First of all, disclosure: I have been diagnosed (via neurological testing) as ADD (Inattentive type). The following is my reading on the available popular and to a modest extent technical literature on the topic. IANA doctor or psychologist. Someone else recommended Hallowell’s Driven To Distraction as a good introductory primer; I can only follow up on that with Hallowell’s Delivered From Distraction, which largely covers the same material as the previous book but also goes into more detail on current and speculative treatments and coping strategies. There is more detailed reading available on the topic, of course, both in layman’s terms and technical literature, but Hallowell is an easy, quick read and he covers the high points while not descending to victimhood; indeed, his view of the “disorder” is that is more of a variation or “different way of thinking” than properly classified as an illness or syndrome.
“Lazy” like “hyperactive”, “angry”, “detached”, “retarded”, et cetera describe the result of a behavior rather than the root cause of it. Lazy, in particular, is a label that tends to be dismissively applied, bringing along the semantic implication of moral turpitude. This is sometimes the case–some people would just rather lay about than do anything–but it also includes people who don’t make an effort out of fear of failure, lack of initative/guidence, passive-aggressive resistance, and so forth. In the case of ADD, it is characterized not by mere “lazyness”, nor a complete inability to focus, but rather a difficulty in controlling attentional focus, often combined with hyperfocus (focusing on one activity while out all other distractions) and sometimes hyperactivity, either physically or intellectually.
ADD in particularly can be kind of confusing, because many of the behaviors are attributable to other pathologies; an inability to sit down and do homework often becomes a test of wills between parent and child even though for the child the battle is more internal and unintentional than an act of defiance. And, as has been noted, people with ADD often display paradoxical behaviors; being very “quick” but not studious, easily distractable but capable of great attentional focus, energetic in mental activity but lethargic in action, or disruptive in behavior but empathic in interactions. ADD has traditionally been throught to disappear after adolescence but it is now widely believed that adults simply learn to cope with it (or stuggle, as may be the case).
There are two “forms” of ADD recognized by DSM-IV: ADD with Hyperactivity (the traditional ADHD), and ADD Inattentive Type. (Some researchers have further broken down the pathology into additional categories but none of these schemas are widely accepted as of yet.) The “hyperactivity” is the more commonly diagnosed form for obvious reasons but the inattentive type may actually be more common, especially among girls and women, generally characterized by daydreaming and attentional distraction, as opposed to uncontrollable hyperactivity.
If you read through the DSM-IV diagnostic parameters, you’ll find a list of fortune-cookie characteristics; by that, I mean that any one, or even many of them, could apply to just about anyone with a pulse. There is, in fact, no positive demarcation between ADD and “not ADD”. The disorder does seem to run in families, even independent of environment, so there is strongly believed to be a genetic, neurological component, but there’s no question that environment also contributes (positively or negatively) to the disorder. There is a diagnostic called qEEG that has demonstrated repeated patterns in persons otherwise diagnosed as ADD; however, there is no definitive neurological explanation for the condition and this alone does not satisfy as a diagnosis. A proper diagnosis should be done by someone trained in neurological diagnostics; most likely either a child psychologist (who do, despite the title, accept adult patients) or a psychologist specializing in neurological pathology (diagnosing ADD, autism, and other neurological conditions). A standard-issue psychiatrist or general practicioneer has neither the training nor the experience to make a definitive diagnosis.
The following is my own, nonprofessional (IANAD or psychologist) opinion on the root cause, distribution, and appropriate view of ADD: The attentional focus that is demanded by modern society (sitting in a cubical, waiting in traffic, et cetera) is an anomoly in natural human evolution; for millions of years, we’ve evolved and survived by being able to rapidly move from one task to another; only recently, in evolutionary terms, has it even been desirable to sit down and focus on a mundane task such as writing a memo about appropriate use of toilet paper or reviewing a technical specifications document. As a result, many people are not neurologically optimized to the demands of modern life; in lieu of the kind of environmental stimulation that is a part of everyday life in the wild (looking for good flint and tools, dodging predators, figuring out how Uggi keeps making fire jump from his fingertips) these people try to create the needed stimulation to keep up with the internal clocking of their minds. Some do this by seeking out thrilling or dangerous expeiences, others by creating disruption in relationships, and yet others by drawing inward into a detached mental environment (daydream) which can be as energetic and detailed as need be.
Obviously, unlike some psychiatric conditions like schitzophrenia, autism, bipolar disorder, et cetera, there is more graduation between “normal” attentional function and ADD, so that there is no clear definition. In fact, it is my conjecture that ADD isn’t a single condition stemming from one root cause, but a number of attentionally-related factors which combine to give a combination of the characteristics that fall under the label of ADD, and indeed, may be part of a metapathology that overlaps with Obsessive Compulstive Disorder, Tourette’s Syndrome, and so forth. To that end, it is properly best considered, as Hallowell does, to be more of a “way of thinking” rather than an illness per se, and treated or modified only insofar as it interferes with productive functioning in school, career, and relationships.
Hallowell states a number of “benefits” of ADD, including unconventional “outside the box” thinking, energy to tackle numerous tasks, and so forth. I think he makes a bit much out of said benefits, and the idea of retro-diagnosing famous people in history (Ben Franklin, Thomas Edison, Albert Einstein) as having ADD based upon their recorded acheivements and behaviors is somewhat disingenous, but there’s no question that many people with ADD are of above-average intellect; perhaps all the more so in order to compensate for their attentional problems. And as others have pointed out, great intellect and creativity is not always welcomed or useful in traditional occupations and educational formats, which serves to amplify any differences, distractions, and detachments of someone who might already be prone to distraction.
In due course, someone will no doubt come along to contest the entire concept of ADD and the treatment, especially phramaceutical, of it. Given the highly mutable nature of the DSM from one edition to another it’s pretty hard to stand on any pathology, particularly one as ambiguous as ADD, as being definitive. (Certainly it can’t be taken as set in stone; the DSM used to classify homosexuality as a “mental defect”.) On the other hand, there’s no doubt that some people have more difficulty controlling attention than others; no matter how strictly disciplined, some children still tend toward excessive outbursts or daydreaming regardless of the consequences; and some (but not all) of these people have found some measure of relief in chemical treatment. Others attack it from a viewpoint of behavior modification, or strict enforced discipline (schedules, ingrained behavior), or by diet and exercise; as with many mental pathologies, not one approach seemed to work equivilently, or at all, for everyone.
A quick note on medication: many, many people have objected to the “doping” of children diagnosed with ADD. Regardless of the effectiveness of the drugs (they work on some, not on others) this belies an ignorance about the classes of drugs used to treat ADD. These fall into two classes; stimulants such as Ritalin and Concerta, and (traditional) antidepressents such as Prozac and Stratera. The former work, seemingly paradoxically, by calming the people down. In fact, the theory behind it is that they speed up or amplify the perceptiveness of the environment, making the surroundings more stimulating. They do not “dope” a person at all, and the dosages are typically 10% or less of what is usually prescribed in a stimulant application. The latter work similarly by preventing reuptake of seratonin or norepinephrine, providing some kind of mental stimulation, though there still isn’t a good understanding of how these drugs render their effects, either in the case of depression or ADD. Obviously, drugs often have side effects, and there are a number of concerns, particularly with regard to antidepressants, in prescribing them to preadolescent children and early teenagers. As with any drug, espeically psychoactive drugs, monitoring by a doctor should accompany prescription.
Personally, the diagnosis of ADD was something of a revelation to me; as with most people, I assumed that a lack of overt hyperactivity disindicated ADD. As a child, I alternated between being criticized for my poor academic work and shoddy homework habits and my exceptional mental faculties and top-end scores on standardized tests. This, accompanied by problems relating to other children, had me shifting between the “special needs” classification and “gifted but troubled” description. My ability to focus on something of interest and be industrious well in excess of my age gave lie to any accusation of lazyness; my “unwillingness” to do tedious, repetitive schoolwork and pay attention in class was an anathema of my primary scholastic career.
Even in adulthood, in both my professional career (engineering) and social interactions, this is something I struggle with mightily. I’m great at figuring out a new, more efficient way of doing things; I suck at implementing it or doing the tedious, day-to-day work. I’m good in social situations where I can provide guidence or discuss the ins and outs of a technical topic; I’m terrible at making small talk, or managing my impatience of people who aren’t ready to go, or handling the mundanities of everyday life. I’m at my best, mentally, when I’m driving down the highway at 80 mph, or hiking a treacherous trails, or behind a keyboard punching out a new design or outlining an algorithm; I’m horribly frusturated by sitting at a desk, reading through the same technical specification for the tenth time or debugging an annoying little perl script that just won’t damn work for no good bloody reason. I’m great at writing (I think); as many can attest, I’m remiss at effective copyediting.
Anyway, to sum up; if you think that controlling and maintaining attention is a problem for you, read up on the topic, talk to a professional, and have it checked out by an experienced and qualified diagnostician. Where you go from there is your choice–I wouldn’t rule out drugs but I wouldn’t recommend allowing yourself to be bullied into them or consider them your only option–but the best thing you can do is understand the nature of your problem and the limitations (and possibly benefits) that it imposes. Don’t play victim, of course, but don’t berate yourself, or allow anyone else to criticize you, for being who and how you are.
Good luck to you.
Stranger