Many of us know the impact of ADHD first hand. We have all heard of or read about the antics of a very energetic child, somewhere in the media – but it was not necessarily called ADHD. Perhaps we thought it was a naughty child or bad parenting.
This paper was a talk, originally presented at a 4 Networking event as a 4Sight – an educational talk, not promoting my business, not a sales pitch, a subject I know something about, on Tuesday 15th November at the Southampton breakfast at the Royal Southampton Yacht Club. The day before I had put the title on the 4 N Facebook forum for discussion purposes. Following a lively debate, I promised to write it up for future reference and further discussion. All I ask is that you please read to the end before firing off comment. Thank you
WHAT IS ADHD?
What do you know about ADHD? What words or thoughts come to mind when you hear the term “ADHD”?
ADHD stands for Attention Deficit Hyperactivity Disorder and this graphic is typical of the sort of answers that question is given.
ADHD is most commonly associated with young boys. Boys are 2 – 4 times more likely to get a “diagnosis”.
Girls – ADD (no H) – tend to inattention rather than hyperactivity; girls tend to want to please, they may be dreamier, “away” with the fairies, but not always. Some girls are undeniably ADHD.
Typical school reports may include the phrases: Not trying hard enough. Not reaching potential. When he/she does the work they do it well. Too many missed deadlines or work not handed in. Personally, I do not like the word diagnosis as it is an assessment used to form an opinion based on the comparison of behaviors on a continuum with those of “normal” children or adults. I prefer to use the word “assessment.”
Cause: ADHD is inherited (the grandparents often say “But his father was just like that at that age” or similar) or from brain injury to the frontal lobe (trauma at birth, accident in the playground, accident in a motor vehicle, etc). A give away sometimes is to look at the family tree. In reality what is known is that there are lower levels of the neurotransmitters dopamine and norepinephrine. This has been verified by looking at the levels of sugar uptake (brain activity) on brain scans and comparing ADHD results with those of other people not described as ADHD.
There are three key behavioral indicators:
Hyperactivity – showing constantly active and sometimes disruptive behavior
Distractibility – a condition in which the attention of the mind is easily distracted by small and irrelevant stimuli
Putting the three traits together and treating each one as a continuum (a range from low level to high level) there are innumerable combinations, but broadly speaking:-
So often ADHD is reported and discussed in a negative way. Whilst the traits can lead to highly challenging behavior and personalities the converse is also true – there are LOTS of positives (sometimes you have to look for them!) and there are LOTS of people with ADHD (or ADD) that are high achieving, high performing and capable people. See the list in Appendix 1.
Statistics: If we look at reality there is possibly around 10% of the population affected with ADHD or ADD from birth BUT they do not necessarily remain challenging or affected by ADHD OR ADD all their lives. Taking three in a class of 30 (10%):
One will grow out of the behaviors at puberty. This correlates with the thought that the behaviors are as a result of the brain maturing slowly (slow developers) – the hormones of puberty rebalance the brain chemistry.
One will learn and use sufficient tricks and tips to cope in the world and will use these workarounds successfully. For example, if they can’t do maths they employ an accountant or get their partner to do the accounts, balance the chequebook and sort out the contracts, etc.
The third individual will struggle with their ADHD behaviors successfully or otherwise right through their adult lives. They are often undiagnosed and slip through the system. It is thought that there may be as many as 1.7 million adults in the UK with undiagnosed ADHD (2.6% of the UK population). The characteristics of ADHD in adults are listed in Appendix 2.
Some countries report higher levels of ADHD, such as America and Australia. This is not surprising when we consider the fact that so many people with recalcitrant behavior were sentenced for transportation to the penal colonies of America and Australia in the eighteenth century. Another bold and adventurous group took the “Ten Pound Pom” tickets out of war-damaged Britain from 1947. The impulsive and risk-taking behavior is also amply demonstrated by early explorers heading out from Europe in ships on adventures to explore, trade and colonize.
2. WHAT ARE THE ISSUES SURROUNDING ADHD?
Why does ADHD get such bad press?
EDUCATIONAL ISSUES: Their school reports tend to say “Could do better” or “Great work when he/she remembers to do it or hand it in.” Whilst many ADHD children have above average IQ’s they often struggle to learn in the traditional confines of mainstream schooling systems which they find mundane and boring. When bored their behavior degenerates resulting in physical activity (pushing, shoving, throwing things, fidgeting, tapping, etc), verbal abuse (including “smart Alec” type comments (the class “clown”) and an inability to stay quiet when told), disturbing other children and being generally disruptive. They often spend a lot of time standing in the corridor, going to the Head Teacher’s office or in detention. In the extreme, they may be excluded from school altogether.
Getting educational support for ADHD children can be time-consuming as often the behavior is blamed on poor parenting and getting a referral (by a GP) for an assessment (by a psychologist) is difficult when the responsible people (the parents) are being blamed for the behavior. The emphasis is often on “bad parents and poor parenting” – yet brilliant parents can have ADHD children – comparisons with the siblings are often not taken into consideration. I have found that most parents of ADHD children are great parents and by learning a few tips and tricks can become exceptional parents.
CAREERS: Many people affected by ADHD manage to go on to significantly successful careers including lawyers, barristers, accountants, artists, celebrities, comedians, businessmen, celebrity chefs, stock brokers, etc. I have heard recently that there is a possibility that Donald Trump (US President-Elect) may have ADHD. Adults with ADHD are 300% more likely to start their own company – they are risk takers and entrepreneurs. They may however also be easily led into crime and spend time at Her Majesty’s Pleasure (i.e. in prison). Again – take a look at Appendix 1.
WORK ISSUES: Many adults with ADHD make challenging employees. They may suffer many disciplinary hearings, late submission of papers/reports, missed deadlines, not being in the right place at the right time, constant lateness, leaving it very late to ask for help – procrastination is a common problem. They may struggle to hold down a job if there are no assistants (PA’s) to keep them organized or if they do not find their work sufficiently stimulating.
DRIVING ISSUES: Bans, speeding tickets and points on their driving license are typical, as are vehicle accidents. Impulsiveness, distractibility and risk-taking behind the wheel of a car are not a great combination.
DEBT ISSUES: Unmanageable debt may build up due to a lack of focus on living within their means, unpaid bills, forgetfulness, extreme mess and general disorganization.
SUBSTANCE ABUSE: Alcohol and drugs – for example, 10 to 12 cups of coffee or cans of coke per DAY, gambling, sex.
EMOTIONAL ISSUES: They may suffer mood swings, irritability, bursts of temper, hypersensitivity to criticism (creating challenging relationships at home and work), a tendency to not accept responsibility for anything that goes wrong on their watch, an inability to see the consequences of their own behavior or actions. The frustration of not fitting in and an inability to maintain “normal” relationships (partners, friends and colleagues) can spill over into depression (and even lead to self-harm, suicide, etc). Many adults with ADHD are initially diagnosed with bipolar disorder, depression and anxiety first.
3. TREATMENT OF ADHD
The treatment of ADHD needs to be multi-focused with the affected person at the center. Like other conditions, ADHD is not a problem until it is a problem. It is important to ensure that they are fully committed and involved in the treatment plan to gain full benefit.
Medication: Various medications are available to treat/support those affected by ADHD. Medication can be used as one component of the treatment regimen. It is not a matter of “pop a pill to solve the problem” as medication does not work in isolation. Medications that have been used to treat ADHD include Ritalin (methylphenidate registered for use by children), Strattera (methylphenidate registered for use by adults, with effect from 2016), Adderall, Concerta (slow release methylphenidate), Tofranil. Side effects of the medication MAY include – headaches, loss of appetite, feeling emotional, feeling like a zombie, reduced energy, tired all the time, inhibit impulses making them less spontaneous. Sometimes the side effects may be present for only a few weeks (3 – 6 weeks) whilst the metabolism adjusts or they may be long term. Some people dislike the side effects of the medication sufficiently to refuse to take it. This may be challenging for parents and partners.
Medical support by psychologists and/or psychiatrists: Apart from doing the assessments to determine if the issue is ADHD (and not another condition) the medical profession is needed to prescribe the medication and to support the affected person in coping with the behaviors they are experiencing and learning coping skills. Psychotherapy can be useful for example in teaching children the befriending and sharing skills they fail to learn in the playground (CBT), in building self-esteem and working out their strengths and weaknesses.
Parenting: Being a parent to an ADHD child can stretch family resources (time, patience, finances, etc) to the limits. One ADHDer can take up all the resources leaving the family in stress (but what about the rest of the family?). All children respond to structure, routine, repetition and firm boundaries (or limits) and ADHD children need them even more. It is important to pick your battles to win the war, so to speak. Some things are non-negotiable – like health and safety. Bedtime, within reason, could be negotiated. BUT self-knowledge is crucial – find out what works for them, subcontract out the things that don’t. The label of ADHD should not be used as a cop-out or excuse for permitting unacceptable behavior. ADHDers do need to learn they have to work harder at a whole range of skills to fit in/cope with everyday things.
School/work: Some support or concessions help ADHD people cope better and feel less lost or outcast and alone at school and work. There is an argument against such support but often without it, they slip through the system and their skills and talents go with them.
Diet: There is strong evidence that ADHD sufferers benefit from dietary intervention. Decreasing refined foods including sugar, and E-numbers whilst boosting other micronutrients may make sufficient improvement in behavior to decrease or even stop the medication.
Examples – there are three examples of adults with ADHD included with a few notes on each, at the end. They are not definitive case studies but an interesting sample. I am certain there are many more on the internet should you go looking.
In closing, people affected by ADHD may be bright, intelligent and wonderful people to know and work with. For some, the sky is the limit whilst others, unfortunately, end up in prison. With greater knowledge, we as a world will become a better place for ADHDers to live in and their skills more fully appreciated.
APPENDIX 1: SYMPTOMS OF (UNDIAGNOSED) ADULT ADHD
ACADEMIC PROBLEMS IN CHILDHOOD You know you have not reached your full potential.
CHRONIC LATENESS You think of 100 things to do when walking out the door.
PROCRASTINATION No one can put things off like you can.
DISTRACTIBILITY Whether it’s emails, texts or daydreams, it’s a huge effort to stay on task.
UNTIDINESS, DISORGANISATION Lost items, missed appointments, forgotten arrangements, piles of paperwork, laundry and clutter.
ANGRY OUTBURSTS You explode over minor issues.
POOR LISTENING SKILLS Your mind wanders and you can’t stop it.
THRILL-SEEKING You’re drawn to risky behaviors – fast driving, extramarital affairs, drugs and alcohol, high adrenalin sports/pass times.
RELATIONSHIP DIFFICULTIES You can be hard to live with for obvious reasons.
TRAFFIC ACCIDENTS Distractibility and impulsiveness are not the best combination behind a wheel.
For help and advice go to www.addiss.co.uk
APPENDIX 2: CELEBRITIES WITH ADHD/ADD
- Sir Winston Churchill
- Albert Einstein
- Robin Williams
- Justin Timberlake
- Jamie Oliver
- Karina Smirnoff – Strictly professional dancer
- Will Smith
- Michael Phelps
- Jim Carrey
- Ty Pennington – host Extreme Makeover
- Richard Branson
- Paris Hilton
- Christopher Knight middle brother Peter in The Brady Bunch
- Howie Mandel – Host Deal or No Deal, USA
- Terry Bradshaw – NFL Quarterback
- James Carville – political consultant and commentator
- Paul Orfalea – Founder of Kinkos (copier chain)
- Pete Rose – major league baseball star
- Michelle Rodrigues – actress “Lost”
- David Neeleman – Founder Jet Blue Airways
- Bruce Jenner – Olympic athlete
- Solange Knowles – singer, Beyonce’s little sister
- Simone Biles – USA gymnast, 4 golds at Rio
- David Blane – magician, illusionist
- Andre Brown
- Glen Lee Beck – US TV and radio host, political commentator
- James Carville – political commentator, media personality
- Jim Carviezel – actor
- Wendy Davis – actress, “Army Wives”
- Katherine Ellison – Pulitzer Prize-winning author and journalist
- Josh Freeman – Buccaneers quarterback
- Ryan Gosling – actor
- Cammi Granator – US women’s ice hockey, gold-winning
- Tim Howard – footballer, goalie
- Louise Mensch – former conservative MP, author
- Trudie Styler – film & theatre producer
- Will.i.am – music producer
- Lauren Evans
- Adam Levine – singer in Marron 5
- Channing Tatum – actor, 21 Jump Street, The Vow
- Louis Smith- Olympic Gymnast
- Ashley McKenzie – Judo gold medallist
- Rory Bremner – comedian
- Ted Turner – founder CNN
- Cameron Herold – Canadian businessman
- Ned Halowell – US psychiatrist
- John Ratey – US psychiatrist
- Dale Archer – US psychiatrist
Born 28 June 1971, she has written 15 novels (under her maiden name Louise Bagshawe). Louise was a Conservative MP, Corby, from May 2010, resigned August 2012 mid-term
Lives in the USA with husband Peter, writes a blog – unfashionista.com. Has a failed business – Menschn (competition to Twitter)
First husband (Anthony LoCicero) married for 9 years, have 3 children. Second husband Peter Mensch (manager of Red Hot Chilli Peppers and Metallica) – his then wife accused her of having a 20-year affair with him
She describes herself as impulsive, distractible, and oversharing (TMI, too often). She also has a low threshold for boredom.
Various careers seeking new challenges – various changes and controversy around her. Hyper-focused and super driven when inspired and engaged (more ADD than ADHD)
“With ADHD your whole focus is on what you are good at, which is why I loved politics but couldn’t keep my bedroom tidy. You are great at what you are good at, but incredibly scatterbrained when it comes to anything else. It’s the stereotype of the “scatterbrained professor”.”
Used class A drugs in her youth. Self-medicating with wine, now does not drink alcohol.
Taking medication makes ADHD ”eminently manageable”.
Cites her personal assistant as her key to sanity and success
Trudie was born 6 January 1954 (age 62). An actress, film producer, married to Sting and a UNICEF ambassador.
“Sting and I have 6 kids between us. A lot of members of our family have ADHD and dyslexia.”
Trudie grew up with both ADHD and dyslexia and describes herself as lost in space with more and more difficulties with maths, writing and reading, which was always laborious and slow.
Uses medication (Adderall) when desired (eg when she has lots of scripts to read).
“One thing I learned about ADHD is that it’s hard to keep your attention and you can’t sit still and you are always moving and thinking about a whole bunch of things. But those traits work well for me in studios and in meetings about creative ideas. I figured out a way of working with it.”
William Adams (born William James Adams, Jr.; March 15, 1975), known professionally as will.i.am, is an American rapper, singer, songwriter, entrepreneur, actor, musician, DJ, record producer and philanthropist.
He is best known as a founding member of the hip-hop band The Black Eyed Peas, with whom he has received multiple awards.
As a music producer, he has produced with other artists including Michael Jackson, Justin Bieber, Kesha, Britney Spears, Miley Cyrus, David Guetta, U2, Rihanna, Cheryl, Lady Gaga, Usher, Justin Timberlake, A. R. Rahman and Nicki Minaj. A judge and voice coach on The Voice.
Adams has never met his father; William Adams Sr. He was raised by his mother, Debra (née Cain). He went public about having ADHD in April 2013.