Is ADHD a gift? Not so fast....

I have read a number of books, articles, and commentary about the idea that ADHD is a gift that we should embrace.  There are undoubtedly a lot of things about ADHD that become so intertwined with someone's personality that it's hard to see where they leave off and the ADHD begins.  You can find people who attribute their success to ADHD and others who will state that medication dulls the "edge" they get from the condition.  The problem with discussing ADHD in this fashion is that it employs a false dichotomy,(look Mom, I'm using that Philosophy degree!). To state that it is a gift gives us only one alternative; that is that it is an undesirable thing or for lack of a better term a curse.  This then frames the discussion in absolute terms and invites us to take sides: it's good, it's bad, it's the source of my success, it's the cause of my failure.

People like to have clear choices and alternatives when they look at things because it simplifies the thought process.  It's so much easier and powerful to state an opinion that is absolute and firm.  We don't like ambiguity or uncertainty.  This is undoubtedly a survival trait that is written into our DNA.  Our ancestors didn't have the luxury of uncertainty.  They needed to know that the water was safe to drink, or the plant was edible, or that the saber tooth tiger was gone.  Absolute certainty was necessary when one poor choice could get you eaten.  But here in the 21st century, this mode of thinking can be counter productive and distract us from having a substantive conversation about a topic like ADHD.  I would argue that for many of the people effected by the disorder, it has been at times a gift, at times a curse, and  at some points a little bit of both.

ADHD as a condition effects areas of the brain that manage executive functions.  These are the things that allow us to organize and plan, delay gratification, restrain our impulses, manage transitions from one activity to the next, and initiate and complete tasks.  The executive functions are kind of like the teacher in Kindergarten; when you have someone who is strong, good with children, and experienced the class runs smoothly.  Put a less competent person in charge and it can be chaos.  When we think of the positives and negatives of ADHD it would seem to make the most sense to look at the benefits of executive function impairment versus the detriments.

An ability to jump from thought to thought and make connections that are not readily apparent can be a tremendous skill for someone who is involved in a creative endeavor or problem solving exercise.  However, the inability to organize and plan effectively surrounding those thoughts can be a great detriment.  Likewise, a person's spontaneity or impulsiveness can be a charming, endearing trait to a new romantic interest.  Fast forward twenty years and that once endearing quality can be a huge source of friction in a marriage.  The ability to hyper focus on one activity for many hours at a time is a great boon to a computer programmer; if that same programmer becomes the CEO of a software company, it may become extremely difficult for that individual to manage the multiple tasks and priorities they are confronted with.

So is ADHD a gift?  I would argue that we need to be careful about thinking in absolutes.  It is neither a gift nor a curse.  It is a neurophysiological condition present in 7 to 15 percent of the population.  It should not be viewed as somehow enhancing who we are as a person, nor should it be allowed to detract from who we are.  We are not our ADHD.  It is a part of us and always will be.  As such, we will continue to have good days and bad days, ups and downs.  The best recommendation I can make is feel good about the strengths and talents you have and don't attribute them to some outside force.  You deserve to think well of yourself.  As far as faults are concerned everyone has them.  Accept yours for what they are and do your best to mitigate them.  You control the person you are and the life you live.  Don't let anyone or anything take that away from you.

The Curse of Too Much Time?

Sometimes it feels like you have all the time in the world.  You get up an hour early, or your expected appointment had to re-schedule.  Or perhaps you just have a quiet day and you want to get some things done and crossed off your to do list.  For many people these days are tremendously productive.  For those of us with ADHD however, these days are tricky.  We struggle with initiating tasks and organizing  our time.  For example a college student may not have a class until 10 or 11 in the morning, and would like to spend the morning hours going to the gym, or doing homework.  He or she finds that this is more difficult in practice; they may sleep too late and end up getting nothing done.  They may get up early enough, but spend the time puttering around their dorm room instead of studying or working out.  Likewise, adults may find that their plans to use time constructively are harder to put into practice than they expected.  You may head to the office early hoping to get caught up on work or get a jump on the day, but end up detouring to Starbuck's to get a latte and read the newspaper.

Maybe you recognize yourself or someone you know in the above examples.  I have come to believe that people with ADHD suffer from the "curse of too much time".  Or to put it another way, you could express this as an immutable law of ADHD: Without specific structured plans time will never be used for the purposes that it was intended for.  How can you ensure that your time is used productively?  How can you get things started so you can build momentum towards a productive day?  Here are a few essentials to keep in mind:

1. Being productive doesn't happen just because you want it to.  You need a plan!  And not just a list, although that's not a bad start.  You need to sit down and decide what you want to get done, what you will need to get it done, and how much time you'll need to do it.  Cleaning out the basement on a day that the local dump is closed may not be the best idea.

2. Have a back up plan; if you take the day off to get some painting done what are you going to do if it rains?

3. Make preparations before you begin.  If you plan to hit the gym in the morning before work pack your bag and have everything else needed ready to go the night before.

4. Be reasonable about what you can get done with the time you have.  Two hours may be plenty of time to balance your checkbook and pay bills but it may not be enough time to drive across town to go shopping.

5. Every now and then, take that extra two hours and just let it pass by.  Read, sleep in, enjoy a movie you've wanted to see, or indulge in some other pastime.  We all need rest and recreation.  Not every waking moment has to be 100% productive.

Having some free time can be a blessing or a curse.  Plan your free time carefully and you may find you have more of it than you thought!

Vacations and ADHD

It's the time of year when most families plan their vacations.  If you have a member (or members) of the family with ADHD it's good to keep in mind that routines and plans are still necessary.  For example, if a spouse has ADHD they will often wait until the last minute to get packed and inevitably forget something essential.  The spouse or parent without ADHD can feel like they have to make all the arrangements to be away, pack the car, and make sure everyone else is packed.  Teenagers can become difficult because their normal routine is being disrupted, and their parents are getting after them.  Without thinking ahead this is a recipe for a bad and stressful start to what should be an enjoyable time of renewal.  Here are some ideas and tips to help make vacation a little more enjoyable.

1. When getting ready to go away make a list of all the thing that will need to be taken care of.  Then divide the list accordingly.  Keep in mind that asking your spouse with ADHD to be responsible for things like stopping the paper, forwarding mail, or arranging for cat sitting may not be the best idea. Likewise, expecting your teenager to enthusiastically mow the lawn just prior to departure may also be unrealistic.  Remember to pick tasks that you are good at and have a better than even chance of completing.

2. Make a plan and stick to it.  If you want to leave at 8 a.m. make sure everyone knows well in advance that 8 a.m. will be the departure time, and then work backwards to determine when bags will need to be packed, when people will need to be awake, etc.

3. Make a list of everything you need and want to bring for the trip, and then use it when your packing.

4. Make sure you will have an adequate supply of your medications for the duration of your trip.

5. While the GPS has eliminated many of the hassles of traveling in unfamiliar areas, it's always a good idea to have a back up in the form of an old fashioned map.

6. Even though you're on vacation it's good to have some kind of structure to the day.  Building the day around a particular activity or event will allow you to have fun without bickering over when something is going to happen during any given day.

7. Finally remember that vacations are about rest and renewal.  If you find that going away is almost as stressful as being home and going to work or school some soul searching is in order.  It could be that your idea of what a vacation is needs to change.

Nothing is ever perfect, but a little planning, structure, and discussion will go a long way towards making your family's summer vacation a little more enjoyable.

 

The Will to Wake: Why morning is the toughest transition some people face

It's no secret that many people with ADHD have a hard time getting up and going in the morning.  Some of the classic stories involve hitting the snooze button multiple times, sleeping through the alarm, getting up to shut the alarm off and then going back to bed, or waking up but having such low energy that they might as well be sleeping.  They do this in spite of the fact that they have school, work, or other commitments to tend to.  Our society in general is exceptionally intolerant of people who can't get out of bed in the morning.  We tend to view these people as lazy, undisciplined, unmotivated, or simply incapable of handling the responsibilities that others can.  Even those who have been diagnosed with ADHD still feel frustration over this most fundamental of transitions; simply put it's hard to wake up.

What is behind this difficulty?  My reading and research has lead me to the conclusion that the mind of someone with ADHD has difficulty activating itself.  A person without ADHD will set their alarm for 6:00 a.m. for example in order to make sure they are up in time to get ready and head to work or school.  When the alarm goes off they may hit the snooze button, but by and large, they are up.  Why?  Their brains take very little time to activate.  "Ok" their subconscious says, "time to get out of bed, take a shower, get dressed, and get out the door."  That's all they need.  They get moving.

Now contrast this with the brain of a person with ADHD.  The alarm goes off.  They hit snooze.  the alarm goes off again.  They hit snooze again.  It hasn't really registered that it's time to wake up.  There's a vague notion that they should get moving, but no real urgency.  The urgency only comes when the realize they will be late and there will be dire consequences.  Or, they may not be able to rouse themselves at all.  There are many parents out there that have fought battle after battle to get their teen out the door and at school on time.  There are also countless adults who are smart, talented and capable, yet they end up losing their jobs or are held back in their careers because of their inability to manage getting to work or to meetings on time. 

This is one of the most vexing aspects of ADHD and it impacts many people on a deeply personal level; they feel bad about themselves for not getting up on time, and they receive feedback that is negative about their inability to get up and get going.  So every day begins with a struggle against your physiology that you think you’re a failure because you can’t overcome it.  It’s a tough way to live.  Think of someone who is only five feet tall who lives in a world that’s built for people six feet tall and above.  Yes, you can reach everything on the lower shelves, but a lot of things are a struggle.  You just can’t make yourself any taller, and everyone seems to be telling you that you should be able to.  What’s needed in this scenario is a stepladder; or, to bring this back to ADHD what’s needed are new strategies and new routines to aid you with becoming better able to get moving when you wake up. 

The first thing to look at is this: what can you change about your life that would give you more time or a schedule that is a better fit for the kind of person you are?  Can you change your work or class schedule?  Can you make preparations the night before so there is less to do in the morning?  Could you relocate so you are closer to your job or school?  What about your evening routine?  Are you getting to bed early enough so you are well rested?  Do you need to look at dietary or lifestyle changes?  Are you exercising enough?  These are all considerations you should look at.  Small changes in any of these areas can reap great rewards.  If you were to pack your bag and iron your shirt the night before work you could potentially save 30 minutes.  That’s 30 more minutes you could sleep, or use to get out the door earlier. 

The next thing to look at is introducing new ideas to help with you with the struggle you may have in the morning.  Is your alarm clock working for you, or do you simply tune it out?  There are dozens of different alarm clocks out there, and some are specially designed with the needs of people with ADHD.  Do you take stimulant medications?  If it is safe to do so, try keeping them on your bedside table, and taking them the first minute or so you are awake.  Even if you hit the snooze button, they will eventually begin the activation process in your brain.  If you find that having other people expecting you somewhere by a certain time is a motivation perhaps joining a car pool might work well for you. If you love getting a coffee or other drink at a shop near where your classes are held or the office use that as an incentive to get out the door earlier.  Being on time means that that latte is waiting for you.  Being late means forgoing the latte for that day.  Of course, if you’re an adult you could always decide to have children.  That will certainly get you up whether you like it or not!

There are legitimate medical reasons that may be causing you to have problems waking up.  Speak with your doctor or medication manager if you have concerns that anything you may be taking is the cause of your morning issues.  Also try to remember that perfection is rarely attainable.  You will probably have a morning here or there where things don’t go as planned.  The key thing to remember is that you are not a passive victim.  You can take action to help you get up and get going.