With ADHD, you’re likely to give up a bigger reward for a smaller one if the smaller one comes NOW and the bigger one LATER. NOW wins time after time. Why? Partly because our future selves are strangers to most of us, and we feel little for them. What do we owe this stranger? For many of us it turns out, “Nothing.” We see this when it comes to money. Specifically, saving it.
I know this can be a bleak subject, but part of the remedy is facing reality. Let’s start with the state of the union on this. I, for one, was blown away.
In the U. S., post-retirement we live 17-20 years on average, and over 50% of us have less than $25,000 saved for these years. This means, apart from social security, over half of us have less than $123/month to live out our “golden years.” More like copper years, right? See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764505/.
Sure, for some, this is a continuation of pre-retirement poverty (it’s hard to save living hand to mouth), but for many this goes back to the present winning over the future. At a great cost.
With ADHD, the cost is likely to be higher. Recent research examining the financial status of adults with and without ADHD (https://www.ncbi.nlm.nih.gov/pubmed/31343233) went beyond confirming prior research noting bad financial news, on average, for those with ADHD. The researchers looked at some of the reasons why this is the case. That is, why less income, less savings, and more debt?
Here’s what they found. Compared to adults without ADHD, adults with it reported more often buying on impulse and more often using “an avoidant or spontaneous decision-making style” (e.g., I will avoid looking at my bank account before buying). On top of this, adults with ADHD scored lower when given measures of financial competence and capacity (e.g., being able to evaluate financial problems and to understand bank statements) . Yikes!
But there is good news is. If you struggle with money, things can be better.
2) Focus on the “cool” versus the “hot” aspects of what you want NOW (e.g., on the color and shape of a cinnamon roll versus the anticipated taste),
3) Sinking your ships by giving yourself no way out (or in) by, for example, leaving money at home when you are out and about apart from what’s needed–no credit cards, Apple Pay, etc.–on hand)–see https://www.youtube.com/watch?v=PPQhj6ktYSo starting where Dan Ariely talks about self-control contracts for more–, and
Hot off the press: Adult ADHD appears to be on the rise. At least the diagnosis of it.
Scholars at Syracuse University compared the prevalence of ADHD among adults from the 2007 and 2012 U.S. National Health Interview Survey and found it jumped. From 3.41% to 4.25%, with the gap between women and men closing by almost a third (31.1%), given the increased prevalence among women of all ages.
I know, I said hot off the press, and we are talking about numbers from 2012. But the study just came out days ago, so it’s hot off the press.
This is an overview of ADHD (Attention Deficit and Hyperactivity Disorder), primarily numbers and names.
What’s the prevalence? It’s estimated to be about 5-6% of the world population of children and 3-4% of the world population of adults (using DSM-IV criteria, DSM-5 criteria increase the estimates slightly). It’s estimated that about 1-2% of children without childhood ADHD may meet criteria for ADHD after 12 years of age. This suggests that about half of the population of adults with ADHD develop it “late.”
123s and ABCs…
When did the first formal description of ADHD appear, albeit under a different name? One best guess is 1798 by Alexander Crichton. Dr. Faraone at SUNY Upstate Medical University suggests it goes back even farther…to Weikard and a 1775 German medical textbook. See https://adhdinadults.com/a-brief-history-of-adhd/
Fast forward to 1968, when it became an official diagnosis here (the U.S.), being added to the DSM-II, clinicians’ reference for diagnoses of mental disorders. It was called Hyperkinetic Disorder of Childhood. The name changed over the years but the essence of the disorder as one of childhood hyperactivity, impulsivity and wayward attention remained.
In 1980, the DSM-III came out and added specifics to the diagnosis, such as indicating that symptoms had to appear before 7 years of age. There was no research showing that 7 was a magic number; only enough clinicians believing this made sense.
In 1994, the DSM-IV softened the age of onset “rules” requiring only some of the symptoms to appear before age 7. Subtypes were also added. It is during the 1990s that Adult ADHD becomes recognized as a valid disorder.
In 2013, the DSM-5 changed the requirement that symptoms be present before age 7 to before age 12.
WHAT IS IT? ADHD is a self-regulation disorder. Regulation is, essentially, flexible self-control described by 4 Ss: starting, sustaining, stopping and switching attention, action, motivation, and more. It is understood as a neurodevelopmental disorder, which is to say it is a way that the brain (“neuro”) develops that affects, more than anything, self-regulation, essentially, decreasing it compared to what’s seen for those without ADHD. And here’s the disorder part: It is associated with distress and/or dysfunction, including poorer results at school and work, higher levels of health-risking behaviors, and being less satisfied with oneself.
What Causes It? It’s believed to result from certain combinations of genes and environmental factors. Genes are believed to be necessary and… insufficient. So are environmental factors.
I know relationships from both a work and personal perspective. What I want to share as a level-2 certified PACT therapist (https://thepactinstitute.com/dividedpage/what-is-pact/) applies to intimate relationships with or without the influence of ADHD. PACT stands for Psychobiological Approach to Couple Therapy (fancy, I know).
When a couple enters into troubled territory, its members can turn to each other for solace and connection, right? Even when the trouble is each feels hurt and misunderstood by the other.
Right? Yes, some couples can. The secure functioning ones. The ones who understand that their relationship depends on this.
Many couples, however, do the opposite. They turn away. Each member feels too hurt, misunderstood, blamed, and afraid. Afraid of more of hurt, more of the same. Too caught up with thoughts of how the other one should know. Should know what I’m feeling, what I want. My hurt and mind. So the members turn away from each other and toward others and other interests to meet his/her own needs. One goes out with friends. The other delves into a creative venture. One joins a club. The other travels alone. Again and again looking outside the relationship for more and more. Each, little by little, turning away, and forgetting how to turn toward, each other. Until…it’s over.
If this is your relationship and you want to turn it around before you and your lover/partner/spouse kill it, try turning toward. Start by doing this physically. Get face-to-face, eye-to-eye with your partner, close enough to see each other’s pupils. Hold for a few minutes. Keep your faces soft and friendly. It may sound simple but can be really hard for couples to do. So no judgments. Of yourself or your partner. Approach it playfully. Then rinse, wash, repeat, as Stan Tatkin, the developer of PACT, likes to say.
My hope is that, for each member, this may be a start to turning toward, and getting to know, the person you once loved fiercely and may find yourself loving fiercely again.
One resource focuses on children and teens; the other is for adults. Both can be remarkably useful for those with ADHD.
The first is understood.org (here) for “learning and attention issues.” What it offers is vast and, though, it’s targeted to parents of children and teens with ADHD, many adults with ADHD can find it of use. Much of what’s suggested for teens applies to adults, except for the context (e.g., work vs. school). Also, given that 25-35% of parents of youth with ADHD are likely to have ADHD (source), parents using the site may want to use the recommendations for themselves as well as their children.
The second resource is JAN, Job Accommodation Network (here), which is all about workplace accommodations for employers and employees needing or wanting to know what the American with Disabilities Act (ADA) encompasses, including job coaches…even the possibility of free ones. Who knew? From what I can tell, fewer than would have liked to have known.
The Dodo bird quote from Alice’s Adventures in Wonderland came to mind as I read the results of a recent study. A randomised, controlled fMRI study of the effects of mindfulness and psychoeducation on the working memory of adults with ADHD found they both worked (for more on working memory, see What predicts ADHD symptom reduction over time?).
After 8 wks, both interventions were found to increase working memory performance and to increase task-related right parietal lobe brain activity to a similar degree (study here). Although I’d like to see the results for a third group who received neither intervention (to rule out any placebo effect), the good news is that, under both conditions, working memory increased. What would be interesting to see next is what happens when we combine mindfulness and psychoeducation.
Research suggests discontent and disloyalty among the reasons, but, hold off on nodding knowingly. The discontent and disloyalty may be on a different side than you imagine.
Research suggests that it’s the partner with ADHD who’s likely to be unhappy. Again, the one with ADHD (the opposite of what many might guess).
One study found that adults with ADHD had more negative perceptions of their relationships and families than their non-ADHD spouses did. These perceptions were also more negative than members of couples where neither had ADHD (see here).
Research also indicates that ADHD’s associated with a higher rate of infidelity. One study delved into this a little and found that “relational alternatives” were of “greater interest” when adults’ inattentive symptoms were high (see here). (This same study found that when either inattentive or hyperactive-impulsive symptoms were high, adults showed “less constructive responses” to a partner’s “bad behavior.”)
There’s more, but the picture painted is that relationships are harder. Namely, harder to sustain (versus start).
So does this mean couple therapy early on? Probably a good idea.
But choose carefully.
Some couple therapies depend on out-of-session assignments, and this could be a set up for failure.
Fights might become about who does the homework and how much of it.
Some couple therapies, however, focus on experiencing useful ways of relating during the session. When my group members ask me about couple therapy, this is the kind that I suggest. One of these is Psychobiological Approach to Couple Therapy (PACT).
There’s no research-tested ADHD-specific couple therapy of which I am aware. Instead, there are therapists who understand ADHD and offer couple therapy/counseling.
One of these is Melissa Orlov, the author of TheADHD Effect on Marriage. Her book describes common patterns of relating between partners when only one has ADHD, and she offers couple counseling through her website (here).