Driven to Distraction (Revised)

by Edward M. Hallowell

  4. Seek encouragement. ADD adults need lots of encouragement. This is in part due to many self-doubts that have accumulated over the years. But it goes beyond that. More than most people, ADD adults wither without encouragement and thrive when given it. They will often work for another person in a way they won’t work for themselves. This is not “bad,” it just is. It should be recognized and taken advantage of.

  5. Realize what ADD is not—i.e., conflict with mother, unconscious fear of success, passive-aggressive personality, etc. People with ADD, of course, may have a conflict with their mother or an unconscious fear of success or have a passive-aggressive personality, but it is important to separate the ADD from these other kinds of problems because the treatment for ADD is completely different.

  6. Educate and involve others. Just as it is key for you to understand ADD, it is equally if not more important for those around you to understand it—family, job, school, friends. Once they get the concept, they will be able to understand you much better and to help you reach your goals.

  7. Give up guilt over high-stimulus-seeking behavior. Understand that you are drawn to intense stimuli. Try to choose them wisely, rather than brooding over the “bad” ones.

  8. Listen to feedback from trusted others. Adults (and children, too) with ADD are notoriously poor self-observers. They use a lot of what can appear to be denial.

  9. Consider joining or starting a support group. Much of the most useful information about ADD has not yet found its way into books but remains stored in the minds of the people who have ADD. In groups this information can come out. Plus, groups are really helpful in giving the kind of support that is so badly needed.

  10. Try to get rid of the negativity that may have infested your system if you have lived for years without knowing that what you had was ADD. A good psychotherapist may help in this regard.

  11. Don’t feel chained to conventional careers or conventional ways of coping. Give yourself permission to be yourself. Give up trying to be the person you always thought you should be—the model student or the organized executive, for example—and let yourself be who you are.

  12. Remember that what you have is a neurological condition. It is genetically transmitted. It is caused by biology, by how your brain is wired. It is not a disease of the will, nor a moral failing, nor some kind of neurosis. It is not caused by a weakness in character, nor by a failure to mature. Its cure is not to be found in the power of the will, nor in punishment, nor in sacrifice, nor in pain. Always remember this. Try as they might, many people with ADD have great trouble accepting the syndrome as being rooted in biology rather than weakness of character.

  13. Try to help others with ADD. You’ll learn a lot about the condition in the process, as well as feel good to boot.

  PERFORMANCE MANAGEMENT

  14. Establish external structure. Structure is the hallmark of the nonpharmacological treatment of the ADD child. It can be equally useful with adults. Once in place, structure works like the walls of the bobsled slide, keeping the speedball sled from careening off the track. Make frequent use of lists, notes to self, color coding, rituals, reminders, files. Also use pattern planning, as described earlier.

  15. Use pizzazz. Try to make your environment as peppy as you want it to be without letting it boil over. If your organization system can be stimulating (imagine that!), instead of boring, then you will be more likely to follow it. For example, in setting things up, try color coding. Mentioned above, color coding deserves emphasis. Many people with ADD are visually oriented. Take advantage of this by making things memorable with color: files, memoranda, texts, schedules, etc. Virtually anything in the black-and-white of type can be made more memorable, arresting, and therefore attention-getting with color.

  16. When it comes to paperwork, use the principle of O.H.I.O: Only Handle It Once. When you receive a document or a memo or any kind of written material, try to only handle it once. Either respond to it right away, on the spot, or throw the document away, or file it permanently. Do not put it in a TO DO box or pile. For people with ADD, TO DO piles might just as well be called NEVER DONE piles. They serve as little menaces around one’s desk or room, silently building guilt, anxiety, and resentment, as well as taking up a lot of space. Get in the habit of acting immediately on your paperwork. Make the wrenching decision to throw something away. Or, overcome inertia and respond to it on the spot. Whatever you do with the document, whenever possible, only handle it once.

  17. Set up your environment to reward rather than deflate. To understand what a deflating environment is, most adult ADDers only need to think back to school. Now that you have the freedom of adulthood, try to set things up so that you will not constantly be reminded of your limitations.

  18. Acknowledge and anticipate the inevitable collapse of X percent of projects undertaken, relationships entered into, obligations incurred. Better that you anticipate these “failures” rather than be surprised by them and brood over them. Think of them as part of the cost of doing business.

  19. Embrace challenges. ADD people thrive with many challenges. As long as you know they won’t all pan out, as long as you don’t get too perfectionistic and fussy, you’ll get a lot done and stay out of trouble. Far better that you be too busy than not busy enough. As the old saying goes, if you want to get something done, ask a busy person.

  20. Make deadlines.

  21. Break down large tasks into small ones. Attach deadlines to the small parts. Then, like magic, the large task will get done. This is one of the simplest and most powerful of all structuring devices. Often a large task will feel overwhelming to the person with ADD. The mere thought of trying to perform the task makes one turn away. On the other hand, if the large task is broken down into small parts, each component may feel quite manageable. (For example, it was only by using this technique that we managed to write this book.)

  22. Prioritize rather than procrastinate. If you cannot handle it only once (tip 16), then be sure to prioritize. When things get busy, the adult ADD person loses perspective: paying an unpaid parking ticket can feel as pressing as putting out the fire that just got started in the wastebasket. Sometimes one becomes paralyzed. Prioritize. Take a deep breath. Put first things first. Then go on to the second and the third task. Don’t stop. Procrastination is one of the hallmarks of adult ADD. You have to really discipline yourself to watch out for it and avoid it.

  23. Accept the fear of things going too well. Accept edginess when things are too easy, when there’s no conflict. Don’t gum things up just to make them more stimulating.

  24. Notice how and where you work best: in a noisy room, on the train, wrapped in three blankets, listening to music, whatever. Children and adults with ADD can do their best under rather odd conditions. Let yourself work under whatever conditions are best for you.

  25. Know that it is OK to do two things at once: carry on a conversation and knit, or take a shower and do your best thinking, or jog and plan a business meeting. Often people with ADD need to be doing several things at once in order to get anything done at all.

  26. Do what you’re good at. Again, if it seems easy, that is OK. There is no rule that says you can only do what you’re bad at.

  27. Leave time between engagements to gather your thoughts. Transitions are difficult for ADDers, and minibreaks can help ease the transition.

  28. Keep a notepad in your car, by your bed, and in your pocketbook or jacket. You never know when a good idea will hit you, or you’ll want to remember something else.

  29. Read with a pen in hand, not only for marginal notes or underlining, but for the inevitable cascade of “other” thoughts that will occur to you.

  MOOD MANAGEMENT

  30. Have structured “blow-out” time. Set aside some time in every week for just letting go. Whatever you like to do—blasting yourself with loud music, taking a trip to the racetrack, having a feast—pick some kind of activity from time to time where you can let loose in a safe way.

  31. R
echarge your batteries. Related to number 30, most adults with ADD need, on a daily basis, some time to waste without feeling guilty about it. One guilt-free way to conceptualize it is to call it time to recharge your batteries. Take a nap, watch TV, meditate. Something calm, restful, at ease.

  32. Choose “good,” helpful addictions, such as exercise. Many adults with ADD have an addictive or compulsive personality such that they are always hooked on something. Try to make this something positive.

  33. Understand mood changes and ways to manage these. Know that your moods will change willy-nilly, independent of what’s going on in the external world. Don’t waste your time looking for someone to blame. Focus rather on learning to tolerate a bad mood, knowing that it will pass, and learning strategies to make it pass sooner. Change sets, i.e., get involved with some new activity (preferably interactive), such as a conversation with a friend, or a tennis game, or reading a book.

  34. Related to number 33, recognize the following cycle, which is very common among adults with ADD:

  a. Something “startles” your psychological system, a change or transition, a disappointment or even a success. The precipitant may be quite trivial, nothing more than an everyday event.

  b. This “startle” is followed by a minipanic with a sudden loss of perspective, the world being set topsy-turvy.

  c. You try to deal with this panic by falling into a mode of obsessing and ruminating over one or another aspect of the situation. This can last for hours, days, even months.

  To break the negative obsessing, have a list of friends to call. Have a few videos that always engross you and get your mind off things. Have ready access to exercise. Have a punching bag or pillow handy if there’s extra angry energy. Rehearse a few pep talks you can give yourself, like, “You’ve been here before. These are the ADD blues. They will soon pass. You are OK.”

  35. Learn how to name your feelings. Many people with ADD, particularly men, get frustrated and angry because they cannot put their feelings into words. With practice and coaching, this is a skill that can be learned.

  36. Expect depression after success. People with ADD commonly complain of feeling depressed, paradoxically, after a big success. This is because the high stimulus of the chase or the challenge or the preparation is over. The deed is done. Win or lose, the adult with ADD misses the conflict, the high stimulus, and feels depressed.

  37. Learn symbols, slogans, sayings as shorthand ways of labeling and quickly putting into perspective slip-ups, mistakes, or mood swings. When you turn left instead of right and take your family on a twenty-minute detour, it is better to be able to say, “There goes my ADD again,” than to have a six-hour fight over your unconscious desire to sabotage the whole trip. These are not excuses. You still have to take responsibility for your actions. It is just good to know where your actions are coming from and where they’re not.

  38. Use “time-outs,” as with children. When you are upset or overstimulated, take a time-out. Go away. Calm down.

  39. Learn how to advocate for yourself. Adults with ADD are so used to being criticized, they are often unnecessarily defensive in putting their own case forward. Learn to get off the defensive.

  40. Avoid premature closure of a project, a conflict, a deal, or a conversation. Don’t “cut to the chase” too soon, even though you’re itching to.

  41. Try to let a successful moment last and be remembered and become sustaining over time. You’ll have to train yourself consciously and deliberately to do this because you’ll naturally tend to forget your successes as you brood over your shortcomings or pessimistically anticipate the worst.

  42. Remember that ADD usually includes a tendency to overfocus or hyperfocus at times. This hyperfocusing can be used constructively or destructively. Be aware of its destructive use: a tendency to obsess or ruminate over some imagined problem without being able to let it go.

  43. Exercise vigorously and regularly. You should schedule exercise into your life and stick with it. It helps you work off excess energy and aggression in a positive way, it allows for noise reduction within the mind, it stimulates the hormonal and neurochemical system in a most therapeutic way, and it soothes and calms the body. When you add all that to the well-known health benefits of exercise, you can see how important exercise is. Make it something fun so you can stick with it over the long haul, i.e., the rest of your life. One particular form of exercise, sexual activity, is very good for ADD.

  INTERPERSONAL LIFE

  44. Make a good choice in a significant other. Obviously, this is good advice for anyone. But it is striking how the adult with ADD can thrive or flounder depending on the choice of mate.

  45. Learn to joke with yourself and others about your various symptoms, from forgetfulness to getting lost all the time to being tactless or impulsive. If you can bring a sense of humor to your failings, others will forgive you much more quickly.

  46. Schedule activities with friends. Adhere to these schedules faithfully. It is crucial for you to keep connected to other people.

  47. Find and join groups where you are liked, appreciated, understood, enjoyed. Even more than most people, people with ADD take great strength from group support.

  48. Don’t stay too long where you aren’t understood or appreciated. Just as people with ADD gain a great deal from supportive groups, they are particularly drained and demoralized by negative groups, and they have a tendency to stay with them too long, vainly trying to make things work out, even when all the evidence shows they can’t.

  49. Pay compliments. Notice other people. In general, get social training if you’re having trouble getting along with people.

  50. Set social deadlines. Without deadlines and dates your social life can atrophy. Just as you will be helped by structuring your business week, so, too, you will benefit from keeping your social calendar organized. This will help you stay in touch with friends and get the kind of social support you need.

  While the tips above refer to treatment in adults, they are also applicable to children and adolescents in many instances. However, there is an important area the tips do not touch upon in the treatment of children, namely the classroom management of ADD. For children with ADD to do well, it is imperative that their teacher understand what ADD is and know how to work with these children in the classroom. The classroom experience can make or break the self-esteem, as well as the intellectual foundation, of children with ADD.

  To assist in the classroom, we offer fifty tips written for ADD children in school. Since these tips were written explicitly for the classroom teacher, you may find it useful to share them with your child’s school.

  Teachers recognize what many professionals do not: that there is no one syndrome of ADD, but many; that ADD rarely occurs in “pure” form by itself, but rather usually shows up entangled with several other problems, such as learning disabilities or mood problems; that the face of ADD changes with the weather, that it’s inconstant and unpredictable; and that the treatment for ADD, despite what may be serenely elucidated in various texts, remains a task of hard work and devotion. The effectiveness of any treatment for this disorder at school depends upon the knowledge and the persistence of the school and the individual teacher.

  The following suggestions are intended for teachers of children of all ages. Some suggestions will be obviously more appropriate for younger children, others for older, but the unifying themes of structure, education, and encouragement pertain to all.

  FIFTY TIPS ON THE CLASSROOM MANAGEMENT OF ADD

  1. First of all, make sure what you are dealing with really is ADD. It is definitely not up to the teacher to diagnose ADD, but you can and should raise questions. Specifically, make sure someone has tested the child’s hearing and vision recently, and make sure other medical problems have been ruled out. Make sure an adequate evaluation has been done. Keep questioning until you are convinced. The responsibility for seeing to all of this is the parents’, not the teacher’s, but the teacher can support the pro
cess.

  2. Build your support. Being a teacher in a classroom where there are two or three kids with ADD can be extremely tiring. Seek the support of the school and the parents. Find a knowledgeable person with whom you can consult when you have a problem. (Learning specialist, child psychiatrist, social worker, school psychologist, pediatrician—the person’s degree doesn’t really matter; what matters is that he or she knows much about ADD, has seen many children with ADD, knows his or her way around a classroom, and can speak plainly). Keep in touch with the parents to ensure you are working toward the same goals. Call on your colleagues for help.

  3. Know your limits. Don’t be afraid to ask for help. You, as a teacher, cannot be expected to be an expert on ADD. You should feel comfortable in asking for help when you feel you need it.

  4. Ask the child what will help. Children with ADD are often very intuitive. They can tell you how they can learn best, if you ask them. They are often too embarrassed to volunteer the information because it can be rather eccentric. But try to sit down with the child individually and ask how he or she learns best. The most insightful “expert” on how the child learns best is often the child himself or herself. It is amazing how often their opinions are ignored or not asked for. In addition, especially with older children, make sure the child understands what ADD is. This will help both of you.

  5. Remember the emotional part of learning. These children need special help in finding enjoyment in the classroom, mastery instead of failure and frustration, excitement instead of boredom or fear. It is essential to pay attention to the emotions involved in the learning process.

  6. Remember that ADD kids need structure. They need their environment to structure externally what they can’t structure internally on their own. Make lists. Children with ADD benefit greatly from having a table or list to refer back to when they get lost in what they’re doing.