Coping with AD/HD

Attention-Deficit/Hyperactivity Disorder frequently appears in news stories as an affliction of children. But adults with the learning disability often remain in the shadows.

Since childhood, they've slipped through the cracks. They were the restless and disruptive boys in class -- the ones who couldn't sit still; or the dreamy, spacey girls who never seemed to pay attention.

AD/HD affects 3 percent to 7 percent of school-age children and between 2 percent and 4 percent of adults, according to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Some experts say that figure is as high as 10 percent.

"It's not just 'kid stuff'. AD/HD carries with a higher prevalence of traffic accidents, job loss, under-employment, failure to finish college, bankruptcy, absentee parenthood and divorce rates," notes Gina Pera, coordinator of Silicon Valley CHADD.

But adults with AD/HD can gain control of their lives with help from medication, counseling and adaptive learning. Beginning Sept. 20, Silicon Valley Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) will host the three-part "Solutions Clinic for Adults with AD/HD," taught by long-time AD/HD coach Frances Strassman. The clinic is designed to help adults with the disability learn to focus attention, improve commitment and manage time.

Strassman was diagnosed with Attention-Deficit Disorder 14 years ago while in her 50s, but she has had problems throughout life, she said.

In school, Strassman had erratic grades, ranging from As to Ds. Although she tested high in aptitude, her retention was poor and she had no sense of time. Distracted, Strassman was constantly losing her keys or wallet.

"I've described my life as walking on a mine field. I didn't know when things would blow up. It affects your self-esteem. You keep bawling yourself out. I would say, 'What's wrong with me? I've missed the last four dental appointments? And the doctor says I have to pay for it,'" she said.

Strassman became immersed in Eastern philosophy and studied with a Taoist master, who taught her a sense of order, she said. She went to an educational psychologist at the College of Marin and enrolled in the disabled students program. When she was diagnosed with AD/HD, Predominantly Inattentive Type (meaning without hyperactivity), she took computer classes designed for brain injury survivors. The classes incrementally increased her focus and improved her memory, Strassman said.

She now coaches people with AD/HD. Her clients include doctors and lawyers -- people whose work depends on focus and attention to detail, she said.

Matt Richardson, a Silicon Valley business analyst at Cisco Systems, plans to attend the Solutions clinic. A tall, affable man with gentle blue eyes, Richardson, 31, was diagnosed with AD/HD only two years ago.

As a child, Richardson was called "hyperactive." He could read a couple of pages in a book, but couldn't remember the content. He couldn't remember people's names and he had trouble prioritizing things.

"Everything gets the same amount of attention. ... I couldn't figure it out. When it came to fulfilling requirements, I couldn't concentrate. Socially, I was trying to understand what people want from relationships," he said.

The biggest change from being a child to becoming an adult was an utter loss of structure: "I went from a structured school day in high school, with times to meet friends, to one that was totally unstructured in college," he said.

Richardson's inability to focus and concentrate made it difficult to join study groups. He eventually dropped out. He went through 15 different jobs, becoming bored after only a few months, he said.

Two years ago, he enrolled at Foothill College. He was eventually tested and found to have AD/HD.

"The biggest challenge is identifying yourself as having a disability. I now see that it was more than being a wild kid."

The causes of AD/HD are not definitive, according to Pera. Research points to a neurobiological cause primarily manifesting in the brain's prefrontal cortex -- the "executive center" in charge of strategizing, planning and delayed gratification.

Contrary to popular views, it isn't caused by excessive sugar intake, food additives, television or poverty and family chaos. AD/HD is highly inheritable. A parent often has the disability, but hasn't been diagnosed. Other factors, such as difficulties during pregnancy prenatal exposure to alcohol and tobacco, significantly low birth weight, and excessively high body lead levels are risk factors for AD/HD.

Many adults and their partners don't realize they have AD/HD, attributing the problems to personality, she added.

At Foothill, in accordance with the American Disabilities Act, Richardson got tutors, extra time for tests and a quiet work environment. A computer that turns text to speech helped him process lessons.

But he still faced misunderstanding about his disability -- something that makes many with AD/HD keep the problem hidden from colleagues and employers.

"People don't realize the sense of isolation. It's a very risky thing to self-identify. When do you do it -- during a job interview? It's seen as a weakness. ... It's very easy to categorize people when they have a disability," he said.

Some professors balked at giving him extra time on tests, which they considered cheating. But Richardson pointed out that since it takes people with AD/HD so much longer to focus and take a test, the extra time "just brings (people with disabilities) closer to a fair playing ground."

He also began taking Ritalin, a stimulant often prescribed for people with AD/HD. It took just 30 minutes for the medication to kick in and change his life.

"It was like being at the optometrist's and flipping through the lenses. With AD/HD, it's like looking through the cloudy ones. When you're on the medicine, it's like you've suddenly flipped to the clear lenses, and you have 20/20 vision," he said.

He cautioned the drug can have drawbacks, especially for people with depression, which is common among those with AD/HD.

"Your experiences aren't changing, but they can get magnified. It enlarges and focuses issues a lot faster than you are ready for," he said.

Richardson has stopped criticizing himself and started reading more. He has learned coping skills, such as taking copious notes. Writing helps him focus.

At work, he kept his disability hidden. One day, a co-worker joked, saying she was having an ADD moment. That is when he realized he wasn't alone.

"With a ton of compensation and coping skills, you can look and feel like the average person," he said.•

The three-part Solutions Clinic for Adults with AD/HD takes place Sept. 20, Oct. 18 and Nov. 15 from 7 to 9 p.m. and at The Friends Meeting House, 957 Colorado Ave., Palo Alto, in the large building at the back of the property. Fee is $5 per session for CHADD members; $10 per session for nonmembers. Cash payments for all three sessions are $10 for CHADD members and $20 for nonmembers. E-mail [email protected] For more information on AD/HD visit www.CHADD.ORG or www.help4adhd.org. For information on Frances Strassman, visit www.morethanorder.org.