barkleyTakingChargeAdult2022

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Barkley, Russell A. Taking Charge of Adult Adhd: Proven Strategies to Succeed at Work, at Home, and in Relationships. Second edition. New York: The Guilford Press, 2022. Kindle.

Jeremy

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FirstAuthor:: Barkley, Russell A.
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Title:: Taking Charge of Adult Adhd: Proven Strategies to Succeed at Work, at Home, and in Relationships
Year:: 2022
Citekey:: barkleyTakingChargeAdult2022
itemType:: book
Publisher:: The Guilford Press
Location:: New York
ISBN:: 978-1-4625-4752-4 978-1-4625-4685-5
Extra:: Medium: Kindle

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Abstract

“Many tens of thousands of readers have found needed information and support in this authoritative guide, now in a revised and updated second edition. Preeminent expert Russell A. Barkley explains what ADHD looks like in adults, how to get an accurate evaluation, and how sufferers can manage symptoms and build the life they want. Readers get hands-on skill-building exercises plus clear answers to frequently asked questions about medications and other treatments. Dr. Barkley offers step-by-step strategies for overcoming challenges in specific areas, such as relationships, parenting, work, money management, and driving. Featuring the latest resources and medication facts, the second edition includes new or expanded discussions of mindfulness, emotional self-control, time management, building a successful career, maintaining a healthy lifestyle, and more”— .

Notes

Jeremy’s Review

An important voice in understanding adult ADHD, Russell Barkley provides resources for what ADHD is, how it can affect one’s life, and to manage symptoms of ADHD. He is also one that treats ADHD as a dysfunction first and foremost.

# Reading Notes

Highlights and Notes

Introduction

This means 4 – 5 % of all adults have ADHD. That’s more than 13 million adults in the United States alone( as of 2020).

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Step One: To Get Started, Get Evaluated

is. It’s a succinct description of the serious time management problems that ADHD creates for adults in their daily lives. That’s because adults with ADHD seem blind to time, or nearsighted toward the future. They live in the“ now ” and struggle to deal with all those“ nexts ” in life.

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One of the things we’re beginning to understand well about adult ADHD is that hyperactivity is seen more in kids with the disorder — but then it usually declines substantially by adolescence and adulthood. Often the only thing that’s left of hyperactivity in adults with ADHD is that feeling of restlessness and the need to keep busy that you may know well.

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kids. Prior to the 1980s the disorder wasn’t widely recognized by clinicians. Sometimes their pediatrician didn’t believe ADHD was real. Or their parents didn’t think“ being hyper or not being able to focus was a reason to take a child to the doctor, ” as one man diagnosed in his mid - 20s reported. These people( and their parents !) may have bought the myth that there was nothing wrong with them that sheer willpower wouldn’t cure. Sometimes people end up undiagnosed because they fall into a gray area between ADHD and non - ADHD symptoms or because they had other problems that muddied the picture.

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Being hyperactive as a child but not as an adult doesn’t mean you don’t have ADHD. But not having any ADHD symptoms as a child or teen probably does mean you don’t have ADHD. ADHD - like symptoms that arose only in adulthood or that haven’t been going on for very long are probably being caused by something else — a brain injury or other physical illness, for example.

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Ironically, the same problems that make it hard for people with ADHD to get things done on time, make wise choices, and even get along with others can make it tough for them to trace their own history accurately — at least until they’ve reached approximately their mid - to late 20s.

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Except in school and possibly at work, intelligence is unlikely to protect you from experiencing some of the impairments typically associated with ADHD, though it may have allowed you to go further in school without your ADHD being noticed than is common in typical adults who had ADHD growing up.

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Children and teens with ADHD that I’ve followed up into adulthood often don’t know the extent of their own symptoms or how much those symptoms are interfering with their life. It’s not until 27 – 32 years of age that adults with ADHD become more consistent in what they say about themselves relative to what others say about them.

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ADHD is not a category that you either fall into or don’t. It is not like pregnancy. It’s more like human height or intelligence. Think of it as a dimension, with different people falling at different points along it.

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So where on that dimension is the division between“ disorder ” and“ no disorder ” ? It’s where impairment in a major life activity occurs. Symptoms are the ways a disorder expresses itself in thoughts and actions. Impairments are the adverse consequences that result from showing those symptoms.

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In brief, these are the reasons to get professional help : ✓ To make sure your symptoms aren’t being caused by a condition other than ADHD that requires attention ✓ To discover whether your problems are being caused by a combination of ADHD and another condition ✓ To get the prescription medication that’s proven to give a huge boost to coping efforts if you do receive a diagnosis of ADHD ✓ To gain access to the latest psychological therapies that can address your various problems with self - control ✓ To find out where your strengths and weaknesses are so you can aim your coping efforts exactly where they’re needed ✓ To get an evaluation that can serve as the basis for getting appropriate accommodations in college, other educational settings, or the workplace under the Americans with Disabilities Act ✓ To access other resources that may help you change an unhealthy lifestyle and poor health maintenance practices, such as assistance with weight loss, quitting smoking, reducing alcohol or marijuana use, or improving your sleep

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What’s important to know right now is that where ADHD symptoms are concerned, medication works. It improves the symptoms, often substantially. It is effective in a large percentage of adults — fewer than 10 % will have no positive response to any of the drugs approved for use with ADHD. Medication even seems to temporarily correct or compensate for the underlying neurological problems that are likely contributing to the ADHD in the first place.

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This is in contrast to what the author documents in the “restless book or whatever it’s called.”

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The success rate for ADHD medications is probably unrivaled by any other medication treatment for any other disorder in psychiatry.

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A lot of other treatments and coping methods have little effect unless the person with ADHD is also taking medication. In my experience, adults with ADHD who choose not to try medication following their diagnosis typically return within 3 – 6 months asking to go on it once they realize that all the other options are not addressing their problems very well.

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In my experience, when you like and trust your doctor, you have a good chance of feeling the same way about anyone the doctor recommends.

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You might feel restless in the middle of the evaluation, eager to get it over with. Try to stay focused on the goal — answers and solutions — and remember that the most important thing to take to your evaluation appointment is an open mind.

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The more different sources the evaluator can use to confirm your symptoms and the impairment you’ve suffered, the firmer the conclusions that can be drawn.

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Someone who knows you well and — this is essential — is in your corner and wants to help you, not just criticize you, might be able to say that in fact you do drive much faster than most people, that your attention sometimes drifts from the road, that you try to multitask or text message while driving, and that you get impatient easily when traffic backs up. On the surface it may feel like an intrusion but try to believe that it is in your own best interest to let the professional speak about your concerns and your history with someone who knows you well, such as a parent, sibling, spouse or live - in partner, or close friend if family members are not available.

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ADHD is a highly genetic disorder, more so than most in psychiatry, so unless you have acquired it through an obvious brain injury in your past, it’s likely to be more common than usual among your relatives. But because adults with ADHD frequently have another disorder too( see Chapter 2), it can be helpful to the evaluator to know about all mental disorders that appear on your family tree and for which you may have a genetic vulnerability.

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There is no diagnostic test for ADHD that is accurate enough to be used in clinical practice. Diagnosis is an art as well as a science. Accurate diagnosis depends on the adept analysis of a professional with the experience to weigh the results gained from different sources and different parts of the evaluation.

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If the evaluator says you don’t have ADHD because you have fewer than the five DSM criteria, indicate that my research and that of others has shown just four symptoms is enough to be considered clinically significant. Or ask to be evaluated again using our nine - item list( page 10).

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Lots of research has shown that many people do have all the earmarks of ADHD without having the full five symptoms from either symptom list. Several studies, my own included, have shown that you actually need only four of the symptoms on either list to be having these problems to a degree inappropriate for an adult.

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Many people with ADHD describe a double whammy in this area : They can’t seem to concentrate long enough to finish routine tasks, and they’re also distracted by virtually anything else that enters their field of consciousness.

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Many teens and adults with ADHD tend to speed when they drive, to lose patience with other drivers and drive aggressively, to rack up parking tickets because they just can’t be bothered to find a legal parking space, and generally to have a very low tolerance for frustration.

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Symptoms alone aren’t enough to produce a diagnosis of ADHD. You have to be impaired by those symptoms.

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Impairment = the social and other adverse consequences or costs that result from expressing the symptoms of ADHD. But there’s another element to the term that’s just as important as this definition : Impairment is defined relative to the average person in the population, known as the norm — it is where most “normal,” or typical, people are found to be performing in any domain of life. It does not mean how you are functioning compared to incredibly bright or highly educated people even if you are one. To be impaired, you must be functioning significantly below the norm or the average( typical) person. Why ? Because the term disorder means just that — you are not functioning typically.

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My colleagues and I published a book in 2008 containing a study in which we asked 146 adults diagnosed with ADHD and 109 adults from a general community sample to tell us whether they had experienced the 18 DSM symptoms often. The answers are shown in the table on the facing page.

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To confuse matters further, 30 – 50 % of those who seem to have the predominantly inattentive presentation of ADHD may not have ADHD at all but something that some researchers, including me, now call a“ sluggish cognitive tempo ”( SCT), a separate deficiency in a different type of attention.

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If you’ve received a diagnosis of ADHD but are not quite ready to own the disorder, take a look at these fast facts. You’re not alone : ✓ ADHD occurs in approximately 5 – 8 % of the childhood population and 4 – 5 % of adults, or as many as 13.6 million as of 2020. ✓ In childhood it is three times more common in boys than girls, but by adulthood the ratio of males to females is approximately 1.6 to 1 or less. ✓ The disorder is found in all countries and ethnic groups studied to date. ✓ ADHD is somewhat more common in urban and population - dense regions than in suburban or rural settings and is found across all social classes. ✓ ADHD is more common among people in certain professions, such as the military, the trades, the performing arts, and sales, and among professional athletes, physical education teachers, and entrepreneurs, than among those in other fields.

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Step Two: Change Your Mindset: Know and Own Your ADHD

Accepting ADHD as part of your psychological makeup is what I mean by“ owning your ADHD. ” If you merely acknowledge the disorder at some distant intellectual level, paying public lip service to the diagnosis but privately rejecting it, you’ll be stuck where you are. People I’ve seen react that way don’t embrace treatment. They’ve wasted time and money on the diagnosis and end up with the same struggles they’ve always had.

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Happiness or at least contentment can come only from accepting yourself as you are, and that includes ADHD. Owning your ADHD doesn’t have to demoralize you, because when you really own it, you too can then conclude“ So what ? ! ” Admit that you have it, accept the diagnosis, own it as you own other features of your self - image, and then you can really begin to work with and master it. You can’t work with something you won’t own and don’t even know much about. So embrace understanding your ADHD, owning it as part of who you really are, and then working to diminish its adverse effects on your life to improve your chances of leading a meaningful, effective, and successful life.

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In my years of counseling adults with ADHD, I’ve come to believe that reframing your view of yourself and your life to put ADHD in the picture is in fact among the most crucial changes you can make to master ADHD. It’s the only way I know to keep ADHD from running, or ruining, your life.

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Studies have shown that you probably inherited ADHD : Ten to 35 % of the immediate family members of children with ADHD also have the disorder. When a parent has ADHD, up to 40 – 57 % of his or her biological children will also have ADHD. This means if you have a parent with ADHD, you are eight times more likely to end up with ADHD than if your parent does not have ADHD. Likewise, if you have ADHD, your offspring are up to eight times more likely to have it also.

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This is just a sampling, but I think you can probably see from these examples that poor inhibition basically means you have difficulty stopping yourself long enough to think about what you’re about to do.

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poor inhibition and limited self - regulation cut such a broad swath through your life : If you can’t stop your own actions, thoughts, and emotions to give time and self - control a chance to get any traction, you won’t be guided to decisions that would be better for your long - term welfare.

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ADHD in Adults Is Not Merely a Trivial Disorder of Attention ! Instead it’s a problem with the ability to organize behavior over time to prepare for the future. The five problem areas in ADHD add up to an exceptional disorder of self - regulation that results in a veritable nearsightedness about the future. And that, as you probably know firsthand, is a recipe for disaster in most major life activities.

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The problems that ADHD creates are not so much with knowledge, or the back part of our brain, but with performance, or the front part of our brain. That is where we use that knowledge in daily life for greater effectiveness. Thus, the problems for you have more to do with not using what you know at critical points of performance in your life than with not knowing what to do.

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Key to understanding ADHD is that many problems labeled simply as“ difficulty paying attention ” are actually problems with impulse control.

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The problem isn’t not knowing what to do( pay attention), but not doing what you know at the right time — which is to STOP before going off on a tangent or reacting to those distracting but irrelevant events.

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People without ADHD can stop themselves from responding to distractions; they do it so automatically that they’re not even aware of having made an effort to do so. You, on the other hand, lack that“ brake ” switch that could keep your mind trained on the task that’s most important to you : the one you need to get done right now.

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Adults with ADHD do not seem to monitor their performance of tasks as well as others, or to use mistakes they make to give them important information that could guide their actions in the immediate future. It’s as if they start on a straight line and stay on it relentlessly no matter the mistakes that may be piling up behind them.

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If what they are doing is particularly fun, rewarding, or interesting, many adults with ADHD may also find it hard to stop even when they’re not making mistakes but need to get on with another task that needs to be done soon but is far less interesting. While some advocates for adults with ADHD call this“ hyperfocusing, ” researchers call this problem perseveration. Perseveration often looks like procrastination. But as you might know, it’s not that the person has decided to put off something that isn’t fun. It’s that he or she decided to keep going on something that is fun.

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The“ time blindness ” of ADHD starts with a lack of impulse control.

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Lacking self - control robs you of free will. This is one of the most tragic consequences of ADHD. You might think you’re doing what you desire. Yet if you can’t inhibit your behavior, you miss out on the delay between an event and your response. That delay is essential : It gives you the chance to think. Even more critically, that delay empowers you to choose freely among all of your available options, both now and in the future.

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Self - control is defined in psychology as any response, or chain of responses, that we direct at ourselves that leads us to change our own behavior instead of just acting on impulse so that we can change what will happen in the future. It is action directed at the self to change that likely future.

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These are the six key components involved in self - control : 1. Self - control is a self - directed action.

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2. These self - directed actions are designed to change your subsequent behavior.

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3. This change in subsequent behavior is designed to achieve a net gain( maximization) of positive outcomes across both the short and long term for the individual. The behavior is directed at the future but will also take the immediate consequences into account to come up with the best bottom line.

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4. Self - control depends on a preference for larger delayed rewards over smaller, immediate ones. If you can’t conceive of the future or you don’t value later consequences, there’s no point to self - control and you won’t use it.

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Psychologists have found that our preference for larger, delayed consequences increases from childhood all the way up to our early 30s, paralleling the development of the frontal lobes of the brain — the seat of our self - control. But ADHD derails that development and leaves even adults picking the smaller immediate outcomes, instead of the larger delayed ones.

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5. Self - control bridges the time lapse between an event, our response, and an outcome. We may not need self - control at all when the gap between event, response, and outcome is small or nil.

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“ Carpe diem ” — seize the day — could be the motto of all adults with ADHD. It’s great on vacation; it’s terrible as a daily rule.

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Researchers refer to bridging the gap between event, response, and outcome over long time spans as a capacity for the cross - temporal organization of behavioral contingencies. It is job one of your executive brain( frontal lobes). That’s a mouthful. Think of it as the ability to engage in time management or, more aptly, to manage yourself relative to the passage of time.

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6. For self - control to occur, we need the capacity for both hindsight and foresight. How do we bind the events, responses, and outcomes of life together when there are large gaps in time between them ? We have to have a fundamental sense of time — that there is a past, a present, and a future — and be able to conjecture about the future.

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Poor inhibition leads to poor self - control and robs you of your free will — the capacity to choose wisely among possible options for responding to events or to your own thoughts.

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Scientists in the field of neuropsychology call the capacities behind self - control the executive functions, or sometimes executive abilities. They’re the actions directed at ourselves, the mental activities we engage in when we think about our future and what we should be doing to get there and to make it better.

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✓ Executive functions operate together but can cause impairments separately. Other scientists and I have divided executive functioning into seven separate abilities to understand them better. But we humans don’t experience them as separate, nor do we use them one at a time as adults.

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The seven executive functions develop one at a time, in sequence, each added to the earlier ones to build a mental structure, like a Swiss Army knife, that gives us a set of mind tools that facilitate our self - control.

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From external to internal : We all start out as babies being controlled by purely external events — a loud noise, a mother’s departure, a wet diaper, or, much later, the commands and directives of our parents — and then we become increasingly managed by internal forms of information, much of which deals with the past and future( images, self - speech, motivation, and so forth, which make up our hindsight and foresight). From others to the self : At first, we need to be controlled and managed entirely by others( such as parents), gradually becoming able to better control ourselves. From the present to the future : When very young, the only thing that matters to us is what’s happening right now. Throughout childhood we become increasingly aware of and directed toward future events. Think of how long you’d expect a typical 3 - year - old to think ahead and plan out her day compared to how far in advance a 14 - year - old should be able to do it( a day or two) and then for what period a 36 - year - old should be able to do so( 6 – 12 weeks ahead). From instant gratification to deferred gratification : More and more as we mature, we find the big prize at the end of the long haul to be worth waiting and working for and so turn away from the small seductions and rewards of the moment to work for those much bigger rewards.

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Self - awareness is the first executive function to emerge in childhood. It goes hand in glove with inhibition because neither one makes any sense without the other right alongside it, which means they both likely develop together or at least very close in time.

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One likely reason we develop self - awareness and other creatures don’t is that we are one of a rare handful of species that survive by living in groups with others, some of whom are kin but others of whom are not !

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granted. But when a disorder like ADHD undermines this basic executive function of self - awareness, it can undermine the entire system of self - regulation and its purpose. A deficit in that executive function means you have less awareness of how you’re acting, how your behavior is coming across to others around you, and what the predictable consequences would be for acting that way.

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Both adults and children with ADHD are often less aware than others of how loudly they’re talking, how much they’re talking, what they’re trying to say, how much they’re moving while saying it, why they’re even saying it( rambling and forgetting their goals), and especially how others are reacting to what they’re saying.

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is. Until age 30 or older, even adults with ADHD cannot be trusted to be the sole judge of their own behavior, symptoms, or impairments; they simply do not have the necessary self - awareness to make accurate self - assessments.

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Nonverbal working memory is the third executive function to develop, just shortly after your ability to monitor your own actions and then to inhibit the immediate urges to act. It’s the capacity to hold information in mind — not through words but through your senses.

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Nonverbal working memory allows not only imitation but the opposite : staying away from what someone else did that proved ineffective. This is called vicarious learning.

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Nonverbal working memory gives us a sense of time, a key to time management.

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Small children can’t see much past a few minutes ahead. And they can’t judge time intervals very well, much less use them to coordinate their actions. But by adulthood( ages 20 – 30), behavior is typically organized to deal with events 8 – 12 weeks ahead, and our sense of the flow of time is almost continuously informing our decisions and actions. And this time horizon can be extended further into the future if the consequences associated with those events are particularly crucial to us.

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Nonverbal working memory may be what makes selfish altruism part of human nature.

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This deficit in nonverbal working memory creates a major gap in the resources that adults with ADHD have to guide their behavior compared to typical adults. So to others you might look like you don’t think before you act. It would be more accurate to say you have trouble remembering — or more accurately, resensing — before you act.

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You may not make a good team player … or know how to be a good friend. When the grasshopper was starving, the ant rebuked him for failing to think ahead and create a nutritional stockpile. Social insurance can save your life. But if you have no concept of the future, sharing what you have with others makes no sense. All you can appreciate at the moment is the loss of your own hard - earned assets.

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The next or fourth executive function to develop in children that facilitates self - control is the ability to talk to yourself, especially in your mind. As kids we do this publicly. We narrate our play, talk to ourselves when alone, and weigh our decisions out loud. As every parent knows, kids can be pretty free with their commentary, even though their remarks may not be too flattering. Gradually children begin to talk to themselves silently, though they may still move their lips. By ages 7 – 9 they suppress even those movements, and now this voice occurs entirely in their mind.

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asking yourself specific questions, such as“ Is he angry at me, at his girlfriend, his boss, or someone else ? ” Describing the situation to yourself and even interrogating yourself with such questions gets you much more specific information than just a mental image might achieve

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3. We can formulate rules and plans. We need verbal working memory( our mind’s voice) to examine how things went in the past and extract from that rules for making sure they go well in the future. Our self - questioning and other self - talk allow us to weigh pros and cons based on our past experience, to talk to ourselves about what we could change to improve the future, and to set out steps toward a goal.

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6. We’re capable of moral reasoning. The rules — laws, ethics, customs — of the culture we live in play an important role in guiding our behavior. If we don’t know what they are and can’t talk to ourselves to remember what they are and how to apply them when we most need them, we can end up on the fringes of society, if not ousted altogether.

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✓ You follow certain rules rigidly. A rule is not doing its job unless it can bend a little. The world does not operate on absolutes. But if you can’t talk to yourself about the pros and cons and review with yourself the particulars of the situation that you’re in, you might follow a rule so rigidly that it will backfire. People with ADHD often lack flexibility.

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The fifth executive function that develops is the self - regulation of emotion. Emotions are primitive yet powerful signals we give off to ourselves and others as to our current feelings, intentions, and state of arousal. But they are also strong motivators of our subsequent actions. They can arouse us to act or prevent us from acting.

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Emotions arise whether we want them to or not.

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Fortunately, nonverbal and verbal working memory are also instrumental in helping us regulate our emotional response.

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Call it drive, willpower, persistence, determination, stick - to - itiveness — what have you. I call it the mind’s fuel tank because it generates the internal“ fuel ” or drive that powers us toward our goals. While I and many other neuropsychologists think of this as a separate executive function( the sixth here in my list), I combine it with emotional self - control because that is what helps to create our self - motivation. The former is therefore indispensable to the latter. By regulating and even creating our emotions with the other executive functions discussed above, we endow ourselves with internal motivation when no one else is handing us any incentive from the outside.

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But we’re embarrassed and disapproving of an adult who bursts into tears or yells in anger in public over a minor frustration like having to stand in a long line at the supermarket.

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When we develop our capacity to regulate our emotions in the service of our goals and longer - term welfare, we gain a sense of command or mastery of our impulsive reactions to events around us. No longer a slave to our passions, we, and not any potentially provocative events, are in charge of what we will decide to do in response to what is happening to us.

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This is what emotional self - control is all about : helping us stop and moderate those powerful knee - jerk emotions and substitute others that are more mature, socially acceptable, and consistent with our longer - term welfare.

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If we can hold images and words in mind, we eventually develop a means to manipulate them. We can take them apart, move them about, and recombine them into new arrangements or sequences in our heads just for the sake of seeing what the results are likely to be. It is our imagination.

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development. Play is simply taking things apart and recombining them just to see what happens or what you wind up with when you do so. It begins with manual manipulation of objects in childhood and progresses to the manipulation of images and even words in your mind.

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Play is training for inventiveness in adult problem solving.

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The capacity to mentally manipulate information and play with it in our minds gives us an incredible capacity for goal - directed creativity and innovation. Thinking outside the box just can’t happen without the mental play that this executive function makes possible. It’s like free will( see Chapter 8) cubed. Not only do you decide what to do, but you do it in a way that might not have occurred to anyone else.

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Ironically, the planning that you may find painfully slow can help you get a project done far faster.

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I hope you can now see that ADHD in adults is not merely a trivial problem with paying attention ! Instead it’s a far - reaching problem affecting the most important human capacities : It’s a condition that robs you of the ability to ignore impulses. It’s a deficit in the brain’s executive functioning that makes it very difficult to regulate and organize your behavior over time to prepare best for the future.

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To put it simply, you and other adults with ADHD are blind to time — or at least myopic. You’re not lacking knowledge or skill. Your problems lie in the executive mechanisms that take what you already know and the skills you already possess and apply them to more effective behavior toward others and the future. In a sense, your intellect( knowledge) has been disconnected from your daily actions( performance). You may know how to act but may not act that way when placed in social settings where these actions would benefit you.

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Before a child engages in a new activity or enters a new social situation, a parent or teacher stops the child, reviews the rules for the upcoming situation with the child, has the child repeat them back, and then reviews what consequences will ensue for obeying or not obeying the rules. You might be able to recruit a family member or your partner to do something similar, softly inquiring before an upcoming important situation how you would like to act in and get out of this new situation.

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We are more likely to behave better, progress in our work, and even improve in our other self - change programs( exercising, losing weight, quitting smoking, and the like) if we make ourselves accountable to a trusted other for doing so.

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✓ Make time physical. ADHD makes you concentrate mainly on the moment, taking your focus away from the signals and internal sense that time is passing. Use kitchen timers, clocks, computers, calendars, smartphones, tablets, and any other devices that can break time down by the hour and issue alarms when a chunk of time has passed. The more external you make the passage of time and structure that time with periodic physical reminders, the more likely you are to manage your time well.

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Normalize the underlying neurological deficits in the brain’s executive system. To date, the only treatment that shows any hope of achieving this end is medication.

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The medications do not reverse these deficits permanently; they do, however, have a remarkable positive effect while they remain in your system.

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There is no scientific evidence for the effectiveness of intervention outside the points of performance in your life where your major problems occur. Avoid talk - or insight - oriented therapy, psychoanalysis, weekly group therapy focusing on complaining, and similar treatments.

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Never stop looking for ways to compensate. You never know everything, so try to remind yourself not to get too confident once you start making progress in working with your ADHD.

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It’s hard to let go of the pain of lost relationships, jobs, education, and overall well - being that you’ve suffered as a result of untreated ADHD.

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You are not a victim. ADHD is not an irreparable handicap. The fact that you’re reading this book says you are looking for answers, not excuses. But some of the people around you may be inclined to view you as a less capable individual because you have this condition.

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Your job going forward is not to excuse yourself from the tasks made difficult by ADHD but to seek out the ADHD equivalent of wheelchair ramps into a building — making accommodations in your physical environment so you are less impaired by your ADHD in various settings.

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So, make( and accept) no excuses ! Own your ADHD, own its consequences, and then seek to minimize or eliminate those disastrous delays in life that are preventing you from being as effective, productive, and successful as people who don’t have ADHD.

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You can find the best resources available for those with ADHD and then use them, use them, use them.

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skeptic. The controversies that surround ADHD and the claims and criticisms from uninformed sources in the popular media have probably left you ready to doubt what you hear. Great ! This tendency will serve you well as you seek knowledge. Question the material you find. Look for or ask for the evidence behind the assertions.

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When you read about research evidence, make sure you know what data the research produced and what conclusions the scientists drew( such as using Google Scholar). Conclusions drawn by other parties, especially nonscientists, particularly when they disagree with the analysis of the investigators, are questionable.

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Step Three: Change Your Brain: Medications for Mastering ADHD

Research shows medications are the most effective treatment currently available for ADHD, being at least twice as effective as nonmedication treatments like counseling or behavior therapy and improving symptoms in 70 – 95 % of the adults who take them.

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There are a lot of reasons to take medicine, but most importantly is that they work and they make most other interventions work better as well.

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We now know that ADHD medications can normalize the behavior of 50 – 65 % of those with ADHD and result in substantial improvements, if not normalization, in another 20 – 30 % of people with the disorder.

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Research over the last decade has shown that these medications actually correct or compensate for the neurological problems underlying ADHD. They do so temporarily, only as long as they are in your bloodstream and brain, which means you have to keep taking them to keep getting their benefits.

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People with ADHD have less electrical activity in the brain, particularly in those regions noted just above, and are less responsive to events, meaning they don’t react to stimulation of these regions as much as others do.

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Stimulants being thrown ADHD  brain to baselineAddiction. Does it always replace the same missing blocks, or does it erode the already supporting systems requiring more medicine later.

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The brains of those with ADHD seem to be deficient in or show excessive reuptake of norepinephrine and dopamine in certain regions related to attention, inhibition, and executive functioning. Other neurochemicals may also be involved.

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Scientists believe the structural abnormalities in the ADHD brain and their poor functional connectivity likely underlie the development of the disorder : This is the genetic legacy that causes most ADHD cases and accounts for why it appears in the descendants of those who have ADHD. In others, the disorder may arise from injuries to these brain areas, such as from exposure to prenatal toxins, premature birth, or repeated head trauma during development. We don’t know how to restore a typical structure to these brains. We do, however, know how to correct the neurochemical imbalances and functional irregularities found in those with ADHD, at least temporarily : medication.

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The“damage” to the brain is there. We can’t fix it, but we can put an appropriate stop gap into place with medicine

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The three basic categories of drugs approved by the U.S. Food and Drug Administration for use with adults who have ADHD — stimulants, nonstimulants, and alpha - 2 hypertension drugs — boost your mind’s ability to respond to whatever is going on in your day. They don’t all work the same way, but the end result is that they manage the symptoms of ADHD effectively in most cases.

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The beauty of what we know about how the medications work is that it proves they are not simply masking or covering up the symptoms of ADHD, and it confirms our knowledge about the functioning of the brain regions involved and its connection to these symptoms. These medicines are not“ Band - Aids, ”“ billy clubs, ”“ chemical straitjackets, ” or merely“ mother’s little helpers, ” as some critics in the popular media have contended. While active in your body, they correct or compensate for the biological problem at the bottom of ADHD.

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The medicine isn’t masking a problem, it’s literally allowing the brain to work as intended. Like a clogged hose. We could put fake plants in place of real plants if the hose doesn’t work, but if we unclogged the hose, we could keep the natural beauty. With adhd, the hose has to be unclogged every day, and if you have the tool, it’s trivial to do so in order to have a nice, natural, garden.

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The effectiveness of medication doesn’t mean it’s the only treatment available. If your symptoms are mild, you may get what you need from the strategies and tools in Steps Four and Five or from a special form of cognitive - behavioral therapy that targets your executive function deficits. Coaching might be of great benefit. Support groups could provide you with shared ideas and inspiration.

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Do what’s best for you, but don’t deny medicine because other strategies are available, especially if you have a more moderate to severe case of ADHD

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Studies have shown that sometimes anxiety and depression are caused by the difficulties of living with ADHD and that when ADHD symptoms are alleviated through medication, anxiety and depression recede.

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ADHD in Adults : What the Science Says,

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Milwaukee study, which followed children from the late 1970s into adulthood in the new millennium,

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But 85 % of those diagnosed as adults were more likely to have other disorders too, particularly anxiety and depression. Why ? We don’t know for sure, but it could be that anxiety and depression were the result of having struggled with ADHD symptoms for years without treatment.

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Years of unknowingly masking may lead to anxiety and depression

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“ Do I deserve to have a tougher life than other people just because I was born with a biological predisposition to ADHD ? ” I don’t know too many people whose answer would be“ yes. ”

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ADHD does not arise from social factors or mere personal choices. You deserve to reap the benefits of any treatment proven to help.

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You should not be prescribed medication for ADHD without a firm diagnosis following a thorough evaluation by a qualified mental health professional.

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Stimulants are also the most controversial medications for ADHD. That is because unlike the nonstimulants, they are classified as Schedule II( potentially addictive) medications by the Drug Enforcement Administration. Despite that classification, when they are taken orally as prescribed for ADHD the risk for addiction is low to nonsignificant.

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The stimulants help ease ADHD symptoms by increasing the availability of several neurochemicals that carry self - control - boosting messages in the brain, especially dopamine. To be available as messengers, the neurochemicals have to be available in the spaces between nerve cells. Think of them as the water in a system of canals. The amphetamines mainly increase the amount of dopamine( and, to a lesser extent, norepinephrine) produced and expressed by the nerve cells so that more ends up in those spaces. Their effect in the brain is like opening a gate to let the water rush out into the canal. Methylphenidate works differently, by mainly decreasing the amount of dopamine that is reabsorbed into the nerve cell after being released — it keeps the lock closed so that the water( neurochemical) level remains high in the canal once it has been released there.

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The reason they don’t make hyperactive kids and adults even more restless than they already are due to ADHD is that these parts of the brain are underactive or underreactive in those with ADHD. There’s not enough norepinephrine and dopamine available to send signals between neurons and stimulate the mind to do what it’s supposed to do — pay attention, sit still, look before leaping, and so forth.

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The stimulants increase dopamine in the regions of the brain known to increase the likelihood of drug addiction( the reward center, or nucleus acumbens) — some of the same regions where the drugs do so much good for people with ADHD.

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Why don’t adults( or children) with ADHD get hooked on the stimulants ? Mainly because the drugs are taken orally, in pill or capsule form, in relatively low doses and thus enter and leave the brain very slowly. Most people who abuse stimulants use higher doses and snort them or inject them into a vein in a solution, such as the stimulant mixed with water. With those delivery systems the drugs hit the brain all at once with a much more powerful wallop. Also, when these medications are used to treat ADHD they are only bringing the dopamine levels up to normal, not raising them rapidly well above normal levels as they would in someone attempting to abuse the drugs through intranasal or intravenous use.

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You may have heard claims that these drugs increase the sensitivity to or risk for abusing other drugs, especially other stimulants. The vast majority of research does not support this claim. More than 16 studies have examined this issue, many, like my own, having followed children with ADHD treated with stimulants for months or years into adulthood. They did not find any increase in risk for later drug abuse.

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the evidence to date does not support any claims that using stimulants as prescribed for managing ADHD contributes to the risk of abusing these or other drugs now or later in life.

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The available evidence actually shows that people on stimulants have a somewhat lower likelihood of sudden death than the general population. This is probably because physicians routinely screen for heart problems before prescribing stimulants and don’t use them for anyone with a family history of sudden death or a personal history of structural heart abnormalities, major arrhythmias, other major cardiac problems, or even high blood pressure. This means that those at greatest cardiac risk with stimulants usually don’t end up with this prescription.

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The stimulants increase heart rate and blood pressure, but only as much as climbing a half flight of stairs. There’s no evidence that they cause high blood pressure in those who didn’t already have it.

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The research is somewhat mixed on whether stimulants worsen anxiety, but enough studies have found this to be the case( though more with children than adults and more with amphetamines than methylphenidate) that you should be aware of this possible adverse effect. If you are concerned about anxiety, the nonstimulants might be a better choice( see

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Although not yet approved for ADHD in adults, a new delivery system became available in June 2019 for use by children and teens with ADHD. It uses methylphenidate but binds it into a unique delivery system that creates a delay in the activation of the medication( brand name Jornay PM). Children take the medicine at 9 : 00 P.M., and the drug activates

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there can be a significant difference. The generic medications appear not to be manufactured with the same degree of rigor as the brand - name medications. The generics have been associated with numerous reports of greater variability in controlling symptoms on a day - to - day basis and less success overall in managing symptoms. Should that occur, ask to be transferred back to the brand - name medicine.

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As long as it’s not past 1 : 00 or 2 : 00 P.M., you can probably take the drug without much impact on your sleep. If you have forgotten for the day, just take it the next day. There appear to be no problems with abrupt cessation of the stimulants, most likely because they wash out of your body within 24 hours in most cases when taken as prescribed.

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Actual physical tolerance seems unlikely with the current ADHD medications, but some individuals report that their medication seems less effective 3 – 6 months after starting their treatment. This usually requires adjusting the dose or, sometimes, changing to a different delivery system or medication.

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Some people adjust their view of themselves once on medication and end up focusing so strongly on areas where they haven’t experienced improvement that they start to believe the drug isn’t working. They may need to stop the medicine for a few days to remind themselves of the positive effects it has had on them — or to discover whether, in fact, the drug is not doing anything for them.

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lol stop taking it and see what happens

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Atomoxetine was studied more than any other ADHD drug before receiving FDA approval, with randomized double - blind studies involving more than 6,000 patients worldwide.

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The drug prevents norepinephrine from being reabsorbed by the nerve cells once released, thus leaving more of the drug outside the cell to act on other, nearby nerve cells. This makes it a natural for treating a disorder marked by a shortage of that chemical messenger.

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On average about 75 % of people get positive effects from the stimulants or the nonstimulants. Some studies suggest that while 50 % of people respond positively to both types of medications, 25 % may respond better to a stimulant than to atomoxetine, while the remaining 25 % may respond better to atomoxetine than to one of the stimulants.

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This might be the treatment of choice for you if you’ve struggled with substance abuse of your own.( In fact, one study of adult alcoholics with ADHD showed that atomoxetine improved ADHD and reduced heavy drinking at the same time.)

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The package insert for atomoxetine warns of a possible increase in suicidal thinking from this drug, though not in suicide attempts. It’s important to note that this risk was not found for teens or adults. Even for children it remains questionable because the methods by which the information was collected in the initial clinical trials weren’t entirely sound and the problem was noted at only one of the 23 sites involved in the study.

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Using a medication to treat a condition for which it is not FDA approved is called“ off - label use ” and can be perfectly safe( and even the best choice). But always ask your doctor to explain the pros and cons and why one drug is preferred over the alternatives.

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Medications for ADHD, especially the stimulants and atomoxetine, are among the safest, most effective, and best studied of all drugs used to treat psychiatric conditions. You have a very good chance — up to 80 % — of zeroing in on a course of treatment that will turn your life around.

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Most doctors are likely to try a stimulant first if you don’t seem to have another disorder besides ADHD, or it’s urgent or a priority to get relatively rapid control over your ADHD( you are about to be fired if your work doesn’t improve, your spouse or partner plans to leave you if things don’t turn around quickly in your relationship, you’re about to fail college classes, and so forth).

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If you think you’re not benefiting from a drug you’re trying, be sure to ask for feedback from someone who lives with you or is otherwise close to you. Sometimes the changes you’re experiencing are easier for others to see.

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People around you will help you gauge how well medicine is helping you, same as getting diagnosed

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Your doctor should always treat the most impairing or life - threatening condition first. If, for example, you have bipolar disorder or serious depression, the first medication tried should be for that condition, before you start an ADHD medication.

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follow - up exams every 3 – 6 months. We’ve found that people often need additional dosage adjustments after the first 3 – 6 months on their medication, whenever they’ve had an unusual weight gain or loss, or when their life circumstances have changed dramatically and so has control of their symptoms.

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In my clinical experience some adults have found that the medication they were taking greatly restricted their range of emotions and even creativity. While this is not common and has not been documented in research studies, these individuals were in unique employment situations where their complaints made some sense.

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Keep in mind that no medication for ADHD will miraculously solve all your problems.

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Living with untreated ADHD for a long time can leave you with a history of mistakes you didn’t need to make. Those mistakes can leave other people expecting bad behavior and poor decisions from you. In turn, you can end up resentful and defensive. Even now that you can function better, you might have trouble looking objectively at what’s causing your problems.

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Therapists and life coaches can be of huge assistance to many adults with ADHD once they have begun a course of effective medication. Please understand, though, that there is no scientific evidence this kind of treatment will suffice on its own.

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Step Four: Change Your Life: Everyday Rules for Success

Change the situation enough, and you reduce how handicapped or disabled you will be within it. Disorders belong to people. Handicaps belong to situations.

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Rule 1 : Stop the Action !

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The problems with self - control that are at the heart of ADHD begin with difficulty resisting impulses.

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Remember, the executive functions give you the capacity to exercise self - control. Making a conscious effort to use that capacity is up to you.

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Figure Out Where Impulsivity Hurts You Most

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You gotta stop playing Tigger and become Winnie the Pooh. Quit being a Robin Williams in some rapid - fire stand - up comedy act and start being more thoughtful, like Tom Hanks or Will Rogers. Slow it down. Think of yourself as a southerner instead of a northerner.

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Rule 2 : See the Past … and Then the Future

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Identify Where You Have Weaknesses in Nonverbal Working Memory

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Strategy : Use an imaginary visual device to turn on your mind’s eye.

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Your mind’s eye( nonverbal working memory) may be weaker and less effective than that of others. But you also have a mind’s voice. And that can serve to enhance what you are trying to visualize in your mind. Read on to Rule 3.

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Rule 3 : Say the Past … and Then the Future

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When we learn to stop the action and then see the past so we can foresee the future, the only way to learn from the mental imagery is to use words to describe it. Talking to ourselves is central to problem solving. It’s essential to planning. It’s even critical to understanding the rules of society.

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Identify Your Biggest Verbal Working Memory Problem Areas

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Strategy : Become your own interviewer. Don’t just see the mental images in your mind : ✓ Discuss them with yourself. ✓ Label them. ✓ Describe just what you are seeing in your mind’s eye. ✓ Then extract some rule or principle from this review that tells you what you want to do the next time you face this situation. That voice in your head is not just there to keep you company. It’s a device to help with self - control.

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Strategy : Narrate what’s happening out loud. Even if you’re around other people, you can pretend you’re using a hands - free device, talking on your cell phone. You’ll blend right in with everyone else. As you know, kids narrate their own play all the time. As adults, we’re supposed to have learned how to make this commentary private and internal. Unfortunately, ADHD has other ideas. So let’s go back to what worked so well when we were kids.

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Rule 4 : Externalize Key Information

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Where Do You Still Have a Lot of Trouble … No Matter How Much Mental Effort You Invest ?

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Strategy : Put physical cues in plain view in problem situations. These cues can take many forms. Here are some examples keyed to particular problem situations :

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Your physical cue must be in plain sight, right in the place where you need the reminder.

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An external cue not only helps you stop what you were impulsively about to do but also tells you what to do instead, and even why you were trying to change yourself for the better in the first place.

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Which brings me to a second idea for reining in an out - of - control to - do list : use a journal. If you keep track of how long you took to do certain tasks, you’ll begin to know yourself and your habits well enough to budget your time more accurately. See the following strategy. Strategy : Carry a journal with you all the time.

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The adults I know with ADHD report that being viewed as more forgetful and less reliable than other adults — being unable to keep and fulfill promises and commitments the way adults are expected to do and generally being thought of as less trustworthy — causes them more shame and distress than just about any other shortcoming that ADHD has handed them.

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Smartphones or digital recording devices are ever present and may seem like an obvious choice for your journal. But I’ve found that people are likely to use and remember to read a small pocket journal, whereas they often misplace their little digital recorder or just forget to replay and listen to what they said earlier.

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Don’t just write in your journal. Refer to it often, hourly if need be, to keep yourself on target in honoring your agreements, completing assigned work, fulfilling promises to others, and meeting those deadlines.

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Rule 5 : Feel the Future

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Unfortunately, for adults( and kids) with ADHD, the threat of negative consequences isn’t the most potent incentive. And even if it were, not everything comes with an obvious, direct, or dire consequence for nonperformance. For many adult goals, you’re just supposed to do what you have to do because it has to get done and getting it done is the right thing to do. A lot of adults in the general population find this intrinsic motivator pretty unmotivating too.

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ADHD makes it hard to stay motivated to complete tasks for all the reasons listed above. But there’s another reason that various responsibilities seem so uncompelling, their purpose so flat and abstract : There is no emotion attached to getting them done.

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Scientists studying human emotions have concluded that a major function of emotion is to cause or motivate us to act. Although emotions are complex, certain emotions generally lead to certain types of actions. Here are just a few examples : Fear leads to“ fight or flight ” — attacking the source of danger or running away. Anger leads us to right a wrong. Joy and pleasure lead to the urge to keep doing what we’re doing. Shame dissuades us from repeating the shameful act.

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But what may really move us to heed the warnings we give ourselves is our memory of how we felt about these consequences.

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How we feel about a situation is different than a moral condition to compete or fail something. I think that can be abstract for people without ADHD because to them it’s a moral issue, for a person with ADHD it’s a feeling about the moral issue.

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Strategy : Ask yourself point blank,“ What will it feel like when I get this done ? ”

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Feel that future, and keep feeling it, all the way, until you get there !

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It’s not that you don’t feel the emotions that others feel. It’s just that you may not have your experiences with them slotted away in your mind to the same extent. Or they may not be as easily retrievable as they are for people who aren’t dealing with ADHD.

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Rule 6 : Break It Down … and Make It Matter

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ADHD can make the future seem hopelessly distant.

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Strategy : Break down longer - term tasks or goals into much, much smaller units or work quotas.

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Don’t be embarrassed to think of yourself in the same way you’d think of a young student with ADHD : You wouldn’t expect a child to come home from school and do 30 math problems in one sitting( nor would a good teacher expect that in the classroom).

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Sign to post on your desk or work area : CHUNK IT, BABY ! Strategy : Make yourself accountable to someone else.

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Making yourself accountable brings in the internal motivator of emotions too. Letting someone else down doesn’t feel good; receiving admiration feels great.

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Strategy : Give yourself little rewards as you accomplish each small objective. When we design programs for children with ADHD, we invariably give them points, tokens, poker chips, or some other reward for achieving the small work quotas discussed above. This, along with praise and approval, helps them get and stay motivated to finish drawn - out work assignments. The same applies to adults, except there is no teacher to dispense the points or rewards. You have to do that for yourself.

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That’s how I wrote this entire book — brick by brick. Or, as Anne Lamott put it in her book on writing, Bird by Bird : Her brother had to write a class paper on birds and could not get started, so their father told him to just write a few sentences on one bird, then come tell him about it, and so on, until the paper was finished. So, my friend, take it bird by bird. Stop briefly to note your success and briefly reward it at the end of each bird.

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Rule 7 : Make Problems External, Physical, and Manual

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It’s not that you’re incapable of logical analysis or you lack intelligence — far from it. It’s just that you need to make the process tangible and external to move through it smoothly and successfully. In essence, you need to be able to use your senses to oil the gears of your mind :

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Our studies have shown that difficulty solving problems in their head keeps affecting people with ADHD as they get older, though in different ways. Young children may have trouble with mental arithmetic. They may not be able to recite backwards a string of digits read aloud to them. As they get older, they can’t hold all the parts of a story in mind( characters, places, dates, actions, and the like) as well as other adults when asked to explain the story concisely or write a paper analyzing the story in some way. Our research now shows that this problem affects adults with ADHD just as much.

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Strategy : Use physical, external tools to solve problems whenever you can. Holding lots of information in your mind and manipulating it in various ways without losing track of anything is a pretty sophisticated ability. It also requires a fair amount of effort, energy, and concentration.

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Rule 2 advised you to externalize something you need to remember by writing it down, posting it on a sign, or creating some other cue. Here in Rule 7 you extend the idea a bit further, externalizing everything you need to consider to solve a problem.

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If you have ADHD, odds are you will be better at solving various problems or completing various mental tasks if you can get them outside of you, broken down into pieces or in some other physical form that you can work with manually in addition to mentally.

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Rule 8 : Have a Sense of Humor !

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ADHD may be serious, but you don’t always have to be.

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As one adult with ADHD told me,“ I want to go sliding into my grave and know that I lived a meaningful life rather than slouch toward my final ending. ”

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We want you to take much the same attitude toward your ADHD : You have it, so you might as well own up to it. And, whenever appropriate, laugh about it.

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Step Five: Change Your Situation: Mastering ADHD in Specific Areas of Your Life

You can enhance your educational achievements through a number of routes, from medication to accommodations provided by the school to self - help strategies. Your best bet for targeting the aids tailored to meet your unique needs is to know as much as you can about your own abilities.

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our studies showed that adults with ADHD were more likely to have been punished at school( 42 % among those just diagnosed — a whopping 62 % among those diagnosed as kids). They had more problems with others at school( 44 % and 53 %, respectively). A huge 71 % of adults diagnosed as children had been suspended or expelled at least once. Obviously, you’re not looking to repeat that kind of experience. Yet you’re likely to have problems again if you’re pursuing adult education classes or workplace educational programs. You can do yourself a big favor by knowing what you can do to get around those problems.

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You are entitled to reasonable adjustments to your educational activities as provided under the Americans with Disabilities Act.

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ADHD medications are the most effective way to begin to address the school and workplace problems that ADHD poses for most adults.

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✓ Get a tactile cueing device that can provide frequent prompts to keep you focused on the work at hand. One possibility is the MotivAider, a small plastic box about the size of your cell phone that holds a small vibrator and a digital clock that can either be set for any interval you wish or set to random intervals so that it vibrates unpredictably.  One place to get the MotivAider is amazon.com.

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✓ Tape or digitally record important lectures or meetings or use the Smartpen digital recorder.  For information on the Smartpen, which records as you take notes, see livescribe.com.

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If you have lots of reading to do for school or work, learn to use the SQ4R method for reading comprehension. Here, briefly, is how it works : Survey the material to be read — just leaf through it quickly to get some idea of how much is to be read, how it is broken up, and so forth. Draft some questions that need to be answered from what you are to read. Often these are at the end of the chapter to be read or have been given to you by your teacher. Now use the 4Rs : Read just one paragraph, recite out loud in a soft voice or whisper what was important in that material, write that material down in your notebook, then review what you just wrote. Do this for each paragraph. This not only makes you review what you’re reading four times per paragraph( read, recite, write, review) but also gives you frequent mental breaks as you shift your concentration at the end of each paragraph from reading to reciting to writing to reviewing across the assignment. As you get good at this, you can read longer passages, such as two paragraphs at a time or an entire page, before engaging in the recite, write, and review steps. This is a great strategy for people with working memory problems.

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More recent opinion suggests that you’re better off using a method called“ time off the clock. ” This involves using a stopwatch to take these timed tests. With this stopwatch you will not get any more time to take the test than do other students, say 1 or 2 hours. But what you are allowed to do is to stop the watch anytime you like, as often as you like, to take a short break of a minute or two.

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Schedule faculty or adviser review meetings often — every 3 – 6 weeks. Remember that the more often you’re held accountable for your work, the better you’ll do.

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Adults with ADHD were found to change jobs more often and to have more trouble meeting the demands of their jobs, working independently, finishing tasks, and getting along with the boss. They were fired or laid off more often than adults without ADHD.

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Coworkers can be huge sources of distraction or“ off - task ” activities, so limit such interference when you can.

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Will your assigned space help you get organized ? If there’s no room for you to put your files and other materials, you could spend the majority of your workday looking for what you need.

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Will you be able to keep track of the passing hours ? If you have no windows, no wall clocks, and no other way to tell what time it is, you’ll have to rely solely on your own tools to keep track of the time and stay on schedule. That can be hard for adults with ADHD, who cannot seem to harness their internal clocks to keep them functioning in a timely manner.

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Will your supervisor be supportive of what you need to get the job done ? Whether the job can be adapted to suit your needs often depends largely on your supervisor. If your boss takes a sink - or - swim attitude with employees and doesn’t give a hoot about individual needs, you should probably find another job.

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If you’re going to assert your right to receive workplace accommodations under the Americans with Disabilities Act, yes. You may have to invoke that law to get what you need.

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Money problems among adults with ADHD run the gamut from overspending to nonpayment of bills to failure to plan for retirement.

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Our research has found that adults with ADHD : Made a lot of impulse purchases Had high credit card balances Exceeded their credit limits more than others Made bill, loan, and rent payments late or not at all Had their cars repossessed more often than others Had lower credit ratings Were more likely to have no savings Were less likely to save for retirement Bounced checks more often than others Often failed to save receipts that could document money - saving tax deductions and other documents for their income tax returns Lost friends after borrowing money and not repaying it

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Money problems are also notorious for causing relationship conflict. Trying to extricate yourself from debt may lead to borrowing money and alienating those who now feel the burden of your financial trouble. Disputes with intimate partners often center on money matters, and they may get even more heated when one person has trouble managing money due to ADHD. Why Money Matters Are

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The mind’s eye is particularly important in controlling the impulse to buy things you don’t need or can’t afford.

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Sleep deprivation, overconsumption of caffeine or alcohol, drug use, lack of exercise, and poor diet can all make you more vulnerable to daily stress and make it harder to control your emotions.

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Unexpected medical costs are one of the biggest sources of unanticipated expenses, large debts, and even bankruptcy.

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The less you see of your cash, the less you can spend it impulsively.

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If you don’t save at least 10 % of your income, you are having your vacation / retirement now and will be working the rest of your life to pay for it !

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The minimum credit card payment is based on a 10 - year payoff plan, assuming no extra debt is added to the card – 10 years !

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Never borrow money for something you consume, wear, or use for entertainment( like flat - screen TVs, iPhones). Borrow just for buying a home, getting a car( maybe), or some other reasonable investment.

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The only time you should buy something whose value goes down the minute you buy it is when it’s a necessity.

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You probably don’t need a psychologist to tell you how ADHD and its underlying problem with self - control create social difficulties.

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The executive function called emotion regulation causes lots of trouble for adults with ADHD. Unfortunately, because it doesn’t seem connected to more widely known symptoms like inattention and hyperactivity, you might not automatically associate emotional upheaval with the disorder. But adults with ADHD report that problems with managing anger, frustration, and hostility when provoked are just as common as their other symptoms and lead to lots of social conflict.

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Emotional control problems may make you act boisterous, silly, or melodramatic, but it’s uncontrolled anger that threatens your relationships most.

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uncomfortable for those in the firing line. You might recognize, ruefully, that some people have opted out of your life because they couldn’t stand the heat. But those revelations don’t automatically translate into different behavior at the moment when you’re provoked.

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Reading entrance and exit cues is just as important as what you do onstage.

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Social encounters with others require more than just the normal give - and - take of conversations or other social actions. Adults have to do a higher level of self - monitoring to know when to start, shift, end, or keep an interaction going. Continuously playing the role of spectator over our own behavior as it plays out with others requires us to perform these steps in every encounter : Read bodily and facial cues Perceive the emotional nuances in tone of voice Adjust our own behavior accordingly

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Our research and other studies have shown that adults with ADHD are more likely to have : Fair to poor dating relationships( four to five times more likely !). Lower - quality marital relationships( our studies found more than a twofold difference). Extramarital affairs.

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Read Gina Pera’s book Is It You, Me, or Adult A.D.D. ?( 1201 Alarm Press, 2008). This is the best book available right now for partners in relationships where one has adult ADHD.

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Multiple recent studies have shown that mindfulness practices can help you cope with the symptoms and executive deficits of adult ADHD, especially those involving emotional control.

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( For more information see The Mindfulness Prescription for Adult ADHD by Lidia Zylowska, described in the Resources.)

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Adults with ADHD report much higher parental stress than other parents.

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Now you have someone else to think of first — a tall order when you have trouble resisting impulses to do what you want right now.

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Research suggests that 30 – 54 % of the children of adults with ADHD will have ADHD.

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Our own study found that the children of adults with ADHD were also more likely to be oppositional and defiant even if they did not have ADHD.

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Several studies show that parents with ADHD are less likely to monitor their children’s activities than other parents. Lack of monitoring is one of several factors that raise the risk of accidental injuries in those children. This may explain, in part, why children with ADHD have more injuries of all types than other kids — many of their parents have ADHD.

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Inconsistency is the bugaboo of parents with ADHD. You might be a harsh taskmaster one day and your child’s fairy godmother the next. Or you might just react impulsively to every( mis) behavior with off - the - cuff comments, directives, commands, or reprimands. This is confusing to kids.

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Guilt, fear, and a desire to avoid more stress may make you downplay signs of ADHD you see in your child. In that case try to trust your spouse or other close relative without ADHD who reports the same concerns.

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Our extensive studies on adults with ADHD revealed significant problems with starting and maintaining social relationships. Adults with ADHD generally say they have fewer close friends than others do, though most said they had some friends. Almost invariably, friendships didn’t last as long as for adults without ADHD.

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Research has found that at least 50 % and as many as 70 % of children with ADHD had no close friends by the time they reached second or third grade. It didn’t take weeks or years for other kids to start rejecting those with ADHD but minutes to hours after the child with ADHD entered a new peer group, such as children at a summer camp.

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Rather, you have deficits in the executive functions that would help you assess risk. To put it simply, where risk is concerned, you usually don’t see that there is any.

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ADHD makes you“ probability blind ” — you don’t look ahead to consider seriously and rationally what might happen as a result of whatever actions you’re considering taking.

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It’s no wonder that children with ADHD are twice as likely as others to die before age 10 and adults with ADHD over four times more likely to die by age 45, largely due to their risk taking and propensity for accidental injuries. And my own recent research shows that all of these adverse health correlates of having ADHD add up to an average of 11 – 13 years of reduced life expectancy compared to others of the same age — that’s two to six times worse than any of the big health risks public health agencies are so concerned about in adults( smoking, obesity, alcohol use, poor nutrition, lack of exercise).

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Adults with ADHD are 2.5 times more likely than other adults to die prematurely from misadventures like car accidents.

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Studies show that adults with ADHD : Already drive as if they are legally intoxicated even if they have had no alcohol Are more adversely affected in their driving by even low doses of alcohol than drivers without ADHD

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According to various studies, kids with ADHD are more likely to spend time in a hospital burn unit, to be involved in pedestrian – auto or bicyclist – auto accidents, to be poisoned, to break bones, to have head injuries, and to lose teeth than other kids.

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There are only a few studies on the sexual activities of teens and adults with ADHD, two of which were done by my research team. We found that children with ADHD started having intercourse an average of a year earlier than other kids, had more partners, used contraception less, and ended up with nearly 10 times more teen pregnancies( as either the father or the mother) and four times as many sexually transmitted diseases.

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Having another disorder besides ADHD doesn’t make you unusual or beyond help. Only 1 in 5 adults with ADHD has ADHD alone.

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Alcohol does not treat the symptoms of ADHD. In fact, it could make them worse.

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Like alcohol, marijuana is consumed in much greater quantities over the lifetime of adults with ADHD than other adults. Why ? That’s not clear to me.

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