Coping with Adult ADHD: My Interview with Michael Laskoff

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Last week I wrote a post entitled, "Why Some People Don't Believe in ADHD"   which generated a lot of discussion among our members on ADHD Central.   One of the people I quoted in my article was Michael Laskoff, a blogger for the Huffington Post who happens to have a diagnosis of adult ADHD.   When Michael dropped by to our site to contribute to our discussion I immediately sought the opportunity to interview him for further insights into how one manages adult ADHD.   Michael has had his share of trials and tribulations due to his ADHD yet he has found ways to manage his disorder that he would like to share with you today.   I hope you find this interview as enlightening and inspiring as I did.
Michael has graciously agreed to answer any questions you might have for him in the form of a comment.

Who is Michael Laskoff?

Michael B. Laskoff is the CEO of AbilTo, which uses a unique approach to create a better alternative for millions of people seeking to overcome commonplace behavioral disorders and life transitions.

Prior to his current work, he co-founded The Branded Asset Management Group, which helped large marketers leverage untapped profit potential in existing brands and worked in senior marketing and strategy roles at Bertlesmann, McKinsey & Co., CompUSA, as well as a number of early ecommerce businesses. His book, Landing on the Right Side of Your Ass dealt with managing job transition, which was also the subject of his BusinessWeek online column; he currently blogs for The Huffington Post.

Laskoff is a graduate of Harvard Business School and University of Chicago.

At what age were you diagnosed with ADHD?   Who diagnosed you?   Did you suspect that you had ADHD before your official diagnosis?

I was 39 years old when I was diagnosed with ADHD, and while I had always know that something wasn't quite right, I had never suspected that the cause was ADHD. As to how I got diagnosed, that was entirely by accident.

I couldn't sleep, and I assumed that the cause of my insomnia was anxiety. So I went to see my doctor and asked for anti-anxiety medication. He declined. Instead, he sent me to a psychologist, Stephen Josephson, who has a reputation for helping people with sleep issues.

After Steve had spent approximately five minutes with me - talking about sleep, he asked me what I was doing to treat my ADHD. He was certain that I had heard it; I, on the other hand, was stunned. I didn't know adults could have ADHD: I had never considered it in a personal context. But as Steve began to read the official diagnostic criteria to me, I knew with absolute certainty that he was on the money.

To make the diagnosis official, I went to the NYU Child Studies Center and met with Dr. Roy Boorady. Roy doesn't normally see adults, but I had learned that child psychologists are often the best trained and most knowledgeable when it comes to diagnosing and treating ADHD in adults. After administering a battery of questionnaires and taking a detailed history, Roy officially concluded that I have ADHD.

What is the worst symptom of ADHD in your personal experience?

Unlike many people with ADHD, I did well in school, graduating with honors from University of Chicago and Harvard Business School. So for me, somewhat unusually, education was less of an issue than it might have been. Far more devastating is what untreated ADHD did to the early part of my career.

Until I was well over 30, I couldn't hold a job for more than a year. This was only possible because I was so good at finding better jobs whenever I lost one. I could become a chameleon, be whatever the interviewer needed me to be, and often land great jobs that I probably never should have gotten in the first place. Unfortunately, I would start to get bored long before I lived up to my 'potential.' And so, I'd start to systematically procrastinate, which meant that I was always on the verge of missing deadlines and deliverables.

As a result, I'd end up stressed and resentful of my employer; my attitude would become what might be best described as 'oppositional.' From there, it was just a matter of time before I quit or got asked to leave. The six or eight months in between were often very hard of everyone. And when that ended, I was thrust back into the job market looking for work, again.

You are very open about disclosing your ADHD.   What sort of response do you usually get from others when you tell them that you have this disorder?   Is it worth the risk to disclose?

ADHD is a personal matter and the decision to disclose is an individual one. I strongly believe that there is a stigma attached to having ADHD; the media has done such a good job of portraying us all as hyperactive, overmedicated children that it's hard for people who are not well versed in the condition to be objective about the reality of dealing with people who have it. For most people starting out in their careers, discretion may therefore be advisable. If you do choose to tell people, it's important to be open to the possibility of an adverse reaction. (Remember, many people don't know that adults can have ADHD.)

Personally, I chose to talk about my ADHD because I felt it's an integral and permanent part of who I am. For me, finding out about the disorder was actually an enormous relief: it explained many issues that had bedeviled my life, and it's treatable. By the time that I started telling people I was already doing cognitive behavioral therapy and taking medication. The combination constituted a positive revolution in the quality of my life. I wanted to people to share some of the excitement that I was feeling as I gained more control of my life.

As to the reactions of other, I think that they generally fall into two categories. One group is fairly fascinated to hear about ADHD and my experiences. Almost everyone knows someone well with ADHD because 4-5% of American adults have it. Very often, people worry - usually without basis - that they themselves might have it when we first talk about it. (I work hard to disabuse of the notion and always tell them to seek professional advice if their fears persist.)

The second group literally responds with disbelief. I have had close friends tell me, with great conviction, that I cannot have ADHD and that I take medication to get an extra 'edge' at work. At first, this made me quite angry, but I've come to understand that my disclosure challenges some of their strongly held beliefs. Over time, however, even the skeptics usually come around.

Do you feel that there are any gifts associated with having ADHD?

I don't personally like the word "gifts" in association with ADHD; it's too similar to the idea of being special. People with ADHD are not special: they are neurologically different.

There's a great deal of empirical evidence to suggest that ADHD symptoms are associated with a quirk in the development of one or more regions of the brain. Impulsivity and lack of focus are two of the more obvious results. Fortunately, the brain is rather marvelous at finding ways to compensate. Thus, some ADHD adults do some highly creative in their outlook or approach to problem solving. Having said that, I think that ADHD adults who are deemed most talented, are those who also work the hardest at mitigating the impact of their ADHD on others around them.

You have written about the experience of being unemployed in your book, "Landing On The Right Side of Your Ass."   Was your unemployment in any way related to your ADHD?   What do you think are the best types of jobs for someone who has ADHD?

ADHD was not the only reason that I lost or walked away from so many jobs, but it was probably the most prevalent factor. For starters, I wasn't aware that I had it, so I couldn't address the problems that it was causing.

People with ADHD grow up spending a lot of time on the defensive as a result of not living up to other people's expectations. Faced with that, most some 'drop out' of a system that doesn't reward them; others find a way to persist while shifting the blame to others. I went the latter route. I would decide that my boss was less gifted, smart or worthy than I was, and use that as an excuse to miss deadline, focus on the wrong thing or generally be disruptive. I justified all of this by telling myself that I 'knew better' and therefore was entitled to special rights and privileges. In reality, I was just being difficult.

As to what careers best suit people with ADHD, I've had the privilege to meet many ADHD business leaders who have succeeded in all kinds of endeavors. Nevertheless, more seem to gravitate toward entrepreneurial roles or to work in situations in which their strengths are appreciated while their weaknesses - e.g., detail orientation - are handled by others. If I had to sum it up, I'd say that ADHD adults do best in high stimulation environments in which dealing with change is more important than refining something that's already well-established.

It seems that you have been greatly helped by ADHD medication.   Can you explain how medication helps with your symptoms?

Let's start with the caveats. One, medication isn't right for everyone. Two, some populations have been overmedicated. Three, under-medication is a much bigger problem than over-medication. I say that because many people who go without medication suffer needlessly and profoundly.

When I met Dr. Roy Boorady, he started me on Adderall XR. Speaking for myself, twenty minutes after taking the first capsule, I felt largely reborn. Instead of wasting my days waiting for the prospect of a missed deadline to motivate me, I could get things done immediately. That made me more productive and reduced my daily stress. With Adderall, the results weren't uniform: it would work well for a few hours, and then the second delayed release would hit my system. I would notice the moment that happened - my heart rate might accelerate for 30 seconds or so. So while it was imperfect, medication vastly improved the quality of my life.

Four or five months after starting Adderall XR, Roy suggested that I try Vyvanse; it has the same active ingredient as Adderall but a much better release mechanism. Since then, I have taken Vyvanse daily, and I have to say that I feel entirely normal all day. For me, it has all the advantages of Adderall with none of the downside. In fact, I only feel 'abnormal' on the rare day when I forget to take medication.

For me, Vyvanse has been nothing less than an epiphany, which is why I've volunteered to collaborate with Shire Pharmaceutical - the manufacturer - to speak, about my positive experiences.

Do you have any advice for the parent who has just found out that their child has been diagnosed with ADHD?   How about for the adult who is newly diagnosed?

Parents should understand that ADHD does not need to limit their child's performance or potential. But there's a lot of bad information out there, so they should seek out the best possible experts available to learn about appropriate options. This is particularly true if medication is part of the equation. There are a lot of choices now, and individual kids respond uniquely to different medications. Very often, the first choice does not have the desired impact, so some structure experimentation is often required. A good child psychiatrist is probably the best person to oversee such a process, but a properly trained pediatrician can also get the job done.

If you're an adult, the studies suggest that a combination of medication and cognitive behavioral therapy produce better outcomes than either individually. I'd encourage people to explore both.

What is the most untrue thing you have heard someone say about ADHD?

ADHD is a childhood condition. The reality is about half of all kids with ADHD never outgrow it.

Last thoughts?

95% of the world does not have ADHD. So while we can ask people to be more understanding of our situation, we have to succeed in a non-ADHD driven world. The responsibility for that lies with the individual who has ADHD. That's not always easy to deal with, but the fact that it's hard doesn't change the reality of the situation.

Thank you Michael for sharing so much of yourself with us here today!   If you are a member of ADHD Central who has adult ADHD we wish to encourage you to share your story.   How do you cope with and manage your ADHD?   Let us hear your story.   Sharing your story is not only healing but it helps others who are facing the same challenges to know that they are not alone.