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"I prefer to distinguish ADD as an attention abundance disorder. Everything is so interesting ... remarkably at the same time!" Frank Coppola
Most people typically shy away from admitting that they have a psychological disorder, but when it comes to ADHD and it's sister disorder, ADD without hyperactivity, the opposite seems to be true. Many associate ADHD with an energetic, chaotic creativity, and proudly declare their ADHD status.
“Hey, I’m in the entertainment industry; it seems everybody’s got ADHD here.”
ADHD – A Popular Diagnosis: It’s not just a popular buzz-word; ADHD also seems to be an ever-increasing diagnosis. But there's nothing blasé about a diagnosis of ADD or ADHD, because this disorder can have serious consequences.
ADHD – In the News: Recently, there’s been criticism that ADHD (and ADD) are being over diagnosed. A recent New York Times article cites that 11 percent of US children are now receiving the diagnosis; and questions its veracity. This is an important critique.
Many kids benefit from medication, but how many are being diagnosed incorrectly or have other factors affecting their ability to pay attention? How many are just getting treated symptomatically, with doctors failing to look under the surface. These questions will shortly bring us to the issue of divorce and ADHD.
ADHD – A Working Definition: ADHD (Attention Deficit Hyperactivity Disorder) is a neurobiological –and frontal lobe - disorder that affects the executive functions of the brain; it impairs the brains ability to control time management, organization, motivation, concentration and self-discipline.
Attention Deficit Disorder in all its varieties is thought to affect up to 5% of children (Diagnostic and Statistical Manual of Mental Disorders, fourth edition); that’s about one in twenty kids. As the name suggests, this disorder is characterised by inattention, hyperactivity and impulsivity. Children with ADHD are described as hyper, impulsive, disruptive, poorly organized, distracted, and even irritating.
Even though a lot of these children are intelligent, they often underperform at school. This is because their distracted state of mind makes learning and paying attention extremely challenging.
It’s not only the inattention component of the disorder that negatively affects academic performance, but the hyperactivity element also compounds this problem. Parents often complain that are at their wits ends because the hyperactivity can be so intense they can't keep up.
Because these kids are highly disruptive, interacting with them can be difficult. Kids with ADHD often develop social problems because their peers may reject them and adults are frustrated by them.
Children with poorly managed ADHD enter adolescence facing an increased risk of drug and alcohol abuse. The normal impulsivity of adolescence is heightened by ADHD, and because they feel rejected and lack the ability to inhibit their impulses, adolescents with ADHD often take unhealthy risks.
ADHD & Your Family: Some children and teens with ADHD are easy to manage. A simple medication intervention or classroom adjustment does the trick. But, more often than not, their high energy and impulsivity is challenging to parents and teachers alike. They may be charming, but not when a teacher constantly has to stop the class to settle things down.
These children can easily split their parents. Often, one parent is "sure" that the other is too liberal or to strict. One parent believes in medicine while the other thinks that the doctor and their partner is taking the easy (and toxic) way out with their son or daughter. Smart kids can pit one parent against the other. Add in other siblings who may feel irritated or neglected, and you can get an unhappy household.
To add fuel to the fire, ADHD kids may have parents with the same disorder. Because children often model the behaviour of their parents, the lack of organization of the distracted child can be magnified by distracted parents.
ADHD & Divorce: As a psychiatrist who treats children, adolescents, and divorcing families, it’s been my experience that divorce can exacerbate the symptoms of ADHD.
Even though ADHD is a neurobiological disorder, social pressures can have an effect. In the midst of a divorce, parents are upset and kids experience more emotional turbulence; for instance, their routines are often disrupted.
Children with ADHD have trouble regulating their emotional responses and the turmoil of a divorce may lead to volatility. Moreover the disruption of living in two homes may make organization challenging, to put it mildly.
And, here is the real problem; the cement that holds parents together in an intact marriage can break down in divorce. ADHD kids need consistency and a rational approach to their problems. Angry or competing parents will undermine their success.
ADHD & Treatment: Some people grow out of ADHD, but it’s not something that you cure. Yet, much can be done. While medication can be extremely helpful, I strongly recommend investigating additional approaches.
Useful interventions include, coaching for executive functioning, supportive psychotherapy, and identifying co-morbid anxiety or learning difficulties. At school, such children should sit in the front of the class, giving the child an increased exposure to the teacher’s presence. And, any LD issue should be addressed separately. Attention is affected by many factors, and a primary frontal lobe issue is just one of them.
Yet, when all is said and done, medication can help a great deal in managing the symptoms of ADHD. Stimulants are usually the first medication of choice for ADHD. They can be quite effective with the majority of well diagnosed cases.
Finally, whether intact or divorced, consider a hard look at how your family is functioning. Often, an assessment of familial stress is required. Imagine examining a distracted boy in school whose parents are breaking up, or simply disagree on how to deal with him. Perhaps the distraction really comes from depression or worries about his life, parents or siblings? You don’t want to medicate without investigating.
Helping Your ADHD Child
1. Educate yourself: ADHD is a real condition: it’s not just a fancy label for naughty children nor is it a sign of inferior intelligence.
2. Get a proper diagnosis: Your child needs to be diagnosed by a medical expert. ADHD shares symptoms with a lot of other psychological and medical disorders. You don't want to miss an underlying anxiety disorder, a learning disabilty or worries about home life. Each of these issues can lead to inattentiveness or make an already existing ADHD case worse.
3. Stay on top of it medically: Check in with your child’s pediatrician or psychiatrist regularly.
4. Stay on top of it educationally: Check in regularly with teachers. Sometimes these children benefit from sitting in the front of the class or having extra time on tests.
5. Medicate when needed: If you decide to go this route, you may find that it is not always simple. There are many stimulants, and now, other medications. Each has its effectiveness and drawbacks. You will need to keep up.
6. He or she needs structure: Make sure time at home and your child’s routine have as much structure as possible. Children with ADHD need consistency, predictability and discipline.
7. Work on your own organization habits: They rub off on your kids. In the case of divorce, try as much a possible to work together with your ex. Having similar rules and a similar schedule in both homes helps a lot.
8. Don’t confuse them: Give brief and clear rules and instructions. Here is where family work can help. It may be a good idea to consult a parenting expert, so that both parents are on the same page.
9. Stay positive: Positive reinforcement for desirable behaviours should swift. Similarly, punishment for any misbehaviour should also be swift, but not harsh.
10. Take care of yourself: Managing a family (intact or not) and an ADHD child can feel like a full time job. Get the support that you need. And, give him or her all the love you’ve got.
Reference
A. Barkley & K. R. Murphy (2006) Attention deficit hyperactivity disorder: A clinical workbook (3rd ed.). New York: Guilford Publications.
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