By Janet Strassman Perlmutter
Trained professionals recommend a three-part approach to managing AD/HD:
1. Education About the Condition
While distractability and impulsivity seem to be the best-known features of this condition, there are many other traits associated with AD/HD, not all of them negative, that few recognize as linked.
Hallowell and others describe people with AD/HD as often very creative, visionary and unconventional. They can be very sensitive as well, not just to distracting sounds, but to visual cues, tactile stimuli (soft vs. scratchy materials, for example) and the emotional tone of others around them.
It’s common for people with AD/HD to have a tough time with transitions, to be vulnerable to overdoing things – even to the point of addictions or compulsive behaviors – and to have a stronger-than-average need for “downtime” to regain energy.
2. Strategies for Success
Once a person with AD/HD begins to see his or her strengths, preferences and vulnerabilities more clearly, the next challenge is to figure out approaches that improve opportunities for success.
Joan was diagnosed with AD/HD when her daughter, who also has AD/HD, was 7. “When I’m interrupted by other people’s demands, I get very frustrated,” she explains. “But there are things I can do to help that, like making sure I get up a bit earlier than the kids and setting aside some time late at night for myself.”
Some adults with AD/HD benefit from working with a time management consultant or a professional organizer to find systems that work. Dahlia figured out on her own that she not only needed an appointment calendar with her at all times, but that she also had to color code each child’s schedule to keep her kids’ appointments straight.
A family member, co-worker or friend who understands the condition can be a great asset – coaching the person through the vulnerable times or helping him or her to refocus. Even kids can play this role at times.
Liv, a marketing professional who was diagnosed with AD/HD in her 30s, depends on a personal digital assistant (PDA) to stay on track. “I try to make it a religion,” she says, adding that her 11-year-old daughter takes responsibility for her soccer schedule by making sure it’s entered into mom’s Palm Pilot™ correctly.
Kim knows she would get overwhelmed by all the things to be put away in her 9-year-old son’s room. So instead, she explains, “I gave him directions to go through his drawers, one by one. He sorted the clothes and brought me what didn’t fit.”
A psychotherapist can help when the kind of coaching needed entails working with the emotional ups and downs that are sometimes associated with AD/HD or when the self-esteem issues are hard to shake. Barkley also recommends couples counseling to help parents reassign household responsibilities as appropriate. “The non-AD/HD parent might be encouraged to take on the more time sensitive responsibilities or to take the lead in matters of child discipline,” he says.
Drug treatment is recommended in some cases, but not all. Adults respond to the same medications as kids with AD/HD. Most, like Adderall™ and Concerta™, are stimulants; a confusing notion since people with AD/HD appear overstimulated to many.
Without medication, “it’s like I vibrate,” Dahlia says.
But the medications are stimulating a person’s ability to “put on the brakes” and the ability to screen out extraneous input, Hallowell explains.
Straterra™ is a medication in a class of its own. Not a stimulant, Barkley says, “we would call it an anti-AD/HD drug if there were such a category.”
Dahlia says her AD/HD medication gives her “a lot more ‘in control’ feeling.” She takes Concerta, a longer-acting version of Ritalin™, which lasts eight to 10 hours. It’s the same medication her kids take.
“It feels less hectic in the house,” she says, since she and her family members are on medication. She clarifies that it’s neither a drugged nor falsely happy feeling she experiences. “It’s like that AD/HD book, Out of the Fog,” she says. “On medication everything becomes clearer, sharper, easier to deal with.”
It’s also important to treat co-existing conditions, Barkley emphasizes. People with AD/HD have a higher than average rate of anxiety and depression, which may also need to be treated. Liv, who has sleep apnea, notices that her AD/HD symptoms are much worse when she’s sleep deprived.
Despite the challenges, Dahlia is enthusiastic about the advantages of AD/HD as well. She recognizes her family members with the condition as people who think outside of the box. They’re “quick thinkers … who have the guts to say or try the outrageous stuff,” she says, adding that “it can be like that with AD/HD. That part is a blast!”
Most important, be yourself, urges Hallowell, meaning do things the way they work for you, even if they’re unconventional. Have a sense of humor, he encourages. And associate with people who understand you. There are more of them around than you might think.