Driven to Distraction (Revised)

by Edward M. Hallowell

  6. Do you drum your fingers a lot, tap your feet, fidget, or pace?

  7. When you read, do you find that you often have to reread a paragraph or an entire page because you are daydreaming?

  8. Do you tune out or space out a lot?

  9. Do you have a hard time relaxing?

  10. Are you excessively impatient?

  11. Do you find that you undertake many projects simultaneously so that your life often resembles a juggler who’s got six more balls in the air than he can handle?

  12. Are you impulsive?

  13. Are you easily distracted?

  14. Even if you are easily distracted, do you find that there are times when your power of concentration is laser-beam intense?

  15. Do you procrastinate chronically?

  16. Do you often get excited by projects and then not follow through?

  17. More than most people, do you feel that it is hard for you to make yourself understood?

  18. Is your memory so porous that if you go from one room to the next to get something, by the time you get to the next room you’ve sometimes forgotten what you were looking for?

  19. Do you smoke cigarettes?

  20. Do you drink too much?

  21. If you have ever tried cocaine, did you find that it helped you focus and calmed you down, rather than making you high?

  22. Do you change the radio station in your car frequently?

  23. Do you wear out your TV remote-control switch by changing stations frequently?

  24. Do you feel driven, as if an engine inside you won’t slow down?

  25. As a kid, were you called words like, “a daydreamer,” “lazy,” “a spaceshot,” “impulsive,” “disruptive,” “lazy,” or just plain “bad”?

  26. In intimate relationships is your inability to linger over conversations an impediment?

  27. Are you always on the go, even when you don’t really want to be?

  28. More than most people, do you hate waiting in line?

  29. Are you constitutionally incapable of reading the directions first?

  30. Do you have a hair-trigger temper?

  31. Are you constantly having to sit on yourself to keep from blurting out the wrong thing?

  32. Do you like to gamble?

  33. Do you feel like exploding inside when someone has trouble getting to the point?

  34. Were you hyperactive as a child?

  35. Are you drawn to situations of high intensity?

  36. Do you often try to do the hard things rather than what comes easily to you?

  37. Are you particularly intuitive?

  38. Do you often find yourself involved in a situation without having planned it at all?

  39. Would you rather have your teeth drilled by a dentist than make or follow a list?

  40. Do you chronically resolve to organize your life better only to find that you’re always on the brink of chaos?

  41. Do you often find that you have an itch you cannot scratch, an appetite for something “more” and you’re not sure what it is?

  42. Would you describe yourself as hypersexual?

  43. One man who turned out to have adult ADD presented with this unusual triad of symptoms: cocaine abuse, frequent reading of pornography, and an addiction to crossword puzzles. Can you understand him, even if you do not have those symptoms?

  44. Would you consider yourself an addictive personality?

  45. Are you more flirtatious than you really mean to be?

  46. Did you grow up in a chaotic, boundaryless family?

  47. Do you find it hard to be alone?

  48. Do you often counter depressive moods by some sort of potentially harmful compulsive behavior such as overworking, overspending, overdrinking, or overeating?

  49. Do you have dyslexia?

  50. Do you have a family history of ADD or hyperactivity?

  51. Do you have a really hard time tolerating frustration?

  52. Are you restless without “action” in your life?

  53. Do you have a hard time reading a book all the way through?

  54. Do you regularly break rules or minor laws rather than put up with the frustration of obeying them?

  55. Are you beset by irrational worries?

  56. Do you frequently make letter or number reversals?

  57. Have you been the driver and at fault in more than four car accidents?

  58. Do you handle money erratically?

  59. Are you a gung-ho, go-for-it sort of person?

  60. Do you find that structure and routine are both rare in your life and soothing when you find them?

  61. Have you been divorced more than once?

  62. Do you struggle to maintain self-esteem?

  63. Do you have poor hand-eye coordination?

  64. As a kid, were you a bit of a klutz at sports?

  65. Have you changed jobs a lot?

  66. Are you a maverick?

  67. Are memos virtually impossible for you to read or write?

  68. Do you find it almost impossible to keep an updated address book, phone book, or Rolodex?

  69. Are you the life of the party one day and hangdog the next?

  70. Given an unexpected chunk of free time, do you often find that you don’t use it well or get depressed during it?

  71. Are you more creative or imaginative than most people?

  72. Is paying attention or staying tuned in a chronic problem for you?

  73. Do you work best in short spurts?

  74. Do you let the bank balance your checkbook?

  75. Are you usually eager to try something new?

  76. Do you find you often get depressed after a success?

  77. Do you hunger after myths and other organizing stories?

  78. Do you feel you fail to live up to your potential?

  79. Are you particularly restless?

  80. Were you a daydreamer in class?

  81. Were you ever the class clown?

  82. Have you ever been described as “needy” or even “insatiable”?

  83. Do you have trouble accurately assessing the impact you have on others?

  84. Do you tend to approach problems intuitively?

  85. When you get lost, do you tend to “feel” your way along rather than refer to a map?

  86. Do you often get distracted during sex, even though you like it?

  87. Were you adopted?

  88. Do you have many allergies?

  89. Did you have frequent ear infections as a child?

  90. Are you much more effective when you are your own boss?

  91. Are you smarter than you’ve been able to demonstrate?

  92. Are you particularly insecure?

  93. Do you have trouble keeping secrets?

  94. Do you often forget what you’re going to say just as you’re about to say it?

  95. Do you love to travel?

  96. Are you claustrophobic?

  97. Have you ever wondered if you’re crazy?

  98. Do you get the gist of things very quickly?

  99. Do you laugh a lot?

  100. Did you have trouble paying attention long enough to read this entire questionnaire?

  8

  What Can You Do About It?

  THE TREATMENT OF ADD

  General Principles of Treatment

  Most people who discover they have ADD, whether children or adults, have suffered a great deal of pain. The emotional experience of ADD is filled with embarrassment, humiliation, and self-castigation. By the time the diagnosis is made, many people with ADD have lost confidence in themselves. Many have been misunderstood repeatedly. Many have consulted with numerous specialists, only to find no real help. As a result, many have lost hope.

  Individuals with ADD may have forgotten what is good about themselves. They may have lost any sense of the possibility of things working out. They are often locked into a kind of tenacious holding pattern, needing all their considerable resiliency and ingenuity just to keep their heads a
bove water.

  And yet their capacity to hope and to dream is immense. More than most people, individuals with ADD have visionary imaginations. They think big thoughts and dream big dreams. They can take the smallest opportunity and imagine turning it into a major break. They can take a chance encounter and turn it into a grand evening out.

  But like most dreamers, they go limp when the dream collapses. Usually, by the time an individual seeks help, this collapse has happened often enough to leave them wary of hoping again.

  Hope begins with the diagnosis. More than with most disorders, often just the making of the diagnosis of ADD exerts a powerful therapeutic effect. The walls of years of misunderstanding come crashing down under the force of a lucid explanation of the cause of the individual’s problems.

  While with other medical conditions the diagnosis directs the treatment, with ADD, to a large extent, the diagnosis is the treatment. The diagnosis brings great relief in and of itself. For example, if you were nearsighted and had never heard of nearsightedness, and for years you had thought your blurry vision and subsequent learning problems were due to lack of effort or moral turpitude, imagine your relief in discovering that there was this condition called nearsightedness, and it had nothing to do with effort or morality, but rather was a neurological condition. So it is with ADD. The diagnosis is liberating.

  Everything else in the treatment evolves logically from an understanding of the diagnosis.

  EDUCATION

  Once the diagnosis has been made, the next step is to learn as much as possible about the condition. The more you know, the better you will be able to construct your treatment to meet your own needs, and the better able you will be to understand your life story in terms of ADD. Effective treatment often requires a radical rethinking of your view of yourself. Understanding the many forms ADD takes will help you not only to recognize how it affects you, but also to explain the syndrome to those around you—family, friends, colleagues, teachers.

  The ability to educate those around you is crucial. ADD has a deep social impact: it affects your home, work, or school environments, as well as your internal life. You need to be able to explain what is going on inside you to those who share the world you move in. For example, if you are able to explain what ADD is to your boss in terms that he or she can understand and sympathize with, you may be able to greatly improve the conditions under which you work. Similarly, if you can explain ADD to your spouse or partner in human terms, you may be able to put the relationship on a whole new footing. In general, the ability to advocate for yourself intelligently is crucial in the successful management of a life with ADD, and it depends upon knowing as much as possible about the syndrome.

  As you learn about ADD, you change yourself. You give yourself a power you never had before, and the power resides in the knowledge. Your knowledge becomes a part of you and silently, subtly works to move you to a new place.

  The treatment of ADD is not passive, not something one reclines to receive. Rather, the treatment is an active process involving work and study.

  In adults the process of education is straightforward: through reading, attending lectures, talking to experts and to others who have ADD, you gradually learn as much as you can about it. In children, however, the process raises questions in most parents’ and teachers’ minds. How much do we tell a child? At what age is he or she old enough to know what ADD is? Should other children in the class know if one child has it? What if the child thinks the diagnosis really means he or she is stupid? How much should a child know about medication?

  These are difficult questions. There is no “right” answer. However, based on extensive experience with many children, families, and schools, I have found the following principle to be the best guide: tell the truth.

  Telling the truth to the child, and to the school, helps de-stigmatize ADD. It helps normalize the syndrome. By not requiring one to skip over certain points or invent childlike euphemisms, it also allows one to convey the information in the simplest and most accurate way. Instead of resorting to some disguised version of the truth—which the child can usually see through anyway, and which conveys a message of secrecy and danger—telling the truth implies there’s nothing to hide, nothing to fear, nothing to be ashamed of.

  When I explain ADD to a child, I usually do so in the presence of one or both parents. I do not use a script, but a typical introduction to ADD might go like this (bear in mind that throughout I pause frequently for questions and I make sure the child does ask a question or two; it is a complete waste of time to deliver a monologue to children with ADD—they stop listening after two sentences):

  As you know, Jimmy, you and your mom and dad have been coming here to talk about how things are going at home and at school. I have found out something about you that I think will help you. We have talked about what school is like for you, and you have told me that you have a lot of trouble paying attention and listening and that you like to look out the window and that it is hard for you to sit still and wait in line and raise your hand and all those kinds of things. Boy, do I know how you feel. Do you know why that is? It is because both you and I have something called attention deficit disorder.

  Attention deficit disorder, or ADD, is sort of like being nearsighted and needing glasses, except the nearsightedness isn’t in our eyes. It’s in how we think. We need glasses for how we think, to help us focus our attention so we won’t daydream so much or change the subject so much or forget things so much or have so much trouble getting organized in the morning or after class.

  Having ADD does not mean we are stupid. Lots of really smart people have had ADD, like Thomas Edison and Mozart and Einstein and the actor Dustin Hoffman—do you know who he is? What we people with ADD do need is special help—like glasses—so we can do the best we can. Only the special help we need isn’t glasses exactly, but other things that help us focus and get organized. Sometimes lists, reminders, and schedules help us. Sometimes a tutor or a coach can help. And sometimes medication can help.

  Lots of other kids have ADD. If anyone asks you about it, it is up to you what you want to tell them, but remember, there is nothing wrong with having ADD, any more than there is anything wrong with wearing glasses.

  I try to be as simple and honest as possible. I believe what I say: there is nothing wrong with having ADD, and there is nothing to be ashamed of. Most children take some time to get used to the idea of having ADD. Most children are ashamed or embarrassed at first. However, I have found that the sooner the topic can be brought out into the open and all questions addressed clearly, the sooner the condition can be accepted by the child as just another part of his or her everyday life.

  I give the same advice to classroom teachers. Tell the truth. If a child is receiving special treatment for ADD, the other kids should be told about this and told why. The other children will notice something is going on anyway; they might as well know what it is. Otherwise the treatment will be shrouded in secrecy, and secrecy always implies there is something to hide. I suggest that the teacher first of all get the permission of the parents and the child, and then explain to the class what ADD is, and what special treatment the child will be receiving, such as sitting close to the teacher, taking untimed tests, having permission to leave the classroom when he or she feels overstimulated or to get medication if that is part of the regimen, receiving individualized homework assignments, and so forth. Since an individualized classroom treatment plan should be set up for the child with ADD anyway, and since the other children will notice it, it is best if they have an accurate explanation for it, rather than allowing the rumor mill to generate an inaccurate one. Furthermore, it is almost certain that other children in the class will have either ADD or some other form of learning disorder. The sooner these conditions can be normalized and understood for what they are, the better for everyone.

  These suggestions to parents and teachers for explaining ADD to children are summarized as follows:

  TEN TIPS FOR PAR
ENTS AND TEACHERS ON EXPLAINING ADD TO CHILDREN

  1. Tell the truth. This is the central, guiding principle. First, educate yourself about ADD, then put what you have learned into your own words, words the child can understand. Don’t just hand the child a book or send the child off to some professional for an explanation. Explain it to yourself, after you have learned about it, then explain it to the child. Be straightforward and honest and clear.

  2. Use an accurate vocabulary. Don’t make up words that have no meaning, or use inaccurate words. The child will carry the explanation you give him wherever he or she goes.

  3. The metaphor of nearsightedness is a useful one to use in explaining ADD to children. It is accurate and emotionally neutral.

  4. Answer questions. Ask for questions. Remember, children often have questions you cannot answer. Don’t be afraid to say you don’t know. Then go find the answer. Books by professionals who deal with ADD are good sources of information; see, for example, Paul Wender’s Hyperactive Children, Adolescents, and Adults, and Russell Barkley’s Attention Deficit Hyperactivity Disorder, and CHADD (Children with Attention Deficit Disorders), a national organization devoted to educating parents, teachers, and professionals about ADD (CHADD, www.chadd.org; 8181 Professional Place-Suite 150, Landover, MD 20785; telephone: 301-306-7070).

  5. Be sure to tell the child what ADD is not: stupidity, retardation, defectiveness, badness, etc.

  6. Give examples of positive role models, either from history, such as Thomas Edison, or from personal experience, like a family member (Mom or Dad?).

  7. If possible, let others know the child has ADD. Let the others in the classroom know (after discussing this with the child and parents), and let others in the extended family know. Again, the message should be that there is nothing to hide, nothing to be ashamed of.

  8. Caution the child not to use ADD as an excuse. Most kids, once they catch on to what ADD is, go through a phase of trying to use it as an excuse. ADD is an explanation, not an excuse. They still have to take responsibility for what they do.

  9. Educate others. Educate the other parents and children in the classroom. Educate members of the extended family. The single strongest weapon we have to ensure that children get proper treatment is knowledge. Spread the knowledge as far as you can; there is still a great deal of ignorance and misinformation out there about ADD.