ADD in Adults?

By Jessie Sholl, Experience Life

An estimated 15 million Americans suffer from ADD, the majority of them undiagnosed. Once considered a childhood disorder that’s outgrown by adolescence, it’s now known that 60 to 70 percent of children diagnosed with ADD continue to experience it as adults.

Characterized primarily by excessive distractibility, impulsivity and restlessness, ADD can wreak havoc in one’s personal and professional life. Too often, substance abuse, serious depression, job failure or a broken marriage are the wreckage left in the disorder’s wake.

“Traffic accidents are eight times more common among those with ADD. The prisons, divorce courts and unemployment lines are full of people with undiagnosed ADD,” says Edward M. Hallowell, MD, director of the Hallowell Center, a clinic specializing in the treatment of ADD in New York City.

“Having ADD can be a curse,” says Hallowell — who speaks from personal experience, having both been diagnosed with the disorder himself and raising two sons with ADD. But, he notes, it is not a life sentence. With the right knowledge, skills and strategies, ADD can be a unique gift that helps people thrive.

That was precisely Jennifer Koretsky’s experience. Before her diagnosis, she says, “I was really struggling. It felt like I had to put in so much more work and effort just to keep things together; it was hard for me to get to work on time; there was never any food in my fridge; there was never any time to keep the apartment clean or get my laundry done. It felt like I was constantly struggling to keep up.”

Her diagnosis, she says, “explained so many of my challenges, like disorganization and poor time management, but it also validated my strengths — creativity, compassion and drive.”

What is ADD?

The hectic pace of modern life, the constant techno-interruptions of email and social media, the omnipresence of speakers and video screens in public spaces — it can make anyone feel distracted. And we all misplace our keys or forget an appointment now and then. But, as Hallowell notes in one of his books, Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder (Ballantine Books, 2005), occasional periods of distraction do not necessarily mean you’re suffering from ADD.

“Because its symptoms abound in modern life,” he writes, “ADD is a seductive diagnosis; it is easy to imagine that you have ADD when you do not.”

It’s the intensity and duration of symptoms that determine a diagnosis of ADD. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) lists 18 symptoms for ADD, clustered into two areas: inattention and hyperactivity-impulsivity. To warrant an ADD diagnosis, one needs to have experienced six or more of the symptoms from one or both of the groups for at least six months. The symptoms must impair your life in some way, and they must occur in two or more areas of your life — for example, home and work. (Hallowell has established a distinct diagnosing protocol at his clinic; see the “Diagnosis: ADD” on page 4.)

Attention deficit disorder is something of a misnomer. Someone with ADD doesn’t have a deficit of attention. It’s actually an inconsistency in attention, which allows people with ADD to hyperfocus at times. And contrary to some outdated stereotypes, many people with ADD are often clever and outgoing. But that combination of sociability and hyperfocus can present its own challenges.

Many people also have the misconception that ADD is limited to hyperactive boys. While boys are diagnosed with ADD three times more often than girls, this is likely because, in girls, the disorder typically presents as the “inattentive” or “dreamy” type (staring out windows or drifting off midconversation), as opposed to the “hyperactive” type.

Next: the ‘Dreamy’ type

Gina Masullo fits the description of the dreamy type. She was nicknamed “The Wanderer” in elementary school, she says, and got a bad reputation because she couldn’t stay put in her seat. “My teachers labeled me ‘under-challenged,’ so I skipped second grade,” she recalls. The move didn’t abate her restlessness, but she coped well enough to avoid getting disastrous grades.

As an adult, Masullo job-hopped. “I’d get really excited about a new job or a new opportunity and then all of a sudden just kind of go cold on it and make another job switch,” she says. “My tolerance for job stresses was pretty low, and I would just get frustrated and give up.”

When she was diagnosed with ADD at 30, Masullo promptly put strategies in place to manage it: She exercises daily, eats a high-protein breakfast and has made behavioral adjustments like using to-do lists. She also sees an ADD coach.

And she seized upon the strengths ADD affords her — energy, creativity and drive — to start her own public relations firm. She’s now thriving professionally and accomplishing things she’d never thought possible — like running her first 5K last year, something she says she’d never had the discipline to attempt before.

History Counts

Diagnosing ADD requires a thorough evaluation with a medical doctor, psychologist or psychiatrist. The evaluation could take one appointment, or it could take a few weeks. The doctor may create a brain map, which is the recording and analysis of brainwave activity through neuroimaging, and a battery of psychological tests. Blood tests can rule out underlying factors such as a thyroid problem.

The most important diagnostic tool, though, is the person’s history. Sanford J. Silverman, PhD, a psychologist at the Center for Attention Deficit and Learning Disorders in Scottsdale, Ariz., has been treating adults with ADD for two decades. Silverman advises bringing along a family member or very close friend to the evaluation. “When you get somebody else’s input — particularly someone close to you that you’re living with — they’re going to point things out that you may not be aware of,” he says.

School records may be helpful, too. Since ADD doesn’t develop in adulthood, a person would have had symptoms dating back to childhood. (Although in rare cases, ADD symptoms can develop after a head injury.)

A proper diagnosis is important, says Silverman, because “you can have ADD symptoms from another disorder. For example, if somebody has an anxiety disorder, they may look like they have some ADD components.”

Sometimes a diagnosis of adult ADD comes on the heels of a child’s diagnosis. That was the case in Melissa Orlov’s family. Her daughter was diagnosed with ADD in 1999 and her husband a few years later. That’s not uncommon, says Orlov, a marriage consultant in Boston and the author of The ADHD Effect on Marriage: Understand and Rebuild Your Relationship in Six Steps (Specialty Press, 2010). “A child is diagnosed because they’re struggling in school; then the parent starts to read up about it and says, ‘Wow, that sounds familiar.’”

For most ADD sufferers, naming what’s been going on brings relief. “When you get the ADD diagnosis, you can finally shed all those accusatory, ‘moral’ diagnoses, like lazy, weak, undisciplined, or, simply, bad,” writes Hallowell in Delivered from Distraction. After the diagnosis, he says, you can begin to “unwrap your gift” — and begin using ADD’s positive aspects to your advantage.

Jessie Sholl is the author of Dirty Secret: A Daughter Comes Clean About Her Mother’s Compulsive Hoarding (Gallery, 2010). She lives in New York City.

Next: Diagnosing ADD

Diagnosis: ADD

The following characteristics are commonly associated with attention deficit disorder, according to Edward Hallowell, MD, director of the Hallowell Center in New York City, which specializes in diagnosing and treating ADD and other cognitive and emotional conditions.

“If you have exhibited at least 12 of the following behaviors since childhood, and if these symptoms are not associated with any other medical or psychiatric condition, you should consider being evaluated by a professional,” says Hallowell.

A sense of underachievement, of not meeting one’s goals (regardless of how much one has actually accomplished)

• Difficulty getting organized

• Chronic procrastination or trouble getting started

• Many projects going simultaneously; trouble with follow-through

• A tendency to say whatever comes to mind without necessarily considering the timing or appropriateness of the remark

• A frequent search for high stimulation

• An intolerance of boredom

• Easy distractibility; trouble focusing attention, tendency to tune out or drift away in the middle of a page or conversation

• Often creative, intuitive, highly intelligent

• Trouble going through established channels and following “proper” procedures

• Impatient; low tolerance of frustration

• Impulsive, either verbally or in action (e.g., impulsive spending of money)

• Changing plans, enacting new schemes or career plans and the like; hot-tempered

• A tendency to worry needlessly, endlessly; a tendency to scan the horizon looking for something to worry about, alternating with attention to or disregard for actual dangers

• A sense of insecurity

• Mood swings, especially when disengaged from a person or a project

• Physical or cognitive restlessness

• A tendency toward addictive behavior

• Chronic problems with self-esteem

• Inaccurate self-observation

• Family history of ADD/ADHD or manic-depressive illness, or depression, substance abuse, or other disorders of impulse control or mood


Related Links:
8 Tips to Focus Your Mind
Yoga Moves to Improve Concentration
8 Morning Activities to Keep You Present All Day

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Travis K.
Travis K.3 years ago

I've been selected with the "gift" off A.D.D. for 9 years now. It is a curse but a curse that can be used for good. I had numerous people tell me lead singers and other famous people had A.D.D. We are a different breed. We see the world differently. Others may say we are weird or out casts. To people who don't know what A.D.D. is like, walk into a room full of teenage girls talking, all at once about different things, don't mean to offend anybody, than try to remember a number, while explain street names while saying your ABC's backwards. Okay, not that extreme but some may agree! It effects my relationships, sleep, and food intake. I'm currently trying to find a specialist to help with A.D.D. and my anxiety tied with it. To many pills!

Anja N.
Justin R.4 years ago

Great article. Thanks.

Jane H.
Jane H.4 years ago

Really important and interesting topic---thanks. We have this in our family.

Petra Luna
Petra Luna4 years ago

I have ADD. And it's hard to read a big wall of text. Some people think my short and direct answers are rude, but I can't focus on these big huge things.

Thanks for making the list easy to read.

Cindy B.
Cindy Black4 years ago

PS, another quick thought: WHY do bipolars and ADD/ADHD's get into so darn much trouble? Because all that excess nervous energy constantly seeks TARGETS: stuff to expend the energy against; stuff to stop it, define it, direct it, contain it. This often fails to serve the person's needs adequately, and it often involves social situations and interactions that can be quite exasperating &/or tiresome for others. My heart goes out to all manics (and ADD/ADHD, PTSD, MAD, GAD and all the other cousins in that fascinating extended family.)

Cindy B.
Cindy Black4 years ago

Interesting how "ADD" seems to be the term de jour for people who've always been called "Bipolar" in the past. Yes, there are some differences, notably the lack of depressive episodes... although the commonest form of bipolar (often called mixed anxiety and depression or MAD) is one in which the person is "up" almost all the time, rarely having an actual depressive slump.

Because of SO MUCH going on in their heads, both conceptually and emotionally, almost all the time, bipolars are extremely disorganized, restless, stimulus-seeking, tangential and distractible... i.e., everything described herein as "ADD."

Also, actually it's NOT so essential to "get an accurate diagnosis" as advised herein. In point of fact, VERY FEW people neatly "inhabit" a particular diagnosis. Instead, in actual practice, 99% of patients are a little of this, a smattering of that, a lot of this under certain circumstances, none of it under others.... No, the MOST IMPORTANT thing is to get an accurate picture of exactly what problems the traits and tendencies bring into a person's life, establish patterns and triggers, learn tools and coping mechanisms and other avenues of control, and go from there. A diagnosis is just a starting point to get one "into the ballpark."

I've worked in mental hospitals for 22 years and I know what I'm talking about. Also I'm about 2/3 bipolar myself. Luckily saved by my father's genes. If HE'D been bipolar too? Yipe!

Emma Peach
Emma Peach4 years ago

Wow... thats 20 out of 20 for me... scarry.. never thought about ADD ... It does say if you suffer from anxiety you may display similar symptoms... now the question is this... Is my anxiety actually misdiagnosed ADD or is it actually Generalised Anxiety... 20 out of 20 on the ADD Symptoms and i've been like that for as long as I can remember.. all my school reports always said the same thing... Intelligent and could do well but lacks attention. lol... I did well in school in the end due i guess to a period of hyperattention lol ... I do wonder... Where i'm from you can't get diagnosed for anything properly so i won't bother going to fnd out.. i'll plod along as i always do... It has it's pittfalls but hey what doesn't...

Teresa Wlosowicz
Teresa W.4 years ago

I've only heard of ADHD, not of ADD.

Alexandra Rodda
Alexandra Rodda4 years ago

Thank you for a very good article.

Bryon S.
Bryon S.4 years ago

@ Jill C. I'm not sure where you got your "FACTS" but it seems obvious to me that you don't know nor have ever been close to someone suffering from ADD. I have a friend who fits the description perfectly and when he comes over it's like a psychological tornado hit and he is not even aware of what damage he has done. I can see it is not anything he can control on his own. i think you would not be so quick to say it is not an illness if you could experience it.