Do you or a loved one suffer from adult Attention Deficit Disorder (ADD)? There has been increasing recognition that this is not only a disorder of children. While many ADD children continue to manifest symptoms in adulthood, there are individuals who have an initial onset of the disorder as an adult. For both children and adults, the primary symptoms that define ADD include impulsivity, hyperactivity, and inattention. The National Institute of Mental Health (NIMH) estimates the one year prevalence of adult ADD at 4.1% and a lifetime prevalence of 8.1%. These are millions of individuals suffering from this syndrome. More men than women are diagnosed with adult ADD.
I mentioned hyperactivity as a symptom but this is one area that does seem to present a bit differently in adulthood. For example, the overt hyperactivity may not be as prevalent for adults. Rather, the adult may experience feelings of uncomfortable restlessness. Adults typically display some combination of the following behaviors:
Need to move; feel restless inside, fidgety
Can't sit through meetings, meals, movies
Extremely impatient
Finish people's sentences; draw rapid conclusions; interrupt others
Drive too fast, reckless
Prefer very active job
On the go; low tolerance for frustration
Talk excessively; may make inappropriate comments; interrupt others
Common symptoms of adult ADD include poor attention; excessive distractibility; problems with memory and forgetfulness; frequently losing things; trouble organizing steps in a project; chronic lateness and procrastination; trouble starting and finishing tasks; careless mistakes; and disorganization.
People with ADD cost the economy billions of dollars. The Center for Disease Control (CDC) noted that this is so because individuals with ADD have more difficulties in school, at work, and in social relationships than those without the disorder. They have higher rates of emergency room visits and automobile accidents, are at greater risk for substance abuse, and experience higher rates of job turnover. The economic cost to American society has been estimated at between $36 billion and $52 billion annually (2005 dollars).
Individuals living with ADD have a greater risk of experiencing stress such as work stress and stressful life events (e.g. bankruptcy, divorce, etc.). Stress actually can cause ADD symptoms to become worse. So what is stress? As I've written about in numerous other posts, stress onset usually occurs when we anticipate or perceive danger or a threat. When you subjectively feel stressed, it is usually because of a change that you don't feel able to handle. Clearly, different people have different senses of what is stressful to them. Some examples include: a long wait in a line, being stuck in traffic, a fast approaching deadline at work, a large bill to pay.
Physiologically, when you perceive a stressor, your sympathetic nervous system is activated. The "fight or flight" response is initiated and the stress hormones adrenaline and cortisol are released. Your pulse increases, blood pressure goes higher, and you breathe faster. You are able to respond quickly to get out of danger. Blood is diverted to the heart, brain, and large muscle groups, so you can think and act quickly. Once the stressor is no longer present, the parasympathetic system takes over from the sympathetic nervous system and gets your body back into its normal state.
Some adults with ADD notice that they enjoy a certain level of stress as it makes them feel motivated, ennervated, and focused. However, that activation frequently turns into feelings of being anxious and overwhelmned. This is because we are not designed to stay alert and activated for long periods of time. Yet, in today's world it is common for people to go from one stressful situation to another. Unless you are able to manage your stressors, your body remains in "fight or flight" mode. It is well established that chronic stress has numerous negative effects on physical and mental health to include increased risk for colds and flu, illnesses such as heart disease and stroke, as well as depression/anxiety and substance use and abuse.
So what can you do as an adult with ADD to better manage your stressors and reduce the likelihood of being overwhelmned? There are several steps for you to employ:
1. Identify what causes you stress - This is usually the first step to solve most problems. Start noticing what stress "triggers" exist for you? To help, consider the following areas:
a. Physical environment. This might include the route you travel to work, distractions on the train or bus, and how you can plan to manage these with less stress.
b. Relationships. Is there tension and stress with people in your life?
c. Money. Do you have financial worries?
d. Life events. Have there been or are there upcoming or present major events, e.g. births, deaths, marriages, illnesses?
e. Lifestyle or behavioral issues. Are you having health challenges, not taking care of yourself, living a disorganized life, having problems managing your time and meeting deadlines, abusing alcohol or drugs?
2. Problem solve to find different ways to handle the problems you identified above. For example, if you are having health challenges, you can make a plan to schedule exercise, see your primary care provider, get more rest, take some time for yourself, etc.
3. Make a stress management plan and implement it. While some stressors may be out of your complete control, most are not. It is important that you plan on a daily/weekly basis to get out of activation mode and reduce your stress. Here are eight ways to better manage your stressors:
1. Exercise. There is research support for the assertion that if you engage in 150 minutes per week of cardiovascular and muscle strengthening exercise that your health benefits physically and mentally increase. I will have more to say about that in an upcoming post.
2. Get regular sleep and make it a priority. No one handles stress well burdened by a chronic lack of sleep accompanied by fatigue.
3. Eat healthy foods.
4. Reduce caffeine and sugar.
5. Avoid alcohol and cigarettes.
6. Practice deep breathing and muscle relaxation. In other posts I've written about the positive effects of progressive muscle relaxation (PMR) on health. PMR combines positive imagery, proper breathing, and reduction of muscle tension.
7. Get a massage regularly. In another post, I've written about the positive effects of therapeutic massage on general relaxation as well as reduction of muscle tension and anxiety.
8. Change how you speak to and about yourself. This is a hallmark of a successful mindset approach. Much of our malaise is caused by what we say to and about ourselves rather than what actually is happening. You can read many of my other posts for details.
So, the answer to the title questions is yes. As challenging as it is to live with adult ADD, how you manage the inevitable stresses of life will either help you live with higher well being or suffer even more. What are you doing currently to manage your stressors? As I always say, how you react to stress is a choice. Make yours a healthy one. Best wishes on your journey.
Dr. Paul Longobardi
For information on these and related topics, please see my website at www.successandmindset.com