About 4.4 percent of American adults — 10 million people — have ADHD. And roughly 8 million children have been diagnosed with the disease, making it one the most commonly occurring mental health disorders in the United States.
The rate of co-occurring substance use disorders is high among those with ADHD. Individuals with this diagnosis are 2.5 times more likely to develop a substance use disorder. A study by researchers at Massachusetts General Hospital found that 15 to 25 percent of adults who have a substance use disorder also have ADHD.
For co-occurring ADHD and substance abuse disorders, the best treatment programs combine medical treatment for ADHD, drug detox and therapy that address both disorders. Additionally, proper ADHD treatment during childhood can prevent further development of the disorder that may lead to a substance use disorder during adulthood.
The risk for substance abuse is often higher for people with ADHD. Compared to the general population, people with ADHD are:
Three times more likely to develop a nicotine use disorder
Two times more likely to develop an alcohol use disorder
Two times more likely to develop a cocaine use disorder
5 times more likely to develop a marijuana use disorder
Research shows that those with ADHD may have lower levels of dopamine — the brain chemical responsible for reward-seeking behavior — and turn to substance abuse or other dopamine-releasing behaviors as a result.
Despite the increased risks, those with co-occurring ADHD and substance use disorders are not doomed to struggle with addiction their entire lives. Many rehab centers offer specialized programs for co-occurring disorders that focus on treating the separate disorders concurrently, giving patients a realistic chance of reaching recovery and living a healthy life.
Treatment for Co-Occurring ADHD and Substance Use Disorder
Treatment for co-occurring mental health and substance use disorders is most effective when the disorders are treated simultaneously. Addressing them at the same time is preferred to treating them one at a time, which was the generally held practice in the past.
Medication is the most common form of treatment for ADHD, and with proper use, it can greatly benefit those with co-occurring ADHD and substance use disorders. Stimulant and nonstimulant medications can be effective in treating individuals with ADHD with or without a co-occurring substance use disorder. The most common types of medications used to treat ADHD are stimulants.
A study by researchers at Massachusetts General Hospital examining the results of six long-term studies found that stimulant treatment for ADHD during youth leads to reduced risk of developing a substance use disorder during adolescence and adulthood.
The two most common stimulants used to treat ADHD are methylphenidate and analogs of amphetamine.
Amphetamine medications activate the reward pathway and trigger the release of dopamine in the brain, bringing balance to dopamine levels among those with ADHD. This can help alleviate drug cravings.
According to researchers at Columbia University, clinical trials of Ritalin (methylphenidate) have also been effective in reducing symptoms of ADHD and substance use disorder when combined with relapse prevention therapy. The drug has a relatively low risk of abuse under proper medical supervision.
Methylphenidate has been used for decades to treat ADHD and has shown to be effective for children and adults. Uncontrolled trials of methylphenidate have shown to have a positive impact in reducing symptoms of ADHD and cocaine use disorders, according to researchers at Columbia University.
Some nonstimulant medications can be used to treat ADHD and may present an alternative to stimulants. While stimulants have a higher abuse potential, nonstimulants are often seen as a less effective treatment option.
Atomoxetine is a selective norepinephrine reuptake inhibitor that can be used to treat ADHD. It affects those with ADHD similarly to stimulants, but in a more gradual manner. With no known abuse potential, atomoxetine is an attractive alternative to stimulant medications.
Tricyclic antidepressants have also been used to treat ADHD. However, they are generally less effective than stimulants in treating ADHD.
Problems with Medication Treatment
Research from Massachusetts General Hospital shows medications that are effective in treating adult ADHD may be effective for adults with ADHD and co-occurring substance use disorders, but the medical benefits of the medications are hindered if an individual is actively abusing substances.
Patients may require higher doses in order for a medication to be effective.
The presence of other substances in a patient’s system may make the therapeutic effects of a medication less effective.
Individuals actively engaging in substance abuse are more difficult to treat with medication, with or without a co-occurring disorder.
Alcohol and ADHD Medications
ADHD medications are associated with high risks when used concurrently with alcohol. Adderall is a medication of particular concern because it is commonly abused by college students who participate in binge drinking culture at parties, bars and nightclubs.
Individuals who abuse Adderall and alcohol together find that the depressant alcohol effects are lessened by the stimulant properties of Adderall, allowing them to drink more for longer periods of time.
Abuse of Adderall or other ADHD medications while drinking may cause people to consume hazardous amounts of alcohol. ADHD medications that block the depressant effects of alcohol may cause individuals to ignore signals from their bodies that they have had enough to drink, which can lead to dangerous health concerns such as alcohol poisoning.
It is crucial for people to consult their doctor about alcohol use while taking any type of ADHD medication.
About the Author: Trey Dyer is a writer for DrugRehab.com. Trey is passionate about breaking the stigma associated with drug addiction in the United States. When Trey is not writing, he can be found fly fishing, playing soccer or cooking BBQ.
Adler, L. et al. (2005, March). Long-term, open-label study of the safety and efficacy of atomoxetine in adults with attention-deficit/hyperactivity disorder: an interim analysis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15766294
Somoza, E. (2004). An open-label pilot study of methylphenidate in the treatment of cocaine dependent patients with adult attention deficit/hyperactivity disorder. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15077842
Wilens, T. et al. (2003, January). Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12509574
“Image courtesy of stock photos/FreeDigtalPhoto.net” Modified on Canva
by Cynthia Hammer, MSW, ACSW – Founder of the non-profit ADD Resources
It Seemed So Easy for Others
Are wondering if you might have ADHD? Will it be immediately clear to you that you have ADHD so you’re able to set about getting diagnosed and treated? Is it the eureka moment that we so often hear about? Can it be as simple as a parent takes their child in to be diagnosed for ADHD, recognizes it in themselves, bursts into tears, is diagnosed and treated, and experiences a dramatic improvement in their life?
It Took Me Years
This was not my journey of awareness and acceptance of having ADHD. It took me over a year after learning about ADHD to realize I had this disorder and another year in treatment to develop a positive attitude. For any of you who may be reluctant to start your journey, I assure you that learning to accept and manage your ADHD will bring you more satisfaction and contentment with your life than you have ever experienced.
I Was So Sure It Was the Fault of My Poor Parenting
Although my brother and nephew were diagnosed with ADHD years ago, no bells went off in my head when we started to have problems with two of our children. Russell Barkley, Ph.D, says 40% of children diagnosed with ADHD have a parent with the same disorder while Ted Mandelkorn, MD, says that over 90% of those diagnosed with ADHD have a relative somewhere in the immediate or extended family who also has the condition. I knew there was a familial connection to the condition but thought what our children were exhibiting was plain, old-fashioned misbehavior. If we could only parent better, they would behave better.
And So It Went
Off and on I had read library books about ADHD. Sometimes I would think it described one or another of my sons, but then again, it did not sound quite like them. So it went for several years. Then my husband heard a pediatrician talk on ADHD. He came home convinced it described one son. We took him to be diagnosed and started him in treatment. After a year of attending treatment sessions with my son, along with more reading and attending CHADD meetings, I tentatively told the pediatrician treating my son that I thought I had ADHD as well and he readily agreed!
My Denial Pushed Back Help
The prime reason it took so long to help my children and myself is denial. No one wants to admit there is something the matter. They don’t want to have any impairment. They don’t want to be different from normal people. The condition is called a disorder, such a hopeless sounding label. My relatives with ADHD were having major problems in their lives. I was reluctant to associate my children with the same condition. Wasn’t this consigning them to a bleak future? Wouldn’t it be more hopeful to keep working on better parenting skills than to say they had this disorder? I thought ADHD was a handicapping condition that would be diagnosed and that would be it. I focused on denying the disorder, instead of on how treatment could bring benefit and improvement.
Accepting the Diagnosis for Others But Not for Me
After accepting the diagnosis and treatment for my sons, why did it take so long to see the condition in myself? Denial, along with two other factors, was at work. ADHD is difficult to self-identify because of its complexity and the lack of clarity in the description of the symptoms. One author would stress certain features or describe them in a way that I could relate to. I would say, “Yes, that’s me!” Another author would describe other features and it wouldn’t sound like me! I should have paid more attention to the wording that introduces a list of characteristics, where it says, for example, “will demonstrate 8 of the following 20 characteristics.” I didn’t need to have all the characteristics to have the condition, but the characteristics had to be of a degree and pervasiveness that they caused significant turmoil in my life.
Lack of Self-Awareness Made It So Hard
The other factor that makes self-identification difficult is related to an ADHD characteristic, a lack of self-awareness. For example, I could feel I had offended a coworker, but I had no insight or understanding of how or why. I was too fearful of what they might say to ask them. ADHDers do not realize how they come across to others. (This is why it is helpful to have outside evaluations of your behaviors from people closely associated with you.) In many ways, people with ADHD delude themselves that they are doing just fine; it’s the others that they work with or associate with who have the problems. ADHDers always have good reasons to justify why they did something the way they did, and they do not understand why others might have a problem with that.
My Son Helped
My lack of self-awareness made me unable to examine my own actions and say to myself, “This is typical ADHD behavior.” However, I was able to look at my son’s troublesome behaviors and recognize that I did similar things. What he did (or did not do) that annoyed me were things that I did! As I analyzed my son’s annoying behaviors, I began to have some understanding of how I annoyed and frustrated others.
My Supervisor Helped
Another factor in my developing awareness was my supervisor. Her grandson recently had been diagnosed with ADHD, and she had read about the condition. She knew my two children had been diagnosed, and we sometimes would share information. During my annual evaluation, she brought up some points about my work that could use improvement, e.g., my inability to be a team player; my penchant for getting excited about a new project, but dropping it when only partly finished, blithely expecting someone to finish it because I had moved on to other things; and my not prioritizing my work so that the most important things got done. She said I was a mixed bag and that made it hard to evaluate me. I did some things very, very well and other things inadequately. I recognized these behavior patterns as common to ADHD. When I mentioned that I thought I might have ADHD (again my tentativeness), she said she thought so too.
Treatment Brought Me Relief
After getting diagnosed by a knowledgeable physician, I entered treatment, and like the condition itself, my emotions became very complicated. Of course, I felt relief, mentally saying over and over again, “So that explains it!” After starting on medicine, I immediately noticed improvements in my functioning and relationships. The education and counseling I received helped me learn which behaviors were related to ADHD, and I instituted techniques for managing or minimizing their disruptive influence. So it surprised me, when almost a year after being diagnosed, I blurted out, “I’ve been in a grieving process.” I hadn’t been aware of feeling this way until the words came out of my mouth.
Yet, I Grieved for the Loss of My Individuality
Why is there grief! I have two explanations. To accept the diagnosis and treatment, I had a loss in my self-image. Prior to knowing I had ADHD, I knew I was an individual. I did some things, maybe many things, differently than others, but I had a pride in most of my characteristics and abilities. Now I was learning that those characteristics that made me special are a disorder. Even though I had not seen the connection, my special characteristics had made my life more difficult than it is for normal people.
I Felt Disabled, Ashamed and Embarrassed
I felt like a disabled person. As I became more aware of how I came across to others, I felt shame and embarrassment. There was something the matter with me. Others could see it. Often they were reacting negatively to me because of how I acted. Even though part of me could see that my relationships were improving because of treatment, another part of me withdrew from relationships. I felt awkward and self-conscious, feeling that I was less than others.
I Grieved for the Life I’d Lost
The second reason for grief was a realization that my whole life had been less than it could have been. If only someone had only known about my ADHD years ago…. If only I had been diagnosed and treated years earlier…. Much in my life would have been better. These thoughts kept going through my mind. I reflected on the inappropriate actions I had taken, the people I had offended, the mistakes I had made. I felt ADD was accountable for all that had been bad in my life.
I Found Others Who Were Angry Instead
Many ADD adults, in addition to grief, experience anger as they recall their life experiences. They have so many unhappy memories of being demeaned, berated, and made to feel inadequate. Now they wonder why no one knew there was something wrong. They wonder why they weren’t treated with more kindness, patience, understanding, and love. It would have made such a difference!
Now, I Am All That I Was and More
With treatment, both grief and anger subside and resolve. I came to realize that knowing I have ADHD did not make me a new person. I stayed the person I was, my unique, special self. Only now I can better control the kind of person I am, and I am better at perceiving how I come across to others so I can adjust my behavior accordingly. Knowing about my ADHD and getting treatment for it did not make me less, as I initially thought. I am all that I was, and now I have the potential to be even more. In this context, I like to think of the American advertising slogan, New and Improved. While I am not a new model, I am an improved one! Life is a continuing adventure.
*About the Author
Cynthia Hammer, MSW, ACSW, an adult with ADHD and the parent of three sons, two with ADHD. At age 49, she learned that she had ADHD and realized she knew very little about the disorder. Cynthia founded ADD Resources in 1994 and went on to become a nationally recognized advocate for the understanding of ADHD among both those who have it and those who treated it. Cynthia is now retired and lives in Tacoma with her husband.
“Photo courtesy of Vlado-Free Digital Photo.net” – Modified on Canva
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood brain disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). These symptoms can make it difficult for a child with ADHD to succeed in school, get along with other children or adults, or finish tasks at home.
Brain imaging studies have revealed that, in youth with ADHD, the brain matures in a normal pattern but is delayed, on average, by about 3 years.1 The delay is most pronounced in brain regions involved in thinking, paying attention, and planning. More recent studies have found that the outermost layer of the brain, the cortex, shows delayed maturation overall,2 and a brain structure important for proper communications between the two halves of the brain shows an abnormal growth pattern.3 These delays and abnormalities may underlie the hallmark symptoms of ADHD and help to explain how the disorder may develop.
Treatments can relieve many symptoms of ADHD, but there is currently no cure for the disorder. With treatment, most people with ADHD can be successful in school and lead productive lives. Researchers are developing more effective treatments and interventions, and using new tools such as brain imaging, to better understand ADHD and to find more effective ways to treat and prevent it.
(Note: I’ve also posted this article as a series of shorter posts. See those here.
Symptoms of ADHD
Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age.
Children who have symptoms of inattention may:
Be easily distracted, miss details, forget things, and frequently switch from one activity to another
Have difficulty focusing on one thing
Become bored with a task after only a few minutes, unless they are doing something enjoyable
Have difficulty focusing attention on organizing and completing a task or learning something new
Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
Not seem to listen when spoken to
Daydream, become easily confused, and move slowly
Have difficulty processing information as quickly and accurately as others
Struggle to follow instructions.
Children who have symptoms of hyperactivity may:
Fidget and squirm in their seats
Dash around, touching or playing with anything and everything in sight
Have trouble sitting still during dinner, school, and story time
Be constantly in motion
Have difficulty doing quiet tasks or activities.
Children who have symptoms of impulsivity may:
Be very impatient
Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
Have difficulty waiting for things they want or waiting their turns in games
Often interrupt conversations or others’ activities.
ADHD Can Be Mistaken for Other Problems
Parents and teachers can miss the fact that children with symptoms of inattention have ADHD because they are often quiet and less likely to act out. They may sit quietly, seeming to work, but they are often not paying attention to what they are doing. They may get along well with other children, whereas children who have more symptoms of hyperactivity or impulsivity tend to have social problems. But children with the inattentive kind of ADHD are not the only ones whose disorders can be missed. For example, adults may think that children with the hyperactive and impulsive symptoms just have disciplinary problems.
Based on the types of symptoms, three kinds (presentations) of ADHD can occur:
Combined Presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months
Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months
Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity but not inattention were present for the past six months.
Because symptoms can change over time, the presentation may change over time as well.
What causes ADHD?
Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD.
Genes. Inherited from our parents, genes are the “blueprints” for who we are. Results from several international studies of twins show that ADHD often runs in families. Researchers are looking at several genes that may make people more likely to develop the disorder.4,5 Knowing the genes involved may one day help researchers prevent the disorder before symptoms develop. Learning about specific genes could also lead to better treatments.
A study of children with ADHD found that those who carry a particular version of a certain gene have thinner brain tissue in the areas of the brain associated with attention. This research showed that the difference was not permanent, however, and as children with this gene grew up, the brain developed to a normal level of thickness. Their ADHD symptoms also improved.6
Researchers are also studying genetic variations that may or may not be inherited, such as duplications or deletions of a segment of DNA. These “copy number variations” (CNVs) can include many genes. Some CNVs occur more frequently among people with ADHD than in unaffected people, suggesting a possible role in the development of the disorder.7,8
Environmental factors. Studies suggest a potential link between cigarette smoking and alcohol use during pregnancy and ADHD in children.9,10 In addition, preschoolers who are exposed to high levels of lead, which can sometimes be found in plumbing fixtures or paint in old buildings, have a higher risk of developing ADHD.11
Brain injuries. Children who have suffered a brain injury may show some behaviors similar to those of ADHD. However, only a small percentage of children with ADHD have suffered a traumatic brain injury.
Sugar. The idea that refined sugar causes ADHD or makes symptoms worse is popular, but more research discounts this theory than supports it.12 In one study, researchers gave children foods containing either sugar or a sugar substitute every other day. The children who received sugar showed no different behavior or learning capabilities than those who received the sugar substitute.13 Another study in which children were given higher than average amounts of sugar or sugar substitutes showed similar results.14
In another study, children who were considered sugar-sensitive by their mothers were given the sugar substitute aspartame, also known as Nutrasweet. Although all the children got aspartame, half their mothers were told their children were given sugar, and the other half were told their children were given aspartame. The mothers who thought their children had gotten sugar rated them as more hyperactive than the other children and were more critical of their behavior, compared to mothers whothought their children received aspartame.15
Food additives. There is currently no research showing that artificial food coloring causes ADHD. However, a small number of children with ADHD may be sensitive to food dyes, artificial flavors, preservatives, or other food additives. They may experience fewer ADHD symptoms on a diet without additives, but such diets are often difficult to maintain.12,16
How is ADHD diagnosed?
Children mature at different rates and have different personalities, temperaments, and energy levels. Most children get distracted, act impulsively, and struggle to concentrate at one time or another. Sometimes, these normal factors may be mistaken for ADHD. ADHD symptoms usually appear early in life, often between the ages of 3 and 6, and because symptoms vary from person to person, the disorder can be hard to diagnose. Parents may first notice that their child loses interest in things sooner than other children or seems constantly “unfocused” or “out of control.” Often, teachers notice the symptoms first, when a child has trouble following rules, or frequently “spaces out” in the classroom or on the playground.
No single test can diagnose a child as having ADHD. Instead, a licensed health professional needs to gather information about the child, and his or her behavior and environment. A family may want to first talk with the child’s pediatrician. Some pediatricians can assess the child themselves, but many will refer the family to a mental health specialist with experience in childhood brain disorders such as ADHD. The pediatrician or mental health specialist will first try to rule out other possibilities for the symptoms. For example, certain situations, events, or health conditions may cause temporary behaviors in a child that seem like ADHD.
Between them, the referring pediatrician and specialist will determine if a child:
Is experiencing undetected seizures that could be associated with other medical conditions
Has a middle ear infection that is causing hearing problems
Has any undetected hearing or vision problems
Has any medical problems that affect thinking and behavior
Has any learning disabilities
Has anxiety or depression, or other psychiatric problems that might cause ADHD-like symptoms
Has been affected by a significant and sudden change, such as the death of a family member, a divorce, or parent’s job loss.
A specialist will also check school and medical records for clues, to see if the child’s home or school settings appear unusually stressful or disrupted, and gather information from the child’s parents and teachers. Coaches, babysitters, and other adults who know the child well also may be consulted.
The specialist also will ask:
Are the behaviors excessive, and do they affect all aspects of the child’s life?
Do they happen more often in this child compared with the child’s peers?
Are the behaviors a continuous problem or a response to a temporary situation?
Do the behaviors occur in several settings or only in one place, such as the playground, classroom, or home?
The specialist pays close attention to the child’s behavior during different situations. Some situations are highly structured, some have less structure. Others would require the child to keep paying attention. Most children with ADHD are better able to control their behaviors in situations where they are getting individual attention and when they are free to focus on enjoyable activities. These types of situations are less important in the assessment. A child also may be evaluated to see how he or she acts in social situations and may be given tests of intellectual ability and academic achievement to see if he or she has a learning disability.
Finally, after gathering all this information, if the child meets the criteria for ADHD, he or she will be diagnosed with the disorder.
How is ADHD treated?
Currently available treatments aim at reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types of psychotherapy, education and training, or a combination of treatments.
Stimulants such as methylphenidate and amphetamines are the most common type of medication used for treating ADHD. Although it may seem counterintuitive to treat hyperactivity with a stimulant, these medications actually activate brain circuits that support attention and focused behavior, thus reducing hyperactivity. In addition, a few non-stimulant medications, such as atomoxetine, guanfacine, and clonidine, are also available. For many children, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medications also may improve physical coordination.
However, a one-size-fits-all approach does not apply for all children with ADHD. What works for one child might not work for another. One child might have side effects with a certain medication, while another child may not. Sometimes several different medications or dosages must be tried before finding one that works for a particular child. Any child taking medications must be monitored closely and carefully by caregivers and doctors.
Stimulant medications come in different forms, such as a pill, capsule, liquid, or skin patch. Some medications also come in short-acting, long-acting, or extended release varieties. In each of these varieties, the active ingredient is the same, but it is released differently in the body. Long-acting or extended release forms often allow a child to take the medication just once a day before school, so he or she doesn’t have to make a daily trip to the school nurse for another dose. Parents and doctors should decide together which medication is best for the child and whether the child needs medication only for school hours or for evenings and weekends, too.
For more information about stimulants and other medications used for treating mental disorders, see the booklet, Mental Health Medications, on the National Institute of Mental Health (NIMH) website. The Food and Drug Administration (FDA) website has the latest information on medication approvals, warnings, and patient information guides.
What are the side effects of stimulant medications?
The most commonly reported side effects are decreased appetite, sleep problems, anxiety, and irritability. Some children also report mild stomachaches or headaches. Most side effects are minor and disappear over time or if the dosage level is lowered.
Decreased appetite. Be sure your child eats healthy meals. If this side effect does not go away, talk to your child’s doctor. Also talk to the doctor if you have concerns about your child’s growth or weight gain while he or she is taking this medication.
Sleep problems. If a child cannot fall asleep, the doctor may prescribe a lower dose of the medication or a shorter-acting form. The doctor might also suggest giving the medication earlier in the day, or stopping the afternoon or evening dose. Adding a prescription for a low dose of a blood pressure medication called clonidine sometimes helps with sleep problems. A consistent sleep routine that includes relaxing elements like warm milk, soft music, or quiet activities in dim light, may also help.
Less common side effects. A few children develop sudden, repetitive movements or sounds called tics. Changing the medication dosage may make tics go away. Some children also may have a personality change, such as appearing “flat” or without emotion. Talk with your child’s doctor if you see any of these side effects.
Are stimulant medications safe?
Under medical supervision, stimulant medications are considered safe. Stimulants do not make children with ADHD feel high, although some kids report feeling slightly different or “funny.”
Preschoolers are more sensitive to the side effects of methylphenidate, and some may experience slower than average growth rates. Very young children should be closely monitored while taking ADHD medications.17,18,19
FDA warning on possible rare side effects
In 2007, the FDA required that all makers of ADHD medications develop Patient Medication Guides that contain information about the risks associated with the medications. The guides must alert patients that the medications may lead to possible cardiovascular (heart and blood) or psychiatric problems. The agency undertook this precaution when a review of data suggested that ADHD patients with existing heart conditions had a slightly higher risk of strokes, heart attacks, and/or sudden death when taking the medications. Recently published studies, however, have not found evidence that using stimulants to treat ADHD increases the risk for cardiovascular problems.20,21
The FDA review also found a slight increased risk, about 1 in 1,000, for medication- related psychiatric problems, such as hearing voices, having hallucinations, becoming suspicious for no reason, or becoming manic (an overly high mood), even in patients without a history of psychiatric problems. The FDA recommends that any treatment plan for ADHD include an initial health history, including family history, and examination for existing cardiovascular and psychiatric problems.
One ADHD medication, the non-stimulant atomoxetine (Strattera), carries another warning. Studies show that children and teenagers who take atomoxetine are more likely to have suicidal thoughts than children and teenagers with ADHD who do not take it.22If your child is taking atomoxetine, watch his or her behavior carefully. A child may develop serious symptoms suddenly, so it is important to pay attention to your child’s behavior every day. Ask other people who spend a lot of time with your child to tell you if they notice changes in your child’s behavior. Call a doctor right away if your child shows any unusual behavior. While taking atomoxetine, your child should see a doctor often, especially at the beginning of treatment, and be sure that your child keeps all appointments with his or her doctor.
Do medications cure ADHD?
Current medications do not cure ADHD. Rather, they control the symptoms for as long as they are taken. Medications can help a child pay attention and complete schoolwork. It is not clear, however, whether medications can help children learn better. Adding behavioral therapy, counseling, and practical support can help children with ADHD and their families to better cope with everyday problems. NIMH-funded research has shown that medication works best when treatment is regularly monitored by the prescribing doctor and the dose is adjusted based on the child’s needs.23
Psychotherapy and Parent strategies
Different types of psychotherapy are used for ADHD. Behavioral therapy aims to help a child change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioral therapy also teaches a child how to monitor his or her own behavior. Learning to give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting, is another goal of behavioral therapy. Parents and teachers also can give positive or negative feedback for certain behaviors. In addition, clear rules, chore lists, and other structured routines can help a child control his or her behavior.
Therapists may teach children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing. Learning to read facial expressions and the tone of voice in others, and how to respond appropriately can also be part of social skills training.
How can parents help?
Children with ADHD need guidance and understanding from their parents and teachers to reach their full potential and to succeed in school. Before a child is diagnosed, frustration, blame, and anger may have built up within a family. Parents and children may need special help to overcome bad feelings. Mental health professionals can educate parents about ADHD and how it impacts a family. They also will help the child and his or her parents develop new skills, attitudes, and ways of relating to each other.
Parenting skills training helps parents learn how to use a system of rewards and consequences to change a child’s behavior. Parents are taught to give immediate and positive feedback for behaviors they want to encourage, and ignore or redirect behaviors they want to discourage. In some cases, the use of “time-outs” may be used when the child’s behavior gets out of control. In a time-out, the child is removed from the upsetting situation and sits alone for a short time to calm down.
Parents are also encouraged to share a pleasant or relaxing activity with the child, to notice and point out what the child does well, and to praise the child’s strengths and abilities. They may also learn to structure situations in more positive ways. For example, they may restrict the number of playmates to one or two, so that their child does not become overstimulated. Or, if the child has trouble completing tasks, parents can help their child divide large tasks into smaller, more manageable steps. Also, parents may benefit from learning stress-management techniques to increase their own ability to deal with frustration, so that they can respond calmly to their child’s behavior.
Sometimes, the whole family may need therapy. Therapists can help family members find better ways to handle disruptive behaviors and to encourage behavior changes. Finally, support groups help parents and families connect with others who have similar problems and concerns. Groups typically meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies, and to talk with experts.
Tips to Help Kids Stay Organized and Follow Directions
Schedule. Keep the same routine every day, from wake-up time to bedtime. Include time for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board in the kitchen. Write changes on the schedule as far in advance as possible.
Organize everyday items. Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys.
Use homework and notebook organizers. Use organizers for school material and supplies. Stress to your child the importance of writing down assignments and bringing home the necessary books.
Be clear and consistent. Children with ADHD need consistent rules they can understand and follow.
Give praise or rewards when rules are followed. Children with ADHD often receive and expect criticism. Look for good behavior, and praise it.
What conditions can coexist with ADHD?
Some children with ADHD also have other illnesses or conditions. For example, they may have one or more of the following:
A learning disability. A child in preschool with a learning disability may have difficulty understanding certain sounds or words or have problems expressing himself or herself in words. A school-aged child may struggle with reading, spelling, writing, and math.
Oppositional defiant disorder. Kids with this condition, in which a child is overly stubborn or rebellious, often argue with adults and refuse to obey rules.
Conduct disorder. This condition includes behaviors in which the child may lie, steal, fight, or bully others. He or she may destroy property, break into homes, or carry or use weapons. These children or teens are also at a higher risk of using illegal substances. Kids with conduct disorder are at risk of getting into trouble at school or with the police.
Anxiety and depression. Treating ADHD may help to decrease anxiety or some forms of depression.
Bipolar disorder. Some children with ADHD may also have this condition in which extreme mood swings go from mania (an extremely high elevated mood) to depression in short periods of time.
Tourette syndrome. Very few children have this brain disorder, but, among those who do, many also have ADHD. People with Tourette syndrome have nervous tics, which can be evident as repetitive, involuntary movements, such as eye blinks, facial twitches, or grimacing, and/or as vocalizations, such as throat-clearing, snorting, sniffing, or barking out words inappropriately. These behaviors can be controlled with medication, behavioral interventions, or both.
ADHD also may coexist with a sleep disorder, bed-wetting, substance abuse, or other disorders or illnesses. For more information on these disorders, visit the NIMH website.
Recognizing ADHD symptoms and seeking help early will lead to better outcomes for both affected children and their families.
How can I work with my child’s school?
If you think your child has ADHD, or a teacher raises concerns, you may be able to request that the school conduct an evaluation to determine whether he or she qualifies for special education services.
Start by speaking with your child’s teacher, school counselor, or the school’s student support team, to begin an evaluation. Also, each state has a Parent Training and Information Center and a Protection and Advocacy Agency (link works) that can help you get an evaluation. A team of professionals conducts the evaluation using a variety of tools and measures. It will look at all areas related to the child’s disability.
Once your child has been evaluated, he or she has several options, depending on the specific needs. If special education services are needed and your child is eligible under the Individuals with Disabilities Education Act, the school district must develop an “individualized education program” specifically for your child within 30 days.
If your child is considered not eligible for special education services—and not all children with ADHD are eligible—he or she still can get “free appropriate public education,” available to all public-school children with disabilities under Section 504 of the Rehabilitation Act of 1973, regardless of the nature or severity of the disability.
For more information on Section 504, consult the U.S. Department of Education’s Office for Civil Rights, which enforces Section 504 in programs and activities that receive Federal education funds.
Transitions can be difficult. Each school year brings a new teacher and new schoolwork, a change that can be especially hard for a child with ADHD who needs routine and structure. Consider telling the teachers that your child has ADHD when he or she starts school or moves to a new class. Additional support will help your child deal with the transition.
Do teens with ADHD have special needs?
Most children with ADHD continue to have symptoms as they enter adolescence. Some children are not diagnosed with ADHD until they reach adolescence. This is more common among children with predominantly inattentive symptoms because they are not necessarily disruptive at home or in school. In these children, the disorder becomes more apparent as academic demands increase and responsibilities mount. For all teens, these years are challenging. But for teens with ADHD, these years may be especially difficult.
Although hyperactivity tends to decrease as a child ages, teens who continue to be hyperactive may feel restless and try to do too many things at once. They may choose tasks or activities that have a quick payoff, rather than those that take more effort, but provide bigger, delayed rewards. Teens with primarily attention deficits struggle with school and other activities in which they are expected to be more self-reliant.
Teens also become more responsible for their own health decisions. When a child with ADHD is young, parents are more likely to be responsible for ensuring that their child maintains treatment. But when the child reaches adolescence, parents have less control, and those with ADHD may have difficulty sticking with treatment.
To help them stay healthy and provide needed structure, teens with ADHD should be given rules that are clear and easy to understand. Helping them stay focused and organized—such as posting a chart listing household chores and responsibilities with spaces to check off completed items—also may help.
Teens with or without ADHD want to be independent and try new things, and sometimes they will break rules. If your teen breaks rules, your response should be as calm and matter-of-fact as possible. Punishment should be used only rarely. Teens with ADHD often have trouble controlling their impulsivity and tempers can flare. Sometimes, a short time-out can be calming.
If your teen asks for later curfews and use of the car, listen to the request, give reasons for your opinions, and listen to your child’s opinion. Rules should be clear once they are set, but communication, negotiation, and compromise are helpful along the way. Maintaining treatments, such as medication and behavioral or family therapy, also can help with managing your teenager’s ADHD.
What about teens and driving?
Although many teens engage in risky behaviors, those with ADHD, especially untreated ADHD, are more likely to take more risks. In fact, in their first few years of driving, teens with ADHD are involved in nearly four times as many car accidents as those who do not have ADHD. They are also more likely to cause injury in accidents, and they get three times as many speeding tickets as their peers.24
Most states now use a graduated licensing system, in which young drivers, both with and without ADHD, learn about progressively more challenging driving situations.25The licensing system consists of three stages—learner’s permit, during which a licensed adult must always be in the car with the driving teen; intermediate (provisional) license; and full licensure. Parents should make sure that their teens, especially those with ADHD, understand and follow the rules of the road. Repeated driving practice under adult supervision is especially important for teens with ADHD.
Can adults have ADHD?
Some children with ADHD continue to have it as adults. And many adults who have the disorder don’t know it. They may feel that it is impossible to get organized, stick to a job, or remember and keep appointments. Daily tasks such as getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the job can be especially challenging for adults with ADHD.
These adults may have a history of failure at school, problems at work, or difficult or failed relationships. Many have had multiple traffic accidents. Like teens, adults with ADHD may seem restless and may try to do several things at once, most of them unsuccessfully. They also tend to prefer “quick fixes,” rather than taking the steps needed to achieve greater rewards.
How is ADHD diagnosed in adults?
Like children, adults who suspect they have ADHD should be evaluated by a licensed mental health professional. But the professional may need to consider a wider range of symptoms when assessing adults for ADHD because their symptoms tend to be more varied and possibly not as clear cut as symptoms seen in children.
To be diagnosed with the condition, an adult must have ADHD symptoms that began in childhood and continued throughout adulthood.26 Health professionals use certain rating scales to determine if an adult meets the diagnostic criteria for ADHD. The mental health professional also will look at the person’s history of childhood behavior and school experiences, and will interview spouses or partners, parents, close friends, and other associates. The person will also undergo a physical exam and various psychological tests.
For some adults, a diagnosis of ADHD can bring a sense of relief. Adults who have had the disorder since childhood, but who have not been diagnosed, may have developed negative feelings about themselves over the years. Receiving a diagnosis allows them to understand the reasons for their problems, and treatment will allow them to deal with their problems more effectively.
How is ADHD treated in adults?
Much like children with the disorder, adults with ADHD are treated with medication, psychotherapy, or a combination of treatments.
Medications. ADHD medications, including extended-release forms, often are prescribed for adults with ADHD.27
Although not FDA-approved specifically for the treatment of ADHD, antidepressants are sometimes used to treat adults with ADHD. The antidepressant bupropion (Wellbutrin), which affects the brain chemical dopamine, showed benefits for adults with ADHD.28 Older antidepressants, called tricyclics, sometimes are used because they, like stimulants or atomoxetine, affect the brain chemical norepinephrine.
Adult prescriptions for stimulants and other medications require special considerations. For example, adults often require other medications for physical problems, such as diabetes or high blood pressure, or for anxiety and depression. Some of these medications may interact badly with stimulants. An adult with ADHD should discuss potential medication options with his or her doctor. These and other issues must be taken into account when a medication is prescribed.
Education and psychotherapy. A professional counselor or therapist can help an adult with ADHD learn how to organize his or her life with tools such as a large calendar or date book, lists, reminder notes, and by assigning a special place for keys, bills, and paperwork. Large tasks can be broken down into smaller, more manageable steps so that completing each part of the task provides a sense of accomplishment.
Psychotherapy, including cognitive behavioral therapy, also can help change one’s poor self-image by examining the experiences that produced it. The therapist encourages the adult with ADHD to adjust to the life changes that come with treatment, such as thinking before acting, or resisting the urge to take unnecessary risks.
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Like many people today, do you find life overwhelming? Is getting through one day an exhausting marathon? Does your day include kids to be picked up, doctor’s appointments, bills to be paid, and dry cleaning to be retrieved? Are you afraid to open envelopes for fear of seeing the negative bank balances and the unpaid bills? Are you afraid of wasting time and money on impulsive flings every time you go shopping? It all adds up to a paralyzing sense of doom called overwhelm.
Today’s hectic world puts tremendous pressure to perform on everyone, but if you have ADHD (Attention Deficit/Hyperactivity Disorder) the pressure is magnified several times over.
Here are some ways ADHD contributes to that desperate feeling.
Number one is poor organization. It is now recognized that ADHD often presents as chronic disorganization. If you have ADHD, you have difficulty sequencing actions (or papers thus the unmanageable piles). Difficulty organizing the events of the day is just one example.
The second problem is an elastic sense of time. You have difficulty estimating how long tasks will take adding to the problem of planning the day.
The third is what I call the slipping clutch or the getting-started syndrome. When you do fix a time to do a task it still doesn’t get done because you can not start. Instead, you get sucked into the internet or the TV or another low priority activity.
Finally, the lack of boundaries makes it difficult for you to say “no”, so you have too many things to do. Poor boundaries also mean that you absorb more than your share of emotional overload; other people’s problems swamp your brain and make it difficult to think coolly about what needs doing.
Take these 6 steps to plan your day and beat overwhelm.
Stop. Recognize that overwhelm has captured your brain and is interfering with your ability to plan and get things done. Take a minute to observe how you are feeling. Take several deep breaths into the abdomen and exhale slowly.
Listen to your self-talk. Change negatives to positives: tell yourself “you can do it”. Talk out loud to yourself at each step as though you were explaining to another person what you need to do.
Make a list of the tasks you need to do, estimate the time needed including travel or set up time. Then weigh the importance and urgency of each task. Could some items wait until tomorrow or next week?
Consider what help you can get. Could a husband or a friend pick up the kids?
Plan the day. Group tasks according to location. If you have to go out, consider the time of day. If you must drive during busy times of the day, allow for extra travel time.
Write out the day’s route map and put it in your purse or place it where you can’t forget it. Now you are ready to go. Go!
Still having difficulty? A coach or coaching program can help you stay on track.
“Image courtesy of StuartMiles/FreeDigitalPhoto.net” Modified on Canva
Published by Sarah Jane Keyser, Copyright 2006, all rights reserved. Coaching Key to ADDPermission is granted to forward or post this content in full for use in a not-for-profit format, as long as this copyright notice and full information about the author, Sarah Jane Keyser, is attached intact. If any other use is desired, permission in writing is required.
*** About Sarah Jane *** Sarah Jane Keyser worked for many years with computers as a programmer, analyst, and user trainer, but her struggle with inattentive ADD kept getting in the way of her plans and dreams. Her credentials include ADD Coach training at the ADD Coach Academy. The Newfield Network’s graduate coaching programme “Mastery in Coaching” and a programme “Coaching Kids and Teens” by Jodi Sleeper-Triplett MCC. She is an American living in Switzerland who coaches in French and English by telephone
The standard meal in Western cultures is loaded with sugar and simple carbohydrates in the form of white bread and pasta, and candy bars and sweet soda for snacks. Such food creates a surge of sugar in the blood which briefly gives a feel of energy, but a flood of insulin follows which removes the sugar from the blood and causes an energy crash leaving you feeling more tired, spacey, confused and inattentive than before. This food also lacks the proteins and vitamins your body needs to build and repair your body.
The ideal program is four or five small meals a day each containing protein and complex carbohydrates to maintain a steady supply of fuel to the brain. Proteins are found in meat, dairy products, nuts and soy products. They provide amino acids, the material to build and repair all the body systems: the immune system, muscles, hormones and especially the neurotransmitters which make the brain function. Complex carbohydrates are found in vegetables, whole grains, and beans. They provide energy but take longer to digest than sugar and simple carbohydrates and, therefore, do not create the insulin surge that leaves you more tired than before. They also contain vitamins, minerals, and fiber which your body needs for optimum health.
A word about fat – In western mythology, fat is a baddy, but, in fact, fats in the form of oils are essential for a healthy brain. By weight, the brain is more than half fat. There are different kinds of oil and all in appropriate quantities are important.
Water is essential. The brain needs a steady supply of oxygen and energy. If the blood flow slows due to dehydration, you will feel sluggish and inattentive. A glass of water will help the blood flow better.
In a school for an Apache Indian Tribe, the program includes exercise five periods a day. If it rains they send the children home because learning is impossible without exercise. 95% of the children are hyperactive.
Until recently, experts thought that new brain cells could not be generated, that the brain cells you had at birth had to last your entire life. Research in the last ten years has shown that the brain is much more plastic. It is like a muscle; it grows when you use it. Brain cells are created, grow and link to other cells in response to usage. Exercise promotes brain growth. Use it or lose it.
The brain is a very expensive organ; it uses 50% of our food and more than 50% of the oxygen brought to the brain in the blood. Exercise increases blood flow and encourages the growth of new capillaries to increase blood carrying capacity. Exercise releases nerve growth factors called Brain Derived Neurotropic Factor (BDNF) known as Miracle-Gro, a fertilizer for the brain. BDNF enables cells to bind to other cells and makes stem cells grow. Pursuing an intellectual or physical activity stimulates the growth of new cells.
Exercise fuels the chemical factory producing neurotransmitters such as endorphins, norepinephrine for arousal and alertness, dopamine for the attention system, and serotonin for mood regulation and stress control. It allows nerve cells to survive and grow. Studies have shown that exercise is as effective as Prozac in combating depression and the results last longer. Exercise also increases a recently discovered neurotransmitter, the neuropeptide of love, called phenylethylamine (PEA).
What kind of exercise suits you?
Intense aerobic exercise is best, 30 to 45 minutes at least five times a week. Once you feel the benefits you won’t want to miss it the other two days. If you aren’t the extreme type, a fast walk, enough to raise your heart rate will do. Dance and Tai Kwon Do or other forms of the martial arts are highly recommended for their total effect on the attention system. They take large amounts of brain power and teach respect for oneself and others and foster resilience. Yoga has also shown good results.
If you already have a well-filled schedule, you can try just running in place or skipping rope for three or four minutes whenever those neurons start playing leap frog under your skin.
Yes, breathing. Oxygen is essential for every cell in your body and especially the brain. Breathing brings oxygen in and blows off waste products like carbon dioxide. Slight changes in oxygen level can change the way you feel and behave. Under emotional stress, anger or anxiety, people change the way they breathe. Breathing becomes shallow and rapid, an inefficient pattern which lowers oxygen levels.
Slow, deep breathing from the belly will help you be more focused and less anxious.
People with ADHD often have difficulty going to sleep at night and even more difficulty getting up in the morning. Sleep deprivation makes ADD symptoms worse and can interfere with every aspect of life. There are many strategies for getting to sleep. Here are some basic rules. Avoid stimulating activities such as TV or exercise for at least two hours before bedtime. Eat a small snack which includes protein such as a glass of warm milk or cheese and crackers before going to bed. Take a warm quiet bath. Play a tape of music or sounds of nature. Experiment to find which ones work for you.
Perhaps you were brought up to believe that work comes before play and the two do not mix. Well, here’s a new belief: doing things you enjoy and thinking enjoyable thoughts is good medicine for the brain.Try it!
When you think positive, happy thoughts your brain produces serotonin the feel-good neurotransmitter. When you think negative stormy thoughts your brain produces adrenaline, the stress hormone. Doing an activity that you enjoy acts as a stimulus for the brain.
Permission is granted to forward or post this content in full for use in a not-for-profit format, as long as this copyright notice and full information about the author, Sarah Jane Keyser, is attached intact. If any other use is desired, permission in writing is required.
“Image courtesy of StuartMiles/FreeDigitalPhoto.net” Modified on Canva
The reason for making this list is that ALL (or most) ADHD’ers have a low self-esteem issue. I wanted to make this list to help myself as well as others.
Follow my steps to a better, more confident YOU!
After all, I made this list for my tribe!!
Let’s get started!
Your first step is STRUCTURE.
By creating structure, each day, you’re giving yourself a reason to wake up and get out of bed!
The second step echoes the first step. Set up a daily to-do list. This will give you a sense of accomplishment (it gives you a reason to be proud of yourself).
Step 3. FOCUS on your good qualities. Look in the mirror and choose 5 things about yourself that you DO like about you! Write these 5 things down and tape it to the mirror (changing the 5 things each week). By choosing 5 things you do like about yourself, you’re creating hope and mindfulness that goes deep down to create a feeling of inner peace. Inner peace leads to a sense of power and in a matter of weeks, a more confident you!
4. Be your own cheerleader! No one else will do it for you. Your only concern should be you. If you have to, tell yourself, “I can do this”, “I am going to do great”, “I AM worthy”.
5. Learn to LIKE yourself. Meditation works wonders!! Sit in a quiet place for 10 minutes and just breathe in and exhale all of that negativity.
6. Get CREATIVE. Do-it-yourself projects, draw/sketch something, crochet or paint a landscape. Anything that makes you use your mind in a positive, constructive way.
7. Get ACTIVE! This means anything from exercise to waking up your street. You could also try Yoga or Karate. This activates the positive chemicals in your brain- happy vibes! If all else fails, DANCE!
Number 7 would tie in perfect for the eighth step as well, which is, SEEK SUPPORT. This can be a family member, a close friend, a Facebook support group or any other networking support groups. Enlist someone you trust to get active with you. Killing two birds with one stone is always a plus! By enlisting a close friend or relative, you’re getting the support aspect as well as working those happy brain cells. If you make this a habit and decide, “I’m not up for this today”, that partner will get your butt up and make you do it! Ah, support is great!! That brings me to number
9. All of us could use a little pep in our step and we’re not getting there by loading up on donuts. Try introducing a, once a day, healthy snack. This will promote energy and unlike donuts, won’t bog you down. With time, you can baby-step your way to healthier meals. Instead of that scone in the morning, try a banana and yogurt. Protein and potassium make for a great and energizing way to start your day. An apple with peanut butter is a great option as well. Make that apple and peanut butter a snack and you have a totally guilt-free snack and an afternoon burst of energy!
10. GET Outside or change the scenery. It’s a great way to promote a healthy mentality and a happier you.
11. TAKE CARE OF YOU! The world is an amazing place, but it’s also very stressful at the same time. Take time for yourself. Get a massage, pedicure or do something you love. (We’re nearly there!)
12. TRY SOMETHING NEW! This is a way to get out of your comfort zone. Say you decide to try Yoga, well, some of those stretches are hard to do. Go with me on this. You sign up for a class, get in there and do better than other first-timers. That will boost your confidence and make you proud that you were able to try something new and excel! If you don’t do as well, hey, practice makes perfect and you’re working your way up to a brilliant confidence level while achieving a goal. That is definitely something to be proud of. It’s a double plus!
13. LEND A HAND! This is a no-brainer for me. I love helping. It makes my inner self-pleased to do something completely selfless and the reward- a smile on someone’s face. Examples of ways to help out are volunteering, helping an elder struggling to carry groceries, etc. Get creative and look around. There’s always someone out there that needs a little assistance.
14. STEP IT UP. Comfort zones are hard to get away from but in order to succeed anywhere in life, you must step it up. Put on a smile (even if you’re not feeling it.) You never know who will see your smile and it impacts their day and mood positively or, to go a bit further, your smile could save a life. I’m not kidding – Those people that are lonely, that never get noticed, the ones that keep a frown because no one cares – You notice. STEP IT UP, greet them. You may be preventing them from ending their life.
15. MEDITATE every morning to promote a peaceful mindset and every night before bed to promote a healthy, restful night’s sleep to wake refreshed and ready to begin your day.
16. BABY STEPS. Nothing happens overnight (Rome wasn’t built in a day), contrary to beliefs and otherwise. Start out slow and work your way up. All good things come with time, so be patient.
Finally, REINFORCE STEPS 1-16 each and every day. A healthier mind and body lead to a happier and more confident YOU!
Allow yourself to follow these steps and you will surely improve your esteem!
Just remember, I believe in you!
Connect your work with your deepest goals and values.
By Kari Miller
If poor concentration, inconsistent follow-through and a feeling of being overwhelmed get in your way, you’ll want to improve your workplace productivity. Make changes that guarantee you complete priority tasks to increase your income and give you more free time for yourself and your family.
Do any of these sound familiar to you?
You easily get sidetracked, jumping from task to task or thought to thought.
When you think about a big project it feels overwhelming and you can’t figure out how to get started, so you just put it off.
You schedule more things in a day than you can get done and consistently underestimate how long it will take to accomplish things – which means you’re always running behind.
You spend time looking for things that seem to be misplaced only to find them right in front of you.
Despite feeling constantly “busy,” you never seem to be “productive.”
You feel more clear-headed, alert and focused when you drink coffee or soda, or smoke cigarettes.
Tips to managing overwhelm at work
If you are dealing with these signs of workplace overload, you’ll want to put the following workplace productivity tips into action.
Remove the “clutter” from your surroundings
One key to better concentration is to limit the distractions around you. Start by choosing one important thing you are going to work on NOW. Make a commitment to do this one task to the best of your ability. Write the name of the task on a post it note and stick the note up on your computer or desk, right in front of you so you can’t miss it. Clear all unnecessary things from your desk. Close unneeded computer programs. Put the task “in the spotlight” so it grabs your attention!
Remove the “clutter” from your mind
There’s an old saying, “garbage in, garbage out.” In this case it means that productivity is the result of mental clarity. There are many things you can do Evaluate your patterns in the following areas and look for ways to improve your basic health and to sharpen your mental acuity.
If you are not exercising every day your body is not adequately eliminating toxins, and these toxins are clouding your mind.
If your diet does not contain adequate nutrients, your mind is paying the price in terms of concentration and memory.
The brain is 75% water and functions by conducting electrical impulses. Your mind will function more quickly and smoothly if your body is properly hydrated.
If sleep is a problem for you, it may help to relax your nervous system for at least an hour every night before turning off the light.
Here are a few of my favorite ways to calm your body so your mind can rest:
take a warm shower or bath
use soothing smells such as lavender either as a lotion or potpourri
put on soothing music or a favorite DVD, lie down, close your eyes and just listen
learn reiki or chakra meditation techniques to take control of your body’s energy system
If you are not giving your body the things it needs to run smoothly, your workplace productivity will suffer. Commit to making changes that will support your body’s ability to do its job smoothly and efficiently or you’ll suffer from “garbage out”!!!
Make changes in your physical environment
There are several ways you can plan your environment to improve your concentration, follow through and productivity. Figure out how you work best in terms of the arrangement of furniture, the kind of chair you use, the lighting and the temperature.
Include movement as a natural element to your work routine. Great ways to do this include alternating sitting with standing or walking. Get an extension for your telephone and attach a headset so you can get up and move around while you talk on the phone. Stand on a balance board while working. This stimulates the attention control center of the brain.
Create “flexible workstations.” Set up two locations outfitted for work and alternate between them every hour or so. This will stimulate your mind and improve concentration. One of your stations can be a high table where you stand while working. You can stand on the balance board at this station, stimulating your nervous system for better attention and concentration.
Shine a spotlight on your values and goals
The most powerful productivity strategy is to connect your work with your deepest goals and values. Find a way to connect what you are doing now to your most cherished beliefs. Find the deep and profound “why” of every task.
For example, if paperwork is boring to you but people really matter to you, find creative ways to remember that you do the paperwork in order to benefit people. This is even stronger if you connect the benefits of doing paperwork to one specific person who you truly care about. Try it, it really helps!
It takes some practice to remember to think of the deep connection and value you bring by completing boring tasks, but with practice, you’ll find you are less resistant to boring tasks and take more pride in accomplishing them!
Display reminders of your values and goals in your environment. Set out pictures of your loved ones to remind yourself how much your work supports their lives. Post inspirational pictures and quotes, much like a vision board to keep you on track to achieving what matters most to you! Keep the items that connect you to your goals in plain sight so they motivate and inspire you to concentrate and get more done!
If workplace overwhelm is not the whole story
If your thoughts race from topic to topic and you constantly feel overwhelmed, even in situations other than work, you may be facing more wide-ranging issues that affect other aspects of your life. If getting things done at work is only one of the struggles you are facing, you may be one of the millions of women living with undiagnosed ADHD.
There are more myths and misinformation about ADHD than most other conditions. ADHD is a biochemical condition affecting the chemical makeup of the brain. It is not a choice and it is not a character flaw. ADHD can’t be caused by poor diet, working too hard or having a stressful life.
If you have ADHD and are not actively managing it, your entire life is affected. There are many strategies that can help women who are living with ADHD. The first step is to get more information about the signs of ADHD in women. Begin right now to take charge.
Take one of these screening tests for ADHD to see if you have symptoms associated with ADHD. If you are concerned, get educated and seek diagnosis to get effective treatment.
Originally published as: “Productivity in the Workplace: Tips for Concentrating and Getting More Done” by Kari Miller – As an ADHD coach and board-certified educational therapist, Dr. Kari helps women conquer their biggest ADHD challenges. She assists women in getting focused, organized, and motivated so they get unstuck, finish what they start, and accomplish more every day! Dr. Miller capitalizes on her expertise as a learning specialist to help women find unique and exciting strategies for managing their ADHD challenges. Through her group and individual coaching programs and online supportive community, she encourages and inspires women to set their sights high and make big changes in their lives! Kari.Miller.email@example.com
“Image courtesy of Marcolm/FreeDigitalPhotos.net” – Modified on Canva.
Yesterday, my husband, Duane, and I celebrated 29 years of marriage. I would like to say it was all blissful, but I’d be lying and I’m a terrible liar. (Not the anniversary! That was wonderful! I mean the 29 years of marriage!)
Until Duane received his diagnosis of ADHD in 1996, neither of us knew what the problem was. Duane and I struggled with dividing household chores (the struggle was not in dividing them, I did it all despite his best efforts and promises to do better), with our finances and the added pressures of Duane’s frequent job changes as he became bored with or lost his jobs. Under so much pressure, we fought… a lot. Duane’s impatience and emotional outbreaks affected our relationship and his relationship with our daughters. The entire family was dysfunctional.
After his diagnosis, Duane began his journey toward embracing the positive and overcoming the negative aspects of his ADHD. Duane and my youngest daughter, as is quite common, received their ADHD diagnosis around the same time – Kyrie was diagnosed first and as we read about her situation, light bulbs went on about Duane’s struggles. And while only Duane and my youngest were diagnosed, I think of us as a family with ADHD. We could only solve this problem working together, and so this was as much my journey as theirs.
Today, as an ADHD coach, when I work with an adult ADHDer, some of our biggest challenges are with the spouse. And I get it. Been there, done that! Being a member of a family with ADHD can be exhausting, nerve-wracking and absolutely frustrating. And I think what I found most frustrating is that I thought I had no control over anything. Once I learned that there were some things I could do to make life with ADHD better for all of us, the building process began and the frustration diminished.
Here’s what I did to fix Duane:
First, I changed my mindset. I realized that I wasn’t the only one suffering in the family. I know Duane had it worse than me – he was living it 24/7. He wanted to be a better partner and a more patient father. Our daughters suffered too. They saw their parents constantly worried, fighting or impatient. Kyrie struggled with her ADHD and learning disabilities, and our oldest daughter, Jennifer, felt neglected as all our efforts were directed at helping Kyrie and Duane. Duane wasn’t the only one who had some work to do, I did too. As parents, we feel for our children and would do anything to make their hurt stop, after all they didn’t ask for this. Oddly enough, we don’t always feel the same empathy towards our spouses with ADHD (even though they didn’t ask for it either!) I let go of my martyrdom and embraced empowerment, realizing that at any given moment, people do the best they can with what they know at the time.
I learned all I could about ADHD. I didn’t just learn so I could help my daughter (which as a mother, I would do without question) but also for my husband. The more I knew, the more empowered I felt. I read books, listened to webinars and went to conferences on ADHD. Attending our first ADDA Conference as a couple was a life-changing event. We both learned so much, met other people coping successfully with what we were going through and left empowered.
I became part of the solution. Duane struggles with several aspects of ADHD, but the worst is his short-term memory, which IS an ADHD problem. So why was I asking him to do things or to pick things up at the store when he didn’t have a pen and paper or his PDA to take notes? I also often asked him to help when he was tired or distracted. How likely was that to turn into a positive situation? It was only when I was willing to let go of the way things were done and turn responsibility over to Duane that we began to make progress. He told me he’d take over certain tasks… if he could do it his way. He took over the grocery shopping. I offered my help if he needed it (secretly thinking we’d probably starve to death waiting for Duane!) To my surprise, he created his own system for doing it (don’t ever tell him I said this, but it’s much more efficient than the way I did it!) and we’ve never looked back.
I took care of myself. I lowered my standards on things that didn’t really matter much, especially in the beginning. So what if I didn’t clean the house EVERY week and cook ALL my meals from scratch? Instead of chasing dust bunnies, I spent time with friends to relax and return to my family a lot more ready to laugh as freak out at the wacky situations most ADHD families encounter regularly.
The most important thing I did was to notice any positive changes. As Duane began to work with his physician and his coach, I avoided nagging about what wasn’t yet addressed – change takes time – and made sure to notice what was moving in the right direction. And I was sure to let him know how much I appreciated it.
There are several other things we did to improve life as an ADHD family. We learned to communicate better how we felt rather than blaming, and we shared our dreams and aspirations. We started dating again; no, we didn’t have much money back then, but using Duane’s vivid imagination, we found fun things to do that cost little or no money. We didn’t get bogged down by social norms of gender roles and what constitutes woman’s work and man’s work, opting instead to take on the jobs around the house that we were better at or liked more.
We even created our own secret language to use discretely in public (I could provide Duane with cues to appropriate behavior in social situations, for example. And he could signal when he couldn’t take another minute of the 47 family members sharing a cabin in the woods for Christmas anymore and needed a break for some peace and quiet.)
And so now 29 years later, here we are still married, and much, much happier. We laugh a lot more and fight a lot less. I can safely say that Duane is my best friend and I, his. Was it easy? Absolutely not, but I’m proud of what we’ve accomplished together and I know it was definitely worth it.
By Linda Walker. Linda Walker, PCC, B. Admin., is a certified ADHD Coach who helps adults with ADHD overcome the special challenges of Attention Deficit Disorder (ADHD) they encounter at home and in the workplace. She is the creator of The Maximum Productivity Makeover for Creative Geniuses, a training program for adults with ADHD and the author of With Time to Spare. http://www.CoachLindaWalker.com Originally Posted May 7, 2013 http://coachlindawalker.com/heres-how-i-fixed-my-adhd-husband/
Self-advocacy can give you the opportunity to speak for yourself regarding your needs and help to secure the necessary support at work or school and for your personal life. We don’t have to struggle so hard. Developing self-knowledgeis the first step. ADD Coach Dana Rayburn reminds us, that, “When properly treated, ADHD loses much of its power over our lives. As adults, we can paint a new picture of who we are and what we contribute to the world…” (1)
The goal is to develop your strengths and delegate your weaknesses.
Don’t go it alone, feeling you have to prove yourself over and over again that you CAN persevere! The truth is, delegating the things you aren’t good at, or just plain don’t like, is a good idea for anyone. If you have ADHD, however, it can make the difference between constant struggle and an enjoyable, successful life.
Negotiate with other workers/family member/friends/employees for help in areas where you struggle. (Hint: Ask them for help in areas where they shine – or at least don’t mind doing with the right incentive). What can you offer or trade to make their lives easier? Make it a point of honor to follow through with your end of the deal.
1stName your challenges both at home and at work. What are your weaknesses? When and where do they cause you the most problems? For basic challenges of ADHD, refer to any ADHD symptom checklist. The official DSMV diagnostic criteria or any of the ADHD screeners we list are good choices. You need to separate your ADHD from yourself. You are NOT the disorder. Your symptoms cause certain behaviors, like being late or missing deadlines, but they don’t define you.
It’s also important to identify the situations when problems are most likely to show up. Being in a hurry, under stress, and during times of transition between places or activities are common reasons. Certain environments can also bring out symptoms. Being unable to move about freely, noise levels and visual distractions are just a few. We often think of ADHD as involving “getting things done,” but don’t neglect to note emotional reactions and uncomfortable social interaction as challenging symptoms.
2ndKnow exactly what your strengths are. Your values, talents, and skills are all contributing factors. You probably have a general idea, but the more specific you can be, the better. According to Myers-Briggs Type Indicator practitioner, Nila Nealy, “You don’t need someone else to tell you what your strengths are. Your heart knows them. Still, I believe that sometimes we take them for granted or are so sucked into the “you must be broken” viewpoint that using tools other people have created can be helpful.” (2) Don’t forget that you have friends and family that can also help you identify your strongest points. (After all, they know you, love you anyway and are probably your biggest fans)
“Give yourself permission to proceed with identifying, embracing and integrating your unique brain wiring into your life,” ~ ADD coach and trainer, David Giwerc. “The standardized ways of learning, processing information, and performing may not work for you…Your job is to discover the options that naturally work for you and integrate them into your daily life…Educating others in your life about what works best for you, can help you facilitate home, school and workplace environments that…serve you.” (3)
Another reason to utilize these tools is that self-esteem is a core issue of ADHD and you may not be comfortable “claiming” your strengths without outside verification. Don’t neglect to ask those who know you well what they think are your strongest points. Your friends and family are likely to be your biggest fans. Don’t let self-denigration get in the way of accepting their positive feedback
3rdYou can’t wait until you ‘get over’ your ADHD before you start your life. Develop strategies that reshape how you approach life. Leading with your strengths rather than your weakness allows you to fully express yourself in new ways. It’s about accepting yourself and making good decisions based on what you do naturally, without the struggle. It is based on getting the help that you need to highlight your ability rather than simply shoring up your weaknesses.
As an adult with ADHD, focusing on what you can’t do may come so naturally that you cannot see the positive aspects of who you are and what you have managed to achieve. Helping to define your “purpose” in life is a great way to inspire action. Partly due to our feelings of shame and inadequacy, we tend to believe that something that comes easily to us has little value. But the ADHD brain “lights up” when we are interested in something and many of our struggles fade away when positively engaged.
“What is something that you are really good at doing? Something that comes naturally to you? Something that you do with hardly any effort or difficulty?
What is one thing that when you do it, you forget about the time, about eating, about using the bathroom, or about any of your responsibilities? Meaning, you are so focused that you naturally forget about everything else.
What is something that you can talk about for hours, and when you talk about it, it lights you up, gets you excited, and gives you energy?”
There are also many Tools for Discovering your Strengths.
Discover your Strengths by assessing your values. – In recent years, some people have proposed that ADHD itself conveys certain strengths. In 2015, the VIA Institute on Character, in conjunction with the ADD Coach Academy, conducted a research study to identify whether there are indeed specific strengths of people who have been diagnosed with ADHD. (5) Instead, but not surprisingly, the study found that most people with ADHD had shared difficulties in areas related to impulsivity and sustaining attention. Their weakest ”Strengths” were Prudence, Self-regulation [self-control] and Perseverance. Although the qualities of Creativity, Humor, Kindness, and Teamwork did rank slightly higher in people with ADHD, their highest “Character Strengths” were uniquely individual.
What was a revelation, however, was that when individuals worked in accordance with their highest values, their weaknesses proved to be situational. That is, they were far less of a factor in getting things done when interest inspired action. As David Giwerc explains, “When you focus on what ignites your heart and your positive energy, you will always be able to self-regulate.” (6) That is why a “Strength-based” approach works so well. You can continue to struggle to “will” yourself to do work which does not inspire you, or create an environment where your interest and urgency based nervous system works with you to achieve what you desire. The eight-minute video at the bottom of the page explains more about character strengths and their place in creating a meaningful life.
VIA Reports– Take the VIA survey, but receive more in-depth reports of your personalized profile. Learn what all 24 of your strengths mean and how they can help you reach a more optimal, positively fulfilled life, whether you are using for yourself or with others. ($10 for youth, $20 to $40 for adults)
The VIA survey is also available for free at AuthenticHappiness at Penn State. Results are not as complete.
Meyers-Briggs Type Indicator Tests
MBTI is what it says it is, an indicator. It points you to the general area of preferences you have for interacting with the world, taking in information and making decisions. Some ways just may feel more natural than others. The MBTI assesses how you get energized as well as the ways you perceive and express yourself.
Official MBTI assessment with certified professionals ($50 or $150 with person-to-person feedback from a certified MBTI practitioner.
The Open Extended Jungian Type Scales was developed as an open-source alternative to the Myers-Briggs Type Indicator. A statistical comparison of the OEJTS with three other online MBTI alternatives found that this test, the OEJTS, was the more accurate. 50 questions. 5 to 7 minutes.
If you want to investigate even further, I recommend the Gallup book, Strengths Finder 2.0– Buy the book. ($18 (+ S&H) Use the code within to take the online test. *One use only. Your Goal is to Identify your top 5 talents. (You can take the test online at Gallup’s Clifton Strengths, but the book provides great personal stories and ideas for using your strengths at work and in your social life.) Top five strengths are the same price as the book ($20) but a report on all 34 strengths is $89. You can upgrade with book purchase for $69)
Remember, the first step towards advocating for yourself, for receiving the help that you need, is getting to know yourself. Explore those areas where you struggle as well as those where you have competency and shine. You are so much more than your symptoms. Don’t battle endlessly with your challenges. Ask for help. Discover your strengths, your best self. Create a more positive future for yourself. You deserve it.
ADHD is often thought of as a childhood diagnosis that magically disappears in late adolescence. In fact, this disorder, which affects upwards of 10% of the population, often persists into adulthood and typically causes individuals to continue to struggle with core symptoms of impulsivity, inattention, and hyperactivity. Despite this, until the last couple of decades the ADHD Adult diagnosis simply did not exist.
As adults, we often stumble upon our own or our partner’s ADHD diagnosis after one or more of our children is diagnosed with the disorder. As diligent parents, we learn much about ADHD and how it affects our children, many of us finding our own “ah-ha” moment somewhere along this journey. This is hardly surprising given that ADHD is a highly inheritable disorder. It is also not surprising that many adults who were never diagnosed as children continue to remain undiagnosed or misdiagnosed as adults. One reason for this is that adults who have ADHD commonly also have co-existing symptoms of anxiety and depression, which compound the diagnostic difficulty. If after reviewing the common symptoms presented in this article you suspect that you or your partner has undiagnosed ADHD, it is essential to receive a comprehensive ADHD evaluation. The key to effective treatment for ADHD, as with any disorder, is an accurate diagnosis.
Knowledge is Power
Just what is Adult ADHD and how might it be impacting your daily life? First, it is important to know that ADHD, despite what some may believe, is real. ADHD is a neurological disorder. It is not the result of laziness, lack of willpower or a creation of the pharmaceutical industry. The information that follows is intended to present an overview of the common symptoms of Adult ADHD.
Difficulty Concentrating and Staying Focused
Adults with ADHD often have difficulty maintaining focus and are easily distracted. This is the “oooh, look at the shiny ball over there” symptom that derails concentration and causes you to bounce from one activity to another. You may find yourself having difficulty paying attention, zoning out without realizing it, having trouble staying focused while reading, struggling to complete even simple tasks, overlooking details, listening poorly and having a hard time remembering conversations or directions.
Disorganization and Forgetfulness
With Adult ADHD, your life may seem out of control as you struggle to stay on top of daily responsibilities. Staying organized, setting priorities, keeping track of tasks and schedules, managing time effectively and remembering what needs to be accomplished are extremely challenging. You may have poor organizational skills at home or work which is often evidenced by extreme clutter in one’s home, office or car. You may have a tendency to put things off and procrastinate due to difficulties with getting tasks started. You may forget appointments, commitments, or work deadlines. You may constantly misplace things, be chronically late or underestimate the time needed to complete tasks.
This is the “ready, fire, aim” response commonly seen in individuals with ADHD, who may act first, and, think later. Adults with ADHD may interrupt others, act or speak before thinking, blurt out thoughts that are rude or inappropriate, talk excessively loud, have poor self-control, display addictive behaviors, and may behave or drive recklessly without regard for consequences.
Just as it is hard for individuals with ADHD to regulate impulses and attention, it is also often difficult to regulate emotions. Many adults with ADHD have difficulty managing their feelings, particularly when they are angry or frustrated. Often, adults with ADHD have poor self-esteem, deal with frustration poorly, tend to be insecure, have spotty relationships, are easily stressed-out, irritable, hypersensitive to criticism, have short fuses, frequent mood swings, and a pervasive sense of underachievement.
Hyperactivity in childhood often morphs into a sense of inner restlessness in adults. Some adults may still be “driven by a motor” but, for many, the symptoms become subtler. Adults with ADHD may feel agitated, become easily bored, have racing thoughts, trouble sitting still, talk non-stop, crave excitement, and take excessive risks.
The Adult ADHD Impact
Maintaining one’s balance in our complex world can be a challenging balancing act for any adult. As a child, you may have been able to compensate for the symptoms of ADHD, only to find that your symptoms increased as you faced the increasing responsibilities of adulthood. Managing careers, homes, children, spouses and other types of relationships places greater demands on your ability to focus, stay organized and remain calm. The more balls you have in the air, the harder they become to juggle.
The Good News
No matter how challenging the struggles in your life may seem, Adult ADHD can be managed through accurate diagnosis, education and effective treatment. With support, structure and knowledge, it is possible to turn ADHD weaknesses into strengths, longstanding limitations into achievements and dreams into realities. One pathway to success lies in utilizing a coach to guide you through this process. Renowned author, Ned Hallowell, in his groundbreaking book Driven to Distraction “particularly likes the idea of an ADHD Coach…keeping the player focused on the task at hand and offering encouragement along the way…. the coach can stave off habits of procrastination, disorganization, and negative thinking.”
Editor’s note: There are no quick and easy answers with ADHD. Although medication helps, there are no magic pills. Strategies for providing effective treatment abound, but no SINGLE treatment will be enough. Your own needs will be unique and the ideas that you used so effectively one month might not work the next. It will take effort and experimentation to find what works best for you. A good place to start would be 16 Steps to Better Self-Esteem with ADHD by Kari Taylor-Hogan or 6 Steps to Survive ADHD Overwhelm – Learn to Plan Your Day by Sarah Jane Keyser.
According to Russell Barkley, Ph.D., “ADHD is not a problem with knowing what to do, rather it is a problem with DOING what you KNOW— the performance part.” You need someone to remind you of how special you are WHILE they help you put together the to-do lists, planners, and calendars that work for YOU. It’s so good to have someone to keep you accountable and cheer you on while you build routines and habits that will help the days go smoother. That’s where ADHD coaching comes in.