Episode 20: October 27, 2009
by Dr. Rob Lamberts, MD
Today’s article is really special and makes me really excited because it is a topic that is very personal and it’s something many people have asked me to cover. Today we are covering…uh…today’s…uh…article…huh…
Enough nonsense. Today’s article begins to cover the topic of attention deficit disorder. Like diabetes, this is a topic that is too big to cover in a single podcast. Today I’ll define attention deficit disorder, and a future podcast will cover its treatment.
Let me state clearly that this episode will be different my other articles. It is largely based on personal experience and opinion. I am not going to spend time spouting statistics or speaking Latin, but instead give you my “insider’s perspective” on attention deficit disorder.
I need to also say that what I am calling attention deficit disorder includes both those people with and without hyperactivity. There is a difference between these two entities, but they have basically the same cause and are treated much in the same way.
What is Attention Deficit Disorder?
So what is attention deficit disorder? I do not consider ADD to be a disease-- something that needs to be fixed, or even a disorder--something that is wrong with the person. I consider ADD to be a description of a certain personality.
People with attention deficit disorder have the following characteristics:
They are easily distracted, they daydream, and they often lose focus--especially with things that don’t interest them.
They have difficulty following directions--some of this is due to a wandering mind, but some is due to a propensity to question others’ decisions.
They talk a lot, and often do so out of turn--tending to interrupt others or blurt out answers before they are asked.
They are constantly in motion--often squirming or fidgeting enough to drive people around them to consider using duct tape or a tranquilizer dart.
They often don’t finish things they start--losing interest or getting bored with things quickly.
Is ADD Immaturity?
Many people have pointed out that these characteristics are found in another group of people: very young children. A four year-old child does not stay on task and also often doesn’t sit still. This has caused many to suggest that ADD is simply a lack of maturity, and in a certain sense, they are right. But as opposed to young children, the person with ADD often has strengths that accompany their weaknesses, including:
Creativity: The daydreaming mind is a mind that doesn’t limit itself. I have found that the most imaginative children are ones being treated for ADD.
Intelligence: Although this is not true for all with ADD, I have seen many gifted children who are simply bored and craving mental stimulation.
Independence: The person who doesn’t follow instructions is often the one who wants to be setting the rules. If they see a rule they don’t like, they immediately question it and have a hard time following it.
Social orientation: Many “class clowns” are kids with ADD. They use their creativity, independence and intelligence to entertain others. They like to talk and do it often. That can put them in a very good social position.
I am not saying that all kids with ADD have all of these characteristics--everyone is different. But what I am saying is that everyone has strengths and weaknesses, and each weakness is usually the flipside of a strength. If someone is very detail-oriented, they are great to put on projects that depend on getting things right. But if you put a detail-oriented person in a situation that requires a broader focus – a “big picture” view of things – they often struggle. In the same way, a laid-back person may be calm amidst chaos, but there are times when that calm is the wrong thing. So with ADD the weaknesses displayed are often the flipside to the strengths.
My Personal Experience with ADD
Why am I so certain about this? Why do I rail against ADD being referred to as a disorder? The answer is simple: I have attention deficit disorder (with hyperactivity, by the way).
I do not consider ADD to be a disease-- something that needs to be fixed, or even a disorder-- I consider ADD to be a description of a certain personality.
When I finished residency and went into practice, I started seeing lots of kids with ADD. I had been taught in medical school and residency how to identify and treat children with this problem, but didn’t really see much of it until I was in practice. As I saw these children, something began to dawn on me: these kids were just like me.
I was the fifth child in our family. My four older siblings were all very calm and well-behaved. That annoyed my parents’ friends, as it seemed my parents had it too easy. Then I came along, and my parents’ friends were delighted. I was in perpetual motion and constantly questioning everything that was told me. When I thought about doing something I never questioned if I should do it, I just did it.
When I was five, my parents expressed their frustration by getting me an appropriate Halloween costume: the devil. I thought it was cool.
In school, I did OK, but not great. I was too interested in making my friends laugh and having a good time to pay attention to the teachers. That got me into a lot of trouble; I had my own designated seat in the principal’s office. Back then there wasn’t an awareness of ADD like there is today. I am certain my teachers would have begged my parents to get me on medication. I was smart, testing well on standardized tests, but my grades didn’t reflect this.
In high school I did well enough to get by--mostly B’s, with some A’s and C’s. I got good grades on my SAT’s, so I got into college; but my choices were definitely limited.
So how did I get into medical school, residency, and on this podcast giving you advice? In college, several significant changes occurred:
I took courses I was interested in and didn’t have to take many that were boring to me
I was much more intellectually challenged by my classes
I started drinking coffee
Caffeine was my stimulant drug and I drank a lot of it. These factors, along with very good professors, let me get good enough grades to make it into medical school, and eventually into the Quick and Dirty Tips podcasting family. Thank goodness for that.
The Moral of the ADD Story
So what’s the point of this story? Why tell you about myself? I hope it encourages parents of children with ADD and adults with ADD as well, which leads me to my quick and dirty tips.
Tip 1: Don’t Assume
A child who gets bad grades might actually be quite smart. The problem is not that they don’t have the intelligence to do well; they may just not be good at school--not having the ability to sit still, listen, and do homework as easily as other children do.
Tip 2: Don’t Give Up
The situation may be the problem, not the child. Sometimes it will just take time for things to get better, and sometimes it will take a change of scenery. As bad as things may seem, they can get better.
Tip 3: Don’t Get Down
I was very fortunate because I had parents who never assumed I was bad or stupid. They stood by me, and that faith made it so I didn’t have big doubts about myself. That is a huge part of why I eventually succeeded.
Tip 4: Don’t Panic
I learned a lot by having to fight through my problems. Just because school was harder for me didn’t mean that my goals had to change. My success in the end was much sweeter because of the times when things weren’t sure.
I have not painted the full picture, and so may have left you with a lot of questions. Be patient. Don’t bombard me with questions about treatment. I promise to tie up the loose ends.
If you have questions you want answered, send them to email@example.com. You can find me on Twitter as @housecalldoc and on Facebook under “House Call Doctor.”
Let me remind you that this article is for informational purposes only. My goal is to add to your medical knowledge and translate some of the weird medical stuff you hear, so when you do go to your doctor, your visits will be more fruitful. I don’t intend to replace your doctor; he or she is the one you should always consult about your own medical condition.
Catch you next time! Stay Healthy!