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December 29, 2008 10:18 AM   Subscribe

Adult ADD... if you've got it, how do YOU handle it?

I've recently been diagnosed with Adult ADD. It certainly explains a lot about my personality, but it leaves me with a LOT of questions. I used to be in the military - and it was the only job I've ever really thrived in. I guess I handle the environment well when forced to focus. That and I tend to hyperfocus, which was perfect as an air traffic controller. But now I'm out of the military in a less constrained environment.

I don't focus on any one task (except bodybuilding) for more than 5 minutes at a time. In the gym I don't think about anything except what's right in front of me. The weight. But at work I jump from task to task (and the internet - like now!) and hardly accomplish any of them. None of it is interesting enough to keep me involved with it for more than a couple of minutes. I've always had a hard time carrying on a conversation because I change subjects to fast, so these days I'm more of a listener. And hey OMG - there's window washers outside!!

At home in the evenings my partner gets upset with me while we're watching TV because I'm also surfing the net and texting on the phone at the same time. He says I can't get enough input. He's kinda right. LOL.

My question(s) is - I'm DEAD SET against doing any drugs to help me focus. Other than the exercise that I already do (again, bodybuilding and cardio 6 days a week), what can I do to help me focus? I found a related AskMe here, but it's over 3 years old. Are there any new approaches to controlling my myself? Are there any mefites out there who are the same way, and what do they do?
posted by matty to Health & Fitness (21 answers total) 65 users marked this as a favorite
 
You could try natural alternatives. There are some oils (Flax seed? Omega 3?) which are purported to work - here is a book link...

If your case is mild enough, you could find that a couple strong cups of coffee or "energy drinks" help - I'm betting you used to drink coffee at work.

Ultimately - try asking a medical professional - a psych who specializes in it would be best.

I know they are typically geared towards prescribing drugs, but in the end it is your choice.

Annectotally we tried many natural alternatives with one of our kids and in the end had to turn to medication - as this is a mild case, it is a tiny amount (less than 10mg of short-activing dexedrine), given only once per day to help focus during school. The difference in ability to focus is so dramatic that the teacher know immediately when we forget to give the medication that day.
posted by jkaczor at 10:31 AM on December 29, 2008


And when I say tiny dose... While researching alternatives we hung out on ADHD forums where parents were talking about doctors prescribing doses starting at 40mg - some even as high as 150mg per dose...

The rule (according to the doctor treating our kid) is to start out with a small dosage, and then slowly increase until you see results.

However - because of your active bodybuilding, I would definately see a specialist. Some ADHD medications (if you go that path) increase the risk of heart complications.
posted by jkaczor at 10:35 AM on December 29, 2008


I understand the stigma of drugs and not wanting to mess up your psychological barometer, but as someone who has benefited enormously from ADD meds, I just wanted to let you know that despite what Newsweek's covers say, Ritalin and Adderol are not actually poison.

That said, I've had to spend many a month without my pills, so I figured out pretty quickly what exacerbated my daydreaming. One thing that makes me feel too frenetic is sugar for breakfast, because it kickstarts bad sugar cravings that distract me all day. Eat "brain foods," like walnuts, vegetables, and good fats. Drink green tea, it'll keep you buzzed if you're not used to caffeine, and purportedly boosts concentration. You're on the right track with exercising, which I recommend doing in the morning so you can focus all day. Pick up meditation, though I can't personally vouch for that.

There are plenty of books about living an unmedicated life with ADD that are sure to have more tips.
posted by zoomorphic at 10:41 AM on December 29, 2008


Listen. I've written papers about the ills of medication for ADD, there are certainly downsides and you're to be commended for resisting the onslaught of voices telling you it's an obvious choice. That said, finding the right medication and taking it regularly makes everything easier for me. It's not the most important thing, by any means, but it makes everything else so much easier. It's a crutch, but an excellent one with few side effects (especially as an adult).

My algorithm is as follows: The timer thing seems absurd but it's really helpful, because when you inevitably zone out you have "lost", at most, 15 minutes. I even do this for things like eating lunch, because I know I could end up running in to someone and getting distracted for hours. The nice part about this psychologically is that you prevent the meta-tasks of scheduling and organizing your time from actually doing work. You make the decision, and then you free your resources to actually do things, with the added benefit of a watchdog timer-esque failure mode.

Give yourself long blocks of time to just spazz out and do whatever as a reward.
posted by phrontist at 10:49 AM on December 29, 2008 [25 favorites]


The nice part about this psychologically is that you prevent the meta-tasks of scheduling and organizing your time from actually doing work.

Sorry, that should read...

The nice part about this psychologically is that you prevent the meta-tasks of scheduling and organizing your time from interfering with actual work.
posted by phrontist at 10:51 AM on December 29, 2008


I'm going to try to provide a counterpoint to your vehement refusal to try medications for this, because I spent the better part of a decade trying to manage ADD without medications, for exactly the same reason, and did my life tremendous damage in the process.

I was diagnosed with ADD as a child in the early 80's: at the time, the conventional wisdom was that kids grew out of it. In 1988, my doctor discontinued Ritalin therapy: I was a sophomore in high school. I struggled for the remainder of my high school time, and managed to make it into college on pure willpower. The first two years were relatively event-free, the last two were impossible, and I dropped out in the second semester of my senior year because I simply could not function well enough to cope.

I would find myself reading the same page of organic chemistry sixteen times, with no improvement in recall. I was failing half of my classes, but excelling in the things I enjoyed, like theater, music, and poetry. I was a tremendous mess.

After I dropped out, I worked in a lawn-and-garden job at Lowe's for just long enough to realize that I was going to shoot myself if I didn't get out. So I managed to get out, and into the internet industry, largely through dumb luck. Understand that during this time I was marginally able to keep myself to a schedule, and was basically unable to retain information without either writing it down or committing it in some way to more permanent form than my memory.

I went through every kind of effort known to man to try to will myself through ADD. Meditation. Exercise. Structured days, to the point where I had every minute of my waking day planned out. Diet and nutrition changes. Some things worked for a little while, but by and large, none of them worked. And I became utterly convinced that my ADD, for whatever reason, was impossible to manage, because, by God, I was not going to rely on some drug as a crutch to make my brain work. Drugs were for pussies who didn't have my kind of mental resources and self-control and willpower. Taking a drug for ADD wasn't addressing the problem, it was just a bandaid, etcetera, etcetera, ad nauseum infinitum.

In 1996, one day, exhausted, I essentially admitted defeat. I figured, what the hell, it couldn't possibly be worse than what I was going through, and I went to see a psychiatrist. And she told me that I was more or less the classic definition of an adult ADD sufferer, that I hadn't ever grown out of it, and that, given my frustration, maybe trying medication for a little while would help. Fuck it, I said, write me the script.

Amusingly, we started with Ritalin, my old friend.

At the risk of sounding evangelical, insane, and generally unreliable, my life changed that day. It became mine again. Maybe it became mine for the first time in my adult life. That one drug, one medication, made it possible for me to actually direct my intellect for as long as I wanted, as hard as I wanted. My sister was in nursing school, and had left a textbook at home: I went through it in about a week, whipping through the exercises, enjoying the hell out of myself, and in general feeling like someone had ripped the shrouds off my brain.

Sometimes a drug is the answer. It isn't always the answer, but I would strongly, strongly urge you to not arbitrarily rule drugs out before you evaluate them against other therapies. Ritalin works for me, but it doesn't work for everyone: I'm not sitting here saying drugs are going to work for you, or that if you just get on the right drug everything will be fine. I'm just saying that you sound an awful lot like me in 1996, and I can say with complete confidence that if I hadn't opened my mind to the possibility that drugs might help, I wouldn't be where I am today. I wouldn't even be close.

I know that you said you're dead set against drugs, so this entire comment amounts to me basically not answering your question. However, I felt it might be worthwhile for you to hear from someone who had the same attitude for a very long time, changed their mind, and had a good outcome.
posted by scrump at 12:01 PM on December 29, 2008 [26 favorites]


Wow Matty, I read that post and thought, this person has been spying on my life. My life is damn near a mirror t yours. In the USAF (CCT) loved it and did well, but totally sketchy in everything outside of it. In the evenings I tend to get banished from the TV due to massive channel surfing while surfing on a laptop and wind up on my gaming PC, I find that keeps me occupied and away from random kitchen grazing. I hit the gym as well.
I have not been diagnosed by my dr, but have been aware of my situation for a long time, and the reason I have not been diagnosed is I don't bring it up because I don't want to be on meds, because as scrump says, meds are for pussies.
However, reading Scrumps post makes me want to rethink that (failed) stratgey.
Thanks for bringing this up.
Let me know what you do and how you make out.
posted by a3matrix at 12:56 PM on December 29, 2008


Ok, I'm wondering what job you have now and if going back to air traffic control (as a civilian) might be a better fit.

Personally, I take a very low dose of ADD meds and it helps me focus, but it is not a "cure" for ADD.

As for techniques, you will probably benefit from a structured schedule at work. I can't be very specific without knowing more about what you do. In the mornings, get some work out of the way before you allow yourself on the internet/email. I keep a notebook next to me so every time I have a distracting thought I can write it down and go back to what I was working on without getting derailed. Later I can go through the notebook and do those things.

You might also benefit from the Emergent Task Timer. It is a free flash application you can keep open in your browser. It beeps every fifteen minutes and you can keep yourself on track and see how much time you are putting into work tasks vs. other things. It's as easy as writing in what tasks you should work on that day and clicking on a bubble every time you spend 15 minutes on it. I would use this with some sort of reward system. Good luck and let us know how it goes.
posted by CoralAmber at 2:22 PM on December 29, 2008


Another vote for medication, as the spouse of someone with ADHD. My husband's experience closely mirrors scrump's - his life changed immediately upon taking the medication. If he could manage it any other way, he would, but the medication has increased his productivity tenfold. Bottom line, it provides him with a much higher quality of life.

Also, our relationship is 1000% better when he's on medication. He can focus on our conversations, he's more patient and calmer, and he contributes more to the relationship.
posted by desjardins at 3:19 PM on December 29, 2008


Agree with the above responses- ADD medication isn't bad when used properly and titrated to the smallest dose possible. And that medication is only part of the solution.

(My doc was talking about an upcoming treatment that's a biofeedback machine. It makes you do boring things and beeps at you when your focus wanes. (Presumably, it's a bit more complicated than that.) But he said that the results are promising.)

Aside from that, I've found that the closest thing in the natural world is green tea. I have no idea what the effects of drinking green tea nonstop are versus low-dose amphetamine, but it fits your request.

Also, Sudafed.
posted by gjc at 5:10 PM on December 29, 2008



I'm not officially diagnosed but I often wonder. I too dislike the idea of medication.

I often ask myself throughout the day, "is this important right now?" If not, I move on to what is. What is most beneficial? What gets me out of work on time? What is the next right thing? Rather than becoming frustrated with a never ending rat-hole, I'll put it down and come back to it later.

I always have a text file open where I sort through items. Usually the ones which fall to the bottom get filed under various idea lists.

I friggin love lists. I read my lists monthly, sort of like the Sunday paper. I just finished a project that was on one of my lists for nearly ten years. I absolutely love lists. I started a list today entitled heroes / heroines. I only put about 50 names down but I'll come back to it later. God I love lists.
posted by ezekieldas at 5:21 PM on December 29, 2008


I have to second scrump. There is little left to add. Since I am a rather low-key not hyperactive person - exact opposite, I never thought I had ADD because I could sit still. However, I couldn't concentrate on jack. ADD meds gave me my brain back. The transformation was so extraordinary that it was like a revelation - like Paul on the road to Damascus, like Buddha under the Boddhi tree. Really I always knew I was smart but thought I lacked discipline and it was a personal failure and a reflection on my own utter inadequacy and that I would amount to nothing.

I understand that you said that you were dead set against it. So I understand it must be frustrating to hear a bunch of people argue with you about that instead of answering the question you asked. yet it is hard to give you any meaningful advice without mentioning meds.

Of course like any other medical therapy, it is a cost-benefit choice and take any advice with a grain of salt, but alternative doesn't necessarily mean better and the advice to lead a good healthy life will help but it is nibbling about the edges.

I understand, I am wary of what I am putting into my body. I give myself "holidays" when I know my schedule isn't intense, and of course on week-ends and vacations. and *always* try to take the lowest dose possible, yet I am convinced that I would be unemployed and unemployable without them.

Could you come back and tell us why (unless we are prying) you reject meds so?
posted by xetere at 6:57 AM on December 30, 2008


Thanks all for the feedback and personal experiences/viewpoints.

CoralAmber - I'm not an ATC in civilian life because I switched from being an enlisted ATC to a Naval Flight Officer (which still required me to hyperfocus for extended periods - I was good at it). When I got out of the Navy I don't qualify for their Phoenix Program for retired ATC's (I didn't retire) and I'm too old to start out fresh - they do indeed have a maximum age limit.

Xetere and several responders - I've been dead set against the drugs for a multitude of reasons... the 'pussy factor' that's been mentioned, the stubborn mindset that I don't NEED anything, and my general fear of anything that may fuck with my head and make me a 'different person'. When it boils down to it, I kinda LIKE me... I don't wanna turn into someone else. Maybe that seems odd, but it's my take on it.

Overall though, I appreciate the different viewpoints. I'm not quite so DEAD set against at least trying some medication now, and I've gotten some good tips on ways to focus and structure myself. Thanks again AskMe.
posted by matty at 11:15 AM on December 30, 2008


Wow, I am so moved by the wealth of knowledgeable information and support here.

Just a few years ago, the questioner would have gotten a lot of unhelpful responses, especially as concerns medication.

Many volunteers have worked hard for years to increase the level of ADHD Awareness -- without one cent from "Big Pharma" -- just for the satisfaction of helping to elevate lives.

It's so great so know that those of us who are a little tired and burned out from the effort can step back a bit and let the messages continue to ripple out.
Happy New Year, everyone. I hope 2009 is good to us all.

Gina Pera
posted by GinaPera at 11:58 AM on December 30, 2008


Ok, thanks for clearing that up for me (I don't know much about the field).

ADD meds really don't change my personality. I'm still bubbly and talk too much and jump from subject to subject. But they do help things like concentration, procrastination, and focus in general. Since they aren't addictive and wear off in a few hours (at least the ones I take), I don't think there would be a problem with you trying a small dose for a few days, if your doctor agrees. Honestly you should see the effects within a half hour. I would suggest taking one right before work and seeing if you feel different that day and then one on your day off and see if that effects anything (like weekend projects or even following movies and tv shows).

I notice a difference if I forget to take my pill. I just feel more unfocused and I can't figure out why I can't seem to stick to anything (until I remember that I didn't take my pill). So it's just a subtle change, but it effects my focus, not my personality.
posted by CoralAmber at 2:22 PM on December 30, 2008


I've been dead set against the drugs for a multitude of reasons... the 'pussy factor' that's been mentioned

I'm guessing that a bunch of guys saying "Well I'm not a pussy" are going to sound defensive and aren't going to carry that much weight with you. So I'll jump in here as a non-ADHD observer and say that the guys I've known who take medication for ADHD are definitely not pussies. Medication was almost always their last choice; none of them said "Yay, I'll just take a pill because I'm too lazy to try anything else!" My husband is also ex-military and had a job that required intense focus, fwiw.

the stubborn mindset that I don't NEED anything

You don't need to do bodybuilding. So why do it? My guess is some combination of feeling good and looking good. It somehow adds benefit to your life, despite probably being painful/frustrating/inconvenient when first starting out.

and my general fear of anything that may fuck with my head and make me a 'different person'. When it boils down to it, I kinda LIKE me... I don't wanna turn into someone else.

My husband was diagnosed 2 years into our (4 year) relationship, so I know the "before" and the "after." The short-release Ritalin wears off after a few hours, so I often see him in a non-medicated state (if he takes it too close to bedtime, he's up half the night). He is definitely not a different person, and I don't dislike him when he's off the meds, HOWEVER: think of a day when you were happy and relaxed. Now think of a day when you were scattered and tense. You're still the same person on both days! Which one do you prefer? Which one do you think your partner prefers? Doesn't exercise influence your mood? Are you a different person on days you do exercise vs. days you don't? You wouldn't stop exercising because it influences your mood in a positive way - that doesn't even make sense. So why eschew something that makes your life better, just because it's in pill form? Don't a lot of bodybuilders drink protein shakes and the like? I fail to see any difference.

Finally - there is nothing wrong with trying something and deciding it's not for you. My husband struggled with a lot of the same issues as you, and he went off of the medication for a period of time. In that time, his career and our relationship started to nosedive, and he figured out that life was far, far better on the medication than off it.
posted by desjardins at 3:20 PM on December 30, 2008


When it boils down to it, I kinda LIKE me... I don't wanna turn into someone else. Maybe that seems odd, but it's my take on it.
I'd like to jump back in here, because you keep voicing things that I could have said years ago. I think the concerns that you are describing are, to some extent, characteristic of people with undiagnosed or uncontrolled ADD, and I'm not entirely sure why.

At any rate, what I want to say is that I've noticed, and the people around me have reported, that, if anything, being medicated seems to make me happier in my own skin: I'm less tense, I tend to not get angry or frustrated as easily, and I appear to be much more at home in the world than when I'm unmedicated. In many ways, the medication frees me up to be even more myself than I already was, because being unmedicated was introducing a hell of a lot of noise into the signal. Once I removed that noise, I actually found it easier to relax and enjoy life, instead of constantly exerting myself to stay on track and flounder through the day.

Yes, it was a personality change, but it was one for the better. Sometimes changing the person we are is a good thing, and that was something I would never have said before I changed my tune on medication. I'd urge you to carefully consider what aspects of your personality you fear losing, and closely examine whether or not those are likely to change or vanish if you control your ADD. For instance, I haven't found any loss of spontaneity or creativity with medication: in fact, I'm able to be more spontaneous and creative, because I don't get in my own way as much or as severely. I can sit down and work on writing in a sustained manner that would have been impossible before.
posted by scrump at 11:50 AM on December 31, 2008


I spent a long time afraid that in some way the drugs would change me (which is amusing, because that's what we want, right?). That taking them was in some way a condemnation of who I was at the moment, an admission that my critics (perceived or otherwise) were right.

It was this question that really got me interested in philosophy, specifically the mind body problem. There are (and I'm going to simplify a lot here) basically two schools of thought here.

The first, and probably most popular (amongst the general public) could be called ontological mind body dualism - meaning, there are two kinds of stuff. Physical stuff, and mental stuff. Some common ways of expressing this view would be to say that people have bodies that are made of physical matter that we can explore scientifically but they also have souls or spirits that are fundamentally different. Most of the popular religions (the exceptions would be almost entirely eastern) believe some version of this.

The second would be monism - the belief that at the bottom of it all, there is only one kind of stuff, one order to all that is, all that exists. There are disagreements as to what that one kind of stuff "is" (which are really, I would say, questions of it's character, it's properties, the way we can come to understand it). You could say that everything is your thought or god's thought, or in any case some type of thought. Another popular route is to say that everything is fundamentally physical physical. What it means to assert that everything is in one category or another is murky (and I would argue, of questionable value, but that's a different rant) - the important thing about monism is that everything is under one order.

Now, I'm no friend of dualism. I think it's disrepute amongst philosophers today is, in the word's of Daniel Dennet, richly deserved. The basic problem with dualism is interaction. If you have a soul, or whatever you'd like to call the nonphysical mind, how can it interact with your body (to do things like say "I have a soul!") without being of the same kind of stuff that your body is. Likewise, how can your mind get signals from the physical world. Dualism seems to me to be nothing more than a throwing up of hands on the the difficult problems of consciousness - much as people used to say the motion of planets or the cause of life and disease were divine mysteries.

Anyway, if you're a dualist, I don't see many qualms with taking the medication. It can't really touch that magical "real you", so insofar as using a really good brush doesn't reflect poorly on a painter, sprucing up the brain you use to interact with the world could hardly count as a problematic corruption of your character.

But if you're not a dualist (and I hope you aren't) things get thornier. You acknowledge that something like a sledgehammer blow to the cranium can destroy the mind we call matty. People can, in fact, must be changing all the time. There is no fundamental, immutable, matty-ness under it all, but a rich interconnected bundle of ever unfolding attributes. As Zen monk Thich Nhat Hahn says: What is happening now to us? In English we say ‘we are’ but it’s proper to say ‘we are becoming’ because things are becoming. We’re not the same person in two consecutive minutes.
A picture of you as baby looks different to you now. The fact is you are not exactly the same as that baby and not entirely a different person either. In a picture of you as a five year old, you are not exactly the same as that child and not entirely a different person either – the form, feelings and mental formations are different.


So taking the meds can be kind of disturbing - you are altering you in an very ouroborosian fashion. By the same token, almost everything you do alters you (pedantically there is no "almost" but we have to consider what changes are significant, which don't cancel out). Going for a run, eating chocolate versus cauliflower, depriving yourself of sleep, fucking until your ears ring, sitting in zen meditation, enjoying a good sorbet or sauvignon, reading a good book, laughing with friends, witnessing a murder, taking LSD - they all get inside you in some small way, they all redefine you. I think everyone knows this to some extent, though it can be a hard thing to consider in day to day life.

Why then, is methyphenidate (Ritalin) more threatening. What deep existential threat does it pose that other more mundane ways of altering your brain/mind makeup don't? I don't see any - you have to judge the desirability of the actual effects of the medication.

When I'm not on the medication (like right now!), my thought processes is kind of like brownian motion - my attention is constantly spinning off in a different direction. This, I think, can make me very creative, because a lot of disparate ideas are brought up in rapid succession. I could write a fair bit about why I like being as I am without the drugs, but I'm going to assume we both have our reasons.

So what do you "lose" on the medication. For me, there are some side effects (greatly mitigated by finding the correct dose) like appetite loss, anxiety, sleep disregulation. My ability to extert sustained mental effort on a task is increased prodigiously. If you take tons of it you can achieve nearly autistic levels of focus, finding unending interest in the most mundane things. This, I think, would be a state with legitimate reasons to avoid - but it's an extreme, and no amount of the drug will turn you in to a (speaking colliquially here...) soulless uncreative zombie. When I'm on the right does, I still daydream as I'd like, but I don't find myself tugged hither and yon... I feel more able to decide which perturbations I'd like to spur on and which I'll ignore. On top of all this Ritalin has the added benefit of being a very easy drug to go on and off of (in small doses). You can choose day to day which patterns of thought suit you.

Daniel Dennet (a well known physicalist I admire) wrote a really interesting book called Elbow Room, about what free will (starting by trying to define what's meant by that) in a deterministic world (where what we call "you" is impacted and indeed constituted by causal interaction with everything else). He uses the metaphor of a pilot avoiding a thunderstorm in speaking about the ways in which some agent can enhance their control over a course of events (you can read the excerpt on google books). To me, taking the drugs are less a surrender of personality or free will than a decision that allows you greater control.
posted by phrontist at 3:39 PM on December 31, 2008 [2 favorites]


Ok - Follow up time!

I decided to try some meds, and they've pretty much changed my world. My biggest concern was that I was going to become 'someone' else, but by and large that hasn't been the case at all! I'm still me... still weird, quirky, prone to bad puns, and unable to walk and chew at the same time. But I understand why some people refer to them as 'smart pills' now - I'm me, but I can focus on something. I don't need to 'jump jump jump jump jump' from thing to thing anymore. If I sit down to read something, I READ it and understand it on the first try - not the 5th.

First I tried Adderall, which was great except it was probably toooo great. I call it the "Eye of Sauron" pill cause I could melt plastic and small children's brains with the intensity of my stare. Yeah, the focus was that strong... but too much so in that I would focus on something to the point of ignoring other things, like someone saying my name while standing right next to me. LOL.

Next stop was Focalin. Much better. Much more 'smooth' and gentle. It's been working well for me in all the ways I've mentioned above. My partner doesn't sit next to me on the couch at night anymore and say "I'm right here" while I'm texting, reading, and surfing the web all while watching TV. At work I can sit in a meeting and actually respond to a question when someone calls my name, and I can follow what's going on (i.e. actually pay attention to the subject matter for a sustained amount of time).

Point is - thank you AskMe for giving me the courage to try taking medication. I was really afraid of it, but you all gave me the ammo I needed to at least give it a shot. It's changed my life, and in many ways given me my life BACK.

Thank you again and again.
posted by matty at 12:48 PM on April 11, 2009 [22 favorites]


I'm so glad to hear that this worked out for you. Congratulations!
posted by scrump at 1:48 PM on April 13, 2009


Congrats! Thanks for the follow up. I love hearing how everything turned out after a question.
posted by CoralAmber at 8:35 PM on April 21, 2009


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