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Mastering ADHD on the Job
November 12, 2006
The Philadelphia Inquirer

The only thing good that career salesman Alan Currie could say about himself on the day he accepted a high-stakes sales job five years ago was that at least he managed to sell himself into a job.

He didn't deserve it, he told himself.

"I'm a complete fraud."

Currie's self-denigrating song is typical of adults with ADHD, attention deficit/hyperactivity disorder. They replay it as they count their offenses -- office disaster zones of haphazard piles, misplaced documents, and lost phone numbers, or the wrong thing said at the wrong time.

But the impact goes beyond one salesman and his career angst.

Mental-health researchers estimate that what was once considered a child's disorder affects more than 4 percent of the adult population. The cost to the economy is nearly $20 billion in the workplace and thousands of dollars a year in diminished earning capacity for individuals.

But that wasn't going to happen to Currie.

Even though Currie, 40, of Paoli, had a natural gift for sales, he had told himself that all his "deals were bluebirds," a sales term for a lucky break. So, in 2001, when he landed his big software-sales job, where he had the potential to more than double his income, he knew it was time to control a condition that had been controlling him.

He sought help, using the standard repertoire of available remedies.

A psychiatrist prescribed medicine. A psychologist became his coach, helping him work out organizational strategies. He harnessed technology, using computer programs, a digital voice recorder, and voice-recognition software to keep him on track.

He even hired his sister at $15 an hour to catch him up on his expense reports. She worked five hours and filed two reports, totaling $9,000.

His strategies worked, although his offices and cars remain a mess. In his first nine months on the job, he beat his full-year quota by 12 percent. By the end of the year, he doubled his salary to $250,000 and was named "rookie of the year."

"It was such a liberating feeling," Currie said. "I could take credit for my success."

A 2005 study in the Journal of Occupational and Environmental Medicine estimates that 120.8 million workdays a year are lost due to ADHD, at a labor cost of $19.6 billion.

"It has a profound effect," said Joseph Biederman, a professor of psychiatry at Harvard University and a leading scholar in the field. "If you are distracted and inattentive, those are things that will lead you not only to not be promoted, but to get fired."

Biederman's study, published in July in Medscape General Medicine, estimates that workers with ADHD are less likely to hold full-time jobs, and typically earn $10,000 less a year than the general population.

"One of the myths is that everybody has it," said J. Russell Ramsay, associate director of the University of Pennsylvania's Adult ADHD Treatment and Research Program.

"People think of this as a nuisance kind of disorder," he said. "But when we look at the life outcomes, the recent research is showing that, rather than being just a nuisance, it is one of the most impairing disorders that we have in psychiatry."

Even as the scientific community gathers more evidence about ADHD on the job, human-resource executives are largely unaware of it.

At Rohm & Haas Co., the chemical company, for example, five seasoned human-resource professionals, including an attorney, told company spokeswoman Laura Hadden that they had never encountered a case of it.

"Management doesn't think along those lines," said Dorothy Stubblebine, a Mantua, N.J., consultant who serves on leadership panels for the national Society for Human Resource Management in Washington.

"They think, 'Are they capable of doing the job? Do they have the skills?' Most of us don't know about it," she said.

Scientists believe ADHD is a genetic condition -- many adults learn they have it when their children are diagnosed.

Certain neurochemicals in the pre-frontal cortex -- the part of the brain that regulates how information is organized and filtered -- are in shorter than the usual supply, Ramsay said.

The result is twofold -- a lack of enough of the chemical that keeps the brain fired up to stay on task, and a lack of enough of the chemical that filters out distraction, so the person doesn't flit from idea to idea or speak or act impulsively.

Some people with ADHD will be more inattentive than hyperactive, while others will be more hyperactive. Some people have both traits, Ramsay said.

Compounding the problem is the pace of today's world and the do-it-yourself culture of most workplaces, said Currie's coach, Michelle Novotni, a Wayne psychologist and one of the founders of the national Attention Deficit Disorder Association, based in Mt. Laurel.

"Back in the good old days, there used to be secretaries," Novotni told 100 attendees at an Attention Deficit Disorder Association conference last month at Penn State's Great Valley campus. "Now, with the advent of computers, ADHD people have to file their own reports" and handle their own calendars. "This has not been a good shift for people with ADHD.

"They are getting slammed -- not because they are not selling well, or not because they aren't investing well, or not because they aren't reaching out to children in the classroom, but because they aren't dotting their i's and crossing their t's."

Now Currie is seeking accommodations from his current employer under the federal Americans with Disabilities Act. He is asking for administrative support, and he wants his company to pay for his coaching sessions.

"It's pennies on a dollar" compared to his earnings, he said. The company is considering his request, Currie said.

People with ADHD can request reasonable accommodations on the job under the ADA, said lawyer Jonathan A. Segal, vice chairman of WolfBlock, Schorr and Solis-Cohen's employment-services group.

But to qualify, workers must have a diagnosis and then be willing to tell their employers. Companies may or may not be able to find a reasonable accommodation.

Picking the right workplace, ADHD coaches say, is the key accommodation. It's best to avoid a place with too many rules and to find a more free-wheeling, collegial culture.

Some experts say ADHD adults can show uncommon energy, vitality and creativity -- partly because they take in more stimulation simultaneously and may, therefore, see connections that others don't.

"They are high-energy, work-very-hard, entrepreneurial types -- the person who is coming up with the good idea when they least expect it," said psychiatrist Edward Hallowell, author of Delivered From Distraction: Getting the Most out of Life with Attention Deficit Disorder, an ADHD classic.

"I think of it as a gift that can be hard to unwrap," he said.

That's how some executives see it. Two poster CEOs who talk about the benefits are Paul Orfalea, the founder of Kinko's, and David Neeleman, who started JetBlue.

That is also how local entrepreneur Dennis Ingle sees it. Like many people with ADD, a variation of ADHD, he runs his own business. He likes it because there are fewer restrictions and the only bureaucracy is one he imposes on himself.

"I'm an ideas guy," said Ingle, 52, who runs his own glass-restoration business, Glasstoration Technologies L.L.C., from his home in Germantown. "I get ideas all the time. The positive things about ADD, I wouldn't trade them in for anything."

But the negative things tore at him, as they did Currie. Sometimes, people who have ADHD are also depressed or have substance-abuse problems, mostly as a result of a years of frustration and diminished success.

"Everything in my whole life was just out of reach," Ingle said. "I thought, if I could just try harder, I could do better. I would get so down."

In 2005, Ingle began to suspect that he had ADD. A psychiatrist confirmed it, and a coach specializing in the disorder helped him understand the condition and gave him methods to work around it.

"There was a lot of self-flagellation," Ingle said. "I had to learn that it's not about character. It's not about will. It's about the brain."

Strategies for working with ADHD
People with attention deficit/hyperactivity disorder need to pay special attention to how they organize their work.

Here are some tips from experts:

  • Get the help you need from someone else. If you can't attend to details, hire someone who can. If you can't afford to hire, barter.
  • Use technology: digital voice recorders, color-coded e-mail, computer calendar reminder features, cell phones, and watches with alarms. Buy headsets to muffle distracting noise at work.
  • Institute a regular review of priorities and tasks.
  • Use a white board to keep goals in plain view.
  • Arrange closed-door times, even in offices with open-door policies.
  • If certain tasks are hard, do them immediately after intense physical exercise. Don't shower. Let the brain chemicals affected by exercise work for you.
  • Focal-point lighting may help with concentration. Put a desk lamp in your cubicle.
  • Sometimes a desk at which one stands can help.
  • Do what you like first and then quickly switch to the harder task. The momentum from the pleasurable task may carry through.
 

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