CHAPTER 1

Understanding ADD

ADD is in the news almost daily. Questions such as "Isn't ADD just a cop-out forsomeone who is lazy?" or "We all have problems with attention at one time oranother—so, what's the big deal?" or "Is there really such a thing asADD?" are bandied about on talk shows, in newspapers, and at cocktail parties.

The answer to the last question is yes, there is such a thing as ADD. It's notjust a cop-out for anyone who is lazy. In fact, people with ADD often workharder than anyone else to meet their responsibilities at home and at work.Although there is no blood test for ADD (as is also true for bipolar disorder orobsessive-compulsive disorder), you can find out whether you have it throughcareful neuropsychological evaluation.

ADD is considered a neurological disorder, and recent research on the brain hasidentified regions in the prefrontal cortex that are smaller or less active thannormal in people with ADD. There is also a tendency for ADD to be genetic. Infact, you may have discovered your ADD after your son or daughter was diagnosedwith it in school.

It is estimated that about 4 percent of the adult population of the UnitedStates, or 8 million people, have ADD. So, you are not the only one in the worldwho is distracted and/or disorganized! In addition, a large proportion of therest of us have had problems with attention and organization at one time oranother. Some of these problems are due to the crazy world in which we live,which demands so much of us. Often we are trying to do two (or more) things atonce (such as trying to be the best parents we can be while doing more thanwhat's required of us at work). We have even coined a new word for this:multitasking. However, the more we try to multitask, the more we will haveproblems with attention: focusing it, sustaining it, and screening outdistractions. If you have ADD, you may think you can multitask successfully, butit is essentially impossible.

In addition, the older we get, the more difficulty we have focusing ourattention. This begins to happen in our forties (about the same time we begin toneed glasses for reading). Problems with attention and organization are notunique to people with ADD, but if you have ADD, these problems will be greaterin intensity and can seriously interfere with your life. Many people with ADDare underemployed or unemployed, or frequently change jobs. They are more likelyto suffer from stress and depression, have low aspirations for themselves, andoften feel "dumb."

It's important to understand that having ADD does not make you any less smartthan other people. Most people with ADD have at least average intelligence, andothers are even gifted. However, it is often the tasks of daily living that cantrip you up.

For example, Hannah, an accomplished painter, totaled her last car because sheforgot to check the oil and the engine seized up (she also forgot to renew herdriver's license). Dwight, a respected teacher, keeps losing money because itoften falls out of his pocket, in which he shoves it without thinking. Dan, aplant manager, can't find his keys in the morning. Milly, who operates her ownbusiness, can't find her car. The stories from our coaching sessions areendless.

Recognizing Symptoms

Most of the world tends to think that having ADD means having problems withattention and distractibility, period. However, if you have ADD, you may alsoexperience many subtle problems of which you might not be aware. These includethe following:

• Acting or speaking impulsively, without thinking

• Difficulty making decisions

• Restlessness

• Difficulty solving problems and thinking clearly

• Disorganization at work and at home

• Frequently losing things

• Poor sense of time

• Easily becoming frustrated or angered

• Difficulty following rules or waiting in line

• Difficulty keeping a job

• Difficulty keeping friends

• Alcoholism and drug abuse

As if this were not enough, people with ADD often develop emotional problems dueto their history of school failure and/or under-achievement. Add to that thefrustration and anxiety that can come with constantly trying to be successful ina world that seems to often misunderstand you and not give you enough time tothink things through. The good news is that nobody has all of these problems, oreven most of them!

You need to understand which problems you do have, and when and in whatsituations they occur. Often problems with attention are situation specific. Forexample, you may have difficulty paying attention when you are bored, but, boy,when you are doing something that interests you, you can work on it for hours.

Many of us have problems with attention or organization. Does this mean we haveADD? Not necessarily. Unless these problems greatly interfere with your life,you probably don't have ADD.

Getting a Diagnosis: How to Tell If You Have ADD

Evaluations for ADD usually begin with a checklist in which you examine all thesymptoms you may be having. If your physician doesn't have such a checklist, goto a licensed psychologist or social worker who specializes in ADD. If theanswers on the checklist point to ADD, you may want to go one step further. Anin-depth neuropsychological evaluation can uncover what your specificdifficulties are—whether you have problems with working memory, or youprocess information slowly, or you have dyslexia. This type of evaluation cangive you a good picture of your-self—highlighting your strengths and yourweaknesses. ADD can make you feel confused and frustrated because your troublesdo not make sense to you. For example, you feel in your bones that you're smart,but you're not making the grade. Often it is only with a comprehensiveevaluation that the subtle yet complex problems underlying these difficultiescan be isolated.

In addition, you may want an official diagnosis of ADD in order to becomeeligible for support and accommodations under the Americans with DisabilitiesAct (ADA). Accommodations in the workplace can help you maximize your strengthswhile bypassing your weaknesses. Here are some examples of accommodations:

• Arranging for you to have a distraction-free workstation

• Requiring you to read...