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printer friendlyTips and Traps: ADHD Lessons Learned
Thirty years is a long time to survive under the cloud of an incomplete diagnosis, but that had been my life until, at the age of 51, my ADHD was finally uncovered. I doubt I will ever forget my total surprise and shock that June day in 1999 when I received this NEW news. I nearly fell off my chair! Like most of the world, I knew little about ADHD, equating it mostly with unruly little boys running around uncontrolled and disrupting their elementary classrooms. I had a lot to learn.
Since that June day, I have dedicated myself to uncovering and unraveling the REAL me. It's been quite a journey. Fortunately, I have had the advantage of seeing both a psychiatrist and a psychologist/coach who are intimately in tune with the variations in, and consequences of, ADHD in adults.
I recently wrote the following notes for two friends, both of whom are new acquaintances, and new to their own ADHD diagnoses. During the past four years I have, indeed, learned a tremendous amount about living with ADHD, and I wanted to share some of my experiences and thoughts with them, and ease their way a bit. To do so, I included notes on medications, ADHD professionals, reading and knowledge, and the mind-boggling subjects of relationships, and why others tend to judge us harshly.
This is my Letter to Them
Dear Friends,
As promised, I'm relating here some of my thoughts and experiences on ADHD. I hope this is of some help to you, but please keep in mind that while those of us with ADHD have a lot in common, we also are the product of our individual backgrounds, and we have different life circumstances to deal with. This may sound obvious, but I think it emphasizes how important it can be to have one or two ADHD professionals in your corner to help you figure out what's best for you. Our similarities may tie us together, but our differences require each of us to consider our uniqueness in determining which treatments and future life plans are most appropriate.
Notes on Meds, Docs, Therapists, and Other Pros
Unlike you, I had no idea I had ADHD, so I consider myself lucky to have been referred to a psychiatrist who KNEW ADHD. [My old psychiatrist retired; he had been treating me for depression for years; he never recognized the ADHD symptoms.] My old Doc suggested I write up a bit of history on my life for the new guy, so I did. This mini-autobiography gave my new Doc HUGE hints that I had ADHD.
I suggest that you also write down some thoughts about your lives, the good stuff and the bad. I continue to use writing to put my thoughts in order, to jog my memory of the past, and to prevent me from forgetting to mention that really important something when I see my pros. You don't have to write a novel. :)
My doc, the new psychiatrist, sees to my meds. Some people find the right drug or drug combo on the first try. Unfortunately, it's taken me four years to get to my current drug cocktail, by far the most effective I've tried. And yes, it's been a real pain trying to get my drugs right. Increasing doses of this, decreasing that, switching to another, adding in yet another, can be tiring and discouraging. But my multitude of drug trials has been worth it. I'm now taking Strattera, a bit of Adderall XR, and trazadone. The last is an antidepressant, but I use it now mostly as a sleep aid.
Some people DO find the right drug(s) for them the first time around, and only need a couple of tweaks to find the right dose. Many other people find a suitable drug/drug mix after a few weeks or months. Don't expect your own drug trials to last nearly as long as mine.
Fine tuning the dosage is common, and necessary. Sometimes it takes a while to figure out how you are reacting to and/or benefiting from a med/dose. It's not always obvious—like taking aspirin and having your headache go away.
Don't expect to take the exact drugs/dosages/combos that someone else does. What works for them is not necessarily what will work best for you.
Psychiatrists vary greatly in their knowledge of and experience with ADHD and meds. The M.D. designation and their extensive additional training are no guarantee that they are up to date on ADHD. Some doctors have yet to accept ADHD as a legitimate diagnosis in adults. And yes, regrettably, the same holds true for other counselors/therapists.
Find the best you can. Talk to others with ADHD and get their suggestions; use referrals from solid sources.
Editor's Note: The National ADHD Directory can be a starting point.
Some psychiatrists also provide therapy and/or coaching, while others prefer to stick to the meds and have another pro concentrate on the rest. Either way is fine. So which pro should you seek out first? I don't think it matters.
Get to the most experienced adult–ADHD expert you can first, whether this person is a therapist/counselor, coach, or psychiatrist. They should be able to refer you to another pro for additional help, if appropriate.
My psychologist/coach is top notch, but I don't think I would have found him on my own—his office sign says something about ‛Adolescent Counseling.‛ At 55, I hardly thought I'm in that age group! My psychiatrist referred me to this man for coaching and therapy as needed; and he does indeed work with a lot of adults.
So Do You Need a Coach? A Therapist/Counselor?
It all depends. I think a coach is certainly a good idea. They can help you sort through your own ADHD symptoms and figure out new and better ways to cope with your problem areas. They are very positive and provide wonderful, knowledgeable support.
A therapist/counselor is also often a good idea. ADHD has always been influencing your perceptions, thoughts and actions, even if you didn't recognize some of its effects. Typically it prevents you from achieving, succeeding, and/or keeping up with you peers; this is a negative recipe that can devastate your self esteem and confidence, in ways you might not even realize.
Editor's Note: Typically counseling should precede coaching unless you have a therapist trained in both areas who can combine them.
Take it from this experienced lady—I never lived up to my potential, but I didn't know why until I began exploring my ADHD and my life. I had a weird combination of genetically-based negatives, in addition to my ADHD, which I grew up with. Fifty years of UNsuccess did a real job on my head, so it's taken some major therapy to recoup and readjust and (finally) start myself off in the right direction. And I'm still working on recognizing my positives and rebuilding my self confidence. Cautionary note here again; my past life isn't your past life, and vice versa. Pros can help you decide if some therapy would be good/right for you.
My psychologist also serves as my coach, which is great for me. And my therapy hasn't been the old Freudian couch concept. It's been much more direct, which is appropriate for ADHD. Sometimes it's been emotionally tough, but the rewards have been wonderful.
Extensive therapy and/or coaching can be expensive, of course. However, a few hospitals, mental health organizations—private and public—and some individual practitioners offer treatments based on a sliding-fee scale or have other funding alternatives. Don't be afraid to ask.
Notes on ADHD Reading and Knowledge
Many of the effects/symptoms of ADHD can be subtle, and/or don't happen ALL the time, and/or are experienced by EVERYONE, like losing your keys, etc. Figuring out just how your ADHD presents can be a little difficult.
Read all you can. Regardless of which pro types you end up working with, you owe it to yourself to become as well-versed in the twists and turns of ADHD as you can. Your pros can then help you to figure out what is really pertinent to your life, and how to better cope.
There are many good ADHD books and authors. Some books are now several years old, but still excellent in describing ADHD symptoms and effects on your life. Driven to Distraction {Hallowell and Ratey}, Women and ADHD {Sari Solden}, and Adult ADD {Whiteman and Novotni} are a few of my favorites.
Beware of many web sites and chats/postings on ADHD. Some are indeed excellent, but I have personally visited a few with really bad and/or outdated advice and comments.
Notes on Dealing With Other People and Their Judgments.
This is a tough one, and very complicated.
ADHD is an unusual disorder in that many of its key symptoms are experienced occasionally by the entire population. For instance, who hasn't forgotten a date, lost something, missed a comment, daydreamed, said something inappropriate, made a late payment, or lost track of time.
These are all common errors made by normal people, i.e., those without ADHD, and normal people consider these errors to be faults of their own, which they can and should correct. They ‛simply‛ have to be more diligent, more careful, pay attention to what they are doing, more responsible, less sloppy. They expect themselves to properly and adequately moderate their own performance so these errors rarely occur. And mostly they do so.
What ‛normals‛ CANNOT UNDERSTAND is that those of us with ADHD are not simply being irresponsible when WE make these errors, and do so, so often. Normals often judge themselves rather harshly when they err, and they can do the same with others who seem to err in the same or similar manner. After all, it's simply a matter of self control, and thinking things through, and planning, and organizing, and watching the clock. Isn't it? (Ha! We can only wish.)
- How to explain that your brain is the culprit—indeed.
- How to explain that you KNOW what you should do, but often JUST CAN'T DO IT.
- How to explain that your brain doesn't process information as accurately, effectively or completely as theirs does.
- How to explain the ADHD deficits in correctly perceiving, processing, and outputting information.
- How to explain the inconsistency with which you do, and do not, accomplish any given task from day to day, week to week, and month to month.
- How to explain the frustration, and sometimes desperation, you feel when trying to 'live up' to someone else's standards, or 'live down' mistakes you have made.
‛Normals‛ very, very rarely are able to comprehend that your brain is somehow physically different and this prevents you from being as good as you want to be doing—whatever—‛all the time.‛ So they tend to judge, and do so negatively, and do so out of their continuing ignorance. They simply can't understand your real problem. ADHD symptoms runs counter to what they've been taught and personally experienced all their lives. Therefore, it doesn't seem real; it doesn't make sense to them.
So the very people on whom you'd like to count for support aren't able to provide much of it, because they don't understand that, despite your BEST efforts and intentions, you will succeed less often than THEY would if THEY tried to do ‛X.‛ Your relationships suffer.
Your relationships can get to the point when, if you ‛blame‛ your ‛ADHD‛ for not doing ‛X‛, they dismiss your ‛explanation‛ as actually being a ‛faked excuse.‛ You're trying to get out of responsibility, or being difficult, or lazy, or deserving of some other pejorative term. You're being judged, most likely unfairly. Relationships can become otherwise strained; contact can lessen or even end. You can begin judging yourself even more negatively, too. None of these are good results, but all are common results, and hard to avoid.
I've fallen into many of these traps over the past four years. It was easy to do. For a long time I considered this ADHD to be a really fascinating disorder, so I talked—a bit too much—to my friends about me and it. I still consider it to be really fascinating, BUT as my true reality hit home more and more, I began to realize that most of my friends just weren't getting it. I HAD always seemed so normal to them, but now I had excuses for this and that, or made negative self-comments when I had difficulties with whatever. And my difficulties repeated, and my comments repeated, and... Well, I think you can see the point. I quickly passed the point of no return with some friends; they really didn't want to talk much with this negative me, and I was now getting embarrassed about talking with them. This wasn't getting ME anywhere!
So I resolved to keep most of my thoughts and comments to myself and to discussions with my pros—the people who really knew ADHD and could give me the right support and advice. And as I eased off my tales of my trials with my friends, the strains in our relationships, for the most part, eased off as well. But I still struggle, somewhat, to keep my ADDled self, to myself and my pros.
I also still struggle somewhat with maintaining a positive perspective and with recognizing my successes ,no matter how small. Every time I find myself listening to my own negative messages, I do my best to shake them off and turn them around to positives. The more positive talk I give myself, the more likely I am to be positive when in the company of others.
So, Can You talk Frankly and Openly With Anyone?
By trial and with some errors, I did find someone who could withstand the onslaught of my weird and hard-to-comprehend ADHDness. I have a friend whose family has had several members with severe mental illnesses.That experience level, however, is NOT sufficient for determining how well someone will become a true listening friend. Many people with that experience are very negative about any and all head problems, neurobiological or not!!
This lady, however, had been a true mental health advocate for years. We had worked on those causes together, and she had known about my depression for at least a decade, and we had become close friends. So I felt that she would be more capable of at least trying to understand my plight, and more willing to lend an ear, and support if possible. And she has done so. She, alone, hears more of my real trials when we get together, and she has proven to be an excellent listener, and offers her support and positive comments, and asks decent and nonjudgmental questions.
Now, that doesn't mean that she really understands all of this strange ADHD stuff. But I have slowly increased her knowledge level by lending her books and articles, and patiently and completely (as possible) explained the subtle differences in how my brain operates, and made comparisons in real time between her abilities and mine on any given task. She can now, on her own, even make the connections between my ADHD deficits and events in the past when I performed poorly or not at all.
I also, however, make every effort to have normal friendship time with her, times when I totally turn off my self-focus, and devote myself to enjoying the event—dinner, a movie, shopping, even just TV—and concentrate on her needs. ADHD can make you seem awfully needy. You must balance this out, or no friend will stay around for long.
This, then, sums up my experience with friends, and their judgments. None of this has been easy for me, and I don't expect these actions/thoughts to be easy for anyone else either. I just keep trying them out, and practicing, and practicing, and practicing.
And I Offer the Following Advice
- Assume Normals will NOT BE ABLE to understand that your forgetfulness, or whatever, is neurologically based. Many professionals still don't get the realities of ADHD, so why assume a layman will do any better. Remember the child's story of the emperor with no clothes? Don't go out naked.
- Don't call attention to your ADHD symptoms. Of course, anyone may say drats (or something like it) when they lose something, but don't volunteer additional ADDled excuses for your missteps. MOVE ON.
- If you need assistance with some task, try to ask for it in terms other than your deficits. For instance, if you're having a party and think you may skip something vital, write out your plans in advance, and call a friend just to see if they have any other suggestions. Most people like to provide such friendly input.
- The less often you refer to your ADHD while with previously negatively-judgmental peers, the better. Over time, this will ease the tension, and you may well find that you can still be friends. If negatively-judgmental peers just won't let the subject die, perhaps you need to move on from them. If they were a close friend before your ADHD, you might ask them if they can stow the negatives. If they can't/don't, DO move on.
- Try to squash the negative self-talk with yourself as well, but don't ignore it entirely. It may be just habit, but you may also be revealing some other internal needs. Openly discuss these messages with your pros. Those with ADHD commonly need to improve their self-image, boost their self-esteem. These messages can also indicate problems with depression or anxiety, or other conditions. A pro can help you sort this all out.
- Select/suggest activities where you shine, and/or where your ADHD symptoms are less likely to impact you. Don't hesitate to try something new.
- Laugh at yourself, and along with others, when you've mismatched the wallpaper, or whatever. The world has not ended because of this flub.
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If there is an area of your life at which you're really horrible, and which impedes on being social, really, really, really work on improving it.
For me, that's spelled cleaning. My house is a rat's nest right now, and there's no way I can have anyone over without having the emergency squad standing by.:) So cleaning it up, reorganizing my piles, ditching stuff, etc., has become a VERY high priority for me.
When I can have friends over for dinner again, it will be a sign to them, and to me, of real improvements being made. They WILL say how great my place looks, and I WILL agree and thank them, and then I WILL move the conversation to something else, and I WILL continue to glow a little bit inside.
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If you have problems with people at work, consider talking to your boss. ADHD is legally considered to be a disability and your workplace should be able to improve your working conditions.
Editor's Note: However caution should be exercised as many bosses don't accept ADHD either and workplaces aren't always accepting of people they need to accommodate.
Many larger companies have a designated office, professionally staffed, to help employees deal with confidential issues arising in the workplace. If these people/offices fail to help, consider taking a new job. Before that, though, talk to your own ADHD pros about your work difficulties. They may have other suggestions, or it may be that another type of work is more suitable for you.
- Talk to yourself in positives. You'll feel better, and you'll act better with others, and more than likely you'll be giving others more positives, too. Perhaps you'll even get more positives in return!
Well, that's about it for now. I'm sure, given another few weeks, I could add more to the above. But I DO want to get this off to you. I hope my experiences and tips are helpful. If you have any questions or thoughts, feel free to send them to me.
Sherrie Zimmerman, email ZimTrail@aol.com
