Fired Up and Ready for CHADD 2012!

In less than two weeks, Nov. 8-10, 2012, CHADD's 24th Annual International Conference takes place right in my backyard! The Hyatt Regency near San Francisco International airport.

I've been so busy helping to plan events (and dealing with medical challenges) that I'm far behind in my posting here. My apologies! It's been for a good cause.

If you're already registered for the conference, great! Please say hello if you see me. If you're still pondering, I encourage you to register today.  This is a tremendous opportunity to cost-effectively learn a lot about ADHD in a short amount of time from top experts.

You'll find something for everyone: adults, parents, family members, teachers, coaches, mental health professionals, and everyone involved in the criminal-justice system. There are presentations from top experts as well as opportunities to chat informally with researchers presenting their posters on ADHD-related topics. There are networking groups for special interests and talks on every possible fact of ADHD. Check out the lineup here.

Now I'd like to tell you about four events of particular interest to me, with more details below:

See excerpts and learn about the making of "Gigante"

1. CHADD's 25 Birthday Gala event.

As the evening's emcee, I have the honor of presenting our guest speakers: the dynamic duo behind the Sundance Awards-bound documentary Gigante, about Major League Ballplayer Andrés Torres and his rise from humble beginnings in Puerto Rico to being voted Most Inspirational Player by his World Series-winning teammates with the San Francisco Giants.

Diagnosed late in life with ADHD, Torres has passionately embraced the cause of creating more awareness, candidly sharing his struggles so that others do not suffer as he did for many years for lack of knowledge.  (Yes, that's Andrés at right, passionately embracing his wife, Soannie.)

2. The CHADD conference's first-ever Adult ADHD Panel

As the originator (with inspiration from Chris Ziegler Dendy's groundbreaking Teen Panels) and moderator, I hope to make it a tradition! Five adults from the local group that I moderate in Palo Alto for Silicon Valley CHADD plus the former coordinator of CHADD of Northern California, San Diego psychotherapist Lew Mills, Ph,D., will talk candidly about their lives pre- and post-diagnosis, the positive impact they've experienced in seeking support in face-to-face Adult ADHD discussion groups, and much more. Takes place Saturday, Nov. 10 10:30 to noon.

3. The "Lunch with Luminaries."

This is a fund-raising auction where you bid to have lunch with four ADHD experts.  I am honored to be joining three much-admired experts and personal friends:  Patricia Quinn, MD, Ari Tuckman, Ph.D., and Chris Ziegler Dendy. Takes place Saturday, Nov. 10, 12:00 pm.

4. ADHD and the Criminal Justice System. 

ADHD is over-represented in the criminal-justice system, and this annual program at the CHADD conference aims to curb that trend by creating ADHD-education outreach to the local police departments and others in the criminal-justice system (district attorneys, probation officers, court official, and so forth).

As unofficial photographer for the Atlanta event, I saw first-hand how passionately the audience, following talks by the experts, engaged with each other about these issues (photo, left). 

Headed by CHADD's favorite "British Bobbies" (two law-enforcement professionals from England named Phil Anderton and Stephen Brown); psychiatrist, researcher, and professor Regina Bussing; and psychiatrist-researcher Catrina Wilkins.

This event is free and the public is encouraged to attend, so please spread the word to anyone you think will be interested (either already attending the conference or living within driving distance). Takes place Thursday, Nov. 8, 1:30-4:30 pm.  At the conference hotel: SFO Hyatt Regency in Burlingame

More details below on the exiting evening we have planned for you at the gala Friday night!

CHADD's 25 Birthday Gala Event - Friday, Nov. 9, 7-9:30 pm.

Following a fabulous dinner and my short factual-fun presentation on "Great Moments in ADHD History," our featured guest speakers take the stage. Business leader William Chang and Sundance Award-winning director Chusy Haney-Jardine are the dynamic duo behind the Sundance competition-bound documentary, Gigante.  They will talk about their own journeys in ADHD discovery, their passion for making films that make a difference, and the making of Gigante (two powerful preview videos here).

Their Plan A production company describes the film this way:

Andrés Torres, in San Francisco parade for Giants World Series win

Gigante is an upcoming, feature-length documentary about Andrés “Yungo” Torres–a grateful, perseverant man with ADHD who happens to be the center-fielder for the San Francisco Giants. Yungo came from humble means, found rejection, mockery, and disappointment, and struggled 10 years in the minors before becoming a major league baseball player.

He has developed strategies and support systems that helped him to become a key player in the Giants' 2010 World Series win. His story inspires hope and motivates others to embrace their own challenges and never give up on their dreams

Chang, who grew up in Japan and was educated at Oxford and Harvard, is a prominent business leader and a principal owner of the San Francisco Giants. Chusy Haney-Jardine is a Sundance Award-winning director. Both are quoted, along with Torres, in this feature story in the San Francisco Chronicle. (Though Torres played with the Mets this past year, Giants fans will long remember Torres the person and player with immense fondness and admiration. He will always be a hero here in the Bay Area!)

More about Torres. He was named the Most Inspirational Player of the San Francisco Giants World Series team of 2010, has made it his mission to speak openly about having ADHD -- and the price he paid for years of ignorance. He wants to make sure that other children and adults with ADHD don't "fall through the cracks" as he did for many years, working his famously big heart out in the minor leagues but failing to make it into the major leagues. Until an observant coach mentioned ADHD.

Like many adults with late-diagnosis ADHD, Andres procrastinated in "doing something about it." But a fortuitous chain of events changed all that. Next thing he knew, he was not only playing Major League Baseball but a key part of the Giants' World Series win. 

Andres Torres with wife Soannie and Gina, right

I had the pleasure of meeting Torres during the making of Gigante, when Haney-Jardine visited my home to interview me as an Adult ADHD expert. I don't know if my filmed interview made it to the final cut, but it doesn't matter. I so enjoyed meeting Haney-Jardine and "evangelizing" on Adult ADHD. Then he asked if he could bring Torres and his lovely wife, Soannie, to my house to talk about ADHD. Of course, I'd love to meet them!  (Soannie said, "You know, we wanted to rent that house across the street but someone beat us to it."  What a coincidence. The Bay Area is a big place!)

Mind you, not being a big baseball fan at the time, I had no idea that a major celebrity and Bay Area hero was sitting on my sofa!  (For all his success and acclaim, Andres is incredibly humble.) To me at that time, he was was simply another adult with ADHD who might benefit from no-nonsense talk about Adult ADHD (my specialty!). But now of course I am one of his biggest fans, as a player and a person. And just a little bit embarrased at emphasizing my point a few time by poking his knee. :-)

Shortly after, I contacted Will Chang and asked to meet with him. Anyone living in my backyard who is this dedicated to increasing ADHD awareness (by producing such a powerful film), I had to meet!  He graciously agreed to meet me at a Starbucks, and we talked for at least an hour. His story alone would make for a great solo talk at the banquet. But to have him and the super creatively charged director Chusy Haney-Jardine and excerpts of this documentary? Truly, it will be a night to remember. I look forward to seeing you at the banquet!

Okay, back to work for me. CHADD staff and volunteers have worked incredibly hard on planning for you the greatest conference ever. I look forward to seeing you there!

Do you plan on attending the conference this year? Have you attended in years' past? Please share your comments below.

The Couple That Gets Fit Together...

This month, YouMeADD blog kicks it up a notch, following last month's Nature Sufficient Syndrome and the hikes my husband and I enjoy.  Now get ready for "Adventure Hikes" for couples and a companion strategy for boosting brain function called Intermittent Fasting.

Your guide: psychiatrist Michael Lara, who will be speaking about The Exercise Prescription for ADHD at the upcoming CHADD International Conference on ADHD in San Francisco. He also wrote a piece for the June issue of CHADD's Attention magazine.

First the back story: I'd heard about Intermittent Fasting and learned more through this BBC documentary. Still, I wondered: Was it another fad or could there be something to it?  I turned to Dr. Lara, a local Silicon Valley psychiatrist and athlete with a long interest in supporting brain function through exercise and dietary strategies.

Not only was he familiar with Intermittent Fasting, he reported some success in his practice from patients using the technique to better manage anxiety and depression. He'd also noticed a "side effect" in these patients: improved physical composition.

Most notable to me and anyone else who needs to lose a few pounds: He said that Intermittent Fasting was in part responsible for his wife's dramatic weight loss (80 pounds!). Each time I've seen May Lara in recent months, she's looked dramatically fitter and younger. See for yourself.

August 2012

December 2010






















When it comes to exercise, Dr. Lara follows his own advice, and so does May. They hit the trail by their home each morning for what they call an "adventure hikes." It sounds more fun than the gym; plus you get Vitamin D!  You're exercising together but adapting the routine for your individual skill and strength levels. I asked for details, and here they are. As soon as my broken toe heals, I might meet them at a local park soon!  Enjoy!                                 –Gina Pera   

Adventure Hiking 101

by Michael Lara, MD

May struggled with obesity almost all of her life. A busy mother of three daughters with a full-time job, she barely had time for herself. Finding time to go to the gym had always been a challenge. But earlier this year, after more than 30 years of struggling, May finally attained her ideal body weight...without ever stepping foot in the gym.

Nature-Sufficient Syndrome

My husband (pictured above, with San Francisco in the background; more photos below) and I had just parked the car last Sunday and were headed for the trail on San Bruno Mountain when I remembered, "Oh! My first-Tuesday blog post is due this week. What shall I write about?"

"Well," he said, following close behind, "you could write about how most of us are too attached to our electronic screens and devices. And how the industry is exploiting human vulnerabilities." This came as welcome news, especially since it wasn't that long ago that between the two of us, it was only me issuing frequent warnings about "cyber addiction" in our house and in society. A great uncontrolled experiment is being conducted our collective brain, and aside from a few researchers raising the alarm, few seem to care.

My husband was an early adapter of personal digital devices, being one of the first Apple Newton users and buying each successive iteration. When we finally purchased a flat-screen HD TV, the effect on him of watching even mediocre commercials was impressive: lounging on the sofa almost slack-jawed and reminding me of a listless opium-den habitué. The rapture lasted only a few weeks, though. Then one night I noticed him looking at my iPad while watching TV. Did I mention that we live smack-dab in Silicon Valley, where the ante is constantly being upped in the digital-distraction game?

Communicating ... Mindfully

This month's guest post comes to you from Mark Bertin, MD, a developmental pediatrician and author of The Family ADHD Solution: A Scientific Approach to Maximizing Your Child’s Attention and Minimizing Parental Stress. – G.P.

 

If you know you have ADHD, you’re probably aware of how distractibility, impulsiveness or difficulty “keeping track” of everyday life affects you.  But are you aware of how it affects your communication style with loved ones?
 
To address this aspect of ADHD’s potential effect on interpersonal relationships, let’s consider a few examples:  

• Distractibility may cause you to miss what's being said or being asked of you – or to even appear disinterested.
• Impulsiveness and reactivity may change your tone in ways you don’t intend  –snapped responses or flares of anger  – leaving your loved one feeling hurt or confused. 
• A busy mind drowns out the details of the conversation for a few minutes, or plans rebuttals for what it anticipates coming next, or doesn’t fully wait to hear out another person’s perspective.  

None of this is intentional, of course, but all of it influences how you come across and engage with others. 

Whether speaking or listening, we can hone our ability to communicate as we would any other skill. One proven method is through the practice of mindfulness. Think of mindfulness simply as getting out of “autopilot” – that habit of automatically acting and reacting while mentally we are somewhere else entirely.  On the outside, we’re smiling and nodding to someone but inside we’re lost in thoughts of the future, past, or anywhere our mind travels. 

"Our Weekend Without Meds"

The most common question I am asked about Adult ADHD (other than "Is it real?") is this: "Does the medication really make a difference?"

I used to recite the facts and figures. After all, double-blind research should provide rock-solid persuasion that yes, for some people with ADHD, the medication is positively life-changing.

Wrong. After only a few times of watching eyes glaze over during my recitations, I got wise: I started answering the question by sharing before-and-after stories of real-life adults with ADHD.

As one of my college journalism professors used to repeat: "Show, Don't Tell." In other words, don't tell your readers what to think by laying out tedious facts and arguments; instead, provide richly detailed stories and let the readers decide for themselves.

With that in mind, I offer you this "as told to" tragicomedy from a friend named Jason about the weekend that Robert, his partner, ran out of medication. (It's not a typo; Jason and Robert are both men, a reminder that ADHD's effect on relationships is not a "Mars-Venus Thing" and that ADHD does not discriminate on the basis of gender, age, or sexual orientation.)

It's important to note that Jason did not know Robert before he was diagnosed with ADHD and started taking medication. In fact, he had assumed Robert was making "too big of a deal" of his ADHD by taking medication. This "lost weekend" made him a believer.

It seemed like no big deal when my partner, Robert, said he’d forgotten to call his doctor and would run out of medicine over the weekend. "I'll just pick it up on Monday, no problem," he’d said. With hindsight, I should have packed a bag and gone to Vegas. He missed only three days’ medication but the downhill effect was dramatic.

I first noticed the difference on Saturday when it took him three hours to pick up cleaning supplies. On Friday, he’d planned to clean out his home office on Sunday. Unfortunately, he made the plans while on his medication and the event took place while he was off.

Sunday I sat down to enjoy some basketball games on TV in peace while Robert cleaned the office. Eight hours later, he asked me to come see how it looked. I didn’t know what to say. Yes, the office was cleaner. But the hallway was lined with junk and massive quantities of cleaning supplies.

Then he checks his e-mail. Two hours later, at midnight, I wander in to tell him goodnight. He is staring at the computer. I asked him what’s the matter. "I don't know." He is a born geek. Turns out, his PC was fine. He couldn't remember what he was trying to do! It wasn’t easy, but I finally got him to recognize it was because he had not had his medication in nearly two days.

On Monday, he found out that he couldn't get the prescription until Tuesday. He spent the evening on EBay shopping for things we didn’t need. Tuesday morning, he asked me to pick up his prescription; he didn’t have time during lunch hour. But he’d transposed two numbers in the address, and without the doctor’s name, I couldn’t find the office.

Luckily, he went by after work, got it, and had it filled. But he’d gotten lost trying to find his own doctor! He called me for directions, extremely frustrated and blaming me because I couldn’t find the doctor’s office earlier. Huh? He slammed down the phone, saying he would call back.

Two hours later, he arrives. When I asked why he hadn’t called back—I was worried— he didn't remember saying he would call. Where had he been for two hours? “Shopping.” But all he had in his hands was the prescription. "Oh, I forgot the things in the car.” He brings in groceries and more of the same cleaning supplies he purchased Saturday! Now, we have two of everything, including the world’s largest bottles of Simple Green!

When we finally got the air cleared over who was responsible for him being lost, we sat down to relax by watching TV. He picked a show about terrorist training. After all the bad news on this topic, not to mention the last three days' tension, I didn’t consider that relaxing. “But it’s really good!” he insisted.

After 20 minutes of watching him “self-medicate” by seeing torture victims suffer atrocities, I said, "No, I don't want to watch this," but he stubbornly left it on. I left the room. He said, "If you don't like it change the channel!" He had forgotten that he was holding the damn thing in a death grip. Argh!!!

He took a dose of the medication this morning. Hopefully, we will be headed back to a more even keel shortly. Hopefully, he will remember to fill his prescription next time before he runs completely out. In fact, I think I’ll put it on the calendar.

How about you? Can relate to these examples? Do you have others to share? What's the biggest difference medication has made in your or your partner's life?

ADHD and "Cyber Junkies"

Once my boyfriend starts on the Internet, there's no turning back. It seems the perfect trap for people with ADHD: He can drift aimlessly from topic to topic with just the click of a mouse. I just wish he could use all that internet time for something useful.   –Beth

My wife was supposed to turn in her masters-thesis outline by Tuesday. After doing nothing for six months, she worked at the computer all night in a last-minute attempt and still spent half the time playing games on Facebook. I think a typewriter would have presented fewer distractions.  –Marco 

My husband seems very addicted to the computer.  Ours is downstairs, and if I ask him to get something from down there it takes him 20 minutes because he stops to play a game or do some "social-networking." When I finally call down to see what is taking so long he yells back in anger. He was addicted to porn at one point. Who knows. Maybe he still is.   –Kim


It's not only the partners of adults with ADHD who report concerns about computer addiction. The adults themselves  curse electronic gadgets' mesmerizing hold over them. In this previous post, for example, Glen says he staves off sleep by scanning every news headline worldwide on the Internet. And he is not alone.


Clearly, many of us recognize this potential problem. But what to do about it? Below, national cyber-addiction expert, author, and support-group leader Kevin Roberts offers pro-active strategies.
                                                                                     –Gina Pera                                    

Are you a Cyber Junkie? 

Five Steps to Take Back Your Life

 

By Kevin Roberts

Author and cyber-addiction expert Kevin Roberts

Do you, like many adults with ADHD struggle to regulate the amount of time you spend online?  Has “social networking” on Facebook turned into real-time isolation?  Is the cyber world sabotaging your chances for success and happiness? If these questions hit home, you’re not alone.

I am an ADHD adult who also suffers from anxiety.  In addition to these challenges, I spent 14,000 hours over ten years wasting my life on computer games, endless Facebook sessions, and random Internet surfing.  The problem is now under control, but it is a daily effort to keep it that way.

We know that somewhere around 50 percent of untreated ADHD adults will, at some point in their lives, turn to substance abuse.  Data has started to mount that an even greater percentage of people with ADHD struggle with excessive, or even addictive, use of the cyber world.  In both cases, people who do not get treatment usually attempt to self-medicate, meaning that they engage in substances, or behaviors, that temporarily ease the discomfort or the disorder.

In my case, I was aware of the ADHD but not of my anxiety.  Computer gaming was my escape, my reprieve from inexplicably feeling ill at ease.  I say escape because when I was on the computer, I had something to occupy my mind, and did not have to focus on feeling bad.  I didn’t know it was anxiety, but I knew at some level, something was not right.  Compulsive computer gaming allowed me to avoid delving into that.

When I finally got disgusted enough with my life, I went into therapy and learned there were triggers that sent me into the cyber-mediated time warp.  I use that term because I, like many cyber junkies, lose track of time when I am on the computer.  Four hours feel like twenty minutes!  I came to a point when I realized I had a problem, and that my life was not the way I really wanted it.

 

STEP 1:  Do you have a problem?

Do you spend more time on the computer, video games, or smart phone than you want to?  Do these behaviors prevent you from having the life you really want?  You may not be a full-fledged addict, but at the very least consider that your online and cyber behaviors may be preventing you from living life to the fullest. Taking this cyber-addiction quiz might help you assess your situation.

To some extent, all the “cyber junkies” I have encountered have issues in their lives that the cyber world helps them avoid. These issues are, for the most part, not the result of their excessive cyber activities, but rather are the factors that drive them to those activities in the first place. Some of us adults with ADHD struggle with social skills, consistent fulfillment of duties and responsibilities, and even with simply keeping our houses clean.  If you regularly choose, like I used to, cyber activities over tackling the challenges of life, it might be time to admit something is amiss.  If you think there could be a problem, get some help!

With my therapist’s guidance, I discovered that what I had for years called boredom was something much more complex.  I would tell myself, “I’m bored,” which I desperately wanted to get out of.  Boredom had plagued me my whole life, especially in school.  I suppose in some ways boredom is restlessness, not satisfied where I’m at, having a desire to do something different, but not knowing what to do.  Rather than wade through this confusion, I shut my mind down to everything except my game. Once I realized that “boredom” was the gateway to addictive binges, I knew what to watch out for. 

  STEP 2:  Know your triggers. 

When you begin to work on yourself, you will find that you become much more aware of the small choices that lead to spending too much time on a computer, smart phone, or video game.  For many cyber junkies, being alone at home increases the likelihood of a cyber-binge.  Others find that emotional upset, whether at work or home, often precedes the hours-long episodes of “screen stasis.”  My therapist had me keep a journal to help me ascertain what my triggers were.  I found this to be most beneficial. 

When we take ownership for our choices, we begin to take power over our lives by short-circuiting what used be an automatic series of behaviors.  The trouble with cyber addictions is that the computer, or smart phone, is always there.  If you’re bored with the task at hand, there’s always a distraction waiting for you online. 

 As I started to successfully interrupt the cascade of events that took me from “boredom” to compulsive gaming and Facebooking, I also noticed a huge uptick in my anxiety.  For me, anxiety is an underlying sense that something bad is going to happen, coupled with helplessness that I don’t know how to prevent it.  The reason I began to experience it much more intensely is because I was actually feeling it, instead of escaping.  Sometimes, it feels worse before it gets better.

I worked with a therapist who got me in touch with the bodily sensations of anxiety: a churning abdomen, tension across my forehead, and jittery hands.  With his help, I was able to recognize those visceral signs and, instead of bee- lining to the computer, I used some of the biofeedback techniques he had taught me to calm down my body, and mind.  I was able to exert control over the seemingly automatic reactions of my body.

  STEP 3:  Cultivate Awareness, Deal with Your Issues. 

If you’re like me, you may often feel like a victim, like there’s nothing you can do differently.  I assure you that no matter what your core issues are, help is available and you’re not alone.  I dropped out of college for several years, and used to spend all my free time playing video games and engaging in endless online social networking.  I am now about to have my second book published, which was made possible by following the five steps in this article!  I also went back to school and got my Master’s degree, a feat which involved a lot of time in front of the computer and therefore really tested me.

The key is to develop exercises and behaviors that make you more aware and that give you a chance to choose a healthy path.  Spending too much time on the computer is often intertwined with not knowing what else to do.  Develop your own daily routine that keeps you mindful of the life you want, whether an aerobic exercise program, meditation practice, or real-world adventures. 

In spite of therapy, meditating, and doing biofeedback every day, I would still fall into the occasional binge, sometimes for a week or more.  I tried several medications for ADHD and anxiety.  I went through a merry-go-round of five different medications, and had powerful side effects with four of them, and the fifth had no impact at all.  On the other hand, I know of several cyber junkies with ADHD who have found that the right medication significantly helps the problem. One 18-year old put it this way:  “When I’m on my meds, the big jolt I get from video games is just not there, and so I don’t feel like getting on.” I have seen ADHD medication transform lives!  This approach deserves serious consideration. 

While not finding the right med for myself, I had been meeting with my therapist once a week, but that just didn’t seem like enough.  I couldn’t afford to go more often, but felt like I needed a higher level of support.  Like many ADHD people, I get excited when something is new, but as routine settles in, I have extraordinary difficulty keeping it going.  As Dr. Russell Barkley has so aptly stated about ADHD people:  “It’s not that they don’t know; it’s that they have problems doing what they know.” 

I have found that the only thing that can keep me on track is support, frequently reaching out to others.  I participate in CHADD support groups, cyber recovery support groups, and have two close friends with whom I check in every day.  These two are also cyber junkies, so we help each other.  I really cannot do it alone.

STEP 4: Develop a Support Network.

During my years of active cyber addiction, I had isolated myself and cloaked my behaviors to such an extent that no one had any clue about the true scope of my problem.  When we try to come out of addiction-mediated isolation, part of that process has got to involve reaching out to other people, not only to get help and support, but to give those things as well!  Support is especially crucial for ADHD people. 

Even with support, you will not be successful unless you remind yourself each and every day why you are making the effort.

STEP 5:  Brainstorm Goals.

In ADHD, the prefrontal cortex functions atypically, accounting for a good chunk of our difficulties with planning, organization, and following through.  One great method to improve this cerebral reality is setting goals.  I type out short-term and long-term goals sheets and I make many copies, putting them in my car, on the bathroom mirror, on the refrigerator, and even in my shoes so I see them before I leave the house.  I have one 18x24 inch poster board with my long-term goals in block letters.  That awaits me every day in the passenger seat of my car.

Again, I get excited at the beginning of a new goal, and then progressively lose steam.  You have to expect that will happen and take measures to ensure that you keep going!  Write down your goals and make sure you are reminded multiple times every day.  Daniel Amen calls this “developing an auxiliary prefrontal cortex,” and I am inclined to agree. 

Make these steps a habit over the next thirty days and you will be on the road to a more balanced, productive, and successful life.  Yes, ADHD carries a great many liabilities.  No sane person can deny that.  But I have found that with proper treatment, support, and goals, ADHD people are capable of truly extraordinary accomplishments.  Don’t let the cyber world rob you of success!  

How about you? Can you relate to the "siren call" of just checking your e-mail one more time before you go to bed? Can't tear yourself way from that online multi-player game or that great recipe website? Is "cyber addiction" a problem in your life? Or, what did you do to wean yourself off so much online activity?  

Kevin Roberts is an ADHD coach, educational consultant, and addiction counselor.  A nationally recognized expert in cyber addiction, he is the author of Cyber Junkie: Escape the Gaming and Internet Trap (Hazelden 2010). Click here to visit his blog. Kevin leads face-to-face support groups in Bloomfield Hills, Michigan.

Reaching Out to Your Community

How can we best reach adults with ADHD who have no idea they have it? Based on my 12 years of advocacy, I'd say it is through people with ADHD talking about it openly and honestly with others in their day-to-day communities. In this way, others hear the facts about ADHD from people they already know instead of thinly drawn profiles in the media.

I jokingly refer to our Adult ADHD CHADD group in Palo Alto as  "ADHD without Borders," because the meeting routinely draws transplants from many countries, including China, India, Vietnam, Israel, Germany, and Brazil.

These people often express great relief to finally find a group who understands them, because their friends and family back home typically do not. Realizing the genetic connection, they cannot accept that ADHD is an "American invention." They clearly see that extended family members also have ADHD and they need to be educated. They vow to take the message back home and put ADHD in a context their friends and family can understand.

Q & A: When to Disclose – And More

Dear readers - I hope you like this blog's new, cleaner design!

A few years ago, I participated in an Ask the Expert Chat on "ADHD and Relationships", sponsored by the National Resource Center on ADHD. In this free forum, the public is invited to ask questions of a top ADHD expert in a live online chat. This text-based Q&A is later stored in the CHADD Ask the Expert archive (you can view the topics at that link but access is limited to CHADD members). Participants had so many questions, we had no room for the overflow, so I am sharing them here.

Question: When beginning a new relationship, at what point do you suggest disclosing that you have ADHD and what is a good way to do it?

Hi Rebeca,

Well, I wouldn’t mention it on the first date!  Or perhaps even the third or fifth.

I’d give the person time to get to know you first, so you can avoid the risk of letting that person’s possible misconceptions about ADHD filter perceptions of you. 

Then again, if despite your best efforts, you still have a tendency to “blurt” or “mishear” or some other common ADHD-related trait, it might be good to provide a little education first, so the person won’t misinterpret your behavior as, for example, rude or uncaring. Even then, though, you don’t have to say “I do this because I have ADHD.” Because, again, you don’t know the person’s level of understanding of ADHD. Instead, you can say something like this: “Sometimes I have trouble arriving places on time. I just want you to know that if I’m ever late to meet you, it’s not because I don’t care. I’m working on strategies, but sometimes I slip.”

Wearing “ADHD Eyeglasses” with Care

Maybe this has happened to you. As soon as you started learning about ADHD, you suddenly saw it all around you. No, it's not that new people with ADHD suddenly started popping up in your midst; rather, you started seeing oh-so-familiar behaviors in a new light, through the lens of ADHD knowledge.

Thanks to 21st century brain-science breakthroughs, we’re developing enlightened attitudes about the organ linked to everything we do, feel, or think: the brain. Yet resistance remains, so we can't expect everyone to openly embrace what, after careful study, we've come to accept: ADHD is real, it is more common than anyone knew, and, when left unacknowledged, ADHD symptoms can limit the options and self-realization of those who have it—and their loved ones, too.

Is there a parallel in history, when knowledge that promised to vastly expanded human potential somehow gained acceptance only slowly and amid great opposition? Yes indeed, and now we can’t imagine how our ancestors didn’t immediately “see” the benefits of one such invention: eyeglasses.

Eyeglasses debuted in the 13th century, though crude attempts date back to ancient Rome. It took a few hundred years to perfect the design but much longer to erase the stigma. That’s right, the stigma from wearing eyeglasses. To avoid making “spectacles” of themselves, many people preferred stumbling around.

These days we call eyeglasses “eyewear”—chic accessories for those who need them and vanity items for some who don’t. Eye exams take place routinely, and nobody questions the necessity of "vision correction." More relevant to our analogy, no one suggests that if you can’t see well enough to read then you’re probably not smart enough to understand what you’d be reading. Three cheers for progress.

Vision: A Function of the Brain as well as the Eye

The example of eyeglasses offers a practical application in explaining ADHD. Consider this fact: Vision is only partly a function of the eye. Yes, the eye receives sensory input in the form of light hitting the retina.  But those light patterns are then converted into electrical signals, which travel along brain pathways to a visual processing center. That’s where your brain tells you what you’ve seen and makes sense of it. Or doesn’t.

Q: How to Deal with "Meds Roulette"?

A few years ago, I participated in an Ask the Expert Chat on "ADHD and Relationships", sponsored by the National Resource Center on ADHD. In this free forum, the public is invited to ask questions of a top ADHD expert in a live online chat. This text-based Q&A is later stored in the CHADD Ask the Expert archive (you can view the topics at that link but access is limited to CHADD members). Among CHADD membership's many benefits, I consider this one of the best!

Question from Nina:  How do you deal with a significant other who just got diagnosed with Adult AD/HD and is trying out new medications with all different types of side effects?

Hi Nina,


Okay, so you’re at the stage that we sometimes call “Meds Roulette.” By the time some adults with ADHD are diagnosed, there can be intense pressure to "get better FAST."  Unfortunately, tweaking medications is not a fast process. So, it's important that you both show some patience and use a thoughtful approach. Most of all, it's important that both of you be educated.
 

We are extremely lucky to have many medication options today. Just a few years ago, choices were few and side effects much more problematic. Today’s wide range of options increases the odds that each person can find one that works with their unique biochemistry. We hope that some day, genetic research will help indicate which medication will be most effective for an individual. But we’re not there yet. In the meantime, that means lots of trial and error.

That said, a careful prescribing physician and a pro-active patient can take steps to avoid/minimize potential side effects or cut them short when they do occur. Noting side effects can be an important part of the process; side effects can provide clues as to the underlying neurophysiology and the next direction to consider. Unfortunately, many physicians aren’t so careful in their monitoring or don’t know how to read such clues.
 

The fact is, 75 percent of late-diagnosis adults have a co-existing condition, such as depression or anxiety. A stimulant alone can intensify the depression or anxiety in some people, who might need an antidepressant or anti-anxiety medication in addition to a stimulant. There are many possible concerns and options.

Overall, though, the problems I hear most often involve physicians following no logical plan or method. Instead, they use a more haphazard “pin the meds on the ADHD” approach. For example, some prescribe a medication at too high a dosage, when they should be “starting low and titrating slow.” (This means beginning with a low dosage and increasing it by small increments over time, noticing the effect at each stage.) A most regrettable result is the person deciding that "the cure is worse than the disease" and gives up. That’s a sad waste of opportunity.

Dr. Margaret Weiss is a top ADHD researcher and clinician. She was kind enough to share with me,  so I could share with my book’s readers, the recommended protocol for achieving optimal results with ADHD medication treatment. I am hoping that readers will share it with their doctors, so we can all work together to raise treatment standards. (I make a PDF version of the book available for precisely this type of purpose – so you can print out a few pages to share with the physician, the therapists, etc.)
 

Based on the best experts' advice, I also recommend that the partners of adults with ADHD get involved with the process, taking a team approach, unless it is clear that your ADHD partner can handle it well on his or her own. Throughout treatment, the physician should be asking for your feedback. This is recommended for several reasons:

• Some ADHD adults don’t always notice the changes (positive or negative) or remember to share the details with the physician.
• Some might half-hear or half-forget instructions from the physician. (It’s amazing to me how many ADHD-treating physicians, knowing ADHD challenges, don’t write down instructions for their patients.)
• Some might not notice that the physician is not acting in a methodical or thoughtful manner.

Some people bristle at the idea of a "team approach" when pursuing ADHD treatment. They might say, "My partner is an adult; why should I be involved?" I wrote about the reasons for it in this post, Partners in Life, Partners in ADHD Treatment.

Of course medication is only part of the physical treatment process.  It’s also important to pay attention to diet, sleep, food sensitivities, and exercise.  No medication can offset poor health and lifestyle habits.

When the medication is right, however, it can make life so much easier for everyone. I’m constantly astounded by the positive reports from the adults in our Silicon Valley Adult ADHD discussion group  and the online “partners of adult with ADHD” group as well. It’s an awe-inspiring transformation to witness.  So, if you want best results from medication, know that it takes an educated, pro-active approach!  Here are more resources to help you do just that:

• Adult ADHD Treatment guidelines from the National Resource Center on ADHD
• A video interview with me, Gina Pera, on "the side effects of poor medical treatment for Adult ADHD"
• An overview of ADHD medications, including dosage availability and common side effects, presented by ADHD specialist Ted Mandelkorn, M.D.
• ADHD Practice Guidelines, including rating scales (recommended for gauging medication efficacy) and medication guidelines, compiled by Dr. Margaret Weiss and colleagues at the Canadian ADHD Resource Alliance (CADDRA)

We welcome your comments and advice on finding effective medical treatment for Adult ADHD!

Love Means Saying You're Sorry

This month's insights on Adult ADHD and relationships come from psychologist Ari Tuckman, with two excerpts from his book More Attention, Less Deficit: Success Strategies for Adults with ADHD. Enjoy, and please join in with your comments on these topics!  -- Gina Pera

By Ari  Tuckman, Ph.D.

It's been said that if one person in a relationship has ADHD, then the other person kind of has it, too. The one person’s ADHD affects not only how he interacts with his romantic partner, but also his ability to meet his practical obligations in the relationship, like getting to dinner on time and picking up after himself. This can lead to some predictable and interesting dynamics between the two people as they work to find a better way. Every couple faces their own challenges, but a relationship where one person has ADHD will tend to face certain kinds of challenges—and benefit from certain kinds of strategies.

          It’s important to remember that when it comes to improving your relationships and friendships or reducing the effect that your ADHD has on them, you don’t need to strive for perfection. Often, some partial improvements are enough to make things much better and create a situation where your positive qualities outweigh the negative feelings the other person has about your ADHD-based behaviors. Of course, you may also decide that you’re tired of trying to be something you aren’t and make some choices about who you interact with. Some other people may be much more appreciative of your good qualities and much more tolerant of your negative ones.

          I use the word relationship broadly to refer to interactions of all kinds: family member, friend, coworker, boss, for example, so it doesn’t apply just to romantic relationships. Besides, a lot of the same rules apply to all of these. Usually romantic relationships intensify feelings and thoughts that we can keep simpler in other relationships.
         Below are two excerpts from my book More Attention, Less Deficit: Success Strategies for Adults with ADHD:, drawn from Chapter 15: Relationships and Friendships: Strive for Balance

Q & A on Adult ADHD: What Is Personality, What Are Symptoms?

Continuing with last month's theme of sharing questions and answers from my Ask the Expert chat, here is a two-part question from a reader named Matt. I welcome your responses to both Matt's questions and my answers. -- Gina Pera

1. How do you separate ADHD from the person? Because it is neurological, it just doesn't seem possible. It would be like separating sexual orientation from a person.

Hi Matt,

Boy, that’s a question for the philosophers! But I’ll give it a try. It’s true that, especially with late-diagnosis adult ADHD, you often hear comments such as “I don’t know if I have ADHD or if I am ADHD.”

A 30-something man with ADHD recently told me that his personality is the Life of the Party. But is that really his personality, I asked him, or is it a behavior developed many years ago because he was unable to follow the many conversational threads at a party? 

Adult ADHD Question-and-Answer: on ADHD and "Denial"

A few years ago, I participated in an Ask the Expert Chat on "ADHD and Relationships", sponsored by the National Resource Center on ADHD. In this free forum, the public is invited to ask questions of a top ADHD expert in a live online chat. This text-based Q&A is later stored in the CHADD Ask the Expert archive (you can view the topics at that link but access is limited to CHADD members). Among CHADD membership's many benefits, I consider this one of the best!

      

Reprinted courtesy of "Kev" 
http://www.kevscartoons.com

The Internet is chockablock with information on ADHD, but some of it is unreliable. You can count on these Ask the Expert chats to be solid. (The latest one was with Dr. Russell Barkley.) Moreover,  back issues of CHADD's excellent Attention magazine are stored in the archives for members' access. So, if you're not a CHADD member, I encourage you to sign up now (it's tax-deductible, too!).

During my Ask the Expert chat, the questions came in massive quantities!  So many that I didn't have time to answer them in the chat itself. Fortunately, I saved the file. In the coming months, I will be sharing the most topical questions and answers with you.  This month: What do you do when an adult in your life is "in denial" about what seem obvious ADHD-related challenges?

ADHD and Your Money

My husband and I are now on the same track when it comes to money, but it wasn't always thus.  Conflicting attitudes and goals were a constant source of stress and acrimony.

The best I can describe it is that before my husband's ADHD diagnosis and medical treatment, money was more of an abstraction to him rather than a reality.  He would say that he didn't care about money, but the evidence clearly showed that he cared about the things it would buy.  If he wanted a new gadget, he bought it. If he wanted a new book, he did the Amazon one-click.  There was little thought between want and buy  and little consideration for what might happen between now (when money was coming in) and not now (when sickness, unemployment, or retirement meant it wasn't).

My Depression-era parents had demonstrated good money-management principles for their seven children and, thanks to a meager journalist's salary most of my life, I had ample opportunity to put those stretch-a-dollar principles into practice. As a result, I didn't understand my husband's careless attitude towards money.  Finally, I realized that there was no thinking; there was just impulsivity and no regard for the future or even short-term goals. Money was simply frittered away to impulse purchases, traffic citations, late fees, and, well, you get the idea. Then we learned about ADHD and its common challenges around money.  Even with the diagnosis, though, we did not have a clear path towards better joint financial-management.  

That path would have been much clearer if we had been able to read ADD and Your Money, by

Adult ADHD and "Time Blindness": Dr. Russell Barkley's Tactics for Taming That Trickster, Time

Time.  That's one word that always makes the top of the list when I ask adults in our local CHADD discussion group to name their top ADHD-related challenges.

• Keeping track of time.
• Estimating the time it will take to complete a project.
• Planning for future time instead of getting totally wrapped up in present time.

Managing time is a constant challenge for most humans, especially in our speeded-up age. Yet, for people with ADHD, time can be a particularly shape-shifting trickster. 


No one knows this better than psychologist Russell Barkley, a preeminent researcher, lecturer, expert, and author in the field of ADHD. And no one better explains to the layperson why this is and what to do about it than does Dr. Barkley in his new book, Taking Charge of Adult ADHD. 

The following excerpt, from Chapter 10, offers tips for taking charge of your time. Earlier chapters build a strong foundation for understanding ADHD neurobiology and guidelines for medical treatment; remaining chapters offer straightforward but in-depth strategies for tackling your particular issues in various areas of life.