Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder

411 Pages·2005·1.55 MB·English

by  Edward M. Hallowell, John J. Ratey

CONTENTS

Title Page

Dedication

Epigraph

Preface to the New Edition

Acknowledgments

A Note on Authorship

How to Read This Book

Introduction: Welcome to the World of ADD, Where Landing Is
Learned in Midair

♦ Part One ♦

WHAT’S IT LIKE TO HAVE ADD?

1. The Skinny on ADD: Read This If You Can’t Read the Whole Book

2. The Feel of ADD

3. The Seven Habits of Highly Effective ADD-ers

4. ADD Self-Assessment Quizzes for Adults: A Screening Test

5. Won’t Pay Attention, or Can’t? The Crux of the Matter

6. An Evil, an Illness, or a Kind of Mind? From Stigma to Science

7. The Itch at the Core of ADD

♦ Part Two ♦

THREE STORIES THAT TELL THE STORY

8. The Benevians: How This Diagnosis Can Change Your Life for the Better—

at Any Age

9. Joey: When There’s More Than ADD

10. The O’Brien Family: A Houseful of ADD

♦ Part Three ♦

MAKING THE DIAGNOSIS OF ADD

11. The Steps to Diagnosis

12. The qEEG and the SPECT Scan: Two Useful New Tests Not Widely Used

13. How Do You Tell a Child About the Diagnosis of ADD?

14. Conditions that Coexist with ADD

15. Bipolar Disorder or ADD? How to Tell the Difference

16. ADD, Reading Problems, and Dyslexia

17. Genetics: If I Have ADD, What Are the Odds My Child Will Too? and Other

Interesting Questions

18. Are We Training Our Children to Have ADD?

19. ADD, Addictions, and a New Use of the 12 Steps

♦ Part Four ♦

MASTERING THE POWER AND AVOIDING THE PITFALLS: THE TREATMENT OF ADD

20. The Treatment of ADD: What Works Best

21. The Key to Treating ADD: Find the Buried Treasures

22. How to Find the Buried Treasures: Five Steps That Lead to Lasting Joy

23. How to Find the Buried Treasure in School: One Shining Example That All

Schools Should Follow

24. Major Danger Alert: College and ADD

25. Nutrition and ADD: A Cornerstone of Good Treatment

26. Omega-3 Fatty Acids: A Nutrition-Based Treatment for ADD

27. Physical Exercise: A Great Treatment for ADD and a Magic Tonic for Your

Brain

28. Powerful Exercises for the Brain That Improve Attention

29. Cerebellar Stimulation: A Specific Kind of Physical Exercise That Can Be

Used to Treat ADD

30. To Try Medication or Not: Some Reassuring Guidelines

31. If You Choose to Try Medication, Which Should You Choose?

32. Don’t SPIN

33. And Don’t SLIDE

34. The Big Struggle Revisited: ADD in Families

35. Living Through the Pain of ADD

36. How to Get Rid of Piles: The Kudzu of ADD

37. Worry and ADD

38. Sex and ADD

39. Hallowell & Ratey’s Top Tips for Adult ADD

40. What Kind of Mate Is Best If You Have ADD?

41. What Can You Do If Your Mate Has ADD?

42. Getting Well Enough Organized: The Hallowell Approach

43. What the Best Treatment Must Include

Appendix: A Compendium of Resources

About the Authors

Also by the Authors

Copyright Page

Since this book is about hope and the power of positive human energies, we
dedicate it to the memory of two women who radiated those qualities in their

lives:

Josseyln Hallowell Bliss

and

Priscilla Luke Vail

and to one team that never gives up:

The Boston Red Sox

Boy, what ever you is

and where ever you is,

don’t be what you ain’t,

because when you is

what you ain’t, you isn’t.

—UNCLE REMUS

ACKNOWLEDGMENTS

Many people helped to create this book.

Above all, John and I would like to thank our patients who contributed their

stories, as well as the people who were not patients but contacted us and shared
episodes from their lives. Although their names have been changed, all the
stories are true; we never could have given this book the power that true stories
pack were it not for the courageous cooperation of the dozens of people you find
in these pages.

Many other people supported this work. Ginny Grenham, dear friend and

creative genius, was most helpful, as always. It was she who urged that a chapter
be included on making the transition to college, and she who suggested the
chapter on explaining ADD to children. A devoted advocate of all who live with
ADD, she always finds the best in people and helps them reach and grasp higher
than they think they can.

We also thank Kay Murray and Roxie Nickerson for their painstaking work on

the final section of the book, the resource section.

A great number of top experts helped us in our research. We especially want to

thank Janet Wozniak for her help on the chapter on bipolar disorder and Demitri
Papolos for his comments on that topic. Mel Levine was, as ever, generous,
brilliant, and provocative in sharing his thoughts about attention. Ellen Braaten
was most helpful in discussing psychological and neuropsychological testing.
Sue Smalley was a great help in giving us information for the chapter on
genetics. Stacy Bell and Helen Rasmussen shared their expert knowledge about
nutrition, and Eugene Arnold helped in the evaluation of alternative or
complementary treatments. Len Adler advised us about the most current data on
the new medication Strattera. Ross Greene helped with his innovative ideas on
untangling struggles in families. Susan Cole Ross taught me about educational
therapy, and, a fine writer herself, she also helped to edit the manuscript. Peter
Jensen offered encouragement and knowledge whenever we turned to him,
which was often. Peter Metz, one of the best psychiatrists in the land, was a great
help all along the way. Michael Thompson offered encouragement and wisdom

at many junctures, as he always has.

Diane Santangelo, Peter Mustich, and others from the Rye Union Free School

District gave of their time and experience in showing me the details of a school
system that does it right.

Sam Goldstein, Sally Shaywitz, Clarke Ross, Bob Brooks, Kathleen Hopkins,

Michele Novotni, Sari Solden, Kathleen Nadeau, Patty Quinn, Joe Biederman,
Tom Spencer, Tim Willens, Larry Silver, Rick Lavoie, Russ Barkley, Kevin
Murphy, Kitty McEaddy, Alice Thomas, Thom Hartmann, Theresa Citro, Lynn
Meltzer, Daniel Amen, Jonathan Mooney, and many others from disparate
domains of the ADD and LD communities have always encouraged us and
shared their experiences enthusiastically. Thanks to the efforts of these people
and many others, a community that used to be weakened by division and
dissension now gains strength and even glee from discussion and cooperation.

We also thank our teachers from years ago, men and women at the

Massachusetts Mental Health Center in Boston who helped us learn to listen, to
observe, and to believe in what John Keats called “the holiness of the heart’s
affections.” Many of our best teachers were our patients. And many were faculty
who gave of their hearts and minds tirelessly and enthusiastically. Among the
faculty, Doris Menzer Benaron, Jules Bemporad, William Beuscher, Thomas
Gutheil, Leston Havens, Allan Hobson, Elvin Semrad, and Irvin Taube all
instilled in John and me, as well as hundreds of others in training, a habitual
curiosity and open-mindedness. With their encouragement, we didn’t just study
psychiatry—we studied life.

We thank our agent, Jill Kneerim, for her many years of care and help, and the

team at Ballantine, led by the warm-hearted and astute editorial guidance of
Nancy Miller and her assistant, Deirdre Lanning. Writers often have good reason
to complain about publishers; in this instance, we have reason not only to give
thanks but to feel uplifted by a sense of teamwork and kinship with the
publishers. The team at Ballantine believed in this book from the outset and did
all they could, every step of the way, to make it as good as it could be.

Finally, and most personally, we thank our families. John thanks his wife,

Nancy, and his children, Jessica and Kathryn, for their support, loyalty, and love.
And I thank my wife, Sue, and our children, Lucy, Jack, and Tucker, for making

me the luckiest man on the face of the earth.

A NOTE ON AUTHORSHIP

Edward (Ned) Hallowell wrote this book. Hence, throughout the book, the
pronoun I refers to Ned (me). We refers to both John Ratey and me. When John
is to be singled out, I refer to him by name.

Although I did all the writing, the project was very much a shared one, its

roots extending back to 1978, when John and I first met. Indeed, this
collaboration serves as an excellent example of the five-step process we
recommend in our discussion of the treatment for ADD: connect; play; practice;
achieve mastery; gain recognition. We drew more out of each other than either of
us could have delivered alone. Collaborating wasn’t easy, but it was, in the best
and deepest sense of this word, a joy.

As we contemplated writing this new book, we asked ourselves, “Can two

men who have ADD themselves get their acts together well enough to write a
book about ADD . . . again?” What you hold in your hands right now is the
answer to that question.

This book emerges from the twenty-five years John and I have worked and

played together. I say “played” because even though we’re now in our fifties,
there’s a lot of play in what we do, from working out to brainstorming. This is
one of the many advantages of having ADD as an adult: you are less likely than
other adults to lose your enthusiasm for play, or your ability to do it!

John majored in philosophy in college, and I majored in English. Then we

both headed off to science and medical school. We both wanted to combine the
tradition of the old-fashioned, humanistic doctor with the new wave of medical
science and technology, taking the best from both.

We first met in 1979 when John was chief resident at the Massachusetts

Mental Health Center and I was a first-year resident in psychiatry. Back then,
your chief resident was your teacher, guru, parent, and friend rolled into one.
Your chief was supposed to make sure you ripened from a sleep-deprived novice
fresh from the boot camp called internship into the sort of doctor people in
emotional distress could take comfort from. That was—and is—like transfusing

blood into a patient who is as dry as dust and has no visible veins. John found
veins.

He found more in us than we knew we had. If you ask me, he was the best

chief resident in the history of psychiatry. We’ve been friends now for almost
half of our lives. John is godfather to one of my children, and I was best man at
John’s second wedding.

When we first met, neither of us knew we had ADD. In fact, we didn’t even

know what ADD was! But we knew we liked the way each other thought, and
we also knew that we went through life differently from most other people. We
began to explore what we would later learn is called ADD simply by talking
with each other and comparing notes on what we observed in our patients, in
ourselves, and in what was emerging from psychiatry and neuroscience. It made
for one of the most exciting extended discussions I’ve ever had, and it’s still
going on.

After I completed my residency I went into training in child psychiatry, while

John began his career as a teacher, researcher, and clinician. We remained close
friends, meeting regularly to play squash.

We talked about cases and about brain science all the time. Our discussions

led us all over, one of our favorite places being the world of ADD. Before we
knew it, we were diagnosed with ADD ourselves. The more we learned, the
more we realized how common this little-known condition was. So we decided
to write a book. It took a while to get it done because folks with ADD tend to
procrastinate.

But it got done. In 1994, fifteen years after we met, Driven to Distraction was

published: one of the first books to introduce the general public to the world of
attention deficit disorder.

Since that time, brain science has so taken off that the 1990s was dubbed “the

decade of the brain.” As the passing years brought new knowledge, they also
gave John and me time to develop and test our ideas and learn from the
thousands of new patients we treated.

Because of all that we had learned since 1994, we decided in 2002 that it was

time for a new book. But, we wondered, would it be possible for us to
collaborate a second time? Once was tough enough, but twice? Being dreamers
and risk-takers (two of the attributes often found in adults who have ADD), and
also drawing upon the faith in difficult projects John had developed on the tennis
courts of Pittsburgh and I had developed at Exeter, we decided to give it a go.

The last time we collaborated, we had been able to rely on squash to bring us

together regularly. But age had hit us both. John hurt his shoulder, so he could no
longer play squash. Then I developed such severe osteoarthritis that I had to
have a total hip replacement at the tender age of fifty-two. No more squash for
me, either. Since exercise had always been a key to our collaboration, we began
our meetings for the new book in a gym. After working out on the StairMaster or
stationary bike, we would sit down at the juice bar to develop our new book.

Gradually, Delivered from Distraction climbed hand over hand out of the

neural networks where it took shape deep within our brains.

Never in this book do we contend that it is easy to live life with ADD. If you

don’t get help, ADD can curse you and make you wretched. But if you work it
right, ADD can enhance your life and make you sparkle. Sometimes it seems all
but impossible to scratch your way out of the mess this complex condition with
such a simple name can turn your life into. But there is always, always hope.

Consider the story of the Harvard medical student who had been languishing

in high school until his ADD was diagnosed. “After that, I discovered I had a
brain,” he told me. His life totally changed once the diagnosis was made. He got
into college, which he never thought he could do. Not only did he get in, he
excelled. He did so well in college that he won a Rhodes Scholarship. Following
the Rhodes, he was admitted to Harvard Medical School.

When I discussed this book with him he responded eagerly, “Oh, good. You

gave ADD its coming-out party with Driven to Distraction. Now it is time to
give ADD its citizenship in the world. That diagnosis saved my life, and it could
save millions more if people really understood it for what it is.”

HOW TO READ THIS BOOK

This is not a textbook. It is a special kind of storybook in which the stories
depict the charms and dilemmas of a unique place: the world of attention deficit
disorder. All the stories in this storybook are true, and include bits of scientific
information as well as suggestions on how to solve the dilemmas the stories
illustrate.

I hope you’ll read this book the way you’d have a conversation with a close

friend over lunch. I hope you will enjoy yourself as you entertain new ideas and
reconsider old ones. Skip around in your mind as you read, get up and go to the
restroom, order another glass of wine, and settle in for an intimate couple of
hours.

There is no surprise ending that you’ll ruin by reading ahead, so feel free to

skip around. That’s the ADD way, after all.

The first chapter has “the skinny,” so you might want to read it right away if

that’s all you think you have time for. Or you might be inclined to read it last as
a kind of summing up. Or you could skip it altogether because you don’t like
“skinnies.”

If you never finish the book, don’t dismay. As Samuel Johnson said, “There

are so few books one reads all the way through.” Just take what you want, enjoy
it, and put it to good use.

When you finish reading—or when our conversation comes to a pause—I

hope you will contact me if you have comments or questions. I love to hear from
readers.
You
can
reach
me
by
e-mail
through
my
website,

www.DrHallowell.com.

Now, please join me in a conversation about the wonderful world of attention

deficit disorder, a world where I live, which I invite you to explore and enjoy
with me.