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April 15, 2007

AVOID SPINNING IN ADD

AVOID THE S.P.I.N. CYCLE OF ADD

 
I often compare the ADD mind to Niagara Falls, both wonders of gargantuan movement and energy.  The trick to making use of the energy in Niagara Falls, and to doing well in life with ADD, is building a hydroelectric plant.  You need to hook the energy up to some contraption that can turn it into a useful product.

Whoever makes your diagnosis could say to you what might have been said to someone who lived next to Niagara Falls all her life but never understood how to deal best with a waterfall.  “This waterfall is an insurmountable obstacle if your goal is to paddle.  But, if you will change your plan, I can show you how you can turn this waterfall into something wonderful.  This waterfall can generate enough energy to light up millions of homes.  People will pay you for all that electricity.  You just need to throw away your paddle and build a hydroelectric plant.”

When treatment begins, you are on your way to building that plant.  Treating ADD may seem as difficult as building a hydroelectric plant—but it can be just as successful.  You need to know some of the major pitfalls.  This chapter and the next address two of the most common.

After an initial burst of improvement at the beginning of treatment of ADD, there is usually a leveling off.  This may be followed by long, frustrating periods during which the person with ADD—or the entire family—feels stuck, as if they are simply spinning their wheels instead of making the kind of progress they should be making.  Such spinning happens in people of all ages, but it is especially a problem in older adolescents and adults.  With children, the natural forces of development, coupled with the influence of parents and school, usually prevail and the child progresses.

However, when the diagnosis is not made until late adolescence or adulthood, prolonged periods of going nowhere can stultify treatment.  As one woman wrote to me, “I know you know this already, but there are some people who stubbornly resist help, who are caught in patterns too deeply rooted in the subconscious to be freed from.  Sometimes I wonder if I am one of those.  So don’t bet your money on this horse.  Remember, you can't save everyone, kid.” 

I call these periods of being stuck “spinning,” based on an acronym, S.P.I.N.  The term sums up the usual causes of getting stuck:

  “S” stands for Shame.
  “P” stands for Pessimism and Negativity.
  “I” stands for Isolation.
  “N” stands for No Creative, Productive Outlet.

  Getting un-stuck often depends on reversing the influence of some or all of the components of SPIN.  You can do this with a therapist, a coach, a spouse, a support group, a friend, a pastor, a relative, or all of the above.  Let me offer some suggestions on each element of SPIN.

  Shame:  The older you get, the more shame you are apt to feel if your ADD is undiagnosed.  You feel ashamed of what a mess your pocketbook always is in.  You feel ashamed of how late you usually are, no matter how hard you try not to be.  You feel ashamed that you haven’t made more of the abilities you were born with. 

  The shame may penetrate to deeper levels.  You may feel ashamed of your thoughts, desires, and predilections. You may feel the only way you can be accepted is by putting on a mask, and that the real you is fundamentally flawed.

  Such shame is toxic.  It is also traumatic.  It raises your stress hormone levels and eventually corrodes your memory and executive functions.  While your fifth grade school teacher may have planted the roots of that shame, you are now the one who intensifies it.  You imagine harsh judges everywhere, as if the world were swarming with strict fifth grade school teachers.  You project the harsh judgments you are making of yourself out onto everyone you meet.  Soon the world becomes like a huge set of judgmental eyes, looming down on you, and your only option is to hide. 

  With a therapist, with a friend, with a spouse—with someone, because it is all but impossible to do this alone—you need to talk through or “confess” what you take to be your sins.  As you do this, you will discover that they are not nearly as bad in the eyes of others as they are in your eyes.  It is all right that you have messes.  People enjoy your unpredictable remarks, and those who don’t can look elsewhere for friends.  It is all right that you are late.  Sure, it would be good to try to be on time, but as long as people know you are not just blowing them off, they can forgive lateness.  If they can’t, you don’t need them as friends, either.  How boring it would be if everyone were “normal.”  Where would Monty Python or Mel Brooks have come from?  Remember, what is strange today becomes truth or art tomorrow. 

  Not only does shame hurt, it also is the chief cause of a huge problem in adults who have ADD, namely, the inability to feel good about their achievements.  It is common for ADD adults to be all but impervious to positive remarks.  Whatever they have legitimately achieved they feel must have been done by someone else, or by accident. 

  One of the main reasons adults with ADD can’t take pleasure in their own successes and creations is, simply, shame.  They feel too ashamed to feel good.  They feel too defective to feel nourished.  They feel it is practically immoral to feel proud of themselves.  Healthy pride is such an alien emotion that they have to look back into the dim recesses of their childhoods to find the last time they felt proud of themselves, if they can find an instance even then.

  Shame prevents you from allowing your best self to emerge.  Shame gets in the way of every forward step you try to take.  You call a business and instead of asking to speak to the president or person in charge, you figure you’re too small potatoes for them, so you speak to an underling who can do nothing for you.  You apply for a job, but instead of making a strong case for what you can do for the company, you present a self-effacing persona that is charming, but uninspiring.  You go shopping for clothes and pick outfits that allow you to recede into the background as much as possible.  You shake hands, but have trouble making strong eye contact.  You want to ask a question at a lecture, but you fear that your question is a stupid one.  You have a bright idea, but you don’t do anything with it because you figure it must not be that good if you thought of it.  You do all the work on a project, then don’t speak up when someone else gets credit for what you’ve done.  When someone doesn’t call you back, you assume it was because they found you lacking in some way.  And on, and on.

  Try as best you can to override your feelings of shame.  When you shake hands, make eye contact and give a strong handshake, even if you feel second-rate.  When someone doesn’t call you back, assume they’re simply too busy and give them a call.  If, indeed, they do find you lacking and reject you, don’t internalize their judgment.  Look elsewhere.  You don’t want someone who rejects you, anyway.  And remember, rejection in one place is just the first step on the way to acceptance somewhere else, unless you let that first rejection stop you.

  It is heartbreaking to watch an adult contribute wonderfully to the world, only to feel every day as if she hadn’t.  It is painful to watch an adult work hard and do much good, only to feel as if someone else had done it.

  To allow the adult who has ADD to take deserved pleasure and pride in what he has done, he needs to detoxify the shame that has plagued him for years.

  To detoxify his shame, he needs to engage in a deliberate, prolonged process.  It will take some time.  But it can and should be done.  As long as he feels intense shame, he will never feel the kind of joy in life that he has every right to feel.  He will stay stuck in a painful place. Instead, with someone else’s help, he can work toward accepting and enjoying his true self. 

    If you struggle with this issue, you should try to get rid of the people in your life who disapprove of you or don’t like or love you for who you are.  Get rid of or avoid the people who are overly critical of you rather than accepting of you.  Get rid of the harsh fifth grade school teachers in your life—and within yourself.

  Getting rid of that witch within you will be a lot easier if you get rid of the ones who surround you.  Your shame has allowed them to stay.  You have felt that’s what you need—daily reprimands, daily belittlements, daily control.  But that’s the opposite of what you need.  It’s your shame that’s let those people into your life.  Your determination not to be ruled by shame any longer will send them away.

  You need acceptance.  You need people who see the best in you and want to help you develop that.  As you surround yourself more and more with people who see more good in you than you see in yourself, the frightened, ashamed you will start to feel less afraid, less ashamed, and you will dare to feel proud, a little bit at a time.

  Pessimism and Negativity:  Pessimism and negative thinking create a roadblock that conscious intent can actually dislodge like a battering ram if properly aimed.  Pessimism and negativity—which may be boulder-sized due to years of failure and frustration—block your growth at every turn.  If every time you have a new idea or go to meet a new person or begin to play a game you feel, “Why bother? This won’t work out well,” you constantly reduce the chances that anything will work out well.

  One remedy for pessimism is to achieve some successes, but in order to gain those successes you may need to overcome your pessimism.  Sounds like a Catch-22, doesn’t it?  But there is a way out of the Catch-22.  You can control what you think, to a certain degree.  You need to work on dismantling your pessimism.  That does not mean you should become a foolish, empty-headed Pollyanna.  However, it does mean you should escape the embrace of Cassandra, the doom-sayer inside of you.

  Controlling what you think is the domain of what is currently called cognitive therapy.  Aaron Beck, and his student David Burns, have written superb, practical manuals on how to break the shackles of negative thinking.  Also, Martin Seligman describes a method for achieving optimism in his book, Learned Optimism.

  My favorite book on this topic for the ADD audience  is The Art of Living, by the Roman philosopher Epictetus, as translated and put into a modern idiom by Sharon Lebell. One reason I like to recommend it to people who have ADD is that it is short—under 100 pages.  Another reason is that it has stood the test of time, and then some.  Epictetus lived over 2000 years ago.  He is the true father of cognitive therapy.  His basic, guiding principle is that a person should determine what he can control and what he can’t and then work on what he can control—similar to the serenity prayer used in Alcoholics Anonymous.

  One element of life we can control, at least somewhat, is how we think.  Epictetus began his life as a slave.  Ordered around every day, poorly fed, beaten, and abused as a slave, he evolved a way of thinking that refused to intensify his suffering by adding to it with wretched thoughts.  He was so persuasive in teaching others his methods that he was released from slavery and became renowned as a great philosopher.  His words were written down by his students and compiled into one of the first and best “self-help” books ever, a book that was so useful in dealing with difficult situations that Roman soldiers often carried copies of it as they marched off into battle.

  It worked for Roman soldiers, and it can work today.  I highly recommend this slim volume if you suffer from excessive pessimism or persistently negative thinking.

  Isolation:  Isolation is often the by-product of shame, pessimism, and negativity.  It intensifies the shame and negativity, and can lead to depression, toxic anxiety, drug and alcohol abuse, and generally poor performance in all aspects of life.

  Staying connected with others is the most important life line any of us has.  And yet, as naturally inclined to connect as most people with ADD are, their shame and negativity can grow so intense as to lead them to cut themselves off.

  If you feel this happening to you, do all you can to counteract it.  You may feel that all you want to do is to hide.  Try as hard as you can not to let yourself do that.  Talk to a friend.  Go see a therapist.  Pick up the telephone and call someone you trust. 

  Isolation develops gradually, almost imperceptibly, and you justify it to yourself as it happens.  “Those people are just a bunch of hypocrites.”  “They don’t really want me there.”  “I’m too tired.”  “I just want to stay at home and relax.”  “I need my down time.”  “My doctor told me to avoid stressful situations.” 

  Of course, isolation is better than the company of nasty, disapproving, shame-inducing witches and warlocks.  So, as you try to reconnect, do so judiciously.  One friend makes for a good start.  Have a regular lunch date.  Or a weekly squash game!

  No Creative, Productive Outlet:  All of us do better when we are creatively and productively engaged in some activity. It doesn’t have to be overtly creative, like writing a poem or painting a portrait.  Almost any activity can become a productive outlet that you feel good about.  Cooking a meal certainly can be.  Even doing laundry can be.

  How can doing laundry be fulfilling?  By turning it into a form of play, by turning it into a game.  Children show us how to do this all the time.  My 8-year-old son, Tucker, turns his bath into a creative activity every time he takes one.  He adds a few action figures and the game is on. 

  If you are willing to be a little silly and let yourself go, you can turn doing your laundry—or anything else for that matter—into a playful, creative activity.

  The more you can do that the more likely the activity will turn into flow, a psychological term invented by the great pioneer of the psychology of happiness, Mihaly Csikszentmihalyi.  Flow is the state of mind in which you lose awareness of time, of place, even of yourself, and you become one with what you’re doing.  In these states we are at our happiest as well as at our most effective. 

  The doorway to flow is play. You can play at anything you do. If you have ADD, play comes naturally to you.  So do it!

  Play is deep.  Play changes the world.  Play can turn the most mundane of tasks into an activity you lose yourself in.  Play is not a silly, superficial activity.  By play, I mean creative engagement with whatever it is you are doing.  The opposite of play is doing exactly what you are told to do; that is the refuge of people who have attention surplus disorder.  For people who have ADD, play should come easily.  You just have to get shame, pessimism, and negativity out of the way and make sure you’re not so isolated that you get too depressed to play.

  To get out of S.P.I.N., play.  As you play, you will find something you like to play at over and over again.  With any luck, it will have value to others.  That is called a great career: some form of play that someone else is willing to pay you to do.

  At core, being stuck means not having a creative, productive outlet.  If you hook up to a creative outlet you can’t stay stuck.  Oh, sure, you can get blocked.  You can have periods of inactivity or frustration.  But then you will start to fiddle around—to play—and you will dislodge the block.

  Adults with ADD who stagnate after starting treatment need to find some creative outlet to get going again. Everyone does better with such outlets, but for people with ADD they are essential for a fulfilling life.

  Once you find a creative outlet, or several, you will be much more able to hook your waterfall up to a hydroelectric plant.  Don’t say you can’t find it.  That’s negativity speaking.  Get with someone who believes in you, or listen to the part of yourself that believes in you.  Brainstorm. Try this. Try that.  You’ll find your hydroelectric plant.
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Comments

judi

This process appears really powerful and life-changing. Thanks for explaining the risks of shame, and I wish all the courage to change.

Patrice V.

Dear Dr. Hallowell,

Today is Sunday and for the last couple of days I knew something was amiss when I woke up as tired as when I went to sleep.

I'm a 52 year old mom who was finally diagnosed ADHD (after several misdiagnoses elsewhere) at your Sudbury clinic a few months ago and, just as you said, I've been on a roll!

But a few days ago, I began feeling overwhelmed. I looked around the house and it was a mess. With increasingly warm temperatures I've been outdoors doing the outdoor stuff. Yet, when I looked outdoors, all I saw was unfinished projects. Walking past my office, all I could see were stacks of papers and a messy desk. In the basement, on my way to do laundry, all I noticed were piles of boxes that still needed unpacking from our move last summer. Why could I not see the progress I knew I made every day?

The signs were clear, I was beginning a trip down THAT road, Depression Highway. So I sat down at the computer a little while ago, looked at the black screen and asked "How can I help myself? What can I do?"

In desperation, I went to your website.. and there you were, with a new blog, extending a caring, helping hand and soothing voice to my hurting and frightened mind. I read your posting about SPIN and felt warm tears stream down my cheeks. Then I read about the TURBO brain and I laughed out loud.

You are right, ADHD is such a gift and it can be such a scary hardship. Often I think I am one of the lucky ones, so happy with my extra energy, flood of ideas, indomitable spirit and zest for life...then I have these dark days where I feel so overwhelmed by the many directions and choices before me. The fear leaves me paralyzed. I know all the answers..break it down into small chunks, make a list, one thing at a time, fifteen minute intervals, yet I still feel like a deer staring at the headlights of a car racing toward me.

An inner voice takes on a new litany. I have been a fool, living in denial, I am really a messy, disorganized and tardy person who doesn't follow through, just like "everybody thinks".

But, you are right, Dr. Hallowell, these are only childhood messages. I think I shall label them "Mrs. Prim Thoughts".

Mrs. Prim is as skinny as a rail, wagging a bony, crooked finger at me as she says yet again how I have not reached my "potential". Flooded with shame, I miserably look down, only to see, to my utter fascination, that Mrs. Prim's nylons have drooped and are bunched around her ankles just above dowdy, black shoes.

Slowly absorbing this amazingly funny scene, I KNOW I can't possibly take Mrs. Prim's admonishiments to heart.. she is simply a silly, old fifth grade teacher that lives in my imagination. And now, with a light heart, I can scamper away, back to my blissful world of ideas and good cheer, messy piles and forgotten appointments It's time to play!

Thank you so much for your blog. I shall stop by to read it every time Mrs. Prim with her bony, pointing finger arrives.

Ned Hallowell

Patrice,


What a beautiful comment. I am so glad you nailed Mrs. Prim and have cut her down to size in your mind. And what a superlative mind you have! The price we pay for having an imagnation is that it can turn on us, if we are not careful. That's why we all need each other so very, very much. I, for example, felt as uplifted by your comment as you felt by mine. We truly all do need each other in this thing called life, especially if you are a creative person or a sensitve person or some one who has ADD or all of the above. Thanks so much for your posting. I look forward to more!!!

Raevyn

Patrice, I too have a name for that hateful inner voice! I call her Helga! I'm glad that I'm not alone in thie personification. It really helps me to pin down that negativity and yell at Helga rather than hating myself.

Kathy

I don't know if this is spinning exactly. But yesterday I was ironing, yes, ironing, and I found that for a few minutes I was actually ENJOYING ironing. Then my mind went back to its normal self, wondering what I "should" be doing right now and what I "need" to do next, and how long is this going to take, and I have so many other things that I need to get done, like finish organizing the linen closet and HEY maybe I should disassemble the computers and printers on that one desk because I always use my laptop anyway and then I could use that desk for, well, something else, and also I really need to clear out my dresser drawers because I have all kinds of things in there that I don't wear and I could use more space, and meanwhile what about that fun sewing I wanted to do, no, I don't have time for "fun" anything right now, I need to get going on . . .

As long as I was WITH the ironing and only the ironing, I was enjoying the peace and quiet of just smoothing those wrinkles out of everything and hearing the whoosh of the steam coming from the iron. I realized that I can enjoy almost anything if I can give myself up to it and shut out the competing thoughts that want to drive me nuts. My problem, of course, is, how do I not have 30 million ideas competing for space in my brain every waking moment?

MG

I'm nodding my head the whole time I'm reading this....I just left a job I loved after only 8 months. I was the activities director at an assisted living facility. I was scared to death when I took the job--knowing I'd have to be responsbile for so much. But slowly I learned, and because my love for the elderly motivated me (never did I want to let them down), I managed to do a pretty good job. And according to some, a pretty great job. But at the end, when a new micro-managing boss with severe ego issues and major ethical deficiencies came in, I lost it. I tried to go through channels and address "issues", but was rebuffed.

Finally, I put in my notice saying I could no longer work for this manager. I then wrote a long detailed letter to the CEO of her exploits and she was fired eight days later. I would love my old job back, but am sure I'm labeled as a trouble maker now, even though I only wrote the facts. This job was perfect--I had to have lots of balls in the air, but the stimulation was enough so that things always came together, as long as there was no boss breathing down my neck. So now I am faced with deciding if I can do this kind of thing again. It's in my heart, but I know too well these environments are fraught with landmines for my "root for the underdog, not the corporation" mentality.

I feel like I failed because I could not stomach the politics and work around it. It was like a switch flipped one day and nothing could keep me there a minute longer.

I got closer this time to finding a good match than I ever have though. Overall, the experience was a success. And I always remember something you said, Dr. Hallowell, that the trick to living successfully with ADD is to find the right job and the right spouse. I think that sums it up in a nutshell:) Thanks for all the great work you do---

MG

Stephanie

It is so funny- I clicked to this blog to check it out & my 7 yr old son came in. He saw your picture & said- I like Dr Hallowell- He is the one who gave me his book & signed it. He is nice. Then he saw the sidebar about the turbo brain post & said- I have a turbo brain- you do too don't you mom?! Then he gave me a hug & walked out.

I read this blog and was seeing my cycle - my sadness with myself- my tiredness with being different and struggling always to somehow fit in & do things the "right" way.

I wish to spare my son this- so I put him on Straterra which while it works- he is calmer, not as "impulsive"- the principal of the school called me to ask what I had done with my son last spring- he is not my son. The spark is not there. So he is not on it again. And he is happy. He just won't be when school starts again and his 2nd grade teacher wants him to conform and his spirit won't.

Play... how do you play when it seems you just keep hitting wall after wall after wall.

I keep trying to be thankful for the gift of this different mind my son & I seem to have. I also try to be thankful for the strength my 9 yr old daughter will have from dealing with her life threatening food allergies, asthma, eczema, acid reflux, latex allergy. I am unsure as to what gifts will come if she is diagnosed with dyslexia- she is being tested in August. My 3 yr old will gain strength after dealing with her life threatening food allergies. I have yet to find a gift from my 3 yr old daughters congenital heart defect except that it is one of the fixable ones after open heart surgery.
I cannot find friends for my son- the moms don't call back for play days. My girls cannot enroll in camps as the whole anaphylaxis thing throws a monkey wrench into it.
I find my ADD brain is having trouble coping with all of this & I cannot play. This is when I wish my brain was different. My non ADD husband can deal with all of this and his professional career. I am weepy & cannot get laundry done. I have had enough of my different brain for now.
The good news- I will probably change my feelings tomorrow. I may hop in the car with the kids & take a road trip for 2 weeks- hopefully to the beach.

KimberleyP

Stephanie,

My heart goes out to you, girl! We share in what I call the "mother guilt complex" that is associated with raising these remarkable children (well, really, ALL children, but it seems especially evident in my case toward my add kid, as I have one add and one without add). Anyway, I don't know about you, but I am often overwhelmed with anxiety about how my children will fare when they are grown, especially my add-dyslexic kid. He is going on 12 and I hear you when you describe the keeping friends issue. But I have recently found out about a social skills workshop for these amazing kids and have enrolled my son. I'm looking forward to him learning the social skills he needs in order to survive in middle school. You know, the abstract things we have all picked up over the years that tell us how to get along with other people in the world? Well, since he has a "turbo" brain, he doesn't slow down long enough to pick up on those abstract ideas and he needs to learn these things in a concrete manner. That's what this workshop is all about. It's made specifically for kids like our's. I find solace in this.

Just the fact that there are people out there in the world who are gifted and loving and concerned for our children enough to want to use their own special talents to teach our wonderful kids the "how to's" that they need...and the people like Dr.s Hallowell, Ratey, Greene and many others who also use their talents to write the books that inform us parents of how to support our children and advocate for them...as well as how to use our magnificent brains and help ourselves get along in the world!

For these people I am eternally grateful. I feel deeply thankful that I have the kind of brain that is motivated to seek out knowledge, to inform me how to be a better parent, as well as how to live in the moment and play through the mundane chores. (or sometimes I just ignore the mundane chores and just PLAY!)

But it can be difficult to parent in an add family. I have experienced an overwhelming amount of feelings around this. And just in the midst of my HUGEST and worst SPIN, I found a support group for parents with add/learning disabled kids. It, along with seeing a counselor, has helped me immensely.

I have learned the incredible lesson of loving myself. Only after giving to myself can I give to others. As a mother and a registered nurse, this lesson has proven to be priceless to me.

Thank you, Dr. Hallowell, for providing us with this forum.

JenniferC

The internal dialogue within myself and fellow Adder's can be a killer. I was not diagnosed until the age of 20, I turned 23 this past May. I've had to be proactive about learning ways to make my life the best I can. Lots of struggle and support from my mother led me to the diagnosis which opened up my eyes that there are rhyme and reason to why certain tasks are more difficult and need to be done differently than "the norm" sometimes. I have to carefully watch my wording so that I am not putting myself down or minimizing my intelligence or aptitude. I have had plenty of practice since I was born of both the harsh self criticism and outside criticism.

My mantra is 'to surround myself with positive people who have positive energy'.
With this ADD, how would I have time for negative people anyways. Right. My sarcasm and wit is a coping mechanism. Being around positive energy people will take it light heartedly as its intended.

Reading 'Delivered From Distraction' and 'Learning Outside The Lines' are huge parts to my self-awareness and knowing I am not alone.

Thank you for your research and devotion to ADD!

Anonymous

How do you keep from SPINning if you're already isolated, depressed and ashamed? I have ADHD and people can't stand being around me, regardless if I'm positive or not. Attitude dosen't make much of a difference if people won't tell you how you're screwing up.

Anonymous

How do you keep from SPINning if you're already isolated, depressed and ashamed? I have ADHD and people can't stand being around me, regardless if I'm positive or not. Attitude dosen't make much of a difference if people won't tell you how you're screwing up.

Kat G.

I don't have SPIN, I have PIN: my mother is the one who is ashamed of me!: I spent most of my life wondering what the H**l was wrong with me, until I was diagnosed - at 43 years old!!!

My life is a mess. I live with my parents because even tho I have a hugh IQ, I have never had emotional/mental support from anyone in my family, who actually won't believe I have ADD, and I have never had the money/focus to go to school & work at the same time, so I work at menial jobs that are unfulfilling & frustrating & don't pay me enough to live alone. I have no place to do anything creative, so whenever the urge comes on I get irritable & depressed. No one wants to have a relationship with an irritable, depressed person who doesn't know how to have one anyway because my main examples were fighting & screaming. And my 3 babies died long ago thanks in part to my 'loving' mother.

If I wasn't strong, surprizingly mentally healthy and UNashamed, I probably would have committed suicide long ago. Thank the gods I don't have in me whatever it takes to do that.

{By the way, speaking as a card-carrying, cauldron-stirring, broom-riding, born again (and again) Pagan Witch, I resent that comment in the text. Why not call those people exactly what they are?: insensitive assholes!!!}

I have one friend locally, but she is usually busy with her 2 small kids, & my church is 40 miles away & gas became too expensive for me to go. I can only rarely afford to call my 2 out-of-state friends.

WHY all this bitching? Because those of us who are poor (at/below poverty) don't have the resources to get the help we need and many end up as the addicts on the street (self-medicating). I am lucky because I somehow managed to get thru almost 4 years of Navy service and now, finally, am getting a small amount of help. Of course its the gov't: slow and cumbersome.

I would give almost anything to get some REAL help & become a truely contributing member of society, but every program I run across seemd geared toward kids/people with kids. Those of us who got lost in the system suffer deeply with frustraton & depression. It is truely horrible to feel cursed with brains. If I was stupider I wouldn't feel so bad. I wouldn't feel so jealous of people who have supportive, loving families.

At the same time I wouldn't trade the way I think for anything, even tho it took Welbutrin to give me a good "time sense", and I'm still socially inept (too honest!). When I had a place to be creative I did terrific things that people admired & I can zone out of depression by playing fum music & think of myself as dancing. Its just I would rather LIVE in the REAL world than just exsist in this dream world.

So tell me, where does a fat, middle-aged, poor single woman go for help? I'd REALLY like to know ***[sign: "will work for sanity"]***

none

In response to Kat, it sounds as if these issues are causing you to suffer a real and debilitating condition. Social Security can sometimes be of (some) help with SSI and medicare. When a person is suffering from a disability such as this they are often entitled to supplementary security income and medical benefits. Try contacting Social Security at 1 800 772 1213 and ask about applying for SSI. You will need to have a diagnosis from your doctor though if you cannot afford this you can ask them about getting assistance with your diagnosis. Look online at www.ssa.gov for more info. You can also look in your local yellow pages under "Human Services" or "Social Services" agencies. Unfortunately, as with any government service, the bureaurocracy can be relentless so stick with it!
Best of luck to you.

Stacey Turis

Dr. H, I love you. I love you, I love you, I love you. If I (and you) weren't happily married, I would marry you. Wow, wouldn't that be interesting? ;0 (No, it would be SCARY).
About 6 weeks ago, I came out of a 6-month slide (with an adult lifetime of 6, 8, & 12-month SLIDES under my belt). Let me tell you, I didn't know how I was going to make it. I was done. I couldn't imagine facing the rest of my life. I was so exhausted; I was ready to give up. Fortunately, I have kids and a husband and family that care for me. To be honest, the only thing that has kept me from taking my life, is not wanting to cause pain to those that love me. That's it. I just couldn't imagine putting them through that, so I kept on truckin'. One day, I was lying in my bed trying to make sense of my thoughts (of course), and I turned over with tears pouring out, and saw your book on the floor (that had been lying next to my bed since being diagnosed LAST October). Apparently I had stopped reading at the end of the chapter before the SPIN and SLIDE. I started reading, and I couldn't believe it. I could not f'ing believe it. You saved my life that day (figuratively and quite-possibly literally). I made my family read those chapters, and for the first time, they understood me. I am 34 years old, and for the first time I was understood. I can't explain (probably don't need to) what that felt like. It got me out of my SLIDE. Reading the story about the Mom that couldn't keep up with life was (and is) so painful for me to read, because it is my every day. And when I read that, I felt it. But it is also wonderful. It was so therapeutic for me that one day, I was responding to an email from a friend inquiring about my ADD. While describing the feelings of SLIDE, in my mind, I went away to the dead place. I had to feel it to describe it. When I really examined the pain (objectively since I was not actually in the "dead place" at the time), I had a sort of epiphany. It made me change the way I looked at life every day. Here is the email...
**********************************
This whole ADD thing has been a trip. The really cool part is there is now a nicely packaged, single reason for all of the things I felt were wrong...I have always told my mom "it shouldn't be this hard...it isn't this hard for other people...this isn't normal”.

I always felt misunderstood. I was always called weird (which I was totally ok with...weird is a compliment, I think), but I just didn't really understand what people thought was weird about me. I have a tendency to be anxious. I am completely overtaken by the moods of others. I procrastinate. I can't pay bills and keep track of finances, and have no emotional tie with money. I can't keep friends, except for those who have grown to accept me (and don’t try to change me). I don’t bond easily with people. I stress myself trying to help everyone. I'm constantly on a self-improvement plan. I feel nature in my bones. I get in a funk where I feel dead inside. I am easily overwhelmed. I don't like to be touched. The sound of a telephone makes me want to put my fist through a wall. I can have a horrendous temper and snap, but forget about it 5 seconds later. I have horrible word recall. I always forget what I'm talking about mid-sentence. I don't pay attention to getting to my destination when I drive, and have ended up in the wrong state more than once. I love animals so much it's often painful. I am emotionally and physically affected by the sadness and heartbreak of others. I can't watch TV. Overhead lights bother me. A ceiling fan on my skin makes me crazy. Smells can make me throw up. I can’t make casual conversation on the phone. I sometimes don't understand people when they speak (especially if they speak too fast), and have to read lips. I can't maintain eye contact during a conversation and if I try to, I feel like my eyes are going to pop out of my head. I "have no regard for safety", according to my husband. The list can go on and on and on...but, the beauty of it is, it all stems from one thing...ADD. That's it!

So now, instead of a billion-trillion things being weird and not-quite right about me...it is only one. I have only one thing wrong with me!!!!!!! Yippeee! The thing is, there is such mental anguish that comes from constantly TRYING to be organized, trying to be on-time, trying to be “with it”, TRYING to be a less loud and rowdy version of yourself, and just basically putting so much energy into trying to be a person that you PHYSICALLY CAN NOT BE (hold a gun to my head, and I get worse, not better), it slowly kills you. On top of that, there are such immense and painful feelings of self-shame...of being such a loser that "can't keep friends… etc." My self-talk is embarrassing…I would never speak to anyone the way I speak to myself. It doesn’t end there…you can physically feel the disappointment and frustration from others.
My mom is SO incredibly responsible. Before, learning about the mental challenges of ADD, I think it was hard for her to understand why I have such a hard time keeping up with everything. She was constantly trying to fix things, and saying things like... "Keep a notebook by your medicine so you can write it down when you take it". It is such a simple idea, keeping a notebook. That is just SO logical. Well, ADD isn’t logical! We have since learned that in the past, every time she gave me pointers, I would get so defensive and so angry with myself because she made it sound so simple, but for some reason, I couldn't do it. I would try to explain… "Mom if it was just a matter of being able to do it, I would do it!"
Now she understands, but she still forgets sometimes (well most of the time), and immediately steps in with a "logical solution" to my woes, but now, I just say "GEE MOM...WHAT A GREAT IDEA!" and then we giggle. What a difference. Now, I almost look forward to her hearing her little "logical tips", just so I can mess with her.
After all of these years, I am beginning to come to terms with my diagnosis of Adult ADD. I can appreciate my extra intuitiveness, creativity, and what I consider a pretty cool brain. I believe with all of my heart, that those with ADD have true gifts that need to be celebrated. I am even ok with the fact that after three years, I still can't remember which house is mine when I am pulling into the garage from the back (I do it daily). No, it’s isn’t the forgetfulness that gets me down, my personal struggle has always been fighting the anxiety and depression that seem to go hand in hand with ADD. Second by second, minute by minute, hour by hour... just waiting for something bad to happen. Well, that wasn’t really working for me, so I have decided to look at life with ADD differently. For instance, right now, I feel like I have a pretty good hold on my life. However, I am fully aware the bottom will come out and I will fall into the "dead place" again...probably sooner rather than later.

I think the key is knowing and also accepting that it will happen. With this brain disorder, I can't count on perfect mental health, but I can let go of that terrifying, exhausting feeling of "holding on for dear life" every second of every day. I have always imagined myself constantly walking on the edge of a cliff, trying desperately not to fall off. I have decided to change my perception of the way my life works…it doesn't have to be a stressful analogy like walking on the edge of a cliff. Why can't I have a peaceful analogy for my life? It's my life, and it’s my analogy, therefore I have decided to change it to the more Zen analogy of floating down a river.
The current in a river can be slow and steady or running pretty fast. White-water rapids are also pretty much guaranteed at some point in the river which means you'll be "holding on for dear life" while your raft bounces off of rocks, and you gasp and choke as you unintentionally drink gallons of river water.

Is that how normal people think? Of life's analogy more described as a river? Not ADD people. Because of the physiology of our brains, we get blasted from every direction (that's what it feels like, too...like a continuous attack, not only mentally, but physically. Smells, sounds, every sense is constantly being over-stimulated) every second of every waking day. That's why we feel like we are walking on the edge...we are just struggling to survive the day. When you add the juggling of life, you have to be pretty steady to keep your balance. That is sometimes more than we can handle. We panic, we drop the balls, and we fall. Anything seemingly minor can knock us right off the edge, but we struggle mightily to keep our balance, because if we fall, we will land in the dead place.

I wrote this about the dead place...
"The dead place is dark, lonely & suffocating. The voice from the dead place talks to me and tells me that I'll never leave, I'll be there forever or until I can't take it anymore and decide to "check out". I begin to believe it, because it is the only voice I hear. I can hear the faint cry from the other voices. The other voices are so far away. I can't hear what they're saying. I know they're trying to tell me something, but the voice from the dead place begins talking louder now. I get frustrated, straining painfully to hear the words of the other voices. After some time, the other voices give up, turning away in frustration. I have no idea they were trying to tell me to hold out my hand, that they brought a rope to help me climb out of the dead place. Since I'm not holding out my hand, they think I'm ignoring them. They don't know that I can't hear them, that their voices are mixed and jumbled. They have decided that I must like it in that deep, dark, dead place or I would hold out my hand.

My stomach flips as the dark, heavy fabric of their frustration shrouds my head, making it almost impossible to breathe, see or hear. The fabric starts to move, and slowly begins snaking in and out of my eyes, ears, nose and mouth, before settling heavily in my brain. Immediately, my senses begin to fade, and my vision is replaced with the mottled, gray-brown color of the fabric. My stomach jerks as I gag from the sickly sweet smell of it. Pain makes me recoil from the accusing heat of it burning my skin. I gag again as my mouth fills with the sharp, metallic taste of it. Confused, angry, embarrassed & hurt, I begin to mentally disconnect and disengage from the other voices, and their judgments. Doing so will prevent this pain in the future.

Afraid of suffocating, and as the feeling of shame becomes unbearable, I turn slowly back to face the dead place. Sadly, I realize I am more comfortable down here than balancing up on the cliff constantly surrounded by the other voices. I sigh, accepting the familiar sense of defeat and begin to listen to the unthinkable words of the voice from the dead place. I begin to forget about my “other life”, balancing on the edge of the cliff, and look for somewhere to rest my eyes. My energy is depleted, and it is too hard to stay awake. As the dead place senses its victory, it begins to whisper wickedly about hopelessness, loneliness, shame, guilt and defeat. An old movie projector noisily jumps to life. I watch with dread as images of every failed job, business, friendship, relationship, etc. begin to flicker by on the wall. On another wall, I watch a parade of faces of the people I've let down in my lifetime. I feel ashamed, and cry out from the sharp stab of hate I have for myself. Like a broken record, I begin to attack myself. If I love them, why do I let them down? Why am I like this? Why can’t I be normal? Why is this so hard for me? I realize with panic, I don't have the answers. I'll never have the answers. My throat tightens with pain, and I can't breathe. My heart responds by beating frantically. My stomachs pinches with tension and my hands start to shake. Gasping to get a breath, every movement becomes a struggle.

Remembering the words of the voice from the dead place, I slowly realize that I’m not strong enough (I must have been tricking myself into thinking I ever was strong) to endure this mental & physical torture for another second, let alone a lifetime.

At this point, I have two choices. I can either climb, bloody fingernail by bloody fingernail, back to the top of the cliff to my designated post of teetering on the edge, (knowing full well that I'll fall to the dead place again soon, and go through the nightmare again), or I can just kill myself...I know, it sounds pretty dramatic, but think about it...if I killed myself, I would never have to wobble on the edge of the cliff OR endure the eternal suffering of the dead place again.

My only problem with that scenario is that I just can't imagine that my purpose in this world is to live a constant, daily struggle for a lifetime of years just to end it by gagging down some pain pills and crapping my pants while the bodily gasses escape from my butt like loud popping noises. That's not really what I had in mind by "going out with a bang". I want to see what this was all for. I want to see it through till the end. It's the only way I'll ever know how strong I truly am. So, from now on, whenever I find myself in the dead place, I am going to choose the bloody fingernail route. When it comes down to it, I have decided I would rather go through a lifetime of my own torture than to put those that I I love through the pain of a self-inflicted "going out with a fart instead of a bang"."

See, isn't the river analogy better? Instead of standing on the edge of a cliff, waiting with dread to lose my balance, I am floating down the river drinking a cold beer. Yes, I know there will be some crazy-ass rapids hidden around the bend in the river, but I’m not putting this beer down until I'm drinking that river water.
**********************************
Yesterday, after fighting it for 4 days, I again fell into the dead place. I'm not really sure what sent me there. But this time, I knew what to do. This time I knew I would make it. I told myself the words you told me (in your book) to say. I told myself that here I am, but I'll climb back out, and it will be ok again. I told myself not to listen to my brain. I called my husband, and told him I was in the dead place, and that I needed help. He told me that he knew I was heading there, and even told me when I started falling. He asked me if I needed to get away, etc., and told me that we will work through it together. I felt better, but not great. I then called my mom. She told me that I am "doing too much...etc.". I had to get off the phone with her at that point because the kids were arguing, but the CRAZIEST thing happened. She called me back 5 minutes later, and apologized! I didn't know what she was apologizing for...she said because she was trying to fix things again. She said what she needed to be doing was helping me get through it instead of trying to fix it. When I told her that I hadn't even noticed, that I knew she was right, so I was just taking my beating, she said, "It wasn't meant to be a beating. I was trying to fix it. I was telling you that because I don't want you to keep making the same mistakes, but you don't need that, you need to get through this". I was floored. I thought, "WOW! ADD at its finest. No wonder we (ADD'ers) are so f*cked up! Here is my Mom trying to help me, and I am "taking my beating". How many times has that happened in my life? How many "beatings" can a person take before they hate themselves? How many "beatings" were by loved ones trying to help?" The fact that she recognized it, and apologized (with no prompting from me, since I didn't even see what was going on) literally catapulted me from the dead place, back to my little boat, floating down the river, with my cold beer in hand. I went from a 6 month SLIDE to a 6-hour SLIDE! Can you believe it??? I can't believe it. I haven't even told my Mom that I am out of it, because I'm afraid (of course) that it's too good to be true. But, I know I'm out of it. How can I ever thank you for this? It's not about you writing a book, Dr. H. - it's about you saving human lives. I really hope you remember that if you happen to land in the dead place.
Kindest Regards & Deep Gratitude,
Stacey Turis

M

I haven't read about SPIN until now and that's exactly where I'm at. Overwhelmed, cluttered and feeling disorganized no matter how much effort I put into not being so.
I've been working 9- 10 hour days with little time for myself or my family. I'm very tired and I'm in sixth gear trying to cope with everything. Burnout is right around the corner if it isn't already here. I cry alot when I get home.
I know that I can change this.
However,
I'm the boss at my job and my staff is relying on me to keep this place running.
We have a labour shortage where I live and I can't find anyone to work shifts so I'm working overtime to copensate.
This is NOT where I want to be but I feel so guilty for wanting to quit and find something better suited to my needs as a person and family member.
People are relying on me.
One lady told me that I made her job so much better by being there.
How do I deal with that?
I feel ashamed because I don't want to let these people down.
I'm letting myself down.
I'm exhausted.

I know I need time for play!
I know I need time to be creative.
I don't know what to do.

Dave

Really glad I saw this today. Thanks for posting it Dr. Hallowell.

Thom Mansen

Does anyone have any experience or advice relating to ADD in academia. I am an Associate Professor at the University of Utah and am trying to go for promotion to Professor. I was only diagnosed with ADD about 6 years ago, so most of my academic life has been affected by ADD without knowing it. Needless to say, I have not been able to meet the "stringent criteria" for scholarship for promotion. I have done may other things {surprise, surprise} but as far as being involved in long term research and getting multiple publications, I have not been able to engage in those activites. I know what I am up against, but I would appreciate it if anyone else has had any experiences in dealing with academia and their narrow perception of what scholarship and research are about.

Spirited Away

Dear Dr Hallowell,

thank you SO VERY MUCH for this article! You saved my life!


kim

My now 10 y/o son was diagnosed at the age of 4 by our school district with "Autistic Tendancies". He received fine/gross motor skills therapy for 1 year. Then at the age of 7 he was diagnosed by a professional with ADD with inattention. I have ALWAYS felt he was mis-diagnosed with ADD and showed many signs for Asperger Syndrom. I was hoping you could tell me what the difference is between the two disorders, so I can be certain he was correctly diagnosed. And if there was an online test you could direct me to to figure this out. Thank you for your help. Sincerely Mrs K Franzese

T

Hello, I'm spinning in the seventh circle of procrastinating hell this morning and came upon this blog. I really liked the SPIN definition/description, but have a comment/question. You wrote:

"Not only does shame hurt, it also is the chief cause of a huge problem in adults who have ADD, namely, the inability to feel good about their achievements. It is common for ADD adults to be all but impervious to positive remarks. Whatever they have legitimately achieved they feel must have been done by someone else, or by accident.

One of the main reasons adults with ADD can’t take pleasure in their own successes and creations is, simply, shame. They feel too ashamed to feel good. They feel too defective to feel nourished. They feel it is practically immoral to feel proud of themselves. Healthy pride is such an alien emotion that they have to look back into the dim recesses of their childhoods to find the last time they felt proud of themselves, if they can find an instance even then."

Is shame really a chief cause of "the inability to feel good about their achievements", or an effect that amplifies the cause of the problem? Maybe we are all but impervious to positive remarks or have difficulty feeling proud of ourselves simply because we're not generating enough dopamine in response in the first place?

Labeling shame as the problem seems analogous to treating the "underlying depression" when ADD is the core issue. Treat my ADD, give me enough alarm clocks/ reminders/ graphical organizers, etc., and I'll be the happiest person on the planet!)

...back after hours of self-education - Googling to you! - on dopamine to ask: is ADD possibly the result of a problem or uneven activity within the brain opioid pathway (which governs "liking" or feeling pleasure), which then influences the production of dopamine (the "wanting", motivation pathway)? If so then exercising makes a lot of sense - producing all those endorphins would have a positive effect on the production of dopamine.

Kathy

Hi Dr. Hallowell,

My family physician gave me your website and I've enjoyed reading up on ADHD. My husband and I have custody of our 7 year old grandson who has just been diagnosed with a "turbo brain". I ordered omega-3 capsules today and we are going to try a TSS worker for extra help in school. I feel very pressured by his teacher to put him on medication. What are your feelings about Ritalin and other ADHD meds?
Thank you, Kathy

Robin

Dr. Hallowell,
I think your website is cruel. How can you NOT be isolated if your ADHD prevents you from forming relationships?? Just because you desperately want them doesn't mean that people will accept you, or your ADHD!! You seem to think that just because someone wants something, they should be ENTITLED to have it, if they just want it enough. Nonsense. What about all those ostracized, isolated kids on the playground who desperately want friends, and are still isolated?
Your best self is who your are when the ADHD is at is least noticeable. I.E. when your meds are at their peak. Most people with ADHD are unbearable without them, myself included. Is that 'negativity'? NO it's a FACT!! Just like ADHD is absolutely NOT a gift. It's a disorder, an impairment, no different from any other developmental affliction. If your fortunate enough to have spent THOUSANDS of dollars on therapy and treatment, you might find ways of adapting to your impairments. And that's what the therapy is for!! Adaptation!! Learning how to adapt to the world, and be as 'normal' as possible. Most of of will not be so fortunate as to be a CEO, or rich enough to afford extravagant therapy fees. So us 'poor people' will have to make do with medication. I'm not sorry for myself, or expect anybody to take care of me. Like so many with ADHD, we have to learn to get by without social support, since websites like these continue to spout the 'rubbish' that there's nothing wrong with us. So we become lonely, begging someone to tell us what we're doing wrong. DON'T ASSUME WE HAVE FRIENDS.

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Alissa DiRubbo

Hello

I really need some help. I have had LD/ADHD all my life. I managed to get an MLS degree while working as a library assistant.

I've been working at a small academic college for almost 2 years. I teach, and peform librarian duties. I managed to keep things together and multi task

The problem is that my boss is an overachiever and works 24/7 at home and work. Now she has given an assignment where we have to write annotations for all online library resources by next wed. She knows I have LD/ADHD but she doesn't care as long as she can volunteer for all these projects. I just cataloged all these faculty textbooks and she still doesn't like it. I am trying to find another job, but there are none right now. I feel like crap and do not want to go back tomorrow.

I try very hard to multi-task, but I cannot stay up every night until 3 or 4 in the morning and go to work at 8:30. Kudos to those who can, but I cannot. Maybe I should just quit my job and go work in consolidated industries for the disabled.

Any suggestions for how to handle this?

Katherine Schlem

Dear Dr. Hallowll,

Thank you so much for your book, Delivered from Distraction. I"m a dual diagnosis Bipolar II/ADHD - Inattentive Type. I have been under treatment with Wellbutrin SR, Lithium and Xanax for about a year now. About three months ago, my wonderful psychiatrist allowed me to start Strattera. I recently went back for a follow-up armed with your book and we have decided to add the Amantadine used by Dr. Singer as an additional therapy. All I can say after about 1 week on this combination, I feel better and have more energy and more organization than I ever have before. I finally have motivation to get work done and this says a lot as even in my manic phases at tims, I felt so lethargic I could barely pull myself off the couch. So thank you Dr. Hallowell and also to your friend, Dr. Singer. You may have saved my life and my marriage and made me a mother to be proud of.

Sincerely
Katherine Schlem
Also, feel free to contact me if you would care to.

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