What is Attention Deficit Hyperactivity Disorder (ADHD)? part 1

So really. What the heck is it? Well maybe I can tell you what it's not. It's not a disease (STD's are a disease). It's not a deformity (an extra ear on your knee pit - now THAT's a deformity). It's not lower intelligence. It might be a chemical imbalance depending on other symptoms like Hyper/hypothyroidism etc. But the kind you have from birth is not a chemical imbalance.  So what is it? Let's move through this together.

The church of Scientology has issued many controversial statements, documentaries, adds and so on about this and many other human maladies. I have nothing against this religion nor any other and think each person should be allowed to practice what they believe to the fullest of their ability so long as it does impede on the same for me. As they would want it, ADHD is a myth. Like I said to each their own. However, they're morons to try and mislead many into thinking it doesn't exist. Neither does cancer, mental retardation or Pink Eye exist according to that line of thinking. Let them have it that way. It helps thin out the gene pool and keeps  them in the fringe with public faces like Tom "Mr. Glib" Cruise. Wooo. Yeah he's grounded.

I would tell you that the condition is not really a "deficit", per se. It's more like the opposite of a "deficit" - excessive. A flood of sensory input and no ability what so ever to filter out even the smallest stimulus coming in through the 5 senses. Sometimes it's like overload. You try to focus on this thing, but because the radar antenna of your attention is whirring around in a circle picking up every little stimulus then only picking up a bit and piece of the thing you're trying to concentrate on you get a little of every thing and all of nothing. Some people would say, "well just pay attention, focus." I'd say shut-up you don't know what you are asking.

The Davidson Institute for Talent Development out of Reno, Nevada says:

"People with ADHD describe that they are drawn to all the stimuli around them equally and simultaneously. They are like jugglers who give fleeting attention to each ball in the air. Nothing gets sustained, undivided involvement.

TAKE HOME MESSAGE #1: For persons with ADHD, the ability to maintain attention and impulse control is determined by one factor-- if the task is interesting, desired, or challenging, the individual with ADHD has no problem with distractibility or impulsivity. If, on the other hand, the task is boring, it is a neurologic impossibility to stay on task. Interest and challenge only determine the ability to function, not importance. This "interest based performance" is coming to be the hallmark diagnostic symptom of the disorder and the key to successful management once medication treatment has been established.

The swings of attention can be profound from states of "zoned out" dissociation to a condition known as hyperfocus. As many as 40 percent of adolescents and adults with ADHD can enter what appears to be an altered state of consciousness while doing activities which they consider particularly intriguing. During a hyperfocus the person performs at almost 100 percent efficiency, does not notice the passage of time, does not become tired or hungry, and has virtually 100 percent comprehension and retention of what he reads."

I couldn't have said it BETTER. Because the neurology needs higher stimulation to stay in the realm of where a person without ADHD is KEY here. Trying to simply listen to my wife tell me a story about something that happened to her during the day is a prime opportunity for my attention to zone and become numb-ish to the details being related. I want to listen, I can even feel my self sinking or drifting. Now comes the character attachments we make to some one who "doesn't listen to their spouse when they are talking". I don't care about her, I don't listen to her, I am self centered, self absorbed, just tolerate her. True? FALSE!!! Got some news for you. It has nothing to do  what so ever with what I think of my spouse or how I feel for her. It has every thing to do with the neurology and the ability to keep my consciousness "afloat" and in the moment. Do I feel like crap that I can't remember that she told me that story by the next day when she asks me something about it? you bet. Then comes the guilt, the name calling, the argument entitled "You never listen to me, you must not care". Blah blah blah..Get a grip here. Take a breath. You were just privy to one of a couple of dozen moments like that happening daily. In a meeting at work, with your boss in his office, with your mom on the phone, with your daughter in the car on the way home from school. God help us we don't mean it like that. It is how we are built. You could argue "So you're built to be selfish and self absorbed"? No. That is how someone with out ADHD is taught to understand that pattern. The pattern does not make the intent nor outcome. It is a symptom of something else. In this case ADHD. In a person with out ADHD? Sure, you betchya it's very likely to be an inattentive ass-hole. 

Continued later in part 2.

Attention Deficit Hyperactivity Disorder: ADHD in Adults

Credit where credit is due: This article is found on WebMD. I feel that opening this blog with this article is a good leaping off point to talk about the many generic descriptions mentioned in this article in a more personalized way. While this article is a good "High Level" look at what ADHD/ADD is in adults it really cannot be well understood by someone without ADHD not having a personal frame of reference in which to compare. If you ARE ADHD then this entire article will mean something to you but there are many of us who wish that the non-ADHD could understand better yet have the lack of ability to quantify it to them that in a way that says "You know when I do this thing or that thing you absolutely hate and get so infuriated with? Well it's not a bad "habit". It's a symptom of what I am and I have little to no control over it." 

We'll address the control and coping habits in a later post but keep that idea on the fore front of your mind. These symptoms are NOT habits. We have no control over them. We develop coping behaviors to mitigate the symptoms but that does not make them go away. And in many cases the coping mechanisms can be a wrong course of action to cope and cause more problems than the actual symptom! I could've retired when I was 30 if I had a dime for every time a non-ADHD person said something like

"You know if you would just <You fill in what ever it is that person is trying to tell you how to do better> then ...

1.     I wouldn't be so angry with you all the time 

2.     You wouldn't be broke all the time 

3.     This wouldn't happen all the time

4.     You'd have a better reputation on your job

5.     I could keep going with a litany of "then" but you get the idea

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Attention Deficit Hyperactivity Disorder: ADHD in Adults

What is Attention Deficit Hyperactivity Disorder (ADHD)?

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most well-recognized childhood developmental problems. This condition is characterized by inattention, hyperactivity and impulsiveness. It is now known that these symptoms continue into adulthood for about 60% of children with ADHD. That translates into 4% of the US adult population, or 8 million adults. However, few adults are identified or treated for adult ADHD.    

ADHD in Adults

Adults with ADHD may have difficulty following directions, remembering information, concentrating, organizing tasks or completing work within time limits. If these difficulties are not managed appropriately, they can cause associated behavioral, emotional, social, vocational and academic problems.

Adult ADHD Statistics

·         ADHD afflicts approximately 3% to 5% of school-age children and an estimated 60% of those will maintain the disorder into adulthood.

·         Prevalence rates for ADHD in adults are not as well determined as rates for children, but fall in the 1% to 5% range.

·         ADHD affects males at higher rate than females in childhood, but this ratio seems to even out by adulthood.

Common Behaviors and Problems of Adult ADHD

The following behaviors and problems may stem directly from ADHD or may be the result of related adjustment difficulties:

·         Chronic lateness and forgetfulness.

·         Anxiety.

·         Low self-esteem.

·         Employment problems.

·         Difficulty controlling anger.

·         Impulsiveness.

·         Substance abuse or addiction.

·         Poor organization skills.

·         Procrastination.

·         Low frustration tolerance.

·         Chronic boredom.

·         Difficulty concentrating when reading.

·         Mood swings.

·         Depression.

·         Relationship problems.

These behaviors may be mild to severe and can vary with the situation or be present all of the time. Some adults with ADHD may be able to concentrate if they are interested in or excited about what they are doing. Others may have difficulty focusing under any circumstances. Some adults look for stimulation, but others avoid it. In addition, adults with ADHD can be withdrawn and antisocial, or they can be overly social and unable to be alone.

School-Related Impairments Linked to Adult ADHD

Adults with ADHD may have:

·         Had a history of poorer educational performance and were underachievers.

·         Had more frequent school disciplinary actions.

·         Had to repeat a grade.

·         Dropped out of school more often.

Work-Related Impairments Linked to Adult ADHD

Adults with ADHD are more likely to:

·         Change employers frequently and perform poorly.

·         Have had fewer occupational achievements, independent of psychiatric status.

Social-Related Impairments Linked to Adult ADHD

Adults with ADHD are more likely to:

·         Have a lower socioeconomic status.

·         Have driving violations such as: be cited for speeding; have their licenses suspended; be involved in more crashes; rate themselves and others as using poorer driving habits.

·         Use illegal substances more frequently.

·         Smoke cigarettes.

·         Self-report psychological maladjustment more often.

Relationship-Related Impairments Linked to Adult ADHD

Adults with ADHD are more likely to:

·         Have more marital problems and multiple marriages.

·         Have higher incidence of separation and divorce.

Much of this functional impairment diminishes with remission of the disorder and can be mitigated by appropriate treatment.

How Is Adult ADHD Diagnosed?

While researchers may disagree about age of childhood onset in diagnosing adult ADHD, all agree that ADHD is not an adult-onset disorder and must be verified from childhood. An assessment of ADHD symptoms and behavior from childhood may include any or all of the following:

·         A questionnaire to determine if the adult had ADHD in childhood.

·         School report cards, if available, to look for comments about behavior problems, poor focus, lack of effort or underachievement relative to the student's potential.

·         Discussion with the parents to determine any symptoms during childhood.

·         A complete history from the adult with the symptoms. He or she may self report symptoms in childhood.

·         The developmental history would be consistent with ADHD, including evidence of problems with peers, other delays such as bed wetting, school failure, suspensions, or special interventions such as sitting in front of the class, etc.

A strong family history of ADHD may also be informative, given the strong genetic component of the disorder.

Other examinations may also be performed, including:

·         A physical exam to rule out medical or neurological illness.

·         An EEG, CT, or MRI.

·         Psychoeducational testing (for example: IQ test, achievement testing) if a learning disability is suspected.

Medications to Treat Adult ADHD

The same drug treatments proven to be efficacious in children appear to benefit adults with ADHD.

·         Ritalin

·         Concerta

·         Vyvanse

·         Adderall

·         Focalin

·         Dexedrin

In the past, the first treatment offered to adults with ADHD has been stimulant drugs. Studies show that approximately two thirds of adults with ADHD who are given these medications show significant improvement in ADHD symptoms.

However, there are some difficulties in using stimulants to treat ADHD in adults. Stimulants are controlled substances and it is not uncommon for adults with ADHD to have or to have had problems with substance abuse. Short acting stimulants may wear off quickly and since adult patients administer the medication themselves, and usually have problems with forgetfulness, compliance can be problematic with multiple day dosing. Adults may experience significant difficulty in the evening when they do housework, pay bills, help children with homework or drive, or are tempted to use substances 'to relax'. Learn more about Stimulant therapy for ADHD.

Stratterra is the only nonstimulant medication approved by the Food and Drug Administration (FDA) for the treatment of ADHD, not just for children and adolescents, but for adults as well. This is the first medication to receive an FDA indication for treatment of ADHD in adults.

Strattera does not have abuse potential and does not require a special prescription.

Behavioral Treatments for Adult ADHD

Adult ADHD may be treated with one or more of the following:

·         Individual cognitive and behavioral therapy to enhance self-esteem.

·         Relaxation training and stress management to reduce anxiety and stress.

·         Behavioral coaching to teach the person strategies for organizing home and work activities.

·         Job coaching or mentoring to support better working relationships and improve on-the-job performance.

·         Family education and therapy.

In-depth assessment, treatment planning, medication management, individual therapy, education and family support are all necessary to help the adult with ADHD function in new ways and build his or her self-esteem. Because ADHD is often associated with other conditions (such as specific learning disabilities, anxiety and mood disorders, obsessive compulsive disorder and chemical dependency), in-depth assessment is the first step in developing a comprehensive, customized treatment plan.

Psychosocial Behavior Management Strategies

Adults with ADHD can also benefit from some basic organizational concepts and behavior management strategies to help manage the condition. Here are ways to train yourself to overcome these problems or make them more manageable:

·         Take medications as directed. If you are taking any medications for ADHD or any other condition, be sure and take them exactly as prescribed. Missing a dose or taking two doses at once to catch up on missed doses can have negative consequences for you and others. If you are noticing side effects or other problems, speak to your health care provider as soon as possible.

·         Organize yourself. Train yourself to become more organized. Make lists of daily tasks (be reasonable!) and strive to complete them. Use a daily planner, leave notes for yourself and set your alarm clock when you need to remember an appointment or other activity.

·         Control impulsive behavior. If you have a tendency to do things you later regret, such as interrupting or getting angry at others, manage the impulse by counting to 10 while breathing slowly instead of acting out. Usually the impulse will pass as quickly as it appeared.

·         Minimize distractions. Find ways to reduce the distractions throughout the day. If you find yourself being distracted by loud music or the television, turn it off or use earplugs. Move yourself to a quieter location or ask others to help reduce distractions.

·         Find constructive outlets for excess energy. People with ADHD sometimes seem to have more nervous energy than others, and this hyperactivity needs to have an outlet of some sort. A hobby or other pastime can be helpful.

·         Ask for help. We all need help from time to time and it is important to not be afraid to ask for it when you need it. If you are having disruptive thoughts or behaviors, ask a counselor if they have any techniques that might help control them.

Living with Adult ADHD

Although most people don't outgrow ADHD, they do learn to adapt. If the difficulties associated with ADHD are managed appropriately throughout their lives, adults with ADHD can learn to develop personal strengths and become productive and successful.

Further Reading:

·         Adult ADHD, Bipolar Disorder May Overlap

·         ADHD in Adults

·         Underdiagnosed Hyperactivity-- Adults

·         ADHD and Alcoholism May be Linked

·         Adult ADHD Underdiagnosed?

·         Managing Adult ADHD

·         ADHD in Adults Slideshow