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Driven to Distraction (Revised): Recognizing and Coping with Attention Deficit Disorder, by Edward M. Hallowell M.D., John J. Ratey M.D.



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Driven to Distraction (Revised): Recognizing and Coping with Attention Deficit Disorder, by Edward M. Hallowell M.D., John J. Ratey M.D.

Groundbreaking and comprehensive, Driven to Distraction has been a lifeline to the approximately eighteen million Americans who are thought to have ADHD. Now the bestselling book is revised and updated with current medical information for a new generation searching for answers.

Through vivid stories and case histories of patients—both adults and children—Hallowell and Ratey explore the varied forms ADHD takes, from hyperactivity to daydreaming. They dispel common myths, offer helpful coping tools, and give a thorough accounting of all treatment options as well as tips for dealing with a diagnosed child, partner, or family member. But most importantly, they focus on the positives that can come with this “disorder”—including high energy, intuitiveness, creativity, and enthusiasm.

  • Sales Rank: #2730 in Books
  • Brand: Hallowell, Edward M. MD/ Ratey, John J.
  • Published on: 2011-09-13
  • Released on: 2011-09-13
  • Original language: English
  • Number of items: 1
  • Dimensions: 8.00" h x .90" w x 5.10" l, .68 pounds
  • Binding: Paperback
  • 400 pages
Features
  • Driven to Distraction: Recognizing and Coping With Attention Deficit Disorder

Review
“A very readable, highly informative and helpful book.” –The New York Times Book Review

“Conversational in tone, encyclopedic in content, and, best of all, utterly convincing because of its grounding in clinical experience, Driven to Distraction should make Attention Deficit Disorder comprehensible even to the most distractible reader.”—Peter D. Kramer, M.D., author of Listening to Prozac�

“This is an important and much-needed book! Wise, practical, and reassuring.” —Jane M. Healy, Ph.D., author of Endangered Minds and Different Learners

“The first comprehensive book on the subject for the lay reader.” —The Boston Globe

About the Author
Edward M. Hallowell, M.D., is in private practice in adult and child psychiatry and has offices in both the Boston area and New York City. He lives with his wife, Sue, and children, Lucy, Jack, and Tucker.�

John J. Ratey, M.D. is a Clinical Associate Professor of Psychiatry at Harvard Medical School and is in private practice. He lives in the Boston area.�

Excerpt. � Reprinted by permission. All rights reserved.
— 1 —

What Is Attention Deficit Disorder?

Once you catch on to what this syndrome is all about, you'll see it everywhere. People you used to think of as disorganized or manic or hyper or creative but unpredictable, people who you know could do more if they could just "get it together," people who have bounced around in school or in their professional lives, people who have made it to the top but who still feel driven or disorganized, these may be people who in fact have attention deficit disorder. You may even recognize some of the symptoms in your own behavior. Many of the symptoms of ADD are so common to us all that for the term ADD to have specific meaning, rather than just be a scientific-sounding label for the complex lives we lead, we need to define the syndrome carefully. The best way to understand what ADD is—and what it is not—is to see how it affects the lives of people who have it.

In the cases that follow, and in the many case illustrations that appear in this book, one can witness the struggles individuals faced to break through inaccurate labels and unfair judgments. As their stories unfold, a definition of ADD emerges.

Case 1: Jim

It was eleven o'clock at night and Jim Finnegan was up pacing in his study. This was where he often found himself at night: alone, pacing, trying to get things together. Now approaching the halfway point of life, Jim was getting desperate. He looked around the room and took in the disorder. The room looked as if the contents of a bag lady's shopping cart had been dumped into it. Books, papers, odd socks, old letters, a few half-smoked packages of Marlboros, and other loose ends lay scattered about, much like the bits and pieces of cognition that were strewn about in his mind.

Jim looked up at the TO DO list that was tacked to the corkboard above his desk. There were seventeen items, the final one circled several times in black ink and marked with exclamation points: "Reorganization proposal due Tues., 3/19!!!" This was Mon., 3/18. Jim hadn't started on the proposal. He'd been thinking about it for weeks, ever since he told his boss that he had a plan that would increase productivity, as well as morale, in the office. His boss had said fine, come up with a written proposal and we'll see how it looks. His boss had also added a remark about how he hoped Jim would have enough "follow-through" to actually get something done this time.

Jim knew what he wanted to say. He'd known for months what he wanted to say. The office needed a new computer system, and the men and women out front needed more authority so they could make decisions on the spot so everybody's time wouldn't be wasted in unnecessary meetings. Efficiency would go up and morale would definitely improve. It was simple. Obvious. All the ideas were detailed on the various scraps of paper that dotted the floor of his room.

But all Jim could do was pace. Where do I start? he thought to himself. If it doesn't come out right, I'll look stupid, probably get fired. So what else is new? Why should this job be any different? Great ideas, no follow-through. That's me, good old Jim. He kicked the trash basket and added to the mess on the floor. OK, breathe in, breathe out, he told himself.

He sat down at his word processor and stared at the screen. Then he went over to his desk and began to straighten things up. The telephone rang and he barked at it, "Can't you see I'm busy?" When the answering machine came on, he heard Pauline's voice: "Jim, I'm going to sleep now. I just wanted to see how your proposal is coming. Good luck with it tomorrow." He didn't have the heart to pick up the phone.

The night went on agonizingly. One minor distraction after another would knock Jim off-line as he tried to clutch onto the task at hand. A cat would meow outside. He'd think of something someone had said three days ago and wonder what they really meant by that. He'd want a new pencil because the one he had felt heavy in his hand. Finally, he got down the words "A Proposal for Office Reorganization at Unger Laboratories." Then nothing. "Just say what you want to say," a friend had told him. OK, say what you want to say. But nothing came. He thought of a new job he wanted to apply for. Maybe I should just bag this and go to bed. Can't do that. No matter how bad it is, I've got to finish this proposal.

By 4 A.M. he was beat. But not beaten. The words began to come. Somehow his extreme fatigue had lifted the censor in his mind and he found himself explaining his ideas simply and efficiently. By six he was in bed, hoping to get a little sleep before his meeting with his boss at nine.

The only trouble was that at nine he was still in bed, having forgotten to set the alarm before he went to sleep. When he arrived in a panic at the office at noon, he knew from the look on his boss's face that no matter how good the proposal was, his days at Unger were over. "Why don't you find a place with a little bit more flexibility?" his boss said, and thanked him for his proposal. "You're an idea man, Jim. Find a place that can accommodate to your style."

"I don't get it," he said to Pauline over drinks several weeks later. "I know I have more to offer than getting myself fired every six months. But it's always the same old story. Great ideas, but can't get it done. Even in high school, can you believe that? The guidance counselor, she was this really nice lady, she told me that I had the highest IQ in the class, and so she just couldn't figure out why I had such a hard time living up to my potential."

"You know what's not fair?" Pauline said, turning the stem of her Manhattan glass between her thumb and forefinger. "They took the ideas in your proposal and used them. Dramatic improvement. Everybody's happier and work is up. Those were your ideas, Jim, and you got fired. It's not fair."

"I don't know what's wrong with me," Jim said. "I don't know what to do."

Jim had attention deficit disorder. When he came to see me at the age of thirty-two, he had been living a life of chronic underachievement, falling short of his goals both at work and in relationships because of an underlying neurological problem that made it difficult for him to pay attention, sustain effort, and complete tasks.

ADD is a neurological syndrome whose classic defining triad of symptoms include impulsivity, distractibility, and hyperactivity or excess energy. About 18 million Americans have it today; while awareness has increased in the years since Driven to Distraction was first published, many still do not know that they have it. The condition occurs in children and adults, men and women, boys and girls, and it cuts across all ethnic groups, socioeconomic strata, levels of education, and degrees of intelligence. It used to be thought that this was a disorder of childhood alone, and that one outgrew it during adolescence. We now know that only about a third of the ADD population outgrows it; two-thirds have it throughout adulthood. ADD is not a learning disability or a language disability or dyslexia, and it is not associated with low intelligence. In fact, many people who have ADD are very smart. It's just that their smartness gets tangled up inside. Undoing the tangle to get a smooth run on the line can take more patience and perseverance than they can consistently bring to bear.

•••

Where does the syndrome begin and normal behavior leave off? What is impulsivity? What is distractibility? How much energy is excess? These are the questions we will explore throughout this book, mainly in the context of individual cases, like Jim's. Considering the symptoms, can't we all recognize parts of ourselves? Yes. However, one bases the diagnosis of ADD not on the mere presence of these symptoms, but on their severity and duration, and the extent to which they interfere with everyday life.

When Jim came for consultation, he was at wit's end. He came into my office, sat down in one of the easy chairs, and began to run his fingers through his curly hair. He leaned forward, alternately looking at me or staring at the floor. "I don't know where to begin. I don't even know what I'm doing here," he said, shaking his head as if to say no, this won't help either.

"Did you have any trouble finding your way here?" I asked. He was twenty minutes late, so I figured he might have gotten lost.

"Yes, yes, I did," he said. "Your directions were fine, it wasn't your fault. I just turned left where I should have turned right and then I was gonzo, school was out. It's a miracle I got here at all. I ended up at some gas station in Somerville."

"Well, it can be pretty confusing," I said, hoping to let him relax a bit. Of the people who consult with me for problems related to ADD, probably about a half are either late for their first appointment or miss it altogether. I have come to expect it. It comes with the territory. My patients, however, usually feel very bad about it and so begin the session thinking that I am going to reprimand them in some way. "You certainly aren't the first person to get lost coming here," I said.

"Really?" he asked. "That's good to hear." He took a deep breath to say something, but paused, as if the words had crowded in his throat, then let his breath out in a long sigh, the words apparently dispersed. He went through the same cycle a second time before I asked him if maybe he could use a few moments just to collect his thoughts while I wrote down some bits of information about him like his name, address, and telephone number. That seemed to help. "OK," Jim said. "Let's start."

"OK," I responded, leaning back in my chair, folding my hands behind my head. There was another long pause, and another sigh from Jim. "I can see that it's hard for you to get started," I said. "Maybe we could focus on what the problem is that brought you here."

"Yes," he said, "OK." With that little bit of prodding from me, Jim began to fill in most of his history. A normal childhood, or so it seemed to him. But when I pressed for more detail, Jim acknowledged that he was quite rambunctious in grade school and enjoyed getting into mischief. He got good grades even though he never really studied. "I thought school was like playtime," he said. But with high school, things got tougher. His innate intelligence couldn't carry him so easily anymore, and he began to fall behind. He started to get lectures from his teachers and parents on his moral shortcomings, how he was letting himself and everyone else down, how in the long run he'd be the worse for it, and so forth. His self-esteem fell, although somehow his inborn temperament was buoyant enough to keep him fairly upbeat. After stumbling through college, he began a long series of jobs in various computer-related fields.

"You like computers?" I asked.

"I could have invented them," he said with great enthusiasm. "I love them. I just have this understanding of them, you know what I mean? I know what makes them tick, and I know how to get the most out of them. If only I could tell people what I know. If only I didn't screw up every time I get a chance—"

"How do you screw up?" I asked.

"How do I screw up?" he asked, then repeated the question again, turning it into a sorrowful statement by his tone of voice. "How do I screw up. I forget. I argue. I postpone. I procrastinate. I get lost. I get mad. I don't follow through. You name it, I do it. I'll get into these discussions with my boss, and I'll see my way is right, and the next thing you know, I'm calling him a stupid jerk for not seeing that I'm right. Tends to get you fired, calling your boss a stupid jerk. Or I'll have this idea, but I won't be able to find it, like it's a jumble lost in the closet or something. It's in there, I know it's in there, but I just can't get it out. I want to get it out, I try to get it out, but I can't. One of my old girlfriends told me before she left me that I should face it, I'm just a loser. Maybe she's right, I don't know."

"You cared about her?" I asked.

"For a while. But then she got fed up, like all the rest have. I mean, I'm pretty intense to be with."

"Where do you think that intensity comes from?" I asked.

"I don't know," he said. "It's always been there, though."

The longer we talked, the clearer it became how right Jim was, how the intensity had always been there, seldom harnessed, but always burning. That intensity may in part explain why ADD is common among people in high-energy fields, from sales to advertising to commodities to any high-pressure, high-stimulus kind of work. "Have you ever consulted a psychiatrist before?" I asked.

"A couple of times," Jim said. "They were nice guys, but nothing really changed. One of them told me not to drink so much."

"How much do you drink?"

"I binge. When I really want to let loose, I go out and tie one on. It's an old family tradition. My dad drank a lot. I guess you could say he was an alcoholic. I don't think I'm an alcoholic, but that's what they all say, huh? Anyway, I get these terrible hangovers the next day, so I don't go back to it for a while."

Often people with ADD self-medicate with alcohol or marijuana or cocaine. Cocaine, particularly, is similar to one of the medications used in the pharmacological treatment of ADD.

Most helpful customer reviews

119 of 123 people found the following review helpful.
It's what I've been looking for!
By Stephanie
I have struggled with ADD for a very long time. I have known for awhile that I have it, but I had no idea how much of my life it affected. I found the stories of ADD at different ages very helpful, because I found myself in them for each stage of life and the struggles I encountered. Looking back, I realized that I am not defective, I'm just built differently. I have learned new ways to communicate with people, to approach problems, and even how to look back on my life. I found a lot of healing within these pages.

I had a lot of pain growing up and thought there was something very wrong with me. This led to many instances of depression, self-esteem issues, suicidal ideation, isolation, anger, and self recrimination. Why couldn't I just get it together? Why was I angry so often? (one story was particularly illuminating--in which the therapist asks the guy WHY he has so much anger and he says it's from many years of built-up frustration. It made so much sense.) Why couldn't I stay motivated in school or work? Why am I so scattered and disorganized?

I was born in 1980...ADHD research was still in its infancy, and so my symptoms weren't recognized. I remember one kid that was diagnosed as having it and everybody made fun of him and I was under the impression that it was an excuse. As I got into adulthood, I remember seeing a commercial for adult ADHD that put a name on what I was experiencing, but still tried to deny it was a problem. This has had wide-ranging effects on my life that I didn't even realize. Through this book, I have found that there is no shame in choosing to take medication or seeking out coaching or therapy. I have found a new appreciation for my creative ADHD brain and a way to approach awkward situations with humor so people can understand me better. I have also reached out to many people that I fear I may have alienated in my past or hurt with my impulsive behavior. I have rebuilt many bridges and mended friendships and even my family.

This is not a made-up disorder. It's not laziness and cannot just be overcome by sheer willpower. I've tried. I eventually run out of steam and it took so much effort to keep it going for so long that when I ran out of steam, my motivation and willpower to do just about anything went out the window. I'm so grateful to the authors of this book. I found so many answers that I have been looking for for so long. I didn't even realize this was the answer I was searching for, even though it was in front of my face for a very long time.

Thank you SO much for the detailed descriptions that explain how ADHD affects ALL areas of life. Thank you also for the case histories that I could relate to and feel like I wasn't alone. Excellent book and VERY highly recommended for sufferers of adult ADHD, or those that choose to be in relationship with someone that has it.

93 of 99 people found the following review helpful.
Holy Sh.., I have ADHD
By BA from CT
This is a fantastic book for anybody who wants to learn about ADHD. It was only after reading this book that I broke down and got myself tested. I was one of the many people that thought ADHD was an excuse for people with a lack of discipline and will power. I have never been more wrong in my entire life. I only wish I had known about it earlier. It could have saved my family and I a lot of heart ache and pain, not to mention money. It really is a tragedy to have gone through so many frustrating episodes in your life and find out that they probably could have been prevented or at least mitigated to some degree.

The best part of this book is the real life examples that the author describes. If you have ADHD, they will defenitely hit home. One in particular felt like it was taken straight from my life. ADHD is a tricky disorder because there's no definitive test for it. In fact, ADHD is really not a good name for it because the hyper activity wears off as you get older. I think it should be called something like Executive Function Disorder. That to me is a more accurate description. Executive Function is really what is lacking. The inability to follow through with goals, get organized, and multi-task. The name belittles the condition.

The one thing that is still a mystery to me is why it is so prevelent today. How is it possible that there is such an increase in people who have it? I hope one day there's an answer. While I think it's ridiculous when I hear people say they're grateful they have ADHD, I am grateful that the treatment and medication really does work for the vast majority of people. That's really the only good news.

I can also understand somebody's hesitency about taking medication. Who wants to take pills that alter your brain. I don't. All I can say is that habitual underachievement whether academically, socially, or monetarily isn't good for your brain either. Your a fool if you don't give it a chance. Exercise really does help and is almost as important as the medication. If you have ADHD and you're not exercising than you're just as foolish as somebody who won't give medication a try. Since ADHD is basically a lack of dopamine in your brain and exercise is guarenteed to increase dopamine in your brain you don't need to go to medical school to understand why it's a good idea. My aim is to take as little medication as possible. I think of exercise as a natural dopamine supplement. Less medication equels less potential for negative side effects. Exercise will also help with any kind of depression and self esteem issues you might have as a result of not accomplishing what you want out of life, thanks in part to the disorder. In closing, I think every responsible parent should educate themselves on this topic. I certainly wish mine had. You don't need to read a book on it to become aware of what to look for. If my parents had known about it, they would have avoided an incredible amount of anger and frustration. The book lays it all out there. It was important for me to read it.

147 of 165 people found the following review helpful.
A solid "eh": not exactly what I expected.
By bouncy mouse
I've known about my ADHD for a very long time (since I was 7 - I'm now 23). I've had better and worse moments throughout my life, but my recent step into "REAL!" adulthood and living on my own has, at times, brought out the worst in my motivation, distractibility, and organization. These issues pushed me to look for books that would not only explain my situation (hopefully from a new perspective), but also give me concrete, useful, and detailed solutions/ideas to fix said issues. I saw this book when I was searching, but decided not to buy it and ordered two others instead. Two days later, while babysitting, I saw this exact book sitting on the shelf. I pulled it out once the kid went to sleep to see if I had missed out by not buying it. I didn't read the entire thing in the few hours I had, but I got through most of it pretty thoroughly, and skimmed the parts I didn't get to. So with that being said, take my review with a grain of salt: I did not read it cover to cover. I read enough, however, to feel that I could give a relatively decent and intelligent review.

My Reactions:
(-) From an aesthetic standpoint, this is not really an ADHD-friendly book. I was on my medication and I wasn't even able to read entire chapters without wanting to skip through crap. It's just page after page after page of text, which gets really boring really fast. Big things that bothered me: (A) There are no chapter summaries. (B) There are no chapter previews. With chapters as long and dense as his are, having at least one of these two things (previews/summaries), if not both, would have been REALLY helpful. (C) I didn't find the ways in which the sub-sections of chapters were organized all that helpful. I wasn't sure when (or if) to expect them in any chapter, and I was never sure what they would be about (more on this in my next point). There was also, at times, so much text between sections of the sub-sections that I didn't even remember what he was talking about to begin with. It doesn't have to look like a children's book, with colors and pictures and cartoon turtles holding signs listing the five main points, but honestly? ....I wouldn't say "no" to a turtle or two, as long as it succinctly summarized what it took the author seven pages to explain, because the information was generally good!

(-) Maybe it's just me, but I needed more structure to the chapters. They read like stories, which is great, except that I was never really able to get a firm grasp on (and continue to remember) the point of each chapter while I was reading it. It felt like I was reading Huckleberry Finn (or whatever) for school; I'd finish an enjoyable chapter, but then suddenly have to figure out the overlying theme. Huck sailed down the river, yes, but WHY?! WHAT DOES IT MEAN?! It's been about 3 hours since I last looked at the book, and all I really remember content-wise are a bunch of unrelated case study stories. I know there were themes to each chapter, but I didn't feel like I GOT them, if that makes sense. (And for the record, because I know I would think it if I were reading this, I don't struggle with reading comprehension or anything like that.)

(+/-) Oh, and about the case studies... DANG there are a lot of them. The (+) about this: yes, it is comforting and reassuring to see myself in some of these examples and stories. I recognize my problems in someone else's story, and go "Oh thank God, I'm not alone!" They were also pretty entertaining. At first. Then they started to get old... The (-) about this: they got old. There are only so many times I can go "OH YAY, I'M NOT ALONE!!!". Eventually I start saying, "Okay... soooooo can you give me some LEGITIMATE ways to deal with the problems these people are having? How did they fix them??" Story after story doesn't give me solutions; it tells me that someone had problems, and then they were fixed! Hurrah! He talks about some solutions for this stuff at the end of the book, but.... we have ADHD... by the time we get to the end of the bok, we can't remember the case studies well enough to connect them with the proposed solutions. It would have been much more helpful if he added the solutions to each of the case study's problems at the end of each case study (or chapter) AND a big "summary solution" chapter at the end.

(-) I honestly don't think I've ever said this about an author because I don't think m/any do something like this on purpose, and I like to give people the benefit of the doubt, but I sorta felt like he was just showing me all the great examples of how he has successfully helped people with ADHD via case study stories. It was almost like guarded previews of where 15 therapy sessions with him might get you. The issue I have with this is that it's discouraging, to me. It was like, "Hey look - these people were successful after sessions in therapy with me and practicing good habits they learned in therapy, and this and that, and also the other, and...." It was deceptive, because at first I felt like I WAS getting something out of all his case study stories! But then, the more I thought about what I was reading, the more I felt like I WASN'T getting anything out of it. I was getting bits and pieces of things he had done with clients, and suggestions (keep a strict schedule, slowly incorporate new routines into your current one, etc.) but never the whole thing. Maybe that's just a personal problem though, haha.

(-) Didn't feel like the book actually gave me any good solutions for the symptoms ADHD. He suggests that you tell your boss about it to improve your work experience, but then doesn't tell you how. HOWWWW?! Seriously! It would be important to know HOW to tell the guy who SIGNS YOUR PAYCHECKS that you might be "screwing up" (per se) all the time... arriving late, turning things in late, forgetting meetings, etc. Yes, your boss needs to know. How do you tell him?!? The author suggests to be patient, be prepared to counter misconceptions, etc., and that's all fine and dandy, but it really doesn't tell me a damn thing that I don't already know. Also, "keep lists" and "stick to a schedule", etc. ....yeah, if those worked I wouldn't be here looking for a book to help me. Normal people do that without problems. ADHD people can't do that without problems. Tell me HOW do to that without having problems.

So ultimately, I don't think this is a bad book. Am I glad I didn't buy it? Yes. I feel like I didn't get enough structured and concrete examples/explanations of how to solve my ADHD problems, which is what I was expecting to get. It more felt like I was being comforted for not being alone with my problems, and that they are solvable through being organized by keeping a schedule in a planner! Maybe it's just a difference of what I needed vs. what this book gave me, or maybe I just missed all the good parts, or missed all the parts that actually included the things I disliked about the book. I am indeed looking for very specific advice about how to deal with the issues I'm having, and maybe this book just isn't that. For what it's worth, I did order (and am very excited to receive) Organizing Solutions for People With Attention Deficit Disorder: Tips and Tools to Help You Take Charge of Your Life and Get Organized, which is much different than this book. But regardless of what I am/was looking for, I quite honestly didn't find this book all that helpful. It was an enjoyable read for the stories, and had some useful information, but I feel like it was lacking somewhat.

I do, however, appear to be in the minority, so maybe it's just me :)

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