There are many facets to attention: coming to attention, focusing on a task, attending to details, and sustaining attention. Many ADDers have difficulty with one or more of these attentional components. I continue to have difficulty paying attention to details. For example, within the last few days, I dropped my car keys in the middle of a town square. Fortunately they were retrieved by a cop. Then. I misread the details on a cell phone bill, and went in complaining to the cell phone store, only to be told that clearly I didn’t correctly read the bill . A day later, I couldn’t find my cell phone at home and called the last people I visited to see if they found it. They undertook a major search. I then found that the phone was in my house but on vibrate so I couldn’t call it. Today, I asked for utensils from a waiter in the restaurant, and they were in my lap. And so forth… Do you have this perennial problem?
Many people with this difficulty find that stimulant medication helps them attend to details on specific tasks, but not on activities they’re not working on. What do you do then? I suggest for myself and others , at least with important such as car keys, cell phones, parking places, that you need to check and rehearse in your mind where these items or places are. Or put them in the same place every time to avoid some of your attentional difficulties. Don’t sweat the less important things, like going in to an expensive restaurant and ordering food you can’t afford, because you didn’t read the menu well outside. You need to delete these things from your mind… and let them go, or you’ll forever be annoyed with yourself.
Friday, October 31, 2008
Sunday, October 26, 2008
WHAT TYPE OF JOB FITS AN ADDER?
I am ADDer, and struggled with finding the right job for years until I finally settled in to what I do now- a general clinical psychologist with an ADD coaching practice. It’s always been said that an ADDer needs a structured job But if the job is in a busy workplace and the ADDer is easily distracted,, it becomes hard to focus on the task at hand . I took a structured job in a hospital research lab early on. There were no distractions, but the job was repetitive and after a while, not stimulating. I became bored, my arousal level was low and I often didn’t attend to important details. So if an ADDer gets a structured job, he needs to make sure the workplace is suitable, the tasks have enough variability, stimulation and a low level of distractibility, to keep up the arousal level necessary to remain task focused.
Ultimately, I became a clinical psychologist in private practice, which is entrepreneurial and very stimulating. I can focus well on clients, maybe even hyperfocus, However I have some significant challenges I am disorganized , particularly with billing, which was tedious, so I lost out on money by not doing follow-ups. I had to hire a billing -and client-friendly- office manager who helped tremendously. The other problem I have is that clients today, while they may be serious about seeking therapy, often will come at odd hours each day leaving many open hours. How do I fill the empty hours? With athletic activities . workshops and courses, although my schedule is not predictable. So I’m still working on the structure of the day and week. Therefore, if an ADDer wants to be an entrepreneur, consider getting help to organize and figure out what to do with non-work related time. Perhaps even some part-time work. In another arena.
If you are an ADDer, are you in the right job?
Ultimately, I became a clinical psychologist in private practice, which is entrepreneurial and very stimulating. I can focus well on clients, maybe even hyperfocus, However I have some significant challenges I am disorganized , particularly with billing, which was tedious, so I lost out on money by not doing follow-ups. I had to hire a billing -and client-friendly- office manager who helped tremendously. The other problem I have is that clients today, while they may be serious about seeking therapy, often will come at odd hours each day leaving many open hours. How do I fill the empty hours? With athletic activities . workshops and courses, although my schedule is not predictable. So I’m still working on the structure of the day and week. Therefore, if an ADDer wants to be an entrepreneur, consider getting help to organize and figure out what to do with non-work related time. Perhaps even some part-time work. In another arena.
If you are an ADDer, are you in the right job?
Monday, October 20, 2008
AROUSAL LEVEL AND ADD
ADDers have to struggle to maintain an optimal arousal level. Although I’m not a psychopharmacologist ( although I have a Masters in Biochemsitry), I have learned that the stimulant medications for ADD probably increase arousal and alertness by increasing the neurotransmitter Dopamine. However, I have coached many people with an ADD brain style, and they report minimal to great benefits with stimulants.
So why do they need coaching? Because, for numerous unstimulating tasks, despite increased alertness, they still lack motivation and organizational skills, and can’t initiate or complete tasks on a consistent basis. Some find ( particularly older people) that they feel an increased heart rate ( at which point I ask them to check with their doctors about an EKG). That’s what happened to me with all the stimulants I tried. They increased my alertness, but at the price of increasing my heart rate and anxiety
Individuals with a non-ADD brain style, usually manage to regulate the neurotransmitters involved in arousal. Also, they will often only do a rewarding task, if they finished a tedious one first. Contrary to common sense, the ADDer works in a reverse manner. I learned in my ADD coaching, that frequently, it works well for ADDers if do something enjoyable first to build up their arousal level and then they find that they can do the tedious task, It’s incredible! Two recent examples in my clinical work involved: first, an artist who loved to paint, but hadn’t done so in a while, because she convinced herself that she had to clean up her house first. When it was suggested to her that she painted first which was stimulating for that she might then be motivated enough to clean her house. It worked for her!.
Second, was a middle-age man who rode his motorcycle for an hour in order to build up his arousal. And then he was able to work on his taxes. Amazing!
Another strategy which worked with a medical student, was having her read for 45 minutes setting her clock to ring when the time was over. Then she was to take a 15 Minute break doing something active, and return to her studies afterward. It worked!
As an ADDer, have you experienced success with these strategies?
So why do they need coaching? Because, for numerous unstimulating tasks, despite increased alertness, they still lack motivation and organizational skills, and can’t initiate or complete tasks on a consistent basis. Some find ( particularly older people) that they feel an increased heart rate ( at which point I ask them to check with their doctors about an EKG). That’s what happened to me with all the stimulants I tried. They increased my alertness, but at the price of increasing my heart rate and anxiety
Individuals with a non-ADD brain style, usually manage to regulate the neurotransmitters involved in arousal. Also, they will often only do a rewarding task, if they finished a tedious one first. Contrary to common sense, the ADDer works in a reverse manner. I learned in my ADD coaching, that frequently, it works well for ADDers if do something enjoyable first to build up their arousal level and then they find that they can do the tedious task, It’s incredible! Two recent examples in my clinical work involved: first, an artist who loved to paint, but hadn’t done so in a while, because she convinced herself that she had to clean up her house first. When it was suggested to her that she painted first which was stimulating for that she might then be motivated enough to clean her house. It worked for her!.
Second, was a middle-age man who rode his motorcycle for an hour in order to build up his arousal. And then he was able to work on his taxes. Amazing!
Another strategy which worked with a medical student, was having her read for 45 minutes setting her clock to ring when the time was over. Then she was to take a 15 Minute break doing something active, and return to her studies afterward. It worked!
As an ADDer, have you experienced success with these strategies?
Tuesday, October 14, 2008
PLANNING A TASK: DO’S AND DON’T’S
For ADDers, initiating and finishing tasks are great challenges. For the non-ADDers, simple tasks, even if they are tedious, they can be accomplished with less effort. They can make lists, check items off daily, and use organizers. These typical procedures usually don’t work for ADDers ( For example, this blog has been on the top of my list for several days, and there have been many distractions before actually writing it). Actually, for the ADDer, just writing a list is reinforcing enough, with the ADDers having the illusion that the task is already accomplished!
Importantly, the arousal level is generally low for anyone doing a tedious task, but even lower for ADDers, who craves stimulation and can’t get started. Furthermore, the ADDer has a poor conception of time, and usually underestimates the time needed. Finally, there are many distractions and diversions that help avoid starting and completing tasks.
Now, what would help the ADDer? First, the time estimated to complete the task should be doubled, since time is generally underestimated. Once the time is figured out, the task can be broken into smaller chunks. Also, the ADDer needs to specify to himself the time of day he is most likely to do a tedious task. Often, I leave a task for after 8:P.M., knowing at some level, I will be too tired to do it. Now I’m trying to learn to do tedious tasks in the late morning or afternoon, when my arousal level is highest, and when I’m most likely to feel like doing it.
Importantly, the arousal level is generally low for anyone doing a tedious task, but even lower for ADDers, who craves stimulation and can’t get started. Furthermore, the ADDer has a poor conception of time, and usually underestimates the time needed. Finally, there are many distractions and diversions that help avoid starting and completing tasks.
Now, what would help the ADDer? First, the time estimated to complete the task should be doubled, since time is generally underestimated. Once the time is figured out, the task can be broken into smaller chunks. Also, the ADDer needs to specify to himself the time of day he is most likely to do a tedious task. Often, I leave a task for after 8:P.M., knowing at some level, I will be too tired to do it. Now I’m trying to learn to do tedious tasks in the late morning or afternoon, when my arousal level is highest, and when I’m most likely to feel like doing it.
Sunday, October 12, 2008
ARE YOU DEPRESSED OR IS IT ADD?
From my clinical experience there are several possibilities. ADD and Depression can coexist, or ADD can result from Depression, or ADD can at times cause Depression.
How do you figure this out? You need to go to a clinician, who has expertise in ADD to help you sort it out. Many health professionals, are not familiar with or believe in adult ADD. As a life-long ADDer who works with many adult ADD folks, I feel strongly that I can help with this dilemma.
From my personal experience, depressive feelings can result from ADD symptoms such as the failure to initiate important tasks( like this blog), too much unstructured and unstimulating or boring periods, and the inability to often organize tasks and activities.
Until recently, in my knowledge, antidepressants were given as the sole medication for ADD people who were also depressed. Often their moods improved, but other ADD behaviors still remained. Now this awareness has led to the use of stimulant medications for many, coupled with cognitive/behavioral therapy ( Some will take antidepressants as well, depending on their level of functioning).
From my personal, clinical and coaching experience, an individual with an ADD brain-style needs to be aware that their mood drops during unstructured times, and they need to plan ACTIVE rather than passive “relaxing” experiences during these periods. Passive activities such as watching TV will not elevate your arousal level or mood; in fact moods may get even lower because of disappointment in lack of accomplishing anything.
How do you figure this out? You need to go to a clinician, who has expertise in ADD to help you sort it out. Many health professionals, are not familiar with or believe in adult ADD. As a life-long ADDer who works with many adult ADD folks, I feel strongly that I can help with this dilemma.
From my personal experience, depressive feelings can result from ADD symptoms such as the failure to initiate important tasks( like this blog), too much unstructured and unstimulating or boring periods, and the inability to often organize tasks and activities.
Until recently, in my knowledge, antidepressants were given as the sole medication for ADD people who were also depressed. Often their moods improved, but other ADD behaviors still remained. Now this awareness has led to the use of stimulant medications for many, coupled with cognitive/behavioral therapy ( Some will take antidepressants as well, depending on their level of functioning).
From my personal, clinical and coaching experience, an individual with an ADD brain-style needs to be aware that their mood drops during unstructured times, and they need to plan ACTIVE rather than passive “relaxing” experiences during these periods. Passive activities such as watching TV will not elevate your arousal level or mood; in fact moods may get even lower because of disappointment in lack of accomplishing anything.
Friday, October 3, 2008
Saving a Marriage with an ADD Diagnosis
I recently treated two couples with severe marital problems verging on divorce. In one, the spouse claimed that her husband was passive- aggressive, didn’t listen or follow through with her requests despite agreeing to them. Further exploration revealed a cluster of behaviors he exhibited indicative of ADD. His wife understood that many of his behaviors were due to ADD, and reframing them as such drastically changed the situation. Similarly, in another situation with a newly married couple, the spouse was told by his wife that her impulsive, irritable and often disinhibited behaviors were due in large part to ADD. He did not believe in or understand the ramifications of this diagnosis. I had him read Hallowell’s and Ratey’s Driven to Distraction which opened his eyes.
In both cases, as a coach and clinician, I had to work with the ADD and the non-ADD spouse to recognize their different brain styles, and to learn how to adapt to each other.
In both cases, as a coach and clinician, I had to work with the ADD and the non-ADD spouse to recognize their different brain styles, and to learn how to adapt to each other.
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