Betty W. Phillips, Ph.D., Psychology
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Have you ever wondered if you could have an attention deficit disorder? (The condition can be called ADD for Attention Deficit Disorder or ADHD for Attention Deficit Hyperactivity Disorder. For purposes of these articles, I'll just use ADD.) This article is the first in a series about adult ADD and how to cope with this condition.

My perspective about ADD begins with the understanding that we all have relative strengths and weaknesses. One individual difference is attention control: not a disease, just a difference. However it must be noted that the skill of attention control is crucial in our modern world, from school days with all those achievement tests, to computers and blackberries, to desk jobs, to running a household. ADD is certainly not a disease like influenza or cancer. Because it's called a disorder, ADD qualifies for medical insurance coverage for evaluation and treatment, and that's a good thing.

Individuals with ADD often have many valuable skills such as divergent thinking, perceptual sensitivities, creativity and energy which help balance out their difficulty with attention control. One theory of ADD promoted by Thom Hartmann in fact points out the evolutionary survival asset of people with ADD in a "hunter/gatherer" role, while also describing disadvantages of ADD for individuals in the modern world where linear, organizational "farmer" jobs predominate. As we discuss ADD, we will need to focus upon the deficits or dysfunctions caused by this condition. Just realize that all relative weaknesses can be described in terms of disorders and dysfunctions, and every relative weakness has associated strengths.

So what is ADD? It is a lifelong individual difference which could have been diagnosed in childhood and is generally not outgrown throughout the life cycle. It's very important to understand that ADD symptoms never occur 100 percent of the time but appear variably depending upon the individual and the circumstances. Individuals with ADD can be very focused and efficient at times -- most often when the task is high interest, short duration, and when the task stimuli are intense, vivid attention-catchers. ADD symptoms fall into three to four categories as follows: (1) Inattention: difficulty focusing or shifting voluntary attention. ADD individuals may have difficulty keeping their minds on one task, may experience problems organizing and completing tasks, and may get bored quickly. (2) Distractibility. Attention may be pulled to internal stimuli (daydreaming) or to external changes in the environment. Irrelevant sights or sounds can draw attention away from the task at hand, and the individual may have difficulty filtering out background noises. When attention is refocused, the individual may forget to return to the original task. (3) Impulsivity. Individuals with ADD experience difficulty thinking before acting and curbing immediate responses to the environment. They may feel fidgety and restless, often with internal tension (which is sometimes confused with or accompanied by anxiety.) (4) Hyperactivity. Combined forms of ADD with hyperactivity (usually labeled as ADHD) include obvious overactive behavior or smaller muscle restlessness. When a task requires someone to remain still for a length of time, the individual with ADHD may begin to experience internal tension which can only be relieved by movement. Thus individuals with ADHD may often bounce from one activity to another to discharge this tension.

What has modern research contributed to the understanding of ADD? It is now understood that ADD involves a difference in neurochemical transmission in the brain areas associated with organizing and focusing, especially the prefrontal cortex. The chemical transmitters dopamine and norepinephrine appear insufficient in this area of the brain when attention control is needed for maximum efficiency. Glucose is the brain's main source of energy, and individuals with ADD appear to have less glucose activity in the parts of the brain that control attention. These differences can also be described as difference is in brain wave activity. Beta and gamma brain waves are related to efficient learning and attention control, but appear inconsistently in the ADD prefrontal cortex when focused attention is necessary, replaced by alpha and theta waves which are associated with relaxation and daydreaming rather than focused attention. This information is important to help design strategies and treatments for improving attention control for all of us and also is especially important for individuals with ADD.

ADD has a demonstrable genetic component although it can also be produced by life events such as brain trauma. Yes it does "run in families." If a child has ADD, there is a 25-30% chance the father has ADD, a 15-20% chance the mother has ADD, and a 25-35% chance that a sibling will also have ADD.

ADD usually has had a significant effect on individual self-esteem by the time it is diagnosed. "Lazy, crazy, dumb..." People with ADD have heard it all. The roots of this stigmatization are historical. As early as 1902, an article published in the British journal Lancet described these children as having "Morbid Defects of Moral Control." To combat this unfounded stigma, we will be discussing methods of reinforcing and maintaining self-esteem in individuals with ADD.

Subsequent articles in this series will further examine ADD, provide information about diagnosis/ therapy/coaching services and most important will describe approaches to maximize individual strengths in coping with ADD. In the meantime you can request consultation and assistance from a professional trained in assessing and treating ADD.

I've been ending my articles with humor, as joking is one of the skills that makes life a little more pleasant and fun. So I'll poke a little fun at my profession.

"Doctor, doctor, I keep thinking I'm invisible." "Who said that?"
"Doctor, doctor, nobody understands me. "What do you mean by that?"
"Doctor, doctor, I hear ringing in my ears." "Don't answer!"
"Doctor, doctor, I can't concentrate. One minute I'm okay and the next minute I'm blank!...
"How long have you had this problem?" "What problem?"