I love words and their meanings. I read and hear words and gain understanding. I use words and impart understanding. Yet, if you ask me to define a word, I’ll run for the dictionary every time. I cannot define words. It’s baffling but I don’t spend a lot of time trying to figure it out. I just have dictionaries. There is a dictionary in my office, in my kitchen, yes, even in my pop-up camper.
When ADD/ADHD became an official diagnosis in our lives, my first question was What is it? There is no dictionary with a definition of ADD. If you read a book, you’ll get a definition. Read another and you’ll get another definition. I have a good picture of what it looks like but struggle with explaining it to other people. This is important. I will and AM dealing with it. But, will and CAN they deal with it? Not without knowledge and understanding. This is no simple matter. ADD is complicated. And, misunderstood. Understanding is what the ADD person needs the most.
This is my attempt to define ADD with the least amount of the most correct words possible. It is important to remember that the disorder will ultimately manifest itself in as many different ways as there are people. Dr. Edward M. Hallowell, M.D., coauthor Driven to Distraction and an ADD person himself, says “If you’ve seen one person with ADD, you’ve seen one person with ADD.”
Disease vs. Disorder vs. Syndrome
We should begin with a clarification of the difference between a disease, a disorder and a syndrome.
Disease: a morbid entity characterized usually by at least two of these criteria:
Recognized cause – virus, bacteria, etc.
Identifiable group of signs and symptoms
Consistent anatomic alterations
Examples: cancer, arthritis, Parkinson’s disease.
Disorder: a derangement or abnormality of function.
Examples: Sleep disorder, post traumatic stress disorder, generalized anxiety disorder.
Syndrome: a cluster of symptoms known to appear together; may or may not have a known cause.
ADD or attention deficit disorder is a derangement or abnormality of function. ADHD includes hyperactivity. The core issue is an inability to attend or focus. ADD resides in the prefrontal cortex and possesses a neurology. It can be measured in brain activity, or more accurately, underactivity of the prefrontal cortex. This neurology is very well explained in the ADHD Information Library. The basic symptoms are impulsivity, hyperactivity and a lack of inhibition. The brief explanation below was taken from the ADHD Information Library:
The frontal lobes help us to pay attention to tasks, focus concentration, make good decisions, plan ahead, learn and remember what we have learned. The frontal lobes also help us to behave appropriately for a given situation. Emotional issues such as anger, frustration, and irritability reside in that cortex.
The inhibitory mechanisms of the cortex keep us from being hyperactive, from saying things out of turn, and from getting mad at inappropriate times, for examples. These inhibitory mechanisms of the cortex help us to “inhibit” our behaviors.
ADD manifests itself in behaviors cited above. Complicating matters is the fact that many ADD people possess many positive attributes such as high intelligence, creativity, outgoing personalities and loving natures. These attributes are pitted against the behaviors. This is what makes ADD so misunderstood. What we see – the attributes – is not what we get – the behaviors.
The ADD person resides almost entirely in the moment. Hindsight and forethought do not guide the judgment and decision making that happens in a persons life on a moment to moment basis. He does not call to mind the consequences of prior actions and does not think about what he needs to do now to facilitate what needs to be done two hours from now or even 15 minutes from now. Transitioning from one activity to another is difficult. Due to the lack of inhibition, thinking before speaking or acting is difficult. The results of this paradox are damaged self esteem from being unable to meet expectations (others and self), chronic underachievement and near constant frustration.
I have found some excellent resources, a few of which can be found on the front page under ADD Books. What I find most useful, when called upon to explain ADD to another person, is an illustration. Thomas E. Brown, Ph.D., has written a book entitled Attention Deficit Disorder – The Unfocused Mind in Children and Adults. He refers to ADD as a syndrome, a cluster of symptoms that impairs focus. I think the first paragraph of the introduction to his book is an excellent illustration of ADD. I have published it on my page entitled “Snapshot of ADD”.
This commentary is a personal perspective on the nature ADD. The experience of ADD will vary from person to person and depend whether you are the person with ADD or the person living with a person with ADD. I happen to be both. Whatever your case may be, it is in the best interests of everyone involved to learn as much as possible about ADD. Knowledge is power. More importantly, knowledge will lead to understanding and will be the foundation of whatever treatment program you decide to engage. The best to you.
* The term Attention Deficit Disorder or ADD includes Attention Deficit Hyperactive Disorder or ADHD.