Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder

by Edward M. Hallowell

While we all need external structure in our lives—some degree of predictability, routine, organization—those with ADD need it much more than most people. They need external structure so much because they so lack internal structure. They carry with them a frightening sense that their world might cave in at any moment.

the feeling that gibberish is being passed off as coherent conversation,

there. Or, on a larger scale, the most important item on your agenda for a given day might be to make a certain telephone call, a call that, say, has crucial business consequences. You mean to do it, you want to do it, you are not afraid of doing it, indeed you are eager to make the call and feel confident about doing it. And yet, as the day progresses, you never get around to making the call. An invisible shield of procrastination seems to separate you from the task. You sharpen your pencil instead, talk to an associate, pay some bills, have lunch, get interrupted by a minor problem, return some other calls to clear your desk so you can make the important call, only to find that the end of the day has come and the call still has not been made. Or, on

Often I feel like I have to push through a wall to get into a job. No matter how organized I try to be, I always mess up! Stream-of-consciousness way of doing housework—hop from this to that with no apparent logic, just a schedule. Always trying to organize things, but it doesn’t come easily. If I don’t organize them, I won’t know where they are. Lose what’s in my head very easily. Organize my life around projects. They give me something to think about.

Feel that I have to push myself all the time, especially getting into things.

Problem with lateness. Even when there is plenty of time, I fill it up and then cut things too close or lose track of the time. I don’t have a sense of the passing of time. Inwardly feel desperate.

management have been very helpful in keeping me on track. I reread them every so often. I have been thinking more about the issue of my father: the last I wrote to you was that I couldn’t imagine wanting a relationship with a father. Since then I have noticed that I have a desire to relate to some of the older “father figures” in my life, ones that are somewhat of a kindred spirit to me. And, probably, as I rethink it, my father, his sister, and my sister have ADD or something like it. A while back I dreamed I was in the house I grew up in. I was furiously angry at a woman who has been somewhat like an older sister to me. She is a very efficient person who can keep track of ten things at once. I think that she represented my mother, who cared for me but didn’t understand me. Perhaps the greatest benefit that has come since discovering that my husband and I have ADD is that we can understand each other. Previously, I felt that my friends understood me much more than he did. Since finding out about ADD and getting treatment, he is much happier, more productive, more accepting of himself, and easier to talk to. He used to be like a machine that tried to give answers; now I feel that he is the person who understands me the most. As in children, ADD in adults occurs on a wide spectrum. There are severe

irascible

he actively brooded within himself, carrying on an internal monologue like a preacher from the pulpit about the extent of his sins.

Instead of paying attention evenly, you hyperfocus on everything negative.

harangue

You organize around a bad mood and you don’t let go. You hold on to it for dear life. You don’t dare give it up for fear that chaos will replace it.”

I’ve been calling it depression because it hurts so much, but it’s more of a fight than a depression, now that you mention it.”

Instead of engaging in the argument, instead of answering back to the preacher in the pulpit, you need to ignore him.

Go for a run. Call someone on the telephone. Write a letter. Turn on loud music.

When you’re in one of those moods, it is not the time for introspection. Beware the preacher because he is beguiling.

you overwork as a way of getting stimulated,

16. Avoid

the pattern of victim and victimizer.

Married to Distraction. It was not exclusively about ADD, but about how our

You don’t mean to do the things you do do, and you don’t do the things you mean to

The main symptoms of the condition are easy distractibility, impulsivity, and restlessness, all of which Tommy has.”

unclenched, then the family can begin the commonsense process of negotiation. The two keys to reaching this point are first, making the diagnosis of ADD, and second, persuading the family unconscious to grant permission for there to be change within the family system. How do you talk to the family unconscious? How do you get it to grant permission to change? The methods a therapist typically uses include interpretation,

Getting to Yes: Negotiating Agreement Without Giving In, by Roger Fisher and William Ury. Originally intended for application to business and diplomacy, this book is better than almost any psychology or family-therapy text for learning how to negotiate effectively in families.

Typical problem areas include study time, morning time, bedtime, dinnertime, times of transition (leaving the house and the like), and vacations.

the evidence now shows that there are hosts of children and adults who have all the other symptoms of ADD but who are not hyperactive, or even overactive. If anything, they are

These are the daydreamers. These are the kids—often girls—who sit in the back of the class and twirl their hair through their fingers while staring out the window and thinking long, long thoughts. These are the adults who drift off during conversations or in the midst of reading a page. These are the people, often highly imaginative, who are building stairways to heaven in the midst of conversations, or writing plays in their minds while not finishing their day’s work, or nodding agreeably and politely while not hearing what is being said at all. They steal away silently, without the noisemaking of their hyperactive brethren, but they steal away just the same.

Usually in these people the core symptom is distractibility. It is a quiet phenomenon, their shifting

attention. It happens as silently, but as definitely, as a cut in a film sequence. Imagine, one moment you are in one place, and in the next moment you are somewhere else. You don’t really notice it. Rather you go along with it, as you go along with a cut in a movie. The narrative carries you, as you view your own internal story, your own internal screening of the day’s events.

The mind meanders like a brook, winding through the contours of the land, bending here, falling there, qui...

But in other ways it is anything but charming. It can be downright disabling not to be able to rely on your own mind to remember things, to prompt you to get to places on time, to keep you involved in a conversation when you want to be, or focused on a page you rea...

The meandering brook, in its desultory way, seems to be forever carrying you away f...

The person with “anxious ADD” often starts the day, or any moment of repose, by rapidly scanning his or her mental horizon in search of something to worry about. Once a subject of worry has been located, the individual locks in on it like a heat-sensing rocket and doesn’t let go. No matter how trivial the subject or how painful the worry, the individual keeps the worry alive, returning to it magnetically, obsessively. Some of these people do in fact have obsessive-compulsive disorder, but the majority do not.

ADD with Depression

living with an overflow of energy but an undersupply of self-esteem, the

It is heartening how valiantly people with undiagnosed ADD try in the face of their despair. They don’t give up. They keep pushing.

Your physician will ask about certain specific physical factors that are often associated with ADD, including left-handedness or ambidextrousness, frequent ear infections in childhood, upper respiratory infections or other illnesses as a child, allergies, sleep disturbances, especially great difficulty in falling asleep, or frequently waking up during the night or trouble getting up in the morning, awkwardness or clumsiness or poor hand-eye coordination, bed-wetting as a child, accident-proneness as a child, or high

More than most people, individuals with ADD have visionary imaginations.

They think big thoughts and dream big dreams.

germane

easy distractibility; inability to stay focused—for example, on a task at work or reading a book, homework, or classroom material; impulsive acts or words; difficulty maintaining attention during a conversation; poor frustration tolerance; angry outbursts; mood swings; difficulty getting organized; chronic procrastination; difficulty prioritizing; tendency to worry rather than act; a subjective inner feeling of noise or chaos; tendency to hop from topic to topic or project to project;

and devotion. The effectiveness of any treatment

This epidemic left some victims chronically immobile (as those described by Oliver Sacks in his book Awakenings) and others chronically insomniac, with impaired attention, impaired regulation of activity, and poor impulse control.

diagnostic triad of ADD symptoms: distractibility, impulsivity, and restlessness.

(although the pernicious and unfair tendency to blame parents and children persists to this day among the ill informed).

Overall, the ADD group metabolized glucose at rates 8 percent lower than the control group.

As

one of the most frustrating aspects of ADD is the inability to profit from one’s experience, the inability to focus on consequences, the inability to navigate through tasks or social situations or the world at large by using what has been learned previously. If

Low activity in the frontal areas of the brain could explain the breakdown in goal-directed behavior and self-regulation as described by Barkley.

Another way to understand ADD is to think in terms of underarousal of the brain system.