Welcome folks, Dr. Charles Parker. I'm here to tell you about one of the most important clinical problems that we see almost every day in my outpatient offices. And we've been seeing them since the early 90s and we've been talking about it for many, many years. And it's this following problem regarding misdiagnosis and mistreatment of comorbid attention deficit disorder and depression. So I called the basal ganglion CSOF. A person has depression and ADD at the same time and one of those halves is mist. It makes the whole problem much worse. And the person feels completely untreatable like a treatment failure. You know, if you feel like you're a treatment failure, you've been treated and treated and treated for depression. But it's not getting better. It could be that you have a significant attention deficit disorder problem associated with it. So how does the CSOF work? Well, it's really simple. On this side of the equation, the CSOF is a balance like a regular CSOF. And you've got attention deficit disorder on this side and depression on this side. Okay, so attention deficit disorder has people have a problem with dopamine deficiency. I'm oversimplified, but let's just call it a dopamine, relative dopamine deficiency. And we're going to treat that dopamine deficiency with a dopamine, a dopamine energy, a medication. Something that's going to affect the dopamine function on that side of the equation. And a person who has depression, many forms of depression, predominantly serotonergically related. So you're going to use a serotonin medication for depression. Now, if you mist one of those halves, here's what happens. So assume the person has both problems going on but one half of it's not recognized. So what happens is a smart pediatrician comes in and sees this child with attention deficit disorder treats the dopamine side of the equation and pulls that dopamine up appropriately. What happens to the serotonin? It actually goes down. Well, what happens when serotonin, which is already compromised, goes down? Well, the child feels like they're completely depressed. They crash very hard in the afternoon, vigorously. And what happens then, the individual, most of the time the physician will try to change the dopamine product repeatedly and mist this side of the equation. Theetricians are not trained on the depression side. Some of them are not trained on the attention deficit disorder side, but that's how the oversight occurs. Now, if you take the other side of the equation, what happens frequently with adult psychiatrists, not all of them, but, and this is not all pediatricians, but this is what happens. An individual who sees only part of it, saying adult psychiatrists sees only the depression. They get the serotonin correct, but they aren't really trained to recognize attention deficit problems. In fact, many of them just don't believe in attention deficit disorder, which is the whole other thing. So what happens is you get the serotonin treated, you get the dopamine come down. What happens when a person loses their executive function? You tell me. Bipolar illness. Yeah. It's not bipolar. It is half of the diagnosis is missed. You can't treat a serotonergicly related problem, a depression with the dopamine. Nor can you treat a dopamine problem with serotonin. Serotonin doesn't treat a dopamine problem. Dopamine doesn't treat a serotonin problem. So you have to treat both of the problems simultaneously. It's just like if you came in and you had heart disease and outward position, I said, listen, I know you got heart disease, but I'm going to try and treat it with insulin. I'm going to give you some diabetic medication and I'm going to cross my fingers and hope that it works for a heart disease. I don't think so. So what happens is we have two different, relative, two different disease states, really for one of the better expression. One of them is dopamine, energetically related. One of them is serotonin, energetically related. And we have to treat each one simultaneously, carefully with very clear ideas of what we're doing on both sides of the equation. Very simple, very quick. Think about this. Don't treat depression with a stimulant. Don't treat ADD with a serotonergic antidepressant. It will not work. The person will get worse and they will very likely be called, you guessed it, bipolar illness, and get a big dose of depacote, which they don't deserve. So thanks for your attention. Talk to you later. Have a good one.