Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder

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9780345442314: Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder

Book by Ratey Md John J Hallowell Edward M Md

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Extrait :

Chapter 1

THE SKINNY ON ADD:

READ THIS IF YOU CAN’T READ THE WHOLE BOOK

Most people who have ADD don’t read books all the way through. It’s not because they don’t want to; it’s because reading entire books is very difficult—sort of like singing an entire song in just one breath.

We want to make this book accessible to people who don’t read books all the way through. For those people, our most dear and treasured brothers and sisters in ADD, we offer this first chapter, set off from the rest of the book. Reading this will give you a good idea of what ADD is all about. If you want to learn more, ask someone who loves you to read the whole book and tell you about it. Or you can listen to it on a tape or CD.

We offer this chapter in the ADD-friendly format of Q&A. You can get the skinny on ADD in these thirty questions and answers. For more detail and research-based answers, you can refer to the chapters of particular interest.

For those blessed readers who intend to read the entire book, some of what’s in this Q&A will appear again, but some of it won’t, so you too should read this section.

Q&A ON ADD

Q: What is ADD?

A: Attention deficit disorder, or ADD, is a misleading name for an intriguing kind of mind. ADD is a name for a collection of symptoms, some positive, some negative. For many people, ADD is not a disorder but a trait, a way of being in the world. When it impairs their lives, then it becomes a disorder. But once they learn to manage its disorderly aspects, they can take full advantage of the many talents and gifts embedded in this sparkling kind of mind.

Having ADD is like having a turbocharged race-car brain. If you take certain specific steps, then you can take advantage of the benefits ADD conveys—while avoiding the disasters it can create.

The diagnostic manual of mental problems, called the DSM-IV, defines ADD by a set of eighteen symptoms. To qualify for the diagnosis you need six. These diagnostic criteria are listed in chapter 12. But be careful when you read them. They describe only the downside of ADD. The more you emphasize the downside, the more you create additional pathology: a nasty set of avoidable, secondary problems, like shame, fear, and a sharply diminished sense of what’s possible in life.

The pathology of ADD—its disorderly side—represents only one part of the total picture.

The other part, the part that the DSM-IV and other catalogs of pathology leave out, is the zesty side of ADD. People with ADD have special gifts, even if they are hidden. The most common include originality, creativity, charisma, energy, liveliness, an unusual sense of humor, areas of intellectual brilliance, and spunk. Some of our most successful entrepreneurs have ADD, as do some of our most creative actors, writers, doctors, scientists, attorneys, architects, athletes, and dynamic people in all walks of life.

Q: What is the difference between ADHD and ADD?

A: It’s just a matter of nosology, the classification of disorders. There is an arbitrariness to it all. By the current DSM-IV definition, ADD technically does not exist. By the DSM-IV definition, the term ADHD includes both ADHD with hyperactivity (the H in ADHD) and ADHD without hyperactivity. Technically, this means you can have ADHD with no symptoms of H, hence there is no need for the term ADD. But ADD, the old term, is still used by many clinicians, including the authors of this book. Whichever term you use, the important point to know is that you can have ADHD (or ADD) without showing any signs of hyperactivity or impulsivity whatsoever. ADHD without hyperactivity or impulsivity is more common among females.

Q: What is the typical profile of a person who has ADD?

A: The core symptoms of ADD are excessive distractibility, impulsivity, and restlessness. These can lead both children and adults to underachieve at school, at work, in relationships and marriage, and in all other settings.

In addition, people who have ADD often also exhibit:

Advantageous characteristics:

· Many creative talents, usually underdeveloped until the diagnosis is made

· Original, out-of-the-box thinking

· Tendency toward an unusual way of looking at life, a zany sense of humor, an unpredictable approach to anything and everything

· Remarkable persistence and resilience, if not stubbornness

· Warm-hearted and generous behavior

· Highly intuitive style

Disadvantageous characteristics:

· Difficulty in turning their great ideas into significant actions

· Difficulty in explaining themselves to others

· Chronic underachievement. They may be floundering in school or at work, or they may achieve at a high level (getting good grades or being president of the company does not rule out the diagnosis of ADHD), but they know they could be achieving at a higher level if only they could “find the key.”

· Mood often angry or down in the dumps due to frustration

· Major problems in handling money and making sensible financial plans

· Poor tolerance of frustration

· Inconsistent performance despite great effort. People with ADHD do great one hour and lousy the next, or great one day and lousy the next, regardless of effort and time in preparation. They go from the penthouse to the outhouse in no time at all!

· History of being labeled “lazy” or “a spaceshot” or “an attitude problem” by teachers or employers who do not understand what is really going on (i.e., having ADD)

· Trouble with organization. Kids with ADD organize by stuffing book bags and closets. Adults organize by putting everything into piles. The piles metastasize, soon covering most available space.

· Trouble with time management. People with ADD are terrible at estimating in advance how long a task will take. They typically procrastinate and develop a pattern of getting things done at the last minute.

· Search for high stimulation. People with ADD often are drawn to danger or excitement as a means of focusing. They will drive 100 mph in order to think clearly, for example.

· Tendency to be a maverick (This can be an advantage or a disadvantage!)

· Impatience. People with ADD can’t stand waiting in lines or waiting for others to get to the point.

· Chronic wandering of the mind, or what is called distractibility. Tendency to tune out or drift away in the middle of a page or a conversation. Tendency to change subjects abruptly.

· Alternately highly empathic and highly unempathic, depending upon the level of attention and engagement

· Poor ability to appreciate own strengths or perceive own shortcomings

· Tendency to self-medicate with alcohol or other drugs, or with addictive activities such as gambling, shopping, sexualizing, eating, or risk-taking

· Trouble staying put with one activity until it is done

· Tendency to change channels, change plans, change direction, for no apparent reason

· Failure to learn from mistakes. People with ADD will often use the same strategy that failed them before.

· Easily forgetful of their own failings and those of others. They are quick to forgive, in part because they are quick to forget.

· Difficulty in reading social cues, which can lead to difficulty in making and keeping friends

· Tendency to get lost in own thoughts, no matter what else might be going on

Q: Aren’t most people somewhat like this?

A: The diagnosis of ADD is based not upon the presence of these symptoms—which most people have now and then—but upon the intensity and duration of the symptoms. If you have the symptoms intensely, as compared to a group of your peers, and if you have had them all your life, you may have ADD. An apt comparison can be made with depression. While everyone has been sad, not everyone has been depressed. The difference lies in the intensity and the duration of the sadness. So it is with ADD. If you are intensely distractible, and have been forever, you may have ADD.

Q: What causes ADD? Is it inherited?

A: We don’t know exactly what causes ADD, but we do know it runs in families. Like many traits of behavior and temperament, ADD is genetically influenced, but not genetically determined. Environment combines with genetics to create ADD. Environmental toxins may play a role, watching too much television may play a role, and excessive stimulation may play a role.

You can see the role of genetics just by glancing at basic numbers. We estimate that about 5 to 8 percent of a random sample of children have ADD. But if one parent has it, the chances of a child developing it shoot up to about 30 percent; if both parents have it, the chances leap to more than 50 percent. But genetics don’t tell the whole story. You can also acquire ADD through a lack of oxygen at birth; or from a head injury; or if your mother drank too much alcohol during pregnancy; or from elevated lead levels; perhaps from food allergies and environmental or chemical sensitivities; from too much television, video games, and the like; and in other ways we don’t yet understand.

Q: Other than its being heritable, is there any other evidence that ADD has a biological, physical basis to it, as opposed to psychological or environmental?

A: Brain scans of various kinds have shown differences between the ADD and the non-ADD brain. Four different studies done in the past decade using MRI (magnetic resonance imaging) all found a slight reduction in the size of four regions of the brain: the corpus callosum, the basal ganglia, the frontal lobes, and the cerebellar vermis. While the differences are not consistent enough to provide a diagnostic test for ADD, they do correlate with the symptoms we see in ADD. For example, the frontal lobes help with organization, time management, and decision-making, all areas that people with ADD struggle with. The basal ganglia help to regulate moods and to control impulsive outbursts, which people with ADD also struggle with. And the cerebellum helps with balance, rhythm, coordinated movements, language, and other as yet to be proven functions. It may be that the cerebellum is far more important in regulating attention than we realize today.

Q: How many people have ADD?

A: Roughly 5 to 8 percent (many experts would put that figure much higher, some lower) of the American population has ADD. The majority of adults who have it don’t know it because people used to think ADD was only a children’s condition. We now know that adults have it too. Of the roughly 10 million adults in the United States who have ADD, only about 15 percent have been diagnosed and treated. Until we have a precise diagnostic test for ADD, however, it will be impossible to give truly accurate figures. Studies around the world—in China, Japan, India, Germany, Puerto Rico, and New Zealand—show comparable figures.

Q: Does ADD ever go away on its own?

A: Yes. The symptoms of ADD disappear during puberty in 30 to 40 percent of children, and the symptoms stay gone. ADD therefore persists into adulthood 60 to 70 percent of the time. As the brain matures, it changes in ways that may cause the negative symptoms to abate. Then ADD becomes a trait rather than a disorder. In addition, sometimes the child learns how to compensate so well for his ADD during puberty that it looks as if the ADD has gone away. However, if you interview that child closely, you will discover the symptoms are still there, but the child is struggling mightily—and successfully—to control them. These people still have ADD and would benefit from treatment.

Q: Is ADD overdiagnosed among children?

A: Yes, but also no. It is overdiagnosed in some places, underdiagnosed in others. There are schools and regions where every child who blinks fast seems to get diagnosed with ADD. At the same time, there are places around the country where doctors refuse to make the diagnosis at all because they “don’t believe in ADD.” ADD is not a religious principle; it is a medical diagnosis derived from such solid evidence as genetic studies, brain scans, and worldwide epidemiological surveys.

It is important that we educate doctors, as well as teachers, parents, and school officials, about ADD, so that we can solve the problems of both overdiagnosis and underdiagnosis.

Q: What is the proper procedure to diagnose ADD?

A: There is no surefire test. The best way to diagnose ADD is to combine several tests. The most powerful “test” is your own story, which doctors call your history. As you tell your story, your doctor will be listening for how your attention has varied in different settings throughout your life. In the case of ADD it is important that the history be taken from at least two people, such as parent, teacher, and child, or adult and spouse, since people with ADD are not good at observing themselves.

To supplement the history, there is a relatively new physical test called the quantitative electroencephalogram, or qEEG, that is quite reliable in helping to diagnose ADD. It is a simple, painless brain-wave test, and it is about 90 percent accurate. Though well worth getting, it is not definitive by itself.

In complex cases where the diagnosis is unclear or there is a suspicion of coexisting conditions, especially if there is a history of head injury or other brain trauma, a SPECT scan can help. The SPECT brain scan is not widely available, though we believe it could help a great deal in psychiatry if it were.

In addition to the history, which should include questions based upon the DSM-IV diagnostic criteria, and the qEEG and sometimes the SPECT, other standardized sets of questions, such as the ADHD Rating Scale or the Brown scale, add confidence to the diagnosis. Your doctor can tell you about these tests. None are necessary, but all are helpful.

Finally, neuropsychological testing can help pin down the diagnosis as well as expose associated problems—such as hidden learning disabilities, anxiety, depression, and other potential problems.

Practically speaking, if you are going to see a busy primary-care doctor for your evaluation, the time available to take a history may be brief, and access to neuropsychological testing nonexistent. In these instances, the qEEG becomes even more valuable, as well as the standardized rating scales, especially the DSM-IV criteria.

The best diagnostic procedures also include a search for talents and strengths, as these are the key to the most successful treatments.

Q: Should you always order the qEEG, neuropsychological testing, or a SPECT scan?

A: All three can be helpful, but no, none is absolutely necessary, unless the diagnosis is in doubt, or you suspect associated learning disabilities such as dyslexia, or other coexisting conditions, like brain damage due to an old head injury, or bipolar disorder, or hidden substance abuse. In such cases, you might encourage your doctor to consider getting you neuropsychological testing, a qEEG, or a SPECT scan.

Q: Whom should I see to get a diagnosis?

A: The best way to find a doctor who knows what he is doing is to get a referral from someone you know who has had a good experience with that doctor. (We have provide...

Présentation de l'éditeur :

“If you read only one book about attention deficit disorder, it should be Delivered from Distraction.”—Michael Thompson, Ph.D., New York Times bestselling co-author of Raising Cain

In 1994, Driven to Distraction sparked a revolution in our understanding of attention deficit disorder. Widely recognized as the classic in the field, the book has sold more than a million copies. Now a second revolution is under way in the approach to ADD, and the news is great. Drug therapies, our understanding of the role of diet and exercise, even the way we define the disorder–all are changing radically. And doctors are realizing that millions of adults suffer from this condition, though the vast majority of them remain undiagnosed and untreated. In this new book, Drs. Edward M. Hallowell and John J. Ratey build on the breakthroughs of Driven to Distraction to offer a comprehensive and entirely up-to-date guide to living a successful life with ADD.

As Hallowell and Ratey point out, “attention deficit disorder” is a highly misleading description of an intriguing kind of mind. Original, charismatic, energetic, often brilliant, people with ADD have extraordinary talents and gifts embedded in their highly charged but easily distracted minds. Tailored expressly to ADD learning styles and attention spans, Delivered from Distraction provides accessible, engaging discussions of every aspect of the condition, from diagnosis to finding the proper treatment regime. Inside you’ll discover

· whether ADD runs in families
· new diagnostic procedures, tests, and evaluations
· the links between ADD and other conditions
· how people with ADD can free up their inner talents and strengths
· the new drugs and how they work, and why they’re not for everyone
· exciting advances in nonpharmaceutical therapies, including changes in diet, exercise, and lifestyle
· how to adapt the classic twelve-step program to treat ADD
· sexual problems associated with ADD and how to resolve them
· strategies for dealing with procrastination, clutter, and chronic forgetfulness

ADD is a trait, a way of living in the world. It only becomes a disorder when it impairs your life. Featuring gripping profiles of patients with ADD who have triumphed, Delivered from Distraction is a wise, loving guide to releasing the positive energy that all people with ADD hold inside. If you have ADD or care about someone who does, this is the book you must read.

Praise for Delivered from Distraction

“The definitive source of information on attention deficit disorder.”—Harold S. Koplewicz, M.D., director, Child Study Center, New York University School of Medicine
 
“A deeply wise and truly helpful book, written with frankness, humor, and tremendous empathy.”—Perri Klass, M.D., co-author of Quirky Kids

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Description du livre Random House USA Inc, United States, 2006. Paperback. État : New. Ballantine Books trade pbk. ed. 201 x 132 mm. Language: English . Brand New Book. If you read only one book about attention deficit disorder, it should be Delivered from Distraction. --Michael Thompson, Ph.D., New York Times bestselling co-author of Raising Cain In 1994, Driven to Distraction sparked a revolution in our understanding of attention deficit disorder. Widely recognized as the classic in the field, the book has sold more than a million copies. Now a second revolution is under way in the approach to ADD, and the news is great. Drug therapies, our understanding of the role of diet and exercise, even the way we define the disorder-all are changing radically. And doctors are realizing that millions of adults suffer from this condition, though the vast majority of them remain undiagnosed and untreated. In this new book, Drs. Edward M. Hallowell and John J. Ratey build on the breakthroughs of Driven to Distraction to offer a comprehensive and entirely up-to-date guide to living a successful life with ADD. As Hallowell and Ratey point out, attention deficit disorder is a highly misleading description of an intriguing kind of mind. Original, charismatic, energetic, often brilliant, people with ADD have extraordinary talents and gifts embedded in their highly charged but easily distracted minds. Tailored expressly to ADD learning styles and attention spans, Delivered from Distraction provides accessible, engaging discussions of every aspect of the condition, from diagnosis to finding the proper treatment regime. Inside you ll discover - whether ADD runs in families - new diagnostic procedures, tests, and evaluations - the links between ADD and other conditions - how people with ADD can free up their inner talents and strengths - the new drugs and how they work, and why they re not for everyone - exciting advances in nonpharmaceutical therapies, including changes in diet, exercise, and lifestyle - how to adapt the classic twelve-step program to treat ADD - sexual problems associated with ADD and how to resolve them - strategies for dealing with procrastination, clutter, and chronic forgetfulness ADD is a trait, a way of living in the world. It only becomes a disorder when it impairs your life. Featuring gripping profiles of patients with ADD who have triumphed, Delivered from Distraction is a wise, loving guide to releasing the positive energy that all people with ADD hold inside. If you have ADD or care about someone who does, this is the book you must read. Praise for Delivered from Distraction The definitive source of information on attention deficit disorder. --Harold S. Koplewicz, M.D., director, Child Study Center, New York University School of Medicine A deeply wise and truly helpful book, written with frankness, humor, and tremendous empathy. --Perri Klass, M.D., co-author of Quirky Kids. N° de réf. du libraire ABZ9780345442314

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Description du livre Random House USA Inc, United States, 2006. Paperback. État : New. Ballantine Books trade pbk. ed. 201 x 132 mm. Language: English . Brand New Book. If you read only one book about attention deficit disorder, it should be Delivered from Distraction. --Michael Thompson, Ph.D., New York Times bestselling co-author of Raising Cain In 1994, Driven to Distraction sparked a revolution in our understanding of attention deficit disorder. Widely recognized as the classic in the field, the book has sold more than a million copies. Now a second revolution is under way in the approach to ADD, and the news is great. Drug therapies, our understanding of the role of diet and exercise, even the way we define the disorder-all are changing radically. And doctors are realizing that millions of adults suffer from this condition, though the vast majority of them remain undiagnosed and untreated. In this new book, Drs. Edward M. Hallowell and John J. Ratey build on the breakthroughs of Driven to Distraction to offer a comprehensive and entirely up-to-date guide to living a successful life with ADD. As Hallowell and Ratey point out, attention deficit disorder is a highly misleading description of an intriguing kind of mind. Original, charismatic, energetic, often brilliant, people with ADD have extraordinary talents and gifts embedded in their highly charged but easily distracted minds. Tailored expressly to ADD learning styles and attention spans, Delivered from Distraction provides accessible, engaging discussions of every aspect of the condition, from diagnosis to finding the proper treatment regime. Inside you ll discover - whether ADD runs in families - new diagnostic procedures, tests, and evaluations - the links between ADD and other conditions - how people with ADD can free up their inner talents and strengths - the new drugs and how they work, and why they re not for everyone - exciting advances in nonpharmaceutical therapies, including changes in diet, exercise, and lifestyle - how to adapt the classic twelve-step program to treat ADD - sexual problems associated with ADD and how to resolve them - strategies for dealing with procrastination, clutter, and chronic forgetfulness ADD is a trait, a way of living in the world. It only becomes a disorder when it impairs your life. Featuring gripping profiles of patients with ADD who have triumphed, Delivered from Distraction is a wise, loving guide to releasing the positive energy that all people with ADD hold inside. If you have ADD or care about someone who does, this is the book you must read. Praise for Delivered from Distraction The definitive source of information on attention deficit disorder. --Harold S. Koplewicz, M.D., director, Child Study Center, New York University School of Medicine A deeply wise and truly helpful book, written with frankness, humor, and tremendous empathy. --Perri Klass, M.D., co-author of Quirky Kids. N° de réf. du libraire ABZ9780345442314

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Description du livre Softcover. État : New. In 1994, Driven to Distraction sparked a revolution in our understanding of attention deficit disorder. Widely recognized as the classic in the field, the book has sold more than a million copies. Now a second revolution is under way in the approach to ADD, and the news is great. Drug therapies, our understanding of the role of diet and exercise, even the way we define the disorder–all are changing radically. And doctors are realizing that millions of adults suffer from this condition, though the vast majority of them remain undiagnosed and untreated. In this new book, Drs. Edward M. Hallowell and John J. Ratey build on the breakthroughs of Driven to Distraction to offer a comprehensive and entirely up-to-date guide to living a successful life with ADD.As Hallowell and Ratey point out, "attention deficit disorder" is a highly misleading description of an intriguing kind of mind. Original, charismatic, energetic, often brilliant, people with ADD have extraordinary talents and gifts embedded in their highly charged but easily distracted minds. Tailored expressly to ADD learning styles and attention spans, Delivered from Distractionprovides accessible, engaging discussions of every aspect of the condition, from diagnosis to finding the proper treatment regime. Inside you’ll discover• whether ADD runs in families• new diagnostic procedures, tests, and evaluations• the links between ADD and other conditions• how people with ADD can free up their inner talents and strengths• the new drugs and how they work, and why they’re not for everyone• exciting advances in nonpharmaceutical therapies, including changes in diet, exercise, and lifestyle• how to adapt the classic twelve-step program to treat ADD• sexual problems associated with ADD and how to resolve them• strategies for dealing with procrastination, clutter, and chronic forgetfulnessADD is a trait, a way of living in the world. It only becomes a disorder when it impairs your life. Featuring gripping profiles of patients with ADD who have triumphed, Delivered from Distractionis a wise, loving guide to releasing the positive energy that all people with ADD hold inside. If you have ADD or care about someone who does, this is the book you must read.From the Hardcover edition. N° de réf. du libraire BAA-B-3708547

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