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is not a duty to clear some physical space so that his mind is not oppressed by the clutter, but it is a sensible thing to do if the long-term goal is development.
The adult with attention deficit disorder needs to know that the physical space she occupies can help to either harmonize or disorganize her mind.
If necessary, she may set herself small, incremental goals. It is discouraging to try to accomplish something that may be beyond present capacities. The ADD brain is overwhelmed by a multipartite task. She does not know where to turn, and the all-or-nothing mind-set demands that everything be done at once. Nothing needs to be done at once. The
This task, like all others, requires learning to tolerate failure. The many setbacks of the ADD adult have not necessarily taught him to endure failure but only to be permanently frustrated by it.
2. Sleep hygiene The ADD adult is often a night owl. The origin of the propensity to stay up late is not clear, but I believe we can learn something from observing ADD children.
Something in the ADD adult dreads going to bed and turning the light off. The fear is of being alone with one’s urgent mind for even a few short minutes.
The fear of being alone with the mind is, I believe, an implicit memory of finding oneself, in infancy, cut off from contact with the parent.
“Entering the mad world of dreams each night probably promotes mental health in ways we do not fully understand,” suggests Anthony Storr. “It seems clear that some kind of scanning or re-programming takes place in dreams which has a beneficial effect upon ordinary mental functioning.”[1]
The ADD child completely falls apart when his blood sugar is too low, becomes hyper when it is too high, showing how directly nutritional states affect the brain.
Physical exercise “Is your ‘kid’ getting enough exercise?” I ask ADD adults.
Nature The parent who never takes his child out into nature, away from the city, is depriving him not only of wonderful experiences but also of a powerfully harmonizing influence for the mind.
The adult, too, neglects an important need if she deprives herself of regularly experiencing the outdoors.
impossible number of tasks and responsibilities. The ADD adult’s workaholism and dread of the word “no” leads her to overextend herself. A large proportion of the ADD clients I have seen are juggling too many projects, commitments that leave them with nary a moment to finish a thought.
Recreation There is a difference between entertaining diversions and recreation. Watching television may be entertaining but it is not a process that re-creates.
Re-creation needs activities that nourish the mind or liberate the body. What these may be will vary from person to person, but universally ADD adults deny themselves regularly scheduled times for mental and physical regeneration.
Creative expression It is unusual for me to meet an ADD adult who does not have some secret longing for artistic expression, and almost as unusual to find one actively doing something about it. Essential to finding meaning and p...
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The tendency to creativity of the ADD mind cannot be denied. Even those without an artistic interest will show a creative streak, being able to apply their fertile minds to difficult
Meditation is one way of acting on the neurophysiology of ADD. It is an important way, but not the only one. Any activity, from gardening to martial arts, that promotes mindful concentration will bring benefits. Adults with ADD should at least consider giving themselves some daily opportunity for contemplative solitude. Contemplative solitude is different from being alone in a room, reading, listening to music or being lost in reverie. It means putting some attention on one’s life, one’s thoughts and feelings.
A brain used to decades of inattention and disorganization will not overnight reorganize itself.
All addictions are anesthetics. They separate us from the distress in our consciousness. We throw off our familiar and tired consciousness to assume another mind state we find more comfortable, at least temporarily.
Whether they know it or not, a large number of people addicted to behaviors and substances of various sorts have attention deficit disorder, no matter what their proclivity may be:
Less obvious but no less physiological are the effects on the brain of self-stimulating behaviors. The gambler and the sexaholic, the compulsive shopper and the man or woman who insists on skiing uncharted glaciers are all looking for the same hit of dopamine and endorphins that the ingestion of substances gives the drug addict.
The behavior addict knows, or ought to know, that what separates him from the drug addict’s fate is little more than good fortune.
The addiction is the repeated behavior engaged in despite the certainty that it harms oneself or others.
but the real object of addiction is the thrill of plunging into the behavior, not the love of it.
The major effect was that I could not be present—in both senses of being at home or attentive to my family—whenever I was in the grip of the fever.
In biochemical terms, any addictive substance or behavior is self-medication, self-administered emotional pain relief. But the ADD person is also treating herself for a condition she is not even aware of having.
Whatever behavior or substance one is addicted to, the treatment of attention deficit disorder cannot make headway until one accepts the fact of the addiction and takes steps to end it. It is not possible to lull feelings to sleep and hope to be truly awake.
read everywhere, I once said to my therapist, that I am supposed to heal myself by “feeling my pain and my grief.” Try
“Quite right,” he agreed. “How could you know?” I was spending all my waking hours, as he pointed out, stimulating myself with ceaseless activity, working overtime to keep my brain spinning, gorging it with mind candy—what exactly was I expecting to feel?
The deficient neurochemistry of addiction, like the deficient neurochemistry of ADD, can be traced to events in the first year or two of life, as we know, the brain’s most crucial formative period.[2]
“Social isolation, the early deprivation of emphatic care, causes a permanent reduction of brain opiate receptors,” writes the researcher and theorist Allan Schore.[3]
A significant proportion of the adults I see with ADD admit to substance addictions at some time in their lives, and not a few continue to engage in them into the present.
There are many potential sources of help for the addict wishing to heal, although too many put the emphasis purely on the addiction rather than the underlying causes. “We so often become so preoccupied with the problem the drug use creates,” write Drs. Hallowell and Ratey in Driven to Distraction, “that we fail to consider what purpose the drug must be serving for the user.”[4]
find, too, that the people most closed-minded on the question of medications are also the ones least aware of what attention deficit disorder
There is no way to predict how a given individual will react to a particular medication.
better case can be made that they may prevent addictions, by correcting some of the biochemistry that predisposes a person to substance abuse, as described in the previous chapter.
The main drugs in ADD treatment are the psychostimulants, the most familiar being methylphenidate, known by its trade name Ritalin, and dextroamphetamine sulfate, commonly referred to as Dexedrine. Although they have different modes of action, they both stimulate the activity of the cerebral cortex by balancing the levels of the neurotransmitters (chemical messengers) in the frontal lobe of the brain and in other centers concerned with arousal and attention.
Only one person has the right to decide whether a medication is taken: the one about to be treated
The medications employed in attention deficit disorder cannot be prescribed according to the fixed recipes appropriate for most medical drugs.
The aim of medication is not to control behavior but to help children focus
Adults should have clear and limited expectations for what medication can do for them
some cases they can be of tremendous help, and in others their benefits are more limited. In no case do they resolve the basic problems of low self-esteem, fear of intimacy, driven lifestyles and lack of self-knowledge.
The adult should be aware of her emotional state when setting out to take medications for ADD Not infrequently, the ADD adult may be suffering from chronic low-grade depression or anxiety.
Medications should never be the only treatment, or even the first treatment
Attention deficit disorder is not primarily a medical problem. Neither its causes nor its manifestations are due to illness.
Consider the long-term implications of medication use, not just its short-term benefits
Do not read more into the effects of medication than they merit
Three conclusions may be drawn from that experience. First, the medical view of the world tends not to trust nature very much. Second, there are things in the world that are true, even if they’re not taught in medical school. Third, sometimes doctors have to be educated by the public—under duress, if necessary.
Adults with ADD face the most difficult task of all: learning how to be loving toward themselves. This is the greatest struggle because it requires that we gradually shed the defenses we have come to identify as the self and venture into new territory.
