ADDvice from a Certified ADHD Non-Expert

Okay, so you are an adult who has been diagnosed with Attention Deficit Disorder. You have been given a prescription for medicine, and you've read the bible according to Drs. Hallowell and Ratey. For me, after my initial sense of relief subsided, I asked myself an important question.WHAT DO I DO NOW??

Before I offer my wisdom on this subject, let me qualify my remarks by saying that I am not a health care professional. I am not qualified to offer professional advice on this neuro-psychiatric condition and/or its treatment. I am, however, an adult with ADHD (ADDult) who wishes to share some coping strategies that work for me and to offer encouragement to those of you still searching.

Medication can make a big difference in focusing, staying on-task and reducing distractions. But it only does so much. Perhaps the biggest disappointment of medication is that it initially gives a false sense of security. After the "Honeymoon" period, I realized that there was a lot of hard work ahead of me. When I first began medicine, over a year and a half ago, my initial response was nothing less than astounding. I felt focused, driven and productive. It took awhile to get the correct medicine, dose and dosing regime; but, eventually, my doctor and I found the right combination for a consistent result. Unfortunately, I also realized that there are many facets of ADHD not "cured" by medicine and that my challenges were just beginning.

After reading anything and everything that I could about ADHD and taking my medication religiously, I got frustrated when I would find myself in situations that had ADHD written all over them. On the one hand, the education I got from my reading and research, helped me to understand why this happened. On the other hand, having my ADHD diagnosis, medication and education, made it all the more frustrating. I became my own worst critic. I constantly beat myself up, thinking, "I should know better now" or "This should not be happening to me". This is a very easy and frustrating trap to fall into. The only thing to do is to shake off these thoughts and keep plugging away.

I believe that, while medication is invaluable in the treatment of Attention Deficit Disorder, its role is a limited one. Medication is an important and necessary tool which someone with ADHD to cope with day-to-day living. But in order to truly benefit from medication, it is important to understand its limitations. I explored and examined the mechanisms which I used to cope with ADHD prior to my diagnosis. After all, these coping skills got me through thirteen years of Catholic school, college and law school. I looked back at these strategies to understand what worked for me in the past and might work for me in the future. Hopefully, my medication and my education can aid me in identifying these strategies, and maybe, even improve on them.

Despite the frustrations attending a Catholic elementary school, the highly structured and inflexible environment was very helpful in keeping me moving forward. Unfortunately, this same environment wreaked havoc on an already low self-esteem and low self-confidence. I believe that people with ADHD need structure to point us in the right direction and to push us forward. There is nothing worse than the paralysis I often felt as a child when I didn't know what to do next...In a highly structured situation, the consequences of inaction or mistakes were severe enough to keep me moving. I imagine that life in the military would work the same way. I only wish I had that structure at home. Homework was impossibility as I was left to flounder. Then there was the horrible anxiety of each report card and the punishments that followed.

I examined my academic career to see what methods I had used in the past to cope with my difficulty focusing and comprehending my class work. I remembered that in college, especially during the semesters when I did my best, physical exercise was a major part of my daily routine. Not only did I find that it helped me focus, but the discipline of doing it regularly carried over into my school work. I also remembered that when I was most stressed out, I would run. If something was on my mind, I would run, regardless of what time of day it was-- 11 p.m., midnight or the crack of dawn. During my runs, I found solitude. I was able to think clearly. I could work through the stress and sort out my mind.

Many time management and organizational books advocate dedicating a portion of your day to organizing your desk space and filing. Running was my time to organize and file the chaos in my mind. Physical fitness was the last thing on my mind during those runs. I literally needed to take my mind out for a run. In fact, I never thought of running as exercise. I worked out at the gym for exercise.

I have re-discovered running, and it has brought a new sanity to my life. I wake up at 5 a.m. three days a week. I run for about an hour, hopefully in the dark, and always alone. It accomplishes many things for me. It clears my head, organizes my thoughts and maps out my day. It does something even more important for my ADHD. I have always felt plagued by the lack of control over my life. Feelings of no control of us or our lives are common symptoms of ADHD. My run is MY time, period. For that hour, three days a week, I am the master of my own universe. It may not be much, but it's mine, and I look forward to it.

Running helps me in other ways as well. It sets a positive tone for my day. The discipline of going out religiously carries over into the rest of my life. I find that habits, once formed, are easy to maintain. We are, after all, creatures of habit. One problem with ADDults is that, all too often, our ADHD was undiagnosed in childhood. As a result, we rarely developed good habits as children. This makes our lives much more difficult now.

Does this mean that running is a cure for ADHD? Hardly! Does this mean that it will benefit every one who reads this article? Probably not. The important thing is that it appears to have an effect for me. Each of us is different, yet we have a common theme of concerns. The important thing is to FIND WHAT WORKS FOR YOU AND MAKE IT PART OF YOUR LIFE.

Another technique I discovered in college that helped me cope with my terrible reading comprehension was to wear earplugs. For inattentive types, like me, the ability to read anything is virtually impossible. The ADHD mind wanders quickly, either out of boredom or because it is distracted by external stimuli. A friend who works in an accounting office introduced me to foam earplugs. They were distributed in her office to aid employees in reading difficult (and boring) portions of the tax code. I tried them and was amazed at my ability to literally climb into whatever I was reading. I could create an artificial tunnel in which to focus on my task. From that day on, I always carried a pair of earplugs in my book bag. I wore earplugs in all of my exams. With the earplugs I could completely shut out the rest of the world and concentrate on the task at hand. Years later, during the bar exam, I had several pairs of ear plugs and made good use of them during the two day test. I don't know if I could have gotten through without them.

The problem with earplugs is that the modern office environment is not conducive to completely shutting yourself off from the rest of the world. Phones ring. People drop into your office. This presented a difficult problem for me. A modified solution is to play music in my office during the day. This helps me concentrate. Not just any music. I play instrumental music, either classical music, Spanish guitar or some other type of background music. It aids me tremendously in staying focused. I have heard of studies that demonstrate certain types of music promote focus and attention, often referred to as the "Mozart effect". The term is very interesting in that Mozart himself is thought to have ADHD.

I do not know why the background music works, but I have my theories. Perhaps, the music serves as a white noise which filters out distractions and keeps me on-task. Perhaps, the music proves to be more boring than the task at hand, thereby inducing concentration. Perhaps, the music occupies the part of my mind that tends to wander. I prefer this last explanation most of all. I visualize the inattentive child inside of my head. I picture that the music entertains him and allows me to concentrate. Whatever the reason, it doesn't matter. It works for me, so I do it.

Another thing that helps me to cope with my ADHD is to outline EVERYTHING. I always try, if possible, to think in terms of outlines. It is so important for me to visualize a hierarchy of things, if for no other reason, than it organizes the chaos in my brain. For some reason, if I understand how different facts fit together, something clicks, and my brain will retain it forever. Outlining puts the pieces together and establishes their relationship. As a trial lawyer this is very helpful to me. When I am on trial, I outline the case—every aspect of it. The weird thing is—when I am actually on trial and in front of the jury—I rarely use my outlines. They serve as an organizational tool in preparing my thoughts before hand. Once I stand to address the Court or the Jury, my free flow and my ADHD (the good part of my ADHD) take over. It is like turning on a faucet. Only now, my flow has direction and a solid foundation.

In preparing for trials I developed another coping mechanism. Interestingly enough, it grew directly out of my disorganization. Early in my career, I was plagued by disorganization. I believed I had good instincts in the courtroom, but they were masked by a mountain of papers in front of me. I was concerned that my chaos was being translated into a lack of confidence in me as an advocate. Perception being everything, I had to find a solution. I devised a system. I developed my unique form of a trial notebook. It kept everything at my fingertips. It was perfect. I could put my outlines in it. I could put all of the reports and exhibits inside this notebook so I could find everything at a moment's notice. I bought some transparent sheet protectors and put all of the relevant reports in chronological order inside. They were labeled and indexed. I was not only organized inside courtroom, but more importantly, preparing the notebook, was much like the map that I made for myself when I outlining. The notebook helped me organize the case in my head before having to perform in the courtroom. It served as a solid foundation for the time in front of the jury when my ADHD would take over.

Strangely enough, when my adversaries and colleagues would see me flipping through my notebook, they would say things like "Wow, I wish I could be organized like that" or "You must be one of those super organized people." I always laugh when I hear that.

My trial notebook evolves with every case I try. Perhaps the evolution of the system keeps it fresh and exciting. As ADDults we need to keep things fresh and exciting. Always remember that boredom is our sworn enemy. Like my notebook, these coping skills will develop if you keep at it. Find what works for you and do it. Keep it as simple as possible. If it is difficult at all, chances are you will not do it, or you won't stick with it. Keep it easy and keep it fun.

The search for optimal functioning never ends, but it gets easier, as you start to develop coping skills and make them part of a routine. Once you find something that works for you, think about why and how it worked. I guarantee it will lead you to another workable idea. Remember, like medication, know your limitations, work around them and capitalize on your strengths. Trust me, you have many. Good luck-- and remember-- there are others out there, just like you.

Robert M. Tudisco is a practicing attorney and freelance writer. He is also an adult diagnosed with ADHD. He is the Coordinator for the Westchester County Chapter of CHADD in New York. He is an avid runner and lives with his wife and young son in Eastchester New York. Robert welcomes comments and questions at his website www.ADDcopingskills.com.

This article was first published in Attention! magazine, September/October 2000.

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