Attention deficit disorder (ADD), characterized by distractibility, impulsivity and restlessness affects millions of children. About 60% of those children will continue to have symptoms as adults. In fact, ADD affects 10 million American adults.

The main symptom of childhood ADD—the inability to give sustained or close attention to tasks-often persists into adulthood. However, because most people think of ADD as a childhood condition, nearly nine out of 10 adults with ADD remain undiagnosed and untreated.

That means the biggest downside of adult ADD-unexplained underachievement, when you don't perform as well as you know you could or should-can become a lifelong problem, leading to chronic frustration and depression.

How to figure out if you have adult ADD and steps to take if you do…

Do You Have It?

Because there is no clear cause or biological marker for ADD, there is no definitive test to diagnose it. Combining several tests is the best approach. The two most important…

  • Your history. This is the most powerful "test"-your story, which tells your doctor how your attention has varied in different settings throughout your life at school, at work and at home. A lifetime of inconsistent focus is the hallmark of adult ADD. If the diagnosis is obvious from the history, the diagnostic process can end there.
  • Neuropsychological testing. This is the second-most important diagnostic tool. A psychologist performs a variety of tests that attempt to quantify levels of distractibility as well as impulsivity.

For an accurate diagnosis, see a health professional who has extensive experience diagnosing and treating ADD-perhaps a child psychiatrist or psychologist who specializes in ADD (most child psychiatrists and psychologists also treat adults).

Build Confidence

To foster self-esteem...

  • Educate yourself. By learning what ADD is and is not-and also by helping your spouse and family understand it-you put an entirely new "frame on your life and your experience. When you're diagnosed with ADD, all the bad that may have happened to you because of the disorder-the inability to focus that caused opportunities to disappear and/or the impulsivity that led to huge mistakes—shift out of the darkness of moral condemnation into the light of science. You're not lazy, weak and undisciplined. You have a particular type of brain that generates a particular set of behaviors.

In fact, certain positive traits are associated with adult ADD, including original thinking, a zany sense of humor, remarkable persistence and resilience, warmhearted and generous behavior, and a highly intuitive learning style.

  • Identify and implement talents and strengths. Instead of focusing on what's wrong, focus on what's right-your hidden strengths and potential talents-and developing those. Think about what you love to do. It could be related to the arts or nature or science or helping others-any activity in which your brain "lights up” and you forget who you are and where you are. Practice that activity. Mastery is the key to self-esteem and confidence.

Simple Lifestyle Changes

Many lifestyle changes can improve brain functioning. These include…

  • More sleep. Most people with ADD don't get enough sleep for optimal functioning, usually staying up too late on their computers or watching TV. The amount of sleep you need is the amount that it takes for you to wake up without an alarm clock.
  • Better diet. Poor nutrition can harm the brain, causing distractibility, impulsivity and restlessness. Sensible dietary recommendations for people with ADD include…
  • Eat citrus fruits and other foods that contain vitamin C. They help control the action of dopamine, a neurotransmitter needed in treating ADD. Opt for eating the fruit as opposed to drinking juice-juice is higher in sugar.
  • Avoid refined carbohydrates, such as sugar and white flour.
  • Supplements. You can try the following…
  • Vitamin-mineral supplement that contains recommended daily levels of B-12 and folic acid (which improve cognition)...vitamin D and selenium (which improve brain function)...and zinc (research links low levels to ADD symptoms).
  • Fish oil, which provides omega-3 fatty acids, increases dopamine levels. An adult can safely take up to three grams daily.
  • Alcohol avoidance. People with ADD are more likely to develop alcohol dependence.
  • Regular exercise. Regular physical exercise is one of the best treatments for ADD. Thirty minutes a day of aerobic exercise is plenty, and brisk walking is an excellent choice.

When you are starting to daydream or get spacey, a quick burst of exercise—25 jumping jacks or running up and down a flight of stairs—is like pushing the restart button on your brain, leaving you refreshed and focused.

  • Prayer or meditation. Both help focus and calm the mind.
  • Structure. This is any habit or external device-such as a list or a filing cabinet—that you set up outside your brain to help you make up for what may be missing inside it.
  • Help from a counselor. Various kinds of counseling can help with adult ADD. For example, a "life coach" can help you get organized and make plans to achieve goals. Group therapy for adults with ADD also is a very helpful intervention-talk to your doctor about finding a group.
  • Medication. Medication is a mainstay of the treatment of adult ADD and works in 80% of people who use it. The most commonly used drugs are stimulants, including methylphenidate (Ritalin) and the combination of dextroamphetamine and amphetamine (Adderall).

Talk to your doctor about whether medication is right for you. The goal is to have symptom improvement with no side effects (other than the common symptom of appetite suppression).

That's an achievable goal with the right medication, at the right dose, prescribed by a doctor with extensive experience in treating adult ADD.

Recent finding: A study in The Journal of the American Medical Association showed that people with adult ADD who took medication and underwent cognitive behavioral therapy in which they learned such skills as how to organize and plan) had a 30% greater improvement in symptoms than people taking medication only. This study shows that medication is one valuable element but that it should not be the only element.

ADD Test

The World Health Organization and a team of experts led by doctors from Harvard and New York University developed the Adult SelfReport Scale (ASRS), a brief self-screening test for adults who suspect that they might have ADD. It's not a definitive diagnosis-but 80% of adults who score positive turn out to have ADD. Answer each of the following questions with one of the following responses..."N" for never... "R" for rarely..."S" for sometimes..."0" for often ...or "V" for very often.

1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?

2. How often do you have difficulty getting things done in order when you have to do a task that requires organization?

3. How often do you have problems remembering appointments or obligations?

4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?

5. How often do you fidget or squirm with your hands and feet when you have to sit down for a long time?

6. How often do you feel overly active and compelled to do things, as if you were driven by a motor?

Scoring: If you answered "S" "O" or "V" for questions 1, 2 or 3, give yourself one point for each. If you answered "O," or "V" for questions 4, 5 or 6, give yourself one point for each. Now add up your points. A score of 4 or higher means that you may have ADD. The next step is to find a health-care provider experienced with ADD.

Happiness Is Overrated

Don't try too hard to be happy. Making happiness a personal goal actually makes it harder to achieve.

Recent finding: Women who actively strive for happiness tend to set higher goals for themselves and fall short more often and thus are likely to be more depressed.

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