Meeting the Challenges of Adult ADHD

Who doesn’t have attention problems these days? We jump from Facebook to Twitter to headline news and back to the work we were supposed to be doing. We’re distracted with worries about our kids, our parents, germs, terrorism, politics and money.

But there are some people who struggle more than the rest of us. For them, concentration isn’t just hard, it’s almost impossible — at least on the subjects they don’t find inherently interesting. It’s not that they have an attention disorder as much as a problem maintaining consistent engagement. Their brains tune out more easily than most — they may excel in the subjects they find fascinating, but boring things are more boring, and distracting things are more distracting.

As psychiatrists specializing in adult attention deficit hyperactivity disorder (ADHD), we’ve met thousands of people like this. They are all a little different, but they share certain characteristics: They struggle more than most people to keep up with the demands of daily life; they disappoint people they care about; and they often feel terrible about themselves. We describe people like this with an acronym we call FAST MINDS, explained in our new book of the same name. FAST MINDS stands for:

F – Forgetful
A – Achieving below potential
S – Stuck in a rut
T – Time challenged
M – Motivationally challenged
I – Impulsive
N – Novelty seeking
D – Distractible
S – Scattered.

Four percent of adults have ADHD. Millions more have enough fast-mind traits to keep them from performing as well as they should. Some may find their lives are governed by impulsivity, others may struggle with organization and time management, and still others may find it’s their forgetfulness that gets them into trouble.

In our practices and in our book, we provide strategies to help those with fast minds better understand themselves, maximize their strengths and adapt to their individual challenges. Here are a few of the suggestions we lay out to help people get the most out of their fast minds.

Know your strengths and then focus on them. If you’re great at the big picture but struggle with details, make use of “peripheral brains” — people and things that can take over as much of the drudgery as possible, allowing you more time to shine. Spending money on a housecleaner is probably better than beating yourself up every week for failing yet again to wash the kitchen floor. At work, be the first to volunteer for a team project in which you can steer the ship and leave others to pack the luggage. Even a good calendar system can be an essential peripheral brain, keeping you on track and on schedule.

Create situations to hold yourself accountable. Knowing the housecleaner is coming can motivate you to clean enough so they can get in the front door. If you consistently miss deadlines at work, ask a colleague to help you break down the assignment into easily achievable chunks and then keep tabs on you to make sure you get each one done on time.

Stop beating yourself up. Many adults with fast-mind traits have spent decades feeling like they were letting others down and wondering what was wrong with them. Some people find a diagnosis of ADHD liberating — finally, an explanation for why they’ve always had to struggle so much. We think people with these traits need to spend some time patting themselves on the back and focusing on their strengths rather than dwelling on their weaknesses. ADHD is a brain-based condition — it’s not their fault.

Prioritize healthful habits. This may sound a bit like the advice your mother gave you, but eating regular, healthful meals, exercising often, and sleeping enough hours on a steady schedule can make a huge difference for fast minds. Research shows that people with ADHD are more likely to struggle with these basics, often keeping crazy sleep schedules and surviving on junk food and caffeine. As anyone who’s ever had a cold knows, when you’re not feeling well, it’s harder to concentrate, harder to perform at your best and harder to feel good about yourself.

Although there has been much criticism about overuse of ADHD medications and even doubts about whether ADHD really exists, we’ve seen enough suffering in our practices to confirm that ADHD is a real disorder and causes significant problems in the areas of people’s lives that really count: relationships, family, career and health. And today there is scientific proof that ADHD is a brain-based condition: Neuroimaging allows us to see that there are biological differences between the ADHD brain and the non-ADHD brain. Medication is very often transformative for ADHD individuals because it can help control focus and behavior, but it’s usually not the answer for all of their problems. Effective treatment involves behavioral and lifestyle changes too.

Research has shown that cognitive behavioral therapy — a form of talk therapy that reframes problems and helps people get out of their own way — is quite effective. We’ve also seen people with fast minds helped by yoga, exercise, mindfulness, meditation, support groups and accounting classes. You have to understand your own strengths and weaknesses and then figure out what helps you connect and engage and feel good about yourself, and what you can stick with over time.

If you don’t have a fast mind but are concerned about people in your life who do, we offer many suggestions for how you can help. For starters, you can learn about the condition to understand what they’re up against, encourage them to take constructive paths and hold them accountable for their promises.

Making it through life with a fast mind can be difficult. We are now discovering that ADHD doesn’t just affect how people learn perform, and communicate; it also has an impact on sleep and eating patterns and on emotional expression. And people with ADHD often have compounding problems, such as learning disabilities and mood disorders. But all of these hurdles are surmountable. We have seen dramatic improvement in patients who are willing to take a balanced, personalized approach to helping themselves by choosing lifestyle and behavioral strategies that work for them.

Dr. Tim Bilkey and Dr. Craig Surman are the authors of Fast Minds: How to Thrive If You Have ADHD (Or Think You Might) (Berkley 2013). Bilkey is the developer of Fast Minds, an accredited educational program for physicians, and the founder of the Bilkey ADHD Clinic for Women in Toronto. Dr. Surman is assistant professor of psychiatry at Harvard Medical School and the scientific coordinator of the Adult ADHD Research Program at Massachusetts General Hospital.

Be the first to comment

Leave a Reply

Your email address will not be published.


*