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INSIGHT AND
EDUCATION:
1. Be sure of the diagnosis.
Make sure you're working with a professional who
really understands ADD and has excluded related or
similar conditions such as anxiety
states, agitated depression,
hyperthyroidism, manic depressive illness, or
obsessive compulsive
disorder.
2. Educate yourself. Perhaps
the single most powerful treatment for ADD is
understanding ADD in the first place. Read books.
Talk with professionals. Talk with other adults who
have ADD. You'll be able to design your own
treatment to your own version of
ADD.
3. Coaching. It is useful for
you to have a coach, for some person near to you to
keep after you in a supportive way. Your coach can
help you get organized, stay on task, give you
encouragement, or remind you to get back to work.
Friend, colleague, or therapist (it is possible,
but risky for your coach to be your spouse), a
coach is someone to stay on you to get things done,
exhort you as coaches do, keep tabs on you, and in
general be in your corner, on your side. A coach
can be tremendously helpful in treating
ADD.
4. Encouragement. ADD adults
need lots of encouragement. This is in part due to
their having many self-doubts that have accumulated
over the years. But it goes beyond
that. More than the average person, the ADD adult
withers without encouragement and positively
thrives when given it. The ADD adult will often
work for another person in a way he won't work for
himself. This is not "bad," it just is. It should
be recognized and taken advantage
of.
5. Realize what ADD is NOT,
i.e., conflict with mother, etc.
6. Educate and involve
others. Just as it is key for you to understand
ADD, it is equally, if not more important, for
those around you to understand it--family, friends,
people at work or at school. Once they get the
concept they will be able to understand you much
better and to help you out as well. It
is particularly helpful if your boss
can be aware of the kinds of structures that help
people with ADD.
7. Give up guilt over
high-stimulus seeking behavior. Understand that you
are drawn to high stimuli. Try to choose them
wisely, rather than brooding over the "bad"
ones.
8. Listen to feedback from
trusted others. Adults (and children,
too) with ADD are notoriously poor self
observers. They use a lot of what can appear to be
denial.
9. Consider joining or
starting a support group. Much of the most useful
information about ADD has not yet found
its way into books but remains stored in the minds
of the people who have ADD. In groups
this information can come out. Plus,
groups are really helpful in giving the kind of
support that is so badly needed.
10. Try to get rid of the
negativity that may have infested
your system if you have lived for years without
knowing what you had was ADD. A good
psychotherapist may help in this regard. Learn to
break the tapes of negativity that can play
relentlessly in the ADD mind.
11. Don't feel chained to
conventional careers or conventional ways of
coping. Give yourself permission to be yourself.
Give up trying to be the person you always thought
you should be -- the model student or the organized
executive, for example--and let yourself be who you
are.
12. Remember that what you
have is a neurological condition. It is genetically
transmitted. It is caused by biology, by how
your brain is wired. It is NOT a disease of the
will, nor a moral failing. It is NOT caused by a
weakness in character, nor by a failure to mature.
It's cure is not to be found in the power of the
will, nor in punishment, nor in sacrifice, nor in
pain. ALWAYS REMEMBER THIS. Try as they might, many
people with ADD have great trouble accepting the
syndrome as being rooted in biology rather than
weakness of character.
13. Try to help others with
ADD. You'll learn a lot about the condition in the
process, as well as feel good to
boot.
PERFORMANCE
MANAGEMENT:
14. External structure.
Structure is the hallmark of the
non-pharmacological treatment of the ADD child. It
can be like the walls of the bobsled slide, keeping
the speedball sled from careening off the track.
Make frequent use of:
- 1) notes to self
- 2) color coding
- 3) rituals
- 4) lists
- 5) reminders
- 6) files
15. Color coding. Mentioned
above, color coding deserves emphasis. Many people
with ADD are visually oriented. Take advantage of
this by making things memorable with color: files,
memoranda, texts, schedules, etc. Virtually
anything in the black and white of type can be made
more memorable, arresting, and therefore
attention-getting with color.
16. Use pizzazz. In keeping
with #15, try to make your environment as peppy as
you want it to be without letting it boil
over.
17. Set up your environment
to reward rather than deflate. To understand what a
deflating environment is, all most adult ADDers
need do is think back to school. Now that you have
the freedom of adulthood, try to set things up so
that you will not constantly be reminded of your
limitations.
18. Acknowledge and
anticipate the inevitable collapse of x% of
projects undertaken, relationships entered into
obligations incurred.
19. Embrace challenges. ADD
people thrive with many challenges. As long as you
know they won't all pan out, as long as you don't
get too perfectionistic and fussy,
you'll
get a lot done and stay out of
trouble.
20. Make deadlines. Think of
deadlines as motivational devices rather than
echoes of doom. If it helps, call them lifelines,
instead of deadlines. In any case, make them and
stick to them.
21. Break down large tasks
into small ones. Attach deadlines to the small
parts. Then, like magic, the large task will get
done. This is one of the simplest and most powerful
of all structuring devices. Often a large task will
feel overwhelming to the person with ADD. The mere
thought of trying to perform the task makes one
turn away. On the other hand, if the large task is
broken down into small parts, each component may
feel quite manageable.
22. Prioritize. Avoid
procrastination. When things get busy, the
adult ADD person loses perspective: paying an
unpaid parking ticket can feel as pressing as
putting out the fire that just got started in the
wastebasket. Prioritize. Take a deep breath.
Put first things first. Procrastination is one of
the hallmarks of adult ADD. You have to really
discipline yourself to watch out for it and avoid
it.
23. Accept fear of things
going too well, Accept edginess when things are too
easy, when there's no conflict. Don't gum things
up, just to make them more
stimulating.
24. Notice how and where you
work best: in a noisy room, on the train, wrapped
in three blankets, listening to music, whatever.
Children and adults with ADD can do their best
under rather odd conditions. Let yourself work
under whatever conditions are best for
you.
25. Know that it is O.K. to
do two things at once: carry on a conversation and
knit, or take a shower and do your best thinking,
or jog and plan a business meeting. Often people
with ADD need to be doing several things at once in
order to get anything done at all.
26. Do what you're good at.
Again, if it seems easy, that is O.K. There is no
rule that says you can only do what you're bad
at.
27. Leave time between
engagements to gather your thoughts. Transitions
are difficult for ADDers, and mini-breaks can help
ease the transition.
28. Keep a notepad in your
car, by your bed, and in your pocketbook or jacket.
You never know when a good idea will hit you, or
you'll want to remember something
else.
29. Read with a pen in hand,
not only for marginal notes or underlining, but for
the inevitable cascade of "other" thoughts that
will occur to you.
MOOD
MANAGEMENT:
30. Have structured
"blow-out" time. Set aside some time in every week
for just letting go. Whatever you like to do --
blasting yourself with loud music, taking a trip to
the race track, having a feast -- pick some kind of
activity from time to time where you can let loose
in a safe way.
31. Recharge your batteries.
Related to #30 most adults with ADD need feeling
guilty about it. One guilt-free
way to conceptualize it is to call it time to
recharge your batteries. Take a nap, watch TV,
meditate. Some-thing calm, restful, at
ease.
32. Choose "good," helpful
addictions such as exercise. Many adults with ADD
have an addictive or compulsive personality such
that they are always hooked on something. Try to
make this something positive.
33. Understand mood changes
and ways to manage these. Know that your moods will
change willy-nilly, independent
of what's going on in the external world. Don't
waste your time ferreting out the reason why or
looking for someone to blame. Focus rather on
learning to tolerate a bad mood, knowing that it
will pass, and learning strategies to make it pass
sooner. Changing sets, i.e. getting involved with
some new activity (preferably interactive) such as
a conversation with a friend or a tennis game or
reading a book will often help.
34. Related to #33, recognize
the following cycle which is very common among
adults with ADD:
- a. Something
"startles" your psychological system, a
change or transition, a disappointment or
even a success. The precipitant may be quite
trivia.
-
- b. This "startle" is
followed by a mini-panic with a sudden loss
of perspective, the world being
set topsy-turvy.
-
- c. You try to deal
with this panic by falling into a mode of
obsessing and ruminating over one or another
aspect of the situation. This can last for
hours, days, even months.
35. Plan scenarios to deal
with the inevitable blahs. Have a list of friends
to call. Have a few videos that always engross you
and get your mind off things. Have ready access to
exercise. Have a punching bag or pillow handy if
there's extra angry energy. Rehearse a few pep
talks you can give yourself, like,
‘’You've been here before. These are the
ADD blues. They will soon pass. You are
OK."
36. Expect depression after
success. People with ADD commonly complain of
feeling depressed, paradoxically, after a big
success. This is because the high stimulus of the
chase or the challenge or the preparation is
over. The deed is done. Win or lose, the
adult with ADD misses the conflict, the high
stimulus, and feels depressed.
37. Learn symbols, slogans,
sayings as shorthand ways of labeling and quickly
putting into perspective slip ups, mistakes, or
mood swings. When you turn left instead of right
and take your family on a 20-minute detour, it is
better to be able to say, "There goes my ADD
again," than to have a 6-hour fight over your
unconscious desire to sabotage the whole trip.
These are not excuses. You still have to take
responsibility for your actions. It is just good to
know where your actions are coming from and where
they're not.
38. Use "time-outs" as with
children. When you are upset or over stimulated,
take a time-out. Go away. Calm
down.
39. Learn how to advocate for
yourself. Adults with ADD are so used to
being criticized, they are often unnecessarily
defensive in putting their own case forward. Learn
to get off the defensive.
40. Avoid premature closure
of a project, a conflict, a deal, or a
conversation. Don't "cut to the
chase'' too soon, even though
you're itching to.
41. Try to let the successful
moment last and be remembered, become sustaining
over time. You'll have to consciously and
deliberately train yourself to do this because
you'll just as soon
forget.
42. Remember that ADD usually
includes a tendency to over focus or hyper focus at
times. This hyper focusing can be used
constructively or destructively. Be aware of its
destructive use: a tendency to obsess or ruminate
over some imagined problem without being able to
let it go.
43. Exercise vigorously and
regularly. You should schedule this into Your
life and stick with it. Exercise is positively one
of the best treatments for ADD. It helps work off
excess energy and aggression in a positive way, it
allows for noise-reduction within the mind, it
stimulates the hormonal and neurochemical system in
a most therapeutic way, and it soothes and calms
the body. When you add all that to the well-known
health bene- fits of exercise, you can see how
important exercise is. Make it something fun so you
can stick with it over the long haul, i.e. the rest
of you life.
INTERPERSONAL
LIFE:
44. Make a good choice in a
significant other. Obviously this is good advice
for anyone. But it is striking how the adult with
ADD can thrive or flounder depending on the choice
of mate.
45. Learn to joke with
yourself and others about your various symptoms,
from forgetfulness, to getting lost all the time,
to being tactless or impulsive, whatever. If you
canbe relaxed about it all to have a sense of
humor, others will forgive you much
more.
46. Schedule activities with
friends. Adhere to these schedules faithfully. It
is crucial for you to keep connected to other
people.
47. Find and join groups
where you are liked, appreciated, understood,
enjoyed. People with ADD take great strength from
group support.
48. Reverse of #47. Don't
stay too long where you aren't understood or
appreciated. Just as people with ADD gain a great
deal from supportive groups, they are particularly
drained and by negative groups.
49. Pay compliments. Notice
other people. In general, get social training, as
from your coach.
50. Set social deadlines.
Without deadlines and dates your social life can
atrophy. Just as you will be helped by structuring
your business week, so too you will benefit from
keeping your social calendar organized. This will
help you stay in touch with friends and get the
kind of social support you need.
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