Chapter 25: ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a neurological condition that is characterized by difficulty with executive functioning (planning, organization, emotional regulation, self-monitoring, time management, and self-control), a low threshold for boredom, and, in some cases, impulsivity.
 
TWO TYPES OF ADHD
ADHD (previously known as attention-deficit disorder or ADD) is subdivided into hyperactive and inattentive types. This means that, respectively, some with ADHD tend to be hyper and impulsive, while others are more inattentive and internally disorganized. This latter category is more common among females with the condition. As a matter of fact, women with ADHD often fly under the diagnostic radar, as gender roles can influence the way ADHD presents itself.
     
While children who get diagnosed with ADHD typically first show symptoms of hyperactivity and poor impulse control, adults who seek treatment for ADHD more often complain of difficulty with organization, time management, chronic procrastination, and motivation problems.
 
THE ROLE OF DEPRESSION AND LOW SELF-WORTH
Attention-deficit/hyperactivity disorder isn’t just about focus; depression and low self-worth are common secondary symptoms. People with ADHD have typically struggled tremendously in school and employment settings. They have often been told that they need to calm down, focus, and get with the program. This combination of experiencing painful struggles in school and work, being the target of frequent criticism, and having the nagging feeling that “I’m just not living up to my full potential” can really take a toll on one’s sense of Self.

The truth is, ADHD is not a disease to be cured, but rather a condition to be managed. In fact, there are some experts who challenge the notion that ADHD is a disorder.
 
THE UPSIDE OF ADHD
In his book, The ADHD Advantage, Dale Archer highlights the benefits of ADHD. Flipping the symptom profile around, Archer points out the strengths that many people with this condition have, such as “an ability to multitask, a propensity to thrive in situations of chaos; creative, nonlinear thinking; an adventurous spirit; a capacity for hyper-focus on something that fascinates you; resilience; high energy; a willingness to take calculated risks; and calmness under pressure.” If you are able to effectively harness these qualities, you can experience unique advantages in life. On the other hand, without adequate structure, support, and education, living with ADHD can cause tremendous difficulty and distress.
     
A BRIEF HISTORY OF ADHD
While many think of ADHD as a relatively new diagnosis, the phenomenon has been documented for centuries. In ancient Greece, Hippocrates, the father of modern medicine, wrote about patients who had difficulty focusing on any one task and reacted with exceptional speed to things around them. Other physicians and educators have made similar observations over the years. Early terminology for the disorder included “nervous child” and “hyperkinetic reaction of childhood.”
     
Modern psychiatry coined the term ADD, which was first introduced in 1980. It was later modified to ADHD in 1987. While originally considered a disorder of childhood that one will grow out of, it is now understood to be a lifelong condition.
     
Much controversy currently surrounds the diagnosis of ADHD, due largely to the aggressive marketing efforts of Big Pharma to medicate those with the condition. Beginning in the 1990s, widespread financial incentives for doctors to prescribe ADHD medications, combined with television ads targeted to frazzled educators and exhausted parents, led to an explosion of the diagnosis, especially in young children.
     
While some of this trend was clearly due to better assessment procedures, there was also a zeitgeist of labeling all hyper children as having the disorder. The unfortunate side effect of this was young children being overprescribed stimulant medication. While prescriptions for medication have arguably gotten out of control, for many with the disorder, medication is tremendously helpful, if not essential.
     
Richard Louv, author of Last Child in the Woods, has attempted to connect ADHD to what he has termed “nature-deficit disorder,” the result of society’s lack of connection to the natural world. While there is no empirical evidence to support the existence of nature-deficit disorder as a clinical syndrome, the concept bears further examination. As with any condition or disorder, there is always more to learn.
 
DIAGNOSIS AND TREATMENT
If you suspect that you may have ADHD, obtaining a proper diagnosis is key. Any licensed mental health professional can assess you for ADHD. In some cases, your therapist may refer you to a psychiatrist, psychologist, or neurologist who specializes in ADHD for further assessment and testing. Once an accurate diagnosis has been made, treatment can begin. Therapy for ADHD involves a combination of education, supportive counseling, mindfulness practice, and, in some cases, medication. In addition to traditional psychotherapy, individuals with ADHD may also benefit from working with a life coach.
   
If you have been diagnosed with ADHD, the first step is to learn as much as you can. Both Driven to Distraction and The ADHD Advantage are written by psychiatrists who themselves have ADHD. Both books are highly informative, accessible, compassionate, and practical in their approach.

​The next step is to work with your therapist and other supportive people in your life to develop structure and habits that are tailored to your needs. Another aspect of your therapy may involve working through any difficult emotions associated with living with ADHD, including both past and present experiences that have caused distress.
   
Finally, it is important to note that, in many cases, ADHD presents unique challenges in relationships. It can be very helpful for your significant other and close relatives to become educated about the condition.