You Mean I'm Not Lazy, Stupid or Crazy?!: The Classic Self-Help Book for Adults With Attention Deficit Disorder (32 page)

Structure
and order can take the form of a family ritual or tradition. The ritual signals the beginning of special, shared family time. It can help family members put aside the stresses of the day, concentrate on being with each other and become aware of the comfortable haven of home. When the family has gathered, say grace, recite a poem or sing a song. Try a show-and-tell time for sharing anecdotes or
telling jokes. Begin your meal with word games, trivia or threaded stories that each person builds on in turn. The ritual can be
anything
. The idea is to impose structure so family members take turns and learn to listen to one another.

Change the Rules:
If someone is having a difficult day or is particularly hyperactive, she should have permission to leave the table. Just be sure to have an established
procedure for requests to miss family meals.

If All Else Fails, Eliminate Family Meals:
They are a lovely convention and can help families connect. In an ADD family, however, the disadvantages of a family meal can outweigh the advantages. When temperamental characteristics come together in a small space, the mixture can be combustible!

PR:
“During our initial visit to a therapist, we decided
that family meals, our nightly ritual, frequently destroyed an otherwise reasonable day and had to be eliminated.

“Our family meals resembled a hotly contested sporting event with angry opponents. My hyperactive son is particularly sensitive to smells and as a child was an extraordinarily picky eater. Jeremy spent most of our torturous dinner hour falling off his
chair and using his gifted verbal
skills to compare the smell of the meal to various decaying animals. Dad performed as head coach of the opposing team. He spent most of the mealtime describing the lack of food in his parents’ mountain village in southern Italy. He used every means at his disposal to force Jeremy to eat. I donned my referee’s cap, quoting scientific research to support my assertion that our son would not die
of malnutrition—and I attempted to maintain order.

“The compromise that Dr. Melowsky helped us reach reduced the stress and brought peace to our kitchen. We decided that we would invite Jeremy to dinner but he wouldn’t have to join us. The dinner rule was that he could decline to eat with us but had to refrain from character assassination of his mother’s cooking. When he finally got hungry, he
would be responsible for fixing his own sandwich and cleaning up after himself.

“I suppose one could argue that we gave in to our son by letting him skip the family meals. But the key is that we didn’t eliminate our rules. We simply changed them to meet our family’s needs. The family harmony was well worth the skeptical and disapproving looks of outsiders who didn’t understand the dynamics of
ADD.”

We’re going to leave the family dinner and join the Baker family in an Outing Ordeal. We invite you to join the scene already in progress.

Family Fun: An Evening at the Movies

The Baker family is getting ready to go out for a movie and Jan feels more anxious with each passing moment. As usual, she feels perplexed that she’s always late for everything. Before the children were born, she
had always managed to get to appointments on time. She doesn’t stop long to ponder this because Jennifer interrupts, asking where her purse is, and Amy engages her in combat over the outfit she won’t be caught dead wearing.

As she begins to put on her makeup, Tom demands a consultation on his slacks and the color of his sweater. Amy’s discovery that her blouse is wrinkled sends Jan running to
the laundry room to iron it. Now immersed in distractions, she momentarily forgets the time deadline and decides to pick up the dirty laundry on her way downstairs. When she gets to the basement, she starts working on a stained pair of jeans and throws Amy’s blouse in the washer instead of ironing it.

The timer she set as a warning for the family to finish their preparations goes off. Jan realizes
with a start that she has gotten off track again! She arrives back in her bedroom to Jennifer’s bloodcurdling screams for protection against Amy, who has threatened her with death if Jennifer doesn’t stop hiding her shoes. As the time ticks away and the stress mounts, the yelling gets louder as everyone blames somebody else for the problems with getting ready on time.

Finally all the members
of the Baker family are ready to leave—everyone except Jan. Zachary, the only person who took care of himself, attempts to come to his mother’s aid as the rest of the family accuses her of making the family late again!

Notes: Outing Ordeals

Many of us with ADD aren’t well known for our punctuality. With our time sense, or lack thereof, we regularly set new records for travel time from point A
to point B. Somehow we manage to climb into our cars precisely at the moment we’re supposed to be arriving at our meeting on the other side of town! We have trouble organizing, we get distracted and we routinely forget things.

Getting oneself organized to be somewhere at a certain time is difficult, but getting an entire family organized is infinitely more complicated! If your family is anything
like either of ours, getting dressed and out the door for an outing is a major production. Jan can’t figure out why she’s always late, but it really isn’t
hard to understand. If you multiply the difficulty by the number of people in a family, the extra time required grows exponentially as family relationships do when each new member arrives.

This scene is avoidable if the family designs an action
plan. Without a specific plan, an ADD family’s Outing Ordeals will continue. The following suggestions might be useful for your family’s action plan.

Survival Tips for Outing Ordeals

Identify Individual Dynamics:
The first step is for each family member to identify her unique contributions to the family’s disorganization. It’s easy to point the finger at someone else—each family member does contribute
to the general disorganization and chaos. A more productive approach would be to help each family member decide what he or she needs to do to be ready on time. Then the whole family can come together and figure out an action plan.

For instance, Jan may require an uninterrupted half-hour to get herself together, and Tom may need help choosing his clothing since he’s color-blind. If Tom and Jan
discuss their needs in advance, they can strike a bargain. Tom can agree to give Jan the time she needs by running interference with the kids and saving his own requests until she’s ready. Jan can agree to give Tom her undivided attention to help him choose an outfit after she’s ready.

Establish Family Responsibilities:
The family needs to think through the chores that must be done before anyone
can leave. Who will feed the dog and put her in the basement? Who will have the responsibility for turning on the porch lights? The division of labor should be explained and assigned in advance to each of the family members.

The planning may even need to include things such as a bathroom schedule to avoid the problem of everyone trying to get into one or two bathrooms at the same time. It would
also help if
everyone gets dressed and ready in separate areas so they don’t distract one another. Clothing can be assembled and laid out well in advance, so there’s time to do needed laundry or repairs.

Prepare a Work Detail for the Family:
To reduce the number of “I forgot’s” or “What am I supposed to do’s,” give everyone their own checklist of responsibilities.

Reduce Distractions:
It never
fails that the phone rings in the middle of preparations. Take it off the hook. This isn’t the time for reading the newspaper or watching TV either. The “No Distractions” rule for mealtimes applies as well. The television should be off-limits, the newspaper or other reading material set aside and the stereo turned off. Anyone who operates more efficiently with background music can wear headphones
to reduce the distractions for other family members.

Set a Timer:
Jan’s use of a timer is a good idea, but it’s best to set it to sound a warning and then a final signal when it’s time to leave. To allow for a margin of error, set the departure time earlier than is really necessary. It’s nice to have extra time to clean up the dirt from the flower pot Jennifer knocks over when she cartwheels
into it!

If it’s important to get to an event on time, set a prewarning signal. This gives everyone plenty of time to get dressed and ready before the second warning rings. Family members can read, watch TV or play short games during the extra time.

If all this careful planning seems like too much work, weigh it against the stress and conflict your family experiences when they operate in the
usual fashion. Try it both ways before you decide.

In the next chapter, we will go deeper into the realm of relating with a discussion of sexuality, the most intimate kind of relating. In addition, we will explore the topic of ADD and gender issues, including the impact of hormones on ADD symptoms.

Chapter 10
Gender Issues and Sexuality

A
DD comes in a rainbow assortment of flavors. We have the “bouncing off the wall” hyperactive types, the “never seem to wake up and get activated” folks and many varieties of activity level in between. Some of us, using almost superhuman effort, keep our noses bolted to the grindstone most of the time. Others are distractible butterflies who can’t stay with
a single focus to save their lives. When you add in different learning styles, personality factors and other human differences, the variety is infinite.

One of the most striking differences in how ADD presents itself has to do with gender. In the history of ADD awareness, the focus has been almost exclusively on males. That was because women and girls tend to have a more hidden, subtler form
of the disorder. Only recently have researchers begun looking at how ADD manifests in girls and women. It used to be thought that there were as many as nine times more males than females with ADD. We now have research indicating that the ratio may be closer to two to one. There is not enough space in this book to go into great depth on the subject of gender and ADD, so we refer you to the excellent
books by Sari Solden and by Patricia O. Quinn and Kathleen G. Nadeau (see Suggested Reading) for more details on this topic. Here are some of the highlights.

Sexy Brains and Hormones

Got your attention? Actually, this is not about the brain and sexual activity, but the fact that male and female brains are different. Of course, you knew that. No doubt you have read or listened to news stories
on the latest brain research. We now know that even sexual preference can be linked to variation in size of parts of the brain. We know that there are brain-based differences in ADD. In 1990, Alan Zametkin demonstrated that ADD brains functioned differently from the brains of people without ADD. The frontal lobes are not as active (measured by glucose metabolism on a PET scan) when a person with ADD
does a task that requires concentration. Since then, a number of studies have been done that examine various parts of the ADD brain. Two other examples of brain differences in individuals with ADD are (1) the relative size of brain hemispheres (are the right and left hemispheres the same size or different?) and (2) the size of the basal ganglia.

Both of these brain features are
also
different
in males and females. Although the research on gender issues and ADD has barely begun, it is clear that there are biological factors that contribute to the ways ADD shows up differently in men and women.

Hormones:
Okay, first we had the anatomy lesson, now it’s time for a minilecture on physiology. Hormones have a profound effect on both form and function in the human body. Testosterone, a male
hormone, has an impact on both brain development and behavior. During brain development, testosterone acts on brain hemispheres to create differences between them. In males, gray matter on the right side of the brain is thicker than on the left. We are all aware of the most dramatic effect of testosterone on behavior—aggression. On the female hormonal side, the most valuable player is estrogen.
In contrast to the effect of testosterone, estrogen decreases aggressive behavior, impulsivity and hostility.

Well, you guessed it, if you didn’t already know this: ADD males are generally more aggressive than ADD females. They also tend to be more impulsive and inattentive. Does this mean that women with ADD have an easier time of it than ADD men? If their symptoms are less severe, ADD is not
such a big problem for women, right?

Of course, it’s not that simple. Women have certain characteristics and challenges that can magnify the impact of their symptoms. In the next few sections we will take a look at how the more subtle women’s form of ADD can create as many problems as the out-there/in-your-face male variety. It is important to add that there are many men and women who do not
fit the general pattern for their gender. There are gentle, spacey, inattentive men, and women who really know how to put the “H” in hyperactivity. Each person with ADD is unique.