Attention Deficits - Living with ADD and ADHD
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Most people with Attention Deficit Disorder don’t know they have it.
Indeed, the disorder was not recognized until the 1980’s, and it was not until the 1990’s that the recognition of adult ADD was established. However, it is a condition that can have a significant impact on the way a person functions in the world. Unfortunately, Attention Deficit Disorder is poorly named. It is not so much a disorder as it is a difference in the way some people process information and focus their attention. And to call it a deficit fails to recognize the many strengths that these people have. ADD, however, is perhaps a better name than the old word for it – minimal brain dysfunction.
Researchers used to think that what they called “hyperactivity” was a condition found in childhood that was outgrown during adolescence. We know now that about one-third of children with these symptoms outgrow them during adolescence, and the other two-thirds continue to show symptoms into adulthood. Adult ADD is the topic of much current scientific research, and many adults are now able to put a name on what for them has been a lifetime of feeling misunderstood. The professional community now recognizes two variants of this condition – the “hyperactive” type (often referred to as Attention Deficit Hyperactivity Disorder or ADHD) and the “inattentive” type (commonly referred to as ADD).
Although not much is known today about the causes of ADD and ADHD, researchers agree that it is a neurochemical disorder, and it likely has a genetic component. That is, it tends to run in families. In fact, many adults with these symptoms don’t know that it has a label until one of their blood relatives is diagnosed with the disorder. It occurs in women and men, boys and girls, adults and children. It cuts across socioeconomic strata, income levels, educational levels, and levels of intelligence. It is not the same as a learning disability, dyslexia, or a language disability, and it is certainly not associated with low intelligence. Poor parenting, early trauma, labeling, or other psychological factors do not cause ADD. There may be, however, significant psychological problems that develop from growing up with the disorder.
Daydreaming is one of the defining characteristics of ADD. In conversation, the person may jump from topic to topic.
The ADD/ADHD Experience
Think of ADD and ADHD as the inability to turn off stimuli. Most of us are able to block out information from our environment, and this keeps us from becoming overwhelmed. For example, if we are trying to concentrate on a book, we tend to block out sounds from music or television in the background. If we are trying to listen to a teacher’s lecture, we don’t pay attention to what we see outside through the window. We tend to focus on one line of thought at the time to keep ourselves from becoming confused and chaotic. The person with ADD or ADHD, on the other hand, cannot turn off these external stimuli as well as most people (although they certainly block out most stimuli). Their lives become a struggle to filter out and manage the oversupply of information they have to deal with. What they are trying to do is to protect their sensitive inner selves. If the amount of information from their environment becomes overwhelming, they can become overstimulated. “Hyperactivity” is simply the response of the nervous system to an onslaught of stimulation.
This brings us to the three defining symptoms of ADD and ADHD –
Distractibility – is usually associated with the “inattentive” type of attention deficiency, although it is found in both ADD and ADHD. Rather than focusing on one thing, the mind wanders to different arenas. Daydreaming is one of the defining characteristics of ADD. In conversation, the person may jump from topic to topic. In class, a student listening to a lecture suddenly finds herself looking out the window and then having fantasies about her upcoming summer vacation.
Other symptoms associated with distractibility include:
- Inattentiveness to details
- A tendency to misplace belongings
- Difficulty in completing tasks once they are started
- Avoidance of tasks that require concentration
- Poor ability to plan
Impulsivity – is found in both types of attention deficit, ADD and ADHD. Most of us have the ability to insert a thought between a stimulus and our response to the stimulus. That is, we are able to inhibit our responses by thinking things through. Although people with ADD/ADHD are able to inhibit their impulses most of the time, at times they feel overwhelmed with stimulation and they simply take action without thinking about the consequences. This is why people with ADD or ADHD are quickly aroused to anger.
Other traits associated with impulsivity include:
- Poor interpersonal boundaries (e.g., intruding when somebody is speaking)
- Blurting out a response before a speaker is finished
- Difficulty in waiting for one’s turn
Hyperactivity or Excess Energy – is found more frequently in ADHD than in ADD, by definition. It occurs when the nervous system is unable to cope with an oversupply of stimulation that cannot be controlled or filtered out. Rather than channeling this energy into daydreaming, the person stays connected to the energy and increases bodily activity.
Other indicators of hyperactivity include:
- Fidgeting (playing with fingers, feet constantly moving, toe tapping)
- Difficulty engaging in quiet activities
- A pressured need to talk
Other Characteristics of ADD and ADHD
There are many other characteristics found in people with an attention deficit. (Most of us experience at least some of these in our day-today lives, so it is not advisable to conclude that you have ADD if some of these items describe your behavior.) These include:
- Problems managing your time (not giving yourself enough time for a task)
- A tendency to take on too many tasks at the same time
- Difficulty in concentrating when reading or watching a movie
- Problems managing finances and balancing a checkbook
- Difficulty controlling temper
- A history of underachievement and not meeting one’s goals
- A history of periodic depression starting in adolescence
- Depending on other people to take care of life’s details
- Frequent moving and changing jobs
- Difficulty with long-term relationships
- A low tolerance for frustration
- A tendency to stay up late and rise late
- Losing track of the conversation when someone else is talking
- Chronic procrastination
- Frequently searching for high stimulation experiences
- Hyperfocusing at times to compensate for difficulty in maintaining attention
- A sense of insecurity
- Problems with negative self-esteem
- A tendency to worry
- Mood swings, especially when not engaged in an activity
- A tendency toward substance abuse (especially caffeine, cocaine or amphetamine)
If you have many of these symptoms and are having difficulty in everyday living because of them, you might want to consider an assessment by a trained professional. Treatment for ADD and ADHD is generally effective and can have a highly positive effect on the quality of your life.
It may seem that having ADD or ADHD is a negative experience, but this need not be the case. In fact, many creative people and wellknown historical figures probably had an attention deficit. For example, it has been speculated that Albert Einstein, perhaps the greatest mind of the twentieth century, suffered from ADD. He certainly had difficulty in his early school years, as do many people with ADD. But he also had many of the positive qualities found in people with this disorder. For example, people with ADD tend to be creative, energetic, talkative, socially aware, insightful, spontaneous, and enthusiastic. Once a person learns how to contain the symptoms that cause problems, the positive qualities can surface. In fact, with the proper treatment, people with ADD and ADHD can live productive, normal lives.
People with ADD or ADHD are sensitive. The are highly aware and are bombarded daily with stimulation that they need to manage.
Some Considerations in Dealing with ADD and ADHD
People who suffer from ADD and ADHD, through no fault of their own, often cause difficulty for other people. Their minds might wander during a conversation, they might blurt out remarks, which are inappropriate to the situation, or they never show up on time for appointments. During childhood they might create difficulties for both parents and teachers, especially when their activity level is high. Schoolchildren with ADD may daydream frequently in class or may have trouble following a logical line of thought. They put off working on assignments and then turn them in late or not at all. It is easy to understand why people with attention deficits invite anger from other people. Other people often label the sufferer mercilessly and do everything in their power to coerce more appropriate behavior. The ADD sufferer is frequently treated in a thoughtless, and often brutal, manner by others.
People with ADD or ADHD are sensitive. They are highly aware and are bombarded daily with stimulation that they need to manage. Their goal is to protect their fragile inner lives. Life becomes a struggle to maintain a balance between the integrity of the inner world and the onslaught of stimuli from the external. This struggle is intensified when they must deal with negative feedback from other people. Thus, people with attention deficit disorders often have to deal with self-image issues and depression. They constantly hear feedback telling them that they are intrusive, out of control, or low achievers. They end up feeling lonely and isolated. As they internalize the negative messages they hear from others, they begin to feel that way about themselves.
Because of the negative way the world tends to treat them, people with attention deficits develop psychological problems, even though ADD and ADHD have biological causes. Fortunately, a trained professional therapist is able to work productively with clients on these issues in a safe and understanding setting. Once a person with attention problems makes the decision to find treatment, a more normal and easier life lies just ahead.
What Are the Treatment Options for ADD and ADHD?
Most people with an attention deficit don’t suspect that this is their problem, or that it even has a name. They have been exposed to a great deal of pain in their lives, and they finally see a professional therapist for a number of related problems, such as work difficulties, relationship difficulties, depression, or substance abuse.
Treatment for ADD and ADHD usually consists of the following:
- First, find a trained professional who seems knowledgeable; you should feel comfortable with this person.
- You will first review your history with your therapist. This includes your family history, your physical (medical) history, your development, your history in school, at home and in jobs, and your history in relationships.
- Your therapist will rule out other possible causes for your difficulties (such as anxiety, depression or substance abuse).
- You will likely be given a psychological assessment, although not necessarily in all cases. Sometimes a lengthy interview will suffice.
- Once the diagnosis is made, your first goal will be to educate yourself about ADD and ADHD. You will read books, articles or resources you find on the Internet.
- With the help of your therapist, you will work on restructuring your life, both internally and externally. Internally, you start to think about yourself differently and you examine your self-image issues. Externally, you work on ways to improve how you organize and insert control into your life.
- You will start a course of psychotherapy in order to gain an understanding of what made you who you are today and what you can do to take a different orientation toward your life. This may also involve joining a therapy or support group with other people who share similar problems.
- You may or may not be referred to a physician regarding using medication. Many people with attention deficits benefit from safe doses of stimulant medication, while others benefit from antidepressant or antianxiety medication.
Most people with an attention deficit don't suspect that this is their problem.
Jody Michael Associates:
Hallowell, Edward M., and John J. Ratey. Driven to Distraction. Simon and Schuster, 1994, $14.00. ISBN: 0-684-80128-0.
Nadeau, Kathleen G. Adventures in Fast Forward: Life, Love and Work for the ADD Adult. Brunner-Routledge, 1996, $21.95. ISBN: 0-87630-800-0.