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The Natural Progression of ADHD into Adulthood    
Author: Bob Seay    
Source: ADHDNews.com    
Date: October 1998    
     
It wasn't all that long ago when conventional wisdom held that ADD/ADHD was a childhood disorder that we would grow out of as we grew older. Those of us who live with Adult ADD knew better. Eventually the professionals caught up and recognized that fact. ADD in adults is now being diagnosed and treated in much larger numbers than ever before.

As we look at the lives of these ADDults, we begin to see some patterns. Those who believe in the "ADD is a disorder" mindset might call these patterns "the natural progression of the disease". These patterns reinforce the idea that when you try to force fit an ADD person into a non-ADD world, you are bound to create a lot of problems.

Look at the numbers
Depression: up to 70% of ADD people have been treated for depression
Bi-polar disorder: 20% (vs. 1% of the general population)
Sleep problems: 50%
Social phobias: 31% (Brown)

These numbers represent those who have been diagnosed and treated as ADD people. We also know that among the undiagnosed ADD population there are myriad other problems: self-medication with cocaine or other drugs (an estimated 15-20% of cocaine addicts are undiagnosed ADDers), conduct disorders, and more.
One has to wonder if dementia in the elderly is not as least partially included as well. You forget where you put your keys when you're 30 and its ADD you forget when you're 70, and they ship you off to the nursing home.

I am firmly of the "hunter/farmer" mindset I have a hard time thinking of our unique nonlinear brains as "disordered". However, I am not so naive that I cannot see the results of our differences over time. Why is this important?

If we understand the nature of the ADD brain, and if we know that we may be predisposed towards depression or other illness, then we can better recognize and understand what is happening when these things occur. Rather than waiting until we are suicidal to face the fact that it is Depression that is killing us, we can recognize that Depression is part of living with ADD and be ready to begin treatment before it reaches that point.

These disorders do not occur in every person diagnosed with ADD. But, they do occur in significant enough numbers that we can no longer ignore the evidence.
I usually write the upbeat stuff about ADD, and I realize that reading that your ADD child will probably develop depression and may become bipolar is not exactly in keeping with my reputation as Mr. Happy. But, this can be a positive step. Knowing that you are not alone that so many of us live with these "advanced stages" of ADD, is always encouraging. You are not a freak. This is simply part of the process. By understanding that, you and your child will be better able to seek and receive help before reaching critical levels.
Bob Seay is the guide to the ADD site at The Mining Co.
He can be reached at http://add.miningco.com.

  Adult ADD

Frederick Still, a British pediatrician, first recognized Attention Deficit Disorder in 1902.  Although we still have a lot to learn about the disorder, we have learned a great deal about the nature of the neuro-biological disorder that we refer to as ADD or ADHD. One of the things that we have learned is that it occurs in childhood and persists into adulthood in about 70% of all diagnosed cases. This disorder affects an adult’s ability to concentrate, control impulses and stay organized. It impacts one’s ability to function in the workplace and at home. When these conditions are undiagnosed, they can place a tremendous amount of burden on every aspect of an individual’s life. This can make one feel ashamed, deficient and depressed. People living with this disorder can be greatly helped by a professional assessment and treatment plan.

The symptoms that occur in adults vary in type and severity. These behaviors can cause problems at work, home, and in daily interactions. Some of the common characteristics of ADHD in adulthood are:

• A short attention span, especially for mundane day-to-day activities.
• Enthusiastic beginnings with interest dwindling before completion; poor follow through.
• Tendency toward impulsive behavior. Tend to make decisions before carefully thinking through the consequences.
• Might change jobs frequently.
• May have trouble managing money. Tend to overspend and disregard a budget.
• Make repeated careless mistakes on the job.
• Communication skills are limited. Have difficulty listening, tend to interrupt conversations, and speak without considering the possible reaction of others.
• May have difficulty controlling their temper.
• Tend to have a low frustration tolerance.
• Difficulty maintaining a long-term relationship.
• Greater than average tendency toward substance abuse.
• Difficulty concentrating when reading- prefers newspaper and/or magazine articles to books.
• Generally disorganized; frequently running late; rushed and unprepared.
• Tendency to over commit themselves.
• Problems with time management; have difficulty estimating how long a task might take.
• Have difficulty prioritizing.
• Pattern of achieving less than siblings. Have a history of being told that they are "not living up to their potential." (Source unknown)

For the undiagnosed ADDer, it is easy to look back on their childhood years and see that they probably felt like they were different in some way. Restlessness, social awkwardness, distractibility, inability to concentrate can be seen as a pattern in their childhood. One must remember that ADD is a lifetime affliction, not something that they just acquired. Frequently adolescents with unrecognized ADD get further and further behind in school from not being able to organize their schoolwork, procrastinating or forgetting to turn in completed assignments. They are seen as underachievers socially and academically and may express their frustrations in oppositional or anti social behaviors. They often see themselves as bad and carry negative attitudes into their adult lives. Oftentimes, the psychological effects of the undiagnosed ADD are worse than the original limitations of the disorder. These affects are carried on into adulthood. Jackson and Farrugia (1997) believe that this negative world-view comes because the adult with ADHD will:

"Perceive that nobody understands how difficult it is for them to work steadily, become organized, keep friends and set goals for themselves. They become even more discouraged when people around them give advice on how they 'should' act and who they 'should' be."

Research suggests that even those with coping techniques may be performing far below their capabilities. This may be due to, in part, the inability to develop adequate coping mechanisms for prioritizing many tasks and viewing them as individual pieces rather than the whole. It becomes easy to see how the adult with ADHD can quickly come to feel inadequate, "embarrassed and humiliated" by their inability to cope. Hayes (1999) states "adults with learning disabilities find, too, that their successes or failures in their personal lives or jobs are more affected by their social skills than by their academic learning."

As adults, ADDers are more prone to be in the lay off cuts. The most valuable employees are the ones retained. The adult ADDer often doesn’t see any of their problems on they job. They just aren’t aware of the “cues” that are given that would indicate that things are not going well. Other factors in job difficulty include cognitive deficits in academic, language and verbal learning; short-term memory difficulties; restlessness, distractibility, impatience; and a low tolerance for frustration. 

Link our solutions for cognitive deficits

Here are some things to look for that may indicate a problem:

• Lack of eye-contact from supervisors and bosses
• Less conversation
• Less discussion about up-coming planning for the job
• Sudden attempts to identify and "document" employee failures
• Sudden increase in critical comments
• Increase general discussion on difficulties company is having

Working smarter and not harder may be the answer and to do that will mean a very thorough assessment of what you do and how you do it. Solicit support from your friends and those who care about you. Make them part of the solution instead of part of the problem due to lack of understanding. Above all accept yourself for who you are and recognize your strengths. Life needn't be hard, unless we are determined to make it that way.

We as adult ADDers need to find ourselves in a career position that will nurture our strengths and require the least amount of modifications and accommodations. Our jobs must reflect our strengths. ADDers have unique mental abilities make them more likely to excel at certain careers: Sales, detective work, entrepreneurs, and—pay close attention editors—writers! An Adult ADDer is often capable of doing more than one thing at a time and function better than others under pressure. Some can be very flexible and open-minded.  We can change strategy on a moments notice and are extremely quick thinkers. Because our minds "zap" from item to item, we often find solutions to things that can't be handled by "normal" people. ADD can be used to your advantage when you accentuate the positives.

 All people with ADHD have natural talents and abilities that they can draw on to create fine lives and careers for themselves. In fact, many people with ADHD even feel that their patterns of behavior give them unique, often unrecognized, advantages. People with ADHD tend to be outgoing and ready for action. Because of their drive for excitement and stimulation, many become successful in business, sports, construction, and public speaking. Because of their ability to think about many things at once, many have won acclaim as artists and inventors. Many choose work that gives them freedom to move around and release excess energy.

Communication skills can sometimes be a problem in the workplace. One way to improve these skills is to consciously practice good communication with friends and family. If we define communication skills as “the ability to receive and relay information clearly and effectively”, these skills would include:

• Listening - receives, attends to, understands and responds to verbal and nonverbal messages
• Speaking - clearly organizes and effectively presents ideas orally
• Reading - locates, understands, and interprets written information in prose and documents to perform tasks
• Writing - organizes and effectively presents ideas and information in writing
• Interpreting - delineates and analyzes oral and written information and synthesizes information into a conclusion
• Negotiating - works toward agreement while maintaining position
• Persuading - communicates ideas to justify position, overcome resistance, and convince others

Improved communication skills not only open up better employment opportunities. Mastering the art of polite conversation helps in all areas of social interaction - jobs, relationships, and education... you name it. Communication is the key. If this is a problem in your life, I’m sure it has a painful affect on personal relationships too. A healthy relationship requires communication. This is true for marriages, friendships or parenting.

Conversation skills can be a challenge for people who have AD/HD, but there are some things you can do to make it easier. First, understand that AD/HD – yours and/or theirs – can make communication more complicated. "Once you recognize that interpersonal relationships can and do require 'work' for those with AD/HD, you may feel less anxious and frustrated," notes Michele Novotni, an ADD social skills expert. "If your expectation is that listening is hard, you are more likely to gear up to the challenge. However, if your expectation is that it should be easy, you may often find yourself frustrated and overwhelmed."

You can purchase Michele Novotni's book online at Amazon.com There is a link on our home page to Amazon.com

Within a family structure including an adult with ADHD, there are also spousal and child conflicts. The spouse may feel resentful, as if they are parenting an entertaining but irresponsible child. They may instead feel rejected and angry if the sufferer engages in activities outside the house or hyper-focuses inside the house. The spouse also can feel the adult with ADHD does not care about the family when they fail to complete household tasks continuously.

Couples And ADD

When one partner in the relationship has ADD, it's critically important for BOTH of them to understand not just how the ADD effects that person, but also how it effects the relationship.

The partner with ADD is likely to be less organized, less predictable, and less attentive than the other one. It can be easy for the non-ADD partner to misinterpret those behaviors as "not caring" or as being "passive-aggressive".......that's simply NOT TRUE in most cases!

Most of the time ADD behaviors which cause problems are not malicious behaviors -- usually it's just a case of the ADD not being managed well and the person needing to learn more coping skills. It helps to keep in mind a "biological perspective" though -- that the basis for most ADD behavior is biological in nature -- it has to do with how the brain works -- and is NOT usually due to bad intentions or lack of caring!

It's also easy for the non-ADD partner to become frustrated and fall into a critical/blaming mode of behavior -- that usually just makes things worse. Sit down and discuss specific behaviors which are causing problems and then make some changes in how things are done -- like any couple must do, with or without ADD. Focus on the BEHAVIOR as the problem though, not the PERSON -- very important distinction! :)

Another problem is if the non-ADD partner becomes the "rescuer" in the relationship, and the person with ADD takes on the "helpless victim" role. This is very bad for BOTH partners involved and will only lead to more problems.

The couple needs to clearly delegate responsibility for certain duties or jobs, and EACH of them has to follow through on their end without being babied or bullied by the other. The person with ADD needs to structure the environment in whatever way he/she needs to make sure that those things get done!

People with ADD are not "crippled" in any sense and should never use ADD as an excuse for irresponsible behavior. If some behavior is a problem.....fix it!! Never make excuses.  (From an ADDA handout)

The adult ADHD sufferer needs to feel that he/she can access this care in order to provide a fuller life for themselves, and for those around them. I highly recommend checking out our coaching program to help you become more successful in your everyday life.  

ADHD affects the sufferer throughout the lifespan, from home-life to academics to social contacts, to risks for other conditions, and finally to self-worth. Whether it is a label that one gives to their self or a medical diagnosis, we have the capability to treat this condition. 

Many things can be done to help those with attentional difficulties. There are several good interventions, ranging from medications to non-medication treatments. We provide the best of the alternative treatments. They have been heavily researched and have a consistent record of accomplishment in aiding their users in obtaining optimum performance. Click on the Home page button to find out the benefits of our programs. 

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References for research cited:

Hayes, M. L. (1994). Social Skills: The bottom line for adult LD success. Available online: http://www.ldonline.org/ld_indepth/social_skills/social-1.html [December 3, 1999].

Jackson, B, & Farrugia, D. (1997). Diagnosis and treatment of adults with attention deficit hyperactivity disorder. Journal of Counseling and Development, 75(4), 312-320.

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