Dealing with ADHD in the workplace (Guest commentary)

More than four per cent of all adults affected

It’s a simple fact: Children with attention deficit hyperactivity disorder (ADHD) grow up to be adults with ADHD.

ADHD is often viewed as a trivial problem rather than a serious illness such as bipolar disorder or schizophrenia. But ADHD is a serious, lifelong illness of self-control. It’s a relentless onslaught of small wounds each day that affects every aspect of patients’ lives.

It also affects adults differently than children, with symptoms such as insomnia, unstable moods, anxiety, depression, lack of motivation, disorganization and procrastination. And it’s more common than generally believed. A 2005 article in the Journal of Occupational Environmental Medicine estimated more than four per cent of adults suffer from ADHD.

Trouble keeping jobs

Workers with ADHD face many roadblocks in trying to hold onto a job. They do quite well at getting jobs, but unfortunately many have a tough time keeping them.

What leads to their inconsistent output? ADHD manifests itself in a disconnect between effort and ability. For most people, ability increases proportionately with effort. The more they try, the more they can do. The ADHD experience, however, is very different. Their most productive times are the most effortless. When they are emotionally invested, they can access all their mental abilities with little effort. But when they are struggling to do a task with no emotional attachment, they have to expend a great deal of effort with little or no result. Trying harder makes it worse, so being encouraged to try harder is counterproductive.

For the ADHD individual, ability is dependent upon emotion. The emotion can be positive, such as enthusiasm, interest, respect and caring. Or it can be negative, such as fear, guilt or shame. When such emotions run high, an ADHD individual performs as well as — or better than — a non-ADHD individual.

They are the calm, effective leaders in an emergency. They find solutions to unsolvable puzzles. They make personal sacrifices for a just cause. When they can genuinely buy into the value of a task, they are focused, productive, innovative, dedicated, enthusiastic and steadfast. They do not become equal to the non-ADHD individual, they actually function better. The problem is such brilliant performance is rarely enduring because it is dependent on high levels of emotional investment.

When the ADHD employee is asked or told to do something, they often ask “Why?” It is not to be impertinent, insubordinate or oppositional, but rather to understand and “buy in” emotionally. The emotional investment in the task at hand provides the ability to do the job.

Making ADHD work in life and on the job

What about all the ordinary chores of everyday life? The book My Brain Still Needs Glasses by Annick Vincent, a practicing psychiatrist at the Institut universitaire en santé mentale, Centre hospitalier Robert-Giffard in Quebec City, discusses various organizational habits that can help people with ADHD stay focused and better organized.

Vincent recommends reducing noise level and visual distractions as well as scheduling a specific time for tackling activities such as sending e-mails, returning phone calls and writing reports. She also suggests listing the order in which those tasks will be performed. Consequently the individual’s day timer becomes his ally. Using a watch or electronic device as a prompt to switch tasks, colour-coding work files and asking for information and reminders to be sent in writing all help people with ADHD to stay on track.

Routine and structure will increase productivity, however, some employees with ADHD still require a high motivation to complete a task.

There is a wide range of long-acting medication available that gives people with ADHD access to their abilities in the absence of emotional investment. It allows them to do ordinary, unspectacular tasks.

There are also a variety of resources that employees with ADHD can consult for assistance. Websites such as those of the Canadian ADHD Resource Alliance (www.caddra.ca), the Centre for ADD/ADHD Advocacy, Canada (www.caddac.ca), CHADD Canada (www.chaddcanada.org) and specialty coaches are among the many resources adults can consult for support in the day-to-day management of their condition.

Providing more knowledge and better understanding of ADHD to HR, employee assistance programs and the general public will help avoid common misconceptions about ADHD and reveal the treatment options available and the roles of motivation and emotional investment within ADHD. This knowledge will allow companies to harvest the plentiful potential the ADHD individual brings to the table but, most importantly, allow ADHD individuals to become contributing, productive and successful employees with a commensurate sense of accomplishment, job satisfaction and self respect.

Thomas Fischer is a practicing Calgary psychiatrist who specializes in patients with adult ADHD.

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