Medical treatment for ADHD, anxiety, depression, OCD and binge eating disorder.
Thursday, April 26th, 2012
What does living successfully with Adult ADHD mean to you? Perhaps you think success is focusing more easily or following-through on projects. Perhaps it’s getting organized or finding a job more suited to your ADHD personality. Success often seems like a far away dream to ADHD adults. Fortunately, as an ADD Coach, my clients show me first hand how targeted guidance and hard work make success possible. You can live an ADHD-friendly, satisfying and successful life. How To Live Successfully with Adult ADHD
People Share What ADHD Really Feels Like
People Share What ADHD Really Feels Like
Many people misunderstand what it means to have attention deficit hyperactivity disorder. “ADHD is not like pregnancy,” said Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor in the department of psychiatry at Harvard Medical School. “It is not an either you have it or you don’t phenomenon.” Each of us has some ADHD traits some of the time, he said.
“When diagnoses exist on a spectrum like that, it can lead people who have a trait, but not ADHD, to think that they know what the latter part of the spectrum feels like, when they don’t.”
We asked people who have ADHD to share what ADHD feels like. You might notice both similarities and differences in their descriptions, because as writer Kelly Babcock said, “ADHD is never exactly the same for any two people.”
“What is Executive Function Disorder, and how is it different from ADHD?”
Article on from www.ADDitudemag.com
A child or an adult with attention deficit hyperactivity disorder (ADHD) might be hyperactive, inattentive, and/or impulsive. Clinicians have always understood hyperactivity and impulsivity. The understanding of inattention, though, has shifted from primarily “the inability to stay on task” to a broader concept called executive function disorder (EFD), which involves a pattern of chronic difficulties in executing daily tasks.
The steps of executive function:
Around the time of puberty, the frontal part of the cortex of the brain matures, allowing individuals to perform higher-level tasks like those required in executive function. Think of executive function as what the chief executive officer of a company must do — analyze, organize, decide, and execute. Very similarly, the six steps of executive function are:
What is executive function disorder (EFD)?
It follows naturally that someone with issues with executive functioning may have problems with analyzing, planning, organizing, scheduling, and completing tasks at all — or on deadline.
A child without problems with executive function may appear like this: A middle-schooler’s teacher assigns the class a book to read, and writes the due date for the book report on the board. A student must be able to determine where to get the book and how long he thinks it will take to finish reading it. If the teacher has a specific book-report format, the student will have to keep it in mind as he reads the book and takes notes. He needs enough time to write a rough draft, get help from teachers or parents, if needed, and write a final draft by the due date. If the student has good executive function skills, the work will get done on time. If he has EFD, it won’t.
Children and adults with EFD have problems organizing materials and setting schedules. They misplace papers, reports, and other school materials. They might have similar problems keeping track of their personal items or keeping their bedroom organized. No matter how hard they try, they fall short.
A Tale of Two Children: One Diagnosed With ADHD and EFD, One Diagnosed With EFD and LD
Marcus, a fifth-grader, had difficulty staying on task and completing his schoolwork. He also had problems keeping his backpack and papers organized and remembering what to bring home from or take to school. Psycho-educational testing showed that he was bright, but that he had difficulties with processing speed and working memory. These findings, plus other studies, showed evidence of difficulties with executive function. The psychologist concluded that Marcus had ADHD, inattentive type, and started him on a stimulant medication. He showed significant improvement in all areas.
Ethan, a sixth-grader, received the same diagnosis but had a different result. The presenting problems, and the psycho-educational test results, were the same as Marcus’. Ethan was given a stimulant, but his symptoms didn’t improve. A closer review of his psycho-educational test results showed that he had problems retaining what he read and with written work. Ethan had EFD, but his problems resulted in Learning Disabilities (LD). He needed tutoring, plus accommodations, to overcome his challenges.
If you look at the criteria used to diagnose ADHD, inattentive type, you could understand why a child with EFD might be diagnosed as having ADHD. But it’s important to know that EFD can cause learning disabilities (LD).
Martha Bridge Denckla, M.D., an expert on executive function disorder, says, “EFD can be a reflection of ADHD, but it might also indicate an LD.” When a professional evaluating a child or adult finds evidence of EFD, it is essential for her to clarify whether the disorder results in ADHD, LD, or both. Only then can the child or adult receive the appropriate treatment for his specific problem.
In elementary school, a child learns to read, to write, and the basics of spelling, grammar, punctuation, and capitalization. She learns basic math concepts — addition, subtraction, fractions, and decimals. In middle and high school, with expanded executive function abilities, the student has a greater ability to organize and process information.
When reading, the student must organize the content before it can be stored. This is reading fluency. When writing, a student must be able to pull information from memory and to organize this information before he can start. A teacher might ask, “Can you tell me the theme of the book, and give examples to illustrate it?” The ability to retrieve and organize information in order to write a response is called writing fluency. Solving math problems requires retrieving learned concepts (formulas, rules) as well as known facts (multiplication tables) — and to use this information to find the answer.
A student with EFD might have difficulty organizing information before storing it in memory, or difficulty organizing information that is retrieved from memory. He might read a chapter but not retain what he has read. He might know the material but be unable to write an answer or start a paper because he cannot organize his thoughts. He might be able to write out math equations, but makes careless errors along the way.
When such students are tested, the results might show that their problems stem from EFD, but professionals are too quick to decide that the problem is ADHD. Professionals must look closely at the educational part of the assessment. If the results show that the student has difficulties with reading, writing, or math fluency, the EFD is also a reflection of an LD. It is vital to make the correct diagnosis — for the child’s sake.
Not all practitioners understand that executive function disorder can bring a diagnosis of ADHD, LD, or both. Even when psycho-educational test results support a diagnosis of LD, some conclude that the child has ADHD, inattentive type.
Russell Barkley, Ph.D., who has been at the forefront of exploring the relationship between ADHD and EFD, says, “It is not that the individual does not know what to do. It is that somehow it does not get done.”
The symptoms of ADHD, inattentive type, often improve with a stimulant. The symptoms of LD don’t improve with medication. The best way to manage LD is through specialized accommodations and one-on-one work with a learning specialist.
Observe your child closely at home. Now that you understand how EFD affects learning, look for signs of LD and ADHD. If the only focus is on ADHD, talk with your family doctor and school professionals about your concerns.
If necessary, share this article with the school administrators and other professionals to educate them about the relationship between EFD, LD, and attention deficit.
People with ADHD feel emotions more intensely than others do. When they feel happiness and excitement, it makes them more interesting and engaging. But strong emotion has its downside as well. People with ADHD are impulsive. They get carried away by what they are feeling, and act on it without considering how it will affect other people or themselves. If you see something interesting at the store, you may get excited and buy that item and forget the rest of your shopping list.
This is the challenge of emotional self-control — having the appropriate emotion and feeling it at the right intensity. When it comes to getting things done, people with ADHD struggle with both sides of the equation.
They get excited about distractions and get bored with the tasks they should be doing. They can’t hunker down. They can’t get things done. They may wonder, “Why am I so emotional all the time?”
Lack of emotional control creates common and predictable struggles in daily life:
Good solutions begin with a clear understanding of the problem. Most of the strategies for emotional self-control discussed here are based on three basic ideas: manage your stress, have strategies to control your emotions in situations that set them off, own up to your reactions.
1. Manage your stress. Everyone feels stressed out and overwhelmed sometimes. To the extent that you can, try to limit how many demands you have pressing on you at any one time.
2. Avoid over-committing yourself. Everything seems interesting until we find that we have too much going on. You can minimize crunch-time stress by taking less on and by graciously bowing out of some commitments when necessary — and with enough warning.
3. Get enough sleep. We are more positive and less reactive when we’ve gotten enough shut-eye.
4. Exercise regularly. Physical activity is a great stress reliever. It doesn’t matter how you exercise, as long as you do it regularly. Even doing a set of push-ups or going for a quick walk around the block can clear your head and put things in perspective.
5. Make time for yourself. It’s important to set some time aside for you to do something for your own pleasure. If you don’t recharge the batteries, you will burn out.
6. Treat co-occurring anxiety and depression. Adults with ADHD are more likely to be anxious and depressed. Untreated, these conditions may make your emotional control worse, so it is smart to address these professionally.
7. Avoid emotionally provoking situations. It’s harder to calm a strong reaction than it is to avoid it in the first place. This doesn’t mean that you should avoid every uncomfortable or difficult situation, but you should know that some situations aren’t worth the potential trouble.
8. Create a plan…ahead of time for how to respond to a situation that you know will evoke some strong feelings. Think about how you can respond to different things the other person might do, as well as what outcomes you hope to achieve. Review the plan right before you go into the situation and keep it in your mind during the situation. If possible, bring in some written notes.
9. Take a break. If your two choices are to blow up or walk away, it’s better to walk away. Even five seconds may be enough to help you calm down and gather yourself. If you are feeling angry at someone with whom you have an ongoing relationship, explain to him or her that a break will help you collect your thoughts and lead to a better outcome for everyone.
10. Train others to talk you down. If you know you will get emotional in certain situations — political discussions, sales at certain stores — train some of your family and friends to talk to you about the bigger picture, or another person’s perspective, so that you can catch yourself earlier in the process of getting caught up in a feeling.
11. Remind yourself that, no matter how strong the emotion you are feeling, it will fade. This could be a positive feeling, like being excited over a potential purchase, or a negative feeling, like a date that went badly. You will still have the feeling, but know that you will feel differently.
12. Remind yourself of the other person’s perspective. We react to people we are closest to. As much as we like to think that we’re justified in our feelings, there are times when we react to someone for reasons that have little to do with that person. Don’t take things personally that have little to do with you.
13. Separate feeling from acting. Our emotions often drive our behavior, but there doesn’t have to be a direct connection between the two. Although it’s easier said than done, it’s possible to notice the feeling that you’re having and what it makes you want to do without acting on it. Mindfulness training teaches people how to do this.
14. Educate others about your emotional patterns. Explain to family members, and close friends, and perhaps some coworkers, that your initial reaction tends to be stronger than that of other people, but that you settle down quickly and can have a productive discussion. This helps them not to overreact to your reaction. You may also coach them on how you would like them to respond to you when you have a strong emotional reaction.
15. After you cool off, explain what you really meant. If something came out wrong, or if you said something that you didn’t really mean, tell the person what your rationale was and what you meant. Don’t deny what the other person perceived, but let her know that you had better intentions than you conveyed.
Excerpted from the book Understand Your Brain, Get More Done, by ARI TUCKMAN, Psy.D., MBA. Copyright 2012.
When ADHD problems, challenges, and stress make you feel frustrated and overwhelmed with anxiety, consider whether you’d be as hard on someone else as you are on yourself.
I talked with a client who has attention deficit hyperactivity disorder (ADHD) a while back about the problems she was dealing with at work. She was so stressed out about being behind that she skipped the office holiday party so that she could get catch up on work. Besides, she didn’t feel that she deserved to go to the party when she had so many things to do.
My client reminded me of a woman who stood up at one of my talks about “Overcoming Chronic Overwhelm.” She said: “Everything you’re saying makes sense — manage stress, slow down, and take care of yourself. But I feel like I bring chaos everywhere I go. How can I spend time managing stress or taking care of myself when I cause so much stress for everyone around me?”
I was glad that this woman had the courage to talk about her problems, because it allowed me to address a mindset that I see in a lot of adults with ADHD: We think that we’re so high-maintenance for those around us — with our disorganization, inability to manage time, and lack of focus — that we need to make up for all the things we are, and are not.
If you feel this way, take a deep breath and read me loud and clear: You are wrong! You’re punishing yourself for who you are. Having adult ADHD might make you difficult to deal with at times (I certainly am), but it:
does not make you a bad person
does not make you a difficult person
is not a reason to punish yourself
Having adult ADHD means that you have certain strengths and challenges. So does everyone else. You might have a hard time staying organized at work, yet be a superstar at customer service. Your coworker who is extremely organized may not be a good people person.
I asked the audience at my talk, “Would you ever tell your coworker, ‘Oh, you didn’t clean up your desk today? Then you’d better skip that dinner date and stay late until you get it done!’”
Everyone laughed. We wouldn’t impose the punishments on others that we impose on ourselves. And when it comes to overcoming overwhelm, one thing is clear: If you don’t allow yourself time to manage your stress, slow down, and make self-care a priority, you’ll never break out of the overwhelm-burnout cycle. You’ll be forever stressed, trying to catch up and feeling like you owe something to everyone.
Stop punishing yourself. Start living.
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We wanted to take a moment to thank you all so much for bearing with us throughout this transition, and provide you with some updated information.
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