Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder

by Edward M. Hallowell

Instead of paying attention evenly, you hyperfocus on everything negative. This happens subtly, but profoundly.

“You mean,” he said, “my mind may fall into one of these ruminative cycles, as you call them,

When you’re in one of those moods, it is not the time for introspection.

they struggle with the secondary symptoms that years of living with undiagnosed ADD created. These are symptoms such as impaired self-image, low self-esteem, depression, fearfulness of others, mistrust of self, skittishness in relationships, and anger over the past. These wounds heal very slowly.

I don’t mind that he gets up in the middle of the night because he’s bored and wants to go flying;

Many people with ADD find that certain forms of highly stimulating behavior help them focus, and they turn to these behaviors as a kind of unwitting self-treatment or self-medication of their ADD. Some people turn to gambling as a source of high stimulation and the concomitant focusing it provides. Some people turn to high-risk activities such as driving at high speeds or skydiving. In Brian’s case, he was using the high stimulation of romance to help him focus.

People with ADD have a tendency to bring premature closure to discussions, to go for the bottom line.

negative thinking is a most corrosive force in the treatment of ADD.

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

My father was just as dumb and stubborn as I am. If I didn’t do what he told me to do, he took off his belt and hit me with it until I did what he told me to do.” “Did that method work?” the psychiatrist asked. “Oh, sure,” Dad said. “In the short run. I did what he told me to do. But I learned to hate the son of a bitch. I’ve forgiven him now, I guess, because he was just doing what he knew, probably just what had been done to him. But it cost us a relationship. I still can’t talk to him. I just can’t imagine talking to him about anything that matters. So we have really stilted conversations that both of us can’t wait to end. Then we go off and wish we had a better relationship with each other.”

When he discovered, at age fifty-seven, that he had ADD, that indeed there was a reason for his underachievement, he became elated and couldn’t wait to share the news with his older sister, the family matriarch since his mother had died. She responded coldly, saying, “I’m happy for you, George, if you’ve found something that makes you happy.”

This ADD thing has not only silently blocked me from successfully doing those things that have been expected of me, but it has done so in such a way that I (along with most others similarly blessed) came to believe that my inability to perform was a matter of choice and therefore a massive character flaw. I have genuinely felt that to be true for as long as I can remember. In addition, it has been apparent to me as well as to all with whom I have had contact that I have had the ability, intelligence, good looks, sense of propriety, and whatever else seemed important in the quest for success … another false start.

I have not had control over those functions of my mind that allow me to sustain interest in almost anything of significance in my life.

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.

“I can be working on a project at my desk,” reports one patient, “when, without really knowing it, I begin to think about some other idea my work suggests. Then I follow that thought, or I may even leave my desk to go get something, and by the time I’ve gone to get the thing, I’ve forgotten what it was I was going to get. I’m almost sleepwalking. Hours can pass in this unfocused state. Lots of interesting thoughts pass by, I can be engaged in lots of creative enterprises, but relatively little gets done. I can combat it consciously for a few minutes, but the moment I get into anything, the moment I stop monitoring what I’m doing and get into the flow of the work, then I’m at the mercy of my whims. If I could just stay focused for even one hour, I could probably get my whole day’s work done.”

For some people, the experience of ADD is one of chronic anxiety. What bothers them most is not the inattentiveness or impulsivity of ADD, but the attendant anxiety they so frequently feel.

This tendency to organize around worry defines the subtype of ADD with anxiety.

life is too hard, too much of a struggle, that perhaps it would be better if life were to end than go on.

I don’t think I’ve ever really been happy. For as long as I can remember, there’s always been a sadness tugging at me. Sometimes I forget about it. I guess that’s when you could say I was happy. But the minute I start to think, then the bad feeling comes back. It isn’t despair. I’ve never attempted suicide or anything like that. It’s just that I’ve never felt good, about myself or about life or about the future. It’s all been an uphill battle. I guess I always thought that’s just what life was—one long series of disappointments interrupted by moments of hope.

He may, in his stumbling, stumble onto something new and wonderful. It is therefore vital that we keep the windows of these children’s minds clean, that we keep them free of the smudge and grease of shame, criticism, defeatism, and devaluation.

A specific math disability may often be found with ADD, as may other specific learning disabilities, particularly difficulty in learning foreign languages.

Others do not reverse letters per se, but anticipate letters or sounds incorrectly, and so misread words, for example mistaking “battlefield” for “bachelor” or “filament” for “firmament” or even “metaphor” for “medical.”

They seem to think that the idea that intelligence may be a more complicated matter than smart versus stupid is just a fancy way of dancing around the truth: you either have it or you don’t. Such thinking can turn school into one long, dismal ordeal.

This is the brutal process of the breaking of the spirit of a child.

School!

feeling of unease or what psychiatrists call “dysphoria,” doesn’t have a context or even a name. It’s just life, in the minds of the people who feel it.

In bearing with the tension of the unknown or the unfamiliar, one can enable something new to come into existence. If one forecloses a thought too quickly, because it seems too weird or strange or disorganized, then the pattern or beauty that may be hidden within the fantasy will get lost.

People with ADD are always reacting. Even when they look calm and sedate, they are usually churning inside, taking this piece of data and moving it there, pushing this thought through their emotional network, putting that idea on the fire to burn, exploding or subsiding, but always in motion. Such hyperreactivity enhances creativity because it increases the number of collisions in the brain. Each collision has the potential to emit new light, new matter, as when subatomic particles collide.

Once medication helped him focus, Brian used psychotherapy to learn to stay with an emotion. He began to find that his emotions could be stimulating in their own right, and in a safe and useful way.

Caffeinism

In intimate relationships is your inability to linger over conversations an impediment?

They are often locked into a kind of tenacious holding pattern, needing all their considerable resiliency and ingenuity just to keep their heads above water.

The diagnosis brings great relief in and of itself. For example, if you were nearsighted and had never heard of nearsightedness, and for years you had thought your blurry vision and subsequent learning problems were due to lack of effort or moral turpitude, imagine your relief in discovering that there was this condition called nearsightedness, and it had nothing to do with effort or morality, but rather was a neurological condition. So it is with ADD. The diagnosis is liberating.

Structure refers to essential tools like lists, reminders, notepads, appointment books, filing systems, Rolodexes, bulletin boards, schedules, receipts, IN- and OUT-boxes, answering machines, computer systems, alarm clocks, and alarm watches.

Although people with ADD tend to be outgoing and gregarious, they can also harbor strong feelings of isolation, loneliness, and disconnectedness. Their stance in life is often one of reaching out but not quite making contact, as if running alongside a speeding train, trying to grasp the hand that is being held out to them to help them on board.

Very often at the initial stage of treatment there is great reluctance to try medication. Parents do not want to “drug” their child, or the adult with ADD wants to make it on his own, without the aid of some unknown medication. This hesitancy may be deeply felt and must be dealt with carefully.

In addition, there is an effective all-day preparation called Vyvanse, which is a purer form of amphetamine than Adderall.

More than most people, ADD adults wither without encouragement and thrive when given it. They will often work for another person in a way they won’t work for themselves. This is not “bad,” it just is. It should be recognized and taken advantage of.

True!

Give up trying to be the person you always thought you should be—the model student or the organized executive, for example—and let yourself be who you are.

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.

Notice how and where you work best: in a noisy room, on the train, wrapped in three blankets, listening to music, whatever. Children and adults with ADD can do their best under rather odd conditions. Let yourself work under whatever conditions are best for you.

Know that it is OK to do two things at once: carry on a conversation and knit, or take a shower and do your best thinking, or jog and plan a business meeting. Often people with ADD need to be doing several things at once in order to get anything done at all.

people with ADD are hard, energetic workers. Tapping into their true potential is like harnessing rushing rapids to a hydroelectric turbine.

talks back,

"don't back talk me, boy" said a million times

The usual “treatment” for these children was physical punishment.

Usual these days too

“There is no ADD while playing Nintendo,” Dr. Barkley is fond of saying, not meaning, of course, that the child will be motivated only in desirable situations, but that the rapid, ever-compelling, visually complex nature of the video game, and its constant rewards, sufficiently engage the child to rivet attention.