National Alliance on Mental Illness
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Taking Control of ADHD
By Nancy Abramson
I am a middle-aged woman with many creative and athletic gifts, good friends, a solid marriage and wonderful children but I have a secret that I share with almost no one: I have attention-deficit hyperactivity disorder (ADHD)—the “inattentive” type. It has been an obstacle of varying degrees for my entire life. While the distraction and impulsivity more commonly associated with ADHD are definitely challenges for me, a more persistent problem is that my brain takes forever to “turn on”—to attend, focus, sustain interest and follow through with a task—and then it turns off whenever it wants. This happens despite my efforts to manage nutrition, sleep, exercise, medication and all kinds of other factors.
As an adult with ADHD, who was diagnosed in my early 30s, I fight deeply ingrained low self-esteem, anxiety and depression, all of which are commonly associated with ADHD. I understand why. I was a spacey, dreamy but smart and successful girl until about age 13. At that age, perhaps with the onset of hormonal change, the depression and anxiety kicked in. Throughout my teens, the ADHD brain fog slowed me down almost to a complete stop on a daily basis. My over-achieving parents scolded me and called me “sedentary,” which I was. I was literally stuck in place.
Finding the right kind of help has taken a very long time. While far better educated and supported now that I am older, I am still looking for ways to live and learn better. I was almost 30 when I first learned about ADHD while reading an article by Dr. Ned Hallowell in a Boston newspaper. I recognized myself immediately but it took another five years to persuade my insurance company to direct me to a specialist who would diagnose and treat me. I soon found a supportive doctor at Georgetown University Medical School. Otherwise, I felt very much alone and very different from others. Now, almost 20 years past my initial diagnosis, I feel that the “team” I have in place, consisting of a cognitive behavioral therapist, a psychiatrist and an internist, is what I really need to function well. It has taken several tries to get the best match of personality and insurance coverage.
With the Internet’s arrival, reading about others with stories like mine has been a tremendous boost. Also enormously helpful has been learning that many psychologists, psychiatrists, neurologists and other cognitive scientists are actively exploring why some brains are so deeply under-aroused. Learning about these developments provides me with fresh motivation to take better care of my cognitive needs and a sense of hope for a higher level of cognitive functioning.
Lacking support, I was the one to search for helpful books, websites and resources. I served as my own advocate. This was not easy with my low self-esteem and depression. It has been a long road.
I continue to keep my ADHD brain a secret from almost all of my friends and my employers. Many of my most supportive conversations in ADHD Internet forums have been anonymous. It has been nearly impossible to openly share my ADHD experiences when one is harshly judged for living with this disorder. This is obvious when looking at the comments that often follow media stories on ADHD. Many comment that we are fakes seeking help from snake oil and encouraging others to follow suit.
On the other hand, I have shared my story with one or two friends, after much thought and deliberation, and after allowing the feeling of trust to grow and flourish. This has been deeply nourishing for me, so I would encourage others to be as careful but as committed to being connected with others.
I have also shared my diagnosis with my daughters, not to share my difficulties but more to encourage them to talk about their own, should they (or their friends) experience ADHD symptoms. Dr. Hallowell writes eloquently about the danger of becoming isolated as I have been so many times. Perhaps I would have had an appropriate intervention much earlier than my 30s had society and my high school been more aware of ADHD, had my parents been more involved and had the guidance counselor I sought help from considered it a serious problem when I described my depressive thoughts and enormous difficulty completing my work.
Parents today have access to many resources to help educate them about the many treatment options. If they decide that medication is needed, then they should also know that a child or an adult with ADHD still needs supplemental support and coaching to truly succeed.
Exercise has been an incredible help to me. When my brain gets sleepy midday, a quick walk will always help. Sometimes a bike ride will invigorate me, which will make me feel good about myself, which will in turn increase my motivation to take on tasks that my brain normally does not handle well. Other times, a bike ride will tire me out and, at that point, medications are not effective, which can lead to a downward spiral.
An approach I find extremely helpful in reading a detailed paper or learning a new subject is to combine it with riding my stationery bike. Any kind of sustained movement I make while reading or even listening to a book or podcast allows me to remember what I have read or listened to with improved detail.
I also find that proper hydration is important. Also, certain foods amplify my ADHD symptoms. I avoid alcohol, dairy, sweets and fruit juice, because they have a negative effect on my ADHD medication. If I take a stimulant medication, I avoid caffeine and caffeine-containing foods (chocolate), because they affect my sleep patterns. Adequate sleep is important for a successful day. Literature on sleep suggests that a sleep-deprived brain experiences cognitive challenges that are identical to ADHD.
I have not worked in an office for several years but may be returning to office work. If so, I will try to walk or bike to work so that my brain is as awake as possible when I get there. I will make a daily walk a ritual during the work day and keep my work-day diet stable and similar to what I eat at home.
I have not worked with an ADHD coach but I have purchased many books by ADHD experts, and I consult these frequently. I also seek out videos and podcasts by ADHD coaches and other experts. I have taken control of ADHD and am managing quite well with it in my life.