Attention Deficit Disorder. First of all I resent the term. As far as I'm concerned most people have Attention Surplus Disorder. I mean, life being what it is, who can pay attention to anything for very long? Is it really a sign of mental health to be able to balance your checkbook, sit still in your chair, and never speak out of turn? As far as I can see, many people who don't have ADD are charter members of the Congenitally Boring.

But anyway, be that as it may, there is this syndrome called ADD or ADHD, depending on what book you read. So what's it like to have ADD? Some people say the so-called syndrome doesn't even exist, but believe me, it does. Many metaphors come to mind to describe it. It's like driving in the rain with bad windshield wipers. Everything is smudged and blurred and you're speeding along, and it's reeeeally frustrating not being able to see very well. Or it's like listening to a radio station with a lot of static and you have to strain to hear what's going on. Or, it's like trying to build a house of cards in a dust storm. You have to build a structure to protect yourself from the wind before you can even start on the cards.

In other ways it's like being super-charged all the time. You get one idea and you have to act on it, and then, what do you know, but you've got another idea before you've finished up with the first one, and so you go for that one, but of course a third idea intercepts the second, and you just have to follow that one, and pretty soon people are calling you disorganized and impulsive and all sorts of impolite words that miss the point completely. Because you're trying really hard. It's just that you have all these invisible vectors pulling you this way and that which makes it really hard to stay on task.

Plus which, you're spilling over all the time. You're drumming your fingers, tapping your feet, humming a song, whistling, looking here, looking there, scratching, stretching, doodling, and people think you're not paying attention or that you're not interested, but all you're doing is spilling over so that you can pay attention. I can pay a lot better attention when I'm taking a walk or listening to music or even when I'm in a crowded, noisy room than when I'm still and surrounded by silence. God save me from the reading rooms. Have you ever been into the one in Widener Library? The only thing that saves it is that so many of the people who use it have ADD that there's a constant soothing bustle.

What is it like to have ADD? Buzzing. Being here and there and everywhere. Someone once said, "Time is the thing that keeps everything from happening all at once." Time parcels moments out into separate bits so that we can do one thing at a time. In ADD, this does not happen. In ADD, time collapses. Time becomes a black hole. To the person with ADD it feels as if everything is happening all at once. This creates a sense of inner turmoil or even panic. The individual loses perspective and the ability to prioritize. He or she is always on the go, trying to keep the world from caving in on top.

Museums. (Have you noticed how I skip around? That's part of the deal. I change channels a lot. And radio stations. Drives my wife nuts. "Can't we listen to just one song all the way through?") Anyway, museums. The way I go through a museum is the way some people go through Filene's basement. Some of this, some of that, oh, this one looks nice, but what about that rack over there? Gotta hurry, gotta run. It's not that I don't like art. I love art. But my way of loving it makes most people think I'm a real Philistine. On the other hand, sometimes I can sit and look at one painting for a long while. I'll get into the world of the painting and buzz around in there until I forget about everything else. In these moments I, like most people with ADD, can hyperfocus, which gives the lie to the notion that we can never pay attention. Sometimes we have turbocharged focusing abilities. It just depends upon the situation.

Lines. I'm almost incapable of waiting in lines. I just can't wait, you see. That's the hell of it. Impulse leads to action. I'm very short on what you might call the intermediate reflective step between impulse and action. That's why I, like so many people with ADD, lack tact. Tact is entirely dependent on the ability to consider one's words before uttering them. We ADD types don't do this so well. I remember in the fifth grade I noticed my math teacher's hair in a new style and blurted out, "Mr. Cook, is that a toupe you're wearing?" I got kicked out of class. I've since learned how to say these inappropriate things in such a way or at such a time that they can in fact be helpful. But it has taken time. That's the thing about ADD. It takes a lot of adapting to get on in life. But it certainly can be done, and be done very well.

As you might imagine, intimacy can be a problem if you've got to be constantly changing the subject, pacing, scratching and blurting out tactless remarks. My wife has learned not to take my tuning out personally, and she says that when I'm there, I'm really there. At first, when we met, she thought I was some kind of nut, as I would bolt out of restaurants at the end of meals or disappear to another planet during a conversation. Now she has grown accustomed to my sudden coming and goings.

Many of us with ADD crave high-stimulus situations. In my case, I love the racetrack. And I love the high-intensity crucible of doing psychotherapy. And I love having lots of people around. Obviously this tendency can get you into trouble, which is why ADD is high among criminals and self-destructive risk-takers. It is also high among so-called Type A personalities, as well as among manic-depressives, sociopaths and criminals, violent people, drug abusers, and alcoholics. But is is also high among creative and intuitive people in all fields, and among highly energetic, highly productive people.

Which is to say there is a positive side to all this. Usually the positive doesn't get mentioned when people speak about ADD because there is a natural tendency to focus on what goes wrong, or at least on what has to be somehow controlled. But often once the ADD has been diagnosed, and the child or the adult, with the help of teachers and parents or spouses, friends, and colleagues, has learned how to cope with it, an untapped realm of the brain swims into view. Suddenly the radio station is tuned in, the windshield is clear, the sand storm has died down. And the child or adult, who had been such a problem, such a nudge, such a general pain in the neck to himself and everybody else, that person starts doing things he'd never been able to do before. He surprises everyone around him, and he surprises himself. I use the male pronoun, but it could just as easily be she, as we are seeing more and more ADD among females as we are looking for it.

Often these people are highly imaginative and intuitive. They have a "feel" for things, a way of seeing right into the heart of matters while others have to reason their way along methodically. This is the person who can't explain how he thought of the solution, or where the idea for the story came from, or why suddenly he produced such a painting, or how he knew the short cut to the answer, but all he can say is he just knew it, he could feel it. This is the man or woman who makes million dollar deals in a catnap and pulls them off the next day. This is the child who, having been reprimanded for blurting something out, is then praised for having blurted out something brilliant. These are the people who learn and know and do and go by touch and feel.

These people can feel a lot. In places where most of us are blind, they can, if not see the light, at least feel the light, and they can produce answers apparently out of the dark. It is important for others to be sensitive to this "sixth sense" many ADD people have, and to nurture it. If the environment insists on rational, linear thinking and "good" behavior from these people all the time, then they may never develop their intuitive style to the point where they can use it profitably. It can be exasperating to listen to people talk. They can sound so vague or rambling. But if you take them seriously and grope along with them, often you will find they are on the brink of startling conclusions or surprising solutions.

What I am saying is that their cognitive style is qualitatively different from most people's, and what may seem impaired, with patience and encouragement may become gifted.

The thing to remember is that if the diagnosis can be made, then most of the bad stuff associated with ADD can be avoided or contained. The diagnosis can be liberating, particularly for people who have been stuck with labels like, "lazy", "stubborn", "willful", "disruptive", "impossible", "tyrannical", "a spaceshot", "brain damaged", "stupid", or just plain "bad". Making the diagnosis of ADD can take the case from the court of moral judgment to the clinic of neuropsychiatric treatment.

What is the treatment all about? Anything that turns down the noise. Just making the diagnosis helps turn down the noise of guilt and self-recrimination. Building certain kinds of structure into one's life can help a lot. Working in small spurts rather than long hauls. Breaking tasks down into smaller tasks. Making lists. Getting help where you need it, whether it's having a secretary, or an accountant, or an automatic bank teller, or a good filing system, or a home computer, getting help where you need it. Maybe applying external limits on your impulses. Or getting enough exercise to work off some of the noise inside. Finding support. Getting someone in your corner to coach you, to keep you on track. Medication can help a great deal too, but it is far from the whole solution. The good news is that treatment can really help.

Let me leave you by telling you that we need your help and understanding. We may make mess-piles wherever we go, but with your help, those mess-piles can be turned into realms of reason and art. So, if you know someone like me who's acting up and daydreaming and forgetting this or that and just not getting with the program, consider ADD before he starts believing all the bad things people are saying about him and it's too late.

The main point of the talk is that there is a more complex subjective experience to ADD than a list of symptoms can possibly impart. ADD is a way of life, and until recently it has been hidden, even from the view of those who have it. The human experience of ADD is more than just a collection of symptoms. It is a way of living. Before the syndrome is diagnosed that way of living may be filled with pain and misunderstanding. After the diagnosis is made, one often finds new possibilities and the chance for real change.

The adult syndrome of ADD, so long unrecognized, is now at last bursting upon the scene. Thankfully, millions of adults who have had to think of themselves as defective or unable to get their acts together, will instead be able to make the most of their considerable abilities. It is a hopeful time indeed.

Also see: 50 Tips On The Management Of Adult Attention Deficit Disorder

Address Correspondence to:

Edward M. Hallowell, M.D.
328 Broadway
Cambridge, MA 02139