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Attention Deficit Disorder???

Jacqueline Todorov

In the past 6 months or so, I have been looking back over my life. It has not been because there has been a major upheaval but rather a revelation and explanation to a life long struggle. In October of 1997, I was diagnosed with Attention Deficit Disorder inattentive type. I am now 31 years old and in my graduating year of Nursing.

Until recently, my knowledge of this condition was limited to hyperactive boys, mainly because this is where all the research is focused. There are 2 main types of ADD, with and without hyperactivity. There are subcategories that apply depending on the presenting signs and symptoms such as inattentiveness and impulsivity. While hyperactivity is the giant sized red flag for this condition, a number of symptoms are used in diagnosis. Here is a list of them:

Diagnostic Criteria For Attention Deficit/Hyperactivity Disorder

Six (or more) of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

Inattention
  1. often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
  2. often has difficulties sustaining attention in tasks or play activities
  3. often does not seem to listen when spoken to directly
  4. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace ( not due to oppositional behavior or failure to understand instructions).
  5. often has difficulty organizing tasks and activities
  6. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
  7. often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
  8. is often easily distracted by extraneous stimuli
  9. is often forgetful in daily activities

Six or more of the following symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity
  1. often fidgets with hands or feet or squirms in seat
  2. often leaves seat in classroom or in other situations in which remaining seated is expected
  3. often runs about or climbs excessively is situations in which it is inappropriate ( in adolescents or adults, may be limited to subjective feelings of restlessness)
  4. often has difficulty playing or engaging in leisure activities quietly
  5. is often "on the go" or often acts as if "driven by a motor" (f) often talks excessively
Impulsivity
  1. often blurts out answers before questions have been completed
  2. often has difficulty awaiting turn
  3. often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition to the inattention and/or hyperactivity/impulsivity, other diagnostic criteria are:

  1. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age seven.
  2. Some impairment from the symptoms is present in two or more settings (e.g., at school, at work, or at home).
  3. There must be clear evidence of clinically significant impairment in social, academic or occupational functioning.
  4. The symptoms do not occur exclusively during the course of pervasive developmental disorder, schizophrenia, or other psychotic disorders, and are not better accounted for by another mental disorder (e.g., mood disorder, disassociative disorder, or personality disorder).

(Adapted from DSM-IV, Washington, D.C.: American Psychiatric Association, 1994, pp. 83-85.)

A complication of ADD is that there is in most ADD-ers a tendency towards depression and anxiety. Professionals have not yet figured out if the condition causes these symptoms or are a result of trying to cope with ADD.

In my case, the struggle of getting big assignments done well and on time were my downfall at school. I am the master of procrastination. I would put off the big assignment until the night before and work all night to get it done and have a very sloppy assignment to hand in to the teacher. Invariably, the stress of waiting to do it was harder on me than just getting it done. I would, however, repeat this cycle over and over until I was so stressed out I couldn't think straight. Last year, I failed a course by 2 marks for this very reason.

In the fall, determined to graduate this year, I took myself to the centre for students with disabilities at my college to see what could be done to ensure that I would achieve this goal. After 10 hours of testing I had my answer. This was a relief.

The impact it has had on how I view myself and how I work has been dramatically altered. I am now on medication that will help with the anxiety and depression as well as the ADD. I also changed the way I plan things. I was never one for a routine but I have one now. Just getting up and ready in the morning in a predetermined way has done wonders. Organizational skills as well as medication has made it possible for me to live a more fruitful and productive life. I feel better now than I ever had before.

Getting up on time in the morning and knowing and sticking to a schedule so that I am out of the house on time and at school with enough to spare for me to grab a coffee and study my patient assignment for the day, without doing the "chicken without a head" routine everyday has gone a long way towards improving my self-esteem and confidence. I have even gotten back into the habit saying my morning prayers on the bus ride to the hospital!

If you or your child has ever heard " this child is smart and could really do well if only he would try" then it is perhaps time to have a serious look at getting a professional assessment done. I am not an advocate for homeschooling but in the case of ADD and other learning disabilities I would seriously think about it. As a child, the only time I learned well was in a 1 to 1 situation.

In conclusion, I would just like to say that this is not a condition that can be diagnosed by a lay person. Even pediatricians have difficulty diagnosing and treating this problem. This is one for a professional in the field of psychology or psychiatry. If you are not comfortable with the first on try another. Many parents know when something is "not right" with their children, but are seldom right about what is wrong. So please find a professional that you trust to make the diagnosis.

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