Colleges and university are cutting back on their involvement with ADHD, primarily due to abuse of the psychiatric medications — stimulants like Ritalin — prescribed to treat the disorder. Students — whether they are malingering the symptoms or actually have it — are prescribed a drug to treat ADHD (sometimes from different providers in different states), then sell a few (or all the) pills on the side. Profit!

Now universities are becoming wise to the epidemic nature of the problem, as some studies have suggested up to a third of college students are illicitly taking ADHD stimulants.

This might help curb the abuse problem, but will it also make it harder for people with actual ADHD to receive treatment?

The short answer is, yes, of course. Students with a pre-existing diagnosis of attention deficit or attention deficit hyperactivity disorder will still often be able to get their prescriptions filled while at school. The university just doesn’t want to do the diagnosing of ADHD any longer.

I’ve long wondered at the wisdom of universities getting into the ADHD business in the first place. University counseling centers generally shrug off long-term treatment of serious mental illness. So it’s never been clear to me why they were comfortable prescribing medications for ADHD.

The New York Times notes — in a well-written take on this issue by Alan Schwarz — that the changes are sweeping campuses throughout the country:

Lisa Beach endured two months of testing and paperwork before the student health office at her college approved a diagnosis of attention deficit hyperactivity disorder. Then, to get a prescription for Vyvanse, a standard treatment for A.D.H.D., she had to sign a formal contract — promising to submit to drug testing, to see a mental health professional every month and to not share the pills. [...]

The University of Alabama and Marist College, like Fresno State, require students to sign contracts promising not to misuse pills or share them with classmates. Some schools, citing the rigor required to make a proper A.D.H.D. diagnosis, forbid their clinicians to make one (George Mason) or prescribe stimulants (William & Mary), and instead refer students to off-campus providers. Marquette requires students to sign releases allowing clinicians to phone their parents for full medical histories and to confirm the truth of the symptoms.

“We get complaints that you’re making it hard to get treatment,” said Dr. Jon Porter, director of medical, counseling and psychiatry services at the University of Vermont, which will not perform diagnostic evaluations for A.D.H.D. “There’s some truth to that. The counterweight is these prescriptions can be abused at a high rate, and we’re not willing to be a part of that and end up with kids sick or dead.”

Not everyone is convinced:

“If a university is very concerned about stimulant abuse, I would think the worst thing they could do is to relinquish this responsibility to unknown community practitioners,” Ms. Hughes [CEO of CHADD, an advocacy organization] said. “Nonprescribed use of stimulant medications on campus is a serious problem that can’t just be punted to someone else outside the school grounds.”

She has a point. The 2010 suicide death of Kyle Craig, who abused Adderall prescribed by his local physician at home and not by the university he attended, suggests the problem is more wide-ranging than perhaps some university officials understand.

However, this sort of effort on the part of Fresno State is amazing and should be applauded:

And in a rare policy among colleges, students receiving prescriptions to treat A.D.H.D. must see a Fresno State therapist regularly — not for a cursory five-minute “med check” but for at least one 50-minute session a month.

Psychotherapy required for ADHD treatment? Nice — finally an institution that listens to the research and understands that medications are, for most, not a life-long answer.

I think that, by and large, this is a measured response to a very serious problem of stimulant abuse among college students. Students have long enjoyed free healthcare on campus, with counseling an additional free service they receive. But student counseling centers mostly refer students with serious, ongoing mental health or mental illness to local providers in the community — they’re simply not well-equipped to treat people with such concerns. I see no reason why ADHD should be an exception.

What this does for the colleges that are mostly getting out of the ADHD business is to limit the overall amount of prescriptions floating around for these stimulant meds. That should drive down supply, drive up prices, and make it less attractive as a “study” option for students without ADHD.

As for the students who actually have attention deficit disorder? I think they will still be able to get the treatment they need. Having seen people at community mental health centers, I know that if there’s a will, people will find a way to pay for mental health services.

Read the full article: Colleges Tackle Illicit Use of A.D.H.D. Pills

Register:  https://www4.gotomeeting.com/register/469236071

Description:  This special Mother’s Day webinar features best-selling author and Psych Central blogger Zoë Kessler (ADHD from A to Zoë) and special guest Lisa Aro, aka “Queen of the Distracted.”

Mark it on your calendar now, and check out additional information about the webinar inside…

Aro has earned her crown as the busy mom of 7 kids (6 with ADHD), and a husband who also has ADHD. Aro chronicles her family life at her blog, Queen of the Distracted. No family is without its challenges; when you add ADHD into the mix, family life gets even more complicated.

Join Zoë and Lisa for an informal and informative chat on parenting ADHD kids from the perspective of a grown-up ADHD kid (Zoë) and a non-ADHD mom (Lisa) with lots of insights on how to manage the many foibles and follies while still enjoying the fun of an active ADHD family.

You’ll get lots of tips on how prevent burnout and bring out the best in your ADHD bunch as Lisa and Zoë share their stories with honesty and insight.

We look forward to having you join us on Tuesday, May 7 at 7:00 p.m. (EST) for this special one-hour pre-Mother’s Day event.

Register today!
Click here to register: Mother’s Day with ADHD: How to Keep it Happy!

It also doesn’t help that credit cards are so easy to use. “Credit cards are rather intangible. They’re plastic, easy to store and don’t look like money. It’s much easier handing a card to a clerk than reaching for cash that generally has more meaning and is more concrete.”

Psychotherapist Stephanie Sarkis, Ph.D, agreed. “Credit cards can give the illusion that one is not really spending ‘real’ money.”

Plus, you get instant gratification, and the negative consequences are delayed, since your bills don’t arrive for weeks, Matlen added.

But while using credit cards is more challenging when you have ADHD, you can learn to use them responsibly. Below, Matlen and Sarkis shared their practical and realistic suggestions.

1. Use cash.

“It’s much easier to hand over a little plastic card than a wad of bills that the person worked very hard to earn,” Matlen said. Cash is tangible. “[U]sing cash is a giant cue that there is only so much money available once some or much of it is spent.”

2. Use one credit card.

If you can’t use cash all the time, have one card for all your purchases, Matlen said. And make sure it has the lowest finance fees you can find, she said.

3. Get a credit card with full payment requirements.

Some people have a remaining balance on their credit cards each month, which leads to finance charges, said Sarkis, author of several books on adult ADHD, including 10 Simple Solutions to Adult ADD.

She compared having an unpaid balance to “taking out a high-interest loan. An item that seemed like a deal at 50 percent off may actually cost you 200 percent for the original cost if you don’t pay off your balance.” That’s why she suggested having a card like an American Express that requires paying off the full balance every month.

4. Set up automatic withdrawals.

It’s common for adults with ADHD to rack up late fees, because they forget to pay their bills. This is why having money automatically taken out of your account every month is helpful. But, as Sarkis said, you have to make sure there’s enough money in your account.

5. Set up online payments.

Another option is to pay your bill online, Matlen said. Set up reminders to help you pay on time, she said. For instance, you can create reminders in an online calendar and with alarms on your phone.

6. Create a system for bills.

If online payments aren’t possible, Matlen also suggested keeping a box or manila folder for your bills: When each bill arrives, open it, and look at the due date. Write that date on the envelope, and put the bill in your box or folder. Keep the bills in the order in which they’re due. Then, pick two days each month to pay your bills. Note those days in your calendar.

7. Have a pre-paid card.

Both experts suggested having a pre-paid card that fits your budget. “This helps to prevent over-spending on credit cards,” Matlen said.

8. Take drastic measures.

Some readers might need to take more drastic measures. For instance, for clients whose over-spending is particularly bad, Matlen suggests “they take their credit cards and put them in the freezer so that they aren’t so easily accessible.”

9. Give yourself a day to reconsider purchases.  

According to Matlen, when it seems like you’re making an impulsive buy, stop and take a picture of the item instead. (Most cell phones have cameras.) Then give yourself one day to decide if you really want it.

10. Shop with a person who can keep you accountable.

“Shop with someone who can help you curb your impulsive buying,” Matlen said.

It’s common for adults with ADHD to overspend and forget to pay their bills. But while these problems are prevalent, they’re also surmountable. The key is to find a system that works for you and stick with it.

For instance, you might lose everything from your keys to your phone to important papers. And this can cost you both time and money, Sarkis says.

In her book she offers a variety of valuable tips to stop losing your things along with advice on what to do if you do lose something. Here’s a selection of her suggestions.

Have a Home for Everything

One technique is to store items where you typically use them. Sarkis uses the example of reading glasses. If you read in bed, keep your glasses on your nightstand so they’re easily accessible.

Also, store similar items together. Use clear containers with pullout drawers. This way you can see what’s in each container, and you don’t have to bother unstacking containers with lids. Use divider trays in desk drawers to keep office supplies organized.

Have a basket or rack by the door for your keys. As soon as you get home, put your keys in their place.

When finding a home for your things, Sarkis suggests asking yourself these questions:

• “How often do I use this item?
• Where do I use it the most?
• Is there a better location for this item?
• Are there similar items to store with this item?”

Establish Daily Rituals

According to Sarkis, “going through the same routine each day can help you save time and avoid losing things.” She suggests making a list of all the steps you take to get ready every morning. Laminate your list. As you go through your morning routine, cross off each item. For instance, your list might include: taking a shower, getting dressed, making breakfast for yourself and your kids, and making their lunches.

To keep items together, keep a small tray in your bedroom. In it put the items you need to carry with you, such as your wallet, money clip and phone. Sarkis also suggests spending 15 minutes every night to put things away, and laying out your entire outfit for the next day.

Every day, before leaving your house, double-check that you have everything you need. You also can write a list of items – such as your wallet, keys, phone and planner – and laminate the list. Create a smaller version, and carry it with you.

Figure Out What You Lose Most

Consider what item you tend to lose most often. Then think about how you usually lose it:

• “Does it fall out of your bag?
• Do you put it down somewhere and accidentally leave it?
• Do you put it in a special place in your house and then forget where you put it?”

Next, brainstorm how you can stop losing this object. Maybe you could buy a product that helps you keep track of this item. Or maybe you could change your behavior or routine.

For instance, if the item always falls out of your bag, “you may need to purchase a bag with zippered pockets or a key clip,” Sarkis writes.

When You Do Lose Something

If you do lose something, keep it in perspective. Everyone loses things from time to time. Plus, losing an item is minor compared to other losses. Stay positive. “Say to yourself over and over, ‘I will find this item,’” Sarkis writes.

Retrace your steps by remembering where you were, and either visiting or calling these locations. Because losing something can feel overwhelming, take a break. You’re less likely to find what you’re looking for when you’re furious or frustrated.

While it’s common to lose things when you have ADHD, you can minimize the losses by practicing effective strategies, such as the ones above.

So what is alternative treatment? You may already have some experience with the most popular, according to the Monitor on Psychology. Meditation, biofeedback, hypnosis and progressive muscle relaxation are all popular complementary or alternative psychological treatments. 

Although you may be familiar with the most popular, there are dozens of alternative and complementary treatments, which typically fall into four categories:  mind-body medicine, biologically-based practices, manipulative and body-based practices and energy medicine.

The Monitor article reports that, although these, and many other, alternative and complementary treatments have been around for thousands of years, the National Institute of Health (NIH) has been studying their usefulness, safety and role in improving health and health care for only a little more than a decade.

But many people embrace these treatments and are visiting alternative medicine practitioners more frequently than they visit their primary care doctors.  And these treatments are big business. A 2007 study found that $34 billion is spent each year on products and services for alternative and complementary medicines.

Continued research on the effectiveness of these treatments is ongoing and crucial.  However, current research suggests that many are effective for treating a wide range of problems, ailments and disorders.

There are too many to document in one post, but the following are the top 4 according to frequency of use, as reported in the Monitor.

1. Dietary Supplements.

Dietary supplements are used to promote general health, as well as to improve depression and anxiety and to decrease pain.  Common supplements reported in the Monitor include ginkgo biloba, St. John’s wort and vitamin supplements.  Although regulated by the FDA, they are held to very different quality standards than more conventional medicines.

• Caution: The FDA does not review the safety and effectiveness of any supplement before it is sold to consumers.  Supplements can vary widely from brand to brand and may interact with other medications. They should not be used without the knowledge of a physician.

2. Meditation.

Meditation is a process in which people learn to focus their attention in a particular way and on purpose.  It is used to treat a variety of symptoms, including high blood pressure, chronic pain, anxiety, depression, stress and insomnia.  It is also used to promote general health and well-being.

Meditation is integrated into many psychological treatments and practices with positive results; however, there are no formal qualifications necessary to practice it.  It is important that those who use this method receive appropriate training.

3. Chiropractic.

Chiropractic physicians use noninvasive treatments, such as spinal manipulations or chiropractic adjustments, with the aim of improving nerve and organ functioning by aligning spinal vertebrae.  These treatments are used to treat an array of ailments, from pain and headaches to stress and ADHD, among others.

Becoming a chiropractic physician requires several years of graduate work.  Most psychologists are unlikely to hold a chiropractic degree and, if they did, it would not be appropriate to serve as both a psychologist and chiropractor for the same client.

4. Aromatherapy.

Aromatherapy uses smells and aromas naturally extracted from plants to balance, harmonize and promote health of mind, body and spirit.  It is used clinically to relieve symptoms typically addressed in psychotherapy; holistically, to improve overall well-being; and aesthetically, in various oils and skin care products.

The Monitor cites recent research that indicates that aromatherapy can help treat pain, anxiety and agitation specific to dementia.  However, while certification is not required, it is recommended.  There are also risks related to toxicity, skin irritation and dosing regulations that require a competent professional to oversee, the article states.

Reference

Barnett, J.E., Shale, A.J.,(2013). Alternative Techniques.  Monitor on Psychology, 44(4).

“Adults with ADHD are highly distracted, impulsive and cannot tolerate boredom,” Matlen said. This makes it difficult to accomplish tasks, whether at home or at work. Structure, however, helps adults perform everything from daily chores to demanding projects at work, she said.

It also helps adults with ADHD get moving, said Stephanie Sarkis, Ph.D, a psychotherapist and author of 10 Simple Solutions to Adult ADD. “Inertia is the enemy of people with ADHD,” Sarkis said. She likens it to Newton’s first law. “An object that is at rest will stay at rest unless an external force acts upon it. This is especially true for people with ADHD.”

In short, according to Matlen, “Routines are a way to structure a day and make success possible.”

But people with ADHD tend to eschew structure. Why?

For one, the nature of ADHD makes setting and following routines more arduous. ADHD is an impairment in executive functioning. “This makes it difficult for us to organize our time, set deadlines, organize material for a task, and know how long it will take us to complete something,” Sarkis said.

People with ADHD have a love/hate relationship with routine, Matlen said. “ADD adults generally like variety, diversity and novel experiences because their brain needs to constantly be stimulated. Structure, as much as it is needed in the person’s life, can feel frightfully unnatural.”

They also might jump in too fast. According to Jennifer Koretsky, a senior certified ADHD coach and author of Odd One Out: The Maverick’s Guide to Adult ADD, adults with ADHD have good intentions but they “create a complicated routine too quickly. The details of the routine become hard to remember, boring, or tedious, and the person can find themselves thinking that they failed at one more thing despite their best effort.”

But this doesn’t mean that setting up a realistic and reliable routine is impossible. The key is to start small and find what works for you. Below, the experts — who also have ADHD — provide pointers on setting up a successful and sensible routine.

1. Ease into the routine.

According to Koretsky, “It’s often better to add to an existing routine than to try to create a completely new one.” That’s why she suggested adding one task at a time. Then practice this task over and over until it “becomes second nature.”

Koretsky gave the example of a woman who forgets to take her medication. She already has a morning routine. After she wakes up, she feeds the cat and makes lunch for her kids. She can slide her medication into the slot between feeding the cat and making the lunches. “Once she practices this for a while and it becomes a habit, she can consider adding another task to her morning routine.”

2. Imagine your ideal on paper.

If you’re just starting out, Matlen suggested “getting a notebook and writing down an ideal schedule, from morning to night [with] one [schedule] for workdays [and] one for non-work days [such as] weekends and holidays.”

In addition, have a good idea of the time each task takes, she said. For instance, how long does it take you to do laundry, drive your kids to school or get to work? You might have to time yourself to find out.

This is important, because many people either under- or overestimate their time. “With overestimating, it can feel overwhelming, thus causing us to procrastinate,” Matlen said. “When underestimating, it helps us to realize we do need to assign more time to the task.”

3. Keep a detailed schedule. “

Make sure every 30 minutes of your schedule is blocked out,” Sarkis said. “This includes scheduling free time and social time too!”

4. Use visual cues.

People with ADHD respond well to visual cues, according to the experts. For instance, Sarkis suggested color-coding your schedule. “Make work or school hours blue, errand time red, commuting time green, and so on.” Or you can use whiteboards to write down your daily schedule and long-term plans, Matlen said.

5. Use checklists.

Matlen’s clients use checklists throughout their days to stay on track. She uses an LED-lit “boogie board” to help her daughter remember what she needs for school. “Next to each item is a box and she checks each one as she gathers her backpack, lunch, etc.”

6. Use what’s best for you.

“The key is using techniques that work for you,” Matlen said. This might be a daily paper planner, a voice recorder, talking watch, computer reminders or software programs, she said. “If you’re a techie person, computer reminders and software programs are great. If you’re more of a ‘paper’ person, write your routines in a planner and keep it with you at all times.”

7. Reframe routine.

“I think adults with ADD tend to see routines as impinging on their sense of freedom. Structure and routines, in the end, actually free up the person,” Matlen said. She suggested reminding yourself that structure is a support, not a hindrance. “Remind yourself that these are tools to help you, not to make your life miserable.” They help you work more efficiently so you can get things done and have more time for the projects you enjoy, she added.

8. Know your rhythm. “

Know what time of the day you’re most productive and put into your routine the things that require the most brainpower during those times,” Matlen said. For instance, if you’re not a morning person, she said, do everything you need for the next day at night. This might include packing your own lunch (or your kids’), laying out what you’ll wear and having your briefcase ready.

9. Get help.

“Seek out the guidance of counselors, coaches, organizers, or trusted friends and family members,” Sarkis said.

Creating and following a routine when you have ADHD requires effort and time. “It can take months to get into a rhythm, a groove, to learn and remember to use these systems,” Matlen said. But it’s worth it. As Sarkis said, “routines and structure are essential to the well-being of an adult with ADHD.”

Do you often find yourself distracted until time is wasted? The challenges of ADHD and attention deficit disorder (ADD) are very real. But there is hope. When you understand how ADHD has been affecting all areas of your life, you can learn to minimize its impact and live successfully with ADD /ADHD.

Here are some steps to help you build confidence, clarify and prioritize your goals, minimize your ADHD challenges, and get you past being stuck to actually following through with your plans.

1. Plan.

   Start each day by taking time to think about what you want to accomplish that day with specific emphasis on one to five things.

2. Check in periodically during the day.

   Ask yourself frequently during the day if what you are doing at that moment is what you want to be doing and if it is helping you accomplish your goals.

3. Use a planning system.

   The more time we spend planning a project, the less time is required for it. Use a calendar, smart phone, or computer calendar to keep track of tasks and break them down into manageable parts.

4. Concentrate.

   The amount of time spent on a project is not what counts; it’s the amount of uninterrupted time. Make sure you are in the right environment for you.

5. Take breaks.

   Working for long periods of time can decrease energy, as well as increase stress, tension, and boredom. Switching from a mental task to a physical task and back can provide relief, increase your efficiency, reduce tension, and even benefit your health.

6. Reduce clutter.

   In most cases, clutter hinders concentration and causes frustration and tension. When you find your desk or work space becoming chaotic, take time to reorganize.

7. Avoid perfectionism.

   There is a difference between striving for excellence and striving for perfection. Getting something 85 percent perfect and handed in is better than 150 percent or more than perfect and not handed in.

8. Learn to say no.

   Learn to decline, tactfully, politely, yet firmly. Practice what you will say often.

9. Don’t procrastinate.

   Waiting until the end may feel like you have more energy to do the task, but more than likely you will end up rushed, out of time and with results less than what you would have done if you had started earlier. Decide to change habits immediately, but don’t take on too much too quickly.

10. Delegate.

    Decide to delegate the tasks that someone else can do, wants to do and take you too long to do.

You can learn these and other new skills to help you better cope with your attention deficit disorder symptoms. Consider enrolling a trusted friend or family member, too, for additional assistance in help keeping you on-task and more focused.

For instance, psychotherapy can help you better understand how ADHD affects your life. And it can help you develop the necessary skills for managing symptoms, being successful and having healthy relationships.

But in order for therapy to be most effective, you’ll have to work at it.

In his excellent and comprehensive book More Attention, Less Deficit: Success Strategies for Adults with ADHD, clinical psychologist Ari Tuckman, Psy.D, features valuable tips for getting the most out of therapy. Here are five tips from his book.

1. Be an active participant.  

Don’t expect your therapist to do the work for you. Therapy is a collaboration. As Tuckman writes, “The harder you work at it, the more you will get from it. It’s won’t always be easy, but it will be good for you.”

2. Remember that change takes time.

“It’s easy to get excited about something new (This therapy stuff is awesome!) and just as easy to grow bored with it later (We just talk about the same stuff),” Tuckman writes. Remind yourself that change takes time and patience, he writes. But doesn’t anything worthwhile?

3 Be honest and direct with your therapist.

Don’t assume your therapist knows what you’re thinking, feeling or what you need.  Always speak up.

For instance, if you think your therapist is criticizing or nagging you, “… Ask about it, because that perception can really undermine your relationship,” Tuckman writes. It could be that you’re, understandably, extra sensitive after years of criticism. Either way, exploring your feelings is critical in therapy, he notes.

Also, be honest about the therapy itself. “Tell him when you feel that you’re not focusing on the areas that you want to focus on or if it’s not as helpful as you want.”

4. Take notes.

People with ADHD can ramble, which can eat away at their therapy appointment. Tuckman suggests bringing in some notes to your session of the main points you’d like to discuss. You can share your notes with your therapist in the beginning of every session, and they can redirect you when you go off topic.

It’s also helpful to write notes after situations between sessions. That’s because, according to Tuckman, “Good therapy tends to rely on details — what happened, how you felt, what you did next.” So if you have a hard time remembering these points, take notes after something happens, as well.

5. Work between sessions.

Often therapists will assign “homework” for you to do between sessions to help you practice and cement the skills you’re learning in therapy. If you forget to do your assignments, create reminders. For instance, write it down in your planner, and set several alarms on your cell phone and computer. Sometimes, it isn’t that you forgot to do your homework; it’s that you didn’t understand it in the first place. Be sure to raise any questions you might have, so you’re clear on your assignments.

There are many things you can do to ensure you benefit greatly from therapy. Tuckman also stresses the importance of being yourself. He writes, “The goal is for the therapist to really get to know you. Not just the polite you that knows all the social rules, but also the private you that you try to not show too often.”

The challenges facing a person who is married or in a relationship with someone who has untreated Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (ADD or ADHD) can be difficult to navigate.

These challenges may be completely hidden to the rest of the world. No one seems to understand what you struggle with. Your spouse is such a “great guy” and may appear “together” to everyone else.

This article attempts to address some of the predictable patterns that one may experience being married to someone with ADD or ADHD and why it creates such difficulty. 

Being married to someone with untreated ADD is often fraught with a predictable progressive pattern that goes from happy to confused to angry, and finally, to hopeless. How does this happen and why is this so predictable in couples whose spouses have untreated ADD or ADHD?

In an attempt to answer that question let’s look at some of the patterns that typically come up in these kinds of relationships.  It is important to recognize the symptoms of ADD/ADHD, especially if you suspect your relationship might struggle due to this disorder.

In the beginning phase of the courtship between you and your ADD spouse, you may have been completely swept off your feet or ravished with both attention and affection, while being the primary focus of your partner’s life. His “hyperfocus” on the relationship probably felt intoxicating and romantic. But, this feeling faded over time.

When someone with ADD enters into a new romantic relationship, the initial excitement feels so stimulating to the ADD brain (which is being flooded with adrenaline and endorphins) that it causes the person to completely turn their attention to you. However, this kind of excitement diminishes over time, along with the adrenaline rush as the ADD spouse looks elsewhere for stimulation.

Of course, this is not conscious on his part, and he may not even be aware that this has happened. However, as time goes on, the non-ADD partner may experience the following seven feelings associated with his/her spouse’s need to find stimulation in places outside of the marital relationship:

1. A sense of rejection. Individuals with ADD may often be distracted and find it difficult to pay attention to their partner. This may lead you to feel neglected or it may be interpreted as disinterest on the part of your spouse.

2. Loneliness. If your partner seems disinterested in what you are saying or appears to ignore you, it would be easy to understand that one might feel lonely.

3. Feeling ignored. Partners of individuals with ADD often get the feeling that all their good advice and suggestions are not taken to heart. This may cause the non – ADD partner to feel ignored, disrespected or offended.

4. Frustration or anger. The same kinds of problems keep presenting themselves over and over again. It is difficult to understand how you can have discussions around a problem, think that you are being understood and still the same problem persists.

Resentment and anger become pervasive when one feels disregarded, disrespected, ignored and often alone in the relationship. Some spouses will become irate and scream at their partner, while others will shut down and block all emotions. This will leave a partner in the cold. Either way, one can see how this pattern becomes increasingly destructive.

5. Exhaustion. As the non-ADD spouse tries to compensate for the lack of equal sharing or follow through in responsibilities, you can often feel depleted. As if no amount of effort seems to resolve these same issues that continue to plague your marriage.

Due to the inconsistency in your spouse’s ability to follow through and remember to do things, the feelings of being burdened with more of your fair share of responsibilities can create more feelings of stress.

6. A sense of hopelessness. When one’s best effort to resolve these problems go nowhere, the sense of sadness and lack of hope may pervade the relationship and lead to a separation or divorce. 

There is hope. With understanding and knowledge, one can transcend these feelings and find a new way of being in the relationship. Learning all you can about ADD and how it affects your partner is vital. It is important to remember that even though your partner may no longer be hyper-focused on you and your relationship, that does not mean he does not still love you.

Since he probably isn’t even aware that your relationship has changed, he might not understand why you are always so angry and demanding. Your increasing frustration, anger and demands only further damage any chances of communication or intimacy, as your partner feels that he can never please you and that he is not enough.

He might feel unloved. Patterns of frustration and anger can be avoided when both partners understand the way the ADD symptoms are affecting your marriage. You must learn different behaviors to heal these kinds of wounds through education, communication and counseling.

More marriage advice from YourTango Experts: 

• 4 Skills You Need Before Getting Married
• Why Do Men Get Married? [VIDEO]

For more articles and help with these kinds of issues, please visit my blog at addadults.net/blog.

Psychotherapy targets specific ADHD symptoms that interfere with daily life, such as disorganization, distractibility and impulsivity. It helps you better understand your ADHD and improve all areas of your life, including home, work and relationships.

But not all therapists are created equal. That’s why it’s important to do your research, and be selective. Below, two ADHD experts share their tips on finding a good clinician.

Starting Your Search

Begin your search by asking your primary care physician if they can suggest good therapists who specialize in ADHD, said Terry Matlen, ACSW, a psychotherapist and author of Survival Tips for Women with ADHD. “Sadly, most will come up dry, but it’s worth trying.”

Ask friends, family and anyone else who has ADHD for recommendations, according to Matlen and Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor in the department of psychiatry at Harvard Medical School. They both noted that word of mouth is a great way to find practitioners.

If you’re looking for a therapist for your child, consult other parents of kids with ADHD. Ask them if their child is making progress, Olivardia said. “Do they or their children feel understood and validated by the therapy?” Another option is to ask the school psychologist for recommendations, he said.

Check out organizations that advocate for ADHD, such as CHADD or ADDA, he said. For instance, you can call CHADD (800-233-4050) to find out if there’s a chapter in your area, Matlen said. “Most all chapters keep a list of clinicians in the area that are adult ADD savvy.” Matlen’s website also offers a professional directory.

If you’re already part of a local support group, ask if they have good recommendations, Olivardia said. Consider calling the closest teaching hospital, Matlen said. “Ask for the psychology or psychiatry department and find out who on staff works with adult ADHD.”

Refining Your Search

Olivardia suggested selecting two or three potential therapists, and meeting with all of them. Matlen also suggested briefly interviewing the clinicians over the phone. The key, according to both experts, is to figure out who you feel most comfortable with. It’s important you feel safe sharing your struggles and concerns with your therapist, Matlen said.

Questions to Ask

In addition to figuring out who you’re comfortable with, it’s important to find a clinician who has experience working with ADHD clients. As Matlen said, it doesn’t matter whether the professional is a physician, psychologist, social worker or nurse practitioner. Experience is king.

Matlen and Olivardia suggested asking these questions:

• How many patients with ADHD have you worked with in the last 5 years? “At least 10 patients would give you some assurance that they have seen ADHD manifested with different types of patients with different associated issues,” Olivardia said. However, if someone has treated fewer individuals, but has “a clear philosophy in ADHD treatment, exhibits personality traits that click with you and is up to date on the research,” they might be a better fit.

• Have you read ADHD research or attended conferences, seminars or workshops on ADHD? You want to confirm that your therapist is very knowledgeable about ADHD. “Ask if they are familiar with the works of Dr. Russell Barkley, Dr. Ned Hallowell [and] Dr. John Ratey,” Matlen said.

• How do you view ADHD? Some practitioners see ADHD as a “curse,” while others see it as a “gift,” Olivardia said. “Seek a therapist who can validate and treat the areas that may feel like a ‘curse’ while also highlighting and optimizing the strengths or the ‘gifts.’” Viewing ADHD as a curse can make a person with ADHD feel like they’re defective, while viewing ADHD as a gift may gloss over the difficulties ADHD symptoms cause, he said.

• How do you evaluate ADHD? You can’t accurately diagnose someone with ADHD with a checklist or screener, Matlen said. “The eval should last longer than 20 minutes and include a history, clinical observations, a meeting with someone familiar with the patient to corroborate the patient’s statements and history, and much more.”

• How do you treat ADHD? “Different styles will work for different people,” Olivardia said. However, the most effective approach is cognitive-behavioral therapy, “which focuses on addressing any negative self talk while developing strategies of action that are ADHD friendly.” This can include “re-fram[ing] who you are as a person with ADHD, and also gaining skills in various areas of your life [such as] relationships, work, parenting [and] time management,” Matlen said.

• What are your thoughts on medication for adult ADHD? “We know that, combined with therapy, [medication] is the most effective treatment. If they are anti-medication, and it doesn’t match your own philosophy, you might want to look elsewhere,” Matlen said.

Olivardia suggested asking these additional questions about therapy: “How do you deal with ADHD symptoms, which may present themselves in the actual therapy? For example, how do missed sessions get handled? What if I forget to do my ‘homework’?  How do you manage when patients may be getting distracted in the therapy? How do you ‘mix it up’ for a patient to prevent boredom?”

Red Flags

Regarding warning signs that a therapist isn’t for you, “Your gut will guide you,” Matlen said. These are potential red flags:

• The therapist does all the talking, but doesn’t ask about your issues, Matlen said.
• They’re chronically late for your sessions, she said.
• They seem condescending or question whether your ADHD is real, she said.
• They don’t seem to “get” you, she said.
• They want to change you. “You are seeking help in changing behaviors and habits, but you are who you are,” Olivardia said.
• They’re rigid or inflexible, and believe they know what’s best, he said. “Granted, you are seeking them for their expertise, but remember they may be experts on ADHD but are not experts on you. You want to make sure the clinician is seeing you as a unique person who has ADHD.”
• You consistently feel worse after your sessions, Matlen said.

Other Options

What do you do if there are zero clinicians who treat ADHD clients? “There are many gifted general therapists one can see, who would be open to learning more about ADHD,” Matlen said. If you find a therapist you’re comfortable with, ask if they’ll read books about ADHD. You might need to explain how ADHD affects adults, she said.

“The beauty of the Internet is that it now allows people from all over the world to access resources online,” Olivardia said. The ADHD websites above offer educational webinars and lectures, he said. You’ll also find helpful information on ADHD experts’ websites, such as Dr. Russell Barkley and Dr. Ari Tuckman.

Many ADHD coaches offer services using Skype or telephone, he said. And you might find an ADHD support group in your town.

It might take multiple sessions to figure out whether a clinician is a good match for you, but don’t waste months or even years with someone who isn’t, Matlen said. “Don’t give up in finding the right person. It takes some work but it will be worth it,” Olivardia said.

“Although there are positive aspects to being in a relationship with someone with ADHD, there are also issues that can pose as problems,” said Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor in the department of psychiatry at Harvard Medical School.

For instance, managing a household can become a source of tension for both partners. “The stereotypical pattern is that the non-ADHD partner winds up taking on more and more of the workload, while the ADHD partner feels increasingly criticized and like they can’t do anything right,” according to Ari Tuckman, Psy.D, a psychologist and author of More Attention, Less Deficit: Successful Strategies for Adults with ADHD and Understand Your ADHD, Get More Done.

Non-ADHD partners also often misinterpret their partner’s behaviors. These assumptions can trigger more problematic patterns. As Tuckman said, an ADHD partner forgetting to buy the milk — maybe one too many times — becomes “He simply didn’t want to.” “When we assume behaviors are intentional, we tend to react with anger, which only makes the other person defensive–and then perhaps it does become intentional.”

Similarly, when an ADHD partner gets distracted during conversations, the non-ADHD partner may assume they just don’t want to pay attention. And they can feel insignificant or disrespected, Olivardia said.

Building intimacy can create another challenge, since it requires partners to be present in the moment, he said. “It can feel as if [the partner with ADHD is] anywhere but here.”

In other words, certain actions and circumstances get lost in translation, chipping away at your relationship. Fortunately, there are many strategies for overcoming these kinds of challenges. Below, Olivardia and Tuckman share 10 suggestions.

Fortunately, there are many strategies for overcoming these kinds of challenges. Below, Olivardia and Tuckman share 10 suggestions.

1. Educate yourself about ADHD.

It’s important for both partners to get educated about ADHD. Behaviors you think your partner is doing intentionally often are symptoms of their ADHD. Learning about the disorder can help you avoid jumping to erroneous conclusions.

For partners with ADHD, getting educated provides a window into myriad effective strategies for managing symptoms such as distractibility and impulsivity. (It’s also important to make sure you’re getting properly treated.)

2. Educate yourself about your partner. According to Tuckman, consider: “What situations do they handle well and what situations tend to not work out? For example, if they want a reminder, what is the best way to give it?”

3. Avoid attacking your partner’s character.

Non-ADHD partners may call their partners “lazy, disrespectful, self-absorbed or immature,” Olivardia said. Again, educating yourself about ADHD will help you better understand how it functions. What looks like laziness, for instance, is really an impairment in executive functioning, which affects a person’s ability to start and complete a task. (This includes everything from getting organized to sustaining attention.)

4. Get involved in treatment.

It’s often very helpful for non-ADHD partners to participate in their partner’s treatment. “For example, [they can] offer their observations to help a prescriber get the medications right or to work together with a therapist so that both people’s needs are being met,” Tuckman said.

5. Reframe conversations.

“Encourage the ADHD partner to be mindful of their traits and how some of them can be problematic in relationships,” Olivardia said. For instance, when talking to your partner, frame an ADHD symptom as having both an upside and downside.

He gave this example: “Your need for stimulation can be an asset in that you find the coolest places for us to go out on dates. However, that same need for stimulation makes it difficult for you to focus when we are having serious conversations.”

“It is important that the ADHD person does not get the message that they need to change the essence of who they are, but rather work on changing aspects of how they do things,” Olivardia said.

6. Do chores at the same time.

While one person washes the dishes, the other can do laundry, Olivardia said. “It gives the ADHD partner a degree of accountability,” and after you’re finished, “do something fun.”

7. Delegate.

If you can’t do chores simultaneously, delegate, he said. “Make a list of what and when chores will be done and by whom.”

8. Preserve the passion in your relationship.

“Relationships take work and it is important to maintain fun and excitement,” Olivardia said. Have each partner take turns picking a new activity at least once a month. He suggested everything from an improv class to salsa dancing to camping.

9. Build intimacy with sensory elements.

ADHD partners may require a higher degree of stimulation, even in the most stimulating of situations, Olivardia said. Non-ADHD partners can help enhance their partners’ attention by adding sensory elements. “Light a candle, have music on, or buy sheets that are extra soft…Being verbal and having eye contact can also be grounding to someone with ADHD and keep them in the mment.”

10. Remember you’re on the same team.

Communicate regularly about what needs to be done, Tuckman said. “…Have a mentality of both people being on the same team, rather than feeling like it’s a zero sum situation where for one person has to win, the other has to lose.”

ADHD can make relationships challenging. But problem-solving around these obstacles and maintaining the excitement and enjoyment in your relationship can help tremendously. As Tuckman said, “You don’t need to re-invent the wheel and figure everything out on your own.”

Try the above strategies, seek resources specifically on ADHD and relationships (like this website), and consider counseling.

Kessler tells the story of feeling like her life had derailed after her father died. She felt like was scattered and unable to focus and she couldn’t find a way to get back on track.

Attention deficit hyperactivity disorder (ADHD/ADD) is most often discussed when talking about children, teens or young adults. But the fact is, many adults also suffer the disorder and don’t always become aware of it until well into adulthood.

Zoë’s story is an inspiration. Not only did she find a way to understand her condition and get help for it, but she writes about it for the world, sharing her own personal trials and tribulations in living with ADD.

Journalist Isabel Teotonio helps weave Zoë’s story:

“I became massively overwhelmed,” recalls Kessler, a writer who lives in Owen Sound. “I found myself spinning and going from room to room in my apartment and not quite knowing what I should be doing next.”

A friend suspected she had ADHD and suggested she talk to her doctor about it. At age 46, Kessler was diagnosed with attention deficit/hyperactivity disorder.

She finally understood why she had always been so impulsive, why she felt so overwhelmed in university and had such rapid-fire thoughts.

And these are the kinds of symptoms we often hear about in adults with ADD or ADHD. Yet this diagnosis is so often missed, or misdiagnosed, in adults.

Luckily, treatment is available for anyone with ADHD or ADD. All you need do is seek it out:

For Kessler [...] treatment has helped get her life back on track. Her therapy includes taking a stimulant and doing exercise, yoga and meditation.

“It helped me to cope with the challenges I had while being able to be more productive (as a writer) and accomplish my dreams and move forward.”

Kudos to Zoë for the courage to tell her story to the Toronto Star, as as well as to the newspaper for publishing it.

Read the full article: Could you have adult ADHD?

But while ADHD comes with a variety of obstacles, there are just as many solutions to help you manage symptoms and lead a satisfying life.

Terry Matlen, ACSW, is a psychotherapist and author of the book Survival Tips for Women with ADHD.

Matlen also has ADHD. Below, she discusses the most common problems, along with strategies to try.

Time Management

According to Matlen, women with ADHD tend to run late regularly, lose track of time and have difficulty figuring out how long tasks will take. These time management troubles can lead to serious consequences, affecting jobs and even ruining relationships.

“Women contact me all the time, worried that they will lose their jobs because they can’t seem to get to work on time. Their partners are furious with them because they can’t get ready for the day or an outing, daydreaming the time away in the bathroom instead of getting dressed. Friends drop them because they forget to meet for lunch dates or worse, forget to call at all, letting the friendships wither away and die.”

Strategies: Matlen encouraged women to use visual reminders, such as Post-it notes on mirrors or walls. You can even get creative with your surfaces, like one woman she spoke to: “She used soap crayons to write reminders on the outside of her car windshield!”

• Instead of focusing on the time you need to be at an appointment, focus on the time you need to leave your house, she said. “Then work backwards from there.”
• Keep clocks everywhere, including your shower. Set multiple alarms, and have them in different spots, “so that you have to get up and turn them all off.”
• Take advantage of technology by setting reminders on your computer, sending yourself an email and leaving yourself a voicemail, Matlen said. “If you constantly find that you’re not getting certain chores or projects done in time, start a journal and note how long it actually takes to do things so that in the future, you can give yourself the allotted time and not fall behind.” To keep in touch with friends, schedule specific times in your planner to call them.

Parenting

“Often, women with ADD hit the wall when children come into their lives. They’ve been able, somewhat, to keep things together, but once they become mothers, the responsibilities, work and stress multiply to the point of complete overwhelm,” Matlen said.

Strategies: Hire a babysitter even when you’re home. Ask loved ones for help, including your partner, friends and family. Matlen noted that this helps you get much-needed rest and explore your interests. “Though this is an entirely personal decision, it might be helpful to think about the age span between children. Having two or three in diapers means much more work on mother.”

Co-Occurring Disorders

A high percentage of women also struggle with co-occurring disorders, such as depression and anxiety, Matlen said. For instance, according to ADHD expert Ari Tuckman, Psy.D, in his book More Attention, Less Deficit: Success Strategies for Adults with ADHD, “ADHD can give you a lot to worry about…There is also the constant grind of daily stress that comes from not making efficient use of time because of distractibility, avoidance, and procrastination. Life keeps moving, so tasks pile up and the stress builds until it finally explodes in a mad dash of activity.”

Strategies: “It’s important to share these problems or symptoms with your health care provider so that appropriate treatment can be offered,” Matlen said. This might mean taking another medication, such as an antidepressant. Psychotherapy, such as cognitive-behavioral therapy, is tremendously helpful for treating depression and anxiety.

(You’ll find more information on ADHD and anxiety here; and ADHD and depression here.)

Hormones

ADHD symptoms tend to worsen in women who are perimenopausal or menopausal, a time when estrogen dips. Estrogen affects the release of dopamine and serotonin. A deficiency in dopamine makes it more difficult to concentrate and focus, while shrinking serotonin dampens mood.

Strategies: Work with your gynecologist and other physicians to find the best treatment for you. Your medication might need to be tweaked, or your doctor might recommend hormone therapy, Matlen said.

(This article discusses four suggestions for managing the hormonal fluctuations of menopause or perimenopause.)

Social Interactions

Women with ADHD also can have a hard time connecting with others. According to Tuckman in his book, people with ADHD “…know how to read social cues, but they don’t do well if they get distracted or caught up in what they are thinking or saying. They may get so absorbed in their next comment that they can barely hold it in until the other person finally stops talking. If they do blurt it out, they may be seen as self-centered or controlling because they don’t give the other person an equal chance to talk.”

Strategies: To pay better attention during interactions, focus on the speaker’s mouth, Matlen said. “Try and keep your eyes on the person’s mouth, as if you’re dancing with a partner and need the cues for when to talk, when to stay quiet.”

If you’re still having difficulty focusing – because of distractions in your environment or your internal dialogue – ask the person questions about themselves, or find a quiet space to talk, she added.

Another great resource for improving social skills is books. Matlen recommended Michele Novotni’s book What Does Everyone Know That I Don’t.

Every person with ADHD is different, so the above strategies may or may not work for you. The key is to experiment, seek support and make sure you’re receiving proper professional treatment.

Whether you have kids or not, balancing a slew of commitments can get overwhelming for women with ADHD, said Stephanie Sarkis, Ph.D, a psychotherapist and author of several books on ADHD, including 10 Simple Solutions to Adult ADD. That’s because the nature of ADHD makes it tougher to prioritize and schedule, she said.

And, unfortunately, it’s common for women with ADHD to beat themselves up for not getting things done. Many women feel incapable and struggle with low self-esteem, Matlen said. “Women with ADHD are well aware of their shortcomings, but often they don’t understand [them] in the context of their ADHD brain.”

Here, Matlen and Sarkis, who both have ADHD, offer their tips for coping with overwhelm when you have the disorder.

Create Structure

Structure is vital for people with ADHD, and it’s key for calming the sensation of being overwhelmed, Sarkis said. Without it, she said, inertia can set in, leading to even more stress over time. When creating a structured schedule, record everything you need to do each day. Block off free time, too.

Get Educated

Educate yourself on how ADHD affects you, Matlen said. For instance, ADHD has nothing to do with being incapable, unintelligent or lazy. ADHD is a medical disorder that impairs your executive functioning, or your ability to plan, prioritize, organize and pay attention.

Take a Step Back

Reassess your situation and options, Matlen said. For instance, if you have kids and work full-time, can you switch to a flexible schedule, work from home or go part-time? “Know that once your children are older, the workload as a parent often retreats and full time work might be easier,” she said.

Hire Help

This might mean hiring a housekeeper, professional organizer, bookkeeper and babysitter, even when you’re home, Matlen said. Many people mistakenly believe that hiring professional help is a luxury. It’s not.

As Matlen explained, “it’s an accommodation so that the adult woman with ADHD can manage her full schedule without falling apart.” For instance, hiring a bookkeeper to manage your bills and filing not only helps you stay organized but it also lets you avoid overdraft fees and IRS penalties. (And those definitely get pricey.)

Set Limits

“It is important to set limits and say ‘no’ to the things that are not a good use of our time, or things that do not make us happy,” Sarkis said. Saying no can feel uncomfortable, especially if you’re a people-pleaser.

If this sounds familiar, Sarkis suggested these three strategies.

1. Recognize that you might be a people-pleaser.According to Sarkis, a people-pleaser does things for others to their own detriment. They withhold their feelings or give until it hurts. They may be afraid of showing their “true self” because of a fear of rejection or dislike by others.
2. Consider the reasons you don’t set limits. For instance, Sarkis said, is it because you’re iffy on what setting limits entails or you’re worried what’ll happen when you do decline?
3. Determine which activities provide energy and which drain it. Then consider how you can minimize or eliminate the negative ones.

“The more you say “yes” to things you enjoy and “no” to unhealthy or non-beneficial things in your life, the happier you will be.”

And always remember that it’s OK to say no, she said. “In fact, it is one of your rights as a person.“

Revise Your Expectations

Avoid setting sky-high expectations, and comparing yourself to others without ADHD. As Matlen said, “Don’t expect your home to look like your neighbor’s or sister’s. When ADHD is in the mix, it’s imperative to give yourself some slack.”

Reach Out

Connect with other women who have ADHD and struggle with the same or similar experiences. Remember you’re not alone! Matlen suggested checking out these websites: www.ADDConsults.com, www.MomsWithADD.com, www.WomenWithADHD.com. Or “search on Facebook for ‘women with ADHD.’”

Seek Therapy

Women with ADHD can feel especially overwhelmed when their ADHD isn’t being properly treated. Seek therapy with a clinician who specializes in adult ADHD. Therapy can help you manage disruptive symptoms – and dismantle decades of diminished self-esteem, Matlen said. Plus, a therapist can help you establish structure for your day, Sarkis said.

Reassess Your Relationships

“You need people in your court – people who understand you and will not judge or berate you,” Matlen said. She suggested surrounding yourself with loved ones who understand and accept you, and letting go of people who don’t and of toxic relationships.

Remember Your Strengths

When you’re overwhelmed, it’s easy to forget your strengths and focus on your shortcomings. But Matlen encouraged readers to focus on strengths. “You may be a great listener, have musical or art talent, be full of exciting ideas and projects, etc.”

Having ADHD is overwhelming enough. But when you’re juggling many responsibilities and wearing many hats, you might feel like you’re sinking.

As Matlen said, remember to cut yourself some slack. Re-evaluate your schedule, consider all your options and seek support. ADHD is a real disorder that disrupts your daily life. But with some help and readjustments, you can curb your stress and anxiety.

At school, teachers face varying forms of misbehavior: A child may wander around the classroom when he is supposed to be working at his desk, or talk out of turn when she is supposed to raise her hand. 

Parents often confront issues such as siblings squabbling at dinnertime, or children whining or throwing tantrums when they don’t get their way.

Parents, teachers and caregivers often respond to misbehavior by verbally correcting the child and doling out consequences. But some teachers are being taught a strategy called active ignoring. They overlook disruptive behavior and either focus on a child who is behaving, or wait until the misbehaving child exhibits a desirable behavior.  For example, a teacher may ignore a child calling out an answer and call on the student who is raising her hand.

These techniques are taught in a program called teacher-child interaction therapy (TCIT), which is based on a similar program for parents. Early studies suggest that these approaches, whether in the classroom or at home, improve children’s behavior.

Parent-child interaction therapy (PCIT) is designed for children with emotional and behavioral disorders.  Its aim is to change the quality of the relationship between parents and children by changing the way they interact.

When children misbehave or have more serious behavior problems, such as violent outbursts and tantrums, it is easy for parents and caregivers to react with anger and frustration or harsh limits.

The goal of PCIT is to help parents show greater warmth, responsiveness, and sensitivity to their child’s behaviors. Studies indicate a quality parent-child relationship helps children develop a secure sense of their relationships and more effective emotional and behavioral regulation. Contingency management is the underlying principle. Contingencies — two events that tend to occur together — can have a great effect on how children act.

PCIT and TCIT advocate altering the paired events.  Instead of pairing misbehavior and attention, these programs pair positive behavior and attention.  The assumption is that children want and need adult attention. That makes it a reinforcer — something that, when paired with an action, makes that action more likely.

For example, a parent might respond to a child when out running errands by saying “you stayed right by me in the store, and you talked nicely, so we’re going to stop and get an ice cream cone on the way out.” In this instance, the parent is pairing both positive attention and a reward (ice cream) with the positive behavior.

Pair attention with misbehavior and you get more misbehavior. 

But if you ignore the misbehavior and wait for a desired behavior, with time, you increase the desired behavior. While waiting can certainly be difficult, it may be worth it to learn a little extra patience to help your children grow.

More information about PCIT can be found here.