By Taylor J.
Welcome to Chapter 3 of the “You, Me, and ADHD Online Book Club,” based on Gina’s first book: Is It You, Me, or Adult A.D.D.?
We all need that friend that we can trust, the one who can tell us that we have a piece of spinach stuck between our teeth, or no, those pants look really uncomfortable on us. We need to know that someone has our best interests at heart, and when we get wound up, can help us take a step or two back, and see the big picture.
At just the right time, Gina was that friend for me.
One night, I was so frustrated and angry with my husband, and told the support group, “Don’t give me the ADHD excuse! I have exactly the same diagnosis he does! Yet, I would never, in a million years treat him the way he treats me [on XYZ issue].”
Gina—in her perpetually calm, rational manner—said that everything he was doing was textbook ADHD. She pointed out that his behavior was completely contrary to his character. She asked if he was medicated at the time. (“Well, no, he said it had worn off.”) She then said characterizing my ADHD and his ADHD, as “exactly the same” was “myopic” at best.
[Note from Gina: Being 100 percent Italian, I am laughing uproariously at the “perpetually calm” part.]
I confess, in my post-baby, sleep-deprived state, I had to look that one up:
“a myopic patient”
I chose to believe that my long-time friend had my best interests at heart. I listened to Gina’s advice, and when she turned out to be right, Dr. Math and I worked through that episode in our marriage with tender care.
As I read through chapter three, however, now I can see the full extent of what Gina meant:
Trying to understand ADHD can feel like trying to nail Jell-O to a wall. Even within one person, the traits can appear slippery and shape-shifting over time or in different circumstances.
Chapter 3 helps us understand why ADHD can look so different in different late-diagnosis adults. Not only are they individuals experiencing various aspects of a highly variable syndrome, but they are also carrying around decades of poor coping strategies, developed in order to survive challenges that didn’t have a name.
A Key ADHD Challenge: Self-Regulation
We begin with a primary challenge for people with ADHD: self-regulation.
Adults with ADHD typically have trouble achieving balanced behavior, and instead zigzag between one extreme and the other.
Please, as you’re reading the book, underline that. Put stars beside it. Highlight it. Write that phrase on sticky notes and put it on your bathroom mirror.
How many things in our daily lives require self-regulation? Without even looking in the book, we can reel a few off—eating, arriving on time, staying in school, doing chores, playing video games, managing your temper, finding your stuff, and being consistent in, well, anything!
Also, since ADHD affects individuals—that is, people who have their own distinct upbringing, faith, political views, socioeconomic status, and personality—how many different ways can “self-regulation” problems affect these individuals?
ADHD Symptoms—or Poor Coping Strategies?
It’s mind-blowing to realize that ADHD can look so different, just between Dr. Math and me. But now let’s add another layer of confusion: which of our behaviors are ADHD-related and which behaviors are poor coping skills, developed after years of living without knowing we had ADHD?
Chapter 3 helps us distinguish between symptoms and poor coping strategies. It also provides strategies for staying positive while we sort out all those behaviors—and it can feel like we’re sorting them one M&M or Skittle at a time!
I want to focus on two highlights that helped me understand ADHD more in my life, and in our marriage: Executive Functions and working memory.
Viewing ADHD Through the Executive Functions Model
One way to think of ADHD-related challenges is in terms of Executive Functions. (EF for short). Those functions are responsible for
- Formulating goals
- Planning for their execution
- Carrying those plans out effectively
- Changing course
- Improvising in the face of obstacles or failure, and
- Doing it all successfully, in the absence of external direction or structure
That’s a lot.
Think of your Executive Functions as the conductor of a very large orchestra. Our brain has lots of instruments, such as intelligence, creativity, emotional regulation, physical energy regulation, and sensory information (smell, touch, sound, etc.). The job of any conductor is to direct and cue the musicians at just the right time, to create beautiful music. If the conductor is sloppy, or misses a cue, the music sounds awful, no matter how skilled the musicians are.
Sht. Sht. Sht.
I experienced this first-hand in college, when I sang in the university choir and orchestra performance of Mahler’s Second. The conductor had so much energy, and was so emotionally moved by the piece during the performance, that he forgot to cue us to begin with the first word of that passage: Schtein.
Instead, we all came in at different times. I cringed as the sound of “sht…sht…sht…sht” was repeated at different beats all across the choir, and the entire piece was marred by that one mishap.
We were fantastic singers! We all knew what we were doing! This had nothing to do with our skill level, our perception of music, or how much we’d practiced.
In the same way, Executive Function disorders have nothing to do with a person’s intelligence or creativity. You can be a brilliant PhD (like my husband) or a fantastic athlete (like Michael Phelps) or have any other gifts or challenges. However, those pesky Executive Functions are hard-wired, and not something we learn.
Looking Back On My Own “Roller Coaster Track”
Now, looking back on my life, it’s a bit more easy to understand why I became defensive and hard-to-please in some areas of my life and, in other areas, developed a propensity to bend over backwards and aim for perfection.
Using Gina’s metaphor, ADHD “laid the track” for my personal roller coaster, but the feedback I received from people around me gave me a much more rickety-than-necessary ride.
- “You have so much potential!”
- “You’re brilliant, if you’d just apply yourself.”
- “You really need to grow up and get organized.”
- “Why don’t you slow down? You should lay off the caffeine!”
“Not surprisingly,” Gina writes, “many children with ADHD grow discouraged, depressed, resentful, and irritable.”
My husband had it even worse. His parents were extremely organized, providing everything the anti-medication wingnuts say “good parents” should provide to “keep their kids off medication.” Lots of farm work. Reminders. Tight schedules. Following up for him.
They did a great job! He was a Valedictorian, and got a full scholarship to college! That ADHD is gone, right? Wrong.
When he grew up, got married, and had children, there was no one around to be his external mental structure. He (understandably) didn’t know why I couldn’t provide the same amount of structure that his mom gave him.
Common coping mechanisms among many late-diagnosis adults include:
- Rationalizing and blaming
- Being aggressive
- Rushing through tasks and activities.
I’m surprised that, “Throwing our hands in the air and saying, ‘Screw it all!’” isn’t listed among them.
Another amazing take-away from this chapter is the “five mental modules” that are affected by Executive Function Disorders. I’m only going to focus on the one that blew my mind:
Poor (or “leaky”) working memory
The concept of “working memory” is different from “I can’t remember things.” Instead, working memory is “our ability to hold information in our minds and use it to guide our actions.”
With strong working memory, our actions stay anchored in the past (where goals are set) and connected to the future (where goals are met.)
Now for the particular part that blew my mind….
Poor working memory disconnects cause from effect, impairing the ability to predict and prepare for outcomes.
What? Excuse me while I walk around the room for a minute and digest that.
Have any of you ever watched the TV show “Hoarders?” I once saw an episode with a lady who had piles and piles of dolls in her house. Yet she held one doll up to the psychologist and yelled, “How is this doll a problem? This is a cute little doll with stringy hair and china hands and feet….”
The psychologist kept trying to re-direct her attention back to the pile of dolls that was buckling the foundation of her house, and draining her bank account. She couldn’t see that this doll was one of thousands.
Making Connections, Pre-Diagnosis
This is why I couldn’t understand how my husband with a PhD couldn’t understand certain things. I struggled for years just to be heard, just to try to make him understand how several of his behaviors were affecting me.
Once, and only once, I succeeded in spelling this out before treatment.
We were sitting at Panera, drinking their hazelnut coffee, and I was trying to explain why I needed to buy some storage containers for the kids’ clothes.
I asked, “Do you see the big picture of why I’m asking for this $100?”
“Of course!” he said. “So the system will sort everything out, and it’ll be a lot easier to find what you need.”
“Well, yes. But if we sort everything out, and it’s easier to find what I need, then I can cut down the amount of time I spend doing housework, which means I’ll have more time to work on my novel.”
He looked at me like I’d sprayed him with a water gun. “Did you just connect storage tubs to your calling as a writer?”
It never occurred to him that time spent doing one activity meant that time could not be spent elsewhere.
Now to hear from you, dear readers, with some points to launch the discussion:
• How does the primary challenge of “self-regulation” show up in you or your partner?
• Which of the “five mental modules” have you seen affected?
• In what activities do you or your partner tend to “zig-zag” from one-extreme to the other?
In two weeks, we’ll talk about Chapter 4.