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Frequently Asked Questions

The following questions comprise some of the most frequently asked questions by patients seeking the expertise of The Being Well Center in treating ADD/ADHD. Further resources on ADD/ADHD can be found in our Resource Center.
Please click on the question to view answer underneath.
  1.  What specific behaviors indicate that an individual might have ADD?

  • Low Arousal – People with ADD are less alert and awake. They often show signs of sleepiness, particularly during activities that require focused attention, and are frequently fidgety.
  • Impulsivity – Individuals with ADD frequently speak and act without first thinking about their words and actions; they often make careless mistakes and do or say inappropriate things.
  • Distractibility – ADD Individuals have difficulty focusing their attention. They often have a hard time organizing themselves, thinking clearly, and expressing themselves.
  • Short Attention Span -Individuals with ADD have difficulty staying focused on a project or an activity for a sustained period; rather than becoming increasingly focused over time, more often than not, they jump from one thing to another, failing to complete and task begun.
  • Poor Monitoring – People with ADD fail to check themselves; they are unable to critically evaluate their behavior and appear to be unaware of the consequences of their actions.

  2.  Is ADD the same as hyperactivity?

    Hyperactivity is one of the many labels that have been used over the years to describe individuals who demonstrate the characteristics of ADD. Today, many divide ADHD into subtypes: primarily inattentive, primarily impulsive, and combined type. The BWC does not embrace these labels and diagnoses. Including hyperactivity in the diagnostic label perpetuates the myth in the minds of many lay and professional people that a person must demonstrate hyperactivity in order to have ADD. This is not the case; the majority of individuals with ADD demonstrate normal to low activity level. When all is said and done, what matters most in understanding and identifying ADD are the five key characteristics of inattention. Apart from this, every individual with ADD is unique: some hyperactive, some underactive, some overreacting, some with thick skins, some gifted, some mentally retarded…What we wee on the outside is the result of how the core attentional characteristics mix with other traits, skills, and abilities.

  3.  What causes ADD?

    The exact cause of ADD is unknown but most of the evidence now points to the fact that ADD has a genetic basis. Medical literature suggests that ADD is linked to inborn differences in the parts of the brain that control paying attention. These differences appear to involve the chemicals that transmit electrical charges (i.e. neurotransmitters). Generally, people with ADD appear to have either an inadequate amount of dopamine or norepinephrine or both, or the neurotransmitters that are present are not functioning properly. Researchers have begun to identify specific genes that show up more frequently in people who have ADD. Dr. Liden suggests that ADD is a polygenic problem. That is, there are probably a variety of underlying genotypes (combinations of genes) that are responsible for a common phenotype (the outward manifestations of ADD).

  4.  Does ADD run in families?

    Yes, but the actual patter of how it is passed on from generation to generation is unclear. In Dr. Liden’s clinical experience, more than 90% of the parents of children with ADD can identify another family member with similar problems. It might be a brother or a sister, an aunt or an uncle, or, most commonly, one of the parents themselves.

  5.  If 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. Television, the computer, and hand-held electronic games are the most common examples of attention-magnets in everyday life. Sometimes apparently efficient attention in a person with ADD is deceptive. He has simple 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.

  6.  How does ADD affect learning?

    Attention plays a major role in learning since all information coming into and out of a person’s brain is filtered by attention. Poor attention affects both incidental and school learning. A personal who has a weakness in attention is less able to receive all of the input from the environment – structured or unstructured – that is necessary for learning. ADD can also interfere with a person’s ability to demonstrate what he has learned. In school, people with ADD may fail to complete all their daily work, add instead of subtract on achievement tests, make careless errors, reverse letter when reading or writing, and forget to capitalize and punctuate in written language tasks. ADD negatively affects learning. But it is important to remember that ADD, as a biologically based individual difference, can occur in anyone – an individual who is gifted, learning disabled, mentally retarded, or has average learning ability.

  7.  What is the impact of ADD on marriage?

    The impact of ADD on marriage is often profound. Frequently, marital difficulties begin before the wedding: the impulsive ADD individual meets someone; he quickly gets caught up in feeling loved and connected; with all the intensity of feeling, thinking does not occur. Before the two really know each other, they get married. Maybe in a week, or a month, or six months, but very soon, one or the other know they have made a terrible mistake. For couples who chose to marry after getting to know each other, the key issues are different. Frequently, I see them when the spouse who does not have ADD has reached his limit; he wanted a partner and is feeling resentful that he married a child. There are still other couples that make their way to my office thwn the partner without ADD feels her spouse is just not connected to her as she had hoped. Her conclusion is that she either has married an insensitive jerk or he doesn’t love her anymore. Rather, she has married a good man with ADD who still loves her. His poor attention, however, interferes with his ability to read between the lines, tune into nonverbal cues, and monitor his own lack of responsiveness.

  8.  How does ADD impact day-to-day functioning?

    Good attention is necessary for all of us to efficiently meet the demands of a typical day. For the individual with ADD, daily tasks are far from effortless. Each requires alertness, impulse control, vigilance, and monitoring. Daily tasks requiring efficient attention include:
    1. Wake up refreshed and on time

    2. Do personal hygiene routines (shower/bathe/ brush teeth)

    3. Have regular bowel movements

    4. Get dressed and ready to leave on time for school/work

    5. Eat regular meals and make good choices about quality/quantity

    6. Complete assigned tasks doing quality work in a timely fashion

    7. Set limits and manage time

    8. Control emotions

    9. Have good social skills and communicate effectively

    10. Use seat belts

    11. Do household chores

    12. Pay bills and be financially responsible

    13. Take medications and follow medical recommendations

    14. Make responsible decisions regarding smoking, drinking, drugs, and sex

    15. Maintain predictable bedtime and wake time

  9.  What types of health problems are associated with ADD?

    There is a wide range of health problems associate with ADD Some of the health problems are a consequence of unhealthy living patterns and behaviors that can result from ADD, some are related to the chronic stress frequently associated with ADD and unhealthy attempts to cope with it, and some are related to the consequences of the chronic failure associated with ADD. Health problems, which seem to be associated with ADD through one or more of these mechanisms, include the following
    1. Alcoholism/Addictive Disorders
    2. Obesity/Anorexia/Bulimia
    3. Sleep Disorders
    4. Tourette Syndrome/Tic Disorders
    5. Chronic Constipation
    6. Hypertension
    7. Recurrent Otitis Media
    8. Allergies/Recurrent Infections/Immunological Disorders
    9. Accidents – Ingestions/Automobile, etc.
    10. Depression/Anxiety/Suicide
    11. Bipolar/Obsessive Compulsive and Oppositional Defiant Disorders
    12. Child/Spousal Abuse
    13. Chronic Fatigue Syndrome
    14. Unplanned Pregnancy/Sexually Transmitted Diseases
    15. Recurrent Headaches
    16. Fibromyalgia

10.  How is ADD diagnosed?

    Once an individual is suspected of having ADD, it is imperative that he participate in a comprehensive assessment to establish the diagnosis and to develop a treatment plan. A comprehensive assessment of ADD should include a medical, educational, vocational, and behavioral history, a survey of daily activities and independent functioning, a general physical and neurological examination, sensory screening, and a neurodevelopmental assessment. The goal of such a comprehensive assessment should not simply be to establish the diagnosis of ADD. Rather, it should be used to generate a description of the individual's strengths and weaknesses in many areas. When emphasis is shifted from labeling the problem "ADD" to understanding the individual’s unique patter of strengths and weaknesses, it helps to ensure that a treatment plan addressing all contributing factors will be developed.

11.  Why are people with ADD frequently misdiagnosed?

    The ways that ADD shows itself are highly variable from person to person depending upon an individual’s age, unique personality characteristics, profile of strengths and weaknesses, and the stresses and demands placed upon him. The fact that there is no definitive test for ADD further complicates diagnosis. This means that making the diagnosis of ADD requires qualitative data interpretation and decision making. Unless it is highly systematic, such qualitative diagnostic techniques are susceptible to multiple sources of error.

12.  How is ADD treated?

    Since ADD is a chronic medical disorder that affects all areas of an individual’s life, it requires long-term follow-up treatment that addresses all aspects of the problem. Most often, the Being Well Center recommends a three-pronged approach to treating ADD
    1. Counseling the individual. This involves helping the individual to become more aware of his problem, to learn strategies for controlling and compensating for inattention, and to develop techniques for improved life problem solving.
    2. Working with significant others. This involves helping parents, spouses, teachers, co-workers, and others to understand and accept the problem to set realistic expectations, and to effectively manage difficult behavior.
    3. Using medical therapy. This involves using medication as an aide to improve attention and to make the individual more available for other treatments.

13.  What can be done to help someone who is resistant accept treatment?

    How we can best deal with resistance to evaluation and treatment varies dependent upon the individual's age.
    1. In younger children, we rarely see resistance. Once they see the positive impact of medication and other strategies on their school experience, social interactions, and home life, most young children are happy and actually excited about treatment.
    2. There is much more resistance from young adolescents who struggle with the notion that ADD and its treatment make them different from their peers. Empathy and demystification of ADD and its treatment frequently promote acceptance in young adolescents. It is also important that parents take charge by setting clear limits about taking medication and participating in follow-up counseling.
    3. When dealing with older adolescents and young adults, addressing resistance is often more challenging. We frequently see older adolescents or young adults who have struggled for years, been accused of being lazy or stupid, or been told that they could do it if they just tried harder. It is often necessary for parents to focus on establishing firm limits and to stop enabling in order to motivate the older adolescent or young adult to comply with treatment.
    4. Addressing resistance to evaluation and treatment with an adult, particularly a spouse, can be tricky. Adults may have many reasons for not wanting to become involved in treatment. Some may have developed a version of that hardened, self-protective shell and belligerently proclaim, "I'm just fine the way I am!" It is important for significant others to provide direct feedback when problem behaviors occur and be careful to avoid enabling, codependent behaviors that can mask the impact of untreated ADD.

14.  Can individuals with ADD be successful in college?

    Absolutely. Many individuals with ADD are very successful in college. For others, however, ADD significantly compromises the students’ ability to experience the same success. Not only do the expectations for academic performance, independent functioning, and social decision making dramatically increase in college, this jump occurs far from home away from the support, structure, and monitoring of mom, dad, and the invested high school teacher. While it can be extremely challenging, college provides the ADD individual with the opportunity to grow in ways he never can if he is living at home. In our experience, the keys to success for the ADD student in college include the following: a good self awareness, an acceptance of ADD, treatment compliance, a willingness to seek and use support services, a commitment to maintaining a healthy daily routine, a willingness to work harder than many other students, adequate academic skills, good study skills and work habits, the ability to function independently, efficient social skills, good problem solving, and the motivation to succeed. Wow!

15.  What can an adult with ADD do in the workplace when ADD is interfering with job performance?

    ADD can interfere with job performance in countless ways. Productivity problems, poor performance reviews, or probationary status may be indications that attention weaknesses are negatively impacting in the workplace. When this occurs, the adult with ADD may invoke the Americans with Disabilities Act (ADA). Under this law, employers may be required to make accommodations that allow the person with disability to be successful on the job. In my experience, calling upon the ADA should be done cautiously and only when employment is at risk. When, upon considering the risks involved in sharing personal medical information with an employer, the adult with ADD chooses to invoke the ADA, he may begin be discussing with his employer his disability, its impact upon job performance, and his request for accommodations. When the request for accommodations are reasonable and will not cause the employer under hardship or alter the job’s basic requirements, the employer is required to make those or similar accommodations.