CommonHealth

By Karen Weintraub
Guest Contributor

When you think about ADHD, what do you imagine? If you’re like most people, it’s probably a stereotypical image of a young boy bouncing off the walls, buzzing with pent-up, unfocused energy.

But many people with ADHD aren’t hyperactive at all, and by the time they reach adulthood, most hyperactive people have calmed down — at least on the outside. This helps explain why Attention Deficit Hyperactivity Disorder, which used to be considered a childhood condition, is now being diagnosed in adults as well.

There are some who dismiss the condition as massively over-diagnosed, perhaps as a ploy by drug companies to boost business. And maybe there’s some truth to that on the margins. Not everyone who’s got ideas racing through their head should be medicated. (Just ask most of the faculty at MIT.)

But there are large numbers of people — studies suggest it’s as many as 4 percent of adults – who are profoundly affected by the symptoms of ADHD. Many can’t hold a job or stick with a relationship. They’re chronically late or forgetful. They jump into jobs and purchases and relationships without thinking them through, only to regret their impulsive actions later. They get stuck in self-destructive patterns, fall prey to addiction and depression. And they can’t figure out why they struggle so much more than everyone else.

For this population, a diagnosis can be a huge relief, explaining why they’ve always felt out of step with the world.

Here are a few other things you might not have known about ADHD, drawn from a new book I co-write, Fast Minds, How to Thrive if You Have ADHD (Or Think You Might) published by Berkley Books:

Medication Can’t Fix ADHD
Treating ADHD in adults with medication can be helpful – and it’s often the first suggestion a diagnosing doctor will make. But it’s not enough. Adults with ADHD often need help getting and staying organized, even with their own priorities in life. They may need help at critical moments, making a constructive choice, rather than a destructive one. And they need emotional support to counteract all the negative messages they’ve received all their lives when their actions didn’t meet other people’s expectations.

Not Everyone Who’s High Energy Has ADHD
Our images of ADHD come from celebrities who talk about having it, like singer Adam Levine or actor and game show host Howie Mandel. But many people with the condition struggle to get up off the couch. They were the quiet ones in class who always seemed like they were in their own world. As adults, they may be unsure of what to do, or want to do so many things that they paralyze themselves. On the other hand, there are plenty of people who have some of the traits of ADHD without being impaired by the condition. Some of the same organizational and self-control strategies may help.

People With ADHD Don’t Have Trouble Paying Attention
They have trouble paying attention to the “right” things. They may spend hours playing video games, or tinkering in the basement or writing the Great American Novel. What they can’t do well is control what to pay attention to. If something isn’t inherently interesting to them, it takes a huge amount of effort for them to tune in. For the book, we interviewed one man who felt like he screwed up everything in his life except his parenting, because his late-in-life kids were so important to him, that it was always easy to make them a priority. For another, his children were always having to describe their day two or three times, because he kept tuning out. He didn’t love his children any less, he just struggled to keep his attention on them. This can be a huge problem in a relationship, of course, with spouses and parents dismissed as uncaring.

There Isn’t One Brand Of ADHD
Everyone’s traits, struggles and ability to cope are different. Some people with ADHD are hugely popular, the funniest, most interesting people in every room – even as they struggle to pay their bills or hold down a job. Other people can’t maintain relationships, but are great in emergencies, when the pressure and thrill of the moment seem to give them super-human powers.

Intelligence Has Nothing To Do With ADHD
There are Harvard professors with the condition, as well as stockbrokers, firefighters, housewives, shop clerks, business owners, writers and artists. Being smart can help people with ADHD perform better but having ADHD says nothing about someone’s intellectual capabilities. Through a genetic fluke or cosmic joke, people with ADHD often have other diagnosable conditions as well, such as learning disabilities, depression or addiction problems. It’s as if whatever happens to give the brain attention challenges also strikes elsewhere to create more trouble.

Many People With ADHD Struggle With Short-Term Memory
They can remember where they grew up, but not the meeting their boss told them about 3 minutes earlier. Having a good calendar and reminder system can be one of the most important strategies for someone with ADHD.

Many People with ADHD Have Trouble Sticking To Healthy Routines
Research shows that people with ADHD are more likely to have problems with sleep patterns, for example. Others are impulsive about their eating habits, or never use their gym memberships. Simply ensuring a healthy diet, regular exercise and 8 hours of sleep a night means better self-control and function. But keeping these routines takes special effort for people with ADHD.

ADHD Can Appear Differently At Different Times In Life
We know people who thrived in high school, but fell apart in college, when the workload was higher and they had to wash their own laundry; and people who were huge successes when they were single, but struggled mightily when they had to get their kids out of the house in the morning as well as themselves. It helps to recognize and plan for these extra stresses – and not beat yourself up when life gets harder.

A Key To Managing ADHD Is To Seek Out Places Where You Thrive
An accountant told us that he loves his work because as long as he follows his checklist, he knows he’s doing a good job. A professor hates rules and needs to set his own agenda. They both do their jobs well, but they’d be disasters in the other’s position. Just like everyone else, people with ADHD need to understand their strengths and weaknesses and find or build an environment that will help them thrive. We know people who are the first at work to volunteer for jobs that suit their skills, so they don’t get stuck doing the ones that aren’t a good fit.

ADHD Is A Lifelong Condition
The disorder affects people in multiple areas of their life – home, work, school, relationships, etc. But people don’t have to be captive to their ADHD. As Canadian comedian Rick Green once said of himself: “I used to suffer from ADHD. And now I just have it.”

Karen Weintraub, a Cambridge-based health and scientist journalist, wrote Fast Minds with Dr. Craig Surman, an assistant professor at Harvard Medical School and Massachusetts General Hospital, and Dr. Timothy Bilkey, an expert in adult ADHD in private practice in Ontario, Canada.