Today’s blog explores the topic of ADD and some non-professional, personal thoughts on this “condition” and tools that I have found to be supportive in relieving adults of some of the symptoms associated with ADD.
A Collective Growl
On May 13th, when I posted the blog, Mental Health Week – Let’s Get Started I’m pretty sure I heard a collective growl of frustration and disgust when ADD (Attention Deficit Disorder) was included on the list of diagnosable mental illnesses. When we keep in mind NAMI‘s broad definition of mental illness: a medical condition that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning, we can better understand how ADD is included on the list of mental illness diagnoses.
Because I heard the collective groan over ADD being included in the list of mental illnesses, I felt the topic of ADD as it relates to mental illness might deserve some special treatment. In offering special treatment regarding the topic of ADD, I will be treading very lightly because I am NOT a medical doctor, psychiatrist, psychologist, social worker or counselor. That being said, I have worked with many adults who present symptoms consistent with ADD and I have observed some similarities in their temperments and backgrounds that may prove to be useful in developing an integrated approach to treatment. (Please note that this discussion is ONLY regarding adults who are presenting symptoms consistent with ADD and are only my observations. I do not typically work with children so I cannot speak with any level of experience in this area.)
Symptoms of ADD
According to NAMI, there are actually thought to be three different types of ADHD, each with different symptoms: predominantly inattentive, predominantly hyperactive/impulsive and combined.
Those living with the predominantly inattentive type often:
- fail to pay close attention to details or make careless mistakes in schoolwork, work or other activities;
- have difficulty sustaining attention to tasks or leisure activities;
- do not seem to listen when spoken to directly;
- do not follow through on instructions and fail to finish schoolwork, chores or duties in the workplace;
- have difficulty organizing tasks and activities;
- avoid, dislike or are reluctant to engage in tasks that require sustained mental effort;
- lose things necessary for tasks or activities;
- are easily distracted by extraneous stimuli; and are forgetful in daily activities.
Those living with the predominantly hyperactive/impulsive type often:
- fidget with their hands or feet or squirm in their seat;
- leave their seat in situations in which remaining seated is expected;
- move excessively or feel restless during situations in which such behavior is inappropriate;
- have difficulty engaging in leisure activities quietly;
- are “on the go” or act as if “driven by a motor;”
- talk excessively;
- blurt out answers before questions have been completed;
- have difficulty awaiting their turn; and
- interrupt or intrude on others.
I have worked with adults who have presented many of these symptoms and every one of them has shared with me one common experience.
Every single adult that I have worked with who presents symptoms of ADD experienced their childhood as traumatic in some way. (Before going into further discussion on this, it is important to note that what is perceived as traumatic for one person might not be traumatic to another. We each perceive our human experiences through a unique lens based on our temperments, upbringing and coping skills.) These traumatic experiences may have come in the form of physical, mental, emotional, sexual or spiritual abuse. Others may have experienced their parents’ divorce, a job change or an illness as traumatic. Some grew up in home environments that to them felt unsafe, unpredictable or simply inconsistent with the needs of their unique temperment. To those born as a highly sensitive person, sometimes life itself can be perceived as traumatic. Whatever the experience or event, it was perceived in their body as traumatic. As a result of the perceived trauma, they developed certain coping mechanisms that allowed them to survive an environment that on some level did not feel safe.
Defense Mechanisms and Adaptive Strategies
In adults that I have worked with who struggle with symptoms consistent with ADD, I have observed certain behaviors that I have come to call adaptive strategies or coping mechanisms. It was through the application of these strategies that these individuals attempted to create a sense of safety in an otherwise “unsafe” environment. While these behaviors may have given them a temporary sense of safety and a temporary sense of having control over their environment, all they really did was create more anxiety within them. The behaviors I have seen look something like this:
- Compulsive planning or (what I call) anticipatory thinking. Through this strategy, the brain is occupied with the constant anticipating of “what comes next” or “what might happen” or “the list of all the things I have to accomplish today, tomorrow, next week, next month, next year.” It is the mind’s way of trying to gain control by planning and predicting all the possible events of our lives. It is also the brain’s way of staying in high-alert, on-guard for the next possible trauma or unsafe event. While planning and to-do lists are not bad on their own, when indulged to this extent, they become an obstacle rather than a help on our path. This kind of thinking puts the body always on alert by stirring up the adrenaline we will need to fight or flee the next perceived trauma. The irony is that instead of calming us and helping us to feel safe, this stirring up of adrenaline puts the body and the mind under additional stress and when stressed enough either the body, the mind or both will shut down. This manifests as depression, emotional and mental paralysis, the inability to concentrate on or complete tasks.
- High Sensitivity. High Sensitivity might be a case of what came first, high sensitivity or ADD? The specific experience of high sensitivity I am referring to here is, the ability to “read a room” or “being able to read people.” Through this strategy, we can walk into a room and FEEL if it is safe or meet a person and determine if they FEEL safe. This high sensitivity may be an inborn trait which pre-disposes us to experience our environments as traumatic, it might also be an adaptive strategy we developed to create an illusion of safety in an otherwise “unsafe” environment. If we can determine ahead of time that someone or someplace is not safe, then we can protect ourselves or leave.
- Self-Stimulating behaviors. These “adaptive strategies” work in a similar way to the “anticipatory thinking” above. Those that feel unsafe in their environment have to create a system that will help to create the illusion of safety. Self-stimulating behaviors stir up the adrenaline we need to maintain a posture of “high-alert.” Some of these self-stimulating behaviors include: self-destructive behaviors, creating chaos or conflict, stirring up problems where problems don’t exist, use and sometimes abuse of stimulating substances: energy drinks, caffeine, amphetamines, etc.
What happens in the brain and integrative treatment
When we grew up in environments that we perceived as unsafe and when we developed adaptive strategies to create the temporary illusion of safety, we created new thought and behavior patterns in our brain. One of the traditional methods of treatment for adults diagnosed with ADD is medications to either stimulate those states of high-alert or to re-wire those deeply imbedded neuro-pathways. As NAMI points out, an integrated approach to the treatment of mental illnesses has proven to be the most successful and this is equally true in the treatment of symptoms of ADD. The goal with those experiencing symptoms of ADD is to help them to feel safe in their environment without having to use adaptive strategies that in the end prove to be counterproductive. There are two tools in particular that I have found to be helpful in supporting the reduction of stress and increasing a sense of safety in those suffering with ADD.
Trauma Release and Meditation
For those suffering with symptoms of ADD who perceived their environment as traumatic or unsafe, the first goal would be to eliminate the trauma that is trapped in the body. (Two fabulous books on trauma release: Waking the Tiger by Peter A. Levine and The Instinct to Heal by David Servan-Schreiber) There are countless protocols that assist us in the release of trauma: EMDR, Quantum Bio-Feedback, Reiki, Meditation, Creative Visualization, Guided Meditation, Physical movement, etc. Once the trauma has been released (which may prove to be an on-going process), the next step is to create a foundation of safety. Traditional talk-therapy and behavior modification therapy can assist with this process. In addition to this, the tool I have found to be most helpful to creating the sense of safety that effectively lowers our anxiety and stress while giving us the clear thinking channels we need to create new patterns of behavior is good old fashioned meditation. Disciplined attention to a daily spiritual practice – specifically, ones that engage the creative centers of the brain (ie: Lectio-Divina, Imagination-Contemplation, mantra, chant, creative projects, etc.) goes a long way in creating the foundation of inner peace and safety that we need to avoid the stress-inducing adaptive behaviors and create new patterns of behavior rooted in clear thinking and focused attention that will prove to be productive in way that is free from stress. NOTE: to those with ADD, trying to step immediately into silent meditation, centering prayer or zen practice might cause nothing but frustration. Choose a practice that engages the mind and helps it naturally move to a quieter place. 🙂
In closing, ADD is a complex condition the causes of which are not completely known and neither is the sure path to effective treatment. I am simply sharing with you a few things I have observed along with tools that some have found to be helpful in their journey of healing. As is the case in the treatment of all mental illnesses, an integrative approach is helpful. Consult your doctor, your therapist, local support groups and explore stress-relieving practices that may assist you in creating a better quality of life.