Reporter's Notebook

ADD and Add-iction

An explanation, not an excuse


Laurence Traynor

The best day of my life? Getting diagnosed with ADD. The worst day? The same one.

I have attention deficit disorder (ADD). Learning that you have ADD in adulthood can be a bit startling. Although I have always had ADD, I was not diagnosed until 1992, the same year I got sober. 

ADD has been around for centuries, but the term wasn't coined until the 1970s. Only recently has this genetic neurological syndrome been identified and diagnosed among adults. This was a tremendous breakthrough for adults previously thought to be lazy, stupid, and crazy. About 5 percent of adults in the US have ADD.

ADD is not a fad but rather a medical diagnosis. Although attention deficit hyperactivity disorder (ADHD) is the term used in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, I prefer to use the term ADD. You, like me, may have ADD with no hyperactivity-related symptoms.

Undiagnosed, ADD can cripple adults socially, emotionally, and professionally. My personal diagnostic triad of ADD symptoms includes distractibility, impulsivity, and restlessness. Symptoms may also include an inability to focus, information processing difficulty, forgetfulness, a propensity for daydreaming, underachievement, and disorganization. Ask someone with ADD the sum of one plus one, and you may get an answer of 11. 

Many adults with ADD are drawn to high stimulus situations as a means of alleviating boredom and clearing their mind of distractions. The dominant feature of the adult ADD brain is the inability to inhibit certain thoughts, feelings, behaviors, or cravings. 

For those with ADD, the high associated with seeking excitement is intoxicating and, paradoxically, therapeutically calming, often giving way to what is known as hyper-focusing. Impulsivity, high energy, frustration, risk-taking behavior, and low self-esteem all add to the likelihood that those with ADD can end up in troubling situations.

Since childhood, I have suffered from chronic frustration, low self-esteem and feelings of failure. I knew something was wrong prior to my diagnosis, and had spent my whole life searching for the cause. 

My distress, anxiety, and history of failure, confusion, and unhappiness resulted in deep-rooted pain and low self-esteem. I felt the pain of being emotionally and mentally different, of missing what others got, and of getting what others missed. 

ADD caused me to struggle socially, always feeling out of place. I felt like it had started to rain and I was the third monkey running to get aboard the ark.  

My ADD drove me to the brink of suicide as I suffered dark, interminable moods where all I was overwhelmed by feelings of worthlessness.

To me, ADD is similar to pornography: I can't define it, but I know it when I see it. Since a concise definition does not exist, we must rely on descriptions of symptoms to define ADD. 

People with ADD love to play, hate being bored, and often misperceive, mishear, and misunderstand others. We simply find distractions impossible to resist and can spend a lifetime dodging the necessity of organizing ourselves. An invisible shield of procrastination keeps us from completing the simplest of tasks.

I was fortunate to attend a small, Rhode Island prep school, the Providence Country Day School. Parent-teacher conferences each year yielded the same result: “Laurie is a smart boy, if he would only apply himself.” I was much more interested in looking out the classroom windows. To this day, I've never met a window I didn't like. 

I thought myself a fraud and survived by continually winging it. Fake it till you make it was my adolescent mantra.

My life dramatically changed in 1992 after reading Edward Hallowell’s groundbreaking book, Driven to Distraction.

Everything suddenly made sense.

Once my ADD diagnosis had been confirmed, my next step was to learn as much as possible about this condition. 

As I studied ADD, I learned that it manifests itself differently in different people with varying degrees of intensity. I learned that ADD does not go away and if one has it as a child, one has it for life. 

Alcohol was my drug of choice and I relied on it to treat my dark, depressive, ADD-related moods. Because it feels so good to be focused and calm, people with ADD become highly vulnerable and risk becoming addicted to this self-medicating behavior. 

Like alcoholics, many people with ADD have trouble accepting that it's rooted in biology and is not a character weakness.

A neurological syndrome, ADD, again like alcoholism, is one of the most inheritable of all psychiatric conditions. Ninety to 95 percent of people diagnosed with ADD inherited it.

Coexisting anxiety and depressive disorders among adults with ADD are as common as drug and alcohol abuse. The connection clinicians observe with ADD and subsequent addiction is striking. Most clinicians who work with adults with ADD observe higher than usual rates of alcohol and drug abuse. Because the dominant feature of the ADD brain is the inability to inhibit or put the brakes on certain thoughts, feelings, behaviors, or cravings, people with ADD are more apt to develop addictions.

Many scientists believe that self-medication with a substance such as cocaine, marijuana, or alcohol is based on biological processes. The introduced substance interacts with various neurotransmitter systems and reduces symptoms of anxiety, depression, or distractibility. The addiction-related problems surface when the brain starts craving the substance to maintain its preferred balance. 

Since individuals with ADD are at much greater risk for developing problems associated with addiction, it would be wise for anyone who suffers from ADD to be aware of this inherent predisposition.

Many adults with ADD who don’t know they have it but have successfully achieved years of continuous sobriety, often realize after reading a story similar to this one that they, too, have undiagnosed ADD.

The starting point for all treatment for ADD is getting an accurate diagnosis by a medical doctor. There is no one recipe for treatment, nor a definitive test for ADD. The diagnosis of ADD is based primarily on sharing an individual's history with a doctor. Adults historically stumble onto an ADD diagnosis by word of mouth or by learning about it through their children.

There is a distinct difference between ADD and pseudo-ADD. Pseudo-ADD means that one has ADD symptoms without the actual ADD diagnosis. What differentiates ADD from pseudo-ADD is the duration and intensity of symptoms. Feeling disorganized, being prone to procrastination, and having trouble with relationships may simply be pseudo-ADD. The person with true ADD experiences symptoms most of the time and feels more intensely. Most importantly, the symptoms of an adult with ADD tend to dramatically interfere with everyday life. 

In many ways the most dangerous aspect of undiagnosed and untreated ADD is the continued assault on one’s self-respect and self-esteem.

The longer the diagnosis of ADD is delayed, the greater the risk becomes of alcoholism, drug addiction, and additional secondary problems. Living with ADD is similar to being nearsighted, as both deal with focusing-related problems. An ADD diagnosis is no more shameful than having to wear eyeglasses.

Having ADD is nobody’s fault and when adult ADD is detected and appropriately treated, the results are often dramatic and life changing, as has been the case for me. 

Traynor is a national drug and alcohol treatment executive. He helps connect alcoholics and their loved ones with public and private alcohol assistance resources.