Coping With Attention Deficit Disorder (ADD/ADHD).

To Whom It May Concern…

I wasn’t diagnosed with Attention Deficit Disorder (ADD) until I was an adult, that said, in retrospect the symptoms were fairly clear throughout my childhood and teenage years. ADD is traditionally associated with ADHD (Attention Deficit Hyperactivity Disorder), but ADHD is actually a type of ADD. ADHD is best known b/c it has all the symptoms of ADD PLUS a huge bundle of energy and externally inappropriate behavior (e.g. talking in class, running when one should be sitting, etc.) that are highly visible. Someone with ADD can much more easily fly under the radar since most of their symptoms will be internal rather than external.

The cerebellum is largely responsible for coordinating...
The cerebellum is largely responsible for coordinating the unconscious aspects of proprioception. (Photo credit: Wikipedia)

Anyways, I’ve written up this short post for those who have asked me how I manage being ADD. This article fits nicely alongside my previous article, “Surviving the Darkness: A Crash Course in Muddling Through Anxiety, Depression, And So On.” Now I just need to write another article on Obsessive-Compulsive Disorder (emphasis on Scrupulosity) and I’ll have shared my coping techniques for all my major mental ills.

Do You Have ADD?

Mental Disorders should be diagnosed by a professional (psychiatrist/psychologist). Why? Because the various disorders can overlap in various ways. For example, my anxiety may appear as ADD as it drains all my attention from what I need to be focusing on. Or conversely, my anxiety could be caused by my inability to focus which is in turn caused by my ADD. You really don’t want to try and treat the wrong thing. While there is overlap in the symptoms, the treatments are oftentimes significantly different – and you could spend years unsuccessfully battling ADD when you really have x (or nothing at all).

So, I suggest talking to a psychiatrist/psychologist as a first step if you believe there is something amiss with your brain.

Medication

I know, I know, you don’t want to hear about medication – but I’m going to tell you about it anyways. I don’t want to suggest that folks go on pills if they don’t need them – on the other hand, if your psychiatrist believes you have a disorder and thinks medication is a good mode of treatment – I’d encourage you to consider it, especially for ADD. Why? Because you will be able to tell within a few days if you respond to the medication. For me, I think the first day I started taking Adderall it made a huge difference in my ability to focus…and has continued to have significant dividends for me.

I currently take the generic form of Adderall XR at a dosage of 20 mg per day – this is a relatively low dose. See the end of this article for an Appendix discussing in more detail medication – but for now, I just wanted to raise it as a possibility.

Psychoeducation

It is important to understand the nature of your illness, why it occurs, what makes it worse, what makes it better, and so on. This is a process of psychoeducation. I’ve read two excellent books on the subject – and they are both excellent and I would recommend reading both. The first is Taking Charge of Adult ADHD by Dr. Russell A. Barkley. The second is Delivered from Distraction by Drs. Edward M. Hallowell and John J. Ratey. If you have to choose just one – go with Taking Charge of Adult ADHD.

These books will help normalize your experiences – demonstrating that you are not alone in what you feel and think. They will also provide you with information on medications and numerous other forms of treatment. If you don’t want to see a doctor right from the start these can provide a good starting place with their self-evaluation quizzes which demonstrate the likelihood of your having this disorder in a preliminary manner.

Distraction

I play video games – particularly, historical, turn-based strategy war games…any turn-based game will do though. Why turn-based? B/c the computer takes a turn, which means you have nothing to do for a period of time – and during that time you can get some work done (e.g. homework). No, you can’t do this at work – but for tasks at home, it can be a real help.

In my case I might play a five minute turn, then begin doing research / whatever for the next twenty minutes, then take another five minute term and so on.

Task Management

To some extent we have to live with the fact that we have a REALLY hard time staying on task. This just isn’t going to go away. Take the time to learn how to manage tasks and ensure that you are getting done what really needs to be done. David Allen’s excellent book Getting Things Done is a great tool in this area.

Get Help

My smartphone is crucial to my successful in everyday life. My mind wanders at a million miles a minute. Without my smartphone beeping at me to eat, to attend meetings, to remember holidays – I would not, and I did not (my wife will bear witness!).

Take the opportunity to find people who have strengths in your weak areas. If you are on a team at work, try to ensure you get someone who is disciplined, orderly, time-oriented, etc. on your team. You may be a great idea person, an energetic creator – but your ability to get everything done in the required order on time may be insufficient. There is no shame in accepting the assistance of others to do better.

No Shame

When I write these articles I think to myself, “Do I really want to write this? Folks are going to think I’m crazy. What if they don’t want me to work for them, or think I can’t be responsible b/c of the illnesses I struggle with?” I feel shame and guilt over my weaknesses – but the truth is they are real and I’ve got to live with them…and, honestly, most folks who interact with me don’t know I have these issues – unless they read an article like this or I tell them.

Our illnesses are a weakness, but they are also oftentimes a strength. They allow us to see things from a different perspective and to attack problems from a different angle. In spite of these weaknesses I don’t find myself producing inferior work to others…though I do find myself producing inferior work compared to my potential. But each day I progress a little further in my ability to manage these handicaps.

Don’t let others shame or guilt you if you struggle with these forms of illness. Don’t let folks make you feel stupid or like a dead weight – you aren’t. Most importantly, tell the little voice inside your head to shut up when it criticizes you, b/c that is the harshest voice of all.

Appendix: Adderall

There was some concern about Adderall in the past causing death in some patients. From what I understand more recent studies have shown mitigating circumstances to be involved in all deaths by patients on Adderall (but go look at the reports and ask your doctor…I’m no clinician).

When I first took Adderall it caused heart palpitations. Now, I have Wolf-Parkinson-White syndrome, so right there I have a heart condition which makes my case a bit abnormal compared to most.

That said, I took Adderall for some time and the palpitations decreased in frequency. Eventually I moved to XR (extended release) b/c Adderall is a quick-acting medication which is flushed out of the system in a matter of hours and I needed something that would help me focus throughout the day – not just for four hours. Once I began taking XR, palpitations ceased entirely, though when I later took a regular release Adderall I again experienced heart palpitations – so I stay away from them.

Again, I have WPW and have heart palpitations on occasion (and have had them for years before ever starting Adderall).

“But Dave, I don’t want to rely upon drugs.” Do you drink coffee, tea, energy drinks? Consume large amounts of sugar? Then you are already relying upon a drug. I just take one in smaller amounts under the supervision of a doctor. Which do you think is safer/healthier? 🙂

Mental Health Reading List (Part II) – OCD and AD(H)D.

Per my introductory post, in several upcoming posts I want to discuss briefly different mental disorders and recommend a book or two that I’ve found informative. This list isn’t just for sufferers, as I mention in my early post it is my opinion that anyone who wants to be a leader (educational, religious, political, business) should familiarize themselves with the major psychological disorders. Today we will talk about OCD and ADHD.

Obsessive-Compulsive Disorder (OCD):

According to the National Institute of Mental Health this disorder affects 2.2 million U.S. adults each year. The NIMH defines OCD as, “…an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called ‘rituals,’ however, provides only temporary relief, and not performing them markedly increases anxiety.”

Recommended Reading:

  • Rapoport, Judith L. The Boy Who Couldn’t Stop Washing: The Experience and Treatment of Obsessive-Compulsive Disorder. Signet, 1991. 304 pp. My Comments: This book is perhaps the best volume I have ever read on OCD. Unfortunately, it is nearly eighteen years old. Here’s hoping for an updated edition in the near future! Still, its case studies are priceless in helping both those who suffer and those who don’t understand the disorder. Not to mention that Rapoport is one of the definitive experts in the field.
  • Crawford, Mark.  The Obsessive-Compulsive Trap: Real Help for a Real Disorder. Regal Books, 2004. 168 pp. My Comments: This volume is much smaller and more recent than Rapoports’ but lacks the depth of case studies Rapoport’s book provides. Still, it covers most of the bases and is a quick read. It is written from a distinctly Christian perspective.

Attention Deficit (Hyperactive) Disorder:

ADHD is perhaps one of the more common disorders and a polarizing disorder. There is a significant number of individuals who challenge the existence of ADHD, believing it to be an excuse for behavioral and social issues. That said, it affects between 3-5% of children and over 4% of adults according to the NIMH and is Wikipedia describes it as, “is characterized by a persistent pattern of impulsiveness and inattention, with or without a component of hyperactivity.”

Recommended Reading:

Concluding Note:

Recognizing and dealing with what is wrong with ourselves can be huge. It can help us function at a higher level and enjoy life more. It can also be useful when we see these sorts of disorders in others. It can give us a sense of empathy that we might not otherwise be able to experience. The suffering caused by mental disorders while not visible is tremendous, and working together we can significantly increase our own and others overall health by getting the medical help we need and being there for one another.