Keep the Strengths. Ditch the Deficits

There is a widespread concern that treating ADD or ADHD with medication is a zero-sum game in which the medications improve focus and on-task performance, but they do so at the expense of mental energy and creativity. There is no study that supports this trade-off, but the rumors persist. My own experience was quite the opposite. It’s just one person’s story, but I hope it can help put to rest any concerns you might have. 

Like everyone else, I’ve got some personal strengths–intelligence and curiosity, for example. Those were huge blessings in my first career, a 25+ year stint as a student. I’ve also got a bunch of average

Sudoku puzzle: difficulty level was labeled 'Evil'.

Sudoku puzzle: difficulty level was labeled ‘Evil’.

abilities like typing speed, lawn mowing skills and most sports. One can find happiness without excellence in these, and I am living proof.

Finally, there’s some things I’m very bad at. Sudoku is one of them. Oddly, I enjoyed Sudoku puzzle books for years and considered myself pretty advanced, because I enjoyed doing the hardest ones in the back of the books. When apps were first invented, I loaded a Sudoku app on my smart phone and began to enjoy the electronic version, until some genius upgraded the app to include comparative stats. This means that when you finish a game, it tells you how your time compares to everyone else who finished that same puzzle. Turns out, I’m very bad at Sudoku. Or, at least, I’m very slow, but that’s probably the same thing.

I’m also bad at a list that a psychologist asked me about in great detail one day: focusing, listening, task initiation, task completion, organization, memory, follow-through, etc. Very bad. So bad, in fact, that I had married someone who is exceptional at those things, so I wouldn’t have to think about how bad I was at them. We complemented each other well. Together, we had no weaknesses, except Sudoku.

Problem was, both our sons were bad at that whole list, too, and my wife was collapsing under the burden of organizing four people who either couldn’t or didn’t help. I didn’t understand why all the help I tried so hard to offer contributed so little. She couldn’t understand why what I called “trying” made so little difference. So I went to the psychologist to see whether I was unwilling to help or incapable of helping. The differential diagnosis was bleak: either I was evil or disabled.

Turned out, it was the latter, which isn’t so bleak after all, because ADD is treatable. The magnitude of this truth didn’t become clear to me until after I tried medication for the ADD. All kinds of things started going better. I wasn’t trying harder, but trying now seemed to make a difference. It felt like my engine was going the same speed, but my wheels were suddenly going faster. (Having ADD is a lot like having a clutch that slips, for you automotive geeks, and medication is like someone popped in a new clutch which delivers so much torque that you realize the clutch has been slipping since you first bought the car.) The same amount of “trying” now yielded a lot more progress. The difference it made in our marriage and parenting was life-changing.

The improvements in my personal life, my marriage, parenting, friendships and career in the years since I began treatment are uncountable. Some of them are subtle, some are enormous. Virtually all of them have required effort, practice, fine-tuning to maintain or optimize.

But here is the main point. Neither I nor my wife, can think of anything that got worse from ADD medications. There has been no trade-off, unless you count the cost of the medications or the too-insignificant-to-bother-about side effects. Complaining about minor side effects of life-changing treatments seems to me like complaining that a basketball fell in your lap when you were given court-side seats at an NBA game. A lot of folks would love to have that problem.

Spider solitaire--4 suits

Spider solitaire–4 suits

For the record, ADD treatment hasn’t make me gifted at focus, listening, task initiation, task completion, organization, memory, follow-through, etc. With effort, I’m probably average at them, which is all it takes to be life-changing.

Unfortunately, treatment never helped my Sudoku stats, so I took up Spider Solitaire. I’m quite enjoying it at the highest difficulty level, ever since I found out how to turn off the comparative stats.

Physician specializing in diagnosis and management of attention deficit disorders and related conditions.

Posted in ADD, ADHD
16 comments on “Keep the Strengths. Ditch the Deficits
  1. Rhonda Hester says:

    Love the stories of comparison, Oren! Chris must be a saint! 🙂 Good job, Oren, you married UP!! Keep the blog coming!! Rhonda

    Liked by 2 people

    • Yep, Rhonda. Like they say, “Behind every successful man stands a good woman who must have been out of her mind to agree to marry him, but over the tiresome years has redeemed her original foolishness by helping him rise from the gutter of his own miserable ambitions to achieve some semblance of the life possibility that his mother originally invested in him.” And give my best to Tim, will you?!

      Liked by 1 person

  2. Linda says:

    I totally agree with you. I am recently diagnosed with inattentive add as an adult who has had problems for many years undiagnosed. I tried for several years to ask for help but felt,like there was always a door slammed in my face…..like my doctor saying I needed $2,000 worth of paper tests to prove I had it….even though I had every symptom. I didn’t have the $2,000…so went untreated. I called several places and everyone seemed to want these expensive tests. When my daughter was diagnosed it was a 3 or 4 page test I answered and so did her teachers from 1st, 2nd, and 3rd grades. No $2,000. Years later I finally got a specialist who agreed to do testing but more like my daughter’s…and not extra costs. I started medication a few months ago. I certainly don’t feel like superwoman on meds….but like you said now my efforts show some progress around the house, etc. I used to feel like I was busy all day and not one thing got accomplished…..but now I actually get a few things completed. I think my husband expected miracles out of me on medication….but at least it is helping.

    Liked by 1 person

    • Thanks for your story, Linda. Your words ring true. The medications don’t make miracles happen, but it is a miracle when we go from efforts that accomplish nothing to efforts that do.

      Like

  3. oren- the only downside i’ve had from the meds is mild side effects, jittery and upset stomach. they left when i changed to the daytrana patch. now only problem is if i forget to take it off by 2pm, then insomnia. but my cell phone has an alarm, so no problem.
    i dont know were people get this stuff.

    Like

  4. Anita Hoag says:

    Hi Dr. Mason, I wrote my master’s thesis on mothers’ perceptions of family communication when having an ADHD child. It was a qualitative research study where I interviewed 9 mothers. For 7 out of 9 mothers, deciding whether or not to medicate their child was the hardest decision they had to make. One mother has a master’s degree and attended one of the most competitive universities in the country. She couldn’t comprehend putting her own son on medication until her mother-in-law, who is a licensed marriage and family therapist stepped in. She told her that asking her son to go without medication is like asking her to go without glasses. It just isn’t fair. Now that he is on medication, it’s like he is a different kid.

    My own son has ADHD–he was diagnosed when he was eight-years-old. We didn’t start medicating him until the end of his 6th grade. It was also the toughest decision we had to make for him. In the end, we got lucky in that the first medication worked. It’s still working almost two years later. During that time he was also diagnosed with dyslexia. A combination of the medication and the educational support that he is getting from his school has made him go from a low C student to somebody who is making all A’s.

    I find it interesting that there are so many misconceptions about ADHD medications. They are all different, and I don’t think parents make the decision lightly to drug up their kid, which is contrary to what the public perception is.

    Thank you for your story. I hope it helps the parents and the general public understand there is a positive side to using medication.

    Liked by 2 people

    • Anita, thank you for your story and your remarkable transparency. Nobody tortures themselves over choosing glasses for their child’s vision, because the outcome is beneficial in a way we can grasp, but when we don’t grasp our children’s mental health struggles, choosing treatment becomes much harder.

      Liked by 1 person

  5. my goodness! – i do (did) the test as part of the $150 fifty minute session – ie we have one session, i send you home with the Brown test, you bring it back and i score it (5 minutes) and we discuss it and plan treatment – so maybe two sessions total for diagnosis, treatment plan, and prescription if needed..
    linda, glad you got help. the medicine will help you focus enough to develop strategies which will make a diference.

    Liked by 1 person

  6. Dr. Mindy says:

    Fantastic analogy… Would make a great carton to use for educational purposes!

    Like

  7. Phillipa says:

    Thanks for this article. Having a son I believe will be diagnosed with ADD, and me worrying hugely about possible meds, your article has made me breathe a little more easily.

    Like

  8. […] ‹ Keep the Strengths. Ditch the Deficits […]

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  9. ginbean says:

    Thank you for this blog! Please keep them coming! Perhaps it’s just my perception but I have noticed it’s so hard to get good information about medicating children. The whole “try everything else before you try meds” hurts a lot of children but it’s almost impossible to find good information that doesn’t imply if you use best practices you’re a bad parent.

    Like

    • That is so true and so strange! Medication is no panacea and has to be done carefully, but the uneducated fervor against the use of medications mystifies me about as much as the fervor FOR trying things that aren’t proven.

      Like

  10. Mark says:

    Isn’t it true that meds lose efficacy over a period of time ? let us say adderal is great but 12 to 16 months down the road it does not help as much.

    Like

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Oren Mason MD
Oren Mason MD

Oren Mason MD

Physician specializing in diagnosis and management of attention deficit disorders and related conditions.

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