|
Monthly NewsNote
November 2004
 Email this article to a friend
Managing Adult Attention Deficit Disorder
After the diagnosis of adult ADD is made and medication use established, we
must deal with how the condition affects the patient’s life. Let’s
call this “ADD Management”, which is a critical part of successful
treatment.
The first part of ADD Management is for the physician or therapist to ask all
the questions necessary to understand the patient’s functioning in detail.
Let’s talk about Fred. He is an attorney and came to see me because he
was having trouble getting things done. He came in with pictures of his desk.
What a mess. It was covered with piles of papers, and so was the floor. I asked
him about a usual day. He told me that when he got to work he got a cup of coffee
and then wandered from desk to desk talking to other attorneys about business
and social items. It often took over half an hour for him to get to his desk.
Once there he had to find his daily schedule and begin the day’s work.
He had a computer right there but it was of little help. He told me that he
almost missed deadlines, was often late for appointments, and was always behind
in his work.
It was clear that distractibility, lack of focus, and poor organizational skills
were all problems.
Fred’s needs went beyond medication. Learning how to manage his day and
job requirements was clearly essential. He was helped by a coach who reviewed
his computer programs, set up better systems in dealing with paper and even
helped his secretary learn how she could support her boss more effectively.
Now his day goes much more smoothly, and it’s much easier for him to get
his job done.
Now let’s think about Jane, a housewife with two elementary school age
children. In the morning Jane had to get two children up and out on time. Of
course, they had to be dressed, fed, and sent off with backpacks holding all
the things that needed to be there. Not easy for anyone, but very hard if you
are distracted, unfocused and not well organized.
Then came her household chores like making beds and doing laundry. As we talked
it became clear that nothing was done in an orderly manner. Chores took all
day rather than a few minutes. She had little or no time for herself, and of
course, at 3 PM the kids were back.
She told me that she might never finish the beds, that clothes might not get
out of the dryer until 10 PM and shopping was often done just to cover the needs
of the day. In passing she mentioned that there were piles of paper every where
and bill paying was always a nightmare.
A plan was worked out to help Jane schedule activities. She found books on
organization helpful. With these new routines and the medication, Jane found
she functioned better and had more time for herself.
These examples focus on just a small part of a person’s life. Other things
such as difficulty reading, clutter, marital tensions due to ADD symptoms, etc.
need to be identified and addressed.
If you are a therapist working with an ADD patient, be sure the daily functioning
is clearly understood and brought under control. If you are the patient, be
sure all areas of your problem are discussed and handled because medication
is not always enough.
|
