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Coping with ADD/ADHD

Life with ADD can feel like you are living in a kaleidoscope, where sounds, images, and thoughts are constantly shifting. You feel easily bored, yet helpless to keep your mind on tasks you need to complete. You’re distracted by unimportant sights and sounds, as your mind drives you from one thought or activity to the next. You are often so wrapped up in a collage of thoughts and images that you don't notice when someone speaks to you. Does this sound familiar to you or someone you love?

What is ADD or ADHD?
People with ADD or attention deficit disorder are often inconsistent. One day they can "do it," and the next it seems they can’t. They can have difficulty remembering simple things yet have excellent memories for complex issues. Usually, they have problems with following through on instructions, paying attention to what they need to attend to, are poor listeners, are disorganized, miss details, have trouble with tasks that require planning or long-term effort, appear to be easily distracted, or forgetful. In addition, some with ADD can be fidgety, verbally impulsive, unable to wait their turn, and act on impulse regardless of consequences. However, not all people with ADD have all of these symptoms all of the time.

Traditionally a person with ADD or ADHD is thought to be "hyper," therefore many who have ADD/ADHD with no hyperactivity are not being identified or treated. Individuals with ADD without hyperactivity are often considered to be day-dreamers or "absent-minded professors".

It’s important to remember that ADD is not a learning disability. For children ADD obviously affects their performance in school. For children and adults with ADD, it will also affect many aspects of their life, which can include relationships with others, running a home, keeping track of finances, and organizing, planning, and managing most areas of one’s life.

Diagnosing ADD
A thorough evaluation is necessary in making an accurate diagnosis and should include gathering information from a variety of sources. A review of the person’s medical, academic and family history is essential. In the case of a child this is done through a detailed, structured interview with the parents. Behavior rating scales are filled out by parents and teachers to provide information on types and severity of ADD or ADHD symptoms, as well as types and severity of other emotional or behavior problems. Depression, anxiety and other emotional disorders are tested through a comprehensive psychological screening. Intellectual and achievement testing is used to help screen for and then assess learning problems, and areas of strength and weakness.

To assess whether a person has ADD or ADHD, specialists consider several questions: Are these behaviors excessive, long-term, and pervasive? Is this a continuous problem, not just a response to a temporary situation? Do the behaviors occur in several settings or only in one specific place? The person's pattern of behavior is then compared against a set of criteria and characteristics of the disorder.

Treating ADD
For decades, medications have been used to treat the symptoms of attention deficit disorders. Stimulants such as methylphenidate (Ritalin), dextroamphetamine (Dexedrine or Dextrostat), and pemoline (Cylert) seem to be the most effective in both children and adults. For many people, these medicines dramatically reduce their hyperactivity and improve their ability to focus, work, and learn.

When people see such immediate improvement, they often think medication is all that's needed. This is not the case. These medicines will not cure the disorder. They only temporarily control the symptoms. Although the drugs help people pay attention and complete their work, they can't increase knowledge or improve academic skills. The drugs alone won’t help people improve their self-esteem or cope with problems. These require other kinds of treatment and support.

For lasting improvement, medications should be used along with treatments that aid in these other areas. There are no quick cures. The most significant, long-lasting improvements are made when medication is combined with behavioral therapy, emotional counseling, and practical support.

Life can be hard for children with ADD or ADHD. It's not easy coping with these frustrations day after day. They don’t have many experiences that build their self-esteem and competence. Faced with these daily frustrations can make both children and adults with ADD fear that they are strange, abnormal, or stupid. Some children release their frustration by acting contrary, starting fights, or destroying property. Some turn the frustration into body ailments, like the child who gets a stomachache everyday before school. Others hold their needs and fears inside, so that no one sees how badly they feel.

In individual counseling, a therapist can help the child or adult with ADD learn to feel better about themselves. They do this by helping them recognize that having a disability does not reflect who they are as a person. Over time the therapist can help people with ADD identify and build on their strengths, cope with daily problems, and learn to control their attention and aggression.

It's also difficult having a sibling who gets angry, grabs your toys, and loses your things. It's especially hard being the parent of a child with ADD. In fact, parents often feel powerless because the usual methods of discipline, like reasoning and scolding, don't seem to work. However, for some children, being scolded by their parents, siblings and teachers seems to be the only attention they get. Often, the cycle of frustration has gone on so long that it will take time to undo. The parents may need special help to develop techniques for managing the patterns of behavior. In many cases the entire family may need help. In such cases, mental health professionals can counsel the child and the family, helping them to develop healthy new skills, attitudes, and ways of relating to each other.

In therapy a patient talks with the therapist about their upsetting thoughts and feelings, explore self-defeating patterns of behavior, and learn alternative ways to handle their emotions. Cognitive-behavioral therapy helps people work on immediate issues by supporting them directly in changing their behavior.

Support groups can be valuable as members have the opportunity to share frustrations and successes, referrals to specialists, and information about what works. Many find that sharing experiences with others who have similar problems helps them realize that they aren't alone.

Dr. Kathy Marshack can help you. She is accepting new clients and has two office locations for your convenience. If you live in the Portland, Oregon or Vancouver, Washington area (or can drive to these locations) please call to set up your first appointment. See Therapy FAQs for more information. Please give us a call at (360) 256-0448 or (503) 222-6678 or email us at