ADD impacts all aspects of life. In this chapter I’ll list some of the most common complaints patients and their families bring into my office.
As a child, teen, or adult, ADD often has a negative impact on a person’s ability to interact with others. Here are some of the reasons:
Many people with ADD have failed in relationships so many times in the past that they don’t want to experience the pain anymore. They avoid relationships or they make excuses to be by themselves.
People with ADD are often teased by others. Their behavior brings negative attention to themselves. Additionally, the impulsivity and conflict-driven nature causes them to tease others, sometimes to the point where the other person becomes very upset.
Fighting is typical for many people with ADD. It may be related to impulsivity (saying things without thinking), stimulation-seeking behavior, misperceptions, rage outbursts, and chronically low self-esteem. The fighting leads to chronic stress for the person with ADD and those in his or her family.
Misperceptions often cause serious problems in relationships. Often the parent or spouse of an ADD person has to spend an inordinate amount of time correcting misperceptions that lead to disagreements. Once, on the night before I was leaving on a business trip, I told my wife that I was going to miss her. She heard my words as “I’m not going to miss you” and she was angry at me for the rest of the night, no matter what I said.
Due to distractibility, conversations are often cut short or left uncompleted, leaving the other person feeling unimportant. When a person is distracted, he or she may miss large chunks of conversations and may unconsciously fill in missing pieces with negative information.
The ADD person’s need to have what they want right away often causes problems in situations where they need to take turns, such as in conversations or games.
This is perhaps the most damaging problem with ADD in relationships. Just because a person has a thought doesn’t mean that it is accurate or that he or she even necessarily believes it. Many people with ADD just say what comes to mind. They then get stuck in defending these statements, which causes further problems.
Even though the person with ADD wants to finish what he or she starts, distractibility gets in the way and many things may be left half done. This leads to many resentments, arguments, and frustrations felt by others.
Often the level of activity or noise created by the ADD person causes frustration and irritability in others.
At the same time the ADD person may also be sensitive to noise. They often need to escape from others to feel calm or peaceful inside.
When the person is sensitive to touch, they often shy away from affection. This can harm a relationship, especially if the person’s partner wants or needs affection.
Sometimes people with ADD talk for self-stimulation. There is an internal drive to go on and on. This may irritate others, who feel like a prisoner of the conversation because they feel that they cannot get a word in the conversation.
The partners of some ADD people complain that there is little talking or emotional expression in the relationship. “He seems turned off when he comes home” is a common complaint. Often parents will ask their children about their day and the only response they’ll get is “Fine” or “Okay.” These kids are often called non-elaborators.
This causes problems in a relationship because the ADD person often doesn’t live up to their part of the chores or agreements.
This type of behavior worries the parents, partners, or friends of the ADD person. Friends often feel pressured to go along with dangerous behavior, causing a rift in the relationship.
Many family members of ADD children, teens, and adults have told me that they never know what to expect from the ADD person. “One minute she’s happy, the next minute she’s screaming,” is a common complaint. Small amounts of stress may trigger off huge explosions.
Some studies have reported that up to 85 percent of people with ADD have rage outbursts, often with little provocation. After this occurs several times in a relationship, the parent, partner, or friend becomes “gun shy” and starts to withdraw from the person. Untreated ADD is often involved in abusive relationships.
When people do not feel good about themselves, it impairs their ability to relate to others. They have difficulty taking compliments or getting outside of themselves to truly understand the other person. The brain filters information coming in from the environment. When the brain’s filter (self-esteem) is negative, people tend to only see the negative and ignore any positive. Many partners of ADD people complain that when they give their partner a compliment, the latter find a way to make it look like they have just been criticized.
This is a common complaint of people living with someone who has ADD. They say that the person looks for trouble. Rather than ignoring a minor incident, he or she focuses on it and has difficulty letting it go. Things in an ADD house do not remain peaceful for long periods of time.
As mentioned above, ADD people often feel restless or anxious. This often causes them to search for ways to relax. They may use excessive sex, food, or alcohol to try to calm themselves. I treated one man who had sex with his girlfriend over five hundred times in the last year of their relationship. She left him, because she felt that their relationship was only based upon sex.
Many people with ADD have trouble getting outside of themselves to see the emotional needs of others. They are often labeled as spoiled, immature, or self-centered.
Often people with ADD engage in repetitive, negative arguments with others. They seem not to learn from the interpersonal mistakes from their past and repeat them again and again.
The ADD person often waits until the very last minute to get things done (bills; buying birthday, anniversary, or Christmas gifts; etc.). This may irritate those around them who feel the need to pick up the loose pieces.
ADD often causes serious problems in families. I have seen “caring” families fall apart because of the turmoil caused by having an ADD child. I have also seen many divorces between people who “truly loved each other” because of the stress of one or both partners having ADD. Many of the issues listed in the previous section apply here. Here are several other important issues to consider.
ADD children and teenagers are often experts at getting their parents to yell at them. As I mentioned above, the ADD person often has decreased activity in their frontal lobes and they “unconsciously” seek stimulation to feel more awake or alert. In a family, this takes on many forms, such as temper tantrums, noise, and high activity.
ADD kids may also be skilled at getting their parents to fight with each other. Splitting parental authority gives children and teenagers too much power and increases the turmoil. Often the scenario is that the mother will blame the father for being “too absent” or “too harsh,” and the father will blame the mother for being “too inconsistent” and “too soft.” Of course, this goes both ways. I have seen many couples separate, in part, to stop the turmoil they lived in at home.
In families with an ADD child, teen, or adult there is often the expectation that there will be problems, so people begin to avoid each other or predict there will be problems. For example, a mother recently told me she expected that her ADD husband wouldn’t finish the dinner dishes as he promised. Before he even had a chance to do them, she “resentfully” cleaned them. She was angry at him for the rest of the night, even though she didn’t give him a chance to be helpful.
Denial: “There’s nothing wrong with the child! He only needs more time, more attention, more discipline, more love, a better teacher, a better school, a firmer mother, a father who is more available.” These are common excuses parents make to deny that any problem exists. Admitting that there is a problem is often so painful that many parents go years and years without seeking help. Denial can seriously harm a child’s or teen’s chances for success!
Grief: There is often a grieving process that occurs in a family with an untreated ADD person. The parents or spouse often feel the loss of having a “normal” child, teen, or spouse and end up feeling very sad that the situation is not as they expected it would be.
On Guard: For many parents, living with an ADD child is like being in a war zone. They have to be constantly on guard that the child won’t run out into the street, won’t break something at the store, or won’t run off at a park. This chronic watchfulness causes much internal tension for parents.
Guilt: This is a significant issue for many people who live with those who have ADD. The turmoil that an ADD child, teen, or adult causes often brings on bad feelings. Parents or spouses are not “supposed” to have bad feelings toward people they love and so end up burdened by feelings of guilt. In the treatment section, I’ll discuss how to break the cycle of guilt.
Anger: Being upset or angry at the teachers, doctors, day care workers, and the other parent is common in parents with an ADD child. The levels of frustration are so high in these families that people look for someone on whom to blow off steam.
Envy: “Why can’t we have normal kids? We didn’t do anything to deserve the turmoil. It’s not fair.”
Blame: “You spoil him. How’s he ever going to learn if you do everything for him?” “You’re too soft on her.” “You never say a kind word to him.” “If only you would be home more, then we wouldn’t have these problems with her.” Blame is very destructive and rarely, if ever, helpful. Yet, it is all too common in ADD families.
Isolation: “Everyone thinks I’m a bad parent. No one else has these problems. I can’t go anywhere with him, I’m stuck at home.” Feelings of isolation are very common. Many parents of ADD children feel that they are the only ones in the world who have these problems. Joining a support group can be very helpful for these people.
Bargaining: “Maybe she’ll be okay if we put her in a new school.” “Maybe if we put him in outside activities his attitude will improve.” “Maybe if I leave his father, we’ll all feel better.” Many parents of ADD children attribute their problems to outside forces and feel that making radical lifestyle changes will help. Without the right treatment, however, these changes are rarely helpful.
Depression: “I’m a failure as a parent. I’ve failed my child. I have no business raising children. I should go to work and leave him with a sitter. I’m so tired that I can’t do this anymore.” The physical and emotional drain of having an ADD child can often trigger off a significant depression. Watch your moods.
Children with ADD often irritate their siblings to the point of causing tears, anger, or fighting. Siblings develop negative feelings toward the ADD child because they are often embarrassed by their outrageous behavior at school or with friends.
Since ADD, for the most part, is a genetic disorder, it is more likely that siblings may also have features of ADD. Having two or more members of a family with untreated ADD can completely disorganize the family.
Oftentimes in families with an ADD child, there is an identified “good” child and a “bad” (ADD) child. Because the parents’ self-esteem is so damaged by having an unrecognized ADD child they will often avoid the ADD child and focus a lot of positive energy on the other child and think that they are more “perfect” than they really are. This causes resentment in the ADD child. It also causes the “perfect” child to subvert any progress that the ADD child might make. Corey and Sarah were an example of this “sibling subversion.” Here’s an example:
Corey, nine, had a severe case of ADD. He would throw three-hour temper tantrums, had problems nearly every day in school, and was chronically noncompliant with his mother. Six-year-old Sarah, with long, curly, red hair, was her mother’s angel. She could do no wrong. With treatment, Corey began to significantly improve. But, in therapy, Corey told me that his little sister was “flipping him off” with her middle finger. When he told his mother, she did not believe him, saying, “Sarah wouldn’t do that, she’s too sweet.” I told the mother to watch them secretly when they were playing together. Sure enough, Sarah was using her middle finger to drive Corey crazy. She was having difficulty losing her place in the family as the “perfect” child and she had a stake in Corey remaining a problem.
Embarrassment: Just as parents are blamed by neighbors for unacceptable behavior of their child, so brothers and sisters are often held responsible or ridiculed by their peers for the actions of their ADD sibling.
Anger: An ADD child can evoke intense emotions in his brother or sister.
Resentment: A sibling may feel very resentful at being labeled “weirdo’s sister” or having a child come up and say, “Hey, do you know what your brother did?”
Put-Upon: Siblings feel urged to include the ADD child in their play and free-time activities. He or she often has few friends of their own and it’s natural for parents to seek relief.
Guilt: Like parents, siblings often feel guilty for emotions they harbor. They care deeply in spite of the behavior they live with.
Out of Control: Brothers and sisters find it difficult to engage the ADD child in play without constant struggles over rules and issues of control. They may strike out at the ADD child as a result of being constantly frustrated.
Jealousy: Siblings often question the double standards that exist in the rules that they are governed by. The ADD child is often rewarded when the behavior does not warrant it as a way of pacifying him or her at the time.
Whether for children, teenagers, or adults, ADD has a powerful negative impact on a person’s ability to do well in school. Except for classes that are small or highly interesting, many people with ADD have significant problems. Here is a list of common school problems.
The hyperactivity that often accompanies ADD in childhood causes obvious problems: the child is restless, out of his or her seat, irritating other kids (not to mention the teacher), and causing turmoil and disruption in his or her path. In teens and adults, the restlessness of ADD often distracts others in class who notice the constant movement (i.e., legs shaking, shifting body posture in seats).
Having a short attention span and being easily distracted affects nearly every aspect of school. This will affect a student’s ability to follow teachers in lectures, participate in small groups, and perform consistently on tests. The short attention span often causes the ADD student’s attention to wander while reading or performing class assignments, causing them to take an inordinate amount of time to finish tasks. Distractibility also may get ADD students in trouble, as they tend to be in everyone else’s business.
Impulsiveness causes serious school problems. Blurting out answers in class, responding impulsively on quizzes or tests, and saying things without thinking are typical. I’ve treated many people with ADD who were “tactless” in how they responded to their teachers or professors. One teenager said to her teacher, “You’re a lousy teacher! I don’t know why you explain things like that, but the other teachers know how to explain things a lot better than you do.” All of us have had that thought about certain teachers at one time or another. Most people, however, would never blurt out a statement like that because it would hurt the teacher’s feelings and harm their relationship. But with ADD, the mouth is often engaged before the brain.
Many people with ADD wait until the last minute to complete their tasks for school. If it isn’t the night before, they cannot get their brain upset enough to get their work done. Many parents have told me about the constant fights they have with their children or teens about starting projects early and working on them over time, rather than the night before. Many adults have told me that they never did term papers in school or they used amphetamines the night before the work was due to get it done. Procrastination in school caused the work to be done poorly or for it to be left undone or incomplete.
As I mentioned above, there is a group of people with ADD who have trouble shifting their attention from one thing to another. They have a tendency to get “stuck” or overfocus. This characteristic can be particularly troublesome in school. Getting stuck on an idea early in a lecture may cause the student to miss the information for much of the lecture. Taking notes for these students is often a disaster. Note taking requires constant shifts in attention: from the teacher to the paper to the teacher to the paper, etc.
This symptom often upsets the parents and teachers of ADD students. Forgetting to bring home books, leaving clothes at school, and not turning in homework assignments that were completed are common complaints.
Learning difficulties and disabilities are very common in people with ADD. It is essential to recognize and treat these disabilities if a student is going to perform at his or her potential. Common disabilities are writing disabilities (getting thoughts from the brain to the paper), reading disabilities (shifting or reversing letters or numbers), and visual processing problems and auditory processing problems (trouble accurately hearing what was said).
Many people with ADD have unusual study habits. Most need a very quiet place to study. My wife used to sit in her car under a streetlight to study. She needed an environment that was absolutely quiet and free from distractions. She had trouble studying at home because she saw all the things that needed to be done and was too easily distracted. Other people with ADD need noise in order to study. Some people have told me they need the TV or radio on, or they need some other sort of noise in order to keep themselves awake and focused.
Timed testing situations are often a disaster for those with ADD. Whether it is short math exercises, classroom writing tasks, or testing situations, the more time pressure that is put on these people, the worse it tends to get for them.
Bill, thirty-two, had just been fired from a job he loved. He knew it was his fault, but he just couldn’t organize his time to do the work that was expected. He missed deadlines, seemed to drift off in meetings, and he was often late to work. He knew that his wife would be angry with him. This was the third job he had lost in their three-year marriage. As a child, Bill had taken Ritalin for troubles in school, but he was taken off the medication when he was a teenager. His doctor told him that all kids outgrow the problems he was having. That was bad advice. At the age of thirty-two, Bill still suffered from the effects of ADD.
When ADD is left untreated, it significantly affects the workplace. It costs employers millions of dollars every year in decreased productivity, absenteeism, and employee conflicts. Yet ADD remains vastly underdiagnosed, especially in adults.
There is both a positive and negative side to ADD in the workplace. People with ADD often are high in energy, enthusiastic, full of ideas, and creative. If they surround themselves with people who organize them and manage the details, they can be very successful. In my clinical practice, I treat many highly successful ADD executives. Unfortunately, many people with ADD are not fortunate enough to be in positions that maximize their strengths and minimize their weaknesses. These folks often have serious problems at work. Here are some of the difficulties that people with ADD are likely to have at work:
Research has shown that the more ADD people try to concentrate, the worse it gets for them. Their brain region responsible for concentrated thinking turns off, not on. When a supervisor or manager puts more pressure on them to perform, they often fall off in their work. Then the boss interprets this decreased performance as willful misconduct, and serious problems arise. I once treated a man with ADD who was a ship welder. He told me that whenever his boss put pressure on him to do a better job, his work got worse (even though he really tried to do better). When the boss told him that he liked his work, he became more productive. In supervising someone with ADD, it is much more effective to use praise and encouragement, rather than pressure.
Distractibility is often evident in meetings. People with ADD tend to look around the room, drift off, appear bored, forget where the conversation is going, and interrupt with extraneous information. The distractibility and short attention span may also cause them to take much longer to complete their work than their coworkers. They are often very frustrating to managers and coworkers.
Forgetfulness is common in ADD and a serious handicap on the job. Missed deadlines, forgotten reports, and steps gone undone on a job are just a few examples.
Often, the lack of impulse control gets the ADD person fired. They may say inappropriate things to supervisors, other employees, or customers. I once had a patient who was fired from thirteen jobs because he had trouble controlling his mouth. Even though he really wanted to keep several of the jobs, he would just blurt out what he was thinking before he had a chance to process the thought. Impulsivity also leads to poor decision making. Rather than thinking a problem through, impulsive people want an immediate solution to the problem and act without the necessary forethought. Similarly, the impulsivity causes these people to have trouble going through the established channels at work. They often go right to the top to solve problems, rather than working through the system. This may cause resentments from their coworkers and immediate supervisors. Impulsivity also may lead to such problem behaviors as lying and stealing. I have treated many ADD people who have suffered with the shame and guilt of these behaviors.
Many people with ADD are in constant turmoil with one or more people at work. They seem to “unconsciously” pick out people who are vulnerable to verbally spar with. They also have a tendency to embarrass others, which does not endear them to anyone. Shades of the grown-up version of the class clown are also evident at work, such as cracking inappropriate jokes in meetings. Conflict may follow the ADD person from job to job.
Disorganization is a hallmark of ADD and it can be particularly damaging in the workplace. Often when you look at the person’s work area, it is a wonder they can work in it at all. They tend to have many piles of “stuff”; paperwork is often hard for them to keep straight; and they seem to have a filing system that only they can figure out (and only on good days).
Many people with ADD are chronically late to work because they have significant problems waking up in the morning. I’ve had several patients who bought sirens from alarm companies to help them wake up. Imagine what their neighbors thought! They also tend to lose track of time, which contributes to their lateness.
The energy and enthusiasm of people with ADD often pushes them to start many projects. Unfortunately, their distractibility and short attention span impairs their ability to complete them.
One radio station manager told me that he had started over thirty special projects the year before, but only completed a handful of them. He told me, “I’m always going to get back to them, but I get new ideas that get in the way.”
I also treat a college professor who told me that the year before he saw me he started three hundred different projects. His wife finished the thought by telling me he only completed three.
Many people with ADD suffer from moodiness, excessive worrying, and negativity. This attitude comes from their past. They have many experiences with failure, so they come to expect it. Their “sky is falling” attitude has a tendency to get on the nerves of coworkers and can infect the work environment.
People with ADD are often not a good judge of their own ability. They may overvalue themselves and think they are better at their jobs than they really are, or they may devalue important assets that they have.
This happens with letters or numbers, even phrases or paragraphs. You can imagine the problems this can cause at work. Switching numbers on a phone message can cause many wrong numbers. Reading letters backwards can give different meaning to content. Twisting information from a meeting can cause serious misunderstandings. I once treated a billing clerk who had reversed the amounts on bills she sent out, costing her employer over twelve thousand dollars. I had to meet with the employer to convince him that ADD was a real phenomenon and that the employee was not trying to sabotage his business.
People with ADD have a tendency toward addictions, such as food, alcohol, drugs, even work. Drug or alcohol addictions cause obvious work problems. Food addictions cause health and self-image problems which can impact work. Addiction to work is also a serious problem, because it causes burnout and family problems that eventually show up in the workplace.
The symptoms of ADD frequently cause a person to be inefficient on their job. This causes many people with ADD to put in overtime that managers consider excessive. This may result in a poor job evaluation or firing. To avoid these problems, many people with ADD take their work home in order to finish it.
By the age of six or seven, ADD often has a significant negative impact on self-esteem. Here are some of the reasons why:
Many ADD sufferers have been in conflict either with their parents, friends, or teachers over and over for years. This causes them to develop negative “self-talk” patterns and low self-esteem.
The difficult behavior associated with ADD often incites negative input from others. “Don’t do that.” “Why did you do that?” “Where was your head?” “What’s wrong with you?” “Your brother doesn’t act like that!” “You’d do better if you would try harder.” “Shame on you!” These are common phrases many ADD children hear on a regular basis. Constant negative input turns into low self-esteem.
As mentioned above, people with ADD are often a poor judge of their own ability. They often devalue their strengths and positive attributes, focusing only on their failures.
Most people with ADD have had many failure experiences in life, school, relationships, and work. These failures set them up to expect failure, and whenever a person expects that they will fail, they don’t try their best or they don’t try at all.
ADD often causes negative bonding with parents. Bonding is critical to the emotional health of human beings. Yet, by the time many ADD children are school age, they have such a negative relationship with their parents that they begin not to care about other people, which sets them up for societal problems. Without bonding, people do not care about others, and when a person doesn’t care, he or she has no problems hurting others to get what they want.
Due to the many problems that ADD people have experienced throughout their lives, they often have a sense that they are different from others and that they are “damaged.”
As I mentioned above, there is a high incidence of rage outbursts in people with ADD. The sense of being out of control wounds the person’s self-esteem, making him question why anyone would value someone so volatile.
When people do not feel good about themselves, it impairs their ability to relate to others. They have difficulty taking compliments or getting outside of themselves to truly understand the other person. The brain filters information coming in from the environment. When the brain’s filter (self-esteem) is negative, people tend to only see the negative and ignore any positive. Many partners of ADD people complain that when they give their partner a compliment they find a way to make it look like they have just been criticized.
Thought patterns are the manifestation of self-esteem. Due to difficult past life experiences, many people with ADD have a tendency to think very negatively. They frequently distort situations to make them out to be worse than they really are. They tend to overgeneralize, think in black-and-white terms, predict bad outcomes, label themselves with negative terms, and personalize situations that have little personal meaning. Teaching the ADD person to talk back to negative thoughts is essential to helping them heal.
ADD is a neurobiological disorder with
serious psychological and social consequences.
Children, teens, adults, and parents need to know:
It’s not their fault,
they didn’t cause it,
and there is a lot of hope.
Parents, spouses, and family members
need information and the child, teenager, or adult
with ADD needs good treatment.