Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder

by Edward M. Hallowell

Establish external structure. Structure is the hallmark of the nonpharmacological treatment of the ADD child. It can be equally useful with adults. Once in place, structure works like the walls of the bobsled slide, keeping the speedball sled from careening off the track. Make frequent use of lists, notes to self, color coding, rituals, reminders, files. Also use pattern planning, as described earlier.

Use pizzazz. Try to make your environment as peppy as you want it to be without letting it boil over. If your organization system can be stimulating (imagine that!), instead of boring, then you will be more likely to follow it. For example, in setting things up, try color coding. Mentioned above, color coding deserves emphasis. Many people with ADD are visually oriented. Take advantage of this by making things memorable with color: files, memoranda, texts, schedules, etc. Virtually anything in the black-and-white of type can be made more memorable, arresting, and therefore attention-getting with color.

When it comes to paperwork, use the principle of O.H.I.O: Only Handle It Once. When you receive a document or a memo or any kind of written material, try to only handle it once. Either respond to it right away, on the spot, or throw the document away, or file it permanently. Do not put it in a TO DO box or pile. For people with ADD, TO DO piles might just as well be called NEVER DONE piles. They serve as little menaces around one’s desk or room, silently building guilt, anxiety, and resentment, as well as taking up a lot of space. Get in the habit of acting immediately on your paperwork. Make the wrenching de...

Set up your environment to reward rather than deflate. To understand what a deflating environment is, most adult ADDers only need to think back to school. Now that you have the freedom of adulthood, try to set things up so t...

Acknowledge and anticipate the inevitable collapse of X percent of projects undertaken, relationships entered into, obligations incurred. Better that you anticipate these “failures” rather than be surprised by them and brood ov...

Make deadlines.

Break down large tasks into small ones. Attach deadlines to the small parts. Then, like magic, the large task will get done. This is one of the simplest and most powerful of all structuring devices. Often a large task will feel overwhelming to the person with ADD. The mere thought of trying to perform the task makes one turn away. On the other hand, if the large task is broken down into small parts, each component may feel quite manageable. (For example, it was only by using this technique that we managed to write this book.)

Prioritize rather than procrastinate. If you cannot handle it only once (tip 16), then be sure to prioritize. When things get busy, the adult ADD person loses perspective: paying an unpaid parking ticket can feel as pressing as putting out the fire that just got started in the wastebasket. Sometimes one becomes paralyzed. Prioritize. Take a deep breath. Put first things first. Then go on to the second and the third task. Don’t stop. Procrastin...

Accept the fear of things going too well. Accept edginess when things are too easy, when there’s no conflict. Don’t gum things up...

Leave time between engagements to gather your thoughts. Transitions are difficult for ADDers, and minibreaks can help ease the transition.

Read with a pen in hand, not only for marginal notes or underlining, but for the inevitable cascade of “other” thoughts that will occur to you.

Recharge your batteries. Related to number 30, most adults with ADD need, on a daily basis, some time to waste without feeling guilty about it. One guilt-free way to conceptualize it is to call it time to recharge your batteries. Take a nap, watch TV, meditate. Something calm, restful, at ease.

recognize the following cycle, which is very common among adults with ADD: a. Something “startles” your psychological system, a change or transition, a disappointment or even a success. The precipitant may be quite trivial, nothing more than an everyday event. b. This “startle” is followed by a minipanic with a sudden loss of perspective, the world being set topsy-turvy. c. You try to deal with this panic by falling into a mode of obsessing and ruminating over one or another aspect of the situation. This can last for hours, days, even months. To break the negative obsessing, have a list of friends to call. Have a few videos that always engross you and get your mind off things. Have ready access to exercise. Have a punching bag or pillow handy if there’s extra angry energy. Rehearse a few pep talks you can give yourself, like, “You’ve been here before. These are the ADD blues. They will soon pass. You are OK.”

Expect depression after success. People with ADD commonly complain of feeling depressed, paradoxically, after a big success. This is because the high stimulus of the chase or the challenge or the preparation is over. The deed is done. Win or lose, the adult with ADD misses the conflict, the high stimulus, and feels depressed.

Use “time-outs,” as with children. When you are upset or overstimulated, take a time-out. Go away. Calm down.

Learn how to advocate for yourself. Adults with ADD are so used to being criticized, they are often unnecessarily defensive in putting their own case forward. Learn to get off the defensive.

Avoid premature closure of a project, a conflict, a deal, or a conversation. Don’t “cut to the chase” too soon...

Try to let a successful moment last and be remembered and become sustaining over time. You’ll have to train yourself consciously and deliberately to do this because you’ll naturally tend to forget your successes as you brood ov...

Remember that ADD usually includes a tendency to overfocus or hyperfocus at times. This hyperfocusing can be used constructively or destructively. Be aware of its destructive use: a tendency to obsess or ruminate o...

Don’t stay too long where you aren’t understood or appreciated. Just as people with ADD gain a great deal from supportive groups, they are particularly drained and demoralized by negative groups, and they have a tendency to stay with them too long, vainly trying to make things work out, even when all the evidence shows they can’t.

If ADD is a problem with inhibiting, we can understand the phenomenon of time collapsing in on itself for people with ADD: instead of being able to carve out discrete activities that would create a sensation of separate moments, the person cannot stop the relentless flow of events. Everything runs together, unbraked, uninhibited. We hear the ADD adult so painfully describing the verbal rush, the inability to stop the words, and the verbal paralysis, or stuttering, derived from the inability to stop the thoughts long enough to find the words. The social intrusiveness that is so characteristic of those who have ADD is the inability to stop at the other’s boundaries. The failure to form intimate relationships is the inability to pause long enough even to listen to the other person, let alone to understand and respect the other’s needs. The impulsivity, the lack of planning, and the outbursts are the inability to restrain the flow of action and feeling.

We also see people with ADD hyperfocusing on an activity, like rockclimbing or driving or work, probably because it allows them to forget about the expectations associated with “time.” Our patients frequently report that they are their most calm when completely caught up in the thrill of it all, whatever the “all” may be. It could be fun, a catastrophe, or a life-or-death crisis. These situations allow the ADD person not only to get into forward motion, but also to forget, to disregard that they need brakes in the first place. In an emergency, it’s full speed ahead. What a relief.