Jan 26

Hallowell and Ratey On “ADHD 2.0”

In ADHD 2.0, Drs. Hallowell and Ratey, both of whom have this “variable attention trait,” draw on the latest science to provide both parents and adults with ADHD a plan for minimizing the downside and maximizing the benefits of ADHD at any age. Publisher of ADHD 2.0 by Dr. Edward M. Hallowell and Dr. John J. Ratey

Over 20 years ago the groundbreaking book Driven to Distraction by Edward M. Hallowell and John J. Ratey opened the eyes of many regarding ADHD, or Attention-Deficit/Hyperactivity Disorder (see previous post).

In their latest, ADHD 2.0: New Science and Essential Strategies for Thriving with Distraction–from Childhood through Adulthood, they attempt, among other goals, to depathologize ADD-related traits. They express a preference, for example, to name ADHD VAST, or Variable Attention Stimulus Trait.

From the Publishers Weekly review: “Despite the disorder’s reputation as a condition that occurs in childhood, the authors write, ADHD can often appear in adulthood, when ‘the demands of life exceed the person’s ability to deal with them.’ ADHD can be channeled in healthy ways once it’s understood, they posit: because people with ADHD feel ‘an omnipresent itch to create,’ the authors encourage readers who have the condition to find a job that highlights creative strengths.”

A pertinent quote from the book: “ADHD is a far richer, more complicated, paradoxical, dangerous, but also potentially advantageous state of being than the oversimplified version most of the general public takes it to be or than even the detailed diagnostic criteria would have you believe. ‘ADHD’ is a term that describes a way of being in the world. It is neither entirely a disorder nor entirely an asset. It is an array of traits specific to a unique kind of mind. It can become a distinct advantage or an abiding curse, depending on how a person manages it.”

As Dr. Lloyd Sederer states in his review (Psychology Today), “Both Hallowell and Ratey take ADHD personally and seriously: Because they too have this condition, and clearly are exemplars for making a big and rewarding life with ADHD.”

Management of ADHD is of course a major focus of this book. Hallowell, says Dr. Sederer, believes that interpersonal “connection” is the top treatment. In addition to other suggestions for effective management of ADHD, the authors note that medications can also be of great benefit.

There is a Medication Table starting on page 122 of ADHD 2.0 that provides all you need to know about what is available. I learned some time ago that the psychoactive medications for ADHD have an indisputably immediate and robustly effective action. This is why Dr. Hallowell urges his patients (and readers) to ‘consider’ them. About 80% of patients respond; 20% do not — but that’s an impressive response rate. When asked to rank (1 to 5) ‘what works for ADHD?’ he places medications at #5. He knows they can significantly help a lot of people, even if they are not at the pinnacle of his pantheon of ADHD treatments. Hallowell also is a doctor who appreciates the additive effects of different, safe, and effective mind/body interventions.

Jul 12

Edward Hallowell: Expert Advice On ADHD

ADHD expert Edward Hallowell has a new book, Because I Come from a Crazy Family: The Making of a Psychiatrist, and it’s his own personal story. But one part of who he is, having ADHD himself, is something many readers have already known.

However, as Hallowell states on his website, his view is that “ADHD is a terrible term”: “As I see it, ADHD is neither a disorder, nor is there a deficit of attention. I see ADHD as a trait, not a disability. When it is managed properly, it can become a huge asset in one’s life. I have both ADHD and dyslexia myself and I wrote the book Positively ADD with Catherine Corman to profile a collection of fabulously successful adults with ADHD.”

Featured below are quotes from two of his most notable books, Driven to Distraction (Revised): Recognizing and Coping with Attention Deficit Disorder, and Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder, both coauthored by John J. Ratey.

Driven to Distraction by Edward Hallowell and John J. Ratey

...You don’t mean to do the things you do do, and you don’t do the things you mean to do.

To tell a person who has ADD to try harder is about as helpful as telling someone who is nearsighted to squint harder.

Most adults with ADD are struggling to express a part of themselves that often seems unraveled as they strive to join the thought behind unto the thought before.

While we all need external structure in our lives—some degree of predictability, routine, organization—those with ADD need it much more than most people. They need external structure so much because they so lack internal structure.

I also see how essential a comprehensive treatment plan is, a plan that incorporates education, understanding, empathy, structure, coaching, a plan for success and physical exercise as well as medication. I see how important the human connection is every step of the way: connection with parent or spouse; with teacher or supervisor; with friend or colleague; with doctor, with therapist, with coach, with the world “out there.” In fact, I see the human connection as the single most powerful therapeutic force in the treatment of ADHD.

Delivered from Distraction by Edward Hallowell and John J. Ratey

It is not a deficit of attention that we ADD-ers have, it is that our attention likes to go where it wants to and we can’t always control it.

Having ADD makes life paradoxical. You can superfocus sometimes, but also space out when you least mean to. You can radiate confidence and also feel as insecure as a cat in a kennel. You can perform at the highest level, feeling incompetent as you do so. You can be loved by many, but feel as if no one really likes you. You can absolutely, totally, intend to do something, then forget to do it. You can have the greatest ideas in the world, but feel as if you can’t accomplish a thing.

THE SEVEN HABITS OF HIGHLY EFFECTIVE ADD ADULTS 1. Do what you’re good at. Don’t spend too much time trying to get good at what you’re bad at. (You did enough of that in school.) 2. Delegate what you’re bad at to others, as often as possible. 3. Connect your energy to a creative outlet. 4. Get well enough organized to achieve your goals. The key here is “well enough.” That doesn’t mean you have to be very well organized at all—just well enough organized to achieve your goals. 5. Ask for and heed advice from people you trust—and ignore, as best you can, the dream-breakers and finger-waggers. 6. Make sure you keep up regular contact with a few close friends. 7. Go with your positive side. Even though you have a negative side, make decisions and run your life with your positive side.

Jul 31

Exercise As Important Therapy: John Medina, John J. Ratey

It turns out that physical exercise isn’t just about watching the Summer Olympics. It’s also something just about everyone can and should do. Scientist John Medina states the following about the first of his 12 “brain rules” (USA Today):

Exercise boosts brain power. Humans adapted during evolution by constantly moving (both to get food and to avoid predators). Medina says we think better in motion. He suggests that people might be more productive if they spent some of the working day (separate from the gym) on treadmills. Another provocative idea: ‘Board meetings might be conducted while people walked 2 miles per hour,’ he writes.

Medina also states that symptoms of depression and anxiety can decrease via workouts. In fact, it’s likely that a combination of therapy and exercise is equally as effective as a combination of antidepressant medication and therapy. According to one study, both combos are 80% successful. He recommends regular aerobic exercise two or three times a week for 30 minutes; and adding a strength training component can further boost cognitive functions.

There are scientific explanations for our workouts positively affecting mood and anxiety levels, of course, one of which has something to do with increased blood flow to the brain and other body parts. Exercise can also stimulate BDNF (Brain Derived Neurotrophic Factor), a growth factor in the brain that aids in neuron health and development. John J. Ratey, M.D., author of the 2008 book Spark: The Revolutionary New Science of Exercise and the Brain calls BDNF “Miracle-Gro for the brain.”

For more info that supports Medina’s, investigate Dr. Ratey’s book. Its description says it was “the first book to explore comprehensively the connection between exercise and the brain,” and observes that Ratey shows that “exercise is truly our best defense against everything from depression to ADD to addiction to aggression to menopause to Alzheimer’s.”

A sample quote from Spark: “Studies show that if researchers exercise rats that have been chronically stressed, that activity makes the hippocampus grow back to its preshriveled state. The mechanisms by which exercise changes how we think and feel are so much more effective than donuts, medicines, and wine. When you say you feel less stressed out after you go for a swim, or even a fast walk, you are.”