Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder

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Inspired by Amanda's and Jason's charming Lovebirds Swap, my partner David and I have decided to do our own leisurely reading project over the next year or two. On no particular schedule, we'll be alternating a book suggested by him with a book suggested by me, and discussing the chosen books here in conversational format. David reads a lot of popular nonfiction on psychology and brain function, and this first installment is his suggestion: Edward M. Hallowell and John J. Ratey's 1994 introduction to Attention Deficit Disorder.

Emily: So, perhaps we should start with a bit of an introduction for the readers. Driven to Distraction came out in 1994, at which time there was a lot less cultural awareness of ADD than there is now. He and his colleague Ratey are giving a broad overview on the disorder from a perspective of their own psychiatric practices.

David: Indeed! Also, we might point out that there has been considerable scientific work in the field since then, which has various ramifications, especially for those of you who have, or think you might have, ADD.

Emily: Yeah, don't diagnose yourself based on this blog post, haha! Go see a professional if some of these symptoms sound familiar. Speaking of which, do you want to talk about how you came upon this book and/or your own experience with ADD?

David: Well, throughout much of elementary school, I struggled both socially and academically. I won't go into the whole story here, but I will say that my trajectory was very typical of a person with ADD, and I probably would have been diagnosed much more quickly had I been born a few years later. I was "very bright," as many teachers and other adults in my life were quick to point out, but also seemed to "have trouble applying myself." By the end of middle school, my parents—having unsuccessfully though persistently tried many avenues for dealing with my situation—finally got a recommendation for a Dr. Jeffrey Pickar at McLean's Hospital, who administered a series of tests, trying to determine if I might have any identifiable, and hopefully treatable, conditions underlying my predicament. His results were definitive, and to me, a hugely significant vindication: I had ADD, and Obsessive-Compulsive Disorder.

Emily: That feeling of vindication is something Hallowell writes about being very common when people are diagnosed with ADD.

David: Yes. I think that a lot of people, looking at it from a distance, might wonder about this, might imagine that it would be kind of devastating, something like being diagnosed with a crippling disease. I certainly don't want to downplay the degree to which ADD can be crippling, but what I heard when I got the diagnosis was something like, "David, you were right all along! You are smart, you have been trying as hard as you can, but there is something which has been holding you back, something beyond your control, no matter how much your teachers punish you, no matter how much your schoolmates bully you. You were doing the best you could."

Emily: It's not like one is going along perfectly comfortably, and then out of left field comes a cancer diagnosis or similar. You, and most of the people in Hallowell's book, were already aware of a serious problem before the diagnosis. It just gave you something of an explanation and starting-point from which to begin to cope.

David: Right! My reaction was something in the vein of, "IN YOUR FACE, WORLD!"

Emily: Haha! So, is that diagnosis when you were introduced to this particular book?

David: Well, no. Sometime after getting and beginning to understand my diagnosis, my mother began what she now refers to as "bibliotherapy," wherein she tried to educate herself more thoroughly about my conditions. I remember seeing the book on her nightstand around that time, but didn't start reading it myself until sometime last year. It was in the midst of my own sort of bibliotherapy, which was driven by a more general interest in the workings and malfunctions of the brain—especially, but not exclusively, my own.

Emily: I was surprised how interesting I found Driven to Distraction - even though it is an overview for the general public, and even though I have lived for ten years or so with an ADD sufferer, there was plenty of information here that surprised me.

David: Oh? I'm glad to hear that you found it interesting. I'd be interested to hear what surprises stand out in your memory.

Emily: Well, one of the points Hallowell stresses is how many different manifestations ADD can take; it really can look completely different in different people. So that some of the symptoms he talked about seemed completely opposite my experience of you - for example, the common ADD symptom of constantly searching for high-stimulation situations. And also the ADD tendency to get impatient when people don't "cut to the chase."

David: Yeah! True enough.

Emily: Whereas you are FAR more patient with rambling interactions than I tend to be. And of the two of us, I am the person far more likely to want to hurry a given decision to closure, whereas you prefer to shop around. The opposite of one might expect given your ADD diagnosis.

David: Ha ha! Yes. ADD is a real cuttlefish of a disorder. And the name—Attention Deficit Disorder—is, if not an outright misnomer, at least quite deceptive.

Emily: Right! Hallowell discusses how the syndrome is really more of an attention regulation problem, not a deficit—so that people with ADD often have the capacity to go into "hyperfocus," where they become intensely wrapped up in a project they're working on, for hours, days or even weeks at a time.

David: We ADD-ers can hyperfocus—almost by definition DO hyperfocus—when we are On A Case, quite to the exclusion of any external stimuli, any awareness of the passage of time, etc., etc.

Emily: Yes, that's a symptom I definitely have seen in you. You'll get totally wrapped up in something you're working on, like coding or recording projects. Or the time back in 2002 when you laboriously constructed a chart of hex color values by going through and testing each six-digit permutation yourself.

David: Yeah, that laboriously constructed chart is a great example of a Very ADD Thing To Do. It's a little hard to say exactly why, but the combination of seeming to need to learn the "hard way," the hyperfocus, the compulsive nature of the task... It's something I thought of bringing up as well.

Emily: The other thing that struck me as eerily relevant? May I bring up the piles?

David: You may!

Emily: Hallowell transcribes the speech of one of his ADD patients as the patient describes his home office. The man writes:

Everything I do goes into a pile. There are little piles and big piles, stacks of papers, stacks of magazines, stacks of books, stacks of bills. Some stacks are mixed. It's like a field, little piles with white tops scattered everywhere like mushrooms. There's no real organization to any of it. I'll just think that pile looks a little small, I can add something to it, or this space needs a new pile, or these things I'll move over to this other pile.

Hallowell himself comments:

These examples reflect the stuff adult ADD is made of. Peter's piles are particularly emblematic. So many adults with ADD have piles, little mess-piles, big mess-piles, piles everywhere. They are like a by-product of the brain's work. What other people somehow put away, people with ADD put into piles.

David: Very true!

Emily: So, as you and I have often made the dorky joke that your operating system supports "PileMaker Pro," this was very familiar to me. But I also thought Peter's description was interesting because of how he describes relating to the piles. Later in his quote he says he's "in synchronicity" with them. Do you have a particular relationship with your piles?

David: I do. This would probably be a good time to bring in my co-morbid conditions, OCD and Anxiety. Without getting too deep into definitions, I'll just say that ADD does commonly coexist with other disorders and conditions. For me, personally, there is a touch of the ol' hoarding mixed in there.

Emily: In fact Hallowell devotes a whole longish chapter to different co-morbidities and how they tend to manifest.

David: Yeah, and, as with so many things, the whole often manifests as more than the sum of the parts. Also, I have a very acute visual/spacial sort of talent, if you can call it that, which, I think, kind of enables my PileMaker Pro organizational replacement system. I don't know if Peter is selling himself short in the above quote, but for me, the piles are not totally random. I have a sense of the Piles, so long as they are not removed from their original place of residence. If I need something, I can usually locate it quite effectively by sort of triangulating, mentally.

The problems arise when I "clean up," which often consists of moving the piles from a public area (the living room) to a private area (the bedroom), and sometimes even combining piles, if I'm really going to do a thorough job of it. At that point, unless I can find some distinguishing visual characteristic of a pile, one which I associate with the item I'm trying to locate, it becomes very difficult to find anything.

Emily: In Peter's example, it's almost like he's deciding on the distribution of items into the piles based on aesthetic appeal. And you're saying you kind of attach visual tags to piles as memory aids?

David: Exactly. And I do so at a very instinctive—or, at least, below-conscious—level. That is a big part of my "magic" with regards to my role as your Accio spell. (I'll let you explain that one.)

Emily: Haha! It's true, you can usually find anything in the house, whereas I can never find anything. We have another dorky joke that I, like the Harry Potter characters, can say "Accio hairbrush!" and the hairbrush will come flying to me in David's hand.

David: If I have seen objects in physical relation to one another, especially within a defined and relatively static space such as our condo, it is usually quite easy for me to recall an object's location by observing in my mind's eye which objects it is spatially attached to.

Emily: It occurs to me vis-a-vis Hallowell's description of the typically ADD search for high-stimulation, which for the most part I don't see in you—do you think the piles are related to that? It certainly makes your study more "high stimulation" in that all the piles make a lot to look at.

David: Ha ha! It does, doesn't it!? Unfortunately, that particular kind of stimulation—visual clutter—seems to exacerbate, rather than quell, my distractability, so I think I'd be better off without it in any case. I don't know if it's a sort of self medication, though... could be.

So, why, you might be asking yourself, don't I just FILE things in the first place, instead of PILING them? Wouldn't that make everything so much easier?

Emily: Yes. I might be asking myself that, indeed.

David: Since I have this "talent" with visual association, having things "hidden away" in a file is disturbing to me on several levels. If I can't see it, and can't associate it with its visual/spacial surroundings, it becomes lost to me on a very deep level. Being in a file cabinet is like being in an institutional building, or a series of suburban cul-de-sacs: everything looks the same.

Emily: Hmm, interesting. That brings up another suggestion Hallowell has for people with ADD, which is to use color and visual cues to "spice up" their filing and time-management systems.

David: Yes! It's not that I can't learn to organize logistically rather than spatially, it's just that it doesn't come as naturally to me. And, it takes effort and strategy to learn this new system, and set up new kinds of aids and compensations; effort not necessary if I were to continue with the piles "system."

Emily: Which, yet again, is a point Hallowell makes: that ADD people have to exert more effort, and on a more conscious level, to pick up coping mechanisms that people without ADD kind of absorb by osmosis. But that doesn't mean it's impossible for them to learn those techniques.

David: Totally! Another thing to bring in here is the common ADD trait of problems with what is called "working memory." Working memory, as I understand it, is sort of one's mind's desktop: the memory designated for attending to items currently or imminently needed for the job currently or imminently at hand. And this is particularly interesting to me, as it brings the psychological ramifications of the disorder—the things my brain has learned about its own workings—front and center. At some level, I know that I have trouble remembering to do things. Therefore, my brain recoils from the idea of putting a crucial item (a bill, for example) somewhere it suspects I'll forget about it, and consequently, forget to deal with it. So, in order to truly deal with the issue of piles, one must not only clean up the mess, but put in place—and crucially, learn to trust—a new system for remembering to complete important actions.

Emily: That makes a lot of sense. It's like what Hallowell says in the section on ADD with Anxiety—which, incidentally, reminded me strongly of you. Hallowell talks about how, when something "startles" the ADD-with-Anxiety brain (a "startle" can be caused by any transition throughout the day, from going on one's lunch break to completing a task) there is a mini-panic because the brain doesn't know how to organize itself now that its former point of focus is removed. So it latches onto the "hottest," most pressing object available, which is often a source of anxiety. The anxiety becomes an organizing principle, even if a counterproductive one. Which reminds me of what you've been saying about your piles—your brain doesn't trust the filing system, so it's trying to organize around the idea of keeping everything it might possibly need within visual contact at all times.

David: I think that's an interesting comparison. It's not necessarily totally analogous, but it strikes me that there is a very similar bend in the underlying logic.

Emily: Yes. So, another thing I really appreciated about Driven to Distraction was Hallowell's sensitivity around the issue of "what is normal?" or put another way "Is this a real disorder?""

David: This is a very important, and very vexing point. I, personally, find it to be one of the most interesting and meaty points, as well.

Emily: I agree. I mean, just thinking about the extent to which people use "ADD" as shorthand for the standard, high-distraction lifestyle expected of us in the Western world is pretty revealing. I appreciated Hallowell's acknowledgment that everyone sometimes feels in the ways he describes, but that this cultural state isn't the same as actual ADD, which is a real, neurological disorder.

David: Right. So, several things about that. One of them is the individual's experience of him- or herself. As we were talking about just earlier today, it can be very difficult for a person who has been diagnosed as having a particular problem to figure out—just internally, for his or her own benefit and satisfaction—where He or She as a person (or personality) leaves off, and where The Disease picks up.

Another issue is the subjective nature of the diagnosis in the first place. This is something that Hallowell addresses somewhat in Driven to Distraction, and it's also addressed by Peter Kramer in Listening to Prozac. Kramer refers to it, if I remember correctly, as "the brackets of normalcy," and he spends quite a bit of time in various sections of his book talking about how and why those brackets sometimes shift. These kinds of mental illnesses—ADD, OCD—are defined relative to their surroundings, relative to the established vision of "normal," which necessarily relies on the behaviors of the surrounding culture and individuals for definition.

Emily: I wondered a lot about cross-cultural diagnoses while reading Hallowell, since the definition of "normal" levels of distractability and scattered-ness is surely different in different cultures.

David: Right! And, I personally find this to be a very challenging aspect of self-definition, and self-identification with my disorders. There are some aspects of what is considered "disordered" that I find to be valuable, even as compared to their equivalent "normal" counterparts in our society.

Emily: I liked Hallowell's take on that phenomenon, that he acknowledges that there can be strengths that come along with the liabilities of ADD.

David: Yeah. I think it's really good that he emphasizes that, and I kind of wish he spent more time giving specific examples. There's so much negative messaging that people with ADD receive en masse and individually, both before and after they get the diagnosis, that I think it's really crucial to ongoing mental health and self esteem to actively look at and cultivate the "good" parts of the disorder (depending on context, of course).

Emily: In that spirit, there was a little passage in Hallowell that reminded me of you in a positive way. He's discussing a patient of his in who had the "daydreamer" variety of ADD, and he writes:

People with ADD do look out windows. They do not stay on track. They stray. But they also see new things or find new ways to see old things. They are not just the tuned-out of this world; they are also tuned in, often to the fresh and new.

That strongly reminded me of the experience of taking walks with you. You are always the "noticer" on walks, making observations of little unusual details that most other folks miss.

David: Thank you, Sweetie! I think that that is tied in with my ADD, and it is something I find valuable. This highlights one of the difficult choices brought up by the possibility of treating the disorder: Will you loose the stuff you like, along with the proverbial bath water? I think it's an experiment each individual has to undertake (or not) on his or her own. And then the decision about whether or not to take psych meds adds whole other layers of complication. It's an emotionally and ideologically contentious decision to begin with, and then it's combined with a diagnostic process subject to the values of a specific time and place, values about which the individual seeking treatment might have deeply mixed feelings.

Emily: Yes. Hallowell is generally pro-meds, but I liked that he a) doesn't present them as the be-all and end-all of treatment, and b) fully acknowledges that everyone's process is different and that, while meds are often very effective, many patients have also had good results from pursuing a non-medicated route of behavior modification, open communication, and coping mechanisms. So it's not like the decision about whether or not to pursue treatment is only one of whether or not to pursue medication.

David: Right! That's a good point, and I agree that he presented a pretty good balance of options in the book. One more thing about my own observations re: treatment with medication. I'm a fairly analytical, self-observatory person, but I have found it to be fascinating and illuminating to see that some problems which I had attributed to laziness, character flaws, and the like (with all the guilt and baggage that goes along with that) have actually responded to medication.

Emily: Interesting. Do any particular examples leap to mind?

David: Well, lateness has been almost a life-long problem for me, and it turns out that my disorders have a huge impact on my punctuality in both obvious and subtle ways. I also remember feeling like, the first time I got on a good combination of medications, my homework was somehow just "getting done." It was kind of a crazy feeling: doing my homework had been a problem for me for literally over half my life, and then, all of a sudden, without me feeling like I was actually doing anything differently, it was just... "getting done." I kind of couldn't believe it.

Emily: Yeah, no doubt! It must have felt like magic.

David: It kind of did! And, that actually brings up another interesting tangled web of emotions I (and I think many other people) feel when thinking about medication: Having been told, in various direct and indirect ways, and at least partially having believed, for so long that it was somehow my fault that I was having these problems, I felt quite deeply that the corollary to that was that it was my responsibility to deal with them, fix them. Having that responsibility usurped by a chemical is deeply confusing, even as it is a deep and multi-layered relief.

Emily: Hallowell describes a number of patients with similar or related feelings around medication. Like it was somehow a "cheat" or an admission they couldn't fix the problem by themselves.

David: Right. Other people can do the things that I am being told to do, and I am shirking part of my responsibility by giving myself this "unfair" advantage. (It's somehow easy to ignore that a) I started out with an "unfair" disadvantage; and that b) I don't know those Other People well enough to understand their process, or their tools, or their crutches.)

Emily: It's a difficult thing to sort out.

David: Very!

Emily: Well, this has been a great conversation; thanks for the interesting first pick in our reading project.

David: I'm so glad you liked it! I started Gilead this very morning, and I already love it; I'm looking forward to next time.

*******

Up next in David and my joint reading project: my first suggestion, Marilynne Robinson's Gilead.

35 Comments

  • What a fascinating post! I really enjoyed reading both of your comments on this book and learning about ADD. I can't wait for your next joint post!

  • I really thought it was interesting that, while you are the one who read the book, the review felt far more like it was your gentleman's review - not negative, I hope I don't sound like that. It points out to me, in fact, how reading a book that someone else found meaning in (nonfic or fic, whether or not it's this simply applicable to that other person) can open up your ability to comprehend that person. The image people always have is that understanding a book someone else loves just gives you insight into what made them - I think, rather, it helps the two of you share a common vocabulary for discussing the parts of them that they use the book as a lens to understand. Bravo, your conversation was fascinating. I'm afraid I'm not as well attuned to Amanda's taste - so far she has disliked most of the books I had her read!

    On the subject of the book itself, though...

    I was diagnosed in my Junior year of high school with an attention disorder, and can laughingly/shudderingly sympathize with many of your husband's war stories. At the same time, I didn't respond to any of the medications they offered me (well, that's not strictly true: I responded, just negatively), and never had any other treatment, really, short of a few visits with a therapist who didn't seem to look me in the face.

    I've since wondered, in fact, if I have the same disorder that all the other attention sufferers I've met have had (and working in technology, one meets a lot of attention sufferers - an interesting point for another post would be to explore why this might be). I've been told that the diseases cover a braoad spectrum of individual behaviors, and perhaps this is all there is to it - I'm a different species of the same genus. But, as you mentioned, the trouble is that hwen you say ADD or ADHD, people tend to immediately assume they understand what is a very deep and subtle aspect of your character, which can be a little bitt frustrating, and estranging. The behavior I understand, sure: everyone knows a parent with a little boy who acts silly and crazy and did ever-so-much better after starting to take a small dose of uppers every morning, so the assumption is that this must be the way 'I am' without drugs - whereas I'm not, not really. As a result, I very seldom tell people I was ever diagnosed with it, and usually add lots of caveats when I do (which just makes me sound like I'm being an exceptionalist, which drives me back to behavior A - don't talk, let people think I'm just lazy). Additionally, the problem is in part I think that when one is told that they are a certain way - lazy, distractible, difficult, whatever - this label begins to have a power of the 'actual' rather than the pathological character of that person - so, for instance, I'm very good at going into a sort of focused cave of interest at work, but for most of my life (often as your homme mentions, with good reason) I would have described this as being very BAD about going into such a cave. At the same time, most of the things I'm at all proud of, I've dragged up from the depths of such a cave, but subconsciously, I find myself avoiding situations where I'll end up hyperfocused liek this - and feeling somewhat ashamed even when I do produce something, as if it doesn't REALLY belong to me - it's something like picking flowers from cursed earth - if a flower grows there it might look lovely, but you always suspect it's not an entirely healthy creation (I'm sure I have my own co-morbidities, but have no concrete idea of what they would be called).

    Anyways, I enjoyed your conversation, thanks.

    • Wow, thank you for your insight — both into our entry/process, and into your Self. (Just as a point of clarification, we did both read the book at the same time, so maybe that explains some of the phenomenon you observed...)

      However, yes! I really like what you were saying, about the layers of discovery, how something like this can be a lens into a lens, almost. Great stuff.

      Also, I'm happy to hear you've found a way to work with your attentional thing; I'm way on board about doing some further exploration of the tech/attention-issues overlap. I think it's so interesting how a lot of the new things possible in the digital world seem to exist in a sort of deep symbiosis with ADD-type mental processes (for example, organizing things using tags, rather than in a hierarchical fashion), and, that programmers have come up with so many tools that seem custom made for people with ADD (for example, OmniFocus).

      I really relate both to your feelings of lack of ownership, for lack of better shorthand, and to reacting badly to common ADD meds. I'd be interested to hear what your experience was, but for me, stimulants on their own are pretty much intolerable. I am super sensitive to them, and when I take them I am enveloped by a feeling of impending doom.

      However, when I am taking an SSRI (the class of drugs that includes the famous Prozac), I can tolerate stimulants very well. (The SSRI also treats my comorbids, so there you go. More on that later in the series...)

      In any case, thanks for your thoughtful comments, and best of luck with everything!

      • When I eat something very sugar-fatty, my body, about 30 minutes later, will be overpowered by this horrible, buzzing anti-still feeling. It's not the old hyperactivity trope that you normally associate with getting kids hopped up on sugar. It's almost more like a baby version of what people describe when they talk about coming down off a cocaine high - that there's this strong edge of hyperawareness, and that the only tool you have to control or parse the flood of information - your brain, is looping back and forth wildly between shutting down and starting up, so there's this feeling of continual horror that something significant is occuring and that it's just barely out of the range of your understanding. Ritalin and it's friends made me feel like this, only for the whole day. Sleeping was horrible :D.

        When I went to college, just before I left I was prescribed a tricyclic antidepressant, instead - let me suggest that if you ever have children, it's best not to set them up on a new drug just before sending them to college. They were HORRIBLE.

        I took one other medication in my adulthood (Strattera, I believe?) and it felt as if it had no effect whatsoever, and I eventually stopped taking it. Otherwise, I've never taken anything - and to be perfectly frank, if I coudl only pick one thing to fix about myself, I'm not sure ADHD is worst trait, so it ahs not since been my focus. But, yes I can sympathize with the feeling of being too sensitive to stimulants - I've actually wondered if sometimes the Attention deficit umbrella conflates diseases that have trouble with controlling focus with diseases that result from hypersensitivities to stimulus. This always felt more like my problem - that there would be this whole texture of life around me, and so little things that I should be able to ignore would take over my thought processes (or filtering would shut off entirely, and I'd lose the ability to think in a wave of simply experiencing sensation).

    • Thanks for your meaty comment, Jason! I think some of the David-heaviness you're perceiving is probably because, while I have the experience of living with him and having read this book, he has the experience of having spent a LOT more time thinking about this syndrome and living with it, so it makes sense he would have more to say!

      I definitely relate to what you're saying about the assumptions people make when they hear that ADD label: the hyperactive little boy, etc. Within my memory David has never had the hyperactivity portion of the symptoms, and so for a long time I kind of discounted the ADD part of his diagnosis because the OCD part seemed to fit so much more easily with my own preconceptions about these disorders. Your conflicted feelings about the relative (un)healthiness of the fruits of your own labor also very much remind me of David. It's hard to feel positive about abilities that have been liabilities or crutches at different times in one's life, even if those abilities also have the potential to be a positive.

      Anyway, thanks again for your comment & so glad you enjoyed the conversation. :-)

      • No, no, thank you two for bringing the conversation UP, it was very interesting to listen in to. I'd honestly love to hear someday what it's like to be married to someone with an attention disorder - I imagine, for instance, it must be difficult to process emotions directed at the other person's behavior: when spouse, say, forgets to pay the electric bill that they promised to take care of, are you angry at them for not following through, angry at the disease, what? And how do you process that? One would not, I would think, want to simply stop trusting one's partner to remember things, and treat them like a child, but at the same time - if one cannot think of them as entirely responsible for certain behaviors, it must be difficult to know how to trust their behaviors.

  • I really enjoyed this Emily and David. Thank you. I was particularly interested in the 'piles' because it immediately brought to mind a colleague with whom I used to work who 'organised' everything in this way. When you walked into his office the piles of papers, books, essays, memos and goodness only knows what else were almost intimidating and yet if you asked him for something he could lay his hand on it immediately and he had a better grasp of the minutia of University admin than anyone else in the institution. (Too much so at times, he also had a problem in identifying which bit of that knowledge was relevant and which could be circumnavigated. Meetings could be interminable.) The only time I saw him completely flummoxed was when our offices were decorated and he had to move everything. He was like a completely different being and it took him weeks to recompose himself. Thank you for giving me a better insight into what may have been the way in which he was working and why.

    • Ha ha, totally! That guy sounds like a definite case. :) The lack of insight into relevant vs. irrelevant information, useful vs. useless objects, etc., is extremely common amongst us ADD-ers. (It's great that he was maximizing his weird, pseudo-organizational skills, though...)

      It's so cool that you could relate our entry to that guy, even without having the whole book at your disposal. Thanks for the comment!

    • he also had a problem in identifying which bit of that knowledge was relevant and which could be circumnavigated. Meetings could be interminable.

      Annie, having just gotten out of a 3.5-hour meeting myself, I so feel your pain on this. :-) Seriously though, that characteristic does also remind me of David, and sometimes it can be a positive - like, when there's a compelling REASON to tease out all the obscure causes/effects/minutiae of a situation. Other times, not so much. Glad you enjoyed the conversation!

  • This was wonderful! My husband very likely has ADD and we've talked many a time about his getting a diagnosis but he would rather not for some reason that I don't really understand. He uses the "PileMaker Pro" system too, has a tendency to hyper-focus, but at the same time is always leaving things half-done, has short-term memory difficulty, is a bit OCD and I wouldn't be surprised is somewhere in there he had anxiety issues too. I could go on. I've looked at a number of ADD books but I don't think I've seen this one. I have just requested it from the library. Thanks to you and David for your review!

    • I'm so glad you liked our post! Yeah; the whole "getting a diagnosis" thing can be really intimidating and emotionally fraught. I think that being in the stage where you think you might have something going on, but haven't really decided to get help might be the most nerve wracking of all. (Not that it's guaranteed to be the proverbial walk in the park after that's over with, but none the less.)

      Driven to Distraction is a really good introduction to ADD. Also, I find it to be a very compassionately written book — both Hallowell and Ratey have ADD themselves, so they speak from the perspective of patient, as well as doctor.

      I don't really know the scene in Minneapolis, but the book has a nice resources section, so you'll probably be able to track down some good people to talk to without too much trouble. Like with any personal difficulty, it's ultimately up to him to decide that the idea of living with it is scarier than the idea of opening his hidden self up to (professional) strangers, but you sound like you're giving him support, information, and humor (all of which I've found to be totally indispensable), so he's already in a better way than many people. Good luck!

    • (Sorry if I got preachy at the end there — carried away! :)

    • Stefanie, I noticed while looking for my copy of this book online that Hallowell has since written a follow-up volume called, I think, Delivered from Distraction, which I imagine covers some of the more recent developments in the field. I'd concur with David on the notion that he and Ratey have personal compassion for the subject without the book turning into some kind of what-is-nonfiction-anyway style memoir. You & Bookman seem like an awesome couple so it's interesting that we have some overlap in our partners' personality traits. :-)

  • I found this fascinating. But it makes me wonder about the names we give these relatively recent discoveries in the field of disorders. I mean, even disorder sounds wrong to me, when it is simply a different way of being, like the brain is tuned to a higher pitch frequency. I suffer from chronic fatigue syndrome but detest the name because fatigue is undoubtedly a persistent symptom, but not the most taxing. And when you say 'fatigue' to someone, they think of being a bit tired but basically okay, when in reality you feel like you're about to collapse and die. Anyway, I related very strongly to your comments about medication. Anxiety definitely underlies my condition and I feel strange and wrong taking some medication for it, as if I should really sort it out myself and the meds are themselves a kind of distraction. Much to think about here and a very insightful and illuminating discussion. What a lovely couple you make!

    • Litlove, I was thinking about David and my past conversations on medication while reading some of your recent posts on your own struggle - it's a really hard nut to crack. Especially when one is already coping with anxiety in the first place.

      And I know what you're saying about diagnostic labels and "disorder" versus "syndrome" versus "personality trait." There are certainly personality traits that David has that he feels tie into his ADD, and some of them are good. On the other hand I think he would agree that there comes a point when the mass of symptoms adds up to a critical mass and interferes with the ability to live life, at which point "syndrome" or similar seems fair. But it's obviously such a complex and fraught issue. Thanks for the nice words about the entry; glad you enjoyed it.

  • I'm a piler myself -- I have a nice file cabinet, but it's practically empty (except for long-term storage, such as birth certificates, immunization records, etc. If I put something away, I forget about it completely.

    And I have piles of books everywhere, ha ha!

    That said, I don't think I have ADD. Although, I do get restless with my projects -- more interested in the process than actual completion.

    I think that the danger of diagnostic labels is also that frequently symptons will overlap. For example some characteristics of OCD could also be characteristics of autism spectrum disorders (ASD). We have a few ASD in our family tree so that is what I'm most familiar with.

    Ultimately, there should be better acceptance and lack of judgement of different minds. And, flexibility in teaching methods.

    I love the idea of partners recommending each other books, but all my husband reads is books on the manufacturing process or leadership (in other words, work-related books), which would be completely over my head!

    • Ultimately, there should be better acceptance and lack of judgement of different minds. And, flexibility in teaching methods.

      Yes, definitely. I like what you say about the difficulty of different diagnoses sharing overlapping symptoms. David has read quite a bit about ASD disorders as well (he has a family member with Asperger's), and it certainly seems like there's some overlap there.

      And thanks for the nice words about the overall idea here. Hopefully my suggestions will go over as well. :-)

  • This is great! I'm really looking forward to more of these posts, both for the content and the style.

    While I'm not ADD, I'm an extremely visual person and PileMaker Pro compatible. I do exactly the same thing where I look for objects in my head rather than the real world because it's faster, and then I know exactly where to look. Latest problem is having a small child who likes to move objects around! The piles are currently failing me at work though, too many papers and too little desk surface to work with. So I've shifted to coloured files and am currently trying to make that work. It would probably be easier if I could colour code by topics or something, but I've just got a random stack of old folders. But it is making shifting piles around much easier to cope with.

    • So glad you enjoyed it, Wendy!

      It totally makes sense to me that people who are very visually-oriented would tend more toward the piling/visual association organization system. I feel like I have a kind of photo-negative insight here, because I'm NOT a visual person at all, and can never find a thing unless it's logically filed away in its "correct" place. So it seems right to me that if my visual/lingual dependence were reversed, my organization system would change as well. And man, I imagine that a small child would throw a wrench in the visual-organization works, for sure!

  • Loved this post and especially the conversational format. Great fun.

    I'm pretty sure I had ADD as a child (classic case) and may still have it today, with tons of coping mechanisms in place, especially for work matters. A lot of what you said resonated with me. And also what Jason said. How does my husband react when I forget to pay the bill I said I'd take care of? Well, he pays the bills himself now. :)

    I look forward to more in the series!

    • Hey, you and Teresa were at least partly the inspiration for the conversational format, so I'm glad you liked it Jenny! :-) I always enjoy reading your double-reviews.

      And your second paragraph made me laugh. We have all our bills on automatic withdrawal now, so we don't have to worry about it.

  • Votre conversation à tous les 2 + les commentaires sont passionnants. Quand je m'occupais de l'association pour le soutien de l'enseignement aux enfants malades, nous avons eu des élèves avec tous ces symptômes, et nous avions régulièrement des conférences et des réunions avec des pédopsychiatres pour nous éclairer. Certains étaient pour les médicaments (la ritaline), d'autres contre; mais tous insistaient sur la souffrance de ces enfants et la nécessité de les aider à trouver des méthodes (emploi des couleurs etc) pour les aider à vivre avec leur handicap. Ces élèves, ainsi que tous les élèves malades ou en situation de handicap peuvent bénéficier d'un "projet pédagogique personnalisé".
    Pour les parents: attention à ne pas se contenter de lire les livres sur ces sujets, sinon on trouve que les enfants sont autistes, surdoués, "dys..." ou je ne sais quoi! Il faut voir un spécialiste et faire passer les tests. Je ne sais pas aux USA, mais en France, malheureusement, il faut attendre des mois avant d'avoir un rendez-vous.

    • MC, je te réponds en anglais parce que ta point est importante et la plupart des lecteurs lisent en anglais:

      Your point about encouraging parents not to self-diagnose their kids but to seek professional attention as soon as possible is such a good one. I don't know about wait times in the US health system, but if David's story is any indication it can be challenging to get the right patient/doctor combination, so it's a good idea not to lose any time.

  • Great conversation! I wonder if I can talk Hobgoblin into doing something similar with me? Anyway, I was interested in your thoughts about what is "normal" and how culture affects our way of thinking about illness and health.

    • Thanks, Dorothy! It seems like you and Hobgoblin have similar enough tastes that you'd be prime candidates for a similar project. And I'd be interested in tackling a book that looks at issues like cross-cultural diagnosis of mental illness explicitly, since it was really only hinted at in the Hallowell book.

  • Love the new format. Looking forward to next month's combo post : )

  • Great conversation and informative as well.
    Do Hallowell and Ratey discuss the too major subdivisions... attention deficit disorder either with or without hyperactivity? Most think of ADHD, so ADD without hyperactivity has been often missed and helpful coping mechanisms missed as well.
    I look forward to more of these conversations.
    Bravo!
    Anne

    • Anne, thanks for the contribution of David's copy of this book! :-) Hallowell & Ratey talk a lot about the different manifestations of ADD, including both you mention, but if I recall correctly they don't exactly break it down into the same categories you're doing: ADD without hyperactivity is presented as one of the possible manifestations but not a major taxological division, if that makes sense. Hallowell does discuss his conscious decision to write about ADD, despite the suggestions that the disorder should be called ADHD, for exactly the reasons you mention: he doesn't want to overlook the folks whose ADD does not include hyperactivity.

  • Wow, thank you, Emily and David! This was fascinating. I know not to diagnose myself but am keen on reading the book now. There are so many things about David that I can relate to. They feel weirdly familiar.

    Like, for example, the point about ADD not being just an attention deficit problem but an attention regulation problem. I tend to "hyperfocus" a lot. And I've always blamed it on my obsessive compulsive tendencies (this one I've been diagnosed with and am working on, not yet the actual disorder but bordering on the disorder). E.g. I would lock the door many times just to make sure. And (I still do this) I wash my hands after touching raw meat (when cooking for hubby and kids) about 5 to 10 times. Even when most of the time I wear latex gloves. And it has to be hot water. My hands get very dry because of this and my husband always tells me to stop washing so much. (So embarrassing to talk about this but this is just so weird, I have never thought of myself as a possible candidate for ADD before.)

    I also have a time management problem and have always been late in everything since I was little. It is a problem I haven't ever worked on. I am still as late today as I ever was. I just always think of myself as being lazy, and blame it on that.

    I get anxious with sudden changes. I have "morbid" anxiety too.. will not get into that.

    I also have a "special relationship" with piles. Not like Peter though but more like David. I have a very spatial memory too. Could remember where everything was as long as nobody else moves them around. I have a place for everything. I'm very organized. If stuff aren't in their specific places, I tend to get anxious and this is the sort of thing that my husband finds funny. Sometimes I feel like such a nag because when everything isn't in the proper place my head feels "cluttered." So I always have my notebook/organizer beside me even anywhere in the house so that when I get stressed (with the three little boys, you can imagine how it is for me) with the children's mess I have to write down what I need to do this day or the next, like put back their Lego in this or that bin, etc. Lol. I feel like admitting to you how crazy I am. I have a pile for my husband's receipts and other docs he brings home from work (he tends to just put them everywhere, on the shelves, the kitchen counter, the dining table, etc, so I have to pick up after him). I have a pile for everything.

    I also relate to the "daydreamer" very very much.

    Anyway, enough ranting. I should just probably grab hold of the book and read for myself. THanks again for sharing, you two.

    • Aw, no worries, Claire - we're all crazy, after all! :-) I'm so glad this entry resonated so much with you, and thank you so much for writing about that. I don't know if you saw my comment to Stefanie, but Hallowell wrote a more recent (mid-2000s) book called Delivered from Distraction which might be a slightly more up-to-date run-down of the ADD scene if you're interested in that.

      And it sounds like you and David have a lot in common. I can only imagine the havoc that three little boys would wreak with a visual or piles-based organization system! David and I definitely have different perceptions of when it's necessary to wash, especially with stuff related to the dog. And David has a whole dishwashing system with a "clean" scrub-brush and a "dirty" one, that I still don't totally understand even though I have tried. What kinds of tasks "dirty" the clean brush, for example? Does the dirty brush become "clean" if I put it through the dishwasher? He just kind of laughs and tells me not to worry about it.

      It's interesting that raw meat is a trigger for you since I feel like that's the one thing I'm more sensitive about than David: since I've been a vegetarian basically my whole life, looking at meat preparation and touching raw meat is SO gross to me. I definitely feel the need to wash immediately if I ever need to touch it for some reason.

      Anyway, thanks so much for your comment! :-)

  • Haha too funny! I have clean kitchen towels and dirty kitchen towels and clean knives and dirty knives, and clean bowls and dirty bowls etc, and it drives my husband crazy! The bowls and knives and chopping boards mostly, though, are divided into those that never ever should get touched by meat and those that can. Lol. Anything that touches meat has to be put in the dishwasher so it gets steamed. I too think raw meat is super gross. While I'm not strictly vegetarian, I would probably be if not for the hubby and kids. As it is, I sometimes pick on their food when tempted. But mostly I stick to greens. My youngest son, though, does not appreciate meat as the others do, which I'm very happy about.

    Thanks for the info on the updated book!

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