Me? AD/HD?

Last week I received a fascinating email from long-time reader Dr. Heather Brannon, a family medicine physician who has been treating Attention Deficit Hyperactivity Disorder (aka AD/HD) exclusively since the beginning of 2013. The gist of her email was surprising: had I considered getting diagnosed for AD/HD?

She explained further:

[…] When I was practicing family medicine I stumbled upon the discovery that many of my patients had AD/HD and I found that treating it well was life-changing for them (no exaggeration here at all) because AD/HD impairs every aspect of an adult’s life. I just wanted to send you this email to encourage you to be evaluated for AD/HD and get it treated.  The thing is people don’t realize that AD/HD is caused by a deficiency of dopamine in the brain and we all need dopamine to be interested in things.  AD/HD should really be called Interest Deficit Disorder.  Because it’s a chemical deficiency (like Type 1 Diabetes, hypothyroidism, low testosterone, and menopause) the treatment of choice is medication.  That’s why we use the stimulants but they should really be called “Dopamine Replacement Therapy”. I hope I haven’t offended you by sending this email.  Please understand it is not a criticism or judgement.  I actually recommend several of your tools to my patients.  I just know that angst you feel isn’t necessary. […]

As this was coming from someone who has been following my blog for quite some time, I was highly intrigued. I’d known for a while that some of my tools were very appealing to people who described themselves as AD/HD, as I design them to require minimal focusing, computation, and memorization skills. I thought of this merely as good design / common sense, and didn’t think that I had AD/HD from the Wikipedia article I’d read long ago. I was intrigued enough to look through it again, and noticed I did notice a handful of related disorders that did ring true for me:

  • Anhedonia – “a loss in the ability to experience pleasure from activities usually found enjoyable”; in my case, I don’t even feel like doing these things because I’m feeling burdened by numerous goals. Expressed as a lack of desire to go and do “fun things” because I perceive that as a delay in “getting my stuff moving for the future”.
  • Insomnia – Not so much an issue right now, but I do tend to stay up late because I don’t want to “miss” anything.
  • Difficulty in exercising attentional control; which I had thought of as just being “bored by mundane tasks” instead of an issue. But I am entertaining the possibility.
  • Low tolerance for stress – This despite not having many external stresses; they’re all the kind that comes from my own ambition and the number of goals that I have.
  • Tire easily – These days I find that I need to take a lot of naps. I thought this was due to the amount of energy it takes to be creative and forge new paths for myself, and I am not convinced that this is not the case.

I can think of a lot of causes for these symptoms…stress and depression seemed like likely causes, after all. However, I am not a doctor, and Heather provided a link to a video she had made for her patients, Life History of Someone with AD/HD that was eerily descriptive of how I often feel.

Hm.

Re-evaluating Resistance

I’ve written a lot about the quest to be more productive and proactive over the years. My process has been to look for recurring patterns in my behavior and then hypothesize ways to work around them. I’ve taken inspiration from books like The Alchemist, The War of Art and The Creative Habit, incorporating their wisdom into my belief system: I believe that the great big ball of resistance is part of the creative act. If it was easy, then it wasn’t worth doing.

It never occurred to me that my resistance itself might be due to unbalanced brain chemistry. I reckoned my experience was pretty normal for people with curious minds regulated by high standards and finite resources. I also figured that that everyone had some form of resistance in them somewhere in one form or another. But that isn’t to say that there is ALSO the possibility that there might be something to investigate along the lines of low dopamine production.

My gut reaction: I’m not severely handicapped by my resistance. Personally, I hate the idea of altering my brain chemistry because it makes me who I am; the use of drugs to increase creativity, or reduce fear, or otherwise change my emotional reactions is highly distasteful to me. I have never used drugs recreationally and avoid drinking alcoholic beverages. I don’t even like taking aspirin when I have a headache, if I think a nap will take care of it. My resistance to the idea is tied to the idea that a flexible mind can overcome any obstacle that it faces; one of my favorite movies is Star Trek: The Wrath of Khan‘: I don’t believe in the no-win scenario! I believe in routing around difficulties and outflanking the problems!

So I wrote back:

[…] I don’t really feel impaired, though, probably because I’ve created a comfortable bubble for myself that I’m starting to outgrow. If I wasn’t ambitious or liked to settle, I probably would be existing quite happily and uneventfully like everyone else around me; I see these as the frustrations of anyone who wants things to get done and doesn’t like delays. Since I don’t have a team I’m working with or working FOR me, I see the main barrier as myself, so I write a lot about that. In the interest of emotional transparency, which is one of my values, I identify what I think is the source trigger, and then proceed from there. Maybe that’s a description of AD/HD? I don’t really know what AD/HD is, but what I’m describing doesn’t seem like something holding me back. I do know there’s a lot of users of my productivity tools that identify as or are AD/HD, people who are looking for answers while working in challenging environments. I think relatively speaking, I’m pretty focused, but I don’t like dealing with the unfocus of people around me, and I don’t like inconvenient activities. Is this something that really needs to be ameliorated? 

And a little later, I added the following:

[…] I have tended to think of my challenges in terms of a mismatch in my innate desires and unmet needs versus the need for self sufficiency; everybody has stuff they don’t like to do , right? I think an AD/HD diagnostician would have to be able to convince me that a treatment isn’t about altering brain chemistry to make difficult life decisions easier to make, though I’m not sure exactly what I mean by that. […]

In her email followup, Dr. Brannon made these points:

It’s funny that you say you don’t want to make difficult decisions easier for many reasons. The most interesting to me is that is what most people with AD/HD say.  Because they have had to put forth so much effort all their lives, not only do they think that’s normal, but they also consider it a badge of honor.  While many of them think of themselves as lazy (or maybe significant others and parents think of them that way), they’re actually very industrious and hard-working.  It’s just they have much less to show for all their hard work.

DOH! While I hadn’t thought of it as a “badge of honor”, I had thought of it being an indicator of “worthy challenges”. Which then proceeded to bum me out when I couldn’t overcome them right away.

The good doctor continued with:

I recently had to write a letter to the LPGA for one of my patients who is a professional golfer.  In the letter I explained that treating AD/HD doesn’t create an unfair advantage.  On the contrary, because treating AD/HD effectively just means correcting brain chemistry levels, it really just levels the playing field.  That dopamine deficiency I talked about earlier is like the insulin deficiency in Type 1 Diabetes, testosterone deficiency in men with low T, and estrogen deficiency in women who are menopausal.  Nobody in their right mind would tell a post-menopausal woman to “just try harder” to make the hot flashes go away.  Hehe!

An excellent point. There are two other beliefs that I sensed, which I’ve dragged out of the shadowy muck and defined as follows:

  • I don’t want to be “normalized” through drug therapy. I kind of enjoy my weird creative hurdles. It’s irritating at times, but the struggle to overcome them is challenging. Somewhere in the back of my mind is that my struggle is what has made me who I am.

  • I’m not sure that I want to lose my resistance because I’m USING it. I don’t think it’s possible to eliminate resistance to all things that are challenging; I use it (I think) to identify opportunity. Certain goals are hard, time-consuming, and difficult to track down. Perhaps my attitude toward them can be improved…but what would that mean? I’m a little bit scared of being happy, maybe, without conflict. The writer in me distrusts lack of conflict.

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p>While that’s how I feel, I don’t know for sure how “true” my sentiments really are. Does struggle have to define me? Is this the badge of honor I am making for myself? Am I really using my resistance, or have I fallen victim to Stockholm Syndrome and have become the Patty Hearst of Resistance?

I must admit my ignorance and acquire more data!

20 Comments

  1. Sid Ceaser 2 years ago

    My wife thinks I have ADHD. My uncle has severe ADHD. I fear he might actually eventually suffer a stroke or something from all the stress he deals with on top of his severe ADHD. He was a foster child and they never cared that he couldn’t even sit down at his desk in school and was constantly being sent to the principal’s office for disrupting behavior.

    I should probably have it looked at eventually. I always think I’m too lazy, but it’s because I’m always jumping from thing to thing so fast and becoming bored of each thing.

  2. Elise 2 years ago

    Think long and hard, Dave, about going on meds (looks like you’re doing just that).

    The “insomnia” you describe is actually a shifting of your sleep schedule to something much later than most folks have. You’re “staying up late”, not sleepless. It’s OK!!! Keeping a lid on it would be a great idea, though, because I suspect that (like me) you have a 25-or-26-hour clock, and want to keep pushing everything later all the time. Early exercise, preferably in the sunlight, will help!

    The napping is another issue. Personally, I think revving up your exercise regimen is the best thing you could do — not necessarily in intensity, but in frequency. Even adding a regular 30-40 minute walk around your condo complex (in addition to what you do at the gym) would be a help.

    I’m rather amazed that a doctor, even one who’s followed you a substantial time, would attempt to diagnose you over the internet. By the way, the idea that menopausal women should routinely be given replacement estrogen as a matter of course has been pretty thoroughly debunked. Prescription-happy American medicine continues on its merry way.

    If you weren’t sweating the details of what you do, and asking the tough questions, you simply would not be DAVE.

    MUCH respect, my friend,

    E

  3. Author
    Dave Seah 2 years ago

    Sid: One reason I don’t think that I have AD/HD is that I didn’t have that kind of restlessness in the classroom. Although, now that I think about it, I used to get in trouble in certain classes for talking. I remember spending an entire sing-a-long in Vacation Bible School not hearing the teacher call my name to pay attention during the song, and then admonishing me afterwards. Though partly that might be due to my NOT being able to hear lyrics in music. Maybe they’re related! I would say that I didn’t listen to half of my teachers, even in college, because a lot of the time they weren’t making sense to me, and I would have to learn the material on my own.

    I’m curious about the AD/HD thing for two reasons.

    One, there’s a huge stigma that some people feel about it and the process of diagnosis in the first place, and they feel oppressed by it. If there’s anything I can’t stand, it’s people being oppressed for feeling a certain way. I think it’s good to address this question publicly and work my way through it. It’s never a bad idea, I believe, to face these kinds of questions, though a lot of people will cluck and admonish with their implied doubts instead of affirming the possibility of the thought and helping investigate further. It’s easy to throw out opposing ideas as caution, but I don’t think this is the way forward when we want out of the mess.

    So reason number two is to find out what’s behind this idea of AD/HD. What is dopamine anyway? What ways are there to manage it? How does this relate, if at all, to the challenges I’m facing? It’s going to be difficult to work through it, but I am pretty sure that I will learn something new.

    I see this as something interesting to explore. Two major hindrances I’ve been learning to overcome are doing actions that cause me emotional discomfort (e.g. like a fear of appearing incompetent, or getting lost in a strange city) and overcoming lack of immediate reward (e.g. having to work for hours and hours to make an online store work perfectly, and then not having it work as well as I want). Some of the barriers I put up myself with conditions like “perfectly”, but they are also values. I think these are two hindrances that nearly everyone I know faces in some way or another, just from having talked to a bazillion creative people. And it comes down to a fear of vulnerability, social judgement, and unseen demons lurking under the blanket of our consciousness.

    Maybe you have AD/HD, or maybe you have some other unnamed demons. Since I do not know what the diagnosis and treatment process is for AD/HD, I don’t know what they will suggest. The last thing I would do, though, is judge their process without finding out what it is, or let posts on Facebook tell me how I should think about them. Our individual personal truths may be very different from what the mainstream and the militant pockets of the left and right would have us believe.

    Elise: Thanks Elise for your concern! I am looking at it pretty thoroughly, and am keeping an open mind. Although, I should point out that you’re doing the same remote diagnosis as the doctor! :-)

  4. Martha Edwards 2 years ago

    As a 73 year old who was diagnosed around age 50 with ADDHD, I can attest to the fact that it does affect all aspects of one’s life. I struggle every day with the basic activities of life such as trying to clear my home of clutter and trying to decide on which new hot water heater to install. These struggles don’t just disappear with age as some think. My neurologist does not recommend meds for me now because of high blood pressure and other concerns, but when I was on meds, I could focus on tasks much more easily. Luck!

  5. Joan Vick 2 years ago

    My 2 cents: Drug therapy is interesting. If you take an aspirin because you have a fever, it will bring your fever down. If your fever is normal it won’t bring it down below normal. If you feel like you are drowning, and not going with the flow, the right drugs will help you to float, but won’t elevate you above the surface of the water. I write this to debunk the “if I take medication it will effect my talent” argument. Having said that, your wheels are often turning, but hardly ever spinning.

  6. Tormod Haugen 2 years ago

    Hi Dave,

    Not all men of science are agreeing on what AD/HD really is. Highly gifted children tend to become restless because they do not get enough challenges – they get bored and some tend to seek attention. Look into it from the other side, perhaps an IQ test and a friendly psychologist can help in getting a second opinion. I suggest starting by looking into studies on gifted children – or at least reading what support organizations for families with gifted children write about.

    This isn’t about superiority or geniuses – it is just that for each “slow” child that need more time in school, there is one child that knew how to read and write early and is bored out of their mind when the normal kids learn their alphabet.

    Also remember that the human mind is made to discover patterns, including a diagnosis, so you put weight on what fits and disregard what doesn’t match as well.

    For some of the symptoms, have a look here: http://en.wikipedia.org/wiki/Intellectual_giftedness#Social_and_emotional_issues

    and also from that article:

    Many gifted children are being misdiagnosed by experts to have a pathological condition as these experts don’t have sufficient training in giftedness.The characteristics of gifted children are often similar to that of a pathological condition such as Autism or ADHD.These children may than be forced to be medicated when it is unnecessary and even harmful. ( http://www.sengifted.org/archives/articles/misdiagnosis-and-dual-diagnosis-of-gifted-children )

    I know that this comment is just as biased as any other, and I cannot say anything else than make sure you know what you are doing before trying medication.

    PS. I also suggest Susan Cain’s book “Quiet: The Power of Introverts” – and this video of her TED talk: http://www.ted.com/talks/susan_cain_the_power_of_introverts.html

    Best wishes,

    Tormod Haugen

  7. Author
    Dave Seah 2 years ago

    Martha, Joan, Tormod: That’s all wonderful and varied feedback…thanks for taking the time to share your insights!

    After reading them, I was thinking about what I’ve tried so far to “pattern match” my own set of behaviors. I think this is what I want:

    • to be productive without being stressed out
    • to be comfortable in my own skin
    • to face challenges from a position of strength, not just surviving them

    I’ve looked at a few possible pattern solutions, such as Tormod’s suggestion with “The power of introverts”, Barbara Sher’s “Scanners” idea, Brene Brown’s “The power of vulnerability”, and the personality sorting tools such as Myers-Brigg Type Indicator. Then there’s also a lot of the popular neuroscience books like “Stumbling on Happiness”, “Flow”, and so on. From these sources, I’ve put together a belief system that makes sense to me, but still find difficult to follow. I’m always looking for fresh ways to look at my unique problem set, which I imagine is not all that unique at all if I find the right set of keys or lenses. In the process, I have to challenge my own preconceptions. Joan’s note on aspirin and talent is a good reminder; I have a vivid memory of a conversation with an artist who told me that if I didn’t take drugs, I would never have the mind-blowing experiences that could elevate my work. I decided on the spot that I wanted nothing to do with it; I’d get there a different way, and since then I’ve been pretty militant about enforcing that rule, right up to the point where I have blurred the line between common medicines and mind-altering drug use as being sort of the same thing.

    There is a broad spectrum of behaviors that I have that seem to fit several patterns, and perhaps the key is not something simple. I hadn’t considered “giftedness” as another pattern. I tested very well in school but was not a really great student, so some of the symptoms match there as well.

    Anyway, there’s a lot to investigate! Thanks everyone for your thoughtful comments!

  8. Alicia Diaz 2 years ago

    I was diagnosed with ADHD as an adult, and found that the diagnosis helped to explain a lot about why some events in my life happened the way they did. Impulsivity is great when it helps you identify an awesome husband in 2 days :) – not as great when it keeps you from starting that thing you’ve been planning to start for weeks.

    The diagnosis hasn’t been stigma-y for me, but your mileage may vary. If you like your life and how it’s working out, then yay, and don’t let anyone tell you to change it.

    Re the meds: I find that the meds help me to have more emotional bandwidth – I’m not as likely to get overwhelmed by too many stimuli, and I’m way less likely to lose my patience with my kids. They also help with getting things done (thinking in lines instead of clouds; making decisions faster), but I already had lots of systems to help with that :)

    Bottom line: If your brain chemistry doesn’t interfere with you living the life you want to have, then you don’t need meds. If you have things you can’t control as well as you want, then it doesn’t hurt to consider them. The meds haven’t affected my creativity – I still come up with lots of ideas – but they do even out the high highs and low lows of emotional response, so if your work requires those (applies to artists), that would be another reason to consider carefully when/if to take them. Given they last less than a day (even for the extended release options), it’s not difficult to experiment with a low dose and see if it helps or to skip a day and see what happens. And trust me, you will still have plenty of resistance – they help, but they don’t turn you into a new person :)

    Wishing you luck and light no matter what you choose to do.

  9. Author
    Dave Seah 2 years ago

    Alicia: Thank you for sharing the nuances of your experience! I love the term “emotional bandwidth”, btw…if I understand it right, you are saying that your ability to handle emotional stimuli is not diminished, but you can handle MORE of it without negative reaction?

    On a side note, yesterday was a weirdly productive day. Just thinking about this topic seems to have put the resistance at bay temporarily. I wonder if that is an indicator that it really is some kind of emotional response is empowering the resistance to bug me to distraction? By putting a rational frame on resistance as a subject of interest, it seems to not be able to fight as effectively. Like when I used to play Street Fighter II against my friend Alen, and while he was beating me over and over again I was just nodding and making comments like, “That’s interesting your use of the combination low leg sweep and high punch. If my developing understanding of my character’s moves and this game’s blocking system is accurate, I should be able to execute this counter measure…no, that wasn’t quite right. Oh, there it is! Let me confirm this 10 times in a row…”

    He said it wasn’t any fun to beat me because of the sense of impending doom. Perhaps resistance needs a whuppin’ in the same way!

  10. Alicia Diaz 2 years ago

    @David: Yep, that’s right – I can handle more emotional stimuli without overwhelm or negative behavioral reaction. (as a side note, it also works for physical stimuli – I’m not as afraid of heights when medicated…) Other ways to get a similar effect are to get extra sleep or seriously constrain your stimulation exposure – I have young kids and a full life, so neither are practical options for me :)

    Hooray for productive days!

  11. Tormod Haugen 2 years ago

    @Alicia How great! Just in case it wasn’t obvious, I don’t say that prescription meds are bad, just that some times the same symptoms doesn’t indicate the same problems. I have a friend that is using drugs against bi-polar disorder, and it has really changed their life for the better.

    I don’t want to steer anyone away from doctors and medication – I just see much of myself in Dave’s posts, and I’ve been fine with a bit of coaching, insight into what triggers the different reactions, meditation (as in zen) and a few great friends.

    As I see it, you can be gifted and probably not get any good out of the drugs, but I know that people can also be gifted and have problems that are mitigated by drugs.

    I also do not want to discredit Dr Heather Brannon – she probably know more about this than me, and might very well be right.

    I just wanted to advice caution against jumping to conclusion without asking for second opinions, because I know of people (as in, have met and talked to) that was kind of destroyed by medication at a younger age, and only began getting their life back as grown people when getting off the drugs.

    Best wishes to all,

    Tormod :)

  12. Lynn O'Connor 2 years ago

    I am glad that a professional commented upon this –I’ve considered it reading things you’ve written over the years. ADHD likely would not be a “pathology” in a hunter-gatherer life style, it might be a much needed human variation, within every group. But we don’t live that life-style, nothing close to it. So in our contemporary lives, ADHD or ADD alone is a big problem for many.

    Undiagnosed kids suffer terrifically because they often “fail” at their “work” which is school. They also have difficulty attracting friends. Girls with ADD/ADHD are less likely to attract attention in elementary, middle and high school, because they tend to act out less. But they tend to run wild later. As for drug treatment, it works. If someone without ADHD/ADD is given a trial of Ritalin they go through the ceiling. But if someone with ADHD/ADD gets the same trial, they often find themselves settling down, able to concentrate on things that don’t necessarily fascinate them but that they need to do (one thing about untreated people with ADHD/ADD –they can concentrate intensely on something they are really interested in), and in general, they feel more productive, organized and experience a greater sense of well-being. The only way to find out if treatment will help is to try it. And Ritalin is a rather remarkable medication. It is far less addictive than amphetamine treatments, people on Ritalin routinely go on “Ritalin holidays” when they have no obligations etc (like kids on the weekend), the molecular differences between Ritalin and amphetamines seem to make a big difference. I would not hesitate to try it out.

    Also, we have a study going on (an anonymous online study on personality and emotions) that has a variety of screening tools, including one on ADHD. The only problem is that it is anonymous so I can’t tell you your results unless you give yourself some outrageous age (like 110 for example) and get in touch with me, tell me exactly when you took it, and I’ll score it and get back to you with the results. But there are also online screening tools that will give you results automatically. My own anonymous online study can be found at: http://www.eparg.org/wright/personality/ It would be great if people took it just for fun, not expecting results. And if you are interested, results from the first part of this online study are available for downloading (free) at: http://sgo.sagepub.com/content/3/2/2158244013492540

  13. Michael Schechter 2 years ago

    All I can tell you is this. After some bad early experiences with Ritalin I shied away from medication and treatment for years. I thought I could will my way through it. I made a hell of a lot of progress, but when I finally came around and went back into treatment (medication and therapy), it was as if I was running without weights on my legs.

    I’m in no way, shape or form normalized by my medication. I certainly was by Ritalin, but now that I’ve found the right pill, it’s as if I’m taking aspirin for a headache.

    As for not being able to use it… just imagine how much you’ll be able to use the muscles you’ve developed once they’re focused on the work rather than being spent keeping your focus on the work. This isn’t a matter of eliminating resistance. It’s about eliminating needless resistance so you can focus on the hard stuff.

    I can’t tell you how much energy and effort I was wasting trying to treat a legitimate deficiency with hard work. Like any other tool, treatment didn’t magically solve all my problems, it just helped me to focus on the interesting ones.

    You only lose you if the treatment’s bad. If the treatment is good, you just find it a little easier to put your hard work to better use.

  14. Sophia 2 years ago

    Maybe someone has an illness or a disorder – but maybe they are just waking up to the fact that life as it is usually lived isn’t nearly as meaningful and as satisfactory as popular notions would have us believe.

    From a traditional Buddhist perspective, it makes perfect sense to have little interest in the pursuit of things that are impermanent, stressful and cannot be claimed as I or mine.

  15. Heather Brannon 2 years ago

    As always, Dave, your willingness to let all of us witness your internal debate is refreshing and enlightening. I have to say I’m really impressed with all the comments too. Often this type of discussion highlights how intense people’s opinions are about AD/HD, whether those opinions are based on fact or myth. Of course it helps that the commenters clearly care about you and want to contribute to your discovery which is one of the reasons I’ve followed your blog for so long.

    I think one of the reasons people’s opinions can be so intense is something that several commenters have alluded to here, the damage medication can cause. Fair warning – I’m stepping up on my soapbox now and just to be clear my underlying bias is that most doctors are pompous asses. (I have actually spent the last hour trying to come up with a nicer-sounding label, but in the end accuracy won out over nice.)

    For some reason, doctors will learn what the latest medical evidence says about how to treat high blood pressure or chronic renal failure, but they seem to ignore good medical evidence about how to treat AD/HD. Treating AD/HD well is actually very time-consuming. There is no way to know what dose a person needs so it takes time explaining how medication works, titrating it to find the right dose, knowing what to do about side effects that sometimes mean doses are too high and other times mean doses are too low. The doctor has to ask a lot of questions to be able to discern what direction to go and it’s hard to find a doctor who will actually listen and be curious and concerned enough to find the right answer. So just throwing a pill at someone with AD/HD can do more harm than good.

    But……getting it right can be amazing, life-changing, eye-opening….on both sides of the doctor’s desk.

    I’m encouraged that there are AD/HD treatment centers popping up all over the place because that makes the burden of finding a doctor who has experience treating AD/HD much lighter. Of course that doesn’t mean a doctor practicing outside of a treatment center can’t do a great job. It’s just hard for people looking for help to know where those doctors are.

    Thanks again, Dave, for making us all think.

  16. Tracy 2 years ago

    Regarding restlessness: there are three forms of attention deficit disorder. One is hyperactivity and impulsivity (hyperactivity disorder). One is inattentiveness (attention deficit disorder. One is both combined (attention deficit/hyperativity disorder – ADHD) It is possible to have inattentive ADD and not have restless ADHD.

    Regarding ADD and ADHD symptoms – it is a rare person to not have at least one symptom. When you have ADD or ADHD, you have to have six or more of the symptoms of either inattentiveness, hyperactivity/impulsiveness, or both: http://www.additudemag.com/adhd/article/621.html

    It is important to get diagnosed by a doctor because the symptoms can look like other things, such as lack of sleep, and everyone has different symptoms.

    There is a spectrum of impairment. Some folks can’t finish college or drive; some get through school fine, get tutoring or coaching to help, or some do fine in school but struggle in college, or when they get a more complicated job.

    Regarding ADHD treatment – medication is only one part of the treatment, and many people don’t take it. Folks with ADD/ADHD do best when they take really good care of their body to maximize brain function: sleep, exercise, nutrition (lots of protein), fish oil, mindfulness meditation, all the stuff that is good for the frontal lobe.

    But regarding medications, I don’t think that treating ADD/ADHD with medication is as difficult as treating depression or bipolar disorder. It is some trial and error and time to get to the right dosage and medication, and it doesn’t make attention control perfect, just easier. We do so many different things to think better; drink coffee, play music, fidget to focus, go to a coffeeshop to reduce distractions. Medication is a safe treatment after a proper diagnosis to help our brains concentrate.

    I was diagnosed two years ago, and those close to me can see when my meds wear off at night; when I speak, I jump abruptly from subject to subject as my brain works faster than I am able to speak, and I interrupt people more. I love my brain and the way it works, but the medication helps me stay on task and control my social interactions better at work. I wonder if I would be able to accomplish more in life with a less distracted and impulsive brain.

    I advise you to watch ADD and Loving It for a great general overview: http://totallyaddshop.com/collections/videos

  17. Lynn O'Connor 2 years ago

    I wanted to thank Heather for her very clear description of the importance of “getting it right” in terms of dosage of a medicine like Ritalin. It is literally impossible to tell if an individual will need a higher or a lower dosage, it is so case-specific, and as she said, it takes time on the physician’s part –time and interest, and while another commentator mentioned what pompous asses many physicians are –and that is true– some are really good and worth gold so to speak.

    I also neglected to mention that I wrote about Ritalin in my Psychology Today Blog “Our Empathic Nature” in early 2012, and I think the research I cited there is still relevant, so you might want to read it at: http://www.psychologytoday.com/blog/our-empathic-nature/201202/why-ritalin-is-wrong-or-is-ritalin-wrong-0 The blog post was fairly widely read, so I assume this is certainly a topic of great interest for many –again, I think it’s because ADD/ADHD is probably a natural human variation, much needed in the lifestyle in which we evolved (the hunter-gathering life), and is only problematic in our contemporary, modern world.

  18. Margaret 2 years ago

    One way to think of taking meds for ADD — like getting prescription glasses for blurry vision.

    There’s a good book on ADD called “Driven to Distraction” by Edward Hallowell.

    Lots of people with ADD don’t take medicines, but at least their loved ones know not to take certain behaviors personally (inability to wait in line, seeing their attention wander during conversation, needing to go do something else, low frustration tolerance etc.).

  19. Margaret 2 years ago

    Oh, forgot to mention that some people with ADD self medicate with caffeine, which seems to allow them to focus and relax.

  20. Stephanie 2 years ago

    Hi, Dave, I know this is a bit late but, if you are still open to input, I’d like to share info that is helping me. I’ve been lurking around your blog for about 1 year now; I came for the forms but stayed because I strongly resonated with your struggles (trials, failures, and successes) with creativity, productivity and balance. My strugles with these themes has launched me on a journey of internal truth seeking and the revision of my self-identity. Don’t worry, I’ll spare you the details.

    I am an intellectually gifted-adult female. At the age of 40 I began a medical career and decided to get help with my, long suspected, symptoms of ADHD. Being academically bright is one factor in being gifted however they ARE NOT interchangeable terms; and, as an earlier comment mentioned, giftedness ahares many traits of ADHD — throw in a strong preference for visual-spatial processing and high creativity and you get the possibility for incredible insight, sensitivity, and beauty. You also get an equally incredible set of weaknesses that can be debilitating.

    We humans have a strong need to catagorize and definitively lable things, people, concepts, etc. This can be awesome and life saving, such as identifying atypical cell clusters as cancerous vs benign; but when misused it can be quite limiting and destructive, as when a whole cluster of neuropsyc traits are labled as undesirable. Viewing ADHD as a disorder pushes us to pathologize any manifestation of its symptoms, regardless of whether or not they interefer with our goals. IF you meet the criteria for ADHD, medication can help any problematic areas (like mood, overwhelm, hyperfocus…) but it wont touch traits that stem from other areas of your brain. I am on stimulant meds and they greatly help, but I still have 5+ projects going, am intense when focused, and have trouble weighing out the steps when inspiration hits (this is part of the visual-spatial stuff).

    Understanding these factors has helped me quiet my constant internal critic. I have a better grasp of why I struggle with basic systems that others seem to take for granted (task lists, time management…) and this helps me discover what works and why.

    Good Luck!

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