr. Cerulli grow up?
“I grew up in Melrose, Massachusetts, a northern suburb of Boston. I was born, raised and educated in Massachusetts despite my childhood idea of moving to a warmer climate. My family roots are there, and as I grew those family ties were much more important than escaping a few snow storms in our extended New England winters,” Dr. Cerulli responded.
When I asked Dr. Cerulli to talk about the role models that she had as she made her journey from childhood to adulthood, she quickly pointed to her mother. Her mother has been and continues to be her source of inspiration.
“My mother played a significant role in shaping my journey from childhood to adulthood. I was not an easy child to raise. I was headstrong and stubborn, wanting to learn by my own mistakes rather than listening to guidance. Perhaps that is the core of my love for working with ADHD children and adults. I have special praises for their will and passion. Mom has been and continues to be my inspiration. I distinctly remember as a child, her common household teaching, ‘Never say I can’t, say I’ll try.’ Her work ethic and strength are extraordinary. Without receiving any formal education herself, she emphasized the importance of education and kept her promise that she would find a way to shoulder four children financially and emotionally through college against significant odds.”
What motivated Dr. Cerulli to embark upon a career path which focuses on ADD/ADHD?
“I attended Tufts University in Medford, Massachusetts where I majored in biology, then I went on to attend the University of Massachusetts Medical School in Worcester, Massachusetts where I completed my psychiatry residency at the Harvard Longwood program in Boston. I was always fascinated by the interplay between medicine and psychology, and went on to do a fellowship in Medical Psychiatry at Brigham and Women’s Hospital and then a second fellowship in Neuropsychiatry at Beth Israel Deaconess Medical Center in Boston. During my neuropsychiatry fellowship I cared for clients with various underlying neurobiological conditions that led to psychological and cognitive changes such as Alzheimer’s, strokes, head trauma, and ADHD. I found working with my ADHD patients to be most energizing and rewarding – they get better! With a little guidance and structure ADHD clients will often excel. Many are creative, spontaneous and entrepreneurial thinkers once you get past the structural issues that get in their way. As fate would have it my husband was later diagnosed with ADHD as an adult – no, not by me. And so began my ADHD career personally and professionally.”
The discussion moved to Dr. Cerulli’s position at the national ADD Health and Wellness Center in North Andover, Massachusetts – an institution she co-founded. What are some of the programs and services offered by the ADD Health and Wellness Center to ADHD patients?
“I now gratefully serve as the Chief Medical Officer for the national ADD Health and Wellness Centers which is a national organization. We currently have offices in Dallas, Austin, Houston, and the greater Boston area with plans to open several more locations in the near future including Washington D.C. Our reach is already widespread beyond the clinic walls. We have built-in programs that we can administer 100% by phone such as ADD coaching and Cogmed Working Memory Training which is a five-week software based program the client participates in from the comfort of their own home, with the support of a trained clinician to improve attention, working memory, and academic skills. We are an organization specializing in the holistic care of children and adults, aiming to improve attention, memory, focus, and emotional well being. We help people set and meet their personal goals, improve their minds, learning, behaviors, relationships, and happiness. Did you know that happiness could be a goal?” Dr. Cerulli remarked.
What is ADD? What is ADHD? I was surprised to learn that ADD and ADHD are the same.
“ADD and ADHD are one and the same,” Dr. Cerulli explained. “The correct terminology is ADHD with qualifiers such as predominately inattentive type, predominately hyperactive/impulsive type, or combined type. ADHD is a neurobiological condition with strong genetic underpinnings. The hereditability factor is .77 which means that 77% of people who have ADHD do so based on their genes. That still means that 23% have ADHD based on non-genetic factors such as maternal smoking, birth trauma, or environmental factors. The three hallmark symptoms of ADHD are inattention, impulsivity and hyperactivity or restlessness, but these symptoms can present very differently in each individual. For example, people with ADHD may struggle with varying degrees of difficulty staying on task, paying attention in conversations, following through on details, or organizing and planning events. They may be restless and distractible, or perhaps impulsive and short tempered. Or maybe they simply have the quiet and day-dreamy type of ADHD.”
Is ADHD a new phenomenon? Dr. Cerulli says “No!”
“ADHD is not a new condition. Though the name has changed over time, the diagnosis dates back to the 1930s. It is an old condition with new understanding, research, and awareness. With raised awareness, the term ADHD became more familiar and seemingly “over-diagnosed”. But by statistical measures, 7% of school aged children have ADHD and 4% of adults, which means we are still significantly under-diagnosing the condition.”
So, are there diagnostic tests for ADHD? How is ADHD diagnosed?
“Diagnosing ADHD is simple yet extremely complex at the same time because so many other conditions cause problems with attention and concentration. In our overwhelmed, stressed-out culture on any given day we can all seem like we have ADHD. To add to the confusion, there are many conditions that can co-exist with ADHD such as learning disabilities, anxiety, sleep disorders, and depression or bipolar depression,” Dr. Cerulli responded.
What treatment options are available for ADHD patients?
“Treatment options for ADHD have really broadened. Structured therapy, ADD coaching, working memory training, natural supplements, parent training, academic supports, social skills training, family counseling, and ongoing developments in medications (both stimulant and non-stimulant) are all interventions shown to be helpful. Great news is someone diagnosed with ADHD today has many options beyond Ritalin. It’s an exciting time to be in this field of cognitive behavioral health.”
How effective are psychotropic medications such as Ritalin in combating ADD and ADHD?
“Effectiveness of stimulant medications for ADHD is approximately 70%. That means that most people can find a medication that will help if they choose. However 25 – 30% of people with either not feel benefit from taking medication, or will experience significant side effects that hinder using medication. Common immediate side effects may include loss of appetite, weight loss, jitteriness, heart racing, sleep disturbance, headaches, moodiness, and anxiety,”
I noted that Ritalin has been prescribed and continues to be prescribed for young children who have been diagnosed as having or perceived to have ADD or ADHD. Are we doing more damage than good by allowing our children to take ADD or ADHD? In what ways can Ritalin negatively impact on the physical and intellectual development of our children?
“The long term effects of Ritalin and other stimulant medications have been well studied. Research has shown that stimulants can cause growth delays, exacerbation of tic disorders, and increased tolerance - which means needing higher doses of the medication to get the same benefit. The greatest risk with stimulant medication is their misuse and abuse. Particularly frightening is the sharing and selling of these drugs on college campuses. However, when taken as prescribed with close monitoring by a knowledgeable physician, medication can be helpful. I strongly recommend that clients visit with an ADHD specialist who can carefully evaluate the individual needs of the client from a holistic perspective. Medication should never be the sole focus of ADHD treatment.”
Transcendental Meditation has been introduced as a treatment option for children and adults who have been diagnosed with ADHD. I asked Dr. Cerulli to share her thoughts on transcendental meditation as a treatment option for children and adults who have been diagnosed with ADHD.
“Recent research supports the benefits of transcendental meditation as a wonderful treatment alternative for focus and concentration. Meditation has the unique dual effect of increasing ‘alertness’ brain waves to improve attention, while simultaneously inducing a physical and mental state of relaxation. A perfect fit for someone with ADHD!” Dr. Cerulli opined.
How can our readers contact the ADD Health and Wellness Center?
“Your readers can contact our ADD Health and Wellness offices at 1-866-324-2088 or visit our website at www.addhealthandwellness.com,” Dr. Cerulli commented.
And what’s next for Theresa Cerulli, M.D.?
“I hope to be on this life path for many years to come. I love my work as Chief Medical Officer for ADD Health and Wellness and strive to share our vision with as many people as possible. I’ve followed many clients for over 8 years and feel privileged to be part of their lives. I get to enjoy still working one on one with my clients, yet have the opportunity to extend what I do through teaching training, speaking, and overseeing our organization dedicated solely to this field of cognitive health and well being. We are now working on a book together with our clients who have been willing to share their stories to illustrate our personal team approach to ADHD. I give thanks to all of you who have volunteered for this important project. Where do I go from here? Well, I have the small goal of changing the whole paradigm of how behavioral health care is administered. Why? ‘Never say you can’t, say I’ll try’.”