Q: I am 55 years old and was diagnosed with ADHD five years ago. I work in a very fast-paced environment and my boss is dissatisfied with my inconsistent performance. I understand that inconsistency is a characteristic of ADHD but is there a chance of being consistent in my work performance, or is inconsistency something I'll have to live with?

A: Your best bet may be to get an ADHD coach. A coach can help you: isolate the specific behaviors that make sense to tackle first; provide specific ideas and tactics for how to improve those behaviors; help you track your progress and stay motivated. The Hallowell Centers in NY and Sudbury have coaches.�Another good resource is the ADHD Coaches Organization, ACO, and the Edge Foundation if you have a teen who needs a coach. Coaches often work by phone so you don't need to hire one near you, although as with any profession, the quality of coaches vary so choose carefully.

A coach is a great investment (particularly if your job is on the line) but If you can't afford a coach, then perhaps Nancy Ratey's book "The Disorganized Mind" can help you, or Ari Tuckmans "More Attention, Less Deficit".

Q: My 10-year-old son was diagnosed in September and receives 2 timed-release Ritalin in the morning and by bedtime he is wired. He describes his brain as being out of control and his body as being dead tired. He cries into the night because he can't get his brain to shut off so he can sleep. I've been trying relaxation techniques with him but then I end up losing sleep too. His school work is starting to suffer because he is so tired. Is there anything you recommend to help shut down the busy brain?

A: I would stop the Ritalin. Go back to square one with your doctor. Try to find a medication that helps your son focus during the day, but allows him to sleep at night. This might be a stimulant, but you might also consider Intuniv, as it has sedating side effects. In any case, trial and error is the way to find a pharmacological solution, if there is one. Remember, medication doesn't work in about 20% of cases, but it does work in 80% so the odds are still in your favor. If the Ritalin is helping during the day and it is only when it wears off that your son feels wired, you could either try a low dose of regular Ritalin, say 5 mg., around 5 p.m., or a low dose of clonidine to help with sleep. Work with your doctor on this, as the current situation is clearly not good.
- Ned Hallowell

If you have a child diagnosed with ADHD in your family, chances are good that at least one of the biological parents also has ADHD. There is a diverse and growing body of evidence to support that ADHD is hereditary. In fact, studies suggest that the expression of ADHD is about 80% due to genetic factors, and only 20% environmental. For perspective, that is a similar heritability profile to hair and eye color. (This does not mean that 80% of the children of adults with ADHD will have ADHD - this number is closer to 50%)

Researchers are still trying to untangle what, exactly, is getting inherited that results in ADHD. Recent research by a team of Korean scientists provides further evidence that ADHD is genetically based and may provide some insight. In this study, researchers compared 192 Korean children with ADHD to 196 age-matched children without it, identifying at least one genetic difference (on a gene labeled GIT1) they wished to explore further. They then engineered mice to lack the gene to study it further, as well as study the effect on these mice of drugs commonly used to manage ADHD in humans. They observed both ADHD symptoms in the mice without the gene, and the reduction of those symptoms with the use of these medications. Overall, according to lead author Dr Eunjin Kim, the research "suggests that the reduced expression of GIT1 can lead to ADHD in humans."

What does this mean for you and your family? Here are some things to keep in mind: If you have a child with ADHD in your family, look to see if one or both parents might also have it and, possibly, benefit from an evaluation or treatment ADHD is about brain chemistry and gene expression, not about being lazy or not trying hard enough. Don't ask your ADHD child to "try harder" - ask her to "try differently" - choosing approaches that are shown to work for those with ADHD. Thinking 'brain chemistry' can help anyone with ADHD appreciate the importance of taking care of his body (see nutrition article below). Exercise, good nutrition (specific type of diets), and adequate sleep all directly impact brain chemistry and focus. As in this research study, medication has been shown to be an effective way to regulate brain chemistry and gene expression to reduce or eliminate ADHD symptoms.

Shakespeare described sleep as, "Chief nourisher in life's feast," and more recently neuroscientists have been agreeing with "the Bard." Good sleep is key to physical and mental health. It is essential for mood stability, focus, memory, learning, and handling stress. Researchers at Harvard Medical School claim that a good night's sleep (falling asleep at will, staying asleep and waking up refreshed) evades 1 out of 4 persons. It is even more crucial for persons with ADHD. Sleep deprivation increases hyperactivity, moodiness and inattentiveness. This is because the brain is underaroused and looking for a greater level of alertness. Patients will report that their mind is racing making it difficult to fall asleep. One quarter of persons with ADHD also complain of "restless leg syndrome" making it difficult for some to stay asleep. ADHDers often have poor restorative sleep patterns and less REM or deep sleep. We can never make up for a sleep debt - when we lose it, it's gone.

Here are some suggestions for improving sleep. Put together your to-do - list for the next day so you don't have to do that kind of planning when you're trying to fall asleep. Two hours before your target bedtime avoid overarousal (videogaming, intense movies, loud music). Dim the lights, cool down the room, put on pajamas. Try reading something technical or an old magazine. A mild repetitive form of stimulation like a fan or some soft looping music or lulling nature sounds can help. Ask your doctor about a sleep aid that would not make you groggy in the morning. Also consider natural supplements to be taken under a doctor's supervision only. These may include:
- calcium and magnesium supplements,
- L-theanine (an amino acid found in green tea that reduces stress hormones) helps prolong sleep,
- melatonin helps to initiate sleep. Videogaming saps our melatonin reserve needed for a restful sleep,
- 5-HTP is an amino acid used by our bodies to make melatonin and serotonin needed for restorative sleep.

Discuss taking supplements with your doctor to be sure that they do not interfere with any medications you may be taking. And if worry is the culprit, as Dr. Hallowell suggests, set aside a time to worry, if you must, during the day. Not at bedtime.

Teens have very busy schedules throughout the school year, and anxiously await summer's arrival to relax. Your teen may be home from college or away at camp, but more than likely, they are in a much less structured environment. Summer is an excellent time to remind ADHD teens that they are particularly sensitive to what they digest.

Dr. Hallowell, in Delivered from Distraction, notes that "The most potent medication we have is also our most dangerous and abused drug. It is called food". If our teens do not eat properly, they can become distracted, implusive and restless, not to mention potentially develop all sorts of other symptoms such as diabetes, high blood pressure and obesity. The most common errors, like skipping breakfast or self-medicating with food, can sabotage the best of treatment plans.� Help your teen understand the importance of thinking carefully about the food they eat by talking with them about it as part of their "treatment" - a tool they can use to manage the chemistry of their body and brain for greater clarity and focus.� The best diet for ADHD includes at least a small amount of protein at every meal, and avoids sugar and carb highs and lows (that means no/few sugared soft drinks!)

Of course, teens often eat food that interests them at the moment, so you can help by having healthy "grazing food" around the house, such as packets of nuts, fresh (and sweet) fruits, lower sugar yogurts.� ADDitude Magazine also offers some ideas for the ADHD teen: Bend the Traditional Rules - why not granola for dinner?; Add protein, which helps increase focus and sustain concentration, along with fruits and veggies to create quick liquid smoothie meals; For more information, visit HERE

Be sure to keep the food options healthy, readily available and diverse. If you suspect that your teen is self-medicating with food, seek medical attention as this may be a sign of depression. As long as it is in moderation, go ahead, enjoy a treat. What fun would summer be without an occasional splurge?

Time Management During the Job Hunt

Did you know that only 4-7% of job seekers find a new position by using internet job boards? As in the past, two of the more effective ways to find a job are asking for job leads from friends and family and going to see employers, vacancy or not. This has significant implications for how job seekers spend their time during a job hunt. Most job seekers have trouble managing their time during the unstructured job search process; people with AD/HD tend to have even more trouble engaging in productive activities that lead to job offers and gainful employment.

Here are some pointers for those of you who might be searching for work right now:

In today's job market it is very important to be clear about what your interests and skills are and how you can add value to a hiring organization whether a company, government agency, educational institution or non-profit organization. This requires you to look inside yourself and do some self-exploration. You need to make time for this assessment work before you start reaching out for leads or applying for openings. There are many books on the subject; two of my favorites are "What Color Is Your Parachute?" by Richard N. Bolles and "What Color Is Your Parachute? For Teens" by Carol Christen and Richard N. Bolles.

People with AD/HD also need to assess the types of people that they best work with whether as superiors, colleagues or subordinates. When determining possible positions it is important to consider the types of people that you typically work with in those positions and if you would "fit" in that environment. Spending time researching companies and making contacts for a particular position, or in a specific business environment which you have some reason to believe will be a healthy environment for you, will be motivating.

Determine weekly goals and block out time each day to conduct job search tasks. The recommendation is to block out 5 hours/day for 5 days/week. Spend 60% of your time networking face-to-face, by telephone or via e-mail. Spend 20% on web sites and job boards. Spend 10 - 15% of your time on other activities such as sending out resumes. The other 5-10% of your time should be spent preparing for weekly and daily activities and making sure that you have captured new information learned or gathered such as the names of key contacts and follow-up commitments made.

Robin Roman Wright is a Career & AD/HD Coach at the Hallowell Center in Sudbury who works with teens, young adults and adults of all ages to enhance career satisfaction. She coaches people through the job search process and she works with clients to help them develop time management, decision-making, organizational and/ or study skills. She offers coaching by phone, Skype or in-person and can be reached at (978) 287-0810 or by e-mail at coachrobin@leadershipandcareers.com.

Does your Partner have Adult ADHD? ADHD Relationships have a very high rate of dysfunction - especially if your partner has yet to be diagnosed. Melissa Orlov explains the common symptoms and offers tips on how to make your relationship work. To learn more, go HERE

CDC Survey Shows Increase in Autism, ADHD, and Other Conditions in Children Autism and attention deficit hyperactivity disorder (ADHD) diagnoses are on the rise in the U.S., with one in six children now having these or other developmental disabilities, according to new figures from the CDC. The CDC study did not address the reasons for the increase, but Pediatrician Nancy Murphy, MD, who chairs the American Academy of Pediatrics council on children with disabilities, says the increase can be largely explained by greater awareness about the signs and symptoms by health providers, parents, and teachers. Andrew Adesman, MD, says it is still not clear if unrecognized environmental factors are contributing to a real rise in ADHD and autism and adds that the findings underscore the importance of providing additional resources to diagnose and treat developmental disorders and to research the causes of the increase in ADHD and autism. To read the article, VISIT

Dr. Hallowell's Favorite Moments - Dr. Hallowell was recently profiled in Everyday Health. Go to this link to read about some of his favorite moments as a doc.

Dr. Hallowell launches first iPhone App in August via iTunes app store This new ADHD iPhone app will offer a short, statistically valid quiz allowing undiagnosed individuals insight into their likelihood of having ADHD. Nearly 5% of the global population may have ADHD and most people don't even know they have the condition, and therefore suffer unnecessarily.

This application will also feature a longer descriptive test aimed at gaining a feel for ADHD and the impact it may be having on an individuals' life. Recommendations for follow up and the steps to a formal diagnosis will also be revealed in the application based primarily on Dr. Hallowell's #1 best seller, Delivered from Distraction. Visit Dr. Hallowell's website for more information.

ADHD Summer Enrichment Camp at Leelanau School - July 18 - 22, Glen Arbor, Michigan Students entering grades 5 thru 12 and adults of all ages are invited to spend a week with Ned Hallowell and enjoy an educational and recreational vacation experience that is engaging, unique, memorable and life changing. For more information go HERE.

Shire scholarship - deadline to apply is July 7th, 2011 Twenty five $2,000 scholarships that include a prepaid year of ADHD coaching services, will be awarded on August 9th, 2011. This scholarship is intended for US citizens accepted to or attending an approved college, university, vocational or technical school as an undergraduate student that have been diagnosed with ADHD and are under the care of a licensed health care professional for ADHD. For information call 855-474-4732, or visit HERE.

Social Networking Information for Parents We know you have heard of Facebook, but do you know about Xanga? Or Formspring? Although social networking sites can be beneficial, helping us all keep in touch, they can also be used to harass and bully others. Want to learn more about some of the lesser-known sites and how to educate and protect your teen? Check out this resource from MARC, the Massachusetts Aggression Reduction Center. Other valuable resources include: iSafe.org, The Center for Safe and Responsible Internet Use, and Bullying.org.

Hallowell Center Sudbury Location Has Moved - 144 North Road (the same Cummings Park location, but in the new building) Suite 2450, Sudbury, MA. 01776. The phone number remains the same - (978) 287-0810.

Every Other Tuesday, Sudbury, MA - Free ADHD Adult Support Group - 7:00 pm - 8:30 pm Sudbury Hallowell Center. No registration necessary and free to the public. For more information: Call Rebecca Shafir (978) 287-0810

Calm and Connected - Parenting Your Child with ADHD - beginning June 16th, NYC Hallowell Center. 7 Session Workshop, Thursdays 7-9pm. Includes a 1-hour individual coaching session. This workshop, facilitated by Cindy Goldrich, Ed.M, a parent and ADHD teen life coach, will provide you with the tools to help your child be successful in school, at home, and in life! The specific strategies will help you: Reduce chaos and defiance, Establish rules and expectations and have your child cooperate; Improve your child's self-esteem; Reduce homework stress; and bring back the joy! To register, contact Denise Boline at 212-799-7777 or denise@adhdnewyork.com

ADHD Summer Enrichment Camp at Leelanau School, July 18 - 22, Glen Arbor, Michigan - for students entering grades 5 thru 12 and adults of all ages. For more information go HERE.

The ADHD Effect and Your Marriage, July 25 - 27, Chautauqua, NY - This introductory Seminar by Melissa Orlov helps you understand what's happening in your relationship, why and what you can do about it.� 2 hours per day.� Call 716-357-6348 to register.

Unwrapping the Gifts: A Strength-Based Approach to ADHD Across The Life Span, August 8 - 12, Cape Cod, MA - This week-long series meets Monday - Friday from 9:00am - 12:00 pm. Hosted by: The Cape Cod Institute. For information click HERE.

The ADHD Effect In-Depth�- Start Turning Around Your Relationship, Sept 12 - Oct 26, by phone�- An in-depth phone seminar with Melissa Orlov to help couples learn what they need to know and do to change the course of their marriage for the better. Seven evenings at 8:30pm�EST. �For details, go to this link.

Delivered from Distraction, September 12, Charlottesville, VA Hosted by: Little Keswick Foundation for Special Education. Event Location: Piedmont Virginia Community College, Earl V. Dickinson Building, Charlottesville. Time: 7:00PM - 9:00 PM. The Event is free and OPEN TO THE PUBLIC. For further information visit the WEBSITE.

ADHD Effect on Couples CONTINUING EDUCATION Seminar by phone: Taught by Dr. Ned Hallowell, Sue Hallowell, Dr. Kevin Murphy and Melissa Orlov, this seminar is for counselors interested in learning about ADHD and relationships from the experts. 21 CE credits. Starts October 13th. More info HERE.

email: morlov@hallowellconnections.com

phone: 508-545-2250 Hallowell Connections

web: http://www.drhallowell.com