Adult ADHD in focus
Attention deficit hyperactivity disorder is a condition that can be accompanied by other issues like depression or substance abuse
By Sarah Garrecht Gassen
ARIZONA DAILY STAR
Tucson, Arizona | Published: 01.10.2006
At the end of each workday, Christine Salvesen gathers what she's accomplished for the day, prepares everything she has to tackle the next day and puts the papers in a drawer in her spotless University of Arizona office.
The next morning, she takes out the materials, reviews what she has to do, organizes her extremely detailed to-do list and gets started on work as assistant director of the UA's Disability Resources Center.
The routine keeps Salvesen, 33, organized, which for her is a matter of necessity. Without precise organization, Salvesen said, she gets off track and forgets important deadlines and tasks. "It gives me a sense of control when I come in and my office is organized."
Salvesen was diagnosed with attention deficit hyperactivity disorder, or ADHD, as a sophomore at the UA.
Some research suggests that 4 percent to 5 percent of the adult population meets the diagnostic criteria for one of the four types of attention deficit hyperactivity disorder, which are broken down in the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders," said Tucson psychologist Karl Sachs.
"Most of the people I'm seeing are coping with ADHD and a lot of things that go along with ADHD, like depression," he said. "Sometimes when people come in for counseling, it could be for all the life problems that go along with having ADHD, like failed relationships, vocational problems and substance abuse."
What are commonly referred to as attention deficit disorders can manifest in problems with inattentiveness, such as difficulties focusing, keeping track of time or processing information, while other people lean toward more hyperactivity. Others are affected by both.
ADHD is often thought of as a kids' disorder, because many symptoms show up during the school years. And for a while, it was assumed that people just outgrew it, because sometimes symptoms would change or subside. But now some experts think symptoms show up in other ways — think about how different a classroom or a playground is from a job.
Research indicates it's an organic neurological difference in how a person's brain develops, and it may change but likely never goes away. In fact, 85 percent to 90 percent of cases in which a person is affected by ADHD are genetic and "have nothing to do with child-rearing," said Kevin Blake, Ph.D., a Tucson psychologist whose specialty is adults with learning disabilities, autism or attention disorders. He offers a general description of people with attention deficit disorders as "reliably unreliable."
And if you have one parent with ADHD, there's a 50 percent chance you'll have it, too, Blake said.
Salvesen said that, as a young girl, she was constantly kept after school for talking in class and marked down on her report card for bad citizenship. Looking back, she sees the obvious pattern, but her teachers never took her parents aside and suggested she be evaluated for attention deficit disorder. She was always a good student and built up compensation skills.
Now she helps herself stay focused through organization and by drinking several cups of coffee and tea each day, because she's found that caffeine has a calming effect on her system. "For me, it works."
Other people with ADHD use prescribed medications, therapy or both to manage their health. Sometimes, medicines that are effective when you're a child aren't as effective in adulthood, experts say, so finding the right balance and mix of what works is important.
People with ADHD are more likely, as a group, to try risky behavior and sometimes, trying to self-medicate with illegal drugs is part of that.
"It can be difficult for some people, and some who have ADHD do end up as substance users as an attempt, I think, to cope," said Sachs.
Salvesen writes everything down in notes and keeps a detailed calendar because if she doesn't, she forgets. "It's natural to me; it's my way to compensate and cope with so much information."
Some of the behavioral traits of people with attention deficit disorders can wreak havoc in a work situation. Inability to focus, meet deadlines or remember to do tasks aren't usually considered great work habits. Also not desirable is blurting out the sometimes-inappropriate and snarky comments we all think during boring meetings.
People who have difficulty with hyperactivity and impulse control often have a hard time keeping those thoughts to themselves — and then wonder why other people are mad at them 20 minutes later because they've already moved on, said Blake.
But that doesn't mean that people with ADHD can't be talented, creative and valuable employees, said Carol Gignoux, who consults and lectures about ADHD issues and also coaches people with attention deficit disorders one-on-one.
She wants to get that message to corporate America and help employers understand that, with some often minor accommodations, like clear expectations and instructions, people with ADHD can flourish. She's also convinced that many CEOs and entrepreneurs likely have some kind of attention deficit disorder, because they're frequently risk-takers, think differently and are always on the go.
"They tend to be people who are a little quirky and who don't like to follow routines that other people give them," she said. "They want to go out on their own and try to figure things out, but sometimes it really doesn't work.
"People with ADD would not last a week in a cubicle in some state office building," Gignoux said.
Job failures can be common, because the person hasn't been able to compensate for his or her challenges and many people are loathe to share their diagnosis with an employer — or they may not know that's the root of their problem.
"The question is, 'When do I disclose,' and there's really no good answer for that," Salvesen said. Her co-workers know about her ADHD, but she's known many of them since she was diagnosed as a student.
She recommends making the disclosure decision once you see what a job entails and figure out if you can make it work on your own or if you need a more formal accommodation under the Americans with Disabilities Act. She warns that waiting until your job performance is an issue is a bad move, because it's often too late.
But an employer should tell a worker about problems when they're occurring instead of waiting until a formal performance review. "It's smarter to bring it up when it's happening and give the employee an opportunity to address it and correct the behavior," Salvesen said.
UA anthropology senior Nicole French, 21, was diagnosed with ADHD, without the hyperactivity, when she was 15.
"It was like having a weight lifted off of me, because I always knew something was very different in how I worked in the classroom or played team sports," French said. "I'd be listening, but the rest of my mind was off somewhere else and I looked like I wasn't paying attention, but I was.
"Now that I know what I have, I feel like I can explain it better to others," she said. "Letting people know what to expect of me, what not to expect from me, and having that laid out right away makes it so much easier for me — I'd rather not have people think 'she's kind of strange' or whatever."
She said she can recognize when her way of processing information isn't jibing with the rest of the world. For example, she manages the UA students who work at the dorm reception desks and sometimes notices things at staff meetings.
"I'll explain how to do something the way it would work for me, and I'll give directions in the order it would follow in my head, and then I'll look at them and I'll notice they're not catching it," she said. "They know that sometimes it's just a matter of me finding the best way to work with them."
● Contact reporter Sarah Garrecht Gassen at 573-4117 or email@example.com.
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