What is Attention Deficit Disorder?

Attention Deficit Disorder (ADD) is the most common neuropsychiatric disorder of childhood. Studies have found that the majority of individuals diagnosed with ADD have symptoms that persist well into adulthood. Many who are affected by ADD evade diagnosis as children and come to The Midtown Practice with complaints of focusing difficulties that date back to school age. Together with your clinician, we will work to diagnose the reason for your difficulties with attention and identify any comorbid psychological disorders such as anxiety, depression, or substance abuse. Once we have a clear picture of your symptoms and condition, we will work collaboratively to design a treatment that addresses your focusing issues. Our goal will be to see tangible improvements in your relationships and educational and/or occupational functioning. If you or a loved one is struggling with ADD we can help. We work with children, adolescents, and adults to manage ADD.

Executive Dysfunction

Many of the deficits of ADD are classified as deficits in executive functioning. Executive functioning is defined as the ability to choose and create goals, and enact and sustain behavior in order to complete those goals. Executive functioning deficits in ADD include problems with working memory, which is the critical component of memory that holds information for a brief period of time while performing mental operations on that information. An example of working memory would be holding a person’s address in mind while learning how to get there. In addition, individuals with ADD have difficulty with self-monitoring or screening out information unrelated to a project or goal, initiating tasks, and self-inhibition. These deficits in executive function contribute to inattention problems such as remaining focused on a task for long periods of time, organizing activities, following through, forgetfulness, and poor time management.

Inattention

Although many of us feel distracted by the panoply of demands and sources of information in our modern world, individuals with ADD have much greater struggles with forgetfulness and completing tasks. They frequently wander off while working, lack persistence, and cannot sustain focus. Often children and adults with these problems are labeled defiant, which is extremely frustrating and leads to feelings of low self esteem and identity confusion.

Diagnosis

During your assessment at The Midtown Practice, your clinician will do a thorough history to identify symptoms consistent with a DSM-5 diagnosis of ADD. We will also rule out other disorders that might interfere with attention such as depression, anxiety disorder, or a nonpsychiatric medical issue. In those individuals not diagnosed in childhood, we will do a careful evaluation to see if your symptoms date back to school age. When appropriate, we might ask you to obtain collateral history from your parents or other family members with familiarity of your academic and peer development. This history is especially important because ADD is not something that you acquire as an adult, but rather something that can be traced back to early childhood. History is therefore central to obtaining a proper diagnosis.

A diagnosis of ADD is based on the number and severity of symptoms, the duration of symptoms, and the degree to which these symptoms cause impairment in life. In order to meet the criteria for ADD, we look for significant negative impact in at least two major settings in a person’s life. Examples of the severity of impairment include failure to pay bills in a timely manner, being put on academic or occupational probation due to failing performance, or repeated driving offenses due to distraction and impulsivity.