Emotional ADD

07/23/2012 06:05 pm ET | Updated Sep 19, 2012

Summer is often a time for relaxing, for letting go of educational worries and focusing on the "chill" aspects of living. But for many families, this is also a time of preoccupation about the coming school year, especially when there are one or two kids in the family diagnosed with ADD (with or without the hyperactivity). One aspect that is extremely common but not often talked about is the emotional part of ADD, or what I've called "emotional ADD." This has to do with not only the oppositionalism to firm rules but also with the easy feeling of deflation, a depression-like situation very much related to perceived failure or insult.

When I read John Ratey's book Shadow Syndromes (Ratey is the co-author of Driven to Distraction with Edward Hallowell), I was struck by the description of a very acute sensitivity to external emotional stimuli, especially virulent when it comes to rejection. Ah! I recognized something in myself and this also became a theme in much of my work with adults and children with ADD. In fact, it's a helpful diagnostic hint as well since, as Dr. Ratey points out, depression usually doesn't shift with outer circumstances to the same extent that ADD does.

One way of being especially helpful to an ADD youngster, child or adolescent is to work on the arena of making mistakes. I began working with a patient with ADD -- we'll call her Allie -- when she was 16. Luckily, she had opportunities and talents in the realm of sports, where she thrived. While Allie and her family received junior year athletic scholarship packets, her grades were nowhere to be found in terms of ability or even effort. In fact, although she had tutoring, her major lack was in the arena of mistakes and admitting to not knowing something. She hated getting something wrong, and so she skipped over anything that gave her a signal of what could be a mistake -- and of course she got more things wrong as a result.

I've enjoyed focusing on curiosity in education, and have a personal love of learning and a love of asking. One of the Sesame Street songs that was a favorite in my house was the Big Bird rendition of "Everyone Makes Mistakes" -- definitely worth a listen or two. Of course, learning to learn from mistakes is valuable in life, but with the emotional blows to the ego that come from social or educational defeat in a person with ADD, this merits particular work.

Allie and I not only honed in on her feelings of defeat, but attempted to defeat them by recasting mistakes as necessary, even wonderful, in their capacity to lead to knowledge and learning and asking. While positive psychology is not usually my cup of tea, I felt that in this case, I wasn't so much helping Allie with a positive mindset as I was fighting with her about her prejudices about being a "loser" if she admitted mistakes. Making mistakes can be a gorgeous part of life. What's more, mistakes can give us hints of what might work at a given moment and can thus lead to greater enthusiasm or a different direction in life.

This is a kind of nice story, because Allie is now going into her senior year of college, and she is the optimal ADD showcase human being. She goes through moments of emotional fatigue and feeling down when she is utterly overwhelmed by relationships or course work, but she is living what college can be at its best: A laboratory of learning both life and academic skills, which optimally can be and occasionally are interchangeable. She is fortunate, because therapy helped her become excited about life and excited more and more about including the darker sides in her view. She embraces the different colors of her moods and questions the authority of those who put people down as a matter of habit or hobby. In her social life, she treads slowly, not wanting to give or lose all of her self, which she holds dear. But even when she goes very far down, she is not afraid to ask for help, and feels that life without vulnerability is not worth having.

One answer in the lives of those with ADD as adults is to place themselves in situations where they will win, and sometimes at any cost. That keeps the game exciting and keeps rejection at bay. But the real mistake, the looming and often tragic error that has grave impact on those affected, is that there is no growth without mistakes. Think for a second: If we want to learn about anything at all, if we want to learn about history, we have to be willing to see the mistakes we make, the mistakes of our family and of our country.

ADD, as Edward Hallowell is quick to point out, is not a disorder or a deficit. It is often enough too much energy and need for excitement, accompanied by "bicycle" brakes, or brakes not strong enough to meet the fast pace of life. If we think about the emotional sides of ADD, there also needs to be the understanding that we can be okay, worthy, if we slow down or admit a defeat.

By the way, Hallowell has in conversation mentioned how people with ADD can sometimes incite and exacerbate a fight because the adrenaline rush far exceeds that of attending to a difficult task. One way of seeing this, then, might just be what happened with Allie: helping to make the making of mistakes -- if they are not disastrous or fatal, obviously -- as exciting as anything else.

This would not only work for some for the summer, but for all of us in any season.