ADD and Extreme Temperaments

beingwellcenter_temperamentWhy is it that so many individuals with ADD seem to have extreme temperaments?

It may be that individuals with ADD come into the world with a greater number of these temperamental extremes.

However, it is also possible that these behaviors seem to be more common in individuals with ADD because their attentional differences interfere with their awareness of and ability to control these built-in personality characteristics.

That is, it may be that extremes in temperament such as high activity level, high intensity, low threshold, negative mood, slow adaptability, and short persistence occur just as frequently in the non-ADD populations as in the ADD population.

In order to exert control over these temperamental characteristics, an individual must be aware of his extremes, monitor his behavior, and develop effective ways to keep his extremes in check. As this requires efficient monitoring, problem-solving, vigilance, and impulse control, it is likely that individuals with ADD will struggle with their temperament more frequently and as a consequence, demonstrate these characteristics more often.

Catch up on previous posts in the Pay Attention series.

Patients of all shapes, ages, and sizes come to The Being Well Center and Dr. Craig Liden for diagnoses and treatment plans they can trust. Can we help you too? Visit The Being Well Center for more information about Dr. Liden’s services.

Our current blog series is excerpted from Dr. Liden’s best-selling book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.

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ADD? Why can he concentrate on some things but not others?

Being Well Center | ADD and ConcentrationIf a person has ADD, why can he concentrate on some things but not on others?

At the right place, at the right time, and under the right circumstances, a person with ADD can pay attention. Generally, when this occurs, the individual is highly motivated and has strengths in the skills required to participate successfully in the task at hand.

Sometimes, the intrinsic characteristics of the object or event to which a person with ADD is trying to pay attention are so powerful that they act as magnets that draw out every ounce of attention. Television, the computer, and hand-held electronic games are the most common examples of such seductive magnets in everyday life. Paying attention to TV is a relatively passive act when compared to paying attention to Mom’s lecture about how to behave with the babysitter or the science teacher’s complex description of a chemical reaction.

Sometimes apparently efficient attention in a person with ADD is deceptive. He has simply learned to act attentive. His eyes and ears may be open and his head may be nodding acknowledgement, but he is not tuning in to the fine details of what is happening; in this way, he often misses the richness of the experience. It is only through formal assessment that we can determine the extent to which a person has really paid attention.

Catch up on previous posts in the Pay Attention series.

Patients of all shapes, ages, and sizes come to The Being Well Center and Dr. Craig Liden for diagnoses and treatment plans they can trust. Can we help you too? Visit The Being Well Center for more information about Dr. Liden’s services.

Our current blog series is excerpted from Dr. Liden’s best-selling book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.

Do people have ADD from birth?

ADD Basics FamilyAs we continue laying out the truth about ADD/ADHD, we turn to some of the most common, burning questions my patients, friends, family, and colleagues most commonly ask me.  The answers to these questions form a critical foundation to understanding the truth about Attention Deficit Disorder.

If people are born with ADD, why don’t problems show up right after birth?

ADD becomes apparent only when the inborn attentional differences interfere with the individual’s ability to meet expectations in the environment. Depending upon the severity of a person’s attentional differences, his temperament, the status of other skills and abilities, and the specific nature of environmental expectations, ADD can crop up at any point along the life span from infancy to old age. Let’s take a look at how this can happen.

Typically, individuals with ADD appear to be normal at birth. As children, they are minimally, if at all, delayed in meeting major milestones of accomplishment such as walking and talking. They generally reach school age with only minor problems in controlling their behavior and interacting with peers. The first grade classroom is often the first place where specific expectations for paying attention occur. As a result, the entry into school is one of the more common times when ADD first shows up. Other key transition points in the individual’s life where expectations for increased efficiency of attention can lead to the emergence of ADD include the following:

  • Movement to the upper elementary grades where time constraints are imposed and increased demands are placed on children to function independently
  • Movement to junior/senior high school where more refined organizational and study skills are required
  • Movement to college where fewer supports are available and the ability to function independently is essential
  • Movement into a new home away from parents where there are no supports and the ability to function independently is even more critical
  • Marrying or cohabiting with a partner where functioning impacts upon the quality of life of another person and demands for efficient problem-solving are high
  • Becoming a parent where responsibilities for keeping it all together, all the time is essential

Individuals with ADD who have strengths in other areas (e.g., strong language skills, a charming personality, intellectual giftedness) can go a long time in life without being identified as having a problem. I have seen many children go through elementary school with A’s and B’s only to have the bottom fall out upon entry to middle school or junior high school. In these circumstances, careful probing of the educational history of these children often reveals evidence of attentional weaknesses that have either been overcome with sheer brain power or been overlooked by parents and teachers because these subtle weaknesses hadn’t really led to failure.

While failure to meet increasing school demands is a very common way for ADD to be uncovered, it can also happen as a result of failure to meet increasing demands for independent functioning, social interaction, or problem-solving at home, in childcare, in the neighborhood, or on the job.

Meet Michael

Michael is a good example of this. He is a 10-year-old boy who has always done very well, academically and socially. He has learned new concepts quickly, has shown a gift for memorizing facts, has been easy to get along with, and has always been a great conversationalist.

Until two months ago, he had also functioned very well at home. At that time, however, his mother got a new job that meant she was no longer able to be with Michael after school. And, despite all of her attempts, she had been unable to find someone who would stay with Michael until her new workday ended. So, for the first time, Michael was on his own everyday from 3:00 p.m. to 6:00 p.m.

The new expectation for him was “keep yourself busy and stay out of trouble for three unsupervised, unstructured hours.” This new demand uncovered Michael’s impulsivity, distractibility, and lack of ability to think through the ramifications of his behavior. He broke a living room lamp by rough housing in “off-limits territory”; he burned a hole in the new family room couch while “fooling around” with a butane lighter; and he soaked the bathroom carpet when he ran to answer the telephone, forgetting to first turn off the faucet.

Without his mom around to help him structure his time, to remind him of the house rules, and to watch over his activities, Michael had become dysfunctional.

Meet Emma

Emma’s story is similar. She is a 22-year first year elementary school teacher who has just married. Emma is gifted, kind, funny, sensitive, and very hardworking. Until now she has done well in almost every sphere of her life, but she has never been asked to establish her own home, to share finances, nights, and laundry with someone else, to complete daily lesson plans for five subjects, to effectively manage thirty fifth-grade children for six hours every day, and to negotiate unclear work politics all at the same time.

Emma is a mess. Despite her intelligence, her hard work, her sense of humor and her likeability, she is not experiencing success anywhere in her life.

Catch up on previous posts in the Pay Attention series.

Patients of all shapes, ages, and sizes come to The Being Well Center and Dr. Craig Liden for diagnoses and treatment plans they can trust. Can we help you too? Visit The Being Well Center for more information about Dr. Liden’s services.

Our current blog series is excerpted from Dr. Liden’s best-selling book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.

Jeff is a great kid! He just forgets.

Do you recognize these people?

bwc_lifespan

Annie, age 35

Annie is an attractive mother of three.  To look at her you would never guess what a disaster every area of her life has been since college.  As a young teacher, she never developed lesson plans and couldn’t control her classes.  She wanted to do something else but didn’t feel she had the skills.  Instead, she started a family.  As a homemaker, she rarely cooks a meal, struggles to pick up the house before her husband gets home from work, and has 45 half-done projects.  She manages the family finances–writes the checks, but forgets to mail them.  Her relationship with her husband is poor, and she feels guilty about not meeting her children’s needs.  She’s depressed, and her self-esteem is in the pits.

Adam, age 19

In high school, Adam was the class clown; everyone liked him.  Now, he goes to college because “that’s what everybody does!”  With the distractions of college life–being away from home for the first time, fraternity parties, weekend football games, and wild roommates–he is no longer able to get by on his quick mind and entertaining personality.  By the end of his first semester, he is on academic probation.  Despite this warning, threats by his parents, and all his good intentions, at the end of the second semester, Adam is asked not to return next fall.

Jeff, age 11

Jeff is a great kid!  He just forgets.  He forgets what his homework is.  He forgets to bring home the science book to study for tomorrow’s unit test.  He forgets to bring home his instrument for band practice.  He forgets to hang up his coat, to put his shoes away, and to throw his dirty clothes in the hamper.  He forgets to take out the garbage and to feed the dog.  He forgets to brush his teeth, to tuck his shirt in, and to make his bed.  If Mom wasn’t there to nag him, he’d probably forget everything–but still, he is a great kid.

Do you recognize Justin, Karen, or Lisa?
Do you recognize Melissa, Mark, or Betty?
Do you recognize Tina, Doug, or John?

These are my patients.  You may have recognized your son or daughter, your spouse, your parents, even yourself.  I’ve come to appreciate how ADD can look quite different across the lifespan, depending on circumstances, temperament, and expectations.  For some people, managing a home and family brings the conflict with ADD to a head.  For others, it’s the high expectations (and failures) at college.  Still others struggle in the smaller ways, like chronically forgetting homework.

Our current blog series is here to help you sort through the challenges of identifying and treating ADD / ADHD.  You might find there are a number of things you don’t know about ADD (but should).  You might find that you recognize my patients.  If you’re seeking answers, you’re always welcome at The Being Well Center, or you can download my free e-book, ADD Basics 101, in which I guide you through 10 clear steps to securing a diagnosis and treatment plan you can trust.

Patients of all shapes, ages, and sizes come to The Being Well Center and Dr. Craig Liden for diagnoses and treatment plans they can trust. Can we help you too? Visit The Being Well Center for more information about Dr. Liden’s services.

Our current blog series is excerpted from Dr. Liden’s best-selling book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.

Tina is driving the family crazy

Pay Attention | Being Well Center | Dr. LidenThese are my patients.

These are the people who have come to The Being Well Center to be taught.  These are the people who have trusted us to treat them.

You may recognize your son or daughter, niece or nephew, grandson or granddaughter. Maybe one of them is a child in your childcare center, a student you teach, or just a kid in your neighborhood. It could be that one of them is your brother, your sister, your mom or dad, or your husband or wife.

It’s quite possible that one of these people is you!

The ages, sex, personalities and life circumstances are different but they have one thing in common—they all have Attention Deficit Disorder.

Today, I’d like to introduce you to a few more people who, for the past 30 years, have inspired, challenged, and pushed me onward in the quest to thrive with ADD/ADHD.

Tina, age 9

Tina does okay in school.  She consistently brings home B’s and C’s.  While Mom and Dad had once hoped she would be a straight-A student, they are satisfied with her performance at school.  At home, it’s a different story.  She is driving the family crazy; she has alienated herself from her brothers and sisters, as well as the neighborhood kids.  Her experience at daycare isn’t any better.  She disrupts conversations, spoils games, and breaks all the rules.  She seems totally unable to control her temper, her foul mouth, and her aggressive behavior.

PayAttention! Do You Recognize Justin?Doug, age 15

Doug was never a great student.  Since he has been in junior high, he has been in constant danger of failing his courses.  His teachers feel he is a lazy kid with a bad attitude; they hesitate to cut him a break.  Doug hangs out with the tough guys who smoke cigarettes in the bathroom and drink on the weekends.  The other school are intimidated by his short fuse and tendency to pick a fight over anything.  Actually, when you get to know Doug, he is a real marshmallow who feels lousy about himself.

John, age 68

John could have been anything, but he had wanted to be a doctor for as long as he could remember.  In elementary school, his sleepy, under-aroused demeanor was written off as a sign of boredom in a gifted child.  In medical school, he stayed awake by drinking cup after cup of coffee.  As the top cardiac surgeon in the region, John has stayed focused during grueling surgeries by relying on one adrenaline rush after another.  Problem: 25 years of tranquilizer use has been John’s solution for his ever-present anxiety and nighttime sleeplessness.

Do you recognize Justin, Karen, or Lisa?

Do you recognize Melissa, Mark, or Betty?

Patients of all shapes, ages, and sizes come to The Being Well Center and Dr. Craig Liden for diagnoses and treatment plans they can trust. Can we help you too? Visit The Being Well Center for more information about Dr. Liden’s services.

Our current blog series is excerpted from Dr. Liden’s best-selling book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.

 

Pay Attention!  5 Things You Need to Know (but don’t) About ADD/ADHD

Dr. Craig Liden | The Being Well Center

Based on my observations and studies treating ADD for the past 30 years, it’s fair to say that ADD touches upward of 20% of our population.  More than ever, we need to understand this often misunderstood, misaligned disorder.

People who are treating their ADD are living and thriving.  Let’s make the path to accurate diagnosis and effective treatment plans clear for all.

5 Things Everyone Should Know About ADD/ADHD:

1.    Attention Deficit Disorder is very common in adults. It is suspected that 1 in 25 adults has ADD.  However, only half have been properly diagnosed and less than a quarter are being properly treated.

2.    Untreated adult ADD can result in many chronic issues: obesity, chronic bowel problems, addiction disorders, depression/anxiety, and college failure, not to mention failed relationships, accidents, or poor job performance.  Properly diagnosing and treating ADD could have a huge impact on our society and health care system.

3.    Proper treatment of ADD with medication and counseling always starts with a comprehensive, diagnostic evaluation that includes objective testing, feedback from various members of the patient’s life, and a look at the whole person.

4.    Risks associated with correct medication use are minimal compared to the risks of untreated ADD.  Medication is often necessary but never sufficient and should always be paired with supportive counseling.  Stimulant medications used to treat ADD are generally very safe and are not addictive.

5.    The preferred name for ADD/ADHD is ADD since “Hyperactivity” is only one of many symptoms of ADD patients and shows up in less than 10% of those diagnosed.

Dr. Craig Liden is the Founder and Medical Director of The Being Well Center, an ADD/ADHD diagnostic and treatment center in Pittsburgh, PA that has helped more than 10,000 people worldwide living with ADD.

TRANShealth Inc. is sponsoring a free download of Dr. Liden’s book, ADD/ADHD Basics 101, in which Dr. Liden gives 10 steps to securing a diagnosis and treatment plan you can trust. 

 

Do you recognize these people?

Pay Attention! | Dr. Craig Liden | ADHD girlMelissa, age 8

Missy is a perfect angel.  She quietly sits in the second to the last seat of the fourth row of her third grade class.  The rowdy, disruptive kids sit in the front.  Missy never causes any trouble; she is shy, polite, and…flunking.

Mark, age 10

Mark qualified for the gifted classes at school when he was in second grade.  Even though he is creative, quick, and highly verbal, he rarely gets As on his report card.  His parents and teachers are frustrated that such a bright kid is so sloppy, careless, and irresponsible.  At times they wonder if he’s just bored with it all.

Pay Attention! | Dr. Craig Liden | ADHD womanBetty, age 46

Betty’s daughter was diagnosed with ADD when she was nine years old.  As Betty learned more about her daughter’s problem, she began to wonder if ADD could be the reason for her own long history of difficulties.  In school, Betty’s grades had consistently been pretty good, but she worked so much harder than everyone else.  Now, as an accountant, she is in high demand because the quality of her work.  Her clients have no idea she has to stay up until the wee hours of the morning double and triple checking her calculations.  The daily stress has left her with little energy for her family or household responsibilities.  Over the years, she has grown to feel inadequate and guilty.  She has tried to ease the pain within herself by doing for everyone else–her husband, her children, her parents, her aunt, the school, the church.  Now she has run out of gas.  She’s depressed.  She’s overweight.  Her joints ache.  She has just been diagnosed with fibromyalgia.

Do you recognize Justin, Karen, or Lisa?

These are my patients.

You may have recognized your son or daughter, niece or nephew, grandson or granddaughter. Maybe one of them is a child in your childcare center, a student you teach, or just a kid in your neighborhood. It could be that one of them is your brother, your sister, your mom or dad, or your husband or wife.

It’s quite possible that one of them is you!

The ages, sex, personalities and life circumstances are different but they have one thing in common—they all have Attention Deficit Disorder.

Millions of Americans suspect they may have ADD. Is it time for you to finally get answers?  As I tell my patients when they first come to terms with a diagnosis, it’s exciting to think where things could go!

Patients of all shapes, ages, and sizes come to The Being Well Center and Dr. Craig Liden for diagnoses and treatment plans they can trust. Can we help you too? Visit The Being Well Center for more information about Dr. Liden’s services.

Our current blog series is excerpted from Dr. Liden’s best-selling book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.