Understanding ADHD and Its Impact on Your Practice
Attention Deficit Hyperactivity Disorder, or ADHD as it is commonly known, is not only a childhood condition. It is a neurodevelopmental disorder that begins in childhood and stays into adulthood, although symptoms may change over time.
The challenges for adults, specifically lawyers, living with ADHD was the subject of a recent program sponsored by the Lawyer Assistance Committee, Committee on Attorney Well-Being and the Committee on Law Practice Management. It was a preview of an upcoming free six-week program to help those in the legal community understand and cope with ADHD for themselves, their family members, and their co-workers.
During the event, psychologist Dr. Michael Appelgren said most of the new patients are adults, not children, who are seeking information and diagnostic help for behavior because they think they may have ADHD. In addition to psychotherapy, Appelgren has a concentration in behavioral therapy and neuropsychology which includes executive function coaching.
“In childhood there is a lot more hyperactivity and impulsivity,” he said. “For adults, they will still retain the inattention symptoms, but the hyperactivity in adults will look different.” Adults may be stable for a time but see ADHD symptoms reemerge in times of high stress such as the loss of a loved one, financial stress or moving.
How to Assess & Diagnose ADHD
Appelgren advises that anyone who is concerned about their mental health should first get an updated physical by their general practitioner. This visit, along with routine bloodwork, may rule out other medical factors for behavior changes due to illness, including anemia and vitamin deficiency. Next, Appelgren says patients in his practice undergo testing and observation while he does a thorough review of records from childhood. Three criteria must be present for diagnosing ADHD: symptoms appearing before age 12, the condition cannot be explained by other medical causes and the symptoms appear in more than one setting such as home and work or school.
In the past, children and their parents may have overcompensated for the condition by implementing structured routines or interventions to cope with symptoms. In that case, Appelgren says, adults don’t connect their behavior to ADHD until much later in life.
Dr. Apelgren offers this simple self assessment checklist for patients to use.
Similar to what we hear when discussing health topics like heart disease and stroke – symptoms of ADHD are different in men and women. Currently, there are three times as many men diagnosed with ADHD than women, but Appelgren attributes this to greater awareness of the condition in boys and a greater study of the condition in boys and men.
The condition in boys is manifest by very active behavior, oppositional behavior, anger and irritability.
Girls, however, may be quiet or withdrawn and prone to daydreaming. They may be afraid of social situations, have a tough time focusing or are forgetful. Appelgren says those early symptoms can lead doctors to diagnose girls with depression or anxiety before considering ADHD as a cause. As women reach adulthood, they look for tools to mask their behavior and have feelings of shame and guilt.
Appelgren says women have more work to do caring for children and aging parents in addition to work outside the home. Men often have more support in their work from a spouse and an assistant at their office. Appelgren says men are often encouraged to focus on one area of life, where women are expected to do several tasks at one time.
“Many women see their disorganization issues as a character flaw,” says Appelgren. “She feels negative about herself, so she is at risk for anxiety and depression.”
How ADHD Affects the Legal Profession
The condition can be a double-edged sword for attorneys. There are strengths such as the ability to hyper focus which is helpful in preparing for trial. On the flip side, impulsive behavior may lead to a hasty decision that is not in a client’s best interest. The six-week program will focus on how those in the legal profession can thrive. It will cover topics including time and task management, handling stress, mental flexibility, impulse control and managing your workspace environment. The program is free and registrants are encouraged to attend all six sessions as they build on topics from previous sessions.
You can register for the free six-week program here.