Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood by Edward M. Hallowell & John J. Ratey
After reading "Driven to Distraction",
I mostly try to avoid using the term "ADHD".
Hyperactivity is not uncommon in people with ADD
(Attention Deficit Disorder),
but it is not universal.
After reading the book,
I think lumping it in the definition of the syndrome
is doing a disservice to the people who have it --
especially those that do not exhibit hyperactivity.
Hypothetical Condition
Imagine that you got headaches every time things were too calm.
You would naturally try to do anything to avoid the calm.
As a kid, you would start misbehaving in class,
because kids have limited options.
As you grow up, you would find more interesting ways
to stave off the headaches.
Maybe you would take to driving 20 mph over the speed limit on the highway,
or take up skydiving as a hobby.
Maybe you could even turn your aversion to calmness into a
competitive advantage:
find a high-stress job like air traffic controller
or high-stakes financial analyst.
In college, you would worry about the due date for your paper,
but not do anything about it:
the worrying staves off the calm,
and finishing the paper in an all-nighter is super-stressful.
Attention Deficit Disorder is not like that;
it is much worse.
Instead of just getting a headache,
you are drowning in distractions without something to deliver
high levels of stimulation.
Fortunately,
the difficulty created by having such a challenging disorder
provides much needed stimulation.
People with ADD often use this stimulation to develop coping mechanisms.
Unfortunately, without a lot of luck or outside help,
those coping mechanisms are always stuck on a local maximum.
As soon as they work too well,
things calm down,
and they stop working.
One great way to feel better about yourself and the coping mechanisms
you have developed
is to read about other people,
and be grateful to whatever random forces steered you away
from coping mechanisms that are even more destructive.
Case Studies
The book has a lot of case studies.
I think the point is to show different facts of ADD,
or to show the diversity of the manifestations of the syndrome.
But, instead, I learned something else from them.
The horrifying truth about ADD is that coping mechanisms can always
get worse.
The case studies start mildly.
First, Jim, whose main coping mechanism is waiting until two hours
before week long projects are due to start working on them.
Luckily, his ideas are just good enough that even when he gets fired
from one job, he manages to find another one.
He doesn't get promoted, and often someone else gets the credit
for cleaning up his rough drafts, but at least
he survives.
The case studies continue with Carolyn,
who eventually became a therapist specializing
in ADD, but as a kid, her main coping mechanism was running away from
school, climbing on top of water towers and diving into a book.
The stimulus of climbing those rickety structures, plus the excitement
of the plot-lines, helped her focus.
However,
these coping skills were less helpful in avoiding the
inevitable scolding of Carolyn's mother when,
every Saturday,
her mother learned of her antics.
Max, who earned the nickname Mad Max, used his nickname as a coping mechanism.
He behaved in extreme ways, like intentionally tripping over his feet,
and then pointing to himself and saying "crazy".
Danny and David, adopted twins, took to physical activity.
Mostly in the form of fighting with each other,
fighting with the teachers in the school for special children,
and occasionally doing cartwheels when they were bored.
What they got in return was a lot of physical restraint,
to the point of harm,
from the teachers.
The stories continue,
not necessarily in order how destructive
the coping behavior is
which makes it all the more scary to read.
You never know if you already read the worst one.
Jack, an editor, picks fights with everyone at work,
and compensates for his egregious behavior by being very good at his job.
George does all his work from his phone while driving,
because that's the only way he can concentrate.
Laura developed anxiety in order to focus herself.
Douglas turned to alcoholism and workaholism.
Other People
No man is an island, and people with ADD are no different.
Many people grow up in a family with parents and siblings.
Many people share their life with a long term partner.
The most emotional chapters in the book discuss the story
of the people who live *near* ADD,
especially undiagnosed ADD.
You cannot avoid having sympathy for the wife of someone who is qualified
to be an emergency-room doctor, but then changed careers to a cartoonist,
and then gave up on it to be a freelance writer.
But even harder to read was the story of Tommy and how his ADD
organized his family's dynamics into complete dysfunction.
Tommy's role, as is common for teenagers with ADD, was to be the
screw-up. School is boring even for neurotypical teenagers,
for people with ADD it looks designed as a way to make them fail.
Tommy's mother's role is to react with extreme emotions:
compassion, worry, or anger, more or less in that order.
When Tommy fails to respond to her compassion, she becomes worried,
and when Tommy reacts, she responds with anger and pain.
Tommy's father's role is that of the harsh disciplinarian,
giving harsh penalties when Tommy screws up or hurts his mother.
The role of Alex and Suzie, Tommy's siblings, is to serve as a
contrast. Where he screws up, they toe the line. They listen
to their parents. As their reward, they get to join their parents
side in the big struggle the family is locked in.
When it is indicated that Tommy's problem might be treatable,
everyone's roles is threatened. Not only does Tommy's ADD have
to be addressed, but the entire family needs to learn how to
function without the his ADD providing the stimulation for
everyone else.
Treatment
As a book for lay people,
those suffering from ADD or
close to someone who does,
the book does not focus on when to prescribe medicine.
It is pretty firm in saying that when medicine is prescribed,
it is a good idea to take it.
Further, the book stands up for informed consent,
and does stress the importance of
*being informed*:
often, the resistance to using medication is based on folk tales.
However,
while medication helps with focus,
it usually does not,
by itself,
help unlearn the harmful coping mechanisms.
Though unnecessary, those behaviors have often already become habit.
The book recommends therapy,
but also suggests that other lay people can help
the person with ADD figure out,
and keep to,
structures that will help them.
Conclusion
As with any psychological condition,
and as seems to be the standard in these books,
a list of great people who also suffered from the condition
is mentioned.
Like Robin Williams as the mascot of high-functioning depression,
people with ADD get Albert Einstein.
It is nice to see that the condition does
not have to be debilitating.
Some people with the condition have made
incredible accomplishments.
It is also important to remember that there are a lot of people
with ADD who are not Einstein,
and should not feel bad about it.