Adults with ADHD need structure and accountability

Posted4/8/2013 6:00 AM

Q. I am a man in my 20s and was just diagnosed with ADHD. Is it possible to be successful with this condition?

A. My colleagues Dr. Craig Surman and Dr. Timothy Bilkey, with Karen Weintraub, have just written a wonderful new book on this topic. It's called "Fast Minds: How to Thrive if You Have ADHD (or Think You Might)."


They point out that ADHD -- attention deficit hyperactivity disorder -- afflicts not just children. Plenty of adults, like you, have it. And you absolutely can build a successful life. The key to success is to find -- or create -- an environment that complements your strengths and challenges. The advice they give for people like you falls into several different categories:

• Create structure: Many people with ADHD thrive in environments where their time and tasks are highly regimented. For others with ADHD, being a member of a team, in which each member is responsible for certain accomplishments and regularly accountable for those accomplishments to other team members, allows them to function better than if they were in more independent and solitary roles.

• Reward yourself often: Everyone needs to feel rewarded for a job well done or a task completed. With ADHD, you may need these rewards more often.

• Install accountability: Asking colleagues to regularly remind you about your deadlines is a more powerful stimulus than just a reminder on your calendar. Also, keep reminding yourself about why the work you're doing will be important to others: It helps you to meet your deadlines and to do a good job.

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• Make a new path: I had a patient who was good about following certain routines and bad about following others. He brushed his teeth twice a day without fail. But his wife complained that he kept letting the mail pile up. The default path for someone with ADHD is often the path of least resistance, such as opening the mail later. Recognize your default path. Then, create a way to work around it.

For example, a lot of my patient's mail -- as with most people -- was advertising from various organizations. He and his wife sat down and decided what organizations didn't interest them. Whenever a piece of mail arrived from one of those organizations, they just chucked it without opening it. That left a smaller pile of mail to open and attend to. Simple, perhaps -- but such simple routines can help someone with ADHD function better.

• Use peripheral brains: This is something outside yourself that can help you with everyday functioning. Set an alarm reminder, put a note on your calendar, make a to-do list. For anyone, but particularly for anyone with ADHD, going to the grocery store without a to-do list is a bad idea.

• Remind yourself what is meaningful to you: Keeping a larger goal in mind can make a dramatic difference in your motivation, patience and determination.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to

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