More attention, less deficit : success strategies for adults with ADHD

403 Pages·2009·1.52 MB·English

by  Ari Tuckman

This is the only book on Attention Deficit Hyperactivity Disorder (ADHD) actually
written for adults with ADHD. Brief, ADHD-friendly articles can stand alone or be read
in order, so you can jump around as much as you want. This authoritative guidebook
provides rock-solid information that is easily digestible and totally practical.

Understanding ADHD in Adults: What ADHD is and isn’t; getting diagnosed;
and why your life has been so much harder than it needed to be.

Start with Effective Treatment: Make sense of your treatment options,
including medication, therapy, coaching, and alternative treatments.

Build the Necessary Skills: Learn the basic skills and tools necessary to stay
on top of obligations and live a satisfying life, from time management to
organization.

Improve Specific Areas of Your Life: Apply those skills to your home life,
relationships, and career.

Every page is loaded with practical strategies to make your life better, so you will
benefit whether you read one page or all of them.

“All adults with ADHD can benefit from this book, as well as all people who care
about them. Superb!”
Edward Hallowell, MD

“More Attention, Less Deficit is a great ‘life manual’ on how to live successfully with
any, and all ADHD challenges.”
Nancy A. Ratey, Ed M, MCC, SCAC

“Dr. Tuckman has done a fantastic job at providing a virtual smorgasbord of
information for adults with ADHD.”
Patricia O. Quinn, MD

About the Author

Ari Tuckman, PsyD, MBA, is the author of
Integrative Treatment for Adult ADHD:
A Practical, Easy-to-Use Guide for Clinicians
and Vice President of the Attention Deficit
Disorder Association. He practices in West
Chester, PA.

ISBN-13: 978-1886941748
ISBN-10: 1886941742

9 781886 941748

5 2 4 9 5

Specialty Press, Inc.
300 N.W. 70th Ave., Suite 102
Plantation, Florida 33317
[phone] • www.addwarehouse.com

Self-Help/Psychology
$24.95 US/$27.95 CAN

More Attention, Less Deficit

Success Strategies for Adults with ADHD
Ari Tuckman, PsyD, MBA

Specialty Press, Inc.

“This book should prove enormously instructive for both adults with
ADHD and for clinicians who specialize in its diagnosis and
management.”
Russell A. Barkley, PhD

What the experts are saying
about this book!

More Attention, Less Deficit is outstanding. Written in a clear and easy-to-under -
stand style, the book brings together a vast amount of information, ideas,
suggestions, and research. Dr. Tuckman’s energy and empathy sustain the book
throughout. All adults with ADHD can benefit from this book, as well as all people
who care about them. Superb!
Edward Hallowell, MD, author of various books
and founder of The Hallowell Centers in New York and Massachusetts

Dr. Tuckman has provided us with a richly detailed discussion of ADHD in adults
and especially how it should be managed, directly written for the adult with ADHD
in mind. Wonderfully supportive and informative, this book provides countless
recommendations for addressing the myriad symptoms of poor self-control and
time management, inattention and disorganization, and impulsive and careless
behavior that afflicts nearly every major domain of life activities for adults. The
book should prove enormously instructive for both adults with ADHD and for
clinicians who specialize in its diagnosis and management.
Russell A. Barkley, PhD, Clinical Professor of Psychiatry
Medical University of South Carolina (Charleston)
And Research Professor of Psychiatry, SUNY Upstate Medical University (Syracuse)

More Attention, Less Deficit is a great “life manual” on how to live successfully
with any, and all ADHD challenges. It is full of great strategies and helps the reader
to understand the underlying issues so the strategies can truly stick. Dr. Tuckman’s
book is comprehensive, practical and easy to read—just what the adult with ADHD
needs and wants!
Nancy A. Ratey, EdM, MCC, SCAC
Strategic Life Coach, Author, The Disorganized Mind

Dr. Tuckman has done a fantastic job at providing a virtual smorgasbord of
information for adults with ADHD. By using the menu provided at the beginning
of each chapter, the reader can select articles specific to their situation resulting in
greater reader interest and satisfaction. I wholeheartedly recommend this book for
all adults with ADHD. It’s like getting an individualized consult with Dr. Tuckman!!
Patricia O. Quinn, MD
Director, The Center for Girls and Women with ADHD, Washington, DC
www.addvance.com

More Attention, Less Deficit is the new “Bible” of ADHD. Dr. Tuckman brilliantly
maps out strategies and tips while peppering it with facts in a way that makes it
interesting and easy for the adult with ADHD to devour in bite-sized pieces. A
must-read for all who are touched by ADHD.
Terry Matlen, ACSW
Author of Survival Tips for Women with ADHD, Director, www.addconsults.com

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Dr. Tuckman has given us a thorough compilation of science-based information
on Adult ADHD that is down to earth, easy to understand, practical, and highly
useful. This book provides the essential ingredients of hope, guidance, and
knowledge for anyone who wants to understand and gain better control of this
complex disorder.
Kevin Murphy, Ph.D. President, Adult ADHD Clinic of Central MA

This valuable book will help adults with AD/HD and those who care about them,
have a greater understanding of the disorder—and more importantly—learn what
to do about it. Written in a very user-friendly manner, the book can be read in any
order the reader finds useful. Packed with strategies for successfully manag -
ing symptoms, adults with AD/HD will also find ways to come to terms with all that
the disorder adds and subtracts in their lives. This is no small feat, believe me! An
excellent resource from an author who really “gets” what it is like to have AD/HD.
Marie Paxson, President, CHADD (Children and Adults with Attention Deficit/
Hyperactivity Disorder);
Personal opinion as CHADD does not endorse publications.

This is the first book I have read where a healthcare professional has conveyed an
accurate overview of the coaching process and how it fits into the whole,
comprehensive picture of successful ADHD management. Dr. Tuckman’s book
represents an excellent educational resource, for not only understanding ADHD,
but as a strong starting point to identify potential strategies which can powerfully
enhance the treatment of ADHD.
David Giwerc, MCC, Founder & President, ADD Coach Academy
Former President of the Attention Deficit Disorder Association

As a follow up to his highly respected book for professionals, Integrative
Treatment for Adult ADHD, Dr. Ari Tuckman has done a masterful job culling the
scientific literature to design a user-friendly, comprehensive blueprint for living
well with adult ADHD. More Attention, Less Deficit will be an invaluable resource
for adults living with ADHD, their loved ones seeking to understand the disorder,
and clinicians looking for tried and true coping strategies that will help their
patients.
J. Russell Ramsay, Ph.D., Co-Director, Adult ADHD Treatment & Research Program,
University of Pennsylvania School of Medicine
Author of Cognitive Behavioral Therapy for Adult ADHD:
An Integrative Psychosocial and Medical Approach

Ari Tuckman offers an insightful, practical and most important user friendly guide
for adults with ADHD. This book is chock full of great ideas and exceptional
strategies. Most importantly, Tuckman provides a reasoned and reasonable
appreciation of ADHD, an essential foundation to help those with the condition
find the strength and motivation to take charge of their condition.
Sam Goldstein, Ph.D., Co-Author Clinician's Guide to Adult ADHD

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More Attention,
Less Deficit

Success Strategies

for Adults with
ADHD

Ari Tuckman, PsyD, MBA

Specialty Press, Inc.

300 N.W. 70th Ave., Suite 102

Plantation, Florida 33317

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Copyright © 2009 Ari Tuckman, Psy.D., MBA

All rights reserved.

No part of this book, except those portions specifically noted, may be reproduced
or transmitted in any form or by any means now known or to be invented,
electronic or mechanical, including photocopying, recording, or by any
information storage or retrieval system, without written permission from the
publisher, except for brief quotations. Requests for permission or further
information should be addressed to the publisher.

Cover Design: Michael Wall, Kall Graphics
Layout: Babs Kall, Kall Graphics

Specialty Press, Inc.
300 Northwest 70th Avenue, Suite 102
Plantation, Florida 33317
[phone] • [phone]

Printed in the United States of America

ISBN-13: 978-1-886941-74-8

ISBN-10: 1-886941-74-2

Library of Congress Cataloging-in-Publication Data

Tuckman, Ari.
More attention, less deficit : success strategies for adults with ADHD / Ari
Tuckman.
p. cm.
ISBN 978-1-886941-74-8 (alk. paper)
1. Attention-deficit-disorder in adults. 2. Attention-deficit disorder in adults–
Treatment. I. Title.

RC394.A85T834 2009

616.85'89--dc22

2009005972

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F

Dedication

or Bailey, my little love.
Somehow I managed to write this book
despite the sleep deprivation.
Hopefully we’ll sell enough copies
to pay for all the coffee.

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iii
Table of Contents

How to Read This Book
xiii

What Makes This Book Different?
xiv

Introduction: A Million Things to Make Your Life Better
xv
Section I: UNDERSTANDING ADHD IN ADULTS
1

Chapter 1
EXECUTIVE FUNCTIONS: IT ALL FLOWS FROM HERE
5
Executive Functioning:
Who’s Calling the Shots Around Here, Anyway?
7
Response Inhibition: It Starts with Stopping
8
Working Memory: The Brain’s RAM
9
Sense of Time: It Can’t Be 5:00 Already!
11
Remembering to Remember: It’s All About Timing
12
Emotional Self-Control: Having Feelings Without Acting on Them
13
Self-Activation: Getting That Heavy Ball Rolling
14
Persistence of Effort: The Little Engine That Sometimes Could
16
Hindsight and Forethought:
Using the Past and Future to Guide the Present
17

Chapter 2
DIAGNOSING ADHD:
ACCURATE DIAGNOSIS GUIDES EFFECTIVE TREATMENT
21
ADHD Is Real
24
Effective Treatment Starts with Accurate Diagnosis
24
A Century of ADHD: We’re Finally Getting It Right
25
Say Good-bye to ADD (and Hello to ADHD)
27
What’s in a Name: Attention-Deficit or Deficit in Attention Regulation? 28
Official Diagnostic Criteria: You Should Recognize These
29
Unofficial but Common Symptoms: You’ll Probably Recognize These
30
How Distracted Is Distracted Enough?
32
New Diagnostic Criteria Are Coming (Finally)
33
Including Other Sources of Information
34
Assessment Instruments: Not Necessarily the Best Tool for This Job
37
Brain Scans: Not Enough Science, Too Much Fiction
40
Getting Diagnosed: How Do You Know It’s ADHD?
41
Comorbid Conditions:
Other Conditions Often Come Along for the Ride
43

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iv

Missed Diagnoses:
Why Did It Take Me So Long to Be Correctly Diagnosed?
48
The Good News and Bad News of Greater Public Awareness
52
ADHD Changes with Age: Less Hyper, More Distracted
55
Is ADHD the Same in Men and Women? (Short Answer: Yes)
56
The Relief of Being Diagnosed: Wow, That Explains a Lot!
57

Chapter 3
THE ADHD BRAIN: WIRED A LITTLE DIFFERENTLY
58
The Many Facets of Attention
60
What Causes ADHD? More Nature Than Nurture
60
Things That Don’t Cause ADHD
(But Some People Still Think They Do)
61
Neurology of ADHD
63
Promoting Brain Health
64

Chapter 4
ADHD AFFECTS EVERYTHING: NO WONDER MY LIFE WAS SO HARD! 65
Risk Factors, Protective Factors
68
Consistently Inconsistent: I Can Do Anything Once!
69
Knowing Is Easy; Doing Is Hard
70
ADHD and the Evolving Personality
71
Living Without a Diagnosis: Living the Hard Way
73
ADHD at School: Sometimes Intelligence Isn’t Enough
74
ADHD at Work: More Options Than in School
77
Daily Life Functioning: Doing Everyday Stuff Every Day
79
Money Management: Where Does All My Money Go?
81
Social Skills and Friendships
83
Romantic Relationships: Where’s Cupid Now?
85
Parenting: Hard Enough Under the Best of Circumstances
87
Self-Image and Sense of Effectiveness: A Little Bit Dented
90
Unhelpful Coping Strategies:
Common Habits and Defense Mechanisms
91
Substance Use and Addiction: When the Solution Becomes a Problem 101
Driving: No Big Deal, Until It Is
102
Crime and Punishment: ADHD and the Legal System
103

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v

Section II: START WITH EFFECTIVE TREATMENT
105

Chapter 5
MEDICATION: IMPROVE YOUR BATTING AVERAGE
109
Make an Informed Choice:
The Facts Behind the Medication Controversy
112
The Most Popular Stimulant (Coffee, Anyone?)
113
To Take Medication or Not to Take Medication: It Depends
113
Is Taking Medication Like Wimping Out? The Diabetes Analogy
116
Potential Medication Benefits: What Does It Do?
117
Realistic Expectations for Medication:
Somewhere Between Placebo and Miracle
119
Stimulants and Nonstimulants: You Have Two Options
120
Stimulant Medications: Some of the Basics
120
Commonly Used Stimulants
121
How Stimulants Work: Mostly Dopamine, A Little Norepinephrine
124
How Much Should I Take? Finding the Right Dose
124
Some People Take More Medication in the Afternoon
126
Some People Shouldn’t Take a Stimulant
127
Intentional Abuse of Stimulants: An Unfortunate Reality
129
Medicating Substance Abusers: Balancing the Risks
130
Managing Stimulant Side Effects: General Principles
131
Managing Stimulant Side Effects: Specific Side Effects
132
Nonstimulant Medications: Sometimes a Good Choice
136
Black-Box Warnings: Scary but Rare
138
Using More Than One Medication Simultaneously
138
Strategies for Remembering to Take Your Medication
139
Can My Family Doctor Write My Prescriptions?
139
Medication Monitoring Form
141

Chapter 6
NONMEDICAL TREATMENT PROVIDERS: PILLS DON’T TEACH SKILLS 143
You Need an Expert: A Little Knowledge Isn’t Enough
145
Talk It Out: Therapy Can Offer Clarity and Peace
146
Why Was Past Therapy Not Helpful Enough?
(And Why You Can Expect Better This Time)
148
Get the Most Out of Therapy
150
Goal Setting in Therapy
154
ADHD Coaching: More Than Obvious Advice
155

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vi

What’s the Difference Between Coaching and Therapy?
157
Coach and Therapist: One Person or Two?
160
Coaching Certification: Is This Coach Any Good?
162
Changes on the Outside Create Changes on the Inside
165
How Coaching Helps: A General Coaching Theory
166
Goal Setting in Coaching
167
Create Structure and Schedules: More Guideline Than Jail
170
Professional Organizers: Move That Mountain
170
Don’t Underestimate the Power of a Support Group
172
Group Therapy: Learn with and from Others
173

Chapter 7
NONTRADITIONAL TREATMENTS: MIRACLES OR SNAKE OIL?
175
Nontraditional Treatments: Separate the Wheat from the Chaff
176
Natural = Safe (Except for Radon, Lead, Arsenic…)
179
Diet, Nutrition, and Supplements: Try to Eat Well
180
Does Neurofeedback Work? Maybe
181
Computer-Based Training Programs: Most Won’t Upgrade Your Brain 182
Mindfulness Meditation: We Could All Do with Being Calmer
183
Other Nontraditional Treatments: Don’t Hold Out Hope
184

Section III: BUILD THE NECESSARY SKILLS
185

Chapter 8
SELF-ESTEEM AND EFFECTIVENESS: I CAN DO THIS!
191
I’m Only Getting Treatment to Shut You People Up
194
The Four Stages of Adjustment to a New Diagnosis
195
Fully Accepting the Diagnosis
197
Personal Responsibility: You Can’t Control What You Don’t Accept
199
Rewrite History:
Understand Your Past (and Yourself) in a Different Way
200
Is ADHD an Excuse or an Explanation?
201
ADHD Is Bigger Than Good Intentions
202
Calling All Frauds, Fakes, and Actors
204
Is the Problem ADHD or Motivation?
205
Just Do It
206
Do It Anyway: Avoid Avoidance
207
Change Your Mindset, Change Your Life
208
Overcome Unhelpful Coping Strategies, Bad Habits,
and Defense Mechanisms
209

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vii

Failures Lead to Successes (and Better Self-Esteem)
217
Can I Trust Myself?
219
Take Charge of Your Life
220
Is ADHD a Gift?
222
Build Healthy Self-Esteem
224
Adversity Makes You Stronger (Hopefully)
226
Is Life a Journey or a Destination?
227
Roll Back Anxiety and Depression
228
Manage Excessive Substance Use and Other Addictive Behavior
229
Anger Management: Lengthen That Fuse
231
Perfectionism: Almost Always Overrated
233
ADHD, Eating Disorders, and Weight Management
234

Chapter 9
MEMORY MANAGEMENT: WHAT WAS THAT AGAIN?
237
The Fundamentals of Memory: In and Out
237
Make Your Working Memory Work for You
239
Learn New Things More Effectively
240
Remember What You Were Told
241
Remember to Remember: Prospective Memory
243

Chapter 10
TIME MANAGEMENT: WHAT SHOULD I BE DOING NOW?
247
Time Management for the Time-Blind
248
The Complexity of Lateness
249
How to Be Productive, Not Just Busy
251
Use Time More Efficiently
252
Focus In: Fight Distractibility
253
Resist Impulsive Time Wasters
255
Get Going: Beat Procrastination and Avoidance
256
Break the Lock: Dissolve Hyperfocus
257
Get Places on Time: It Can Actually Happen!
258
Make Your Deadlines (and Impress Your Friends)
259
Escape the Web: Manage Your Online Time
261

Chapter 11
GET ORGANIZED, STAY ORGANIZED: WRESTLE THE AVALANCHE
263
Why Is It So Hard to Get (and Stay) Organized?
264
Less Is More (Organized): Get Rid of Your Extra Stuff
267

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Get Organized Enough: Better Than Chaos, Less Than Perfect
268
The Right Things at the Right Times
270

Chapter 12
USING TOOLS AND TECHNOLOGY
TO STAY ON TOP OF YOUR LIFE: GIZMOS
273
Tools and Technology: General Concepts
274
Sometimes a Simple Calendar Is Enough
275
How to Use Your Planner Well
275
Planners: Paper or Plastic?
277
Use Your To-Do List Effectively: #1. Make a To-Do List
278
It’s About Time: Use Clocks and Alarms to Stay on Track
281
Digital Voice Recorders: Catch Thoughts on the Fly
282

Chapter 13
ACHIEVE YOUR GOALS: TAKE THE LONG VIEW
285
The Chain of Success: Awareness + Skills + Desire = Success
285
Reach Your Short-Term Goals
287
Reach Your Long-Term Goals
288
Survive Repetitive Tasks, Repetitive Tasks, Repetitive Tasks
289
Calm Your Hyperactivity
290

Section IV: IMPROVE SPECIFIC AREAS OF YOUR LIFE
293

Chapter 14
HOUSEHOLD MANAGEMENT:
STAY ON TOP OF THE BORING STUFF AT HOME
297
Create a Lifestyle You Can Live With
298
Actually Get a Good Night’s Sleep
300
Manage the Mail and Get the Bills Out on Time
301
Family Meetings: What’s Happening This Week?
302
The Family Calendar: Let’s Keep It All in One Place
304
Whiteboards: Low-Tech Reminders
305
Stay in the Budget: We Have a Budget?
305
Stop the Flood: Conquer Information Overload
307

Chapter 15
RELATIONSHIPS AND FRIENDSHIPS: STRIVE FOR BALANCE
309
True Intimacy Means Hearing the Bad News,Too
311
No Man Is an Island: How to Get Help When You Need It
312
Overcome Denial: Help Someone Else to Recognize His ADHD
313

viii

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ix

We See Others Through Our Own Lens
315
Expectation Management: Promise Only What You Can Deliver
316
The Value of a Good Apology
318
To Tell or Not to Tell?
319
Relationship Patterns to Avoid: You Can Do Better
323
Restore Balance in the Relationship
324
Fun Stuff in the Bedroom: Improve Your Sex Life
329
Work It Out with Some Help: Couples Therapy
330
Social Skills Training: Helpful or Obvious?
334
Parenting: Stay Sane While Wrangling the Offspring
336

Chapter 16
COLLEGE AND BEYOND: TEACH AN OLD DOG NEW TRICKS
341
Is College Right for You?
342
Some Students Do Better in College After Taking Time Off
343
A Smoother Transition into College
346
Part-Time or Full-Time Student?
348
Strategies for College Success
349
Older Students: You Can Teach an Old Dog New Tricks
350
Read More Effectively
352
Use Available Support Services (Preferably Before Finals)
353

Chapter 17
WORK: HOPEFULLY MORE THAN JUST A PAYCHECK
355
Find a Job and Career That You Can Enjoy
356
Career Counselors Can Help You Find the Right Job
357
Informal Accommodations Often Work Best
358
Formal Accommodations Through the Americans with Disabilities Act 361
Sometimes It’s Better to Just Find a New Job
364
Should You Work for Yourself?
365

EPILOGUE: The Suffering of ADHD
367

APPENDIX: RESOURCES
368
Nonprofit Organizations
368
Websites
368
Professional Directories to Find Qualified Clinicians
369
Publications
370
Teleclasses and Webinars
370

REFERENCES
371

INDEX
373

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