Disorganized? Lazy? Or something else?
Attention deficient / hyperactivity disorder (AD/HD) is not just for kids. Adults also suffer from this disorder.
The most popular recommendation for the control of AD/HD is pharmacological treatment. Children and adolescents treated with stimulants consistently demonstrate response rates around 70 percent. However, any use of medication should follow a careful evaluation including medical, psychiatric, social and cognitive assessments.
Patricia Quinn, M.D., and Kathleen Nadeau, Ph.D., have complied and edited a comprehensive anthology, "Understanding Women with AD/HD." "Most of our understanding of AD/HD is based on the study of males, or more accurately, on the study of boys."
After years of applying one set of norms to both sexes, professionals are beginning to question whether the criteria used to assess males is equally effective in assessing females. "One thing is clear," Nadeau and Quinn point out, "The number of females with AD/HD has been greatly underestimated."
Women routinely do more than one thing at a time: folding the wash as they listen to their child's reading assignment, talking on the telephone as they cut the carrots. Being multi-task oriented is actually respected in our society. Other characteristics that define AH/HD are criticized.
Hyperactivity accompanied by impulsivity can be destructive. Eva and Mark have moved five times in four years. "Eva can't stay still. She will get it in her head that we would be better off in a smaller apartment ... or in a warmer climate ... and off we go," Mark explains. "She refers to this impulsive behavior as 'spontaneous,' but it's difficult to get ahead when we're moving all the time."
Eva says she was considered a difficult child, argumentative and frequently in conflict with her mother. She was always "testing the limits" at school and at home. She complains, "I feel overwhelmed most of the time. I'm a working mom. My job demands too much of my time. My children are hyperactive. My husband expects me to do everything and I can't seem to get anything organized."
Many working women feel overwhelmed. Does that indicate they have AD/HD? Not necessarily. However, Nadeau points out that, "by living impulsively, without planning ahead, and making decisions without considering the consequences, she has unwittingly created a very AD/HD-unfriendly life for herself."
Others symptom of AD/HD include inattention and distractibility.
Disorganization is difficult for most people. Building structure helps us all to schedule the myriad details that make up daily living. However, disorganization is even more destructive for women with AD/HD. They find it difficult to maintain schedules and routines, to get places on time. Relationships dissolve. Their self-esteem suffers because they feel frustrated and ineffective.
Do some of these characteristics sound familiar? Nadeau and Quinn provide a comprehensive "Symptom Inventory." This assessment is divided into segments: "Childhood AD/HD Patterns" includes questions about inattention, hyperactivity, impulsivity, productivity, problems with initiation, problems with follow-through/perseverance, problems with under-arousal, procrastination problems, organizational difficulties, poor time management, problems with fine/gross motor control.
The assessment includes questions about learning issues, social/interpersonal, psychological and problematic behaviors. We found this section most helpful when approaching the subject with one of our clients, whose daughter we suspect is AD/HD. It helped, but not enough. "I don't like labels, " he said. "I think the school system just uses the concept of AD/HD to keep children drugged so they are easier to handle. Rebecca is just spacey."
Being described as "spacey" is one of the symptoms of AD/HD. The Nadeau/Quinn assessment advances to questions pertaining to adult AD/HD patterns. This section includes may of the same characteristics as those indicated for children, adding a few additional characteristic like the "tendency to hyper focus." This includes:
_ I tend to hyper-focus for long periods of time on certain activities.
_ When engaging in certain activities, I lose track of the passage of time.
_ When I'm really concentrating, I don't hear what people say to me.
Women with AD/HD have to work harder than other women. Labeling does help. Once a woman understands why she finds it so difficult to get and stay organized, why she puts off tasks until the very last moments or hates to fill out forms, she can begin to explore treatment options. Behavioral options include a fanatical adherence to staying organized, avoiding over commitment, and learning to refuse requests.
"The potentially damaging impacts of undiagnosed AD/HD include low self-esteem, underachievement, and secondary anxiety and depression," Nadeau/Quinn caution. The relationship between AD/HD and substance abuse is also a critical issue for females.
( Jaine Carter, Ph.D. and James D. Carter, Ph.D. are management consultants and authors of the book, ''He Works She Works _ Successful Strategies for Working Couples.'' www.cartercarter.com
Copyright 2002 Scripps Howard News Service