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Dr. Hallowell's Blog

August 11th, 2014

Dr. Hallowell, “I Know How Terribly Crippling ADHD Can Be.”

Recently I received an “open letter to Ned Hallowell” in which the author took me to task for stating that ADHD is not a disorder but rather a trait.  She then went on to explain how much pain and suffering ADHD has caused her, and she criticized me for implying that she did not have a disorder (which I most certainly did not mean to do).  She said that while ADHD may not have disabled me, it was certainly disabling her.

Her letter reflects a widespread misunderstanding of my position.  Let me take a moment to clarify where I stand.

Whenever I say that ADHD is a trait, I immediately go on to state that it can indeed be a disorder, and that it can ruin a life. The prisons, the ranks of the addicted, the halls of the unemployed, the people who have been multiply divorced, the people who suffer from depression, and even the people who commit suicide are over-represented by people who have ADHD.  It would be absurd to claim that ADHD cannot be a crippling, chronic, lifelong disability.  I fully acknowledge how desperately painful life with ADHD can be.  Short of the severe outcomes mentioned above, ADHD often leads to a lifetime of underachievement, frustration, unmet potential, and ongoing sadness, if not despair.

I know how terribly crippling ADHD can be.  I’ve been treating it for over 30 years in people of all ages, so I have seen firsthand how devastating ADHD can be.

My point in calling it a trait, rather than a disability, is that ADHD, if managed well, can also be associated with success at the very highest levels.  I have adult patients who are self-made millionaires and billionaires; who are CEO’s and successful entrepreneurs; who are Pulitzer Prize winners and Academy Award winners; who are professional athletes; who are brain surgeons and prize winning scientists; in short, I have patients who function at the very top of almost any field you can name.

I also have patients who are blissfully married, love their children, love their friends, and live full and happy lives.

This is what makes ADHD so interesting, if not unique. It can lead a person in one extreme direction or another: either great success or terrible disappointment.  Indeed, both can happen.  A person can lurch from triumph to disaster and back to triumph again.  People with ADHD rarely give up, which is one of the many reason I love them so much.

The key to maximizing the chances of the best outcomes is to get skilled treatment.  Unfortunately, few doctors understand ADHD, either in children or in adults, and so the care that’s meted out is spotty at best.

Great researchers like Russell Barkley, Thomas Brown, Sam Goldstein, Len Adler, Mary Solanto, Peter Jensen, and many more have devoted their careers to pinning down the various ways in which ADHD can impact lives, and we owe them a huge debt.  It was not so long ago that people laughed at ADHD as if it were a moral failing, not a legitimate medical condition, much as people used to trivialize depression or anxiety.

Now, thanks to major advances in neuroscience, epidemiology, cognitive psychology, and various related fields we have a sophisticated understanding of ADHD.  But the public, and much of the medical profession, does not understand ADHD.  It remains shrouded in ignorance and stigma.

Stigma is one of the greatest obstacles to people getting the help they need.  No one wants to be called disabled or disordered.  The reason that I point out that ADHD need not necessarily always cripple a person is, aside from being true, that it instills realistic hope.  I see all my patients as champions in the making. Hope leads to far better outcomes than despair.

This is why the positive psychology movement, let by Martin Seligman and his group at the University of Pennsylvania, have delivered such a profound and pivotal shift in how we regard mental health.  No longer is it only about what’s sick, disordered, disabled, or pathological.  It is also about what’s healthy, gifted, talented, and valuable.  By recognizing both sides, the healthy and the impaired, we stand a far better chance of promoting health and limiting disability.  That’s what I am trying to do with ADHD.

My goal is to educate and also to instill hope, hope rooted in science and true-life experience, that will lead to the best outcomes possible for a brave and resilient group of people subsumed by the cumbersome and confusing term, ADHD.

Please understand.  I know how awful life with ADHD can be.  But I also know how wonderful it can be.  Working together, we can help everyone become the best they can be, whatever obstacles they may face, whatever conditions they contend with.

Our greatest power as people lies in connection, in working together.  As I am fond of saying, “Never worry alone.”  Worrying together we tap into each other’s resources and come up with solution after solution.

Let me say to the woman who wrote me that open letter, You are a brave and strong woman.  You have suffered a great deal.  I am sorry that someone over-simplified my position in such a way that it hurt you.  I hope that this note corrects that, and makes clear what I actually do believe.

Working together, we will progress, we will prevail.  And we will feel joy in doing so.

August 11th, 2014

Dr. Hallowell Explains ADHD in Forbes Magazine

“Telling someone with ADHD to ‘try harder’ is like telling someone who’s nearsighted to squint harder.” – Dr. Hallowell

ADHD explained by Dr. Hallowell in this Forbes Magazine article.

July 30th, 2014

Hallowell Center Boston Ranked by Boston Parents Paper as “Best of the Best” in ADHD

We’re proud to be featured in Boston Parents Paper’s “Best of the Best” issue as one of the top 5 “special needs/ADHD” services in the area.

2014 BostonParents Favorite

 

 

July 28th, 2014

What to Do If You Suspect Your Child Has ADHD

Andrew R. Gilbert, M.D.
Medical Director Hallowell Center

Read entire article at ExpertBeacon:

Attention-Deficit/Hyperactivity Disorder (ADHD) is a psychiatric disorder characterized by symptoms of inattention, impulsivity and/or hyperactivity. ADHD is one of the most common childhood disorders and frequently continues into adolescence and adulthood. Although so many individuals with ADHD are bright, creative, and dynamic and have tremendous gifts, ADHD can greatly interfere with educational, occupational, economic and social functioning. Fortunately, there are many effective approaches to managing, facing and embracing ADHD and helping individuals achieve greater balance in their lives. If you suspect that your child has ADHD there are several simple and straightforward steps to take to get things started.

Do

·         Get informed
·         Find a provider with whom you and your child connect
·         Consider all treatment options
·         Find the right treatment for your child
·         Be optimistic

Don’t

·         Panic
·         Feel stuck with the first provider you meet
·         Immediately rule out treatment options
·         Believe that one size fits all
·         Give up

July 25th, 2014

Dr. Hallowell: Keynote at ADHD ADDA Conference

Dr. Hallowell will give the closing keynote at the ADDA 25th Anniversary International Adult ADHD Conference.

Sunday July 27, 2014

Learn more here.

July 24th, 2014

ADHD SELF-ASSESSMENT QUIZ

Many viewers who watched the Katie Couric episode on Adult ADHD on July 21, 2014

were unable to access the ADHD Self-Assessment Quiz app for various reasons.  So I’m offering it here now so anyone who is interested can take the quiz below.

Please note that the following quiz has no statistical validity whatsoever. I composed it as an additional means of providing a feel for ADD. The more “yes” answers you give on this quiz, the more likely you have ADD.

However, there is no cutoff point, as this is purely descriptive, not diagnostic.

This quiz is a good place to start if you are dealing with an adult who doubts that ADD is real. If the person has ADD, he or she will be surprised at how many questions hit close to home.  A quiz with a similar format appeared in Driven to Distraction. However, this quiz is entirely new; it is longer, covering more ground, and the questions highlight aspects of the ADD experience I have learned about since writing Driven to Distraction.

General Questions

1. Did you turn to this chapter right away, before you read any of the other chapters in this book?

2. Do you feel that you are underachieving in your life, even though you may have achieved a great deal so far?

3. Are you more generous than most people?

4. Do you have more trouble than the average person with staying on track, especially when what you are doing is less than gripping?

5. Do you feel some regrets about the way you are but also feel unable to find any way to change?

6. Would you have made a good inventor?

7. Do you perceive patterns where other people don’t see them?

8. Do you tend to solve problems intuitively rather than logically and methodically?

9. Do words like logically and methodically bring back bad memories?

10. Do you also relish certain qualities you have, regretting that you can’t always present them in such a way that others appreciate them?

11. Are you more tenacious and persistent than the average person?

12. Are you more sentimental than the average person?

13. Do you have an unusually acute sense of smell and sensitivity to touch?

14. When you are sitting, do you frequently drum your fingers on the table or bounce one of your legs up and down using the ball of your foot as a fulcrum?

15. Do you love crossword puzzles, brainteasers, and self-assessment quizzes?

16. Do you love bicycles (even if you don’t ride them anymore)?

17. Do you feel that the positives you have accomplished in life you did by accident, by smoke and mirrors, almost as if someone else achieved them, not you?

18. Do you put up a good front, but inwardly wish you could find a better way in life?

19. Do you go off on tangents easily?

20. On the other hand, do you get really annoyed when other people go off on tangents, wishing they’d hurry up and get to the point?

21. Do you drink coffee or consume other caffeine-containing substances (colas, chocolate, Mountain Dew, some teas) in greater quantities than most people do?

22. Did you have many ear infections when you were a child?

23. Do you like situations of danger and risk?

24. Have you missed many opportunities due to procrastination?

25. Although you may be quiet and reserved, does your mind go a mile a minute most of the time?

26. Are you more of a child at heart today than other adults your age?

27. Do you often get something done extraordinarily well and when you’re finished have very little idea of how you did it?

28. Do you feel huge letdowns after big events or successes, more than the average person does?

29. Are you totally amazed that so many people can’t see through the façades that phony people put up because you can see through them in a second?

30. Do you especially despise hypocrisy?

31. And do you especially admire honesty?

32. Do you wish people were more honest and less politically correct?

33. Did one or both of your parents or their parents drink too much, or suffer from depression or bipolar disorder, or have trouble with gambling, or get into trouble with the law?

34. Do you often drive past the exit you were supposed to take on the highway?

35. Are you chuckling to yourself as you read these questions?

36. Are you a born debater?

37. Were your years of education (school, college, and beyond) marked by underachievement?

38. Are you more prone than the average person to make careless mistakes?

39. Do you feel that if other people knew the real you, they would disapprove of you?

40. Were you the class clown or cutup in school?

41. Did you have trouble completing your education due to problems with organization or getting to class on time?

42. Do you find that marijuana appeals to you because it helps you “chill out”?

43. Do you often make remarks that others consider odd or off the wall?

44. Do you have many different enthusiasms, often wanting to follow more of them than you can possibly keep up with?

45. Do other people comment on how hard it is to get you to stay focused on what they want you to stay focused on, even when you want to focus on that as well?

46. Do you tend to drive fast?

47. Do you often feel an urge to hug the person you are talking to, even if you barely know them, for reasons unrelated to sexual attraction?

48. Did you feel a bit out of it in school, regardless of what grades you got or how socially popular you were?

49. Are you a dreamer?

50. Do you have a sense of humor that is unusual, zany, macabre, or otherwise out of the ordinary?

51. Do you not only think outside the box but have trouble thinking inside the box?

53. Do you find that your thoughts go so fast, your mental organizer can’t keep up with them?

54. Were you hyperactive as a child?

55. Do you find driving a car fast to be a soothing experience?

56. Are you much more forgiving than most people?

57. On the other hand, do you rush to take sides against people who take advantage of others?

58. Do you laugh easily?

59. Even though you may not do it, do you enjoy flirting more than the average person does?

60. Are you slightly less coordinated than others your age?

61. Do you love it when life is going fast?

62. Do you simultaneously yearn to fit in but hate to conform?

Questions About Work

63. Do others complain that if you were more motivated or just tried harder you could pay attention better?

64. Do you sometimes focus extraordinarily well, even superfocus?

65. Do you get frustrated because you can’t make yourself superfocus on demand?

66. Are you embarrassed by what a mess your pocketbook, desk, or office is?

67. Would you have made a good salesperson?

68. Would you have made a rotten accountant?

69. Even if you don’t like doing it, do you do your best work under a deadline?

70. Do you find that you can get more done in twenty minutes while waiting in an airport than in six hours working in your office?

71. Do you wonder why so many people refuse to take chances?

72. Do you love highly stimulating environments, like newsrooms, the floor of the stock exchange (or how you imagine the floor of the stock exchange to be), emergency rooms, courtrooms, or football games?

73. Do you excel in certain areas, but have trouble figuring out how to turn those areas into income generators?

74. Do you have a razor-sharp memory one moment only to be foggy and absentminded the next?

75. Do you have a million new ideas, but have trouble turning them into reality?

76. Do you do your best work when you can be your own boss?

77. Even though you may be at your best when you’re your own boss, do you also benefit from having an assistant who can remind you to stay on track?

78. Do you find that you focus better in the midst of a crisis or an emergency than when all is peaceful and calm around you?

79. When you attend a lecture or other presentation, do you feel you could pay better attention if you could get up and pace around at the back of the room?

80. Even though you noticed it at the time and chortled a bit at what you took to be my own oversight, have you forgotten by now that question 52 was left blank?

81. Do you prefer to work in intense bursts, rather than prolonged intervals?

82. Are you an entrepreneur by nature?

83. Do others comment on how creative or original you are?

84. Do you find that sitting in a meeting is almost always a total waste of your time and agonizing to boot?

Questions About Home Life

85. Are you much more of a night person than a morning person?

86. Do you often offend people without meaning to?

87. Is your own humor sometimes mistaken for an insult?

88. Have you ever gotten divorced?

89. Do you usually know the point a person is getting to before they get there?

90. Do members of your family complain that you often interrupt?

91. Are you much more energetic than other people your age?

92. Are you now, or have you ever been, concerned that you drink too much alcohol?

93. Do you now or did you ever smoke cigarettes?

94. Are you a maverick?

95. Even though you may be a maverick, have you found yourself working for someone or married to someone who wants you to conform?

96. In romance, have you often made the mistake of dating, or even marrying, someone who belittles you, reprimands you, and tries to control you?

97. Do others see more that is good and valuable in you than you do?

98. Do you find that your spouse has to do most of the organizing and planning?

99. Does your spouse/partner resent how much he or she has to do for you to make a go of it with you?

100. Does your partner often tell you how much she or he cares about you but at the same time tells you that she or he is going to leave you unless you can get your act together?

101. Has the quality of your sex life declined due to emotional conflicts with your spouse?

102. Do you find that you have trouble sustaining attention when you are making love, even though you are aroused and interested?

103. Do you think you have a higher level of sexual interest, drive, and curiosity than others your age?

104. Are you thinking about many other things in the back of your mind as you read through this quiz?

105. Is what you are looking forward to doing after you put this quiz down something other than what you are supposed to do next?

106. Do you carry an anger and frustration within you that comes out too easily or at the wrong times?

107. Do you find that you feel much more mentally focused after you exercise?

108. Do you find that you have trouble putting your thoughts into words?

109. Does your spouse tell you that you are a difficult person with whom to communicate?

110. Are you dyslexic or a very slow reader?

111. Do you waste vast quantities of time roaming around on the Internet, sending and receiving e-mails, playing electronic games, and otherwise diverting yourself from what you originally sat

down at your computer to do?

112. Do you love children but also find that you get bored trying to read to them or play a board game with them?

113. Do you feel that your life could be much, much better if only you could make one major change or breakthrough . . . but you don’t know what it is?

114. Is your idea of a perfect dinner party to arrive, have a drink, eat the food, and go home with as little chitchat and dillydallying as possible?

115. Do you sometimes smile in a conversation in hopes that it will be a sufficient contribution, because you have totally lost track of what is being talked about?

116. Do you find it difficult to explain the rules of a game, not because you don’t know them but because you just can’t stand the laborious process of imparting them, step by step?

117. Do you have recurring dreams in which you are mortified to discover you are walking around naked in public?

118. No matter how hard you try to be on time, do you usually arrive late?

119. Do you pray that your children never have to go through what you went through as a child and what you go through now?

120. Do you have trouble lingering when you make love?

121. Do you have trouble lingering in general? For example, if you see something beautiful, like a sunset or a painting, do you have trouble savoring it for more than a few seconds before you feel the need to move on, even though you liked the sunset or the painting?

122. Do you sometimes get exceedingly annoyed (even if you don’t show it) when someone interrupts you when you’re reading the newspaper or working on your computer, even though the interruption was intended to be pleasant?

123. If you have made it this far into this quiz, are you surprised that you have paid attention this long?

124. Do you love basements and attics, even if yours are messy?

125. Even if you don’t talk about them much, do you think about the big questions in life more than you imagine the average person does?

126. Do you feel a great deal of secret shame about how disorganized you are?

127. Even though the questions in this quiz are diverse, can you intuit the theme that ties them all together, even if you can’t explain it logically in words?

128. If you read all the questions in this quiz, and you made it all the way to this question, question 128, let me ask you, was there a point at which you said to yourself, “Wow. How does he know this? This is me!”?

Remember this is not a diagnostic test. It is just a screening tool. So if you feel you have ADHD, then you definitely ought to get a full evaluation. 

Adapted from Delivered from Distraction, Edward M. Hallowell, M.D., John J. Ratey, M.D., Ballantine, 2005.

 

 

 

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