Eucalyptus Magazine / September-October 2012 / Why Can't You Pay Attention?

Why Can't You Pay Attention?

Living with ADD and ADHD

Most of us know a young boy who can’t stop jumping out of his chair or a girl who frequently drifts into daydreams. These are common symptoms of attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD), learning disabilities that occur in nearly 5 percent of children worldwide. Boys are diagnosed more frequently than girls, but this may be because ADHD is sometimes confused with the “normal” hyperactive behavior many young boys exhibit. In girls, ADD and its accompanying lack of attention is more commonly diagnosed. Both ADD and ADHD require treatment in the form of therapy, special educational techniques, and in some cases, medication.

Dr. Anandhi Narasimhan, a Los Angeles psychiatrist who specializes in child and adolescent mental health, says, “ADD/ADHD is not caused by ineffective parenting, lack of willpower, or level of intelligence. It is a neurological condition that limits the amount of dopamine in a person’s brain.”

This lack of dopamine means that ADD/ADHD often occurs alongside disorders such as anxiety and depression. “The level of comorbidity is high,” says Narasimhan. People with ADD/ADHD are six times more likely to have another complicating factor.

ADD/ADHD makes life challenging for children. Many do not succeed in traditional school settings. Donna Austin, Assistant Director at Oakland’s Bayhill High School, a private school dedicated to students with ADD/ADHD and other special needs, says, “All of our students have been unsuccessful in other schools.”

Many of Bayhill’s students have EFD, or Executive Function Disorder, which results in difficulties in organizing and memorizing information, as well as staying on task. EFD often co-exists with ADD/ADHD. To combat this disorder, every Bayhill student is required to take a year-long study skills class. “We find the best [organizational] system for each student. Some of our students like three-ring binders, some do better with accordion files, and some want their schedules on their smartphones,” Austin says.

Bayhill’s success rate shows in its students. This year, 15 students will graduate and five will go on to four-year colleges. “Quite a few of the rest are going to community college,” Austin says. She adds that small class sizes and personal attention are key to student success. “We have 80 students total—10 per class. Classroom management is the key to dealing with kids who have special needs,” Austin says.

Mark (last name withheld), a writer and historian who is now in his 50s, was diagnosed with ADD while in college.

“I was a classic ADD kid—absent-minded, not hyperactive,” he says. Middle and high school were difficult. While in college, taking tests led to self-discovery: “I found that I could score as well as the other students on tests and classwork if I had a little more time to finish.”

Still, Mark says, “Going to college made no sense to me. Music was my calling.” He opted for a career as a musician.  “The ADD made it hard for me to process information visually. I was better with sound.”

Having the personal attention of a mentor and coach helped as well. “ADD people don’t do enough planning. They get into trouble and need help with forethought,” Mark says. He met with his mentor throughout college and continues the practice today with a “life coach.”

“I check in with her several times per week. She keeps me focused,” Mark says.

People with ADD/ADHD often have difficulties with relationships. “I’m lucky that my wife is so good at planning because I’m terrible at it,” Mark says. “She knows that I can’t be relied on to organize our kids, pay bills, or manage our finances. Things would fall apart quickly.”

Children and teens with ADD/ADHD often feel socially isolated. “We teach students how to make friends,” says Austin of Bayhill High School. “Sometimes these kids talk too loud or poke other children. We help them learn how to control their impulsive behavior.”

Barbara Saunders, a special education teacher at Willow Glen High School in San Jose, agrees. “Kids can learn to cope if they are taught some basic self-control. Often, these children have learned to get attention by misbehaving. It helps for the teacher to connect with the child and figure out what he or she is interested in.” ADD/ADHD students often earn the label of being “difficult,” which lowers their self-esteem and leads to more negative behavior.

At Bayhill, students get two five-minute “chill breaks” or time-outs per hour, during which they are allowed to leave the classroom. “It teaches them not to just jump up and run around the room,” says Austin. “They have a legitimate reason to leave, calm down, and return.”

Behavioral modification, therapy, and classroom assistance help most children with ADD/ADHD, but some do not respond to these techniques, in which case medication may be recommended. Typically, the medications for ADD/ADHD are stimulants such as Ritalin, Adderall, and Concerta. “Stimulants increase the amount of dopamine in the brain, [helping] those with ADD/ADHD to focus,” says Dr. Narasimhan. Nonetheless, she adds, “the goal is to avoid medication wherever possible. Drugs have side effects.”

Narasimhan prescribes medication “in cases where a child is failing in school, or has been asked to leave more than one school.” These experiences damage the child’s self-esteem, she says, leading to more problems in the future.

Saunders expresses caution about using medication for ADD/ADHD. “The kids don’t like how it makes them feel,” she says. “It changes their personalities. Sometimes they can’t sleep.”

One of the side effects of ADD/ADHD drugs is a loss of appetite. Teen boys “don’t want to look skinny or underweight. Inadequate diet is a real problem for them,” says Austin. “They are willing to go off their meds and try harder with behavior modification.”

Mark encourages ADD/ADHD sufferers to stay open to the idea of taking medication and to discuss it with their doctors. “I was Mr. Organic,” he says. “I wouldn’t even take aspirin.”
A doctor convinced him to try Wellbutrin, which is not a stimulant and was developed to assist with smoking cessation, depression, and anxiety. He found that this drug helped him whereas others did not. “For me, stimulants were too stimulating. I couldn’t function at all on them,” he says.

People with attention deficit disorder can and do achieve success in life, careers, and relationships. “For every negative about ADD, there’s a positive,” says Mark. “My ADD has helped me as much as it has hindered me.” As a parent of a child who also has ADD, Mark says, “It can be exasperating, but having a child with this condition gives you the opportunity to love yourself through your child.”

Saunders says that if she has one piece of advice for parents and teachers of ADD/ADHD kids, it would be: “Be patient. Don’t give up on these kids.”