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Adult Attention Deficit Disorder
Trouble
completing important tasks and projects?
Performing below
your potential at work or school?
Too stressed,
disorganized and overwhelmed?
Safe non-addictive
medications improve concentration, memory and motivation by 80%
• Almost no side-effects from medications
(when properly prescribed)
• Better emotional stability: less irritable,
more patient, less depression, anxiety or worry
• Remove that feeling of
being overwhelmed and disorganized
• Better job performance; career
advancement; more money
• You won’t feel “weird” or like a “zombie” –just
feel more “normal”
• Better interpersonal relationships at work and at
home; become better liked by family and acquaintances
I've been evaluating and
treating Adult ADD for the past 25 years. I have the most experience in treating
ADD of any physician in northwest Arkansas. Click
here now if you already know that you want an evaluation for ADD. If
you want lots more information about Adult ADD and its treatment, please keep
reading!
Recent studies estimate that
about 4% of adults suffer from ADD—one adult in every 25. Adult ADD is about as
common as asthma or diabetes.
Adult ADD causes difficulty
starting or finishing tasks that are important but non-entertaining.
This is the only required symptom for the diagnosis of ADD. What types of tasks
are important but non-entertaining? Laundry, college term papers, expense
reports, fix-it projects around the house, tax reports, and any type of
paperwork are all examples.
Now, I'll describe other
symptoms that are often--but not always--present in adults with ADD. However,
please keep in mind that even if you don't have any of these other problems
I'm about to describe, you can still have ADD. Remember: the only required
symptom is difficulty starting and completing tasks that are important but
non-entertaining. With that emphasized, I'll now describe other common symptoms
of adult ADD.
With ADD, you tend to
procrastinate tasks that are tedious, even if you know that you should
begin them sooner. Adults with ADD put off tasks until the last possible minute,
and then have to rush through them. Sometimes projects are turned in
late.
Even after beginning a task,
adults with ADD become distracted, lose concentration and start doing
something else of less importance. Suddenly, they realize that much time has
been "wasted" when they intended to work on an important (but tedious) project.
Some adults with ADD have more automobile accidents because they become
distracted while driving.
Paperwork tasks
are usually the most difficult for adults with ADD to start and complete:
writing reports, balancing a checkbook, paying bills, organizing tax information
or expense reports. Reading is also difficult (except for some types of
pleasure reading). Many adults with ADD confess that they hate to read, and that
they never read books if they can avoid it. They find that they have to re-read
the same paragraph several times to retain what it says. They'll suddenly
realize that while their "eyes have been reading" their mind has been far away.
Forgetfulness is
frequently a problem with ADD: losing car keys, important papers, forgetting
appointments or assignments. Sometimes assignments are completed on time, but
the person with ADD forgets to turn them in!
Inattention to
conversations is another frequent problem with ADD. The person finds that he
has no idea what someone has just been saying to him. He finds that he can't pay
attention to meetings and lectures, and has great difficulty taking notes.
Spouses sometimes complain that he's not "really listening."
Excessive boredom is another frequent symptom of ADD. Activities that
most persons would find mildly boring, are intolerably boring to the
person with ADD. In fact, projects that start out interesting, become boring to
the person with ADD "as soon as the new wears off." This is one reason that the
person with ADD begins lots of new projects, but often does not complete
them. New hobbies, room redecorating, yard projects are all begun in earnest,
but soon lose their appeal and are left incomplete.
Impatience often
accompanies boredom. This impatience can cause the person with ADD to be too
interruptive in conversations. And the adult with ADD sometimes becomes
too irritable when delayed or frustrated. In some adults with ADD (not
most), this irritability results in anger outbursts. In fact,
some adults with ADD are very despondent when things are not going their way,
and are overly elated when things are going their way. Their emotions go
from extremely "up" to extremely "down" in just a matter of minutes (this is
called "emotional volatility"), depending on how things are going for them.
(Sometimes this leads to their being mis-diagnosed as having Bipolar
Disorder.)
Some adults with ADD (again,
not most) are very fidgety and have a hard time sitting still through
conversations, meetings, or movies. They feel an urge to be up and moving almost
constantly. Fidgetiness may be as mild as constant shaking of a foot, or so
severe that a person can't sit down. Often these adults were very hyperactive as
children.
You now know the most common
symptoms of Adult ADD. Click here now if you
already know that you want an evaluation for ADD. If you want lots more
information about Adult ADD and its treatment, please keep reading!
Of course, all these ADD
symptoms cause problems in life. The more severe the ADD, the more life
problems it causes. Most adults with ADD don't have all the following
problems.
Tasks in school, at work, and
at home are left incomplete, or are rushed through at the last minute. Rushing
through tasks, and being distractible while working on them, often leads to many
careless errors. This results in lower grades in college or poor
quality work on the job. Time is wasted correcting the errors. Re-doing
tasks leads to a longer workday and to increased stress. Performance reviews may
be lower, and promotions and pay increases may be held back. Relations with
bosses may be damaged.
Problems with bosses lead many
adults with ADD to become self-employed so that they are not immediately
accountable to anyone else for their work performance. They may shift toward
occupations in which punctuality is less essential. Of course, even when
self-employed, careless errors and putting off tasks hurt performance and,
ultimately, reduce income. Also, the paperwork required to run a small business
is difficult for adults with ADD to complete. Tax records can be especially
difficult and can lead to serious financial problems.
Continuing education is
difficult for adults with ADD. Nowadays, everyone needs to update work
skills frequently; technology and job requirements are changing very quickly in
our modern world. Continuing education may involve formal coursework, or it may
simply involve lots of technical reading and self-study. In either case, the
adult with ADD has a hard time paying attention to lectures, or reading
textbooks, or doing the homework involved. This means that as time goes by, the
adult with ADD is less and less up-to-date in skills and able to earn less
income.
Often adults with ADD tell me
that school was difficult, especially in the upper grade levels and in college.
Many were labeled as “under-achievers.” (Many adults with ADD did OK in school
because they never had to study and took easy courses in college—but even they
admit they could have done much better if they had “applied” themselves.)
Some adults with ADD did very well in certain classes that they found very
entertaining or interesting. For example, one particular adult ADD patient
generally made Cs and Ds but always made As in science classes.
Keeping up with household
tasks is difficult for adults with ADD. Laundry piles up, bills go unpaid,
mail goes unopened. Yard work and fix-it projects are left incomplete. Adults
with ADD start these tasks but find themselves wandering away from them before
they're finished. They go from task to task, finishing nothing in a timely
manner. Many common tasks are simply forgotten: picking up clothes from the
cleaners, returning a library book, and the like. This causes increased
expenses, hassles and stress.
Hobbies and projects are
started and abandoned by adults with ADD. They feel initial enthusiasm for a
new project or hobby. Soon, however, boredom sets in and the project or hobby is
left incomplete. Some patients tell me they literally have a dozen unfinished
projects around the house.
Getting to appointments on
time is difficult for some adults with ADD. They tend to forget appointments
or they get distracted when getting ready for an appointment. They may no-show
for the appointment, or they may run late. Lack of concentration and lack of
attention can reduce their awareness of the passage of time so they don't know
until the last minute that they're running late. This can even be a daily
problem in getting to work on time.
Conversing with others
can be a problem for adults with ADD. They can't pay close attention to what the
other person is saying; their mind may even completely wander away for minutes
at a time. They may also interrupt too much, unable to restrain themselves when
they want to say something. Some adults with ADD lose their train of thought
when speaking and ramble from topic to topic. These problems can cause others to
become irritated with them and even to avoid talking with them.
When adults with ADD have poor
impulse control, they say or do things too hastily. They may spend too
much money on something they suddenly desire. They may "tell off" someone who
irritates them. They may suddenly quit a good job because they're bored.
Needless to say, this impulsiveness damages finances and relationships with
family, friends, co-workers, and bosses.
Emotional volatility, when
present, also damages relationships. The adult with ADD can "go from fine
to furious" in a matter of seconds; and then may be fine again a few minutes
later. Unfortunately, others are left hurt, angry, and confused for hours or
days.
Statistics confirm that
adults with ADD have more problems in life: In college students with ADD, the
graduation rate is only 5% (vs. 35% in others). In the world of work, 55% of
adults with ADD are fired (vs. 23% of others). Work supervisors rate adults with
ADD as more oppositional and as having lower work performance. Adults with ADD
change jobs twice as often as others.
Untreated,
adults with ADD have 3 times as many sexual partners as others, and stay with
each romantic partner for less time than others. 54% of adults with ADD do not
have custody of their children.
Untreated, adults with
ADD are much more dangerous when driving: 40% have had 2 or more crashes (vs. 6%
in others) and more than 3 times the number of crashes with injuries; they have
3 times the citations for speeding; 23% have had their driver’s license
suspended (vs. 5% of others). Substance abuse is also higher among adults with
untreated ADD.
You now know most of the
symptoms of adult ADD and the common problems in life caused by ADD.
Click here now if you already know that you
want an evaluation for ADD. If you want lots more information about Adult ADD
and its treatment, please keep reading!
Now, let me briefly discuss
“normal” attention and concentration. Normally concentration and
attention are held by tasks that are important as well as by tasks
that are entertaining. So things like writing a term paper for an important
class, paying the bills, or reading a chapter in a technical book needed for
work should hold our attention quite well. Of course, like all human abilities,
attention and concentration are never perfect and are subject to overload and
fatigue. But normally this is only an occasional problem, not a daily issue.
Normally, inattention, distractibility, and poor
reading retention should not be daily problems that hold you back in
school, at work, or in accomplishing things around the house. When these are
daily problems, ADD is the most common reason.
Clinical depression and anxiety disorders can also cause problems with attention
and concentration. In these situations, however, the more noticeable problem is
the depression or anxiety; the inattention is a secondary symptom and goes away
when the depression or anxiety is treated. (Individuals with ADD often develop
depression and anxiety in adulthood—probably due to increased life stress, and
perhaps due to an underlying biochemical vulnerability related to their
ADD.)
The National Institutes of Mental Health studied
the diagnosis of ADD, and concluded that it is a completely valid medical
problem and can be accurately diagnosed by specialists. The American Medical
Association concluded that the diagnosis is valid, and that most individuals
with ADD are never diagnosed or treated. The American Academy of Pediatrics
agrees that medications are the most effective treatment. The American
Psychiatric Association has created criteria for diagnosis that all medical
organizations accept as valid. ADD is definitely not just normal inattentiveness
or “laziness.” Willpower, attitude, and upbringing seem to have little or
nothing to do with it. ADD is clearly a medical disorder with a definite medical
treatment.
All evidence points toward
problems in the circuits of the brain called the executive function
circuits. These are circuits composed of brain cells that go from the center
of the brain (known as the mid-brain) to the front sides of the brain just
behind the eyebrows (known as the prefrontal cortical area). These circuits run
mainly on the biochemical dopamine. Circuits that go from the mid-brain
to the frontal cortex (just behind the upper forehead) are probably also
involved in executive functions. Other dopamine-controlled circuits, the
nigrostriatal pathway in the central area of the brain, are probably involved in
hyperactivity. [David: INSERT DOPAMINE CIRCUIT PHOTO (with caption)
HERE]
These circuits are called "executive" because
they help us manage the day-to-day details of an organized life—things that come
under the heading of work tasks. These are tasks that are not associated
with much excitement or pleasure. Short-term memory, concentration, ability to
ignore distractions, and motivation to start work are all executive functions.
(Activities that are pleasurable and fun--e.g. video
games--engage different brain circuits. Individuals with ADD usually have no
problem concentrating on pleasurable activities.)
In
adults with ADD, the problem in the executive function circuits involves the
brain chemical dopamine (and to a lesser extent norepinephrine). Studies show
that individuals with ADD have less dopamine functioning in their executive
function circuits. Dopamine is one of many brain chemicals, called
neurotransmitters, that flow from one brain cell to the next in a
circuit, much like electricity flows in a computer circuit.
The problem with dopamine seems to be caused by
genetics in most cases of ADD. The disorder runs in families very
strongly. Usually, if one member of a family has ADD, at least one other member
can easily be identified as having the same symptoms. If a parent has ADD, each
of the children has about a 25% chance of having ADD.
In some cases the dopamine problem in ADD is caused by non-genetic factors.
Maternal smoking or street-drug use during pregnancy can cause ADD. Problems
during delivery can cause ADD. Lead in the environment can cause ADD. Severe
head injuries can cause ADD. But, again, genetics is by far the most common
cause.
You now know most of the symptoms of adult
ADD, the common problems in life caused by ADD, and the probable causes of
ADD. Click here now if you already know
that you want an evaluation for ADD. If you want lots more information about
Adult ADD and its treatment, please keep reading!
Whatever the cause of ADD in
any particular case, the most powerful treatment is medication to
increase the functioning of brain dopamine. Experience has shown that
non-medication treatments such as counseling have almost no effect on the
symptoms of ADD.
Most ADD medications act by
increasing the level of dopamine in the synapses between nerve cells,
where they communicate. This increase in brain dopamine improves virtually
all the symptoms of ADD.
There is a lot of
controversy about ADD medications: Are they addictive? Do they have dangerous
side effects? Are they safe in children? ADD medications have been in use since
the early 1930s. All the evidence is that when taken as directed they are
safe and are not addictive. The medications are safe in children, and
even in elderly adults. Their side-effects are minimal—some reduced appetite is
common the first few weeks.
Currently, the two
most popular medications for treating ADD are Adderall and
Concerta. Both raise brain dopamine levels in the synapses where brain
cells communicate. Adderall is the most successful ADD medication on the market
right now, with Concerta a close second. These medications are taken once or
twice a day, five days per week. (If used seven days per week they quit working
in many individuals.)
Strattera is a new
medication for treating ADD. It raises norepinephrine more than dopamine. For
this reason, it is less powerful than Adderall or Concerta for most patients;
however, it can be taken 7 days a week. Ritalin, Dexedrine, Cylert, clonidine,
Risperdal and Tenex are other medications sometimes used in treating ADD.
What can a person who has ADD expect from taking
Adderall or Concerta? Usually within about 30 minutes thinking is
“clearer.” Thoughts are “less jumbled.” There is a feeling of wanting to
start tasks that are important. There is less boredom, and it’s easier to finish
projects. Thoughts are well focused and distractions are less of a bother. It’s
easier to remember what you need to do. It’s easier to keep your mind on what
you’re reading—and to remember what you’ve read. Conversations are easier to
follow and to remember. However, there is no sense of the medication changing
your "personality."
Most patients report that
their concentration and ability to stay on-task are improved by at least 80%
with the medication.
About every 5 years you should
taper off the medication for a month or so to see if you still need it. However,
the medications are safe to take life-long if needed, and I’ve had 80 year-olds
who took them without problems.
Should you seek an
evaluation for adult ADD? Here is the most important question to ask yourself:
“Do I have problems starting and completing tasks that are important but not
entertaining or interesting?”
If you see a
pattern throughout your life of neglecting, procrastinating, rushing through at
the last minute, leaving incomplete tasks that should have been done sooner and
better—then you need an evaluation for ADD.
Treatment
for ADD will mean better organization, less excess time spent at work, better
career advancement, fewer hassles due to forgetting appointments and tasks, less
cramming at the last minute, easier learning. You’ll feel less overwhelmed and
more in control of your life. For many individuals with ADD treatment will mean
less depression and anxiety, and better relationships with spouse, boss,
customers, and coworkers--and a higher income.
Come
see me for an evaluation appointment. An interview is usually all that’s
needed to make the diagnosis and start treatment. Only rarely are other tests
required. Treatment usually involves simply taking a safe medication; counseling
is rarely needed. You can usually start treatment (and see improvement) within
24 hours of your first visit. Follow-up appointments are only once every few
months once we find the right medication and dose for you.
I am board-certified, and am on the teaching faculty of the
University of Arkansas medical school (not associated with this
service). I have the most experience in the evaluation and treatment of
adult ADD of any physician in northwest Arkansas—in fact, only a handful of
physicians in the entire US have as much experience as I have. My success rate
in treating adult ADD is well over 90%. This means that you have the best chance
of getting the right diagnosis, the right treatment, and the best
outcome—without wasted time or money. (A recent Blue Shield/Blue Cross survey
showed that my patient care was among the most cost-efficient in the
state.)
Customer service at my clinic is the very
best—including very short waits at appointments. You always have easy access to
me personally via e-mail or phone. Satisfaction rates on our patient surveys are
nearly 100%. In fact, I give a 100% money-back satisfaction guarantee!
You really can't lose!
You now know most of the
symptoms of adult ADD, the common problems in life caused by ADD, the probable
causes of ADD, and its treatments. Click
here now if you already know that you want an evaluation for ADD.
To read actual patient
testimonials about Adult ADD and its treatment at my clinic, please keep
reading!
Andrew Alder, Lowell,
AR
“I am a college graduate and my
problems started around 4 years ago, or that I really noticed a problem. My
grades were always real good but when I got to college and at the end of high
school, they just started slowly declining.
“I really
couldn’t concentrate on tasks that I wasn’t interested in. This was fine in high
school because the tasks were so easy and didn’t take any time at all. When I
got to college, I would hate reading. I would try to start a chapter but could
never finish anything. This really caused problems with my
grades.
“I also noticed problems getting involved with
any extra activities like intramural sports or working out, which I used to
enjoy. I played basketball and ran track in high school, but seemed to lose
interest in college. It’s like I really wanted to get involved but, when it came
down to it, I didn’t get motivated enough. I always seemed without energy and
sluggish.
“Now that I have graduated college, I work
at a company as a computer programmer and I have tons of boring paperwork to do
all the time. I had a hard time getting it all finished before the review of the
project took place. This started affecting my performance reviews at work. I
would always procrastinate and try to finish all the boring paperwork at the end
of the project.
“[Treatment at Tate Healthcare
Specialists has been] so far, so good. I am in the process of finding the right
strength of medication that fits me, but the medication works great. I stay
focused on any task that I start. I feel more energized and confident in my
work. I have also joined a gym to get back in shape. I like how the medicine
started [working] right away, and not 2 or 3 months later.”
Blake
Gross, Tulsa, OK
“I had difficulty in
[college] class work and performance. I often got bored and had to have other
things to keep me busy.
“[At Tate Healthcare
Specialists] I noticed that I did not have to wait (sometimes feels endless in a
doctor’s office) to see the doctor. The doctor was helpful, nice and
professional. I was a little nervous at first but the doctor made me feel
comfortable.
“[With medication treatment] it was hard
to sleep at first but I adjusted the time that I took medications and corrected
the problem. I am now taking 20mg in the morning and 10mg in the
afternoon.
“I am able to pay attention in my
3-hour-long classes. They now have started to be more interesting and they go by
a lot faster. I feel that I have gotten involved in my classes and my
participation level has gone up.”
Frankie Kelley, Bella Vista,
AR
“I was unable to manage several
areas of my life, including balancing my checkbook, remembering appointments,
finishing any significant task or project, and was suffering from depression
(consequently).
“My visit was painless; I felt very
comfortable with Dr. Tate, who was quite understanding and professional. The
atmosphere was relaxing and comforting. I opened right up about my
issues.
“The medicine prescribed has made a tremendous
difference in the quality of my life. I am experiencing successes in areas that
I have never been able to manage.
“I am more able to
focus on the present, and on the task at hand. I have an easier time remembering
my priorities, not to mention my appointments. I am feeling more confident and
successful (as a result)."
Alarie J. Brown, Fayetteville,
AR
“I was
diagnosed with ADHD as a kid, but had gone off my medication for college,
believing I’d ‘outgrown’ ADD. When I moved to Fayetteville, I realized my
symptoms hadn’t stopped with maturity but had instead changed a bit but were
very much still a part of my life. I was having difficulty in school and with
juggling work and cleaning my apartment so I started looking for someone
knowledgeable about adult ADHD. I saw a bulletin for Dr. Tate and called for
more information.
“I wanted to be careful to go to a
specialist so as not to be treated improperly. I was also noticing I’d been
depressed a lot over the transitional years of college, and had never addressed
it.
“They [Dr. Tate’s staff] sent me a health form
where I listed symptoms I’d been having and rated on a scale of 1-10 how severe
they had been. Then I sent it back and they called to schedule an appointment.
“I met with Dr. Tate for about 45 minutes the first
appointment and we went over why I was there and my treatment options. I was
very comfortable knowing Dr. Tate was well qualified to treat my ADHD. We
discussed the latest medications available and adjusted them to my condition
specifically. I felt like I was in the right place.
“The treatment has been great. For the first time I feel structured and put
together . . . ‘normal’ even! We worked with many different medication
combinations and Dr. Tate was very good about listening to new changes or
adjusting my medication to reduce side effects. I have been able to eliminate
medication for depression symptoms entirely and have used diet and exercise
instead.
“My ADHD will be with my for my life, but it
isn’t a hindrance any longer and being educated about what to expect is so much
easier than being in the dark and feeling ‘different’ from everyone else out
there.
“Dr. Tate even discussed treatment options
with me about pregnancy, when I’m ready. It helps me to know there is always
help if I need it for possible post-partum depression in the future. Discussing
the possibilities of what my ADHD or depression will do in the future is a
relief compared to going through unprepared for changes.
“I am very pleased with the help I’ve received at
Tate. I can honestly say it is so hard to find specialists on ADHD or
depression, really. I’ve lived in 3 different states over the last 7 years, and
this was a blessing to be able to have treatment so accessible.
“Having ADD, and going untreated, life gets so
overwhelming. But the clarity you find in treatment makes you wonder why you
waited so long to get that peace of mind. You realize all the wasted time you
spent thinking of the stigma of having ADD, when you could have been enjoying
your life to the fullest!”
Becky Ryan, Westville, OK
“[I had] depression, inability to concentrate,
poor memory, anxiety, restless sleep, bulimia, mood swings, major chronic
fatigue.
“[Dr. Tate was] Very understanding and
willing to help. Very familiar with all my problems. Listened to my problems and
didn’t push me away.
“[Treatment has been] Excellent!
Finally received a medication that actually helps me. This gives me more hope
for future outlook and plans.
“Most of the symptoms
listed above have either majorly decreased and some have completely disappeared.
Will be able to be more secure about attending nursing school now, and
succeeding.
“I highly recommend getting treatment if
necessary. They are there to help.”
Get for yourself the same
kinds of improvements these patients describe: better organization, better
performance at work or school, higher income, less stress, better relationships.
The small financial investment you’ll make will be rewarded many times over.
So act now. You can
Do it today. I’m
looking forward to helping you lead a more successful and fulfilling
life!
Jeffrey L. Tate, MD
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