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.

Are you looking for a fast and free online tool to evaluate your possible ADHD? Larry Jasper & Ivan Goldberg have a 24-question evaluation here: “Jasper/Goldberg Adult ADD Questionnaire” at MentalHelp.net.

They include questions like “I find it difficult to read written material unless it is very interesting or very easy.” with 5 possible responses from “Not at all” to “Very much”.

Notes:

Their description: Use this questionnaire to help determine if you need to see a mental health professional for diagnosis and treatment of ADD or ADHD in an adult.

Their disclaimer: Scores on this test are not meant as a diagnosis tool! You should not take this score to represent a mental disorder diagnosis or any type of behavioral healthcare treatment recommendation. Always consult with a trained mental health professional if you are experiencing feelings, thoughts or difficulties that cause you or people you love to be concerned…

Good breathing helps calm the mind and allows us to stay present during difficult moments when our attention might want to flee.

We knew that already, but in case you wanted a reminder written in heavy-duty scientific language, see the abstract, below. Now loosen that necktie!

Mechanisms of mindfulness: Emotion regulation following a focused breathing induction
Joanna J. Arch and Michelle G. Craske, University of California, Los Angeles.

Abstract

The current study investigated whether a 15 min recorded focused breathing induction in a normal, primarily undergraduate population would decrease the intensity and negativity of emotional responses to affectively valenced picture slides and increase willingness to remain in contact with aversive picture slides. The effects of the focused breathing induction were compared with the effects of 15 min recorded inductions of unfocused attention and worrying. The focused breathing group maintained consistent, moderately positive responses to the neutral slides before and after the induction, whereas the unfocused attention and worry groups responded significantly more negatively to the neutral slides after the induction than before it. The focusing breathing group also reported lower negative affect and overall emotional volatility in response to the post-induction slides than the worry group, and greater willingness to view highly negative slides than the unfocused attention group. The lower-reported negative and overall affect in response to the final slide blocks, and greater willingness to view optional negative slides by the focused breathing group may be viewed as more adaptive responding to negative stimuli. The results are discussed as being consistent with emotional regulatory properties of mindfulness.

in Behaviour Research and Therapy
Volume 44, Issue 12, December 2006, Pages 1849-1858

Hyperverbalism (rapid, non-stop talking) is a common symptom in people with attention deficit disorder. For the executive with ADD, the effects of hyperverbalism are at least twofold: (1) it impedes the ADDexec’s ability to listen and (2) it hampers the ability to understood.

Hyperverbalism is also a known symptom in several disorders, including bipolar disorder, autism (including Asperger’s Syndrome). Michael Bartos, MD, has an interesting list of ten similarities (and ten differences) between ADHD and bipolar disorder, available in this article at BipolarCentral.com.

A related term is logorrhea,* which Merriam-Webster defines as “excessive and often incoherent talkativeness or wordiness”. Dorlands Illustrated Medical Dictionary in MerckSource.com defines logorrhea as “excessive volubility, with rapid, pressured speech; as seen in manic episodes of bipolar disorder and in some types of schizophrenia” and lists several synonyms: agitolalia, agitophasia, pressured speech, tachylalia, tachyphasia and verbomania.

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*Fun fact: Fourteen-year-old Nupur Lala spelled “logorrhea” to win the 1999 Scripps Howard National Spelling Bee.

Driven to Distraction by Edward Hallowell and John Ratey is the most well-known book on ADHD (and the ADDexecutive promises to post an in-depth review before long).

In fact, Dr. Ned Hallowell is broadly recognized as one of the most important MDs to research, treat, and write about ADHD in both children and adults.  In 1996 he created the Hallowell Center which provides holistic treatment and education about ADHD for both children and adults.  The Hallowell Center also offers consulting service for businesses/businesspeople affected by ADHD.

Below, an excerpt from their Mission/Vision page:

"Mission Statement

At The Hallowell Center we are committed to helping people lead happier, more productive lives through our balanced treatment approach; integrating brain, body and heart.

Philosophy

The Hallowell Center is dedicated to promoting cognitive and emotional health in both children and adults. We combine the latest knowledge about the brain, learning, human behavior, and emotion with a personal, patient-centered approach to diagnosis and treatment. Our goal is to help people achieve their goals in life.

…It is our mission to bring to you the power of knowledge and the spirit of human connection. In addition to treating individuals, we recognize the importance of working with couples, families, schools and businesses. Our staff integrates a traditional medical practice with natural approaches to health and healing. Our nutritionist can evaluate the effects of diet and natural supplements on your mood, mental focus, sleep, and energy. We also teach stress reduction through meditation and muscle relaxation techniques.

Finally, we have a business consultation arm of The Center which specializes in the psychology of the workplace and organizational dynamics."