Individuals with ADHD can find that their ADHD has both negative and positive impact on their work.  It is important for employers who know that some of their employees are ADHD not to make sweeping generalizations about individuals with ADHD.  This is because, as we have discussed previously, ADHD workers will display a wide range of behaviors (because some ADHD traits fit some people and not others).

Some common behaviors seen in the workplace for employees (or bosses!) with ADHD include:

   *struggling to sit calmly during meetings

   *getting agitated if they have to sit for a long time

   *rushing through tasks and making careless errors

   *not listening fully to instructions given

   *speaking their mind (and opinions) bluntly

   *starting a lot of projects but needing much structure and encouragement to finish them

   *having difficulty in completing large amounts of paperwork

   *talking quickly (and a lot) and interrupting others

   *going off on tangents during conversations and meetings

   *getting easily distracted while working on long term projects

   *being at risk for wasting a lot of time suring the Internet

   *wanting to chase new exciting ideas (and spend a lot of money on them) when they haven’t fully implemented the last greatest idea.

On the other hand, positive aspects that flow from being ADHD have helped many business people become successful.  These positive, job-enhancing qualities include:

   *being creative, generating a lot of new ideas

   *processing information quickly

   *being energetic and able to work long hours

   *being willing to take risks

   *being able to multi-task and get a lot done in a short period of time.

Many successful entrepreneurs and sales professionals have ADHD characteristics (and many are ADHD).  But they usually have aligned themselves either with a methodical, detail-oriented business partner, or they have a very competent exceutive assistant who keeps them organized, follows up on details, and implements action steps.

In fact, a number of successful business people admit they are ADHD but they don’t want to take medication because their ADHD symptoms “work” for them and they don’t want to lose their “edge”.

Practical Suggestions

A number of good books have been written for ADHD adults in the workplace (ADD on the Job , Delivered from Distraction , ADHD Secrets of Success).  However, let me cite some practical steps that can be taken to help manage ADHD symptoms.  Here are a few I have found to be most helpful for adults with ADHD:

   *utlizie a schedule for your week, but provide “holes” of time to insert sompe spur of the moment meetings or tasks - working with your spontaneity.

   *keep a visual list of your daily priorities in view — on your desk, in your car, on your bathroom mirror.

   *minimize distractors in your workplace.

   *keep a pad of paper where you can write down distracting thoughts (things that come to mind that you need to do, but don’ have to do right now.)

   *put your calls on hold and turn off your cell phone (and shut down your email screen) when you have to focus on a project.

   *have a process established (with other individuals involved) for making major decisions and purchases — and don’t circumvent the process!

   *keep a budget with general categories (a very detail-oriented budget will “blow out” most ADHD individuals and they won’t use it.)

   *schedule your day with breaks and try to involve different settings, moving from place to place, if possible.

   *give your coworkers permission to get you “back on track” during meetings and discussions.

The three largest areas of risk for workers with ADHD that I repeated see are:  1. Getting distracted off task and not completing the most important tasks on time.  2. Making impulsive decisions that come back to haunt them because they didn’t consider all of the implications before “pulling the trigger”.  And 3. Struggling significantly with organizational skills and managing paperwork.

If this is you (or someone you work with), I would strongly encourage you to take proactive steps to deal with these issues before they seriously impact your professional future or the health of the business.

ADHD and our Culture: Overdiagnosis

As a psychologist who has specialized in diagnosing and working with ADHD individuals over the past twenty years, I firmly believe ADHD has been (and still is) over diagnosed — and that medications are used too much.

Having said this, I think it is a mistake to “throw the baby out with the bath water”. That is, just because ADHD is over diagnosed does not mean that ADHD does not exist or that there is no one with ADHD. The issue becomes one of proper diagnosis and appropriate treatment and intervention.

To put the diagnostic issue in perspective, the characteristics of ADHD (like most human characteristics) all exist on a continuum. There are individuals with above average attention span and focus, most have an average amount, and others who are below average.

From a professional’s point of view, the task is to try to determine where on the continuum these characteristics lie for the person being evaluated. With regards to distractibility, are they average (when compared to same-age, same-gender peers)? Below average? Well below average? Is their attention span on the low end of average, where it is a “normal” problem? Or is it a more intense struggle and challenge for them (maybe in the low average range)? Or is it so severe that it significantly interferes with their daily life functioning — and hence, reaches the level of a disorder (the last “D” in ADHD)?

In many ways, determining the level of severity is a judgment call (and, as a result, the diagnosis of ADHD can be highly influenced by the professional’s view of how severe the symptoms need to be to warrant a diagnosis [I tend to be more in the middle to conservative side when compared to some mental health professionals]). However, there are some framing principles to help make the decision.

Severity of Symptoms

The level of impact of ADHD (or ADHD-like) characteristics can be judged by the following issues:

Duration. How long have the symptoms been present?

Number of Symptoms. Does the individual display just a few of the symptoms, a large number, or almost all described?

Intensity. How intense are the symptoms? Are they just “sort of” there, or are they a hallmark characteristic of the person, where you “can’t miss” them?

Frequency. Are they symptoms just present occasionally? Frequently? Virtually constantly?

Impact on Daily Functioning. Are the symptoms creating numerous problems in the person’s life (poor performance at work or school)? Are significant others in the person’s life (spouse, children, boss, co-workers raising concerns about these characteristics and how they are impacting their lives?

Personal Story

I have always been a fairly high energy, socially outgoing, fun-loving kind of guy (more so when I was younger; the responsibilities of adulthood have sobered me somewhat). And I had a pattern of starting a lot of projects, moving from one task to another frequently, and leaving the mess there for someone else to pick up after me. I also had a history of making quick decisions, sometimes not always “thinking through” the longer term risks or consequences. And I am definitely stimulation- and excitement-seeking.

But I alwasy did well in school. I could pay attention in class and concentrate while reading. And I got my work done on time. So over the years, when I would speak on ADHD to parents and educators, my wife, kids and friends would tease me, saying something like, “You know you are ADHD, don’t you?” And I’d laugh and say, “Yea, right. No, I’m really more ADHD-like. I do OK.” And they would roll their eyes or sigh.

Then a few years ago, my wife started pressing me (who do you think wound up cleaning up most of my messes?) She would give me chapters on being married to an ADHD individual and say, “This is my life.” (There is a great chapter in Delivered from Distraction by Ratey and Hallowell.) So, after looking at the characteristics in my life and the struggles they produced, I acquiesced and agreed “this is me”. And I also eventually wound up trying medication.

The change in my life — both behaviorally and my subjective experience — has been dramatic. For me, one of the biggest differences is not feeling “on edge” and agitated most of the time. I am not as driven to be active and “doing something” all of the time (although this characteristic is still there, but to a lesser degree). Secondly, I am less impulsive and more able to not have to make a decision “right now”. This has had a positive impact in my overall decision-making, especially with regards to purchases. Finally, I also sleep better (I can “turn my mind off” and get to sleep.) [I am willing to discuss my personal experience further and answer questions, if that would be helpful.]

Conclusion

So, although my personal experience will certainly create some biases, I do continue to believe ADHD is overdiagnosed in our culture (especially in young boys). But I also believe that it is exists and many ADHD individuals may receive significant help by medication (a number of ADHD individuals manage fine without medication). The real issue is to have a thorough evaluation — often other issues that can create ADHD-like symptoms need to be ruled out (depression, anxiety, learning difficulties).

Next, we will take a look at how ADHD affects individuals performance in the workplace.

I am going to post a three-part series on Adult ADD / ADHD.

The first deals with understanding what ADD / ADHD really is. The second takes a look at the issue of overdiagnosis. The third discusses the impact of ADHD characteristics in the workplace.

ADULT ADD / ADHD: MYTH, EXCUSE, OR REALITY?

Adult ADD (Attention Deficit Disorder) is one of those terms that elicits a variety of reactions from people. Some laugh with a derisive tone. Others eyes brighten as if you understand them. Many have that puzzled, quizzical look demonstrating their lack of knowledge of the condition.

Clarifying the terms ADD & ADHD

Let’s first get our terminology correct. ADD (whether adult or otherwise) is no longer the current term used by professionals (although many teachers and non-professionals still use it. The correct diagnostic term is Attention Deficit Hyperactivity Disorder (ADHD). The confusion largely comes from the fact that an individual may have ADHD and not be hyperactive. This is because there are three subtypes of ADHD: a) the hyperactive-impulsive type (sort of your classic “wild boy” that many of us associate ADHD with); b) the inattentive subtype (which used to be called ADD without Hyperactivity); and c) a combined type which has aspects of both hyperactivity/impulsivity and inattentiveness (again, however, an ADHD-combined person may not be hyperactive; they just could be inattentive + impulsive).

The reason this clarification of terminology is needed is because many people when they hear or read about Adult ADHD (or if a friend or relative asks them if they are ADHD), firmly state: “No. I can’t be ADHD because I am not hyperactive — and never have been.”

Characteristics of Adult ADHD

Like any diagnostic category, Adult ADHD (or really, ADHD as found in adults) both describes common characteristics shared by many people but also allows for individual variations. That is, there are adults with ADHD who are very similar and those who are quite different from one another, depending on their individual characteristics and subtype.

Let us look at some clusters of symptoms grouped by general categories.

Attention / Concentration Issues

*short attention span *struggles maintaining mental focus *easily distracted off task *forgetful *can’t pay attention for long in lectures *spaces off during conversations *misplaces items *loses train of thought while reading *starts a lot of tasks but finishes few *distracted by their own thoughts *distracted by things in their environment

Hyperactivity / Fidgetiness

*moves at a fast pace *can’t sit still for long *frequently fidgets with things *legs bounce when sitting *gets agitated if sits for long *doesn’t need much sleep *always “on the go” *frequently looking forward to the “next thing”, struggles living in the present

Impulsivity

*does and says things “on impulse” *talks a lot *interrupts others *speaks mind bluntly *very spontaneous *makes quick decisions *doesn’t think through consequences *excitement seeking *problems managing money *focused on the “now” *puts off tasks & work until later

Miscellaneous

*poor organizational skills *problems managing paperwork *can get “hyperfocused” on a task procrastinates *dives into new projects then loses interest quickly *easily frustrated *quick temper (but gets over it quickly)

We have described what ADHD looks like in adults. In my next entry, we will discuss the issue of overdiagnosis of ADHD in our culture and the challenges this creates.

Spring is a fascinating time of year. New growth. Delicate flowers and flowering trees. Longer days. The return of wildlife and insects (I saw three different types of swallowtail butterflies on our lilac bush this week!) And unpredictable weather.

Growing up in Kansas, I never understood what the “big deal” was about Spring. Spring in Kansas consists of warmer days, some flowers and the greening of the grass. But it also includes blustery, windy days; and teasing warm days followed by cold snaps (just this week we had a late spring snowstorm which dumped four inches of snow on our flowering trees and shrubs — and today it is 30 degrees out). And then there are the spring thunderstorms and tornadoes. Not the idyllic Spring I read about in books. [My favorite memories of Spring are associated with May — making May Day baskets of flowers and giving them to friends and neighbors; warm, sunny days with cool grass underfoot; and flying kites on a warm, breezy day.]

But Spring in the South — that is something different altogether. I came to appreciate and see the wonder of Spring when we lived in Atlanta. First, it comes early (early March). Second, the sights and smells fill your senses — flowering dogwoods, vibrant azaelas, along with all of the beautiful daffodils, tulips, and pansies. Spring in the South is delicious — filling your whole being with the newness of life. And lastly, it is long — lingering for several weeks into the early summer of May.

So what can we learn from Spring? Some lessons are obvious. First, life is comprised of seasons — different periods of life that have different characteristics. Spring demonstrates renewal, rebirth from what has been dormant. This is helpful to keep in mind, in terms of business and personal growth, because it reminds us that there are periods of time where life is more dormant — not much exciting is going on, it doesn’t appear (note the term “appear”) that any growth is occuring, the days seem gray and rather lifeless. But during the winter-time, we need to remember and have the hope that Spring is coming. An example of this in business is to put a newer staff member in a position of responsibility that they are not yet ready to handle all of the challenges that they will face. Or it may be pushing a product onto market too early before you have worked all of the kinks out. In family life, it may be giving your teenager too much freedom too soon.

A second lesson we can learn from Spring is that new growth that is exposed too quickly can be at risk for destruction. Why the negative focus? Because many of us, in our excitement and anticipation of Spring, try to plant new flowers, trees or plants too early. We start seedlings in our home and then when the first warm week of Spring arrives we transplant the new plants in the garden or flowerbed. The problem? We forget that there still may be cold weather and frost, even snow. So we need to be patient, continue to grow our plants inside and protect them from the elements they are not ready to survive, and wait until they have reached the appropriate level of maturity and also for the danger of external risks to subside (they never totally go away.) An example of this in business may be placing a newer staff member in a position of responsibility that they are really not ready to handle all of the challenges they will face — putting them at risk for failure. Or it may be pushing a new product into the marketplace before all of the kinks have been worked out. In family life, this may be giving a teenager (or young adult) more freedom than they really are able to wisely manage.

Lastly, we need to remember that Spring doesn’t last forever. An obvious observation, but still a point worth noting. The creation of new growth generally does not continue year-round. Spring is the time where plants push out new buds and shoots. It is the season of procreation for most animals. Then comes the time for maturing, developing and producing fruit. What is interesting to me (as a novice gardener) is that what is produced in Spring (especially flowers and flowering shrubs and trees) are the results of planning and preparation that was completed in the Fall and Winter. You can’t plant tulips or a dogwood tree in March and expect them to flower this Spring. The same is true in business and in our personal lives. First, it is unrealistic to expect fantastic new growth to occur all the time — that isn’t the way life is. There are times of spurts of growth, times of steady, slow growth, and times of no apparent growth (although the root system may be developing more fully). Secondly, for Spring-like growth to occur, we need to be thinking ahead — planting, refurbishing the soil, pruning, fertilizing. Growth in business or in our personal lives doesn’t just happen (usually) — growth is the result of foresight and planning, and the commitment of time and resources to allow growth to occur when the time is right (similar to the adage, “chance is the combination of opportunity and preparation”).

So, enjoy! Take a walk and let the warm sun and gentle breeze caress your face and skin. Stop and smell the lilacs (the roses aren’t out yet in my part of the country.) Stroll slowly and watch for butterflies and honeybees. And think about the new growth you would like to see in your business and life next year — and start making some plans to make them happen.

This week I have been reading Benjamin Franklin’s The Way to Wealth. I have always been intrigued with Franklin, and I also am personally committed to learning from successful individuals across history. Two of his key themes in The Way to Wealth are the interrelationship between the practice of frugality and industry.

To cite some of Franklin’s comments:

“It is important to realize that all a person has is the product of his or her labor. . . If we are industrious, we shall never starve. . . In short, the way to wealth, if you desire it, it is as plain as the way to market. It depends chiefly on two words, industry and frugality; that is, waste neither time nor money, but make the best of both. Without industry and frugality, nothing will do, and with them everything.”

These thoughts combine with the repeated “drum” I hear in the marketplace from business owners and managers — that it is difficult to find employees with a good work ethic. In fact, a business owner lamented to me today, “I just don’t understand workers today. They don’t want to work — they want to be paid well but they aren’t willing to ‘put in their time’ to learn and work their way up in the organization.” Many times I hear managers talk of the impatience or short-time frame that workers have — they seem to expect to receive rewards (wage increases, promotions) quickly.

A third stream of thought that also weaves together is this. I have had the opportunity to interview numerous (50+) successful multimillionaire business owners across the country as part of my family business coaching over the past few years. One of the questions I consistently ask is: “To what do you attribute your business and financial success?” (and this is usually answered by the business owner and their spouse). One of the two most common responses I get is: perseverance. One businessman stated: “We just kept doing what we were good at and tried to serve our clients well. We worked long and hard — it wasn’t magic and it wasn’t easy.” (Just for your information, the other most common response runs along the theme of “we were in the right place at the right time”, or “God blessed us with an opportunity and we were able to capitalize on it.”)

So to tie it together: Franklin’s focused on industry as part of the formula for creating financial wealth; there is a perception that there is a dearth of workers with a good work ethic currently; and perseverance is repeatedly cited as a key component to financial/business success. So one conclusion I come to is — there are a number of people in our workforce that are probably not going to experience much success (either in the workplace or financially) if they don’t come to understand the importance and necessity of working hard and persevering.

I think a lesson for the rest of us who do work hard is to “hang in there”. Obviously, we need to keep focused on our core competencies and implementing the plan that we believe will bring success, but not to lose heart and give up. On the other hand, as a friend/consultant shared with me just today, the issue isn’t just “working hard”, the goal is to achieve results. Many individuals seem to focus almost exclusively on working hard, thinking that is the goal. But lots of effort without results (however those are measured) is, ultimately, futility. And it seems to me, the ability to determine what actions we should persevere in requires some business savvy, along with a measure of discernment and wisdom.

To close with a bit more from Franklin, he believed to “do well by doing good.” That is, if we choose to serve others and help others become successful, we will eventually experience the benefits of these actions.