“Sometimes we stare so long at a door that is closing, that we see too late the one that is open.” - Alexander Graham Bell
Upon initial consideration, it may appear that using mindfulness to address the symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) would be a frustrating, if not useless, enterprise. The “Diagnostic and Statistical Manual of Mental Disorders” (DSM-IV-TR) explains that the central feature of ADHD is a relatively persistent pattern of inattention and/or hyperactivity-impulsivity that manifests itself more severely (and in multiple settings) than other people at comparable levels of development.
We may have stereotyped ideas in our minds about what someone with ADHD is “like” based on portrayals from the media or from a few people we have known personally. The truth is that ADHD doesn’t always look the same in each person and many people who struggle with ADHD may go undiagnosed for years because their symptoms do not fit the stereotypical portrayal. For these people, there may be an underlying sense of concern about why they seem to struggle with certain things that appear relatively easy for other people, yet the idea of ADHD may never cross their minds because they don’t consider themselves to be a caricature of someone bouncing off the walls or excessively scattered.
Inattention may manifest itself in a variety of settings: at home, with friends, at work, or at school. There may be a tendency to make careless errors, find it difficult to persist with a task to the point of completion, or “jump in” to tasks without enough forethought or planning. To other people, this inattentiveness may come across as if the person is simply not listening, that their mind is “elsewhere,” or that they make sudden shifts in topics of conversation. It may be difficult for people with ADHD to engage in tasks that require sustained mental effort or that they experience as unpleasant in some way.
There may be a marked struggle to maintain an organized work space, despite a conscious desire for greater organization. This inattention may also manifest itself through becoming easily distracted by irrelevant stimuli (e.g., outside noises or trivial events) that are easily ignored by other people. This quality of inattentiveness can make social interactions more difficult, since the individual may struggle to remain mindfully present and engaged in conversation, despite their potential earnest desire to do so.
Hyperactivity may present itself as frequent fidgeting or squirming in one’s seat or having an intense urge to be “on to go” or “in motion.” Levels and specific behavioral manifestations of hyperactivity with ADHD can vary widely depending upon the individual’s developmental stage and environmental context. For young children, this hyperactivity may include more of the running around and struggling to be still behaviors, whereas for adolescents and adults, they may experience this hyperactivity as feeling an intense sense of restlessness and difficulty engaging in quiet, still, and solitary activities.
Impulsivity in the context of ADHD often presents itself as impatience, trouble delaying responses, blurting out answers before questions are completed, difficulty awaiting one’s turn, and frequently interrupting or intruding on others. The individual may have conscious awareness that they are doing these things, but the biologically-based nature of ADHD makes this an authentic struggle for the individual to overcome through sheer will. This impulsivity can extend to getting into accidents or engaging in potentially harmful behaviors without careful consideration of the possible consequences.
Research has found ADHD to be more in common in the first-degree biological relatives of children with ADHD than in the general population. There is considerable evidence that suggests a powerful influence of genetic factors on levels of hyperactivity, impulsivity, and inattention. Remember that genetic predispositions are not guarantees. You can make the choice to actively treat your existing ADHD and create an environmental and developmental context for your own children that can reduce the probability of any genetic predisposition actually manifesting itself into a real behavioral issue. You have more power than you may realize; genes alone do not determine one’s destiny.
Traits of ADHD:
Since the hallmark traits of ADHD are (1) inattentiveness, (2) hyperactivity, and (3) impulsivity, it seems readily apparent that mindfulness is abundantly rich with cognitive, emotional, and behavioral tools to address each of these problem areas. If your initial reaction is something to the effect of “I can’t be mindful because I have ADHD,” then I view this is an excellent indicator that you should make the choice to actively practice mindfulness despite this self-defeating and limiting thought.
Right now, take a moment to notice how a thought as simple as that one can serve to keep you imprisoned from trying something new that could change your life. If you were able to pause and notice the impact of that thought on your overall sense of wellbeing you were just being mindful. See how simple it is?
Researchers at UCLA’s Mindful Awareness Research Center (MARC) investigated the effects of a program called the Mindful Awareness Practices for ADHD (MAP) with 25 adults and 8 adolescents. The participants started off slowly by engaging in meditation for 5 minutes at a time, gradually building up to 20 minutes of meditation. If it was too difficult to sit still for the meditation practice, they would engage in a mindful walking practice instead.
Because people with ADHD tend to be visual learners, the MAP program incorporated visual aides in the process of teaching participants what mindful awareness is all about. For example, they may look at a beautiful picture of a vast blue sky with fluffy white clouds and talk about the sky as representative of the grand space of open awareness and the clouds representing the variety of thoughts, emotions, and sensations that pass through that expansive awareness.
Dr. Zylowska, psychiatrist and founding member of MARC, explains that “mindfulness starts with attention, and that skill is applied to increase awareness of thoughts, emotions and behaviors. In this way mindfulness also leads to increased choice.” At the core of the MAP training is: (1) a focus on the present moment, and (2) cultivating an attitude of openness, curiosity, and acceptance (i.e., being nonjudgmental).
When this attitude of mindfulness is directed towards your experience with ADHD in a thoughtful and compassionate way, you may begin to develop a different relationship with any predisposed tendencies toward hyperactivity, impulsivity, or inattention. Mindfulness exercises provide you with the skills to learn to rest peacefully in a place of pure awareness and gently open the emotional space necessary to begin to learn how to respond to your inner and outer worlds, rather than react to them.
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American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC.
McCullough, L. (2010). Mindfulness Skills Useful in Addressing ADHD. Psych Central. Retrieved on March 18, 2012, from http://psychcentral.com/lib/2010/mindfulness-skills-useful-in-addressing-adhd/
Featured image: ADD Poster by chris.corwin / CC BY-SA 2.0