In the mid-80s when I was in high school (a decade before my attention deficit disorder diagnosis), there were already clear signs that I would be a frustrated adult — full of talent, and fully challenged at putting those talents to use.

See if these teacher comments sound familiar:

Calculus: Phil is an enthusiastic member of this class. He participates freely in class discussion and has many good ideas. It is enjoyable to have him in class but also a frustration. For although he seems to understand new concepts when presented, he doesn’t appear to spend time studying so that these ideas and skills… become part of his general knowledge. Until he can discipline himself to do the hard work involved in the education process, he will not be recognized as the talented special person he wants to be. There will be times in Phil’s life when this will have a lasting impact on what he can achieve. [Emphasis added]

British Literature: Phil’s work is always imaginative and usually insightful. His quiz scores suggest that he might prepare his assignments a little more carefully. Attention to detail is sometimes tedious but always necessary in both analytical and creative writing and thinking.

Philosophy: Phil’s quite good performance in both class discussions and written assignments was marred only by his failure to hand in the mid-term exam on time.

—

Report card illustration from the Discovery Channel’s Educator Resources.

Mental coach Dr. Richard Coop has worked with numerous top athletes, including the late Payne Stewart*. Here’s an excerpt from an interview with Chapel Hill Magazine:

Chapel Hill Magazine: What kinds of demons did Payne face on the golf course?

Dr. Richard Coop: Payne was a deep thinker about golf. He was much smarter than a lot of people, but was also very impulsive. He had a bad case of ADHD [Attention Deficit Hyperactivity Disorder] and so we worked with that. One thing about athletes with ADHD is that they can hyperfocus when the tension level is high. They can sit for hours in front of a video game or perform in a major championship. I used to watch Payne’s eyes in a major championship and he was hyperfocused, but in the John Deere Classic, he wouldn’t show up mentally. That’s one of the things we really had to work on hard with him. When the intensity level wasn’t high, his mind would go on vacation. We had to find ways to make a challenge out of something that he didn’t think was a challenge.

The worst shot I saw him hit was a plain vanilla chip, just something simple that you or I could hit very easily. It was too easy. He would have three or four different ways of playing it and he wouldn’t commit to a specific way. He would get caught in between.

So I would have him call his shot out loud to his caddie to commit to himself and to another person, and to be responsible for his shot. If he had a shot where he had to stand on his head and flop it up over something, he was fantastic. And those were the ones he wanted to practice, like a basketball player who just wanted to practice H-O-R-S-E shots.

–David Droschak, The Mental Side of Golf (Well, what other side is there?), in Chapel Hill Magazine, July/August 2007.

In three paragraphs, Dr. Coop vividly describes what can happen to many executives with attention deficit disorder. We excel when we face big challenges that play to our ADD nature, but we fade quickly when our ADD has room to play and distract. Not long ago, a client told me about one of his former colleagues who “was never happy unless there was a crisis. Unless there was a fire to put out, she didn’t know what to do with herself.”

Naturally, I couldn’t “diagnose” the former colleague without knowing more, but I might hypothesize two things: (1) she didn’t have a plan, and (2) it would have been nice if someone had pointed this out to her. That said, “knowing” her problem wouldn’t necessarily give her a cure.

David Droschak may well have known something about ADD when he asked the question, “What kind of demons did Payne face on the golf course?” To know your demons is an important first step. But to actually deal with them requires much more. Professionals like Dr. Coop can be a massive help. And when the stakes are high enough (e.g., for a professional golfer or for a business owner or executive), the results are well-worth the expense.

*Payne Stewart died in 1999 due to an airplane malfunction. Full story here at About.com’s Payne Stewart bio.

The New York Times has an interesting article on convergence insufficiency and how it is frequently misdiagnosed as attention deficit disorder.

Excerpt:

Dr. David Granet, a professor of ophthalmology and pediatrics at the University of California, San Diego, said: “Everyone is familiar with A.D.H.D. and A.D.D., but not with eye problems, especially not with convergence insufficiency. But we don’t want to send kids for remedial reading and education efforts if they have an eye problem. This should be part of the protocol for eye doctors.”

In 2005, Dr. Granet studied 266 patients with convergence insufficiency. Nearly 10 percent also had diagnoses of attention deficit or hyperactivity — three times that of the general population. The reverse also proved true: examining the hospital records of 1,700 children with A.D.H.D., Dr. Granet and colleagues found that 16 percent also had convergence insufficiency, three times the normal rate.

“When five of the symptoms of A.D.H.D. overlap with C.I.,” he said, “how can you not step back and say, Wait a minute?”

– Laura Novak in Not Autistic or Hyperactive. Just Seeing Double at Times, New York Times, 11 September 2007

Might convergence insufficiency be an issue for adult executives, and might an adult with C.I. have an ADD/ADHD misdiagnosis — either as a child or as an adult? The New York Times article only discusses C.I. cases in children; however, C.I. is known to exist in adults. Given that C.I. is a relatively uncommon diagnosis, it’s not unreasonable to think that some adults diagnosed with ADD/ADHD may actually have C.I., instead.

In any case, the need for a careful and accurate diagnosis of ADD/ADHD is increasingly obvious. ADD/ADHD often comes with co-morbid conditions (anxiety, depression, etc.). And more opportunities for mis-diagnosis (e.g., convergence insufficiency as ADD/ADHD or vice versa) seem to keep appearing.

Choose a good doctor. Ask many questions. Keep looking if you don’t feel confident about your first results.

It’s tempting to make promises, but can you fulfill them all?

– a recent fortune cookie

Such a strange feeling: to not say “yes”. Or to say nothing at all when there’s a call for volunteers — not even an “I’m sorry, but my schedule is full.” Just nothing at all in response to, “Would anyone be willing to help with _____?”

And then the strange surprise, nearly always: to hear nothing in response. No recrimination. No anger. No surprise. Just the sound of silence as your asker moves on to figure out some other solution.

Have you ever avoided a task because you thought you’d get bored?

Have you ever feared a task because you thought you’d get bored, wouldn’t finish, and would suffer consequences?

Assuming you’ve said yes, how many of these tasks might have been important? It’s one thing to avoid reading some useful but boring professional journals. It’s another thing to neglect tracking or tallying your deductible expenses (or your staff’s expense accounts). And it’s a big ‘nother thing to avoid finishing your business plan.

When you prioritize tasks by importance, you’ll have a stronger sense of when to “risk” getting bore. And at least you’ll have a chance at delegating the items that need doing but not necessarily by you. (By the way: a great way to identify priorities is to look at what’s most important in your business plan. You’ve finished your business plan, right?)

“Working memory is a mysterious kind of inward eye that allows us to maintain brain-based models of our surroundings…

“Drugs like guanfacine [occasionally used to treat ADHD] work by stopping production of cyclic AMP, thus allowing the cortical network to remain connected and critical working-memory functions to proceed unchecked.

“[Yale University neurobiologist] Arnsten next plans to investigate whether conditions like ADHD, schizophrenia, and age-related cognitive decline might be touched off by the opening of too many HCN channels, leading to mental lapses.”

– from Gatekeepers of the Mind, in Yale Alumni Magazine, July/August 2007

According to the National Institute of Health, guanfacine (sold under the brand name Tenex® by ESP Pharma) is primarily used for high blood pressure, with some use for migraine headaches and drug withdrawal symptoms.

A Yahoo! Health article on ADD/ADHD states:

“[Other]  medications are sometimes tried if symptoms persist after initial treatment with one of the above medications. These medications are usually not used in younger children.

• Antihypertensives, such as Catapres and Tenex, which may be used to treat aggression and impulsivity not controlled by ADHD medications.”

In ADD in the Corner Office: Five Top Executives Discovered that an LD can be a Capitalist Tool SchwabLearning.org provides a nice article on five prominent CEOs with ADHD, dyslexia, or both. Though David Neeleman (one of the ADHD execs) has recently been removed from his CEO post at JetBlue, his accomplishments in founding and running the company for as long as he did are fully impressive and inspirational. The article opens:

“As students, they seemed to be heading nowhere — fast. A teacher hurled an eraser at one of them, and asked, “Time passes, will you?” Another graduated at the bottom of his high school class and was strongly advised by his principal to go into carpet laying. A third was labeled lazy by her teachers because she had trouble memorizing basic math facts. A fourth was a whiz with numbers but found reading a book a difficult task. The last was always falling behind in his schoolwork and concluded that he was stupid. “How am I going to be successful in anything if I can’t read and write?” he wondered.

“You might say that these nowhere kids turned their lives around. They are, in order, Alan Meckler, chairman and CEO of Jupitermedia; Paul Orfalea, founder of the copying empire, Kinko’s; Diane Swonk, a world-renowned economist; Charles Schwab, a pioneer in the discount brokerage business; and David Neeleman, founder and CEO of JetBlue Airways.

“Besides having difficulty in school, these executives share another thing in common: They all suffer from AD/HD or learning disabilities. Neeleman has AD/HD; Swonk, Meckler, and Schwab have dyslexia, and Orfalea has both. Each managed to turn his or her liabilities into assets on their respective career paths. If you have difficulty with organization, reading, or remembering math facts, these entrepreneurs prove that such limitations don’t preclude a bright future.”

Click here for full article at SchwabLearning.org.