ADHD's Emotional Distress Syndrome

I'd thought I'd share an article that my sister's therapist shared wrote. It really hit a spot with me when I read it. It really enlightened a lot of things for me. Read and enjoy on a out look of ADD/ADHD.

Coping with ADHD’s “Emotional Distress Syndrome”© by James Ochoa, LPC Director, The Life Empowerment Center Austin, TX

Written for Counseling Today magazine

The driving force behind my mission to mentor, coach and counsel individuals with Attention Deficit Hyperactivity Disorder (ADHD) began in 1989 when I had the opportunity to work with bright, vibrant ADHD children. The caveat, however, was my realization that these children, living within their own chaotic ADHD world, were at risk of losing something very precious; a connection to their unique passions, interests and talents. This insight launched my journey as a counselor to empower those with ADHD to recognize and reach their greatest potential. Helping my clients overcome the risk of what I call the “emotional distress syndrome” is an important first step and key therapeutic component to their success. I use this term to describe the cumulative effect of neurological processing differences and behavioral challenges that can break down a person’s emotional tolerance, stamina, and ability to maintain a strong sense of spiritual well-being and emotional health. This remains a factor even after one has been diagnosed, engaged in sound treatment options, and learned effective strategies to compensate for their ADHD. As counselors, if we hope to lay out a plan to manage this long-term risk, I believe it is vital for us to be cognizant of the ways in which ADHD creates a higher risk of distress for our clients’ emotional and spiritual lives. Most adults are capable of handling a significant amount of daily stress, yet because the neurological differences and behavioral characteristics of ADHD are chronic and life-long, one’s emotional distress tends to increase to such a level that it becomes a syndrome, or symptomatic of the chronic emotional distress akin to Post Traumatic Stress Disorder (PTSD.) For individuals who have been living under chronic low-grade emotional distress their entire lives as a result of ADHD, that stress level can negatively impact their ability to reach their potential, feel good about themselves, and create the resilience and stamina necessary to thrive in today’s world. ADHD and PTSD has been researched along the lines of comorbidity, Cuffe, S. P., McCullough, E. L., and Pumariega, A. J. (1994), Fischer et al., 2007, Sarkis et al.( 2005), yet none of the research directly addresses the theory that the disruption of ADHD creates an emotional distress syndrome. This emotional distress is also an exponential factor that multiplies throughout an adult’s life as similar stressful events are linked together, creating a long-term erosion of a person’s ability to cope emotionally, mentally, spiritually and physically. Scenarios such as these can lead to an emotional distress syndrome that potentially develops into a covert form of PTSD; covert because there is no specific trauma that can be clinically cited as precipitating the syndrome, unless one wants to characterize ADHD as the precipitating event. The rate of this decline in functioning depends upon variables such as the severity of the individual’s ADHD, the environment in which they were raised, pre-existing conditions, and an array of other factors. For adults diagnosed with ADHD later in life, being unaware of the true nature of their problems for so many years is often a major factor contributing to the emotional distress syndrome. The mystery of not understanding why they couldn’t focus, finish projects, or remember simple things, is a constant source of frustration. This slowly erodes their confidence and courage along with putting significant stress on their character development along the lines of their self esteem and identity. After many years of untreated ADHD, the anxiety and life disruption a person experiences becomes chronic, and the emotional distress syndrome takes on a life of its own, often evolving into as big of a challenge as the ADHD itself. For many of my adult clients, this syndrome is the single most destructive factor in their lives. I often believe that if I could somehow magically eliminate this distress, many of my clients would live happier, more productive lives. The Educational/Directive Action Approach One of my goals as a therapist is to address the emotional distress syndrome by taking clients beyond a diagnostic understanding of ADHD and educating them on how it affects their lives and by helping personalize life-long strategies to cope with their challenges. This education and strategy development allows the client to better understand the basis of their emotional distress and dramatically lessens their anxiety. Rote strategies routinely given to those diagnosed with ADHD have a tendency to become mere exercises in futility. Without a personalized approach, it is very likely that clients will disconnect from these techniques and risk adding to their emotional distress. This personalization factor is vital in helping clients to create their own unique strategies, structures and routines. Personalized strategies can be as small as choosing a roller ball pen because of the feel of the ink flow, or as large as hiring an executive assistant to help manage the underactive neurology of a client’s prefrontal cortex, the part of the brain necessary in planning, prioritizing and evaluating. Routines, such as listening to certain types of music while studying different subjects, or while engaging in monotonous tasks, is often an effective strategy. One client relied on heavy metal music to keep his mind “geared up” when reviewing detailed schematics, yet another chose to listen to jazz because it gave him a sense of “rhythm and flow” to stay connected while reading historical documents. Our sensory pathways allow natural strategies to develop. A client’s attraction to visual, auditory, or kinesthetic environments often creates connections to effectively discover techniques if we help them recognize and develop these areas. When a client’s interest is sparked you’ll know you’re guiding them in the right direction. ADHD and Character Development In addition to education and personalized strategies, character development is potentially the most critical long-term issue for clients to address. Character development is defined as the two pillars of self-esteem and self-identity, where clients metaphorically stand, to have the courage, confidence and risk-taking ability needed to reach their potential long- term. Helping a client further develop their self-esteem and self-identity is necessary in strengthening their character. There is no doubt that the unconditional love received growing up allows for development of self-esteem, and that unconditional positive regard develops self-identity. In order to strengthen character, it is vital to deal with the emotional distress that adults with ADHD experience because it is a direct stressor on these pillars. If your client has been seen as impulsive and unreliable, or one who comes up with wild ideas and never finishes tasks, they have likely received negative feedback from others, putting them at a much greater risk of having an interrupted sense of esteem and identity. Your client may have grown up not loving or believing in themselves and not seeing their value in the world. If this feeling state carries into adulthood, they will tend to lack the confidence, courage and ability to take the necessary risks to reach their potential. What evolves out of “being different,” more times than not, is ADHD’s emotional distress syndrome. One technique I have found effective in clinically addressing the emotional distress of ADHD is with Eye Movement Desensitization and Reprocessing (EMDR,) developed in the early 1990s by Francine Shapiro, PhD, to treat PTSD. I use this process to desensitize the emotional distress of ADHD and also to help clients strengthen their self- esteem and self-identity and assist them in developing a strong vision of themselves reaching future success. Renee, a 46-year old client in my practice is an excellent example of how EMDR successfully helps adults struggling with the emotional distress of ADHD. Diagnosed with ADHD in 2001, Renee participated in an ADHD educational group and a long-term process group which I facilitated. Renee recently reconnected with me for counseling when her state-agency job finally took its toll, both emotionally and physically, and she was once again at a career crossroads. Her passion since childhood had always been theatre and she aspired to be a professional actor, so our work became centered on taking steps toward building her acting career. She enrolled in an acting class and was asked to name her three greatest fears about becoming an actor, a task that would cause some level of anxiety for many of us. However, Renee’s anxiety peaked because her fears about acting were so closely connected to her ADHD and past career struggles. The emotional distress caused by her ADHD had always created problems, such as memorizing lines (due her distractibility,) being on time (based on her skewed time-orientation,) and being caught up in the stress of the moment (becoming frozen or defensive in over-personalizing feedback.) EMDR helped Renee cope with the heightened emotional distress she experienced whenever she made strides towards becoming an actor and was key in helping to desensitize her past life experiences, her fear of failure, and her inability to memorize her lines. Renee focused on the distress in the acting class, and through the EMDR desensitizing process, was able to considerably lower her distress levels. Prior to this, Renee knew on a certain level that all actors experienced some degree of fear, but because of her low self-esteem and self-identity, coupled with the distress of ADHD, she was convinced that feeling that fear meant she was not truly an actor. Renee’s fears did not entirely dissipate, but her anxiety did become more manageable and she completed the acting class. The diagnostic process of adult ADHD is only the tip of the iceberg. An educational, directive approach to assist clients with developing personalized strategies, coupled with EMDR, will allow them to reach their potential. As clients begin to restructure their lives and understand their neurology, a transformational shift will begin to occur as they gain insight into who they can become in the next five to ten years. This growth will inevitably create some periods of disruption, so be cognizant of the level of nurturing and encouragement your clients will require. This support needs to be deeply rooted in unconditional love and unconditional positive regard. The vital key is to empower clients to create a stronger connection to themselves that will continue to naturally develop. Once empowered more effectively, a diagnosis of ADHD is no longer a sign of dysfunction. Instead, this empowerment allows the client to understand how to live fully and reach incredible potential within the beautiful chaos and intensity of their lives.

Follow Your Gut

When it comes to making decisions I like hearing people opinions, but in the end you have to follow your gut feeling. Cause when it comes down it, it's your decision to follow through with your decision. What am I talking about exactly? Well, here is the basis of what I'm talking about. Every year or so I get an itch to move or do something drastically different that most people think I'm insane for donig. At the moment it's an itch to move out of California to Portland or Seattle. What? Are you crazy? It's always raining there! Yup I know. I like the cold and love the rain. But unlike my itch to move, I'm not going to get up and go right away. Nope. I'm not crazy. Believe it or not I'm pretty responsible. Before going anywhere I will make sure that I have a job that can support me. With having a car payment, this is very important. So why the interest in the Pacific Northwest? Well, about 6 years or so ago, my sister had lived in Portland and the few other times I've visited I've fallen in love with the place. In fact one of my novels takes place just outside of Seattle. I love all the green, water, and bridges. Plus my all time favorite book store is there. This past weekend I did a drive north to watch two of my sisters skate and it was just cemented that I have to start doing some research in to potentially moving up there. Even my good friend that went with me fell in love with the state and is even looking to make a move as well. So, I'm fallowing my gut that this would be a great move. Especially if I'm able to get a job in a field that I love, ie publishing or film. These are two of my greatest passions and have had the hardest of times finding work in them. Hence me being stuck in accounting. Weither it comes to what you are writing or if you want to make a major life change, follow your gut. More times than not it will lead you in the right direction. Now that I've had my little rant on the fact that I want to make a move in my life out of the Bay Area, I have to get back to reality...at least for while I'm at my day job. Gotta pay my bills. :) Good luck in your writing all! I sure know we could all use a little more luck in our lives.

Last minute

I'm the youngist of four girls and two of my sisters have been skating Roller Derby for the last six years. And from the beginning they were naturals at it and have excelled in the Derby world to be some of the top skaters, traveling around the country to compete as well as coach. So when I heard that this weekend would be the last time that Team Legit (flat track skaters from different leagues across the nation) will be skating at Battle on the Bank V, I knew I had to go. With my sisters being in different leauges in different states, it's rare for them to skate with each other competeively let alone against eachother. My mission is set. Find a way to get to the Seattle area this coming up weekend so that I can spend some time with my family cheering them on in doing something that they love to do. Team Legit is currently the reigning champs on the bank track tourniment, so I have to find a way to get there. And I did. With a new car I know that I have a reliable car to get me there, its going to be long drive. Around 14 to be exact. So why not fly? Well it's just cheaper to drive then fly. With a fantastic boss that is letting me take monday off in order not have to rush back right back. The drive is going to be a long drive and I'm super excited about seeing my family, so it's 100% worth it. Sometimes you have to take your plans to relax at home and trash it, in order to go enjoy time with your family no matter how far it is. I know it will be fun. No matter how exhausted I will be from a long drive, seeing my sisters do something they love means the world to me. It's been weeks since I've been able to sit down for a long period of time to write and I have alot of travel plans this summer, so it's going to be hard to find the time to fit it in to that time. It's frustrating cause I get itchy to write, but it's not always possible. But when I do get the time I find that I'm more productive than other times. I guess it's a blessing in disguise. It makes me wonder if I'd get more work done if I had time to work every day instead of every few days. Guess I'll never know. As long as I keep taking baby steps forwards to finishing a work then I'm a happy camper. Would I like to finish faster? Hell to the yes. But if that means that I have to give up time to spend with my family then I rather spend time with my family. So Im happy that I'm able to go on a road trip to see my sisters. Even if that means that I have to put my writing time to the side. I'll find some time some where and I'm still making progress, but family is important to me and I'd do anything for them. Well I got to go get some writing done while I can. I'll post later how my weekend went next week. Keep making progess in your goals and I'll do the same. Laters!

Weddings

This weekend was the first of my friends to get married. Well, technically it's two of my friends who married each other. It was am amazing wedding with small touches that screamed my friends. The man who officated was another of our friends who was the one who introduced the two back in college. Between the three of them they had started the Men's and Women's rugby team at our school. In omage to them being rugby players the cake topper was a bride tackling the goom who is wearing rugby shorts running with a rugby ball. The bride's mother was horrified about. Other than the open bar and none stop dancing after the ceramony, everything was more her parents style then both the bride and groom. Which brought up the topic of what people say about weddings. That the day isn't about the groom, you just have tell him what to wear and when to show up. It's also not so much about the bride either. Though it is alot more so about her then the groom. But it is about the brides mother. Now don't get me wrong the wedding I went to was beautiful. Both friends were happy and everyone had a blast. The ceremony was short and sweet. And the weather was perfect for an outdoor wedding. And yes I did cry. Guess that means I 'm more of a sap than I thought. Like all weekends that involved weddings converstations of our own weddings were talked about as my roommates and one of their mother's. The three of us sat talking about our nonexistant men in our lives and what we would want on our big days when they come. Which really go me thinking. As much as I want to have the big wedding the whole thought terrifies me to be honnest. While I may write romance the whole thing really does scares me. Having grown up in a divorced family since I was 2 all I know is disfunctional relationships. Not to mention that I have a tendency to run from men who actually show interest. So, when it cames to talking about getting married and starting a family it hit me...As much as I want to have those things that everyone else has/wants I feel a bit ashammed to want it when most of my family doesn't have the same warm fuzzy feelings that most people have. That shouldn't be an issue in life but I guess it is. When it comes down to it, I'm more than happy being independent and I don't want to lose that, even if I do end up with someone. In the end if I find the right guy, then I find the right guy. If that includes merrage and kids then so be it. In the end I refuse to let what society's standards define if I'm happy or not. In the end weddings should be a happy event with no drama that celebrates two people's lives coming together. And that was excatly how it was yesterday. It doesn't matter how the wedding goes. What you're wearing or what the food is like or what music is playing. As long as the bride and groom are happy together that is all that matters. And that right there is why I write romance. It's about the struggles and insecurites and fears and finding that person that makes facing all of that worth it. They might not end up always being happy endings, but it's those times that end up making the person you are. And there is nothing wrong with falling in love. Cause it's in thouse times that you learn more about yourself and the world then one might think. Congrats to all the love birds out there and the newly weds. Starting a life together may be tough, but well worth it.

That Just Happened

Today's blog is just going to be a quick update about things that have been happening in my life, instead of just focusing on writing. So, lets get to it shall we? For the past month I've been looking into replacing my old car. A car that the passenger door that wont open unless you turn the key in the lock while lifting the door handle, drivers window that is stuck open an inch, no stereo and so much more. Well after more research than I know what to do with I've finally figured out what car I was going to go with. Being as this would be the first time I've bought a car, and I'm doing it alone the whole process was stressful and overwhelming. So after bribing a guy friend of mine to go test drive a car during my lunch break on Friday, I knew I could do the rest alone. And well I did. Saturday I test drove my second choice of a car and did a breakdown of cost. With the help of the awesome Esther I was able to walk out of there with a new car. Let me tell you people who are car hunting go with the internet sales person for as long as you can. I ended up getting a more than amazing price, while helping keep my nerves about the whole process to a minimum. I can now say that I've bought a car that I wanted, by myself, and have no regrets on the big purchase. It's still a bit surreal that I bought a brand new 2012 Hyundai Elentra Touring. And yes I did squeal in the car when I was driving home. Now I just have to come up with a name for the dark granite grey hatch back. I like Jax, but still open to other names. Along with a new car in the garage I now have to call the charity that I'm donating my old car to, I had finished the first through edit of Mackenzie Falls. On top of that a good friend helping me edit by going through to make sure that it flows just right. already I've sent her the first three chapters that I've already went through for what I'm sure wont be the last time. This round of edits has definitely gone faster than the last. ok....so I lied about not talking about writing. I'm finally keeping up with the work hard play hard. And with everyday we are getting one step closer to the RWA 2012 conference and I can't wait to go. Now I'm off back to work...and maybe go drive me new car. It still hasn't sunk in yet that it's mine. But it is. =)

Burn out

This weekend happened to be my old rugby teams third annual Alumni game (or is it for the boys) so catching up with old college friends took priority over working on writing. Yes, I say my old team even though it's a mens club. Quick explanation...when the team was originally founded while I was in school there wasn't enough men or women to have separate teams so we were co-ed. That's right. I learned to play rugby side by side with the men. Us girls who stuck it out were pretty bad ass. We loved playing the sport and being held to the standards that the guys had only made up better players when we split off to play with the girls. Still we practiced with the boys then. This doesn't happen any more since both teams have enough players. So I still call them my team even though it's all men. lol. For the first time in a couple of months I set my writing a side while I'm still at home and decided that I need to not worry about the RWA conference coming up and getting my writing ready for my first conference and agent pitches. I admit only a few times did I get twitchy about putting pen to paper, but I'm starting to realize that you really do need to find a way to balance out the work with the play. Working a full time day job takes a lot of energy out of you, but when you put on top pursuing a writing career it takes even more time. Especially when you are serious about it. I know that it will take years to get to my goals and I'm trying to start good habits that I'd want to have when I'm able to write full time. That means writing every day. Or at least setting a schedule and sticking to it. Unfortunately with my stubborn determination I've become a bit of a hermit. Ok, maybe a bit more than a hermit. While my roommates and friends go out on weekdays I'm home working and trying to get a good nights sleep so that I can function properly while at the day job the next. Lack of sleep and working with numbers don't really mix. Add in being grumpy on top of that and it doesn't make for a good day. As for weekends well I'm in the more low key nights, where my roommates have different ideas of what to do. That being the case I usually decide to stay home and you guessed it work or read a good book. Which I guess you can say is a form of work (but is it still work if you enjoy what you are doing?). Upside it means that I'm also saving money so that I an afford a car that isn't as old as I am. So, with this weekend, being full of friends in town as well as a book sale at the Center for Sex & Culture with my sister, there would be little time to work on edits or a new manuscript. Now I'm sitting here feeling poorer from going out, but refreshed. It was amazing seeing my old group of friends that we would hang out practically every weekend at my old apartment. Though I now remember why I don't drink so much and that rugby players can definitely hold the mass quantities of booze that they drink. Realization had struck that if I keep up this pace of hermithood then I'm going to end up burning out. And my writing career is only just starting. I don't want to end up hating something that I love doing. No matter how long and hard it might be at times, I love every second of it. Writing is a labor of love that us writers get to share with the rest of the world. With that realization that some times it's good to walk away and take a break, I've decided to start doing that more often. Plus watching rugby had me missing it like crazy and once again confirm that I need to get my butt back in shape. That being said I'm making a belated new years resolution. Find a balance of work and play. So on weekends I'm allowed to go out and have fun. Just means that I'm going to start waking up early to work out and write. What better way to start the day by getting the blood pumping while clearing your head to create worlds for people to enjoy. Not sure yet how I'm going to balance this during the work week yet, but weekends are for fun, working out and in the down time writing. It's possible to do it all! I know it is. Just have to do some trial and error to find out what will work best for me. And with that I'm off to make some more edits. Feels like that's all I'm doing, but in the end the edits is where the book takes shape. The rough draft is just the foundation. I'm going to take all the time I need to get my work, not perfect, but feeling right. As of right now Mackenzie Falls is starting more and more to feel right. That means it's almost done. Till next time! And get to writing! I know I am.

Step 2: Following Through

So, you've done step one in doing what you want. You've set your goals. Let's just say that it's to be published, seeing as that is one of my goals in life.

Now what?

Well you actually have to follow through with all the work that it takes to get to that final goal. You can rarely go from A to Z without going through the rest of the alphabet first.

This is what I do. Break down all the steps it will take get to that final goal. In a way each step is a different goal with in itself. What? You're telling me is that I went from one bullet point on my to do list to like a hundred? Ugh your killing me here.

That is exactly what I'm telling you. Yet I'm also giving you a path you can take where you actually get to cross things off that dreaded to do list. Just so that you don't feel a lone in the length of your long list here is mine that I've come up with working on Mackenzie Falls.

1. Come up with a solid idea - Check Done
2. Come up with a background for my characters, so that I know why they are making the choices they do or will make, and what made the the way that they are - Check Done
3. Come up with a story arch that has the main character grow - Check Done
4. Start writing the actual story till I feel that I've got a good ending, while keeping up a list of new characters that I didn't know would pop up - Check Done
5. Editing. Editing. Editing. Oh wait more editing. (This is where the story really comes to life. It's here that you can clean up the story, the characters and the setting. The things you thought worked once really don't. This is the time that the story really comes to life.) - Not done. Still working on. No matter how frustrating it gets at times. Yes I do want so scream at the computer screen "Why can't you be finished yet!" Well, it's not done yet cause you're not done with it yet. Editing takes time and not over thinking things too much. Yes there is such thing as over editing.
6. Writing the summery to send out with queries to Lit Agents and Editors. What's this? I just finished writing 300 pages now you want me rewrite it in one page? Yup I do. - I've not quite gotten to this yet.
7. Researching Literary Agents that rep the genre you write. See what they require for submissions and make a query for each rep, making sure to include everything they request so that you don't get thrown out because of being lazy. - I'm currently in the process of doing this. I have to say it's fun to research the authors you enjoy to see what agents they work with, and what is out there.
8. Sending out your queries to the agents that fit with what you are looking for. - Not there yet, but getting closer every day.
9. The waiting game. This is where you are waiting to hear if you get represented. This isn't the time to twiddle your thumbs in boredom. This is where you can keep sending your work to more agents, while working on your next idea. Always, always, always, keep working on your next idea as soon as you finish the first. That way you have more stuff to get your name out there to sell once you do get representation. Waiting and getting rejections isn't the most fun, but it's a learning experience. Don't get down on yourself if people say no. Just find out ways to become a better writer.
10. You find an agent that want to rep you. - One day I will get this happy phone call. It's just a matter of putting in the hard work.
11. You get the phone call from your agent. They sold your book! You are getting published! Your big goal is now accomplished. Now it's time to do it all again. Though now that you have an agent you get to skip a few steps. Whoooo! - This is my big goal and it will happen. Time people. It just takes time and determination. I'm willing to put the work in to make this happen. If it takes then years. Then it takes ten years. If it happens over night? Well...I just might be a little skeptical of that to be honest.


See I have a long list to do too. Now don't get me wrong, I'm still learning about how to make myself a better writer, and about the publishing world. This just happens to be the steps that I'm taking. If you're in the publishing world, and know Im wrong, well please tell me. I want to learn from those that have the experience that I don't have.

Take the time to break down all the steps you need to take to reach your goals to make it easier to see that you are following through. It might be a long ways away till you get there, but if you follow through with each step one at a time, then you will get to your big goal. At times where you get discouraged take a moment to look at all the things you were able to cross of your list.

See all those crossed out? Your that much closer than you were before. Take a deep breath and keep taking those baby steps.

It's easier concurring the smaller goals than just a huge one. But all of the sudden you realize...I did it. I followed through on one of the biggest goals you've made.

Now go out and follow through on all your goals whatever they might be. Good luck and keep up the hard work. You're not alone in your journey to reaching your far off goals. I'm right there with you.