ADHD/ADD or iMAD?
ADHD is a term that gets thrown around like an NFL football. What is it REALLY, who’s got it and how much is it over-diagnosed? In fact, ADHD/ADD affects productivity, social skills and the general quality of life for sufferers and those around them.
For sufferers, it feels like constantly and persistently being bombarded with “new shiny objects” to pursue. The compulsion to do this is so strong there is no room to say NO, I don’t want to do that. Listening to other people, following directions and finishing a task or project is difficult because their mind is racing and doesn’t settle on one thing to completion.
The formal definition of ADHD/ADD (according to the Diagnostic and Statistical Manual-V, published by the American Psychiatric Association) divides
Inattention into one set of symptoms (must have 6 or more) and Hyperactivity (must have 6 or more) into another set.
Inattention Symptoms:
- Overlooks details, inaccurate work
- Has difficulty sustaining attention
- Does not seem to listen when spoken to directly
- Does not follow through on school work, projects, easily sidetracked
- Often has difficulty organizing tasks and activities
- Hard to sustain intense mental effort
- Often loses items necessary for task completion, like books, tools, wallet or keys
- Is easily distracted by extraneous stimuli
- Is often forgetful in daily living, like running errands, returning phone calls and doing chores
Hyperactive Symptoms:
- Often fidgets, taps or squirms
- Can’t sit still
- Feeling restless
- Can’t play or do quiet activities quietly
- Often “on the go” as if driven by a motor
- Often talks excessively
- Often blurts out statements, not being able to wait for the other person to finish
- Has a hard time waiting in line
- Often intrudes on others without awareness of how disrupting it is to the other person
A person can be just inattentive or just hyperactive or a combination of both. The ADHD/ADD symptomatic behavior is behavior all of us might do sometimes. People who are truly inattentive or hyperactive show these symptoms more often and more intensely. Daily tasks that involve persistent concentration and follow through is difficult if not impossible.
The ADHD/ADD symptoms describe behavior that makes it sound as if ADHD/ADD people are zoned or spaced out, don’t take in much information and don’t accomplish much. While that can be true, I believe that iMAD© better describes the internal world and experience of people who struggle with, in particular, attentional difficulties. Apart from being a catchy acronym for the current century, iMAD© is a more accurate definition.
IMAD stands for “inappropriate modulation of attention disorder.”
By modulation I am referring to the ability to bring up the “just right” amount of attentional energy to a situation, be it learning something, engaging in person to person communication or following through with a step by step project.
People who are inattentive can go from the extreme of hyper-focusing on one thing for hours to being so scattered they zone out and can’t focus on anything. A patient once described it as holding to a tightly compressed spring until your hands get tired and you can’t do it anymore and having the spring bounce off in an unpredictable direction.
Because iMAD© people are so easily distracted, what they might focus on is not always useful or in the service of completing a task.
For instance, Paul was on the way to the store to pick up food for dinner. When he first walks in the store a display of new over the counter drugs catches his eye. A half hour later he gets a call from his wife wondering where he is. Surprised a half hour has gone by, Paul stumbles for words and says, “Oh, I ran into a friend and we got talking, I’ll be home in a few minutes.”
Paul knew his wife would be angry if he said he was looking at new over the counter drugs. He himself, after the fact, realized that he really got off course and felt bad about it. On the other hand, at the time he entered the store he felt compelled to stop and closely examine the display. A person who does not have iMAD© would see the display, might find it interesting and even look for a couple of minutes. But then, and this is the crucial difference, they would inhibit more looking and shop for dinner.
The point I want to emphasize is that iMAD© people fall victim to “shiny new objects” because they are so naturally distractible.
It is the ALLOCATION of their attention that is the problem, not a DEFICIT of attention. Hence iMAD©.
Medication and talking therapy are useful tools to help someone dealing with iMAD© stay truer to their day to day and longer term goals. As well, talking therapy helps them learn how to pull out of their distractability more quickly and stay focused on the task at hand. It provides tools and step-by-step methods to help iMADs© stay the course.
Maggie Baker, Ph. D.
Psychologist – Financial Therapist
Author of Crazy About Money: “How Emotions Confuse Our Money Choices And What To Do About It”.