Understanding Temperament: Rhythmicity

Temperament: Rhythmicity | The Being Well Center

image via Flickr by David Dodge

A key goal in effective treatment for Attention Deficit Disorder should be to understand our temperament and the temperament of the children we live and work with. 

Understanding the concept of temperament and applying that knowledge to ourselves as parents and teachers and to those around us helps us to better understand behavior…struggles, failures, and successes.

Understanding RHYTHMICITY

Rhythmicity refers to the predictability of our daily bodily routines for sleeping, eating and going to the bathroom. It ranges from highly regular to highly irregular.

Those of us who are highly rhythmic are hungry, have a bowel movement, and feel sleepy at about the same times every day.

Others of us, who are highly irregular do not have a schedule or rhythm at all…our wake-up time varies from day to day; we feel ready for bed at different times and need to go to the bathroom at various, unpredictable times throughout our day.

This unpredictability can present a challenge for the child who is asked to adhere to a rigid school schedule where everyone eats and takes bathroom breaks at the same time every day.


Temperament Traits and ADHD | The Being Well Center | Free PrintableUpcoming blog posts will discuss the other 9 Temperamental Traits that make you and your child unique.  Follow along with this Being Well Center | Temperament Worksheet designed to help you pinpoint where your or your child’s temperament trait falls on the continuum. Catch up on yesterday’s post about Activity Level.


Don’t forget to follow us on Facebook and join a community of people interested in getting the facts straight with compassionate support for ADD/ADHD!

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Attention Deficit Disorder in the Laundromat

image via Flickr, David Goehring

image via Flickr, David Goehring

While the experience I’m about to share occurred 15 years ago, but I remember it like it was yesterday. Its message is as valid today as it was when I was blessed to have had my Laundromat experience.

As Divine Order would have it, I found myself in a laundromat two weeks ago. My plans were to run inside, quickly place my clothing in the washing machine, run to the grocery store, return to the laundromat, place my clothing in the dryer, swing by the hardware store, return to laundromat, and scurry home with my clean clothes in basket.

This, however, was not my destiny.

Rather, I spend two hours at the laundromat that night listening to a story — an all too-true story that I want to share. I hope that it will illustrate the painful truth of my reflections, the serious impact ADD has on the quality of life, and the tremendous need that we must all work to meet.

This is the story of the woman who proctors the events that occur in this laundromat. She watches the people. She cleans the washers. She wipes the tables. She sweeps the floor. And she talks…

 

She works at the laundromat part-time.

She’s been divorced twice.

Her 10-year-old son has a hard time in school.

He struggled for a long time–was held back a grade and was recently placed in the LD classroom.

He has a problem controlling his behavior.

She says she has a real hard time with him.

She says he is always getting in trouble.

He recently started a fire in the boy’s bathroom at school.

He’s been diagnosed as having ADD.

She’s on welfare.

She uses the medical assistance card for health care.

She has other children.

Her son’s father is an alcoholic— she’s certain he has ADD, too.

Her mom left home when she was very young.

Her dad was abusive.

She says that she doesn’t feel that she experienced a lot of love when she was growing up.

She says she’s depressed.

She sees a psychiatrist weekly.

She says she’s been diagnosed as being depressed as a result of a chemical imbalance.

She takes a new drug for her chemical imbalance.

She says that she really doesn’t believe her depression is because of a chemical imbalance.

She thinks she’s depressed because her life is a disaster.

She says her work at the laundromat is the only thing that keeps her going — gets her out and doing something.

But she worries about how bad things get at home when she’s not there.

She has no consistent childcare for her children.

She has seen many counselors.

She says her current psychiatrist wonders why her son does the things he does.

Over the years, she’s been given many different reasons for her son’s behavior: he just wants her attention, he’s emotionally disturbed, he’s reacting to her depression.

She doesn’t know what to think.

She makes sure every day, as her kids go off to school, to say “I love you very much” so that they’ll know no matter what, they’re loved.

She laughs and says she really thinks she has ADD, too.

She doesn’t know what to do about it.

Her son was recently in the psychiatric ward of a local hospital for six weeks.

She says he isn’t much different since coming home from the hospital.

The hospital bill was $38,000.

She didn’t have to pay for any of it.

She says that our tax money paid for all of it.

She’s grateful for that.

She doesn’t know how other people ever get any help.

She thinks that people on welfare get the best medical care in the country.

She says she has a friend who works in the welfare office; he can’t afford to get help for his daughter who has the same problems.

She says her son has been on Ritalin for a while.

When he was in the hospital there was in increase in his dose.

She doesn’t understand why.

She doesn’t really know what ADD is.

She doesn’t know what’s going to happen to her son.

She says she’s frightened for him.

Weekly, he sees a psychiatrist whom she says she met one time for 10 minutes.

She doesn’t know what the psychiatrist talks with him about.

He used to see a different psychiatrist.

She didn’t know what they talked about either.

She says she feels that she’s learned a lot about life from her experiences.

She’s at a loss for how to turn her life around.

Meanwhile, she says she’ll continue to do her best with what’s been offered.

 

At 8 o’clock, the laundromat closed, but I am sure her story goes on and on. Don’t trick yourself into thinking that this is just the story of a welfare mother in a laundromat.

If you have an open ear and an accepting attitude, I have learned that you can hear a similar story from your neighbor, your cousin, your hairdresser, you minister, your grocer, and even from your doctor.


What is your life story with ADD/ADHD?  We’re listening…

The Prognosis for ADD

image via Flickr, by Ginny

image via Flickr, by Ginny

What is the prognosis when ADD is treated appropriately?

The prognosis of ADD is highly variable depending upon a multiplicity of factors. The individual’s temperament. His language skills. His intelligence. His basic academic skills. The profile and severity of attention weakness. His physical characteristics. The integrity of his nervous system. The presence of illness. Stresses in his life. His attitudes and beliefs. His self esteem. His motivation. The expectations set for him. The profile of strengths, weaknesses, and temperamental characteristics of people in his life….

For each individual, the mix of these factors is a little bit different. And for any given individual, the mix is constantly changing. This is what makes ADD such a challenge.

When all these factors are taken into account and appropriate, comprehensive treatments are put into place, the prognosis for ADD is good but guarded.

That is, the ADD individual can be helped to function successfully academically and on the job; he can have meaningful social relationships; and he can function independently.

However, as long as he continues to take on life’s challenges, there is always the possibility that the problems associated with ADD will resurface. But this really is no different from what we all face in our own personal quest for self-development.


There is no magic pill or quick fix for Attention Deficit Disorder.  That’s why Dr. Liden has dedicated over 30 years of his life to diagnosing and treating the disorder, following his patients through many life stages and challenges, helping them achieve success and independence through it all.  His collected wisdom is shared here on the BWC blog and in a number of books.  He also serves as Senior Medical Director of The Being Well Center, which offers Long Distance Services and an affordable Accurate Diagnosis Determination.

5 Reasons We Know ADD is Real

I’ve heard some professionals say, “ADD is just a cover-up label for suburban parents who cannot deal with their emotionally-disturbed kids.” Some write it off as “being in vogue–the problem for this decade.” Others wonder, “If ADD is a result of an inborn physical difference, then why wasn’t it around when we were kids?

I respond strongly to this skepticism. ADD is a very real problem!

Because we are more knowledgeable, we are able to identify ADD more frequently and, thereby, it appears to be in vogue. But ADD was around when we were kids. We just weren’t aware of it.

Biologically-based attention differences are probably no more common in 2014 than they were in 1950. However, dysfunction resulting from these differences is more common because societal expectations have significantly changed over the past several decades. Many of these new demands put a high premium on the individual having efficient attentional skills in a way that was never demanded before. As a result, just as with ADD in an individual, these new societal expectations have uncovered an underlying societal problem that has probably always been there.

1.  New opportunities for our children highlight the existence of ADD

In the ‘40’s and ‘50’s, most parents worried about the basics. Nutritious food on the table and a roof overhead. Reading, writing and arithmetic. Basic health. In fact, my parents worried about whether I would survive polio or die like several of my best playmates. Thanks to amazing technological advances, today we, as parents, take these basics for granted and want much more for our children. We want our children to achieve at school, to go to college, and to get a job that is better than the one we have.

I am constantly impressed how far we will go to provide enriching opportunities and to push our children in the name of wanting them to have the chances we did not have. Often, these “chances” backfire because they require proficiency in areas, like paying attention, that some children just don’t have.

image via Flickr, woodleywonderworks

image via Flickr, woodleywonderworks

In our schools, the demand for high achievement and independent learning has filtered down to earlier and earlier grades. Curriculum content has expanded so that many teachers are overwhelmed and unprepared to introduce a wealth of new material, let alone to teach the basics to children who require some extra help.  Support services in most school districts are shrinking rather than expanding. Access to extra help is often contingent upon student failure rather than being viewed as a preventative response to minor difficulties.

It is easy to see why regular classroom teachers get frustrated when they are placed in the bind of producing high group achievement test scores to please the school board while watching 20% of their class struggle to just get by.  Without support to address these children’s needs, most teachers either become guilty or get burned-out, both of which reduce their effectiveness further.

 2.  Modern parenting styles highlight the existence of ADD

Societal attitudes about discipline and behavior management have changed radically as well. These changes have also contributed to our increased awareness of ADD–the problem that has always been there. The pendulum has swung from the rigid, authoritarian, and, frequently, punitive approach of the ’50’s to a more permissive and democratic approach in the ’70’s and ’80’s.

Today’s parents are more likely to provide a detailed answer to the child’s proverbial question “Why?” than to end the discussion with “Because I said so!” In an attempt to promote self-esteem and foster creativity, many parents hesitate to set firm limits on children’s behavior or to structure their lives. Many parents are afraid to say “No.” They walk on eggshells instead. They try to control their child’s behavior with rewards rather than meaningful consequences. Many children can go with the flow and adapt to whatever management style is used.

However, the more democratic, laid-back approach places demands for self-awareness and self-control on ADD children that they are rarely equipped to meet. The resulting behavior problems in the home or school bring the ADD children into the spotlight and allow us to identify them.

 3.  Modern family units highlight the existence of ADD

image via Flickr, Marco Antonio Torres

image via Flickr, Marco Antonio Torres

The nature of the family unit has significantly changed in the past 50 years. Again, this change has forced us to become aware of the ADD population. More children are being raised in single parent homes. More and more, both parents need to hold full-time jobs outside the home. In our mobile society, Grandma no longer lives two houses away but more commonly, two hundred miles away.

All this means that the support system that previously was there to structure and bail out the child with ADD is no longer present.

Moreover, this prop has been pulled out at a time when society has placed increasing demands on children without creating increasing levels of support.

There is, for example, a shocking lack of affordable, quality childcare services across the country. As a result, many children spend countless hours alone or in the care of people who have not received basic training in child development, let alone training in working with difficult children.

In a permissive society, without supportive props, the ADD child is a set-up to misuse the increased amount of unstructured time available to him. Truancy, vandalism, and delinquency are often the outcome. And each time an individual commits such a “crime,” we have another opportunity to identify ADD.

The pace of growing up has quickened and, as a result, children are faced with increasing expectations to exercise mature social judgment. Adolescent children are placed in the position of having to make independent, adult decisions about sex, drinking, and drugs. These demands put the impulsive ADD child with poor problem-solving skills at an even greater risk for alcoholism, drug addiction, and teenage pregnancy and provide him with another chance to be in the spotlight.

4.  Our technological society highlights the existence of ADD

image via Flickr, Mervi Eskelinen

image via Flickr, Mervi Eskelinen

As our society has moved from an industrially-based to a technologically-based economy, a new set of skills and abilities are now required to make it on the job.

The highly structured, physically demanding, manual labor jobs have been replaced by white-collar positions demanding good organizational skills, effective problem-solving abilities, and independent self-monitoring.

Once again, the individual with ADD is at a disadvantage and at risk for being identified. It would not be surprising to find that individuals with ADD have a disproportionately high representation in the ranks of the unemployed.

5.  Increased stress levels highlight the existence of ADD

Finally, because of these and numerous other reasons, life’s stresses appear to be more complex and challenging than they have ever been. And if there is anything that requires us to be reflective, focused, vigilant monitors, and efficient problem-solvers, it is stress management. Without the prerequisites to meet the challenge, the individual with ADD enters into a devastating downward spiral. Marital difficulties. Money problems. Mounting anxiety and depression. Tranquilizers. Just getting by. Social isolation. Back pain. Sick days. Weight gain. Hypertension. Constant fear. Alcohol abuse. Traffic accidents. Hospitalization. Bankruptcy. Immobilization. Giving up.

ADD is Real, and We Know It.

For all these reasons and probably many more, ADD now plays a more significant and very real role in people’s lives. And, as a result, we all have the opportunity to see its impact.  When people are skeptical about the significance or even the existence of ADD, they create a barrier to overcoming a very serious, but very addressable, health disorder.  Don’t let skepticism rob you of progress toward a better, and easier, life.  ADD is a very real problem.  But it’s a problem with very real solutions.


More answers and information about ADD/ADHD can be found in Dr. Liden’s book, Pay Attention!: Answers to Common Questions About the Diagnosis and Treatment of Attention Deficit Disorder.


10,000 people living with ADD have found hope and help navigating the challenges of ADD at The Being Well Center.  No matter where you are in life, we can help, starting today.

 

Hope for Life After the ADD Diagnosis

What is the prognosis when ADD is treated appropriately?

image via Flickr, pol sifter

image via Flickr, pol sifter

The prognosis of ADD is highly variable depending upon a multiplicity of factors. The individual’s temperament. His language skills. His intelligence. His basic academic skills. The profile and severity of attention weakness. His physical characteristics. The integrity of his nervous system. The presence of illness. Stresses in his life. His attitudes and beliefs. His self esteem. His motivation. The expectations set for him. The profile of strengths, weaknesses, and temperamental characteristics of people in his life.

For each individual, the mix of these factors is a little bit different. And for any given individual, the mix is constantly changing. This is what makes ADD such a challenge.

When all these factors are taken into account and appropriate, comprehensive treatments are put into place, the prognosis for ADD is good but guarded.

That is, the ADD individual can be helped to function successfully academically and on the job; he can have meaningful social relationships; and he can function independently.

However, as long as he continues to take on life’s challenges, there is always the possibility that the problems associated with ADD will resurface.

But this really is no different from what we all face in our own personal quest for self-development.


More than 10,000 people living with ADD have found hope and help navigating the challenges of ADD at The Being Well Center.  No matter where you are in life, we can help, starting today.


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.

 

ADD and Sex

How does ADD impact sexual behavior and functioning?

Over the years, behind the closed door of my office, I have heard hundreds of unusual stories regarding my patients’ sexual activities. I have come to appreciate that, while the topic is often emotionally loaded, the behaviors are generally completely understandable when put into the context of ADD.

ertterdownloadsA certain amount of body exploration and sexual experimentation is normal for all children; in young children with ADD this exploration and experimentation can seem extreme because we see it. Young ADD children often lack that inner voice that says, “Keep your hands out of your pants when others are around” or “Do not touch other kids’ private body parts” or “Don’t draw that in school.”  While other children may have the same impulses, they usually have enough self-control and social monitoring to think first and, in this way, stay out of trouble with their sexual thoughts and feelings.

As children get older it is normal for them to be sexually curious. Oftentimes, older children and adolescents with ADD impulsively act on their curiosity. Then, as a consequence of their poor monitoring and decision-making, they get caught doing something that seems bizarre or perverted to others. The number of older children and adolescents in our practice who have been caught looking at, taking, or even wearing mom’s lingerie, exploring pornographic websites on the computer, using (and running up huge bills) on phone sex hotlines, or sending pornographic photos of themselves to someone they met on the Internet is astonishing. In my experience, upon taking the time to debrief the events with my patients, clearly these behaviors are not signs of perversion or serious mental health problems but rather normal sexual interest in the absence of good self-control.

We all know that in adolescence, sexual exploration continues, and that its consequences can be very serious. Premature experimentation or early sexual involvement can lead to unplanned pregnancy, sexually transmitted diseases, and serious legal trouble. Adolescents with ADD who are struggling with a low self-esteem and lack of acceptance by peers can too easily become involved in sexual relationships to feel good and be accepted never thinking about the potential consequences. In my experience, impulsive kids who struggle in reading the social signals often finds themselves caught up in the heat of the moment and have no idea how to get out.   Many of my ADD adults share with me their scary versions of this story still feeling the regret and guilt.

Dr. Craig Liden | ADD and SexI have found that adults with ADD often struggle with relationships and sexual activities as much as the adolescents do. Impulsivity frequently leads the adult with ADD to jump into relationships and sexual intimacy too quickly. At first, this intimacy feel good; it blots out the pain of loneliness that often accompanies adult ADD. But this quick, feel-good approach to sexuality commonly contributes to promiscuity, addictive involvement in pornography, and risky sexual behavior in the ADD population. In fact, individuals with ADD have been found to have a four times greater risk of acquiring a sexually transmitted disease than the general population.

ADD can also have a significant impact on sexual functioning in “normal” adult relationships as well. It is easy to imagine how the ADD adult with low arousal who finds himself particularly exhausted at the end of the day often has no interest or energy for sex. Many of my patients who have experienced chronic stress as a result managing their weak attention day in and day out struggle with the spectrum of sexual dysfunctions that occur in people who are depressed and anxious — decreased libido, difficulty with arousal, and an inability to reach an orgasm.

Apart from these sexual difficulties, it is not uncommon for the ADD individual’s poor communication and listening skills to interfere with intimacy and, in turn interfere with the quality of his sexual relationships. In my discussions with spouses of ADD individuals, complaints about self-centeredness in the bedroom are the norm.


We’re talking tricky topics this week on the Being Well Center blog.  Check in for discussions about ADD and drug abuse and ADD and chronic health problems.


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.

first photo credit: Patricia Mellin via photopin cc

second photo credit:.Andi. via photopin cc

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.