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Is There An ADD Epidemic in Adults?

by Dr. Lynn Margolies

Published, PsychCentral, Newton TAB, 2012

 



Do you procrastinate? Do you have trouble with self-discipline, focus and motivation? Are you sometimes forgetful? If the answer is yes, then join the club!

Most of us recognize these as some of the symptoms of ADD or Attention Deficit Disorder. (OMG – maybe we all have ADD.)

But these struggles are not the exclusive domain of ADD. Difficulty getting things done and falling prey to distraction, a wandering mind and temptation is a reality for most of us at times. And, of course, it’s all compounded by the constant lure of digital distractions.

With ADD, however, overcoming these obstacles is not simply a matter of choice. Here, lack of capacity can trump the best intentions to use will-power and self-discipline to stay on track. Further, ADD deficits often cause longstanding effects on careers and relationships, leading to underachievement and a chronic sense of frustration, shame, and failure.

ADD is a neurobiological syndrome beginning in childhood that is chronic, pervasive, and hard-wired, with a strong genetic component (Barkley, 2010; Hallowell, 2005). Research indicates that about 4% of adults in the U.S. have ADD (Hallowell, 2005). ADD symptoms also include forgetfulness, impulsivity and difficulties with organization, time-management, staying on task, and shifting attention. Shifting attention here means being able to unglue oneself from a task or know when to stop (Barkley, 2010).

ADD symptoms are essentially executive function deficits, interfering with the ability to follow through on conscious intentions and sustain future or goal-directed activity. Researchers have called ADD a condition of "nearsightedness” (Barkley, 2006, p. 56) with regard to time. ADD creates a blind-spot for the future, often leading to short-sighted decisions and procrastination (Barkley, 2006).

Seventy five percent of people with ADD have at least one other co-existing condition, usually anxiety, depression, and/or substance abuse. Although medicine helps 80% of people with ADD, lack of response or worsening of symptoms may occur when untreated co-existing conditions are mistakenly attributed to ADD (Hallowell, 2005).

Jenny held a high status academic position. In her struggle with ADD, she was most affected by distractibility and procrastination, often surfing the web for interesting political news instead of doing her work.

Jenny was raised by a very critical father who shamed her when she didn’t meet his expectations, or when she asked a question he thought was stupid. Although ADD was an aspect of Jenny’s problem, even with structure and medication, it did not remit until she addressed the psychological issues driving her avoidance.

Jenny internalized the perfectionism imposed on her by her dad, along with a sense of inadequacy, shame, and fear of disapproval. She was easily triggered into a flood of anxiety around her work, fearing she’d be exposed as an imposter. This led to a cycle of inertia, shame and further avoidance. When Jenny could recognize and change the inner critical voice in her head modeled after her dad, she lowered the stakes she set for her performance, and could make use of strategies to treat her ADD.

Structural and biochemical differences in the ADD brain limit the capacity to regulate oneself, or have self-control, for example, to initiate, persevere, or stop behavior so that actions are in line with one’s future goals, rather than immediate impulses. Further, depletion of dopamine, a neurotransmitter involved in the experience of pleasure/reward, creates difficulty sustaining a feeling of vitality, contributing to a pull towards behaviors that provide stimulation – or an adrenaline rush.

Some researchers have found that the secret to harnessing the energy of the ADD mind is finding a naturally compelling creative outlet where focus comes easily. Successful adaptation involves compensation for deficits, for example, by finding environments compatible with the strengths of the ADD brain. Such environments are often fast-paced, intellectually or physically stimulating, or structured, for example, with regular deadlines paced at short intervals. Work that requires intense energy, here-and-now attention, independent thinking, imagination and tenacity may also capitalize on ADD assets. Most importantly, educating ourselves and our loved ones about ADD is essential to prevent needless judgment, shaming, and self-blame that are common with this condition. Then, instead, we will be in a position to harness the unique, inspired energy of the ADD mind.

References:

Barkley, R.A. (2010). Taking charge of adult ADHD (1st ed.). New York, NY: The Guilford Press.

Barkley, R.A. & Murphy, K.R. (2006). Attention deficit hyperactivity disorder: A clinical workbook (3rd ed.). New York: Guilford Publications.

Hallowell, E.M. (2005). Delivered from distraction. New York: Ballantine Bks, Random House Publishing Group.

 

Click a link to go to other articles like this one in the following categories: Executive Functions, ADHDSelf-esteem

 
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Psychologist, Newton Centre, MA.
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