“ADHD Is An Excuse for Irresponsibility.”
Psychologist and ADHD expert J. Russell Ramsay has heard that line so many times he’s named it one of his top three myths about ADHD (the other two follow in future myth-munching posts).
As the co-director at the University of Pennsylvania’s Adult ADHD Treatment and Research Program, he’s noticed that clients often expend much-higher-than-average time and effort trying to meet their responsibilities—typically “twice the effort for half the result.” Instead of seeking an easy way out, he argues, “They want to gain a measure of predictable cause-and-effect in their lives.”
Harold Meyer, founder of The A.D.D. Resource Center in New York City and an ADHD coach, agrees. “People with ADHD usually know what needs to be done,” he says. “Their difficulty, and continual frustration for both themselves and others, is in doing what they know or, at times, thinking before they act. Instead of Ready-Aim-Fire, it’s Ready-Fire-Aim.”
Or, as one of Meyer’s clients put it, “By the time I think about what it is I should have done, I’ve already done the first thing I thought about.”
Yes, it’s true that some adults with ADHD use the diagnosis as an excuse. Frankly, though, that mostly seems to happen when they don’t realize that treatment can largely eliminate the need for excuses of any sort. They’ve simply learned that their ADHD symptoms are not, as long thought, character flaws that they could change “if they really wanted to.” And that, no doubt, must come as a relief.
________________
Next time, we’ll examine Myth #3:
“ADHD Symptoms Are Basic Human Behaviors.”
How about you? Have you heard this ADHD-is-an-excuse line?
Or, did you ever—gasp!— find yourself saying it?
Comments welcome! It’s easy; no annoying codes to decipher.
—Gina Pera
Your article mad me cry. I’m 65 and have recently realized I must have ADHD. It so obvious now…how can a MEDICARE adult get treatment for this? I’m afraid if I go to just any doctor or psych, I’ll get told I just need to straighten up…I know u have courses and I want to do that too, but a diagnosis first…
Oops…I live in Western NC
Hi again, Kate,
Actually, I recommend my course FIRST.
In fact, I designed it to solve a major problem I’ve seen for years.
That is, a person suspects ADHD, sees a “professional” and gets sidetracked into all kinds of mis-diagnosis. All hope is lost far too often.
With my course, I ground you in the sophisticated facts about ADHD (because the Internet is typically too simplistic and stereotypic). Then we go through how the diagnosis is made, step by step, and how to find/work with a professional.
The hard truth is that sometimes we have to steer our own ships. If we leave it to some random professional (sometimes including those who claim ADHD expertise….sometimes especially those)….we leave way too much to chance.
There are downloads based on the DSM-V criteria that help you to document what you perceive as your ADHD-related challenges since childhood. It looks differently over time, with symptoms expressed at developmental stages and depending on the environment.
Moreover, the course gives you the confidence to know exactly how ADHD is challenging you, in ways that extend beyond “behavioral” symptoms sometimes into physical ones (e.g. sleep, health conditions, coordination, etc..).
You can get an overview here.
https://ginapera.adhdsuccesstraining.com/
good luck!
g
I have a good friend who has ADHD, I feel she does NOT have her illness under control. She stayed overnight with me, things were fine till she said ( I need my phone charger from my car) Ok, so she goes out my front door, LEAVES IT OPEN, LEAVES my security door wide open an leaves the dog gate OPEN! I have a Chihuahua who is NOT street wise, there is my dog in the front yard near the street. I FREAKED out and said get my dog !! I was soooooooooooooo pissed off. I explained to her that she almost got my dog killed!!! She said…..” Oh, she’s ok, she wouldn’t get hurt,” Then she says…..” Well, do you want to kill me now” ?? What kind of statement is that?
Hi Gepe,
Has she been your good friend for very long? You’ve seen no other instances of poorly managed ADHD that could affect her and others?
ADHD can limit “insight” — that is, the ability to be objective about one’s behavior.
ADHD can also mean getting used to making mistakes and getting angry responses. Sometimes this is because of low insight but sometimes this is because whatever treatment they are pursuing are poor. (Sometimes I feel that is the standard.)
There’s a reason that I advise ADHD-challenged couples to work as a team on treatment goals. Give poor clinical standards and ADHD symptoms themselves, it can be a gargantuan task for the adult with ADHD to go it alone.
cheers
Gina
My husband is using his ADHD as an excuse for his long-term affair. Could that really be a mitigating factor? I think it’s just an excuse.
Hi there,
I’d say it depends on the circumstances. Yes, ADHD could be a contributor to behavior such as having an affair, but a long-term affair? Hmmm. I really cannot say.
I think most of my friends with ADHD would say, if he knows about his ADHD now and is doing his best to manage it, then continuing a long-term fair and blaming it on ADHD isn’t reasonable.
g
You were certainly thorough in your responses to all of these comments. Hope you got another post out of them! As always, I appreciate your approach and careful attention to research as well as giving credence to personal reports from adults with ADHD. I’ve been “Pinning” your articles faithfully. Thank you for keeping your blog going.
Hi Joan!
How nice of you! You and I….we’ve been in the trenches a long time, haven’t we?
thanks so much for “Pinning” — I haven’t ventured there yet. Too much other work.
Hope you are well.
xo
g
Love this topic Myth: ADHD Is An Excuse for Irresponsibility. As an older (65yrs) adult, diagnosed in my late 40’s and having ridden the roller coaster of finding the right doctor(s) and medication(s) I have to admit I use ADHD as an excuse all the time….. and love it! In fact doing so has helped me tremendously in that rather than beating myself up internally and thinking I’m stupid because of having difficulty in doing some type of task, I remind myself … I’m having difficulty because of the ADHD. It’s the fault of the ADHD.
Then I pull out my bag of ADHD Self Help Tools and proceed doing the difficult task as best I can knowing I’ll eventually complete it – it just may not be at the same pace or following the same steps as other people.
So I guess you’d have to say I don’t use ADHD as an excuse to get out of doing something but rather as the reason I may be doing it differently. But no longer falling into the self-accusatory pattern that only serves to worsen dealing with ADHD.
Hi Diane and thanks for your comment.
Absolutely. ADHD can definitely provide a reason. But it’s not, as some in the public would have it, a non-existent condition that’s simply an excuse for shirking responsibilities.
Good for you and your bag of self-help tools!
g
I am also 65 and feel so happy reading this. I would love advice on how to navigate the medical Medicare world to find a diagnosis –which I no longer doubt–and treatment.
Hi Kate,
Welcome to the ADHD Roller Coaster…..blog. 🙂
That’s a great question….getting ADHD evaluation/treatment through Medicare.
From what I have observed, this is a very local issue. Local in terms of finding a prescriber who will treat geriatric patients with ADHD — and who accepts Medicare.
If that’s not possible, sometimes it’s best go to outside the system and pay out of pocket — for the evaluation and to get the medication “dialed in”. And then bring that diagnosis and treatment back into your Medicare coverage.
good luck,
g
This is great info. I actually wrote a post about this for my blog in the spring – I think I called it “ADD Is Not An Excuse”. I see this all the time in my own family. It makes me crazy! I just signed up for the emails.
Hi Liz,
Just in case you think I lifted that from your blog….;-) …. this is actually an excerpt from my book, published in 2008. 🙂
Welcome to the coaster!
g
Hi Valerie, Congratulations on finally solving the mystery as to why you weren’t “living up to your potential.”
As far as sharing the good news with your family, maybe you just want to hold off on that for a while. Instead, shore yourself up with support from people who do understand ADHD and can cheer on your treatment progress.
I encourage you to check out any local support groups for Adult ADHD. Online support is great, but flesh-in-blood people talking about their stories can be even more validating.
Good luck!
a proper good see of ADHD Roller Coaster: “Is It You, Me, or Adult A.D.D.?” · ADHD Myth #2: An Excuse for Irresponsibility Comfy love it
Gina, I’m glad you included that sentence “Yes, it’s true that some adults with ADHD use the diagnosis as an excuse”. I think actually everybody uses one or the other excuse to behave in a way they would not want to see in others. I include myself into that equation. Haven’t we all been more bitchy because we were sick that day, and rationalized later “Oh, but that was because I was sick”?
I don’t like the generalization much that this is a “myth”. It’s not. It’s human behavior and some people use it more, some less, and some have to work harder than others if they want to avoid it. I’m not saying it is always avoidable. All I’m saying is that it is there all the time.
I get the idea though, that ADD patients have other mechanisms of running decisions.
Thanks for the kind words.
Readers of your blog learn a lot, too!
http://www.beforeyoutakethatpill.com/
Dr. B — Don’t we use the rat model because rats are so similar to humans? 😉
Re: the impaired appetite. Decreased appetite was just one of the common problems with IR Ritalin (and other IR stimulants), which is why the current thinking advises long-acting, gradually released medications like Concerta, Vyvanse, Daytrana, etc.
Anecdotally speaking, I don’t hear that complaint from parents as much as I used to. And there are workarounds. I’m no expert in this, but I see the same kind of poor medication protocols with kids as I see with adults: often too high a dosage (or not high enough) on IR stimulants, which just cause more problems for most people; no way around it. So, it’s hard to know, from these studies, what’s the result from poor clinical practices or best clinical practices.
As for the growth suppression, I think the latest word on that is covered by Dr. James Swanson, on Web MD: http://www.webmd.com/add-adhd/news/20070720/adhd-drug-does-stunt-growth
That’s a great story, Monica — and a prime example of how adults with ADHD often have to “self-advocate.” 🙂
But you have a lot of good stuff here. I am learning a lot of new stuff and I am a shrink!
Yes indeed. Sacrificing themselves for science, poor little things. I used to do research until I had a dream about a giant rat knocking on my door. 🙂 Anyhoo impaired appetite with ritalin is a big deal for moms trying to get their boys to eat and grow. The whole kids and meds thing is a big guilt trip no matter what you do. From what I remember the growth thing amounts to about an inch over the lifetime and your point that the negative effects of the disorder is a good one.
P.S. As far as long-term effects on brain function — rat or human — I’ll have to get back to you. As far as I’m aware, no research has demonstrated negative effects on brain function, and the impact on height, etc. seems to be miniscule at best. But I’m not remembering the latest research on this.
But, as ADHD experts such as Yale psychologist Tom Brown like to point out, we do know the risks of untreated ADHD are significant and severe.
I had to look up the ACNP (American College of NeuroPsychopharmacology). I’m betting many rats gave their lives for those poster sessions, bless their little rat hearts. 🙂
Yes, stimulants have been shown to help with these other manifestations, but with adults that’s mostly from clinical observation and from the adults themselves (and their loved ones, bosses, friends, etc.). It would be difficult to measure improvements in financial management, cooperation, etc. But we do have studies showing the increased rates of bankruptcy, divorce, physical altercations, encounters with the criminal justice system, more lost time on the job, more on-the-job accidents, etc. with adults who have untreated ADHD.
There is a significant body of research on adult ADHD driving skills and medication, though. Driving safety is markedly improved with the use of stimulant medication.
But for late-diagnosis adults, who have a 75% chance of having a comorbidity, treatment is more complicated; it’s seldom a simple matter of taking a stimulant.
Sometimes they carry a lifetime of accumulated sleep debt (ADHD can adversely impact sleep, too), so that needs to be addressed. Sometimes they are depressed and anxious, from the lifetime’s pileup of frustrations and negative feedback.
And, with women, they often aren’t diagnosed until they hit peri-menopause or menopause, when fluctuating hormones wreak havoc with neurotransmitters, pushing them into worse cognitive function. So, sometimes thyroid and other metabolic issues are involved. So are chronic deficiencies in certain vitamins and minerals (particularly Bs, magnesium, calcium, potassium, etc.).
Finding a physician who can carefully address all these issues is tough! It’s tough even to find a physician who knows that, for some people, the AMP medications will push them into irritability and anger. I really like Dr. Charles Parker’s blog because it covers all the bases: http://www.corepsychblog.com
Yes, that is informative. So do stimulants help with these other manifestations of ADHD? And what is your read of the literature on long term effects on brain function and growth from rats and (if there is any data) in humans? I remember seeing a rat poster once when I was wandering around the poster session at the ACNPee pee. meeting (little joke, har har)
Hi Dr. Bremner,
If you mean how many children with ADHD outgrow symptoms as they reach adulthood, the research is mixed, but it’s safe to say about 30% experience symptom mitigation as they mature. That’s why it’s recommended for parents of growing children who take medication to do an annual assessment to see if they indeed should continue the medication.
Key research in this area includes Dr. Barkley’s Milwaukee study, detailed in the book ADHD in Adults: What the Science Says. Here’s how Dr. Stephen Hinshaw, ADHD investigator and Psychology Department chair at UC-Berkeley, summarized it in an interview for my book:
“Psychologist and ADHD researcher Russell Barkley has followed up on the children with ADHD from a study he conducted in the late 1980s. These subjects are now in their early twenties. How many of them still have ADHD? It depends on whom you ask. If you ask those young adults, it’s 5 percent. If you ask their parents, it’s 50 percent. Moreover, if you loosen the diagnostic criteria to measure the adult manifestations of ADHD, as opposed to those of children, it is nearly 70 percent.”
This emphasizes the point that “self-reports” are often problematic when it comes to ADHD.
Another issue: Some people have gotten confused by one of the results from the MTA study follow up, showing that the medication doesn’t provide a long-term benefit for children with ADHD. It’s a complex subject, but basically what the study found is that when you stop medication, you stop getting the benefits. That’s nothing new, though! We know that stimulant medication can be compared to wearing eyeglasses: That is, you see better when you’re wearing the eyeglasses, not because you wore eyeglasses three years ago.
In general, what the public largely doesn’t understand is that ADHD isn’t all about kids paying attention in school. In fact, adults with ADHD can face much bigger problems than they did as children — in managing money, keeping a job (or working at their level of training/education), maintaining relationships, driving safely, avoiding addictions, and living a healthy lifestyle.
I hope that answered your question! 🙂
Gina, from your research how often did kids with ADHD improve as they go into adulthood?