Attention Deficit Disorder: Practical Coping Methods - part 1 pot

Attention Deficit Disorder:

Practical Coping Methods
Barbara C. Fisher, Ph.D. and Ross A. Beckley, Ph.D.
© 1999 by CRC Press LLC
Preface
This book has been rewritten no fewer than five times in an effort to keep
abreast of current information. It is a compilation of personal/professional
experiences, notes, anecdotes, research and hopes that have been stored and
shared over the past decade. New research is occurring constantly and this
disorder, which has been historically looked upon as a disorder of child-
hood, is now being widely accepted as one that spans the lifetime. It is a dis-
order that one is born with, and it does not end with childhood, instead,
symptoms develop and change commensurate with the developmental
cycles of adolescence, adulthood, middle age and advanced age. This book
is meant for parents, children, teachers and ADD adults who are tired of
searching and are ready for answers to their many questions about this very
diverse and complicated disorder.
Our goal is to demystify the vast amount of information that has been gener-
ated and to present this rather confusing disorder in a manner that is both
understandable and applicable by providing what we have learned that is
helpful in addressing this disorder in the individual’s everyday life. This
books addresses the questions of why Ritalin does and doesn’t work, why
ADD is not just a childhood disorder, why ADHD is being over-diagnosed
and why so often the person diagnosed and treated with medication is not
cured and the story is far from over.
The presence of ADD has broken up marriages, prevented many from
attending college, fulfilling their potential, or following the career path that
they truly desire. It has made people feel stupid and incompetent. With new
perspectives, changes can occur, and people can create the life they want
and deserve; they can fulfill their dreams. ADD is a disorder with far-reach-

ing consequences, however, it is also a disorder that can be treated and spe-
cific symptoms can be managed. We prefer to think of ADD as a challenge
that can be met with good physical health, nutrition, specific coping mecha-
nisms, medication, and, most of all, education and understanding. A good
diagnosis identifying all of the various disorders that can complicate the sit-
uation is absolutely imperative.
What we provide to the reader in this book in the way of knowledge about
ADD has been field-tested in a variety of settings—households, schools,
clinics, businesses, colleges, hospitals, and classrooms.
© 1999 by CRC Press LLC
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© 1997 by CRC Press LLC
1
What is Attention Deficit Disorder?
1.1 What Attention Deficit Disorder (ADD) Was Once
Thought to Be
Historically, when Attention Deficit Disorder (ADD) was discussed, we were
referring to Attention Deficit Disorder with Hyperactivity (ADHD). At that
time there was no awareness of ADD without hyperactivity. It was thought
that ADD was a psychological or behavioral problem viewed as a disorder of
childhood. The symptoms were hyperactivity, overactiveness, and attention
deficiency, hence the term ADD.
The theory was that the disorder was the consequence of a system in the
brain not being mature — perhaps due to early birth or damage to the brain.
That underdeveloped system in the brain was thought to be the Reticular
Activating System (RAS), which is involved in general arousal and alertness.
In that underdeveloped or immature state, the result was overactive or
hyperactive behavior on the part of the child. As this system developed, the
symptoms of ADHD and its hyperactive or overactive component would dis-
appear. It was believed that because the system was immature it produced

the overactivate and inappropriate behavior characteristic of hyperactivity, a
motor-driven activity.
Therefore, ADD was not understood as a disorder involving the thought pro-
cesses but as a disorder linked to behavior with symptoms such as a child who
“ran but did not walk” and was continually distracted, not focused, or could
not attend to task. These children were seen as behavioral problems as they did
not respond to directions, but did as they pleased without obeying the rules
and regulations of the family household. The attention disorder was viewed as
ADHD; a rather disruptive behavioral problem that was expected to go away
once the child reached the later stages of adolescence and the RAS matured and
began to function as it should, and no longer produced overactive behavior.
The problem was that ADD and the systems seen did not make sense. Some-
times the behavior would be there and sometimes it would not. There seemed
to be no rhyme or reason. It was difficult to diagnose unless the disorder was
© 1999 by CRC Press LLC
0-8493-????-?/97/$0.00+$.50
© 1997 by CRC Press LLC
2
The Two Subtypes of ADD: ADD Without
Hyperactivity and ADHD
2.1 Understanding the Brain and the Differences Between
ADD and ADHD
ADHD is often over-diagnosed. ADD (without Hyperactivity) is often under-
diagnosed. The result is a lot of confusion and the disorders’ being called the
“yuppie condition” and not being looked at as medical disorders.
In our clinical practice we have found it extremely critical to be able to sep-
arate out the two disorders. The two represent very different issues for treat-
ment and very different relationships with family members and other
significant individuals in a person’s life. There are different expectations
related to each disorder based on different abilities and different ways each

disorder has an impact on thinking and performance. Diagnosis and separa-
tion of ADD with hyperactivity from ADD without hyperactivity allows for
treatment that is designed specifically to address the problems related to each
individual disorder.
The ADHD individual may lie, display manipulative and secretive behav-
iors, and resemble more of the behavioral profile characteristic of delin-
quency, addictive personality, and oppositional defiant disorder. These
behaviors arise not from an attempt to defend and protect oneself as in the
case with ADD without hyperactivity, but as part of the manifestations of the
disorder itself. Aggressive individuals may be seen with this disorder, espe-
cially when it is severe in nature and the impulsivity may be truly there and
also involve another neurotransmitter, serotonin, in addition to the dopam-
ine imbalance. ADHD tends to involve the RAS, the frontal areas of the brain,
and, primarily, dopamine. It is more associated with learning disabilities for
reading, writing and spelling due to the inability to learn as related to prob-
lems of the frontal processes.
© 1999 by CRC Press LLC