Difficulty focusing. Impulsiveness. Restlessness. These are general characteristics that at one time or another can be attributed to most people. But when these traits are habitual and interfere with everyday activities and tasks, they can be signs of attention deficit hyperactivity disorder, known as ADD or ADHD.
Psychologist Wes Crenshaw prefers the term ADD because most people diagnosed with the disorder don’t have hyperactivity.
“It’s the worst branding change since New Coke,” said Crenshaw, who owns Family Psychological Services in Lawrence, Kansas. He is the author of “I Always Want to Be Where I Am Not: Successful Living with ADD & ADHD,” and has been treating children and young adults with ADD for more than 20 years.
According to Crenshaw, some children are fairly easy to diagnose, but others have less overt behaviors and may be missed until they reach an older age.
“There are the obvious ones who in kindergarten, first, second grade just aren’t able to be still. The more difficult ones to find are the ones who simply aren’t able to finish or start certain tasks. Can’t get material out of a book that we can get, read through it, particularly if it’s not interesting. But they may not even read for pleasure. Even books that are really exciting to them, they may just not be able to digest. Being always involved in a different activity than the one you’re in right now … that mental restlessness, you might call it,” he said.
Because most people occasionally have characteristics of ADD, some people don’t believe it is a real disorder. Crenshaw calls it the two myths of ADD: either it doesn’t exist or everyone has it.
“Any mental disorder is something that we say that it is. It’s a series of perceptions or behaviors or emotions that we as a society agree constitute a disorder,” said Crenshaw. “But if you’re going to accept that mental illness exists, than ADD exists.”
And it’s not accurate to say that everyone has ADD because people with ADD exhibit characteristics that are distinctly different from the norm, he added. Some people are what he calls “leaners”—they have traits that lean towards ADD but can be managed without treatment.
“The leaners aren’t impaired enough to get medication or a treatment. That’s just an interesting part of one’s personality,” said Crenshaw.
For kids with higher IQs, a diagnosis of ADD sometimes doesn’t occur until they are older. It can be the freshman year of college, maybe graduate school, before they can no longer manage things on their own.
“They’re smart, they pick things up auditorally, they don’t have to read; they get it out of the lecture. Then you hit your waterloo….There’s that library full of books and you have to read them all,” said Crenshaw.
That’s what happened to Sarah her freshman year of college. (Sarah is a pseudonym used to protect her medical history.)
“I spent hours upon hours studying and it didn’t show up in my grades at all,” said Sarah. “I would go to lectures, and I would write down every word the professor would say, and I would walk out of the classroom and not remember a word of it.”
She went to see a doctor, who recommended a psychologist.
“At first he (the psychologist) was actually kind of skeptical about whether I had it or not …because I hid it so well. And it turns out I had really bad anxiety that covered it up. I knew I would forget things a lot so I had post-it notes everywhere….I knew I didn’t retain reading very well, so I would put out time to read things three different times,” said Sarah.
After mentioning the post-it notes and taking a test, she was diagnosed with ADD.
“I didn’t even really realize that there was a stigma about having ADD until after I was diagnosed,” said Sarah. “Even then it didn’t really bother me. To me it was more of a relief because all along I just thought that I was just lazy and stupid and that’s why I didn’t process things well and why I didn’t remember things well when people were talking to me. So to me it was just a relief that I was going to get to experience life the way I was supposed to all along.”
Sarah manages her ADD with a stimulant medication and regular appointments with a therapist, the generally accepted treatment for the disorder.
According to Crenshaw, the stimulant targets the frontal lobe of the brain, which is the part of the brain that allows us to focus. That combined with psychotherapy to develop new ways of handling situations allows individuals with ADD to “do the things the rest of us take for granted,” he said.
One coping mechanism Sarah has developed, for example, is to color-code information chapter by chapter in a book to help her remember it when it comes time for a test.
Listener response was high during the show. One caller described the almost physical pain he feels when trying to read a book. Another described her difficulties in school and work due to lack of treatment. Twenty years after dropping out of college, she is on medication and is back in school.
Her call in particular struck a chord with Crenshaw.
“We get calls like this and I always want to point out there’s this big trend right now … to bash ADD as a diagnosis, and by doing so bashing those of us who give it, and bashing Sarah, and bashing this caller,” he said. “When we get callers like this and hear how they feel, they’re happy, they’re thankful, they’re liberated from something that’s oppressed them. This isn’t about the drug companies and the jackboot heel of The Man coming in and stomping everybody into Stepford children. It’s about liberation.”
St. Louis on the Air provides discussion about issues and concerns facing the St. Louis area. The show is produced by Mary Edwards and Alex Heuer and hosted by veteran journalist Don Marsh.