“Living With ADHD”

              “Organizing Life One Minute at A time” 

 

   Our goal in treating ADHD must be to use the most appropriate therapy to help your child develop the social and learning skills necessary to reach their fullest potential as a happy child and eventually an independent adult.

 

                 An UncommonSense Health Newsletter

                              from drhuggiebear.com and Frank Barnhill, M.D.

 

Issue 1          Volume 2                   January 2006

 

Happy New Year!

We hope to offer you more valuable information on 2006 as we update our website drhuggiebear.com !

Dr. Frank

 

This UncommonSense Health Newsletter is dedicated to being your source for easy to read, up to date ADHD information on current and important medical issues for your growing family.

 

 

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Dr. Frank’s behavioral rule #1:

       “ADHD is first a diagnosis of exclusion, then a diagnosis of inclusion!”

You must first exclude all the illnesses that mimic ADHD and then be sure the diagnosis fits ADHD traits.

 

 

 

 

 

This Month’s issue:

 

ADHD Treatment

 

Helping ADHD teenagers and adults handle anger producing situations

Frank Barnhill, M.D.

 

It’s no small secret that ADHD teens and adults often handle frustration by displaying either emotional or physical anger and sometimes both. Many parents and spouses have asked for tips on helping their ADHDer learn to handle his or her temper and avoid the negative effects of anger on the ADHDer’s social relationships. Let’s take a look at the common areas of conflict in ADHDer’s lives that cause frustration and lead to anger. Then, we’ll discuss how to help ADHDers learn to manage the effects of conflict.

 

ADHD teenagers and adults often have a multitude of problems handling the transition period from pre-teen (tweeners) to teen years or teen to adult. The degree, to which these ADHDers have problems of course, depends upon which type of ADHD they have and how those traits are expressed. A teenager or adult who is primarily ADHD-inattentive will react much differently than one who is ADHD-hyperactive or ADHD-oppositional, even in the same situations.

 

ADHD-inattentive teens and adults rarely express their emotions in a loud verbal or angry physical manner. Usually these ADHDers become frustrated, cry and often want to be left alone or withdraw from threatening situations. In contrast, ADHD-hyperactive teens and adults see conflict as a stimulus and this seems to turn on the shouting, threatening and sometimes physical anger they display. A word of caution: ADHD traits are displayed to varying degrees from one ADHDer to another. You can’t lump all ADHDers into one category, as they tend to display a wide spectrum of abilities, disabilities, and poorly adapted life skills and traits.

 

It’s probably helpful here to remind you that ADHD-hyperactive teens and adults are the daredevils and thrill seekers. They are highly impulsive and are looking for excitement and situations that move fast and are highly stimulating. Remember, they are the ones who get speeding tickets, don’t do well in interpersonal relationships (have few friends), and laugh at legal problems.

 

Now, let’s take a look at some of the ADHD traits that cause all of these problems:

• ADHDers usually have poor self-esteem and ego structures. They often don’t feel good about themselves for this reason and their self-doubts keep them from effectively developing winning personalities and taking part in social events.
• Teen and adult ADHDers often feel they are not in control of their own lives and as a consequence don’t take criticism or advice well. They can develop paranoid thinking as others are trying to manipulate them, because while they were ages 5 to 15, classmates, friends, parents and teachers usually manipulated them to try to change their behavior or get them to do what they wished.
• They sometimes feel as if they are “dumb” or “stupid” because their inability to focus or pay attention to details of a task and complete an assignment leads to frustration and self-doubt.
• ADHDer’s inability to effectively integrate, absorb, process, and communicate input from visual, auditory (sound) and tactile (touch) sources often leads to confusion and frustration if they are expected to respond very rapidly to an event or question. Just like the rest of us, if we don’t understand a situation, we become confused, perplexed and frustrated until we can resolve the issue. Unfortunately, ADHD teens and adults process these inputs (vision, sound, touch) much slower, have problems thinking through and analyzing an event and can’t effectively store the processed information once it is processed. As a result of these observations, we often say ADHDers have problems with “executive thinking” or the “executive processing centers” of the brain. In addition, their problems with executive thought processing causes communication difficulties resulting in even more frustration.

 

Now that we’ve covered the most common ADHD traits that cause problems in teenagers and adults, let’s continue by discussing ways to help ADHDers build skills to cope with these shortcomings.

 

• You should be prepared to allow your ADHDer to make mistakes and fail so you can use the experience as a teaching tool. Often parents come to my office seeking ways to keep their ADHD child or spouse from failing at something.  As I tell them, if a child never falls down while trying to walk, the he will never learn to pick himself up and keep on going. Failure provides learning experiences. My hero, Walt Disney, reportedly bankrupted more than once, but look at the legacy he built through learning to adapt to failure and mistakes.
  
  You must let them fall down and teach them how to pick themselves up. Once you do so, then it will be much easier to teach them how to avoid falling down in the future. ADHDers are usually really good at remembering mistakes and shortcomings, so one simple reminder of a past event may be enough to prevent or stop a current anger crisis. When teens get a speeding ticket, most parents take their license and car away. A smart parent sends their teenager to a driving school  designed to teach skills to cope with impulsivity, such as building a habit of glancing at the speedometer and correcting speed. Taking the car away doesn’t correct the problem and produces more frustration and feelings of loss of control.
  
  Be sure to remind your ADHDer that everyone makes mistakes, so they are considered “normal”.  More than anything, ADHDers want to be perceived as “normal”.

 

 

• Always tell your ADHDer the truth. They are keen at detecting manipulations. If you don’t like their behavior or attitude, then tell them. I’ve always done so with my ADHD son in the following way: “I love you very much, but I don’t like your attitude.” Then I went on to remind him of how valuable he is as my son and how he is an important part of my life and his family’s heritage.
  
  Then and only then, do we discuss what I don’t like about his attitude or behavior. After this brief discussion, I go on to explain in basic concepts the difference between what he did or said and what others his age would do in the same situation. ADHDers don’t like to be compared to other children or adults as this presents a threat and invokes feelings of guilt and anger, as the ADHDer feels frustration over not being “normal”.
  
  So, don’t use specific persons for comparison. I often say something like, “Kids your age usually don’t kick teachers when asked to spit out their chewing gum.” I don’t say, “See how Tommy spit his gum in the trash can when I asked him to?” This not only causes frustration in being compared to another non-ADHD child, but also sets up an interpersonal conflict between the two of them. I’m sure you can see how this would apply to an adult in a similar situation.
  
  
• Help your ADHDer to learn frustration-anger management by teaching them that the person in control of any conflict is usually the one who keeps his or her cool. I tell my son that the person who shouts, curses, threatens and demands the most is the one who usually loses an argument or fight. I taught him the most effective way to control a conversation is to speak in a low pitched voice so the other person has to quit shouting to hear him. This technique usually deflates a shouting match rapidly. And of course, the fastest way to end any argument is to agree with the other person. If you teach your ADHDer what is really important enough to argue about, then it becomes easier for them to agree and walk away. Parents can use this technique to stop a disagreement with their child.

 

• We often talk about “actively ignoring” ADHD behaviors that really don’t affect us or the ADHDer in a significant way, but how many of you teach your ADHDer to “actively ignore” the little things? If you can teach your ADHD teen or adult to ignore trivial insults and manipulating conversations, you will give them a shield that helps decrease frustration and anger a great deal.
  
  How do you go about giving them a coat of verbal armor?  You teach them how to listen for specific words or tones of a person’s voice and analyze the content so that in thought-input processing, they can accurately interpret and respond to the situation. For example, just as a diabetic teenager playing high school football may pick up the nickname “sugar baby” from his teammates, an ADHD teen may be nick named “flash” because he’s so hyperactive. The first teen’s response was “That’s the same nickname the cheerleaders gave me!” The second teen responded, “Thanks for the compliment.”  “That means you think I’m really a fast running back, right? Both responses ended the problem of degrading nicknames.

 

• Teach your ADHDer how to effectively communicate. How do you do this? Help them practice “not interrupting” as you speak to them. Teach them the art of effective listening and waiting turns to speak. Give them guidelines about what to say and what not to say at social events. Help them develop interests and hobbies that give them enough common knowledge to engage in conversations with friends and others. Helping your ADHDer build good conversational and communication skills will go a long way toward ensuring success in life. After all, no one wants to hire a dull person who can’t communicate. And no one invites a person with awkward verbal and social skills to parties or other social events.
  
  Teaching communication skills can be as easy as helping your ADHDer get in the habit of reading the morning newspaper so he or she can discuss current news and sports events with others. No one wants to hold a one sided conversation about football or basketball. When you can’t hold your own in a conversation, the other person will avoid involving you in future talks.
  
  Teach them to delay answering important questions or making decisions until they have a chance to thoroughly think through each one unless urgency demands immediate action. Keep in mind, forcing an ADHDer to make abrupt decisions about anything can lead to frustration, too rapid an answer of no, or even anger about being pressured. Unfortunately, once an ADHDer has said no, he or she will resist changing their answer, even if they really wish they had said yes. In their mind, to change their answer would be the same as losing control or admitting they were “not normal”.

 

• Teach them alternatives to anger and frustration such as diverting anger energy into a useful activity such as jogging or participating in sports. Some ADHDers get rid of frustration by playing musical instruments, such as drums or guitar. (Ever wonder why ADHDers tap their feet and drum their fingers?) Diverting excess energy into a favorite hobby will help decrease escalating anger and allow your ADHDer an alternative to getting angry in the future.

 

• Discover ways in which to give your ADHDer more control over his or her life. With teens, we suggest letting them follow your guidelines to choose and buy their school clothing. Any time you can involve a teen in making decisions or asking for his or her advice, you improve their feelings of security and self-realization. ADHD adults feel more secure in their personal control when they are asked about important issues that affect them at home or work before final decisions are made. Actually, the earlier their involvement, the more in-control they feel.

 

Helping your ADHDer learn to avoid or manage anger and frustration will go a long way in providing them the tools and skills needed for success in life.

Dr. Frank

 

Have feedback on this article?  drfrank@drhuggiebear.com

 

********************************************************************************************

   Dr. Frank’s Golden Rule:

“ADHD is first a diagnosis of exclusion, then a diagnosis of inclusion”!

 

No portion of this information is intended to be offered as medical advice for the individual. Your family doctor is still the best source of advice for you and your family and you should consult him or her if you have any medical concerns. If you wish to use this article as a parent handout or in your newsletter, please see http://www.drhuggiebear.com/ for our reprint policy . mailto:drfrank@drhuggiebear.com

 

drhuggiebear.com is your source for uncommonsense medical resources.

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All articles are derived from published materials, educational sources and years of experience for each author. No portion of the above-contained information is offered as medical advice in any manner. In times of need, your family doctor or professional counselor is still the best source of advice for you and your family and you should consult him or her if you have any medical concerns. If you have comments or questions, please drop me a line at drfrank@drhuggiebear.com.

Frank Barnhill, M.D. 

All materials, content and graphics are Copyright 2006 Frank Barnhill, M.D.

 

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