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 ADHD 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.
 

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
• An overview of ADHD medications, including dosage availability and common side effects, presented by ADHD specialist Ted Mandelkorn, M.D.

I welcome your comments and advice on finding effective medical treatment for Adult ADHD!—Gina Pera

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

Continuing with last month's theme of sharing questions and my answers from CHADD's 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, I asked him, is that really his personality? Or, could it be 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?