UNDERSTANDING AND COPING WITH ADULT ADHD
by Janet Frank, Ph.D. CPANCF.COM (352) 336-2888
all rights reserved Clinical Psychology Associates of North CentralFlorida 2121 NW 40th Terr. Ste B, Gainesville, Florida 32605
Being a parent is enough to make any of us feel frazzled and unorganized at times. We have all experienced walking into a room, only to forget what we went there for. Having a busy, distracting life is tough enough, but for a parent with Attention Deficit Hyperactivity Disorder, some of the daily challenges take on even more significance. This article is intended to offer some information about ADHD in adults, and to provide some tips for parents and other adults who may have ADHD.
The full name of the disorder is Attention Deficit Hyperactivity Disorder. There are specifications for Hyperactive-Impulsive Type (ADHD) and Inattentive Type (ADD, without the H for hyperactivity). Ed Hallowell, M.D., says that ADHD is a misnomer, that it is really a disorder of attention inconsistency rather than deficit. Individuals with ADHD are capable of sustaining attention for long periods of time, but usually only to tasks that are of significant interest to them. This sometimes interferes in daily functioning, as well all have to do things at times that are not of great interest to us.
Adults with ADHD often exhibit many of the following behaviors: unfinished tasks, broken promises, unfulfilled potential, temper outbursts (emotional sensitivity), resistance to being touched (physical sensitivity), fidgety, tend toward drug/alcohol abuse, inability to cope with the stresses of life, procrastination (due to distractibility), seeming not to hear/being inattentive. ADHD adults also may overfocus (e.g., 12 hours on computer at expense of other important tasks), are impulsive, have difficulty with organization, are easily bored, can’t sit still, and often have learning disabilities.
These comments often characterize someone with ADHD: She doesn’t finish what she starts. He’s irresponsible. She’s smart but she doesn’t settle down. He never follows through. She won’t let me comfort her when she’s upset. He falls asleep watching TV the minute he comes home. She doesn’t realize I’m tired too. He’s so immature.
The severity of ADHD is on a continuum. Being diagnosed depends on how well one manages the symptoms. It’s this continuum that makes it hard to estimate how many people have it. Current estimates range between 1-22% of the general population. Some say more boys than girls have it. Dr. Lynn Weiss believes it’s the same proportionally, but the behavioral characteristics in women are not as easily observed, and may be diagnosed as emotional or unstable behavior instead. Dr. Barkley believes that the diagnostic criteria for children needs to be gender specific, and that currently, girls have to be more impaired than boys to receive the diagnosis.
The current thinking is that ADHD is that it is a genetic disorder. The brain is believed to be less active in the areas controlling attention/concentration. ADHD is also believed to be connected to low levels of a brain chemical called dopamine. Stimulant medications (such as Ritalin) are believed to work because they make that area more active and result in better focus.
It is a misconception that everyone with ADHD has emotional problems, though assessing for co-existing depression or anxiety disorders is important since this has important implications for treatment planning. Sometimes, the emotional difficulties a person experiences are just offshoots of living in a society that has non-ADHD standards. It is simply an issue of the ADHD person’s brain being wired a little differently from most individuals’. Contrary to popular myth, ADHD does not result from poor parenting or family dysfunction.
The diagnosis requires evaluation of childhood, parental, and sibling history and symptoms; school records/teacher comments; checklists used to assess inattention, impulsivity, hyperactivity, and emotionality. It is useful to hear several anecdotes to describe these symptoms, both from the patient and from significant others. Often psychological testing is used to look for patterns of consistent difficulties with attention or inhibition of behaviors, co-existing disorders such as learning disabilities, and rule out other disorders. Psychological testing allows for a more objective evaluation in comparison to others of like age and ability.
Treatment of ADHD often involves a combination of education, medications, and learning skills. According to Dr. Weiss, there are stages of treatment through which an individual will need support:
1. Aha, I have it.
2. Grief–there’s a reason you could not live up to people’s standards!
3. Seek support, understanding, and companionship during grief
4. Seeking, exploration, and experimentation. Everything looks different—try new things.
5. Coming of age– enjoy a new identity, redefine values, honor talents/ gifts
Dr. Hallowell notes several common problems concerning treatment of ADHD:
1) someone key in life does not accept the diagnosis
2) after an initial burst in improvement, progress slows
3) a newly diagnosed person does not want to try meds (although this does not preclude success) 4) no meds seem to work (although Dr. Barkley says try them all in order to find the right one)
5) stigma about using meds, e.g., from pharmacists
6) lack of people who understand what it’s like to have ADHD
7) trouble deciding who to tell about ADHD, and how to tell them
8) hard to find a clinician qualified to diagnose and treat ADHD
9) attempts at structure keep falling apart
10) feelings of shame and embarrassment about having ADHD
Despite numerous possible obstacles and failures that have often occurred prior to diagnosis, adults with ADHD usually possess a number of wonderful qualities and traits. They are sensitive, creative, and often very intuitive. Treatment of adults often includes rebuilding one’s self-image, and learning to express and deal with pent-up anger and guilt. Individual or family therapy, as well as support groups can be helpful, as can learning to say no.
Useful Tips for ADHD Adults
Restructure your life.
- Encourage loved ones to assist by give you extra reminders, while taking the ultimate responsibility.
- Lists are your best friend.
- Pace yourself
- Your work space should be of sufficient space but free of excess distractions
- Experiment with background sound to cover other distractions
- Always have a specific plan. Budget in time for distraction. In other words, allow yourself to procrastinate.
- Try to master distractions. If you can’t see a reason to do something, don’t do it, unless it is a responsibility that cannot be shunned. Pay someone, trade off with a spouse–there has to be an inner willingness, or distraction will likely be a problem.
Learn to negotiate
- Get your temper under control. Never try to make a deal or compromise when your temper is active. Don’t blame others. Your reactions to what anyone does are still your responsibility. Identify the underlying anger and use words to express it.
- Learn not to blame. Remember that it doesn’t matter WHY something happened. But it does matter WHAT happened. Come up with a plan to solve the problem rather than worrying how the problem got there. Be specific. Set the plan in motion, and stick to it.
- Guard against co-dependent behaviors. In codependency, we focus attention on each other rather than taking responsibility for ourselves. A person with ADHD often blames others for problems, and significant others often end up taking responsibility.
- A partner can help break a task down, or facilitate communication with direct questions.
Janet Frank, Ph.D., wrote this article while an Associate and Licensed Psychologist with Clinical Psychology Associates of North Central Florida (CPANCF). The article originally appeared in Gainesvile Family Magazine.
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