Adult ADD

1. ADD is a genetic and biological disorder affecting brain chemistry and executive functions

ADD is a genetic and biological disorder that affects 4.4 percent of the U.S. population (Kessler et al. 2005).

Genetic and biological basis. ADD is inherited through genes, with a 75% chance of inheriting ADD genes from at least one parent. The disorder is characterized by low levels of dopamine in the brain, affecting neurotransmitter function. This biological difference impacts executive functions, which are brain processes responsible for:

• Information processing
• Task initiation
• Mood regulation
• Planning future behavior
• Learning from consequences

Symptoms and subtypes. ADD manifests in three subtypes:

• Inattentive
• Hyperactive/impulsive
• Combined

Each subtype has specific symptoms related to attention, organization, impulse control, and hyperactivity. These symptoms must be present before age seven and cause significant impairment in at least two settings (home, school/work, social) to meet diagnostic criteria.

2. Assemble a treatment team of specialists for comprehensive ADD management

A treatment team is a group of clinicians who help you with your ADD diagnosis and treatment.

Diverse expertise. An effective treatment team should include various professionals to address different aspects of ADD management:

• Prescribing clinicians:

  • Psychiatrists
  • Primary care physicians
  • Advanced registered nurse practitioners
  • Physician's assistants

• Non-prescribing clinicians:

  • Psychologists
  • Licensed professional counselors
  • Licensed clinical social workers
  • Licensed marriage and family therapists

Choosing specialists. When selecting team members, consider their experience with ADD, treatment philosophy, and communication style. Ensure they have up-to-date licenses and positive reviews. Group practices can offer advantages in coordinated care and centralized record-keeping.

3. Diagnosis involves evaluating symptoms, history, and conducting assessments

The more documentation you bring, the more information your clinician has to work with when determining a diagnosis.

Comprehensive evaluation. ADD diagnosis involves a thorough assessment of symptoms, medical history, and functional impairment. Key components include:

• Reviewing current and childhood symptoms
• Examining school records and workplace assessments
• Gathering family medical history
• Collecting input from family and friends

Assessment tools. Clinicians may use various tools to aid diagnosis:

• Rating scales (e.g., Adult ADHD Self-Report Scale, Brown Attention-Deficit Disorder Scales)
• Tests of working memory (e.g., continuous performance tests, Stroop test)
• Motion tracking tests

It's important to note that there is no single definitive test for ADD. Diagnosis relies on a combination of clinical judgment, patient history, and assessment results.

4. Medication, counseling, and lifestyle changes form the cornerstone of ADD treatment

Research shows that the most effective treatment may be a combination of medication and therapy (Jensen 2009; Weiss et al. 2008).

Medication options. FDA-approved medications for ADD include:

• Stimulants (e.g., methylphenidate, dextroamphetamines)
• Non-stimulants (e.g., Strattera, Intuniv)

These medications work by increasing dopamine levels and improving executive function. The choice and dosage of medication depend on individual symptoms, side effects, and response.

Counseling and coaching. Therapeutic approaches like cognitive behavioral therapy (CBT) can help develop coping strategies and address emotional challenges. Coaching focuses on practical skills such as goal-setting, prioritization, and organization.

Lifestyle modifications. Implementing changes in daily routines and environment can significantly improve ADD symptoms:

• Establishing organizational systems
• Practicing good sleep hygiene
• Regular exercise
• Mindful eating habits
• Time management techniques

5. People with ADD are prone to substance abuse, depression, anxiety, and eating disorders

When you have ADD, you are more prone to having a substance abuse problem.

Comorbid disorders. Adults with ADD have a higher risk of developing:

• Substance abuse (20% of ADD adults)
• Depression and anxiety (25-50% of ADD adults)
• Eating disorders (especially in women)

Self-medication. Many individuals with ADD unknowingly self-medicate with substances to alleviate symptoms:

• Caffeine for focus
• Nicotine for concentration
• Alcohol or marijuana for relaxation

Treatment considerations. Addressing comorbid disorders is crucial for effective ADD management. Integrated treatment approaches that target both ADD and co-occurring conditions often yield better outcomes. Seek professional help if you experience symptoms of depression, anxiety, or substance abuse.

6. Implement organizational strategies and self-care practices to manage ADD symptoms

Clutter creates visual stress—a feeling of being overwhelmed because you have too much "stuff" in your environment.

Organizational techniques. Reduce clutter and improve productivity with these strategies:

• Use timers for focused work sessions (e.g., 30 minutes on, 15 minutes break)
• Employ color-coding and labeling systems
• Utilize clear storage containers
• Enlist an "organization buddy" for support

Self-care practices. Maintain physical and mental well-being through:

• Regular sleep schedule (aim for 8 hours nightly)
• Consistent exercise routine (30 minutes, 3 times weekly)
• Mindful eating habits
• Frequent breaks and outdoor time
• Body awareness exercises

These practices help regulate mood, improve focus, and reduce ADD symptoms' impact on daily life.

7. Seek support from groups, family, and friends to navigate life with ADD

Sometimes just meeting people with similar life experiences can make the journey easier.

Support groups. Join ADD-specific support groups for:

• Shared experiences and understanding
• Coping strategies and resources
• Emotional support

Types of groups include:

• Psychoeducational (focus on information and resources)
• Therapeutic (emphasis on personal stories and emotional processing)

Family and friend support. Educate loved ones about ADD to foster understanding and support:

• Share information about the biological basis of ADD
• Explain how symptoms affect daily life
• Discuss ways they can offer support

Online communities. Utilize online forums and social media groups for accessible support and information exchange.

8. Make workplace accommodations and choose ADD-friendly career paths

Jobs that are ADD-friendly tend to have the following characteristics: They are fast-paced, with varied tasks each day.

Workplace accommodations. Implement changes to improve productivity:

• Take frequent short breaks
• Request a distraction-free workspace
• Use noise-canceling headphones
• Ask for written instructions and clear deadlines
• Break large projects into smaller tasks

ADD-friendly careers. Seek jobs with these characteristics:

• Fast-paced environments
• Varied daily tasks
• Opportunity for movement or travel
• Intellectual stimulation and challenges
• Clear expectations and frequent feedback
• Flexible schedules

Examples include emergency services, teaching, sales, and creative fields.

Entrepreneurship. Consider self-employment to leverage ADD strengths, but ensure adequate support and structure.

9. Recognize and leverage the positive traits associated with ADD

The things that got you in trouble when you were a kid have a flip side to them!

Positive ADD traits. Recognize and harness these strengths:

• Creativity and out-of-the-box thinking
• High energy and enthusiasm
• Strong sense of justice and empathy
• Ability to hyperfocus on interests
• Adaptability and quick thinking
• Charisma and social ease

Channeling strengths. Use ADD traits to your advantage:

• Apply creativity to problem-solving in work and personal life
• Utilize high energy for fast-paced careers or physical activities
• Leverage empathy for roles in counseling, teaching, or advocacy
• Harness hyperfocus for deep dives into subjects of interest
• Employ adaptability in dynamic work environments

By recognizing these positive aspects, individuals with ADD can reframe their experiences and find ways to thrive in various areas of life.

Last updated: August 23, 2024